Search results for: overall survival

Authors: Seemab Zehra, A. H. W. Mohammed, E. Pantanella, J. L. Q. Laranja, P. H. De Mello, R. Saleh, A. A. Siddik, A. Al Shaikhi, A. M. Al-Suwailem

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Two separate feeding trials were conducted to determine the effects of using different commercial diets and water temperatures on the growth performance, feed intake, feed conversion ratio (FCR) and condition factor of sobaity seabream Sparidentex hasta. In experiment I, growth performance, feed intake, protein efficiency ratio (PER), feed conversion ratio (FCR) and survival (%) of sobaity seabream Sparidentex hasta (330.5±2.6 g; 26.9±1.0 cm) were evaluated by four different commercial diets (1, 2, 3 and 4) for 80 days. The daily weight gain was around 3.2 g day-1 with an SGR of 0.7% day-1. Both the FCR and PER in the fish were significantly better in diet 2 that contained 46.36% crude protein and 12.54% crude fat. In experiment II, (99±2.6 g; 17.1±1.0 cm). The fish were cultured in 1m3 tanks supplied with seawater from the Red Sea wherein three different rearing temperatures were set as treatments (24, 28 and 32°C). Fish were fed with a commercial diet based on the results of experiment I (46.4% protein; 20.1 MJ kg-1 energy) to satiation for 96 days. Total weight gain was significantly higher for the fish reared in the 32°C group (158.57 g) followed by the 28°C group (138.25 g), while the lowest weight gain was observed in the 24°C group (116.98 g). The FCR was significantly lower in the 32°C group (1.62) as compared to 28 (1.8) and 24°C (1.85) groups. Based on the results obtained from these preliminary studies (experiment I and II), sobaity seabream can attain better growth performance, FCR and PER at 32°C in the Red Sea by feeding commercial diet 2.

Keywords: Sparidentex hasta, nutrition, FCR, Red Sea, growth performance

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Authors: Jaturong Matidtor, Krisna R. Torrissen, Saengtong Pongjareankit, Sudaporn Tongsiri, Jiraporn Rojtinnakorn

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Low survival rate has being particular problem in nursery of marble goby juvenile. The aim of this study was to investigate effect of garlic extract on protein digestive pancreatic enzymes, trypsin (T) and chymotrypsin (C). The marble goby were reared with commercial feed mixed garlic extract at concentration of 0 (control), 0.3, 0.5, 1.0, 3.0 and 5.0% (w/w) for 6 weeks. Analysis of the digestive enzymes at 2 and 6 weeks was performed. Growth parameters; weight gain (WG), specific growth rate (SGR) and feed efficiency (FE), were identified. For T, C and T/C at 2 weeks, values of T and T/C ratio of 0.3% (w/w) group showed significant difference (p < 0.05) with the highest values of 17685.64± 11981.77 U/mg protein and of 51.64 ± 27.46 U/mg protein, respectively. For C at 2 weeks, 0% (w/w) group showed the highest values of 16191.76± 2225.56 U/mg protein. Whereas value of T, C and T/C ratio at 6 weeks, there was no significant difference (p > 0.05). For growth performance, it significantly increased in all garlic extract fed groups (0.3-5.0%, w/w), both at 2 and 6 weeks. At 2 weeks, values of WG and SGR of 0.5% (w/w) group showed the highest values of 71.51 ± 1.60%, and 3.85 ± 0.07%, respectively. For FE, 0.3% (w/w) group showed the highest value of 60.21 ± 6.51%. At 6 weeks, it illustrated that all growth parameters of 5.0% (w/w) group were the highest values; WG = 35.06 ± 5.66%, SGR = 2.14 ± 0.30%, and FE = 5.86 ± 0.68%. We suggested that garlic extract could be available for protein digestive enzyme and growth enhancement in marble goby nursery with artificial feed. This result will be high benefit for commercial aquaculture of marble goby.

Keywords: marble goby, nursery, garlic extract, digestive enzyme, growth

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Authors: Jolene M. Helena, Annie M. Joubert, Peace Mabeta, Magdalena Coetzee, Roy Lakier, Anne E. Mercier

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Targeting the distant tumour and its microenvironment whilst preserving bone density is important in improving the outcomes of patients with bone metastases. 2-Ethyl-3-O-sulphamoyl-estra1,3,5(10)16-tetraene (ESE-16) is an in-silico-designed 2- methoxyestradiol analogue which aimed at enhancing the parent compound’s cytotoxicity and providing a more favourable pharmacokinetic profile. In this study, the potential radiosensitization effects of ESE-16 were investigated in an in vitro bone metastasis model consisting of murine pre-osteoblastic (MC3T3-E1) and pre-osteoclastic (RAW 264.7) bone cells, metastatic prostate (DU 145) and breast (MDA-MB-231) cancer cells, as well as human umbilical vein endothelial cells (HUVECs). Cytotoxicity studies were conducted on all cell lines via spectrophotometric quantification of 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide. The experimental set-up consisted of flow cytometric analysis of cell cycle progression and apoptosis detection (Annexin V-fluorescein isothiocyanate) to determine the lowest ESE-16 and radiation doses to induce apoptosis and significantly reduce cell viability. Subsequent experiments entailed a 24-hour low-dose ESE-16-exposure followed by a single dose of radiation. Termination proceeded 2, 24 or 48 hours thereafter. The effect of the combination treatment was investigated on osteoclasts via tartrate-resistant acid phosphatase (TRAP) activity- and actin ring formation assays. Tumour cell experiments included investigation of mitotic indices via haematoxylin and eosin staining; pro-apoptotic signalling via spectrophotometric quantification of caspase 3; deoxyribonucleic acid (DNA) damage via micronuclei analysis and histone H2A.X phosphorylation (γ-H2A.X); and Western blot analyses of bone morphogenetic protein-7 and matrix metalloproteinase-9. HUVEC experiments included flow cytometric quantification of cell cycle progression and free radical production; fluorescent examination of cytoskeletal morphology; invasion and migration studies on an xCELLigence platform; and Western blot analyses of hypoxia-inducible factor 1-alpha and vascular endothelial growth factor receptor 1 and 2. Tumour cells yielded half-maximal growth inhibitory concentration (GI50) values in the nanomolar range. ESE-16 concentrations of 235 nM (DU 145) and 176 nM (MDA-MB-231) and a radiation dose of 4 Gy were found to be significant in cell cycle and apoptosis experiments. Bone and endothelial cells were exposed to the same doses as DU 145 cells. Cytotoxicity studies on bone cells reported that RAW 264.7 cells were more sensitive to the combination treatment than MC3T3-E1 cells. Mature osteoclasts were more sensitive than pre-osteoclasts with respect to TRAP activity. However, actin ring morphology was retained. The mitotic arrest was evident in tumour and endothelial cells in the mitotic index and cell cycle experiments. Increased caspase 3 activity and superoxide production indicated pro-apoptotic signalling in tumour and endothelial cells. Increased micronuclei numbers and γ-H2A.X foci indicated increased DNA damage in tumour cells. Compromised actin and tubulin morphologies and decreased invasion and migration were observed in endothelial cells. Western blot analyses revealed reduced metastatic and angiogenic signalling. ESE-16-induced radiosensitization inhibits metastatic signalling and tumour cell survival whilst preferentially preserving bone cells. This low-dose combination treatment strategy may promote the quality of life of patients with metastatic bone disease. Future studies will include 3-dimensional in-vitro and murine in-vivo models.

Keywords: angiogenesis, apoptosis, bone metastasis, cancer, cell migration, cytoskeleton, DNA damage, ESE-16, radiosensitization.

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Authors: Shaira L. Kee, Michael Aaron G. Sy, Myles Joshua T. Tan, Hezerul Abdul Karim, Nouar AlDahoul

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Skin diseases are considered the fourth most common disease, with melanoma and non-melanoma skin cancer as the most common type of cancer in Caucasians. The alarming increase in Skin Cancer cases shows an urgent need for further research to improve diagnostic methods, as early diagnosis can significantly improve the 5-year survival rate. Machine Learning algorithms for image pattern analysis in diagnosing skin lesions can dramatically increase the accuracy rate of detection and decrease possible human errors. Several studies have shown the diagnostic performance of computer algorithms outperformed dermatologists. However, existing methods still need improvements to reduce diagnostic errors and generate efficient and accurate results. Our paper proposes an ensemble method to classify dermoscopic images into benign and malignant skin lesions. The experiments were conducted using the International Skin Imaging Collaboration (ISIC) image samples. The dataset contains 3,297 dermoscopic images with benign and malignant categories. The results show improvement in performance with an accuracy of 88% and an F1 score of 87%, outperforming other existing models such as support vector machine (SVM), Residual network (ResNet50), EfficientNetB0, EfficientNetB4, and VGG16.

Keywords: deep learning - VGG16 - efficientNet - CNN – ensemble – dermoscopic images - melanoma

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Authors: Pouya Khaleghi

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Dental implants are a successful treatment modality for restoring both function and aesthetics. Dental implant treatment has predictive results in the replacement of the lost teeth and has a high success rate even in the long term. The most important factor which is responsible for the positive course of implant treatment is the process of osseointegration between the implant structure and the host’s bone tissue. During recent years, many studies have focused on surgical and prosthetic factors, as well as the implant-related factors. However, implant failure still occurs despite the improvements that have led to the increased survival rate of dental implants, which suggests the possible role of some host-related risk factors. Vitamin D is a fat-soluble vitamin regulating calcium and phosphorus metabolism in tissues. The role of vitamin D in bone healing has been under investigation for several years. Vitamin D deficiency has also been associated with impaired and delayed callus formation and fractures healing; however, the role of vitamin D has not been clarified. Therefore, it is extremely important to study the phenomenon of a connection formed between bone tissue and the surface of a titanium implant and find correlations between the 25- hydroxycholecalciferol concentration in blood serum and the course of osseointegration. Because the processes of bone remodeling are very dynamic in the period of actual osseointegration, it is necessary to obtain the correct concentration of vitamin D3 metabolites in blood serum. In conclusion, the correct level of 25-hydroxycholecalciferol on the day of surgery and vitamin D deficiency treatment have a significant influence on the increase in the bone level at the implant site during the process of osseointegration assessed radiologically.

Keywords: implant, osseointegration, vitamin d, dental

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Authors: Aleksandra Twarda, Dobrosława Krzemień, Grzegorz Dubin, Tad A. Holak

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Stabilin-2 belongs to the group of scavenger receptors and plays a crucial role in clearance of more than 10 ligands from the bloodstream, including hyaluronic acid, products of degradation of extracellular matrix and metabolic products. The Link domain, a defining feature of stabilin-2, has a sequence similar to Link domains in other hyaluronic acid receptors, such as CD44 or TSG-6, and is responsible for most of ligands binding. Present knowledge of signal transduction by stabilin-2, as well as ligands’ recognition and binding mechanism, is limited. Until now, no experimental structures have been solved for any segments of stabilin-2. It has recently been demonstrated that the stabilin-2 knock-out or blocking of the receptor by an antibody effectively opposes cancer metastasis by elevating the level of circulating hyaluronic acid. Moreover, loss of expression of stabilin-2 in a peri-tumourous liver correlates with increased survival. Solving of the crystal structure of stabilin-2 and elucidation of the binding mechanism of hyaluronic acid could enable the precise characterization of the interactions in the binding site. These results may allow for designing specific small-molecule inhibitors of stabilin-2 that could be used in cancer therapy. To carry out screening for crystallization of stabilin-2, we cloned constructs of the Link domain of various lengths with or without surrounding domains. The folding properties of the constructs were checked by nuclear magnetic resonance (NMR). It is planned to show the binding of hyaluronic acid to the Link domain using several biochemical methods, i.a. NMR, isothermal titration calorimetry and fluorescence polarization assay.

Keywords: stabilin-2, Link domain, X-ray crystallography, NMR, hyaluronic acid, cancer

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Authors: Osama Al-Sehail

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This paper argues for sustainability as a necessity in the evolution of tall architecture. It provides a different mode for dealing with sustainability in tall architecture, taking into consideration the speciality of its typology. To this end, the article develops a Biomimetic Structural Form as a paradigm to attain Vital Sustainability. A Biomimetic Structural Form, which is derived from the amalgamation of biomimicry as an approach for sustainability defining nature as source of knowledge and inspiration in solving humans’ problems and a Structural Form as a catalyst for evolving tall architecture, is a dynamic paradigm emerging from a conceptualizing and morphological process. A Biomimetic Structural Form is a flow system whose different forces and functions tend to be “better”, more "fit", to “survive”, and to be efficient. Through geometry and function—the two aspects of knowledge extracted from nature—the attributes of the Biomimetic Structural Form are formulated. Vital Sustainability is the survival level of sustainability in natural systems through which a system enhances the performance of its internal working and its interaction with the external environment. A Biomimetic Structural Form, in this context, is a medium for evolving tall architecture to emulate natural models in their ways of coexistence with the environment. As an integral part of this article, the sustainable super tall building 3Ts is discussed as a case study of applying Biomimetic Structural Form.   

Keywords: biomimicry, design in nature, high-rise buildings, sustainability, structural form, tall architecture, vital sustainability

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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Authors: Hakim Bachiri, Mohammed Znari, Moulay Abdeljalil Ait Baamranne

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Population characteristics of Atlas Barbary sheep (Ammotragus lervia lervia) were investigated 20 years following the 1999 introduction of 10 individuals into the fenced nature reserve of Amassine, High Atlas range, Morocco, for promoting wildlife watching and tourism. Population age-sex structure and density were determined in late winter-early spring during four consecutive years (2016-2019) by direct observation before the dispersal of the herd. In this latter case, the line transect distance sampling was successfully applied. Population size increased from 37 to 62 animals during the four-year study period; the maximal population size being 82 individuals recorded in 2006. An estimated population density ranged from 0.25 to 0.41 Barbary sheep/ha during the study period. The adult sex ratio varied from 91 to 67 per 100 females. The apparent birth rate was 14 to 73/100 females. Juveniles and subadults comprised 27-43% of the population, adult males 26-31% and adult females 29-45%. The survival rate from birth to 1 year of age approximated 35%, for adult males was estimated to average 69%/year. The obtained results would be helpful for developing sustainable population management and habitat restoration plan and assessing the feasibility of potential reintroduction/restocking in other areas of the Atlas range.

Keywords: atlas mountains, barbary sheep, demography, management

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Authors: Seyed Abdolreza Mosavi, Alireza Babakhan, Elham Sadat Hoseinifard

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Knowledge-based firms need to design mechanisms for continuous absorptive and creation of knowledge in order to ensure their survival in the competitive arena and to follow the path of development. Considering the project-oriented nature of product development activities in knowledge-based firms on the one hand and the importance of analyzing the factors affecting knowledge absorptive capacity in these firms on the other, the purpose of this study is to identify and classify the factors affecting project management practices on absorptive knowledge capacity. For this purpose, we have studied and reviewed the theoretical literature in the field of project management and absorptive knowledge capacity so as to clarify its dimensions and indexes. Then, using the ISM method, the relationship between them has been studied. To collect data, 21 questionnaires were distributed in project-oriented knowledge-based companies. The results of the ISM method analysis provide a model for the relationship between project management activities and knowledge absorptive capacity, which includes knowledge acquisition capacity, scope management, time management, cost management, quality management, human resource management, communications management, procurement management, risk management, stakeholders management and integration management. Having conducted the MICMAC analysis, we divided the variables into three groups of independent, relational and dependent variables and came up with no variables to be included in the group of autonomous variables.

Keywords: knowledge absorptive capacity, project management practices, knowledge-based firms, interpretive structural modeling

Procedia PDF Downloads 197

Authors: Sarah Hamdan Al-Jahdali, Khaled Alsaad, Abdullah Al-Sayyari

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Objectives: To study the prevalence, clinicopathological features, risk factors and outcome of biopsy proven polyoma (BK) virus infection among Saudi kidney transplant recipients and compare them to negative BK virus group. Methods: We retrospectively reviewed the charts of all the patients with biopsy-proven polyoma (BK) virus infection in King Abdulaziz Medical City in Riyadh between 2005 and 2011. The details of clinical presentation, the indication for kidney biopsy, the laboratory findings at presentation, the natural history of the disease, thepathological findings, the prognosis as well as the response to therapy were all recorded. Results: Kidney biopsy was performed in 37 cases of unexplained graft dysfunction. BK virus was found in 10 (27%). Out of those 10, 3 (30%) ended with graft failure. BK virus occurred in all patients who received ATG induction therapy 100% versus 59.3% in the non BK virus patients (p=0.06). Furthermore, the risk of BK virus was much less in those who received acyclovir as an anti-viral prophylaxis as compared to those who did not receive it (p=0.01). Also, patients with BK virus weighed much less (mean 46.7±20.6 Kgs) than those without BK virus at time of transplantation (mean 64.3±12.1). Graft survival was better among deceased donor kidneys compared to living ones (P=0.016) and with older age (P=0.005). Conclusion: Our findings suggest the involvement of ATG induction therapy, the lack of antiviral prophylaxis therapy and lower weight at transplant as significant risk factors for the development of BK virus infection.

Keywords: BKVAN, BKV, kidney transpant, Saudi Arabia

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Authors: Amira, A. Goma, U. E. Mahrous

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Welfare may be considered to be a subjective experience; it has a biological function that is related to the fitness and survival of the animal accordingly, researches have suggested that welfare is compromised when the animal's evolutionary fitness is reduced. This study was carried out to explain the effect of some managerial stressors as handling and restraint on behavioral patterns and biochemical parameters of rats. A total of 24 (12 males and 12 females) Sprague-Dawley rats (12 months and 150-180g) were allotted into 3 groups, handled group (4 male and 4 female), restrained group (4 male and 4 female) and control group (4 males and 4 females). The obtained results revealed that time spent feeding, drinking frequency, movement and cage exploration increased significantly in handled rats than other groups, while lying time and licking increased significantly in restrained rats than handled and controls. Moreover, social behavior decreased in both stressed groups than control. Triglycerides were significantly increased in handled rats than other groups, while total lipid, total protein and globulin significantly increased in both treated groups than control. Corticosterone increased in restrained and handled rats than control ones. Moreover, there was an increment in packed cell volume significantly in restrained rats than others. These deducted that if we want to study the effect of stress on animal welfare it is necessary to study the effect of such stressors on animal’s behavior and physiological responses.

Keywords: handling, restraint, welfare, rat, behavior, physiology

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Authors: Rohit Singh Dangi, Ravi Kant Pal, Monica Sundd

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Acyl-CoA binding protein (ACBP) is a housekeeping protein which functions as an intracellular carrier of acyl-CoA esters. Given the fact that the amastigote stage (blood stage) of Leishmania depends largely on fatty acids as the energy source, of which a large part is derived from its host, these proteins might have an important role in its survival. In Leishmania major, genome sequencing suggests the presence of six ACBPs, whose function remains largely unknown. For functional and structural characterization, one of the ACBP genes was cloned, and the protein was expressed and purified heterologously. Acyl-CoA ester binding and stoichiometry were analyzed by isothermal titration calorimetry and Dynamic light scattering. Our results shed light on high affinity of ACBP towards longer acyl-CoA esters, such as myristoyl-CoA to arachidonoyl-CoA with single binding site. To understand the binding mechanism & dynamics, Nuclear magnetic resonance assignments of this protein are being done. The protein's crystal structure was determined at 1.5Å resolution and revealed a classical topology for ACBP, containing four alpha-helical bundles. In the binding pocket, the loop between the first and the second helix (16 – 26AA) is four residues longer from other extensively studied ACBPs (PfACBP) and it curls upwards towards the pantothenate moiety of CoA to provide a large tunnel space for long acyl chain insertion.

Keywords: acyl-coa binding protein (ACBP), acyl-coa esters, crystal structure, isothermal titration, calorimetry, Leishmania

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Authors: Yao Song, Danni Cheng, Jianjun Ren

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Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.

Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR

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Authors: J. Gonzalez, P. Jimenez, C. Isaza

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Palms have different characteristics that make them vulnerable; that is the case of the Chamaedorea linearis, with the presence of solitary stems of small diameter and medium leaves, culturally harvested, and in religious festivities used. Additionally, they present a weak apical meristem as the only emergency point, slow development and growth, and an affectation due to the high rate of deforestation in Colombia. Propagation of this species can improve the pressure on wild populations and help their survival in the environment. In this study was used in 177 plants biosolids humus from the Wastewater Treatment Plant (WWTP), located at the UMNG Campus Cajica (Cundinamarca, Colombia). The experiment used a control and two treatments with 10% and 20% of humus. During the process, the variables evaluated were number of leaves, percentage of chlorophyll, stem length, and estimated leaf area. The data set were taking during 14 weeks before the reproductive maturity, evidencing that the most representative development of the palms was in the treatment of 20%, plants in this treatment presented major number of leaves, larger stems, a high quantity of chlorophyll, and was a first treatment that present pinnate leaves them represent an important point in maturity process. The research gives an opportunity to improve times of growth in another species of palms and plants (Product result from INV ING 2986 UMNG).

Keywords: biosolids, humus, growth, palms, wastewater treatment plant, WWTP

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Authors: Mrunmayee Das

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This study aims to explore the film 'Pyasa' directed by actor-director Guru Dutt, filmed during the 1950’s golden age of Hindi cinema. 'Pyasa' was filmed after a decade of India being a new nation and narrates the world-view of a poet dressed in western ideals, tasting modernity, uprooted from his familial and social moorings causing friction of being between survival and self- expression. The research is based on literature review to study the attitudes, particularly the post-colonial, informing the film. In terms of the structure, the relational study of the film and the historical background of that time came first. Further explorations deal with the use of image making, dialogue, and poetry in the form of songs facilitating the central theme of the human plight of poverty, not of material but of thought. The literature review establishes Dutt’s style of expressing melodic melodrama through a dance between light and shadow majorly in the form of song sequences signifying the greys of the society. It was found in this research that melodrama is created by the changing contrasts and use of close-ups. The song sequences convey the tensions of being a contemporary liberal educated youth and having to deal with the societal-ills of this world, which highlights the theme of compulsion towards self-destruction. It is concluded that Dutt’s 'Pyasa' is a autobiographical commentary on the state of a nation doing away with a borrowed identity and refashioning its own.

Keywords: cinema, Guru Dutt, post-colonial India, self-expression

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Authors: Awais Naeem, Osama Shakeel, Faizan Ullah, Abdul Wahid Anwer

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Introduction: To study the clinic-pathological factors, diagnostic factors and survival of extra-pulmonary small cell carcinoma. Methodology: From 1995 to 2017 all patients with a diagnosis of extra-pulmonary small cell carcinoma were included in the study. Demographic variables and clinic-pathological factors were collected. Management of disease was recorded. Short and long term oncological outcomes were recorded. All data was entered and analyzed in SPSS version 21. Results: A total of 14 patients were included in the study. Median age was 53.42 +/- 16.1 years. There were 5 male and 9 female patients. Most common presentation was dysphagia in 16 patient among esophageal small cell carcinoma and while other patient had pain in abdomen. Mean duration of symptoms was 4.23+/-2.91 months .Most common site is esophagus (n=6) followed by gall bladder(n=3). Almost all of the patients received chemo-radiotherapy. Majority of the patient presented with extensive disease. Five patients (35.7%) died during the follow up period, two (14.3%) were alive and rest of the patients were lost to follow up. Mean follow up period was 22.92 months and median follow up was 15 months. Conclusion: Extra-pulmonary small cell carcinoma is rare and needs to be managed aggressively. All patients should be treated with both systemic and local therapies.

Keywords: small cell carcinoma of esophagus, extrapulmonary small cell carcinoma, small cell carcinoma of gall bladder, small cell carcinoma of rectum, small cell carcinoma of stomach

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Authors: Bankole Wright

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The late 20th to the early 21st century has been predominantly characterized by the movement of individuals from one country to another country or countries. The chief reasons for migration have always been premised on socio-cultural, socio-political and socio-economic factors, with influences of migration finding expression through various ways. Indeed, migration experiences have formed points of subjectivity which functions as agencies that propel migrants to strongly quest for migrating from their home space to other socio-cultural space that performs the role of escape for them. This paper interrogates the discourse of migration, agency and subjectivity in Helon Habila’s Travellers. The essay explores the interconnectedness between migration which is the physical [as deployed in this paper] movement from one location to another, agency as seen in the ability to act based on various ideological frameworks within which the action is taken, and subjectivity which identifies with the predominant factors that influence human actions; and how these connections are responsible for defining the diaspora individual. The discourse of what makes migrants desire to move from their various spaces is as critical as the experiences they face in their various host land. Hence, this paper demonstrates, through the analysis of an African diasporic novel, that the quest for migration is mostly determined by certain agencies in the diaspora home space, which characters have been subjects of and desire to escape. Traveller is a novel which chronicles the various experiences of migrants who journey from their various home space to another land as a result of different agencies that precipitated their migration. This paper engages these agencies as impediments to human survival.

Keywords: migration, agency, subjectivity, Helon Habila, diaspora, home, space

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Authors: Rika Uchida

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In teaching sophomore level aural skills, I have dealt with students with absolute pitch do poorly in my courses, particularly in harmonic dictation. They can identify triads; however, identifying quality of seventh chords or chromatic chords poses serious challenges. Most often, they need to spell all the pitches before identifying the chord qualities and Roman Numerals. Growing up in a country where acquiring absolute pitch is considered essential, I started my early music training with fixed do system at age three and learned all my music with solfege. When I was assigned as a TA in aural skills courses at graduate school in US, I had to learn relative pitch quickly. My survival method was listening to music with absolute pitch first, then quickly "translate" to relative pitch. In teaching my courses, I have been using chord progressions (5-8 chords total), in which students are asked to sing chord arpeggiation with movable do solfege. I use same progressions for harmonic dictation; I hoped that students learn to incorporate singing and listening skills by overlapping same materials. This method has proven to be successful for most students; in particular, it has helped students with absolute pitch to hear chord quality and function. Although original progressions are written in C as a tonic, they can identify chords in harmonic dictation in other keys as well. In short, I believe singing chord progression with movable do arpeggiation helps students with absolute pitch to improve hearing function and quality of chords in harmonic dictation.

Keywords: aural skills pedagogy, music theory, absolute pitch, harmonic dictation

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Authors: Imali T. Jayamanne, K. P. Asoka Ramanayake

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Transition from tertiary level education to employment is one of the challenges that many fresh university graduates face after graduation. The transition period or the waiting time to obtain the first employment varies with the socio-economic factors and the general characteristics of a graduate. Compared to other fields of study, Arts graduates in Sri Lanka, have to wait a long time to find their first employment. The objective of this study is to identify the determinants of the transition from higher education to employment of these graduates using survival models. The study is based on a survey that was conducted in the year 2016 on a stratified random sample of Arts graduates from Sri Lankan universities who had graduated in 2012. Among the 469 responses, 36 (8%) waiting times were interval censored and 13 (3%) were right censored. Waiting time for the first employment varied between zero to 51 months. Initially, the log-rank and the Gehan-Wilcoxon tests were performed to identify the significant factors. Gender, ethnicity, GCE Advanced level English grade, civil status, university, class received, degree type, sector of first employment, type of first employment and the educational qualifications required for the first employment were significant at 10%. The Cox proportional hazards model was fitted to model the waiting time for first employment with these significant factors. All factors, except ethnicity and type of employment were significant at 5%. However, since the proportional hazard assumption was violated, the lognormal Accelerated failure time (AFT) model was fitted to model the waiting time for the first employment. The same factors were significant in the AFT model as in Cox proportional model.

Keywords: AFT model, first employment, proportional hazard, survey design, waiting time

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Authors: Mohhamed El Habib Labdouni

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Introduction: Co-infection with VIH and tuberculosis poses one of the major ongoing challenges for global TB and AIDS prevention and control. The objective of this study is to raise the issue of the resurgence of TB, in People living with VIH supported in a referent center in western Algeria. Its epidemiological, clinical, biological and radiological new trends, and to compare the mortality rate between early and delayed ART. Methods: It was a prospective study, during 36 months from the 01st/01/2012 to 31st/12/2014, by identifying and analyzing cases of TB-VIH co-infection. Our population was devised in two groups/ early ART and delayed ART. The primary and secondary endpoints were analyzed with Kaplan-Meier curves and log-rank test the period of follow up, which was fixed at 300 weeks. Results: Sixty cases of co-infection TB -VIH were enrolled in our study: 78.3% had pulmonary tuberculosis associated with extra-pulmonary, 13.3% had only pulmonary tuberculosis and 08.3% presented strictly extra-pulmonary TB. The clinical particularity of this co-infection is the frequency of serious localization such us: pleural 23.3%, peritoneal 31.7%, and meningeal suffusion 13.3%.y-.biologicaly we notice the predominance both of pancytopenia and leucoanemia, hyponatremia in 38,6% and hypokalemia in 19,3%. By analyzing Kaplan-Meier survival curves, we notice that early ART initiation is associated with a significant reduction of all-cause mortality (p = 0,000), and we have identified several prognostic factors such as hypokalemia hyponatremia, leukocytosis thrombopenemia leucothrombopenia (p = 0,005). Conclusion: Our study confirms most of the results reported in the literature. Early ART initiation reduces the rate of all-cause mortality, despite the probability of the occurrence of TB-IRIS.

Keywords: TB-HIV co-infection, early ART, hyponatremia, extrapulmonary tuberculosis

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Authors: Mohadeseh Shojaei Shahrokhabadi, Ding-Geng (Din) Chen

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Positive continuous outcomes with a substantial number of zero values and incomplete longitudinal follow-up are quite common in medical cost data. To jointly model semi-continuous longitudinal cost data and survival data and to provide marginalized covariate effect estimates, a marginalized two-part joint model (MTJM) has been developed for outcome variables with lognormal distributions. In this paper, we propose MTJM models for outcome variables from a generalized gamma (GG) family of distributions. The GG distribution constitutes a general family that includes approximately all of the most frequently used distributions like the Gamma, Exponential, Weibull, and Log Normal. In the proposed MTJM-GG model, the conditional mean from a conventional two-part model with a three-parameter GG distribution is parameterized to provide the marginal interpretation for regression coefficients. In addition, MTJM-gamma and MTJM-Weibull are developed as special cases of MTJM-GG. To illustrate the applicability of the MTJM-GG, we applied the model to a set of real electronic health record data recently collected in Iran, and we provided SAS code for application. The simulation results showed that when the outcome distribution is unknown or misspecified, which is usually the case in real data sets, the MTJM-GG consistently outperforms other models. The GG family of distribution facilitates estimating a model with improved fit over the MTJM-gamma, standard Weibull, or Log-Normal distributions.

Keywords: marginalized two-part model, zero-inflated, right-skewed, semi-continuous, generalized gamma

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Authors: Feng-Tsung Cheng, Shu-Li Wang, Mei-Fang Wu, , Hui-Yu Chuang

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Due to the rapid development of modern technology, the widespread usage of the Internet makes business environment changing quickly. In order to be a leader in the global competitive market and to pursuit survive, “changing” becomes an unspoken rules need to follow for the company survival. The purpose of this paper is to build change model by using SWOT, strategy map, and balance scorecard, KPI and change management theory. The research findings indicate that organizational change plan formulated by the case company should require the employee to resist change factors and performance management system issues into consideration and must be set organizational change related programs, such as performance appraisal reward system, consulting and counseling mechanisms programs to improve motivation and reduce staff negative emotions. Then according to the model revised strategy maps and performance indicators proposed in this paper, such as strategy maps add and modify corporate culture, improve internal processes management, increase the growth rate of net income and other strategies. The performance indicators are based on strategy maps new and modified by adding net income growth rate, to achieve target production rate, manpower training achievement rates and other indicators, through amendments to achieve the company’s goal, be a leading brand of precision machinery industry.

Keywords: organizational change, SWOT analysis, strategy maps, performance indicators

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Authors: Christiana Jonut

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The study addresses tagal as an ecotourism product that is uniquely for Sabah. It is a community based tourism venture that is influenced by the Dusun ethic’s traditional law. The traditional principle of tagal is focused primarily on individual exploitation of riverine resources and it was transformed into a community participation in the riverine conservation to foster the growth or survival of ecotourism. It manages a river into a sustainable manner. A smart partnership system between the community and the authority particularly the Department of Fisheries Sabah, tagal has successfully become an instrument to protect, revive and manage the river fish resources. In 2015, Sabah Fisheries Department added 536 tagal sites. Most tagal sites were turned into a community based tourism venture. They generate income through jobs creation for the purpose of uplifting the local’s economic level. Tagal ecotourism sites also increase environmental awareness of the local people to love their culture, tradition and environment. This venture also promotes the sustainability of the eco-tourism. The objective of this study is to explore the issues and contexts of empowerment of the local people in managing a successful tagal ecotourism. This study further explains how community capacity building is the major influence of empowerment of the local community. The methodology approach used is qualitative where interview is chosen as the data collection method. This is a literature review of exploring empowerment of the local community through various community capacity building initiatives that would motivate the local people to be actively involved in the tagal.

Keywords: capacity building, Tagal, ecotourism, empowerment, Sabah

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Authors: Mamta Rajbhar, Sanjay K. Mohanty

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India's progress in achieving replacement level of fertility is largely contingent on fertility reduction in the state of Uttar Pradesh as it accounts 17% of India's population with a low level of development. Though the TFR in the state has declined from 5.1 in 1991 to 3.4 by 2011, it conceals large differences in fertility level across districts. Using data from multiple sources this paper tests the hypothesis that the improvement in human development significantly reduces the fertility levels in districts of Uttar Pradesh. The unit of analyses is district, and fertility estimates are derived using the reverse survival method(RSM) while human development indices(HDI) are are estimated using uniform methodology adopted by UNDP for three period. The correlation and linear regression models are used to examine the relationship of fertility change and human development indices across districts. Result show the large variation and significant change in fertility level among the districts of Uttar Pradesh. During 1991-2011, eight districts had experienced a decline of TFR by 10-20%, 30 districts by 20-30% and 32 districts had experienced decline of more than 30%. On human development aspect, 17 districts recorded increase of more than 0.170 in HDI, 18 districts in the range of 0.150-0.170, 29 districts between 0.125-0.150 and six districts in the range of 0.1-0.125 during 1991-2011. Study shows significant negative relationship between HDI and TFR. HDI alone explains 70% variation in TFR. Also, the regression coefficient of TFR and HDI has become stronger over time; from -0.524 in 1991, -0.7477 by 2001 and -0.7181 by 2010. The regression analyses indicate that 0.1 point increase in HDI value will lead to 0.78 point decline in TFR. The HDI alone explains 70% variation in TFR. Improving the HDI will certainly reduce the fertility level in the districts.

Keywords: Fertility, HDI, Uttar Pradesh

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Authors: Rajnish Gourh, Nitesh Sharma, Nikhil Patil

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Introduction: Adequate nutrition is essential for improving pregnancy and its outcomes. Failure to comply with the required daily intake of nutrition can lead to complications threatening both mother and child survival. Objectives: To provide access to nutritious diet to mothers in antenatal and post-natal stage for supporting a healthy progressive pregnancy, positive delivery outcome, and lactation and to promote regular consumption of the foods by the mothers and help overcome the dietary gap by nutrition education during pregnancy time. Methodology: Total of 95 ANC mothers were identified from Malvada PHC area, in Palghar district of Maharashtra. This short-term cohort intended for the proposed supplementation and education was targeted for follow-up until birth and six-months of post-natal period. In month of May 2016 to June 2017. Results: Average weight of women was observed 40.01kg, (SD- 5.024) at registered for ANC at Centre in the first month. In same month, average Haemoglobin level of women was observed 9.13gm/dl. Average increase in weight of women during pregnancy in month October 2016 was 48.83kg. Birth weight of 14 babies was less than 2 kgs. 13 babies with birth weight in range of 2.1kgs to 2.4kgs. 68 babies with birth weight in range of 2.5kg to 3kg and above. Conclusion: Importance of consumption of food, improving levels of nutrient intake and outcome of delivery was excellent.

Keywords: delivery status, nutrition, pregnancy, education

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Authors: Guity Karim, Valiollah Ayareh

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Probiotic dairy products are those that contain biologically active components that may affect beneficially one or more target functions in the body, beyond their adequate nutritional effects. As far as chocolate milk is a popular dairy product in the country especially among children and youth, production of a symbiotic (probiotic + peribiotic) new product using chocolate milk, Bifidobacterium lactis (DSM, Netherland) and inulin (Bene, Belgium) would help to promote the nutritional and functional properties of this product. Bifidobacterium Lactis is used as a probiotic in a variety of foods, particularly dairy products like yogurt and as a probiotic bacterium has benefit effects on the human health. Inulin as a peribiotic agent is considered as functional food ingredient. Experimental studies have shown its use as bifidogenic agent. Chocolate milk with different percent of fat (1 and 2 percent), 6 % of sugar and 0.9 % cacao was made, sterilized (UHT) and supplemented with Bifidobacterium lactis and inulin (0.5 %) after cooling . A sample was made without inulin as a control. Bifidobacterium lactis population was enumerated at days 0, 4, 8 and 12 together with measurement of pH, acidity and viscosity of the samples. Also sensory property of the product was evaluated by a 15 panel testers. The number of live bacterial cells was maintained at the functional level of 106-108 cfu/ml after keeping for 12 days in refrigerated temperature (4°C). Coliforms were found to be absent in the products during the storage. Chocolate milk containing 1% fat and inulin has the best effect on the survival and number of B. lactis at day 8 and after that. Moreover, the addition of inulin did not affect the sensorial quality of the product. In this work, chocolate has been evaluated as a potential protective carrier for oral delivery of B. lactis and inulin.

Keywords: chocolate milk, synbiotic, bifidobacterium lactis, inulin

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Authors: Eunhye Cho, Hyuk-Hoon Kim, Sieun Lee, Minjung Kathy Chae

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Introduction: I-gel is a commonly used supraglottic advanced airway device in prehospital out-of-hospital cardiac arrest (OHCA) allowing for minimal interruption of continuous chest compression. However, previous studies have shown that prehospital supraglottic airway had inferior neurologic outcomes and survival compared to no advanced prehospital airway with conventional bag mask ventilation. We hypothesize that continuous compression with i-gel as an advanced airway may cause insufficient ventilation compared to 30:2 chest compression with conventional BVM. Therefore, we investigated the ventilation efficacy of i-gel with the initial arterial blood gas analysis in OHCA patients visiting our ER. Material and Method: Demographics, arrest parameters including i-gel insertion, initial arterial blood gas analysis was retrospectively analysed for 119 transported OHCA patients that visited our ER. Linear regression was done to investigate the association with i-gel insertion and initial pCO2 as a surrogate of prehospital ventilation. Result: A total of 52 patients were analysed for the study. Of the patients who visited the ER during OHCA, 24 patients had i-gel insertion and 28 patients had BVM as airway management in the prehospital phase. Prehospital i-gel insertion was associated with the initial pCO2 level (B coefficient 29.9, SE 10.1, p<0.01) after adjusting for bystander CPR, cardiogenic cause of arrest, EMS call to arrival. Conclusion: Despite many limitations to the study, prehospital insertion of i-gel was associated with high initial pCO2 values in OHCA patients visiting our ER, possibly indicating insufficient ventilation with prehospital i-gel as an advanced airway and continuous chest compressions.

Keywords: arrest, I-gel, prehospital, ventilation

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Authors: Hatem Radwan Ibrahim Radwan

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Leadership is crucial for hotel survival and success. It enables hotels to develop and compete effectively. This research intends to explore the implementation of six leadership styles by frontline hotel managers in four star hotels in Cairo and assess its impact on employees’ creativity and organizational commitment. The leadership patterns considered in this study includes: democratic, autocratic, laissez-faire, transformational, transactional, and ethical leaderships. Questionnaire was used as a research method to gather data. A structured survey was established and distributed on employees in Cairo’s four star hotels. A total of 284 questionnaire forms were returned and usable for statistical analysis. The results of this study identified that transactional and autocratic leadership were the prevalent styles used in four star hotels in Cairo. Two leadership styles proved to have significant high correlation and impact on employees’ creativity and organizational commitment including: transformational and democratic leadership. Besides, laissez-faire leadership was found had a smaller effect on employees’ creativity and ethical leadership had a lesser influence on employees’ commitment. The autocratic leadership had strong negative correlation and significant impact on both dependent variables. This research concludes that frontline hotel managers should adopt transformational and/or democratic leadership style in managing their subordinates.

Keywords: creativity, hotels, leadership styles, organizational commitment

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Authors: Janis Zarins, Kristaps Blums, Oskars Radzins, Renars Deksnis, Atis Svare, Santa Salaka

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Wide tumor resection remains the first choice method for tumors of the oral cavity. Nevertheless, remained tissue defect impacts patients functional and aesthetical outcome, which could be improved using microvascular tissue transfers. Mandibular reconstruction is challenging due to the complexity of composite tissue defects and occlusal relationships for normal eating, chewing, and pain free jaw motions. Individual 3-D virtual planning would provide better symmetry and functional outcome. The main goal of preoperative planning is to develop a customized surgical approach with patient specific cutting guides of the mandible, osteotomy guides of the fibula, pre-bended osteosynthesis plates to perform more precise reconstruction, to decrease the surgery time and reach the best outcome. Our study is based on the analysis of 32 patients operated on between 2019 to 2021. All patients underwent mandible reconstruction with vascularized fibula flaps. Patients characteristics, surgery profile, survival, functional outcome, and quality of life was evaluated. Preoperative planning provided a significant decrease of surgery time and the best arrangement of bone closely similar as before the surgery. In cases of bone asymmetry, deformity and malposition, a new mandible was created using 3D planning to restore the appearance of lower jaw anatomy and functionality.

Keywords: mandibular, 3D planning, cutting guides, fibula flap, reconstruction

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