Search results for: flood risk perception

Authors: Zairunisha

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This paper is concerned with the ways in which Assisted Reproductive Technologies (ARTs) affect women’s lives and perceptions regarding their infertility, contraception and reproductive health. Like other female animals, nature has ordained human female with the biological potential of procreation and becoming mother. However, during the last few decades, this phenomenal disposition of women has become a technological affair to achieve fertility and contraception. Medical practices in patriarchal societies are governed by male scientists, technical and medical professionals who try to control women as procreator instead of providing them choices. The use of ARTs presents innumerable waxed ethical questions and issues such as: the place and role of a child in a woman’s life, freedom of women to make their choices related to use of ARTs, challenges and complexities women face at social and personal levels regarding use of ARTs, effect of ARTs on their life as mothers and other relationships. The paper is based on a survey study to explore and analyze the above ethical issues arising from the use of Assisted Reproductive Technologies (ARTs) by women in New Delhi, the capital of India. A rapid rate of increase in fertility clinics has been noticed recently. It is claimed that these clinics serve women by using ARTs procedures for infertile couples and individuals who want to have child or terminate a pregnancy. The study is an attempt to articulate a critique of ARTs from a feminist perspective. A qualitative feminist research methodology has been adopted for conducting the survey study. An attempt has been made to identify the ways in which a woman’s life is affected in terms of her perceptions, apprehensions, choices and decisions regarding new reproductive technologies. A sample of 18 women of New Delhi was taken to conduct in-depth interviews to investigate their perception and response concerning the use of ARTs with a focus on (i) successful use of ARTs, (ii) unsuccessful use of ARTs, (iii) use of ARTs in progress with results yet to be known. The survey was done to investigate the impact of ARTs on women’s physical, emotional, psychological conditions as well as on their social relations and choices. The complexities and challenges faced by women in the voluntary and involuntary (forced) use of ARTs in Delhi have been illustrated. A critical analysis of interviews revealed that these technologies are used and developed for making profits at the cost of women’s lives through which economically privileged women and individuals are able to purchase services from lesser ones. In this way, the amalgamation of technology and cultural traditions are redefining and re-conceptualising the traditional patterns of motherhood, fatherhood, kinship and family relations within the realm of new ways of reproduction introduced through the use of ARTs.

Keywords: reproductive technologies, infertilities, voluntary, involuntary

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Authors: Chung-Hung Tsai, Ya-Ping Li

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Tourism industry is highly depended on the natural environment and climate. Compared to other industries, it is more susceptible to environment and climate. Taiwan belongs to a sea island country and located in the subtropical monsoon zone. The events of climate variability, frequency of typhoons and rainfalls raged are caused regularly serious disaster. In traditional disaster assessment, it usually focuses on the disaster damage and risk assessment, which is short of the features from different industries to understand the impact of the restoring force in post-disaster resilience and the main factors that constitute resilience. The object of this study is based on disaster recovery experience of tourism area and to understand the main factors affecting the tourist area of disaster resilience. The combinations of literature review and interviews with experts are prepared an early indicator system of the disaster resilience. Then, it is screened through a Fuzzy Delphi Method and Analytic Network Process for weight analysis. Finally, this study will establish the tourism disaster resilience evaluation index system considering the Taiwan's tourism industry characteristics. We hope that be able to enhance disaster resilience after tourist areas and increases the sustainability of industrial development. It is expected to provide government departments the tourism industry as the future owner of the assets in extreme climates responses.

Keywords: resilience, Fuzzy Delphi Method, Analytic Network Process, industrial development

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Authors: Fharia Tilat Loba

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Studies show that there is a certain group of students who are more vulnerable to bullying due to their physical appearance, disability, sexual preference, race, and lack of social and behavioral skills. Students with autism spectrum disorders (ASD) are one of the most vulnerable groups among these at-risk groups. Researchers suggest that focusing on vulnerable groups of students who can be the target of bullying helps to understand the causes and patterns of aggression, which ultimately helps in structuring intervention programs to reduce bullying. Since Australia ratified the United Nations Convention on the Rights of Persons with Disabilities in 2006, it has been committed to providing an inclusive, safe, and effective learning environment for all children. In addition, the 2005 Disability Standards for Education seeks to ensure that students with disabilities can access and participate in education on the same basis as other students, covering all aspects of education, including harassment and victimization. However, bullying hinders students’ ability to fully participate in schooling. The proposed study aims to synthesize the notions of traditional bullying and cyberbullying and attempts to understand the experiences of students with ASD who are experiencing bullying in their schools. The proposed study will primarily focus on identifying the gaps between policy and practice related to bullying, and it will also attempt to understand the experiences of parents of students with ASD and professionals who have experience dealing with bullying at the school level in Australia. This study is expected to contribute to the theoretical knowledge of the bullying phenomenon and provide a reference for advocacy at the school, organization, and government levels.

Keywords: education policy, bullying, Australia, neurodiversity

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Authors: P. Viduthalai, A. K. Divakar, V. Natarajan

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Media is one of the powerful tools that manipulate the world in numerous aspects especially in the form of a communication process. For instance, the concept of the public sphere, which was earlier represented by landlords and elites has now transformed into a virtual public sphere, which is also represented by marginalized people. Unfortunately, this acquisition is still paradoxical. Though the media proliferation and its effects are humongous, still it has not been the same throughout the world. Inequality in access to media has created a technological divide among people. Finally, globalization and approach by the government towards using media for development communication has significantly changed the way in which the media reaches every nook and corner. Monarchy, oligarchy, republic and democracy together form the basis of most governments of the world. Of which, democracy is the one with the highest involvement and participation of the people. Ideally, the participation of the people is what, that keeps the democracy running. A healthy democracy is possible only when people are able to access information that makes citizens responsible and serves to check the functioning of their elected representatives. On one side the media consumption of people plays a crucial role in the formation of the public sphere, and on the other side, big media conglomerates are a serious threat to community participation, which is a goal that the media should strive for in a country like India. How different people consume these different media, differs greatly from length and breadth of the country. Another aspect of this media consumption is that it isn’t passive. People usage and consumption of media are related with the gratification that they derive from the particular media. This aspect varies from person to person and from society to society according to both internal and external factors. This article sets out from the most underlying belief that Malayali Tribes have adopted television and becomes a part of daily life and a day never passes without it especially after the introduction of Free Television Scheme by the past state government. Though they are living in hilly and socially isolated places, they too have started accessing media for understanding about the people of the plains and their culture, dictated by their interest. Many of these interests appear to have a social and psychological origin. The present research attempts to study how gratification of these needs lead Malayali Tribes to form such a virtual public sphere where they could communicate with people of the plains. Data was collected through survey method, from 300 respondents on “Exposure towards Television and their perception”. Conventional anthropological methods like unstructured interviews were also used to supplement the data collection efforts in the three taluks namely Yercaud, Pethanayankkanpalayam and Panamaraththuppatty in Salem district of TamilNadu. The results highlight the role of Television in gratifying needs of the Malayali Tribes.

Keywords: democracy, gratification, Malayali Tribes and television, virtual public sphere

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Authors: Sun-Ki Choi

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The U.S. student loan policy was initiated to improve the equality of educational opportunity and help low-income families to provide higher education opportunities for their children. However, with the increase in the average student loan amount, college graduates with student loans experience problems and restrictions in their early-career choices. This study examines the early career labor market choices of college graduates who obtained student loans to finance their higher education. In this study, National Survey of College Graduates (NSCG) data for 2017 and 2019 was used to estimate the effects of student loans on the employment status and current job wages of graduates with student loans. In the analysis, two groups of workers, those with student loans and those without loans, were compared. Using basic models and Mahalanobis distance matching, it was found that graduates who rely on student loans to finance their education are more likely to participate in the labor market than those who do not. Moreover, in entry-level jobs, graduates with student loans receive lower salaries than those without student loans. College graduates make job-related decisions based on their current and future wages and fringe benefits. Graduates with student loans tend to demonstrate risk-averse behaviors due to their financial restrictions. Thus, student loan debt creates inequity in the early-career labor market for college graduates. Furthermore, this study has implications for policymakers and researchers in terms of the student loan policy.

Keywords: student loan, wage differential, unintended consequences, mahalanobis distance matching

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Authors: Mohammad Tahir Yousafzai, Nighat Nisar, Rehana Khalil

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The aim of this study is to assess the practices of sharp injuries and factors leading to it among medical practitioners in slum areas of Karachi, Pakistan. A cross sectional study was conducted in slum areas of Landhi Town Karachi. All medical practitioners (317) running the private clinics in the areas were asked to participate in the study. Data was collected on self administered pre-tested structured questionnaires. The frequency with percentage and 95% confidence interval was calculated for at least one sharp injury (SI) in the last one year. The factors leading to sharp injuries were assessed using multiple logistic regressions. About 80% of private medical practitioners consented to participate. Among these 87% were males and 13% were female. The mean age was 38±11 years and mean work experience was 12±9 years. The frequency of at least one sharp injury in the last one year was 27%(95% CI: 22.2-32). Almost 47% of Sharp Injuries were caused by needle recapping, less work experience, less than 14 years of schooling, more than 20 patients per day, administering more than 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharp injuries. Injection practices were found inadequate among private medical practitioners in slum areas of Karachi, and the frequency of Sharp Injuries was found high in these areas. There is a risk of occupational transmission of blood borne infections among medical practitioners warranting an urgent need for launching awareness and training on standard precautions for private medical practitioners in the slum areas of Karachi.

Keywords: injection practices, private practitioners, sharp injuries, blood borne infections

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Authors: Tsung-yin Lin, Yi-yu Lee, Ching-hua Hung

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Snoring, the lay term for obstructive breathing during sleep, is one of the most prevalent of obnoxious human habits. Loud snoring usually makes others feel noisy and uncomfortable. Snoring also influences the sleep quality of snorers’ bed partners, because of the noise they do not get to sleep easily. Snoring causes the reduce of sleep quality leading to several medical problems, such as excessive daytime sleepiness, high blood pressure, increased risk for cardiovascular disease and cerebral vascular accident, and etc. There are many non-prescription devices offered for sale on the market, but very limited data are available to support a beneficial effect of these devices on snoring and use in treating obstructive sleep apnea (OSA). Mandibular advancement devices (MADs), also termed as the Mandibular reposition devices (MRDs) are removable devices which are worn at night during sleep. Most devices require dental impression, bite registration, and fabrication by a dental laboratory. Those devices are fixed to upper and lower teeth and are adjusted to advance the mandible. The amount of protrusion is adjusted to meet the therapeutic requirements, comfort, and tolerance. Many devices have a fixed degree of advancement. Some are adjustable in a limited degree. This study focuses on the stress analysis of Mandibular Advancement Devices (MADs), which are considered as a standard treatment of snoring that promoted by American Academy of Sleep Medicine (AASM). This paper proposes a new MAD design, and the finite element analysis (FEA) is introduced to precede the stress simulation for this MAD.

Keywords: finite element analysis, mandibular advancement devices, mechanical stress, snoring

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Authors: Nadezhda Kvatashidze

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The International Accounting Standards Board updated the conceptual framework for financial reporting. The main reason behind it is to resolve the tasks of the accounting, which are caused by the market development and business-transactions of a new economic content. Also, the investors call for higher transparency of information and responsibility for the results in order to make a more accurate risk assessment and forecast. All these make it necessary to further develop the conceptual framework for financial reporting so that the users get useful information. The market development and certain shortcomings of the conceptual framework revealed in practice require its reconsideration and finding new solutions. Some issues and concepts, such as disclosure and supply of information, its qualitative characteristics, assessment, and measurement uncertainty had to be supplemented and perfected. The criteria of recognition of certain elements (assets and liabilities) of reporting had to be updated, too and all this is set out in the updated edition of the conceptual framework for financial reporting, a comprehensive collection of concepts underlying preparation of the financial statement. The main objective of conceptual framework revision is to improve financial reporting and development of clear concepts package. This will support International Accounting Standards Board (IASB) to set common “Approach & Reflection” for similar transactions on the basis of mutually accepted concepts. As a result, companies will be able to develop coherent accounting policies for those transactions or events that are occurred from particular deals to which no standard is used or when standard allows choice of accounting policy.

Keywords: conceptual framework, measurement basis, measurement uncertainty, neutrality, prudence, stewardship

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

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Introduction: Anterior femoral perforation or distal anterior nail position is a known complication of femoral nailing specifically in pertrochantric fractures fixed with cephalomedullary nail. This has been attributed to wrong entry point for the femoral nail, nail with large radius of curvature or malreduced fracture. Left alone anterior perforation of femur or abutment of nail on anterior femur will result in pain and risk stress riser at distal femur and periprosthetic fracture. There have been multiple techniques described to avert or correct this problem ranging from using different nail, entry point change, poller screw to deflect the nail position, use of shorter nail or use of curved guidewire or change of nail to ensure a nail with large radius of curvature Methods: We present this technique which we have used in order to centralise the femoral nail either when the nail has been put anteriorly or when the guide wire has been inserted too anteriorly prior to the insertion of the nail. This technique requires the use of femoral reduction spool from the nailing set. This technique was used by eight trainees of different level of experience under supervision. Results: This technique was easily reproducible without any learning curve without a need for opening of fracture site or change in the entry point with three different femoral nailing sets in twenty-five cases. The process took less than 10 minutes even when revising a malpositioned femoral nail. Conclusion: Our technique of using femoral reduction spool is easily reproducible and repeatable technique for avoidance of non-centralised femoral nail insertion and distal anterior perforation of femoral nail.

Keywords: femoral fracture, nailing, malposition, surgery

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Authors: Juhan Kim, Jinsoo Kim

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South Korea cannot import natural gas in any form other than LNG because of the division of South and North Korea. Further, the high proportion of natural gas in the national energy mix makes this resource crucial for energy security in Korea. Expansion of Panama Canal will allow for reducing the cost of shipping between the Far East and U.S East. Panama Canal expansion can have significant impacts on South Korea. Due to this situation, we review the natural gas optimal portfolio by considering the uniqueness of the Korean Natural gas market and expansion of Panama Canal. In order to assess Korea’s natural gas optimal portfolio, we developed natural gas portfolio model. The model comprises two steps. First, to obtain the optimal long-term spot contract ratio, the study examines the price level and the correlation between spot and long-term contracts by using the Markowitz, portfolio model. The optimal long-term spot contract ratio follows the efficient frontier of the cost/risk level related to this price level and degree of correlation. Second, by applying the obtained long-term contract purchase ratio as the constraint in the linear programming portfolio model, we determined the natural gas optimal import portfolio that minimizes total intangible and tangible costs. Using this model, we derived the optimal natural gas portfolio considering the expansion of Panama Canal. Based on these results, we assess the portfolio for natural gas import to Korea from the perspective of energy security and present some relevant policy proposals.

Keywords: natural gas, Panama Canal, portfolio analysis, South Korea

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Authors: Keith Schofield, Leigh Morland

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Storytelling is an established means of leadership and management development and is also considered a form of leadership of self and others in its own right. This study focuses on the utility of storytelling in the development of management narratives in an MBA programme; sources include programme participants as well as international recruiters, whose voices are often only heard in terms of economic contribution and globalisation. For many MBA candidates, the return to study requires the development of a new identity which complements their professional identity; each candidate has their own journey and expectations, the use of story can enable candidates to explore their aspirations and assumptions and give voice to previously unspoken ideas. For international recruitment, the story of market development and change must be captured if MBAs are to remain fit for purpose. If used effectively, story acts as a form of critical reflection that can inform the learning journeys of individuals, emerging identities as well as the ongoing design and development of programmes. The landscape of management education is shifting; the MBA begins to attract a different kind of candidate, some are younger than before, others are seeking validation for their existing work practices, yet more are entrepreneurial and wish to capitalise on an institutional experience to further their career. There is a shift in context, creating uncertainty and ambiguity for programme managers and recruiters, thus requiring institutions to create a new MBA narrative. This study utilises Lego SeriousPlay as the means to engaging programme participants and international agents in telling the story of their MBA. We asked MBA participants to tell the story of their leadership and management aspirations and compare these to stories of their development journeys, allowing for critical reflection of their respective development gaps. We asked international recruiters, who act as university agents and promote courses in the student’s country of origin, to explore their mental models of MBA candidates and their learning agenda. The purpose of this process was to explore the agent’s perception of the MBA programme and to articulate the student journey from a recruitment perspective. The paper’s unique contribution is in combining these stories in order to explore the assumptions that determine programme design. Data drawn from reflective statements together with images of Lego ‘builds’ created the opportunity for reflection between the mental models of these groups. Findings will inform the design of the MBA journey and experience; we review the extent to which the changing identities of learners are congruent with programme design. Data from international recruiters also determines the extent to which marketing and recruitment strategies identify with would be candidates.

Keywords: critical reflection, programme management, recruitment, storytelling

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Authors: Hossein Barri Ghazani

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Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

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Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Diabetes is a chronic health problem and a major risk factor of stroke. A number of therapeutic modalities exist for diabetes management. It’s still unknown whether the different oral hypoglycemic agents would ameliorate the detrimental effect of diabetes on stroke severity. The objective of this work is to assess the effect of pretreatment with oral hypoglycemic agents, insulin and their combination on stroke severity at presentation. Patients and Methods: Patients admitted to the King Abdullah University Hospital (KAUH)-Jordan with ischemic stroke between January 2015 and December 2016 were evaluated and their comorbid diseases, treatment on admission and their neurologic severity was assessed using the National Institute of Health Stroke Scale (NIHSS) were documented. Stroke severity was compared for non-diabetic patients and diabetic patients treated with different antidiabetic agents. Results: Data from 324 patients with acute stroke was documented. The median age of participants was 69 years. Diabetes was documented in about 50% of the patients. Multinomial regression analysis identified diabetes treatment status as an independent predictor of neurological severity of stroke (p=0.032). Patients treated with oral hypoglycemic agents had a significantly lower NIHSS as compared to nondiabetic patients and insulin treated patients (p < 0.02). The positive effect of oral hypoglycemic agents was blunted by insulin co-treatment. Insulin did not alter the severity of stroke as compared to non-diabetics. Conclusion: Oral hypoglycemic agents may reduce the severity of neurologic deficit of ischemic stroke and may have neuroprotective effect.

Keywords: diabetes, stroke, neuroprotection, oral hypoglycemic agents

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Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

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Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

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Authors: Preethi Grace Theva Neethi Dhas

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A healthy human gut microbiome has commensal and symbiotic functions in digestion and is a decisive factor for human health. The soil microbiome is a crucial component in the ecosystem of soils and their health and resilience. Changes in soil microbiome are linked to human health. Ever since the industrial era, the human and the soil microbiome have been going through drastic changes. The soil microbiome has changed due to industrialization and extensive agricultural practices, whereas humans have less contact with soil and increased intake of highly processed foods, leading to changes in the human gut microbiome. Regenerating the soil becomes crucial in maintaining a healthy ecosystem. The nutrients, once obtained from the soil, need to be given back to the soil. Soil degradation needs to be addressed in effective ways, like adding organic nutrients back to the soil. Manure from animals and humans needs to be returned to the soil, which can complete the nutrient cycle in the soil. On the other hand, fecal sludge management (FSM) is a growing concern in many parts of the developing world. Hence, it becomes crucial to treat and reuse fecal sludge in a safe manner, i.e., low in risk to human health. Co-composting fecal sludge with organic wastes is a practice that allows the safe management of fecal sludge and the safe application of nutrients to the soil. This paper will discuss the possible impact of co-composting fecal sludge with coconut choir waste on the soil, water, and ecosystem at large. Impact parameters like nitrogen, phosphorus, and fecal coliforms will be analyzed. The overall impact of fecal sludge application on the soil will be researched and presented in this study.

Keywords: fecal sludge management, nutrient cycle, soil health, composting

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Authors: Jiahui Yang, John Quigley, Lesley Walls

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In this paper, the authors develop a stochastic model regarding the investment in supplier delivery performance development from a buyer’s perspective. The authors propose a multivariate model through a Multinomial-Dirichlet distribution within an Empirical Bayesian inference framework, representing both the epistemic and aleatory uncertainties in deliveries. A closed form solution is obtained and the lower and upper bound for both optimal investment level and expected profit under uncertainty are derived. The theoretical properties provide decision makers with useful insights regarding supplier delivery performance improvement problems where multiple delivery statuses are involved. The authors also extend the model from a single supplier investment into a supplier portfolio, using a Lagrangian method to obtain a theoretical expression for an optimal investment level and overall expected profit. The model enables a buyer to know how the marginal expected profit/investment level of each supplier changes with respect to the budget and which supplier should be invested in when additional budget is available. An application of this model is illustrated in a simulation study. Overall, the main contribution of this study is to provide an optimal investment decision making framework for supplier development, taking into account multiple delivery statuses as well as multiple projects.

Keywords: decision making, empirical bayesian, portfolio optimization, supplier development, supply chain management

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Authors: Megha Ramnik Kotecha

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To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. Detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected with dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P<0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film unstability. On comparision of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight threatening complications.

Keywords: dry eye, pterygium, Schirmer's test, tear break up time (TBUT)

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Authors: Abdurahman Anwar Shfa

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A Road sidewalk provides benefits, including safety, mobility, and healthier communities by facilitating the movement of goods and people. It enables increased access to daily living and programs in the country. But, these increases in access may be affected by many factors that pose a great challenge in the individuals’ daily activity, ranging from minor injury to death. Those problems are construction roads without sidewalks, using sidewalks for selling purposes, potholes, and west and trees on sidewalks. In this case, our objective is to identify problems related to sidewalks, assess the accessibility of sidewalks to all users, including pedestrians with disabilities, propose appropriate countermeasures for these problems, and prepare the indicator map. This study was undertaken to investigate the performance problems associated with sidewalk, particularly focusing on specified areas of Dire Dawa city kebele 02, to show the main problems and suggest that important consideration should be given to road sidewalk. To meet the objective of research, it is believed to collect data, review sidewalk construction practices and performance problems reported from ERA manual, and carry out a field reconnaissance. This research encompassed a variety of activities regarding sidewalk, including problems and accidents that occurred due to this problem. The purpose of this research is to identify the type of risk to pedestrians who are walking along a roadway and the reasons for those risks. So, based on our study, the sidewalk of Dire Dawa City kebele 02 is not enough. Those sidewalks are not accessible for all pedestrians, including disability.

Keywords: GIS, ERA, GPS, sidewalks way, asphalt road

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Authors: Majid Farsadrooh, Mehran Feizi-Dehnayebi

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Serum albumin is the most abundant protein that is present in the circulatory system of a wide variety of organisms. Although it is a significant macromolecule, it can contribute to osmotic blood pressure and also, plays a superior role in drug disposition and efficiency. Molecular docking simulation can improve in silico drug design and discovery procedures to propound a lead compound and develop it from the discovery step to the clinic. In this study, the molecular docking simulation was applied to select a lead molecule through an investigation of the interaction of the two anticancer drugs (Alitretinoin and Abemaciclib) with Human Serum Albumin (HSA). Then, a series of new compounds (a-e) were suggested using lead molecule modification. Density functional theory (DFT) including MEP map and HOMO-LUMO analysis were used for the newly proposed compounds to predict the reactivity zones on the molecules, stability, and chemical reactivity. DFT calculation illustrated that these new compounds were stable. The estimated binding free energy (ΔG) values for a-e compounds were obtained as -5.78, -5.81, -5.95, -5,98, and -6.11 kcal/mol, respectively. Finally, the pharmaceutical properties and toxicity of these new compounds were estimated through OSIRIS DataWarrior software. The results indicated no risk of tumorigenic, irritant, or reproductive effects and mutagenicity for compounds d and e. As a result, compounds d and e, could be selected for further study as potential therapeutic candidates. Moreover, employing molecular docking simulation with the prediction of pharmaceutical properties helps to discover new potential drug compounds.

Keywords: drug design, anticancer, computational studies, DFT analysis

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Authors: Nawaf Al-Kharashi, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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Superior gluteal artery is one of the largest branches of posterior division of the internal iliac artery. It passes between the lumbosacral and first sacral root to escape from the pelvic cavity through the grater sciatic foramen just above the piriformis. The current study includes 41 cadaver investigates the origin and branch of the superior gluteal artery and clarify the clinical significance. In present study, the superior gluteal artery arises from the posterior division of the internal iliac artery directly in 82.5% whereas it arises indirectly as from the sciatic artery in 15.9%. However, it is congenital absence in 1.6% which is compensated by sciatic artery. The sciatic nerve gains vascular supply from superior gluteal artery in two ways either during its course or giving lateral sacral artery in 27% and lumbar branches in 1.6%. It also supplies the adductors group and iliacus via giving obturator artery in 14.3% and in 1.6% respectively. The superior gluteal artery usually passes between lumbosacral trunk and first sacral root in 82.5% whereas it does not passes the sciatic roots as it arises behind them in 15.9%. With a variability of the superior gluteal artery origin, there is a variability of sciatic nerve roots supply. Further, the superior gluteal artery arising from sciatic artery behind the sciatic roots carries a high risk of intra-pelvic bleeding in case of posterior pelvic fracture. Prolonged ligation of the superior gluteal artery which gives lateral sacral artery may result in sciatic neuropathy. Therefore, surgeons have to be aware of the superior gluteal artery variation in origin, course and branches to reduce the iatrogenic faults.

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery. sciatic neuropathy, sciatic nerve

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Authors: Sven Borén, Henrik Ny

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Ambitions within the EU for moving towards sustainable transport include major emission reductions for fossil fuel road vehicles, especially for buses, trucks, and cars. The electric driveline seems to be an attractive solution for such development. This study first applied the Framework for Strategic Sustainable Development to compare sustainability effects of today’s fossil fuel vehicles with electric vehicles that have batteries or hydrogen fuel cells. The study then addressed a scenario were electric vehicles might be in majority in Europe by 2050. The methodology called Strategic Lifecycle Assessment was first used, were each life cycle phase was assessed for violations against sustainability principles. This indicates where further analysis could be done in order to quantify the magnitude of each violation, and later to create alternative strategies and actions that lead towards sustainability. A Life Cycle Assessment of combustion engine cars, plug-in hybrid cars, battery electric cars and hydrogen fuel cell cars was then conducted to compare and quantify environmental impacts. The authors found major violations of sustainability principles like use of fossil fuels, which contribute to the increase of emission related impacts such as climate change, acidification, eutrophication, ozone depletion, and particulate matters. Other violations were found, such as use of scarce materials for batteries and fuel cells, and also for most life cycle phases for all vehicles when using fossil fuel vehicles for mining, production and transport. Still, the studied current battery and hydrogen fuel cell cars have less severe violations than fossil fuel cars. The life cycle assessment revealed that fossil fuel cars have overall considerably higher environmental impacts compared to electric cars as long as the latter are powered by renewable electricity. By 2050, there will likely be even more sustainable alternatives than the studied electric vehicles when the EU electricity mix mainly should stem from renewable sources, batteries should be recycled, fuel cells should be a mature technology for use in vehicles (containing no scarce materials), and electric drivelines should have replaced combustion engines in other sectors. An uncertainty for fuel cells in 2050 is whether the production of hydrogen will have had time to switch to renewable resources. If so, that would contribute even more to a sustainable development. Except for being adopted in the GreenCharge roadmap, the authors suggest that the results can contribute to planning in the upcoming decades for a sustainable increase of EVs in Europe, and potentially serve as an inspiration for other smaller or larger regions. Further studies could map the environmental effects in LCA further, and include other road vehicles to get a more precise perception of how much they could affect sustainable development.

Keywords: strategic, electric vehicles, sustainability, LCA

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Authors: Samson Obiene, Khamati Shilabukha, Geoffrey Muga, James Kairo

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Mangroves play a vital role in the achievement of multiple goals of global sustainable development (SDG’s), particularly SDG SDG 14 (life under water). Their management, however, is faced with several shortcomings arising from inadequate knowledge on the perceptions of their ecosystem services, hence a need to map mangrove goods and services within SDGs while interrogating the disaggregated perceptions. This study therefore aimed at exploring the parities and disparities in attitudes and perceptions of mangrove ecosystem services among community members of Vanga and the link of the ecosystem services (ESs) to specific SDG targets. The study was based at the Kenya-Tanzania transboundary area in Vanga; where a carbon-offset project on mangroves is being up scaled. Mixed methods approach employing surveys, focus group discussions (FGDs) and reviews of secondary data were used in the study. A two stage cluster samplings was used to select the study population and the sample size. FGDs were conducted purposively selecting active participants in mangrove related activities with distinct socio-demographic characteristics. Sampled respondents comprised of males and females of different occupations and age groups. Secondary data review was used to select specific SDG targets against which mangrove ecosystem services identified through a value chain analysis were mapped. In Vanga, 20 ecosystem services were identified and categorized under supporting, cultural and aesthetic, provisioning and regulating services. According to the findings of this study, 63.9% (95% ci 56.6-69.3) perceived of the ESs as very important for economic development, 10.3% (95% ci 0-21.3) viewed them as important for environmental and ecological development while 25.8% (95% ci 2.2-32.8) were not sure of any role they play in development. In the social-economic disaggregation, ecosystem service values were found to vary with the level of interaction with the ecosystem which depended on gender and other social-economic classes within the study area. The youths, low income earners, women and those with low education levels were also identified as the primary beneficiaries of mangrove ecosystem services. The study also found that of the 17 SDGs, mangroves have a potential of influencing the achievement 12, including, SDGs 1, 2, 3, 4, 6, 8 10, 12, 13, 14, 15 and 17 either directly or indirectly. Generally therefore, the local community is aware of the critical importance mangroves for enhanced livelihood and ecological services but challenges in sustainability still occur as a result the diverse values and of the services and the contradicting interests of the different actors around the ecosystem. It is therefore important to consider parities in values and perception to avoid a ‘tragedy of the commons’ while striving to enhance sustainability of the Mangrove ecosystem.

Keywords: sustainable development, community values, socio-demographics, Vanga, mangrove ecosystem services

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Authors: Pushpa Debnath

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Buddhism implies the ultimate methodology to obtain the acknowledgment to get out from cycling existence applied by the sutras. The Buddha’s natural methodology is the highest way of cessation from suffering existence. To be out of it, one must know the suffering before having tentativeness. According to the Buddha’s methodology, one can observe every being suffer from chronologically grasping craving. It is because lack of knowledge that the Buddha finds the four noble truths which are the basic states. These are suffering, the origin of suffering, cessation of suffering, and the path leading to the cessation of suffering. The Buddha describes that birth is suffering, aging is suffering, sickness is suffering, death is suffering, association with the unexpected is suffering, separation from the pleasant is suffering, and not receiving what one desires is suffering, In brief, the five aggregates of clinging are suffering. As the five aggregates are form, feeling, perception, mental formation, and consciousness. These are known as the matter that we identify with “You, Me” or “He.” The second truth cause of suffering is craving which has three types: craving for sense pleasures, craving for existence, and craving for non-existence. The third truth is the obliteration of craving, suffering can be eliminated to attain the Nibbana. The fourth truth is the path of liberation is the noble eight-fold path consisting of the right view, right intention, right speech, right action, right livelihood, right effort, right mindfulness, and right concentration. The six senses are the media of the eye, ear, nose, tongue, body, and mind sense faculties relating with the five aggregates and the six senses objects visual objects, sounds, smells, tastes, touch, and mind-objects that are contained by every visible being. The first five internal sense bases are material while the mind is a non-material phenomenon. Contact with the external world maintains by receiving through the six senses; visual objects through the eye, sounds through the ear, smells through the nose, tastes through the tongue, touch through the body, and mind-objects through sense faculties. These are the six senses a living being experiences by craving. Everything is conglomerated with all senses faculties through the natural phenomenon which are earth, water, fire, and air element. In this analysis, it is believed that beings are well adapted to the natural phenomenon. Everybody has fear of life because we have hatred, delusion, and anger which are the primary resources of falling into (Samsara) continuously that is the continuity of the natural way. These are the reasons for the suffering that chronically self-diluting through the threefold way. These are the roots of the entire beings suffering so the Buddha finds the enlightenment to uproot from cycling existence and the understanding of the natural consequence. When one could uproot ignorance, one could able to realize the ultimate happiness of Nirvana. From the craving of ignorance, everything starts to be present to the future which gives us mental agonies in existence.

Keywords: purification, morality, natural phenomenon, analysis, development of mind, observatory, Nirvana

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Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park

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Background/Purpose: Previous preclinical and clinical data suggest that increased lymphocytic infiltration would be associated with good prognosis and benefit from immunogenic chemotherapy especially in triple-negative breast cancer (TNBC). We investigated a single-center experience of TNBC and relationship with lymphocytic infiltration. Methods: From January 2004 to December 2012, at the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, we retrospectively reviewed 897 breast cancer patients-clinical outcomes, clinicopathological characteristics, breast cancer subtypes. And we reviewed lymphocytic infiltration of TNBC specimens by two pathologists. Statistical analysis of risk factors associated with recurrence was performed. Results: A total of 897 patients, 76 were TNBC (8.47%). Mean age of TNBC patients were 50.95 (SD10.42) years, mean follow-up periods was 40.06 months. We reviewed 49 slides, and there were 8 recurrent breast cancer patients (16.32%), and 4 patients were expired (8.16%). There were 9 lymphocytic predominant breast cancers (LPBC)-carcinomas with either intratumoral lymphocytes in >60% of tumor cell nests. 1 patient of LPBC was recurred and 8 were not. In multivariate logistic regression, the odds ratio of lymphocytic infiltration was 0.59 (p=0.643). Conclusion: In a single-center experience of TNBC, the lymphocytic infiltration in tumor cell nest might be a good trend on the prognosis but there was not statistically significant.

Keywords: tumor-infiltrating lymphocytes, triple negative breast cancer, medical and health sciences

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Authors: Sumia Fatima, Tayyaba Idrees

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Cardiac Arrest and Heart Failures are an important causes of mortality in developed and developing countries and even a second spent without Cardiopulmonary Resuscitation (CPR) increases the risk of mortality. Youngs doctors are expected to partake in CPR from the first day and if they are not taught basic life support (BLS) skills during their studies. They have next to no opportunity to learn them in clinical settings. To determine the exact level of knowledge of Basic Life Support among medical students. To compare the degree of knowledge among 1st and 2nd year medical students of RMU (Rawalpindi Medical University), using self-structured questionnaires. A cross sectional, qualitative primary study was conducted in March 2020 in order to analyse theoretical and practical knowledge of Basic Life Support among Medical Students of 1st and 2nd year MBBS. Self-Structured Questionnaires were distributed among 300 students, 150 from 1st year and 150 from 2nd year. Data was analysed using SPSS v 22. Chi Square test was employed. The results showed that only 13 (4%) students had received formal BLS training.129 (42%) students had encountered accidents in real life but had not known how to react. Majority responded that Basic Life Support should be made part of medical college curriculum (189 students), 194 participants (64%) had moderate knowledge of both theoretical and practical aspects of BLS. 75-80% students of both 1st and 2nd year had only moderate knowledge, which must be improved for them to be better healthcare providers in future. It was also found that male students had more practical knowledge than females, but both had almost the same proficiency in theoretical knowledge. The study concluded that the level of knowledge of BLS among the students was not up to the mark, and there is a dire need to include BLS training in the medical colleges’ curriculum.

Keywords: basic cardiac life support, cardiac arrest, awareness, medical students

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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Authors: Raju Ranjha, Surbhi Aggarwal

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Background: Inflammation plays an important role in infectious and non-infectious diseases. MiRNA is also reported to play role in inflammation and associated cancers. Chemokine CXCL12 is also known to play role in inflammation and various cancers. CXCL12/CXCR4 chemokine axis was involved in pathogenesis of IBD specially UC. Supplementation of CXCL12 induces homing of dendritic cells to spleen and enhances control of plasmodium parasite in BALB/c mice. We looked at the regulation of CXCL12β by miRNA in UC colitis. Prolonged inflammation of colon in UC patient increases the risk of developing colorectal cancer. We looked at the expression differences of CXCl12β and its targeting miRNA in cancer susceptible area of colon of UC patients. Aim: Aim of this study was to find out the expression regulation of CXCL12β by miRNA in inflammation. Materials and Methods: Biopsy samples and blood samples were collected from UC patients and non-IBD controls. mRNA expression was analyzed using microarray and real-time PCR. CXCL12β targeting miRNA were looked by using online target prediction tools. Expression of CXCL12β in blood samples and cell line supernatant was analyzed using ELISA. miRNA target was validated using dual luciferase assay. Results and conclusion: We found miR-200a regulate the expression of CXCL12β in UC. Expression of CXCL12β was increased in cancer susceptible part of colon and expression of its targeting miRNA was decreased in the same part of colon. miR-200a regulate CXCL12β expression in inflammation and may be an important therapeutic target in inflammation associated cancer.

Keywords: inflammation, miRNA, regulation, CXCL12

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Authors: Menouni Aziza, Chbihi Kaoutar, Duca Radu Corneliu, Gilissen Liesbeth, Bounou Salim, Godderis Lode, El Jaafari Samir

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In Africa, environmental and occupational health risks are mostly underreported. The aim of this research is to develop and implement a sentinel surveillance system comprising training and guidance of occupational physicians (OC) who will report new work-related diseases in African countries. A group of 30 OC are recruited and trained in each of the partner countries (Morocco, Benin and Ethiopia). Each committed OC is asked to recruit 50 workers during a consultation in a time-frame of 6 months (1500 workers per country). Workers are asked to fill out an online questionnaire about their health status and work conditions, including exposure to 20 chemicals. Urine and blood samples are then collected for human biomonitoring of common exposures. Some preliminary results showed that 92% of the employees surveyed are exposed to physical constraints, 44% to chemical agents, and 24% to biological agents. The most common physical constraints are manual handling of loads, noise pollution and thermal pollution. The most frequent chemical risks are exposure to pesticides and fuels. This project will allow a better understanding of effective sentinel systems as a promising method to gather high quality data, which can support policy-making in terms of preventing emerging work-related diseases.

Keywords: sentinel system, occupational diseases, human biomonitoring, Africa

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Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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Authors: Rory Austin Clark

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This primary research represents an ongoing two year inductive mixed-methods project endeavouring to unravel the subjective reality of hyperconnected young adults in Western societies who have come of age with social media and smartphones. It is to be presented as well as analyzed and contextualized through a written master’s thesis as well as a documentary/mockumentary meshed with a Web 2.0 app providing the capacity for prosumer, 'audience 2.0' functionality. The media component seeks to explore not only thematic issues via real-life research interviews and fictional narrative but technical issues within the format relating to the quest for intimate, authentic connection as well as compelling dissemination of scholarly knowledge in an age of ubiquitous personalized daily digital media creation and consumption. The overarching hypothesis is that the aforementioned individuals process and make sense of their world, find shared meaning, and formulate notions-of-self in ways drastically different than pre-2007 via hyper-mediation-of-self and surroundings. In this pursuit, research questions have progressed from examining how young adult digital natives understand their use of social media to notions relating to the potential functionality of Web 2.0 for prosocial and altruistic engagement, on and offline, through the eyes of these individuals no longer understood as simply digital natives, but social media natives, and at the conclusion of that phase of research, as 'neoliberalized social media natives' (NSMN). This represents the two most potent macro factors in the paradigmatic shift in NSMS’s worldview, that they are not just children of social media, but of the palpable shift to neoliberal ways of thinking and being in the western socio-cultures since the 1980s, two phenomena that have a reflexive æffective relationship on their perception of figure and ground. This phase also resulted in the working hypothesis of 'social media comparison anxiety' and a nascent understanding of NSMN’s habitus and habitation in a subjective reality of fully converged online/offline worlds, where any phenomena originating in one realm in some way are, or at the very least can be, re-presented or have effect in the other—creating hyperreal reception. This might also be understood through a 'society as symbolic cyborg model', in which individuals have a 'digital essence'-- the entirety of online content that references a single person, as an auric living, breathing cathedral, museum, gallery, and archive of self of infinite permutations and rhizomatic entry and exit points.

Keywords: affect, hyperreal, neoliberalism, postmodernism, social media native, subjective reality, Web 2.0

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