Search results for: common bile duct exploration

Authors: Jayeola A. O., Ayodele O. S., Olususi J. I.

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From field studies, six (6) lithological units were identified to be common around the study area, which includes quartzites, granites, granite gneiss, porphyritic granites, amphibolite and pegmatites. Petrographical analysis was done to establish the major mineral assemblages and accessory minerals present in selected rock samples, which represents the major rock types in the area. For the purpose of this study, twenty (20) pulverized rock samples were taken to the laboratory for geochemical analysis with their results used in the classification, as well as suggest the geochemical attributes of the rocks. Results from petrographical studies of the rocks under both plane and cross polarized lights revealed the major minerals identified under thin sections to include quartz, feldspar, biotite, hornblende, plagioclase and muscovite with opaque other accessory minerals, which include actinolite, spinel and myrmekite. Geochemical results obtained and interpreted using various geochemical plots or discrimination plots all classified the rocks in the area as belonging to both the peralkaline metaluminous and peraluminous types. Results for the major oxides ratios produced for Na₂O/K₂O, Al₂O₃/Na₂O + CaO + K₂O and Na₂O + CaO + K₂O/Al₂O₃ show the excess of alumina, Al₂O₃ over the alkaline Na₂O +CaO +K₂O thus suggesting peraluminous rocks. While the excess of the alkali over the alumina suggests the peralkaline metaluminous rock type. The results of correlation coefficient show a perfect strong positive correlation, which shows that they are of same geogenic sources, while negative correlation coefficient values indicate a perfect weak negative correlation, suggesting that they are of heterogeneous geogenic sources. From factor analysis, five component groups were identified as Group 1 consists of Ag-Cr-Ni elemental associations suggesting Ag, Cr, and Ni mineralization, predicting the possibility of sulphide mineralization. in the study area. Group ll and lll consist of As-Ni-Hg-Fe-Sn-Co-Pb-Hg element association, which are pathfinder elements to the mineralization of gold. Group 1V and V consist of Cd-Cu-Ag-Co-Zn, which concentrations are significant to elemental associations and mineralization. In conclusion, from the potassium radiometric anomaly map produced, the eastern section (northeastern and southeastern) is observed to be the hot spot and mineralization zone for the study area.

Keywords: petrography, Ila Orangun, petrochemistry, pegmatites, peraluminous

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Authors: Soiduate Ogoye-Atanga

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During funeral ceremonies, it has become common for attendees to jostle for burial programs in some southern Nigerian towns. Beginning from ordinary typewritten text only sheets of paper in the 1980s to their current digitally formatted multicolor magazine style, burial programs continue to be collected and kept in homes where they remain as archival documents of family photo histories and as a veritable form of leveraging family status and visibility in a social economy through the inclusion of lots of choreographically arranged photographs and text. The biographical texts speak of idealized and often lofty and aestheticized accomplishments of deceased peoples, which are often corroborated by an accompanying section of tributes from first the immediate family members, and then from affiliations as well as organizations deceased people belonged, in the form of scanned letterheaded corporate tributes. Others speak of modest biographical texts when the deceased accomplished little. Usually, in majority of the cases, the display of photographs and text in these programs follow a trajectory of historical compartmentalization of the deceased, beginning from parentage to the period of youth, occupation, retirement, and old age as the case may be, which usually drives from black and white historical photographs to the color photography of today. This compartmentalization follows varied models but is designed to show the deceased in varying activities during his lifetime. The production of these programs ranges from the extremely expensive and luscious full colors of near fifty-eighty pages to bland and very simplified low-quality few-page editions in a single color and no photographs, except on the cover. Cost and quality, therefore, become determinants of varying family status and social visibility. By a critical selection of photographs and text, family members construct an idealized image of deceased people and themselves, concentrating on mutuality based on appropriate sartorial selections, socioeconomic grade, and social temperaments that are framed to corroborate the public’s perception of them. Burial magazines, therefore, serve purposes beyond their primary use; they symbolize an orchestrated social site for image-making and the validation of the social status of families, shaped by prior family histories.

Keywords: biographical texts, burial programs, compartmentalization, magazine, multicolor, photo-histories, social status

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Authors: Maryam Beiranvand

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Multi-drug resistance in various microorganisms has increased globally in many healthcare facilities. Less effective antimicrobial activity of drug therapies for infection control becomes trouble. Since 1980, no new type of antimicrobial drug has been identified, even though combinations of antibiotic drugs have been discovered almost every decade. Between 1981 and 2006, over 70% of novel pharmaceuticals and chemical agents came from natural sources. Microorganisms have yielded almost 22,000 natural compounds. The identification of antimicrobial components from endophytes bacteria could help overcome the threat posed by multi-drug resistant strains. The project aims to analyze and identify antimicrobial peptides isolated from entophytic bacteria and their activity against multidrug-resistant Gram-negative bacteria in South Korea. Endophytic Paenibacillus polymyxa. 4G3 isolated from the plant, Gynura procumbery exhibited considerable antimicrobial activity against Methicillin-resistant Staphylococcus aureus, and Escherichia coli. The Rapid Annotations using Subsystems Technology showed that the total size of the draft genome was 5,739,603bp, containing 5178 genes with 45.8% G+C content. Genome annotation using antiSMASH version 6.0.0 was performed, which predicted the most common types of non-ribosomal peptide synthetase (NRPS) and polyketide synthase (PKS). In this study, diethyl aminoethyl cellulose (DEAEC) resin was used as the first step in purifying for unknown peptides, and then the target protein was identified using hydrophilic and hydrophobic solutions, optimal pH, and step-by-step tests for antimicrobial activity. This crude was subjected to C18 chromatography and elution with 0, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100% methanol, respectively. Only the fraction eluted with 20% -60% methanol demonstrated good antimicrobial activity against MDR E. coli. The concentration of the active fragment was measured by the Brad-ford test, and Protein A280 - Thermo Fisher Scientific at the end by examining the SDS PAGE Resolving Gel, 10% Acrylamide and purity were confirmed. Our study showed that, based on the combined results of the analysis and purification. P polymyxa. 4G3 has a high potential exists for producing novel functions of polymyxin E and bacitracin against bacterial pathogens.

Keywords: endophytic bacteria, antimicrobial activity, antimicrobial peptide, whole genome sequencing analysis, multi -drug resistance gram negative bacteria

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Authors: Samul Sahile Kebede

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Back ground: -Immune hemolytic anemia commonly affects human immune deficiency, infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to the drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV, which accompanies the greatest percent from acquired hemolytic anemia. Objective: -The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at the university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. Methods: - An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination, and antihuman globulin test were performed to the diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. Result; - The overall prevalence of immune hemolytic anemia was 2.8 % (10 of 358 participants). Of these, 5 were males, and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40 % mild and 60 % moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). Conclusion and recommendation; Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.

Keywords: anemia, hemolytic, immune, auto immune, HIV/AIDS

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Authors: L. Szymanski, S. Wiak, Z. Kolacinski, G. Raniszewski, L. Pietrzak, Z. Staniszewska

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There exist more than one hundred different types of cancer, and therefore no particular treatment is offered to people struggling with this disease. The character of treatment proposed to a patient will depend on a variety of factors such as type of the cancer diagnosed, advancement of the disease, its location in the body, as well as personal preferences of a patient. None of the commonly known methods of cancer-fighting is recognised as a perfect cure, however great advances in this field have been made over last few decades. Once a patient is diagnosed with cancer, he is in need of medical care and professional treatment for upcoming months, and in most cases even for years. Among the principal modes of treatment offered by medical centres, one can find radiotherapy, chemotherapy, and surgery. All of them can be applied separately or in combination, and the relative contribution of each is usually determined by medical specialist in agreement with a patient. In addition to the conventional treatment option, every day more complementary and alternative therapies are integrated into mainstream care. There is one promising cancer modality - hyperthermia therapy which is based on exposing body tissues to high temperatures. This treatment is still being investigated and is not widely available in hospitals and oncological centres. There are two kinds of hyperthermia therapies with direct and indirect heating. The first is not commonly used due to low efficiency and invasiveness, while the second is deeply investigated and a variety of methods have been developed, including ultrasounds, infrared sauna, induction heating and magnetic hyperthermia. The aim of this work was to examine possibilities of heating magnetic nanoparticles under the influence of electromagnetic field for cancer treatment. For this purpose, multiwalled carbon nanotubes used as nanocarriers for iron particles were investigated for its heating properties. The samples were subjected to an alternating electromagnetic field with frequency range between 110-619 kHz. Moreover, samples with various concentrations of carbon nanotubes were examined. The lowest frequency of 110 kHz and sample containing 10 wt% of carbon nanotubes occurred to influence the most effective heating process. Description of hyperthermia therapy aiming at enhancing currently available cancer treatment was also presented in this paper. Most widely applied conventional cancer modalities such as radiation or chemotherapy were also described. Methods for overcoming the most common obstacles in conventional cancer modalities, such as invasiveness and lack of selectivity, has been presented in magnetic hyperthermia characteristics, which explained the increasing interest of the treatment.

Keywords: hyperthermia, carbon nanotubes, cancer colon cells, ligands

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Authors: Maged El-Sayed Mohamed

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Plant tissue culture practices are presented nowadays as the most promising substitute to a whole plant in the terms of secondary metabolites production. They offer the advantages of high production, tunability and they have less effect on plant ecosystems. Lantana camara is a weed, which is common all over the world as an ornamental plant. Weeds can adapt to any type of soil and climate due to their rich cellular machinery for secondary metabolites’ production. This characteristic is found in Lantana camara as a plant of very rich diversity of secondary metabolites with no dominant class of compounds. Aim: This trait has encouraged the author to develop tissue culture experiments for Lantana camara to be a platform for production and manipulation of secondary metabolites through biotransformation. Methodology: The plant was collected in its flowering stage in September 2014, from which explants were prepared from shoot tip, auxiliary bud and leaf. Different types of culture media were tried as well as four phytohormones and their combinations; NAA, 2,4-D, BAP and kinetin. Explants were grown in dark or in 12 hours dark and light cycles at 25°C. A metabolic profile for the produced callus was made and then compared to the whole plant profile. The metabolic profile was made using GC-MS for volatile constituents (extracted by n-hexane) and by HPLC-MS and capillary electrophoresis-mass spectrometry (CE-MS) for non-volatile constituents (extracted by ethanol and water). Results: The best conditions for the callus induction was achieved using MS media supplied with 30 gm sucrose and NAA/BAP (1:0.2 mg/L). Initiation of callus was favoured by incubation in dark for 20 day. The callus produced under these conditions showed yellow colour, which changed to brownish after 30 days. The rate of callus growth was high, expressed in the callus diameter, which reached to 1.15±0.2 cm in 30 days; however, the induction of callus delayed for 15 days. The metabolic profile for both volatile and non-volatile constituents of callus showed more simple background metabolites than the whole plant with two new (unresolved) peaks in the callus’ nonvolatile constituents’ chromatogram. Conclusion: Lantana camara callus production can be itself a source of new secondary metabolites and could be used for biotransformation studies due to its simple metabolic background, which allow easy identification of newly formed metabolites. The callus production gathered the simple metabolic background with the rich cellular secondary metabolite machinery of the plant, which could be elicited to produce valuable medicinally active products.

Keywords: capillary electrophoresis-mass spectrometry, gas chromatography, metabolic profile, plant tissue culture

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Authors: N. H. D. P. Fonseka, I. H. Rajapakse, A. S. Dissanayake

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Background: Problem drinking, namely alcohol dependence (AD) and alcohol abuse (AA) are associated with major medical, social and economic adverse consequences. Problem drinking behavior is noted among those admitted to hospitals due to alcohol-related medical/surgical complaints as well as those with unrelated complaints. Literature shows an association between alcohol consumption and depression. Aims of this study were to determine the frequency of problem drinking and depression among males with a history of alcohol consumption tertiary care setting in Southern Sri Lanka. Method: Two-hundred male patients who consumed alcohol, receiving care in medical and surgical wards in Teaching Hospital Galle, were assessed. A validated J12 questionnaire of the Mini International Neuropsychiatric Interview was administered to determine frequency AA and AD. A validated PHQ 9 questionnaire to determine the prevalence and severity of depression. Results: Sixty-three participants (31%) had problem drinking. Of them, 61% had AD, and 39% had AA. Depression was noted in 39 (19%) subjects. In those who reported alcohol consumption not amounting to problem drinking, depression was noted in 23 (16%) participants. Mild depression was seen in 17, moderate in five and moderately severe in one. Among those who had problem drinking, 16 (25%) had depression. Mild depression was seen in four, moderate in seven, moderately severe in three and severe in two. Conclusions: A high proportion alcohol users had problem drinking. Adverse consequences associated with problem drinking places a major strain on the health system especially in a low resource setting where healthcare spending is limited and alcohol cessation support services are not well organised. Thus alcohol consumption and problem drinking behaviour need to be inquired into all medical consultations. Community prevalence of depression in Sri Lanka is approximately 10%. Depression among those consuming alcohol was two times higher compared to the general population. The rates of depression among those with problem drinking were especially high being 2.5 times more common than in the general population. A substantial proportion of these patients with depression had moderately severe or severe depression. When depression coexists with problem drinking, it may increase the tendency to consume alcohol as well as act as a barrier to the success of alcohol cessation interventions. Thus screening all patients who consume alcohol for depression, especially those who are problem drinkers becomes an important step in their clinical evaluation. In addition, in view of the high prevalence of problem drinking and coexistent depression, the need to organize a structured alcohol cessation support service in Sri Lanka as well as the need for increasing access to psychological evaluation and treatment of those with problem drinking are highlighted.

Keywords: alcohol abuse, alcohol, depression, problem drinking

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Authors: Scott Hollier, Ruchi Permvattana

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The purpose of this abstract is to share the findings of a recently completed disability-related Internet of Things (IoT) project undertaken at Curtin University in Australia. The project focused on identifying how IoT could support people with disabilities with their educational outcomes. To achieve this, the research consisted of an analysis of current literature and interviews conducted with students with vision, hearing, mobility and print disabilities. While the research acknowledged the ability to collect data with IoT is now a fairly common occurrence, its benefits and applicability still need to be grounded back into real-world applications. Furthermore, it is important to consider if there are sections of our society that may benefit from these developments and if those benefits are being fully realised in a rush by large companies to achieve IoT dominance for their particular product or digital ecosystem. In this context, it is important to consider a group which, to our knowledge, has had little specific mainstream focus in the IoT area –people with disabilities. For people with disabilities, the ability for every device to interact with us and with each other has the potential to yield significant benefits. In terms of engagement, the arrival of smart appliances is already offering benefits such as the ability for a person in a wheelchair to give verbal commands to an IoT-enabled washing machine if the buttons are out of reach, or for a blind person to receive a notification on a smartphone when dinner has finished cooking in an IoT-enabled microwave. With clear benefits of IoT being identified for people with disabilities, it is important to also identify what implications there are for education. With higher education being a critical pathway for many people with disabilities in finding employment, the question as to whether such technologies can support the educational outcomes of people with disabilities was what ultimately led to this research project. This research will discuss several significant findings that have emerged from the research in relation to how consumer-based IoT can be used in the classroom to support the learning needs of students with disabilities, how industrial-based IoT sensors and actuators can be used to monitor and improve the real-time learning outcomes for the delivery of lectures and student engagement, and a proposed method for students to gain more control over their learning environment. The findings shared in this presentation are likely to have significant implications for the use of IoT in the classroom through the implementation of affordable and accessible IoT solutions and will provide guidance as to how policies can be developed as the implications of both benefits and risks continue to be considered by educators.

Keywords: disability, higher education, internet of things, students

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Authors: Woledegebrieal Aregay

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Introduction: Family planning is defined as the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is part of a strategy to reduce poverty, maternal, infant and child mortality; empowers women by lightening the burden of excessive childbearing. Family planning is achieved through the use of different contraceptive methods among which the most effective method is modern family planning methods like Long-Acting Reversible Contraceptive (LARCs) which are IUCD and Implant and these methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to10 years. Methods: An institutional-based cross-sectional study was conducted in Gondar town among female college students from April-May. A simple random sampling technique was employed to recruit a total of 1166 study subjects. Descriptive variables were computed for all predictors & dependent variables. The presence of an association between covariates & LARC use was observed by two tables’ findings using the chi-square test. Bivariate logistic regression was conducted to identify all possible factors affecting LARC utilization & its crude Odds Ratio, 95% Confidence Interval (CI) & P-value was observed. A multivariable logistic regression model was developed to control possible confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) &P-values will be computed to identify significantly associated factors (P < 0.05) with LARC utilization. Result: Utilization of LARCs was 20.4%, the most common is Implant 86(96.5%), and followed by Intra-Uterine Contraceptive Device (IUCD) 3(3.5%). The result of the multivariate analysis revealed that the significant association of marital status of the respondent on utilization of LARC [AOR 3.965(2.051-7.665)], discussion of the respondent about LARC utilization with the husband/boyfriend [AOR 2.198(1.191-4.058)], and attitude of the respondent on implant was found to be associated [AOR 0.365(0.143-0.933)].Conclusion: The level of knowledge and attitude in this study was not satisfactory, the utilization of long-acting reversible contraceptives among college students was relatively satisfactory but if the knowledge and attitude of the participant has improved the prevalence of LARC were increased.

Keywords: utilization, long-acting reversible contraceptive, Ethiopia, Gondar

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Authors: Alan Collins

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This study explains how The People’s Tribunal empowered survivors of child abuse. It examines how People’s tribunals can be effective mean of empowerment; the challenges of empowerment – expectation v. reality; the findings and how they reflect other inquiry findings; and the importance of listening and learning from survivors. UKCSAPT “The People’s Tribunal” was established by survivors of child sex abuse and members of civil society to investigate historic cases of institutional sex abuse. The independent inquiry, led by a panel of four judges, listened to evidence spanning four decades from survivors and experts. A common theme throughout these accounts showed that a series of institutional failures prevented abuse from being reported; and that there are clear links between children being rendered vulnerable by these failures and predatory abuse on an organised scale. It made a series of recommendations including the establishment of a permanent and open forum for victims to share experiences and give evidence, better links between mental health services and police investigations, and training for police and judiciary professionals on the effects of undisclosed sexual abuse. The main findings of the UKCSAPT report were:-There are clear links between children rendered vulnerable by institutional failures and predatory abuse on an organised scale, even if these links often remain obscure. -UK governmental institutions have failed to provide survivors with meaningful opportunities for either healing or justice. -The vital mental health needs of survivors are not being met and this undermines both their psychological recovery and access to justice. -Police and other authorities often lack the training to understand the complex reasons for the inability of survivors to immediately disclose a history of abuse. -Without far-reaching changes in institutional culture and practices, the sexual abuse of children will continue to be a significant scourge in the UK. The report also outlined a series of recommendations for improving reporting and mental health provision, and access to justice for victims were made, including: -A permanent, government-funded popular tribunal should be established to enable survivors to come forward and tell their stories. -Survivors giving evidence should be assigned an advocate to assist their access to justice. -Mental health services should be linked to police investigations to help victims disclose abuse. -Victims who fear reprisals should be provided with a channel though which to give evidence anonymously.

Keywords: empowerment, survivors, sexual, abuse

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Authors: Mark De Ste Croix, Jonathan Hughes, Francisco Ayala, Michal Lehnert

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There are well-known challenges to implementing injury prevention training for youth players but no data are available on the knowledge and understanding of deliverers of such programmes at grass root level. To increase adoption and adherence to such programmes coach knowledge and understanding of injury risk and prevention is essential. Therefore, the purpose of this study was to examine grass-root coaches knowledge and understanding of injury risk and prevention in youth players. 68 grass root coaches (18 females and 50 males) who were attending a one-day injury prevention workshop completed a modified validated questionnaire exploring knowledge and understanding of injury risk and prevention in youth players. Only 59% of coaches agreed that youth players are at a high risk of suffering an injury. There were high levels of agreement that injuries can have negative impacts on team performance (75%) and can cause physical problems in later life (85%), however only around half of coaches felt that injuries affect youth players current quality of life (59%). There was strong agreement that it is possible to prevent injuries in youth players (84%), but coaches were generally unaware of programs to help prevent injuries (84%), and only 9% used some form of injury prevention program. Despite this, nearly all coaches felt that their coaching could benefit from a greater understanding of growth and maturation (91%), injury prevention programmes (91%) and specific exercises (93%) for youth athletes. 17% of coaches rated their knowledge of injury prevention as good/very good at the start of the workshop and this increased to 94% at the end of the workshop. 62% of coaches identified their attitude towards injury prevention as indifferent at the start of the workshop compared with only 1% at the end. Only 14% of coaches at the start of the workshop were confident to deliver an injury prevention session but 83% stated they were confident by the end of the workshop. Finally, 98% of coaches felt that the workshop provided them with the confidence and the knowledge to deliver an injury prevention session and 98% suggested that they would implement injury prevention into their coaching. These data suggest that there is a lack of understanding of grass root coaches that children are a high-risk group for injuries, and that such injuries impact on current quality of life. Despite understanding that injuries can be prevented most grass root coaches do not have the knowledge to implement injury prevention into their coaching and very few do. There is a common consensus amongst these coaches that a greater understanding of such programmes will enhance their coaching. The injury prevention workshop appears to have increased the knowledge and changed the attitude of coaches towards injury prevention. All coaches felt that the workshop provided them with the tools to adopt, implement and deliver injury prevention in their coaching. These data highlight that there is a clear need for education regarding injury risk and prevention to be embedded within the coach education pathway, especially at grass root level.

Keywords: coach education, injury prevention, knowledge, and understanding, youth

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Authors: Kali Prasad Sarma

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Indiscriminate disposal of municipal solid waste (MSW) in open dumping site is a common scenario in developing countries like India which poses a risk to the environment as well as human health. The objective of the present investigation was to find out the concentration of heavy metals (Pb, Cr, Ni, Mn, Zn, Cu, and Cd) and other physicochemical parameters of leachate and soil collected from an open dumping site of Tezpur town, Assam, India and its associated potential ecological risk. Tezpur is an urban agglomeration coming under the category of Class I UAs/Towns with a population of 105,377 as per data released by Government of India for Census 2011. Impact of the leachate on the groundwater was also addressed in our study. The concentrations of heavy metals were determined using ICP-OES. Energy dispersive X-Ray (SEM-EDS) microanalysis was also conducted to see the presence of the studied metals in the soil. X-Ray diffraction analysis (XRD) and Fourier Transform Infrared (FTIR) spectroscopy were also used to identify dominant minerals present in the soil samples. The trend of measured heavy metals in the soil samples was found in the following order: Mn > Pb > Cu > Zn > Cr > Ni > Cd. The assessment of heavy metal contamination in the soil was carried out by calculating enrichment factor (EF), geo-accumulation index (Igeo), contamination factor (Cfi), degree of contamination (Cd), pollution load index (PLI) and ecological risk factor (Eri). The study showed that the concentrations of Pb, Cu, and Cd were much higher than their respective average shale value and the EF of the soil samples depicted very severe enrichment for Pb, Cu, and Cd; moderate enrichment for Cr and Zn. Calculated Igeo values indicated that the soil is moderate to strongly contaminated with Pb and uncontaminated to moderately contaminated with Cd and Cu. The Cfi value for Pb indicates a very strong contamination level of the metal in the soil. The Cfi values for Cu and Cd were 2.37 and 1.65 respectively indicating moderate contamination level. To apportion the possible sources of heavy metal contamination in soil, principal components analysis (PCA) has been adopted. From the leachate, heavy metals are accumulated at the dumping site soil which could easily percolate through the soil and reach the groundwater. The possible relation of groundwater contamination due to leachate percolation was examined by analyzing the heavy metal concentrations in groundwater with respect to distance from the dumping site. The concentrations of Cd and Pb in groundwater (at a distance of 20m from dumping site) exceeded the permissible limit for drinking water as set by WHO. Occurrence of elevated concentration of potentially toxic heavy metals such as Pb and Cd in groundwater and soil are much environmental concern as it is detrimental to human health and ecosystem.

Keywords: groundwater, heavy metal contamination, leachate, open dumping site

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Authors: Hamsa T. Tayeb, Mohammad A. Arafah, Dana M. Bakheet, Duaa M. Khalaf, Agnieszka Tarnoska, Nduna Dzimiri

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Background: CYP2D6 is a member of the cytochrome P450 mixed-function oxidase system. The enzyme is responsible for the metabolism and elimination of approximately 25% of clinically used drugs, especially in breast cancer and psychiatric therapy. Different phenotypes have been described displaying alleles that lead to a complete loss of enzyme activity, reduced function (poor metabolizers – PM), hyperfunctionality (ultrarapid metabolizers–UM) and therefore drug intoxication or loss of drug effect. The prevalence of these variants may vary among different ethnic groups. Furthermore, the xTAG system has been developed to categorized all patients into different groups based on their CYP2D6 substrate metabolization. Aim of the study: To determine the prevalence of the different CYP2D6 variants in our population, and to evaluate their clinical relevance in personalized medicine. Methodology: We used the Luminex xMAP genotyping system to sequence 305 Saudi individuals visiting the Blood Bank of our Institution and determine which polymorphisms of CYP2D6 gene are prevalent in our region. Results: xTAG genotyping showed that 36.72% (112 out of 305 individuals) carried the CYP2D6_*2. Out of the 112 individuals with the *2 SNP, 6.23% had multiple copies of *2 SNP (19 individuals out of 305 individuals), resulting in an UM phenotype. About 33.44% carried the CYP2D6_*41, which leads to decreased activity of the CYP2D6 enzyme. 19.67% had the wild-type alleles and thus had normal enzyme function. Furthermore, 15.74% carried the CYP2D6_*4, which is the most common nonfunctional form of the CYP2D6 enzyme worldwide. 6.56% carried the CYP2D6_*17, resulting in decreased enzyme activity. Approximately 5.73% carried the CYP2D6_*10, consequently decreasing the enzyme activity, resulting in a PM phenotype. 2.30% carried the CYP2D6_*29, leading to decreased metabolic activity of the enzyme, and 2.30% carried the CYP2D6_*35, resulting in an UM phenotype, 1.64% had a whole-gene deletion CYP2D6_*5, thus resulting in the loss of CYP2D6 enzyme production, 0.66% carried the CYP2D6_*6 variant. One individual carried the CYP2D6_*3(B), producing an inactive form of the enzyme, which leads to decrease of enzyme activity, resulting in a PM phenotype. Finally, one individual carried the CYP2D6_*9, which decreases the enzyme activity. Conclusions: Our study demonstrates that different CYP2D6 variants are highly prevalent in ethnic Saudi Arabs. This finding sets a basis for informed genotyping for these variants in personalized medicine. The study also suggests that xTAG is an appropriate procedure for genotyping the CYP2D6 variants in personalized medicine.

Keywords: CYP2D6, hormonal breast cancer, pharmacogenetics, polymorphism, psychiatric treatment, Saudi population

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Authors: T. Mcgraw, F. N. Morin, N. Desai

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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

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This paper is investigated to understand the design, the use, and the consequence of Knowledge Management System (KMS) for knowledge systems sharing and integration. A KMS for knowledge systems sharing and integration is designed to meet the challenges raised by knowledge management researchers and practitioners: the technical, the human, and social factors. Agricultural KMS involves various members coming from different Communities of Practice (CoPs) who possess their own knowledge of multiple practices which need to be combined in the system development. However, the current development of the technology ignored the indigenous knowledge of the local communities, which is the key success factor for agriculture. This research employed the multi-methodological approach to KMS research in action research perspective which consists of four strategies: theory building, experimentation, observation, and system development. Using the KMS development practice of Ethiopian agricultural transformation agency as a case study, this research employed an interpretive analysis using primary qualitative data acquired through in-depth semi-structured interviews and participant observations. The Orlikowski's structuration model of technology has been used to understand the design, the use, and the consequence of the KMS. As a result, the research identified three basic components for the architecture of the shared KMS, namely, the people, the resources, and the implementation subsystems. The KMS were developed using web 2.0 tools to promote knowledge sharing and integration among diverse groups of users in a distributed environment. The use of a shared KMS allows users to access diverse knowledge from a number of users in different groups of participants, enhances the exchange of different forms of knowledge and experience, and creates high interaction and collaboration among participants. The consequences of a shared KMS on the social system includes, the elimination of hierarchical structure, enhance participation, collaboration, and negotiation among users from different CoPs having common interest, knowledge and skill development, integration of diverse knowledge resources, and the requirement of policy and guideline. The research contributes methodologically for the application of system development action research for understanding a conceptual framework for KMS development and use. The research have also theoretical contribution in extending structuration model of technology for the incorporation of variety of knowledge and practical implications to provide management understanding in developing strategies for the potential of web 2.0 tools for sharing and integration of indigenous knowledge.

Keywords: communities of practice, indigenous knowledge, participation, structuration model of technology, Web 2.0 tools

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Authors: Kun Hua O., Dong Woon Kim, Won Hyung Lee

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Introduction: Neuropathic pain induced by spinal or peripheral nerve injury is highly resistant to common painkillers, nerve blocks, and other pain management approaches. Recently, several new therapeutic drug candidates have been developed to control neuropathic pain. In this study, we used the spinal nerve L5 ligation (SNL) model to investigate the ability of intrathecal or intravenous Evans blue to decrease pain behavior and to study the relationship between Evans blue and the neural structure of pain transmission. Method: Neuropathic pain (allodynia) of the left hind paw was induced by unilateral SNL in Sprague-Dawley rats(n=10) in each group. Evans blue (5, 15, 50μg/10μl) or phosphate buffer saline(PBS,10μl) was injected intrathecally at 3days post-ligation or intravenously(1mg/200 μl) 3days and 5days post-ligation . Mechanical sensitivity was assessed using Von Frey filaments at 3 days post-ligation and at 2 hours, days 1, 2, 3, 5,7 after intrathecal Evans blue injection, and on days 2, 4, 7, and 11 at 14 days after intravenous injection. In the intrathecal group, microglia and glutaminergic neurons in the dorsal horn and VNUT(vesicular nucleotide transporter) in the dorsal root ganglia were tested to evaluate co-staining with Evans blue. The experimental procedures were performed in accordance with the animal care guideline of the Korean Academy of Medical Science(Animal ethic committee of Chungnam National University Hospital: CNUH-014-A0005-1). Results: Tight ligation of the L5 spinal nerve induced allodynia in the left hind paw 3 days post-ligation. Intrathecal Evans blue most significantly(P＜0.001) alleviated allodynia at 2 days after intrathecal, but not an intravenous injection. Glutaminergic neurons in the dorsal horn and VNUT in the dorsal root ganglia were co-stained with Evans blue. On the other hand, microglia in the dorsal horn were partially co-stained with Evans blue. Conclusion: We confirmed that Evans blue might have an analgesic effect through the central nervous system, not another system in neuropathic pain of the SNL animal model. These results suggest Evans blue may be a potential new drug for the treatment of chronic pain. This research was supported by the National Research Foundation of Korea (NRF-2020R1A2C100757512), funded by the Ministry of Education.

Keywords: neuropathic pain, Evas blue, intrathecal, intravenous

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Authors: Hoa Pham

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The literature on language teaching and second language acquisition has been largely driven by monolingual ideology with a common assumption that a second language (L2) is best taught and learned in the L2 only. The current study challenges this assumption by reporting learners' positive perceptions of tertiary level teachers' code switching practices in Vietnam. The findings of this study contribute to our understanding of code switching practices in language classrooms from a learners' perspective. Data were collected from student participants who were working towards a Bachelor degree in English within the English for Business Communication stream through the use of focus group interviews. The literature has documented that this method of interviewing has a number of distinct advantages over individual student interviews. For instance, group interactions generated by focus groups create a more natural environment than that of an individual interview because they include a range of communicative processes in which each individual may influence or be influenced by others - as they are in their real life. The process of interaction provides the opportunity to obtain the meanings and answers to a problem that are "socially constructed rather than individually created" leading to the capture of real-life data. The distinct feature of group interaction offered by this technique makes it a powerful means of obtaining deeper and richer data than those from individual interviews. The data generated through this study were analysed using a constant comparative approach. Overall, the students expressed positive views of this practice indicating that it is a useful teaching strategy. Teacher code switching was seen as a learning resource and a source supporting language output. This practice was perceived to promote student comprehension and to aid the learning of content and target language knowledge. This practice was also believed to scaffold the students' language production in different contexts. However, the students indicated their preference for teacher code switching to be constrained, as extensive use was believed to negatively impact on their L2 learning and trigger cognitive reliance on the L1 for L2 learning. The students also perceived that when the L1 was used to a great extent, their ability to develop as autonomous learners was negatively impacted. This study found that teacher code switching was supported in certain contexts by learners, thus suggesting that there is a need for the widespread assumption about the monolingual teaching approach to be re-considered.

Keywords: codeswitching, L1 use, L2 teaching, learners’ perception

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Authors: Saeed Rezaeian, M. Rezaee Boroon

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Nitrogen accumulates in soils during the process of fertilizer addition to promote the plant growth. When the organic matter decomposes, the form of available nitrogen produced is in the form of nitrate, which is highly mobile. The most significant health effect of nitrate ingestion is methemoglobinemia in infants under six months of age (blue baby syndrome). The mobile nutrients, like nitrate nitrogen, are not stored in the soil as the available forms for the long periods and in large amounts. It depends on the needs for the crops such as vegetables. On the other hand, the vegetables will compete actively for nitrate nitrogen as a mobile nutrient and water. The mobile nutrients must be shared. The fewer the plants, the larger this share is for each plant. Also, this nitrate nitrogen is poisonous for the people who use these vegetables. Nitrate is converted to nitrite by the existing bacteria in the stomach and the Gastro-Intestinal (GI) tract. When nitrite is entered into the blood cells, it converts the hemoglobin to methemoglobin, which causes the anoxemia and cyanosis. The increasing use of pesticides and chemical fertilizers, especially the fertilizers with nitrates compounds, which have been common for the increased production of agricultural crops, has caused the nitrate pollution in the (soil, water, and environment). They have caused a lot of damage to humans and animals. In this research, the nitrate accumulation in different kind of vegetables such as; green pepper, tomatoes, egg plants, watermelon, cucumber, and red pepper were observed in the suburbs of Mashhad, Neisabour, and Sabzevar cities. In some of these cities, the information forms of agronomical practices collected were such as; different vegetable crops fertilizer recommendations, varieties, pesticides, irrigation schedules, etc., which were filled out by some of our colleagues in the research areas mentioned above. Analysis of the samples was sent to the soil and water laboratory in our department in Mashhad. The final results from the chemical analysis of samples showed that the mean levels of nitrates from the samples of the fruit crops in the mentioned cities above were all lower than the critical levels. These fruit crop samples were in the order of: 35.91, 8.47, 24.81, 6.03, 46.43, 2.06 mg/kg dry matter, for the following crops such as; tomato, cucumber, eggplant, watermelon, green pepper, and red pepper. Even though, this study was conducted with limited samples and by considering the mean levels, the use of these crops from the nutritional point of view will not cause the poisoning of humans.

Keywords: environmental pollution, human health, nitrate accumulations, nitrate fertilizers

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Authors: Divyans Mahansaria

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User authentication is an important security measure for protecting confidential data and systems. However, the vulnerability while authenticating into a system has significantly increased. Thus, necessary mechanisms must be deployed during the process of authenticating a user to safeguard him/her from the vulnerable attacks. The proposed solution implements a novel authentication mechanism to counter various forms of security breach attacks including phishing, Trojan horse, replay, key logging, Asterisk logging, shoulder surfing, brute force search and others. QR code (Quick Response Code) is a type of matrix barcode or two-dimensional barcode that can be used for storing URLs, text, images and other information. In the proposed solution, during each new authentication request, a QR code is dynamically generated and presented to the user. A piece of generic information is mapped to plurality of elements and stored within the QR code. The mapping of generic information with plurality of elements, randomizes in each new login, and thus the QR code generated for each new authentication request is for one-time use only. In order to authenticate into the system, the user needs to decode the QR code using any QR code decoding software. The QR code decoding software needs to be installed on handheld mobile devices such as smartphones, personal digital assistant (PDA), etc. On decoding the QR code, the user will be presented a mapping between the generic piece of information and plurality of elements using which the user needs to derive cipher secret information corresponding to his/her actual password. Now, in place of the actual password, the user will use this cipher secret information to authenticate into the system. The authentication terminal will receive the cipher secret information and use a validation engine that will decipher the cipher secret information. If the entered secret information is correct, the user will be provided access to the system. Usability study has been carried out on the proposed solution, and the new authentication mechanism was found to be easy to learn and adapt. Mathematical analysis of the time taken to carry out brute force attack on the proposed solution has been carried out. The result of mathematical analysis showed that the solution is almost completely resistant to brute force attack. Today’s standard methods for authentication are subject to a wide variety of software, hardware, and human attacks. The proposed scheme can be very useful in controlling the various types of authentication related attacks especially in a networked computer environment where the use of username and password for authentication is common.

Keywords: authentication, QR code, cipher / decipher text, one time password, secret information

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Authors: Xiaobo Rui, Zhoumo Zeng, Yibo Li

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A novel tri-cantilever energy harvester with magnetic oscillator was presented, which could convert the ambient vibration into electrical energy to power the low-power devices such as wireless sensor networks. The most common way to harvest vibration energy is based on the use of linear resonant devices such as cantilever beam, since this structure creates the highest strain for a given force. The highest efficiency will be achieved when the resonance frequency of the harvester matches the vibration frequency. The limitation of the structure is the narrow effective bandwidth. To overcome this limitation, this article introduces a broadband tri-cantilever harvester with nonlinear stiffness. This energy harvester typically consists of three thin cantilever beams vertically arranged with Neodymium Magnets ( NdFeB)magnetics at its free end and a fixed base at the other end. The three cantilevers have different resonant frequencies by designed in different thicknesses. It is obviously that a similar advantage of multiple resonant frequencies as piezoelectric cantilevers array structure is built. To achieve broadband energy harvesting, magnetic interaction is used to introduce the nonlinear system stiffness to tune the resonant frequency to match the excitation. Since the three cantilever tips are all free and the magnetic force is distance dependent, the resonant frequencies will be complexly changed with the vertical vibration of the free end. Both model and experiment are built. The electromechanically coupled lumped-parameter model is presented. An electromechanical formulation and analytical expressions for the coupled nonlinear vibration response and voltage response are given. The entire structure is fabricated and mechanically attached to a electromagnetic shaker as a vibrating body via the fixed base, in order to couple the vibrations to the cantilever. The cantilevers are bonded with piezoelectric macro-fiber composite (MFC) materials (Model: M8514P2). The size of the cantilevers is 120*20mm2 and the thicknesses are separately 1mm, 0.8mm, 0.6mm. The prototype generator has a measured performance of 160.98 mW effective electrical power and 7.93 DC output voltage via the excitation level of 10m/s2. The 130% increase in the operating bandwidth is achieved. This device is promising to support low-power devices, peer-to-peer wireless nodes, and small-scale wireless sensor networks in ambient vibration environment.

Keywords: tri-cantilever, ambient vibration, energy harvesting, magnetic oscillator

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Authors: Sarwat un Nisa

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One of the remarkable gifts that a human being is blessed with is the ability to speak using a combination of sounds. Different combinations of sounds combine to form a word which in turn make a sentence and therefore give birth to a language. A person can either be a monolingual, i.e., can speak one language or bilingual, i.e., can speak more than one language. Whether a person speaks one language or multiple languages or in whatever language a person speaks, the main aim is to communicate, express ideas, feelings or thoughts. Sometimes the choice of a language is deliberate and sometimes it is a habitual act. The language which is used to put our ideas across speaks many things about our cultural, linguistic and ethnic identities. It can never be claimed that bilinguals are better than monolinguals in terms of linguistic skills, bilinguals or multilinguals have more than one language at their disposal. Therefore, how effectively two languages are used by the same person keeps linguists always intrigued. The most prominent and common features found in the speech of bilingual speakers are code switching and code mixing. The aim of the present paper is to explore these features among the adolescent speakers of Kashmir. The reason for studying the linguistics behavior of adolescents is the age when a person is neither an adult nor a child. They want to drift away from the norms and make a new norm for themselves. Therefore, how their linguistics skills are influenced by their age is of great interest because it can set the trend for the future generation. Kashmir is a multilingual society where three languages, i.e., Kashmiri, Urdu, and English are regularly used by the speakers, especially the educated ones. Kashmiri is widely used at home or mostly among adults. Urdu is the official language, and English is used in schools and for most of the written official correspondences. Thus, it is not uncommon to find these three languages coming in contact with each other quite frequently. The language contact results in the code switching and code mixing. In this paper different aspects of code switching and code mixing are discussed. Research Method: The data were collected from the different districts of Kashmir. The informants did not have prior knowledge of the survey. The situation was spontaneous and natural. The topics were introduced by the interviewer to the group of informants which comprised of three participants. They were asked to discuss the topic, most of the times without any intervention of the interviewer. Along with conversations, the informants also filled in written questionnaires comprising sociolinguistic questions. Questionnaires were analysed to get an idea about the sociolinguistic attitude of the informants. Percentage, frequency, and average were used as statistical tools to analyse the data. Conclusions were drawn taking into consideration of interpretations of both speech samples and questionnaires.

Keywords: code mixing, code switching, Kashmir, bilingualism

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Authors: Mohammed Ahmed, Ziba Nazarlou

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Mild steels have a limited alloying content which makes them vulnerable to excessive corrosion rates in the harsh medium. To overcome this issue, some protective coatings are used to prevent corrosion on the steel surface. The use of specialized coatings, mainly organic coatings (such as epoxies, polyurethanes, and acrylics) and inorganic coatings (such as Polysiloxanes) is the most common method of mitigating corrosion of carbon steel. Incorporating the benefits of organic and inorganic hybrid (OIH) compounds for the designing of hybrid protective coatings is still challenging for industrial applications. There are advantages of inorganic coatings have, but purely inorganic siloxane-based coatings are difficult to use on industrial applications unless they are used at extremely low thicknesses (< 1-2 microns). Hence, most industrial applications try to have a combination of Polysiloxanes with organic compounds.  A hybrid coating possesses an organic section, which transports flexibility and impact resistance, and an inorganic section, which usually helps in the decreasing of porosity and increasing thermal stability and hardness. A number of polymers including polyethylene glycol and polyvinyl pyrrolidone have been reported to inhibit the corrosion mild steel in acidic media. However, reports on the effect of polyethylene oxide (PEO) or its blends on corrosion inhibition of metals is very scarce. Different composition of OIH coatings was synthesized by using silica sol-gel, epoxy, and PEO. The effect of different coating types on the corrosion behavior of carbon steel in harsh solution has been studied by weight loss and electrochemical measurements using Gamry 1000 Interface Potentiostat. Coating structures were investigated by SEM. İt revealed a considerable reduction in corrosion rate for coated sample. Based on these results, OIH coating prepared by epoxy-silica sol gel-PEO and epoxy-silica sol-gel exhibit had a %99.5 and %98 reduction of (Corrosion rate) CR compares to baseline. Cathodic Tafel constant (βc) shows that coatings change both Tafel constants but had more effect on the cathodic process. The evolution of the Potentiostatic scan with time displays stability in potential, some of them in a high value while the other in a low value which can be attributed to the formation of an oxide film covering substrate surface. The coated samples with the group of epoxy coating have a lower potential along with the time test, while the silica group shows higher in potential with respect to time.

Keywords: electrostatic, hybrid coating, corrosion tests, silica sol gel

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Authors: Pradip Kumar Das

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India is a developing country and is also one of the most industrialized developing countries of the world. In post-independence period, industry has grown rapidly in India and with industrialization corporate sector in the country has been growing day after day. Nowadays, the investment is not limited to be shareholders alone, apart from the shareholders the common people of the society have also started investing in shares of the corporate sectors. Thus, the responsibilities of the corporate sectors have increased much. Corporate financial reporting refers to a system which provides valuable information to different types of users in the society for taking resourceful decisions with regards to investment policy, organization credit worthiness, profitability, liquidity, provision of taxation etc. The quality of information available to different users fosters the efficient allocation of resources which are very urgent for economic development of a country like India. It is the responsibility of the management of the corporate sector to convey reliable and authentic information with the help of generally accepted accounting principles. Corporate sectors which disclose information through annual reports should be sufficient enough for the purpose of bringing out the salient features relating to business performances and other activities. However, the disclosures practices of the corporate sectors though annual reports have undergone several major changes from time to time. Many a time, these vital changes are in the fashion of presenting information in the annual reports and addition of so many non-statutory disclosures of the company. Very often managements of the corporate sectors are blamed for concealing true picture which is not desirable at all. The corporate financial reporting practice which in the current period has gained a place of prime importance suffers from certain limitations and invites question from the public about its reliability. Thus, the wide gap created by management between the exhibited picture and the real picture sometimes attains to such extent that the purpose of the reporting practice loses its importance. The requirement of full and adequate disclosure of information including information relating to human resources in the annual report in free trade economy of India helps the prospective investors to select the best portfolio of their investments. This paper is a reflection of a modest attempt of the author to highlight the corporate reporting practices followed in India. A cursory glance of the conceptual study shows limitations along with reliability of the reporting practices and suggests measures to overcome the shortcomings of the financial reporting practices.

Keywords: corporate enterprise, cursory glance, portfolio, yawning gap

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Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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Authors: Vladimir A. Rozov

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Comparative studies of religion and ritual could contribute better understanding of human culture universalities. Belief in supernatural beings seems to be a common feature of the religion. A significant part of the Islamic concepts that concern supernatural beings is based on a tradition based on the Hadiths. They reflect, among other things, his ideas about a proper way to interact with supernatural beings. These ideas to a large extent follow from the pre-Islamic religious experience of the Arabs and had been reflected in a number of ritual actions. Some of those beliefs concern a particular function of clothing. For example, it is known that Muhammad was wrapped in clothes during the revelation of the Quran. The same thing was performed by pre-Islamic soothsayers (kāhin) and by rival opponents of Muhammad during their trances. Muhammad also turned the clothes inside out during religious rituals (prayer for rain). Besides these specific ways of clothing which prove the external similarity of Muhammad with the soothsayers and other people who claimed the connection with supernatural forces, the pre-Islamic soothsayers had another characteristic feature which is physical flaws. In this regard, it is worth to note Muhammad's so-called "Seal the Prophecy" (h̠ ātam an- nubūwwa) -protrusion or outgrowth on his back. Another interesting feature of Muhammad's behavior was his attitude to eating onion and garlic. In particular, the Prophet didn`t eat them and forbade people who had tasted these vegetables to enter mosques, until the smell ceases to be felt. The reason for this ban on eating onion and garlic is caused by a belief that the smell of these products prevents communication with otherworldly forces. The materials of the Hadith also suggest that Muhammad shared faith in the apotropical properties of water. Both of these ideas have parallels in other cultures of the world. Muhammad's actions supposed to provide an interaction with the supernatural beings are not accidental. They have parallels in the culture of pre-Islamic Arabia as well as in many past and present world cultures. The latter fact can be explained by the similarity of the universal human beliefs in supernatural beings and how they should be interacted with. Later a number of similar ideas shared by the Prophet Muhammad was legitimized by the Islamic tradition and formed the basis of popular Islamic rituals. Thus, these parallels emphasize the commonality of human notions of supernatural beings and also demonstrate the significance of the pre-Islamic cultural context in analyzing the genesis of Islamic religious beliefs.

Keywords: hadith, Prophet Muhammad, ritual, supernatural beings

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Authors: Sengul Celik, Alper Ketenci

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In Turkish Constitution about health care in Article 56, it is said that: everyone has the right to live in a healthy and balanced environment. It is the duty of the state and citizens to improve the environment, protect environmental health, and prevent environmental pollution. The state ensures that everyone lives their lives in physical and mental health; it organizes the planning and service of health institutions from a single source in order to realize cooperation by increasing savings and efficiency in human and substance power. The state fulfills this task by utilizing and supervising health and social institutions in the public and private sectors. General health insurance can be established by law for the widespread delivery of health services. To have health care is one of the basic rights of patients. After the coupe attempt in July 2016, the Government of Turkey has announced a state of emergency and issued lots of emergency decrees. By these emergency decrees, lots of people were dismissed from their jobs and lost their some basic social rights. The violations occur in social life. One of the most common observations is the discrimination by government in health care system. This study aims to put forward the violation of human rights in health care system in Turkey due to their discriminated position by an emergency decree. The study is a case study that is based on nine interviews with the people or relatives of people who lost their jobs by an emergency decree in Turkey. In this study, no personally identifiable information was obtained for the safety of individuals. Also no distinctive questions regarding the identity of individuals were asked. The interviews are obtained through internet call applications. The data were analyzed through the requirements of regular health care system in Turkey. The interviews expose that the people or the relatives of people lost their right to have regular health care. They have to pay extra amount both in clinical services and in medication treatment. The patient right to quality medical care without prejudice is violated. It was assessed that the people who are involved in emergency decree and their relatives are discriminated by government and deprived of regular medical care and supervision. Although international legal arrangements and legal responsibilities of the state have been put forward by Article 56, they are violated in practice. To prevent these kinds of violations, some measures should be taken against the deprivation in health care system especially towards the discriminated people by an emergency decree.

Keywords: emergency decree in Turkey, health care, discriminated people, patients rights

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Authors: Marin Kanarev, Delyan Stoyanov, Ivanna Popova, Nadezhda Petrova

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Thanks to increased survival rates in patients bearing oncological malignancies due to recent developments in anti-cancer therapies and diagnostic techniques, observation of clinical cases of metachronous cancers is more common and can provide more in-depth knowledge of their development and, as a result, help clinicians apply suitable therapy. This unusual case of three metachronous tumors presented the opportunity to follow their occurrence, progression, and treatment thoroughly. A 77-year-old male presented with carcinoma ventriculi of the pylorus region, which was surgically removed via upper subtotal stomach resection, a lateral antecolical gastro-enteroanastomosis, and a subsequent Braun anastomosis. An EOX chemotherapy regimen followed. A CT scan four months later showed no indication of recurrence or dissemination. The same scan, performed as a part of the follow-up plan two years later, showed an indication of neoplastic growth in the urinary bladder. After the patient had been directed to a urologist, the suspicion was confirmed, and the growth was histologically diagnosed as a carcinoma of the urinary bladder. An immunohistochemistry test showed an expression of PDL1 of less than 5%, which resulted in treatment with GemCis chemotherapy regimen that led to full remission. Two years and seven months after the first surgery, a CT scan showed again that the two carcinomas were gone. However, four months later, elevated tumor markers prompted a PET/CT scan, which showed data indicative of recurring neoplastic growth in the region of the stomach cardia. It was diagnosed as an adenocarcinoma infiltrating the esophagus. Preoperative chemotherapy with the ECF regimen was completed in four courses, and a CT scan showed no progression of the disease. In less than a month after therapy, the patient underwent laparotomy, debridement, gastrectomy, and a subsequent mechanical terminal-lateral esophago-jejunoanasthomosis. It was verified that the tumor originated from metastasis from the carcinoma ventriculi, which was located in the pylorus. In conclusion, this case report highlights the importance of patient follow-up and studying recurring neoplastic growth. Despite the absence of symptoms, clinicians should maintain a high level of suspicion when evaluating the patient data and choosing the most suitable therapy.

Keywords: carcinoma, follow-up, metachronous, neoplastic growth, recurrence

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Authors: Diego Caballero Vélez

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In 1997 the Schengen Convention was incorporated in the mainstream of EU law by the Amsterdam Treaty. It came into effect in 1999 with the abolition of internal border controls in the EU, a milestone in the European integration project. In the meantime, due to the Yugoslav wars, nearly 700,000 asylum applications were filed in the European countries provoking a major refugee crisis. During this period, the opening of Eastern Europe fostered more cooperation and policy-making at the EU level in migration issues. Currently, a similar migratory crisis is taking place in Europe. The Syrian war has caused the most massive influx of immigrants in Europe since World War II. Nevertheless, the EU is adopting different migration policies from those implemented during the Yugoslav migration crisis. The current crisis has not led to a common European position but national responses have been offered on migration policies and responsibility for border security and asylum-seekers. A lot of factors can explain this change from a cooperation scenario to a no cooperation one, such as the economic crisis, but this research is focused on the premise that 'threat perception' lies at the core of some states grand strategies towards migration and it also influences in multilateral or unilateral responses. Migration rests at the nexus of three dimensions of security, including geopolitical interests, material production, and internal security. According to some scholars, migration policy is an 'integral instrument' of state grand strategy in that context. Political integration at the EU might be altered with the emergence of existential threats. In other words, some areas of the European cooperation can be transformed when a 'critical juncture' occurs, for instance a migration crisis. In that instance, Member states could see migration as a matter of threat that modifies their national interests and willingness to embrace international cooperation. This research will focus on EU Member states´ perceptions of the 90´s migration crisis and the current one. The goal is to evaluate to what extent the perceptions of threat are one of the main factors for explaining the transition from a cooperation scenario to a no-cooperation one in European asylum and security policies. To analyze threat perception in both migration crisis, some relevant Member states are treated as cases of study and a comparative analysis is carried out based on public opinion polls, public and policy discourse in migration, voting practices and deconstruction of the migration policies themselves both at EU level and a national one.

Keywords: cooperation, migration crisis, national responses, threat perception

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Authors: Justus Enninga

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Enthusiasts and skeptics about economic growth have not much in common in their preference for institutional arrangements that solve ecological conflicts. This paper argues that agreement between both opposing schools can be found in the Bloomington Schools’ concept of polycentricity. Growth-enthusiasts who will be referred to as Simons after the economist Julian Simon and growth-skeptics named Ehrlichs after the ecologist Paul R. Ehrlich both profit from a governance structure where many officials and decision structures are assigned limited and relatively autonomous prerogatives to determine, enforce and alter legal relationships. The paper advances this argument in four steps. First, it will provide clarification of what Simons and Ehrlichs mean when they talk about growth and what the arguments for and against growth-enhancing or degrowth policies are for them and for the other site. Secondly, the paper advances the concept of polycentricity as first introduced by Michael Polanyi and later refined to the study of governance by the Bloomington School of institutional analysis around the Nobel Prize laureate Elinor Ostrom. The Bloomington School defines polycentricity as a non-hierarchical, institutional, and cultural framework that makes possible the coexistence of multiple centers of decision making with different objectives and values, that sets the stage for an evolutionary competition between the complementary ideas and methods of those different decision centers. In the third and fourth parts, it is shown how the concept of polycentricity is of crucial importance for growth-enthusiasts and growth-skeptics alike. The shorter third part demonstrates the literature on growth-enhancing policies and argues that large parts of the literature already accept that polycentric forms of governance like markets, the rule of law and federalism are an important part of economic growth. Part four delves into the more nuanced question of how a stagnant steady-state economy or even an economy that de-grows will still find polycentric governance desirable. While the majority of degrowth proposals follow a top-down approach by requiring direct governmental control, a contrasting bottom-up approach is advanced. A decentralized, polycentric approach is desirable because it allows for the utilization of tacit information dispersed in society and an institutionalized discovery process for new solutions to the problem of ecological collective action – no matter whether you belong to the Simons or Ehrlichs in a green political economy.

Keywords: degrowth, green political theory, polycentricity, institutional robustness

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Authors: Zeinab Yazdanfar, Dilan Robert, Daniel Lester, S. Setunge

Abstract:

Scour has been identified as the most common threat to bridge stability worldwide. Traditionally, scour around bridge piers is calculated using the empirical approaches that have considerable limitations and are difficult to generalize. The multi-physic nature of scouring which involves turbulent flow, soil mechanics and solid-fluid interactions cannot be captured by simple empirical equations developed based on limited laboratory data. These limitations can be overcome by direct numerical modeling of coupled hydro-mechanical scour process that provides a robust prediction of bridge scour and valuable insights into the scour process. Several numerical models have been proposed in the literature for bridge scour estimation including Eulerian flow models and coupled Euler-Lagrange models incorporating an empirical sediment transport description. However, the contact forces between particles and the flow-particle interaction haven’t been taken into consideration. Incorporating collisional and frictional forces between soil particles as well as the effect of flow-driven forces on particles will facilitate accurate modeling of the complex nature of scour. In this study, a coupled Computational Fluid Dynamics and Discrete Element Model (CFD-DEM) has been developed to simulate the scour process that directly models the hydro-mechanical interactions between the sediment particles and the flowing water. This approach obviates the need for an empirical description as the fundamental fluid-particle, and particle-particle interactions are fully resolved. The sediment bed is simulated as a dense pack of particles and the frictional and collisional forces between particles are calculated, whilst the turbulent fluid flow is modeled using a Reynolds Averaged Navier Stocks (RANS) approach. The CFD-DEM model is validated against experimental data in order to assess the reliability of the CFD-DEM model. The modeling results reveal the criticality of particle impact on the assessment of scour depth which, to the authors’ best knowledge, hasn’t been considered in previous studies. The results of this study open new perspectives to the scour depth and time assessment which is the key to manage the failure risk of bridge infrastructures.

Keywords: bridge scour, discrete element method, CFD-DEM model, multi-phase model

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