Search results for: acquired%20brain%20injury

Authors: Thomas Louis, Irina Primac, Florent Morfoisse, Tania Durre, Silvia Blacher, Agnes Noel

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In vitro and in vivo lymphangiogenesis assays are essential for the identification of potential lymphangiogenic agents and the screening of pharmacological inhibitors. In the present study, we analyse three biological models: in vitro lymphatic endothelial cell spheroids, in vivo ear sponge assay, and in vivo lymph node colonisation by tumour cells. These assays provide suitable 3D models to test pro- and anti-lymphangiogenic factors or drugs. 3D images were acquired by confocal laser scanning and light sheet fluorescence microscopy. Virtual scan microscopy followed by 3D reconstruction by image aligning methods was also used to obtain 3D images of whole large sponge and ganglion samples. 3D reconstruction, image segmentation, skeletonisation, and other image processing algorithms are described. Fixed and time-lapse imaging techniques are used to analyse lymphatic endothelial cell spheroids behaviour. The study of cell spatial distribution in spheroid models enables to detect interactions between cells and to identify invasion hierarchy and guidance patterns. Global measurements such as volume, length, and density of lymphatic vessels are measured in both in vivo models. Branching density and tortuosity evaluation are also proposed to determine structure complexity. Those properties combined with vessel spatial distribution are evaluated in order to determine lymphangiogenesis extent. Lymphatic endothelial cell invasion and lymphangiogenesis were evaluated under various experimental conditions. The comparison of these conditions enables to identify lymphangiogenic agents and to better comprehend their roles in the lymphangiogenesis process. The proposed methodology is validated by its application on the three presented models.

Keywords: 3D image segmentation, 3D image skeletonisation, cell invasion, confocal microscopy, ear sponges, light sheet microscopy, lymph nodes, lymphangiogenesis, spheroids

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Authors: Nadia Akbarpour

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Pancreatic ductal adenocarcinoma is a forceful and obliterating illness, which is portrayed by intrusiveness, fast movement, and significant protection from treatment. Advances in neurotic arrangement and malignant growth hereditary qualities have worked on our illustrative comprehension of this infection; be that as it may, significant parts of pancreatic disease science remain ineffectively comprehended. A superior comprehension of pancreatic disease science should lead the way to more viable medicines. In the course of the most recent couple of years, there have been significant advances in the sub-atomic and organic comprehension of pancreatic malignancy. This included comprehension of the genomic intricacy of the illness, the job of pancreatic malignant growth undifferentiated organisms, the importance of the growth microenvironment, and the one-of-a-kind metabolic transformation of pancreas disease cells to acquire supplements under hypoxic climate. Endeavors have been made towards the advancement of the practical answer for its treatment with compelled achievement due to its complicated science. It is grounded that pancreatic malignancy undifferentiated cells (CSCs), yet present in a little count, contribute extraordinarily to PC inception, movement, and metastasis. Standard chemo and radiotherapeutic choices, notwithstanding, grow general endurance, the connected aftereffects are a huge concern. In the midst of the latest decade, our understanding with regards to atomic and cell pathways engaged with PC and the job of CSCs in its movement has expanded massively. By and by, the center is to target CSCs. The natural items have acquired a lot of thought as of late as they, generally, sharpen CSCs to chemotherapy and target atomic flagging engaged with different cancers, including PC. Some arranged investigations have demonstrated promising outcomes recommending that assessments in this course bring a ton to the table for the treatment of PC. Albeit preclinical investigations uncovered the significance of natural items in lessening pancreatic carcinoma, restricted examinations have been led to assess their part in centers. The current survey gives another knowledge to late advances in pancreatic malignancy science, treatment, and the current status of natural items in its expectation.

Keywords: pancreatic, genomic, organic, cancer

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Authors: Elizabeth Howarth, Dawn Green, Sean Connolly, Geena Vabulas, Sara Smolley

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Through the EU Horizon 2020 Nuvoic Project, the project team recruited 70 individuals in the UK and Ireland to test the Voiceitt speech recognition app and provide user feedback to developers. The app is designed for people with dysarthric speech, to support communication with unfamiliar people and access to speech-driven technologies such as smart home equipment and smart assistants. Participants with atypical speech, due to a range of conditions such as cerebral palsy, acquired brain injury, Down syndrome, stroke and hearing impairment, were recruited, primarily through organisations supporting disabled people. Most had physical or learning disabilities in addition to dysarthric speech. The project team worked with individuals, their families and local support teams, to provide access to the app, including through additional assistive technologies where needed. Testing was user-led, with participants asked to identify and test use cases most relevant to their daily lives over a period of three months or more. Ongoing technical support and training were provided remotely and in-person throughout the testing period. Structured interviews were used to collect feedback on users' experiences, with delivery adapted to individuals' needs and preferences. Informal feedback was collected through ongoing contact between participants, their families and support teams and the project team. Focus groups were held to collect feedback on specific design proposals. User feedback shared with developers has led to improvements to the user interface and functionality, including faster voice training, simplified navigation, the introduction of gamification elements and of switch access as an alternative to touchscreen access, with other feature requests from users still in development. This work offers a case-study in successful and inclusive co-design with the disabled community.

Keywords: co-design, assistive technology, dysarthria, inclusive speech recognition

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Authors: Peter Fornaro, Lothar Schmitt

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The Digital Humanities Lab and the Institute of Art History at the University of Basel are collaborating in the SNSF research project ‘Digital Materiality’. Its goal is to develop and enhance existing methods for the digital reproduction of cultural heritage objects in order to support art historical research. One part of the project focuses on the visualization of a small eye-catching group of early prints that are noteworthy for their subtle reliefs and glossy surfaces. Additionally, this group of objects – known as ‘paste prints’ – is characterized by its fragile state of preservation. Because of the brittle substances that were used for their production, most paste prints are heavily damaged and thus very hard to examine. These specific material properties make a photographic reproduction extremely difficult. To obtain better results we are working with Reflectance Transformation Imaging (RTI), a computational photographic method that is already used in archaeological and cultural heritage research. This technique allows documenting how three-dimensional surfaces respond to changing lighting situations. Our first results show that RTI can capture the material properties of paste prints and their current state of preservation more accurately than conventional photographs, although there are limitations with glossy surfaces because the mathematical models that are included in RTI are kept simple in order to keep the software robust and easy to use. To improve the method, we are currently developing tools for a more detailed analysis and simulation of the reflectance behavior. An enhanced analytical model for the representation and visualization of gloss will increase the significance of digital representations of cultural heritage objects. For collaborative efforts, we are working on a web-based viewer application for RTI images based on WebGL in order to make acquired data accessible to a broader international research community. At the ICDH Conference, we would like to present unpublished results of our work and discuss the implications of our concept for art history, computational photography and heritage science.

Keywords: art history, computational photography, paste prints, reflectance transformation imaging

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Authors: May Khei Hu, Kevin Leong, Fu Siong Ng, Nicholas Peter

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Introduction: Sympathetic stimulation has been recognised as a potent stimulus of arrhythmogenesis in various cardiac pathologies, possibly by augmenting dispersion of repolarisation. The effects of sympathetic stimulation in healthy subjects however remain unclear. It is, therefore, crucial to first establish the effects of physiological stress on dispersion of repolarisation in healthy subjects before understanding these effects in pathological cardiac conditions. We hypothesised that activation-recovery interval (ARI; which is a surrogate of action potential duration) and dispersion of repolarisation decrease on sympathetic stimulation. Methods: Eight patients aged 18-55 years with structurally normal hearts underwent head-up tilt test (HUTT) and exercise tolerance test (ETT) while wearing the electrocardiographic imaging (ECGi) vest. Patients later underwent CT scan and the epicardial potentials are reconstructed using the ECGi software. Activation and recovery times were determined from the acquired electrograms. ARI was calculated and later corrected using Bazett’s formula. Global and regional dispersion of repolarisation were determined from standard deviation of the corrected ARI (ARIc). One-way analysis of variance (ANOVA) and Wilcoxon test were used to evaluate statistical significance. Results: Global ARIc increased significantly [p<0.01] when patients were tilted upwards but decreased significantly after five minutes [p<0.01]. A subsequent post- hoc analysis revealed that the decrease in R-R was more substantial compared to the change in ARI, resulting in the observed increase in ARIc. Global ARIc decreased on peak exercise [p<0.01] but increased on recovery [p<0.01]. Global dispersion increased significantly on peak exercise [p<0.05] although there were no significant changes in regional dispersion. There were no significant changes in both global and regional dispersion during tilt. Conclusion: ARIc decreases upon sympathetic stimulation in healthy subjects. Global dispersion of repolarisation increases upon exercise although there were no changes in global or regional dispersion during orthostatic stress.

Keywords: dispersion of repolarisation, sympathetic stimulation, Head-up tilt test (HUTT), Exercise tolerance test (ETT), Electrocardiographic imaging (ECGi)

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Authors: Wen Zhen

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Compared to content words, function words have been relatively overlooked by English learners especially articles. The article system, to a certain extent, becomes a resistance to know English better, driven by different elements. Three principal factors can be summarized in term of the nature of the articles when referring to the difficulty of the English article system. However, making the article system more complex are difficulties in the second acquisition process, for [-ART] learners have to create another category, causing even most non-native speakers at proficiency level to make errors. According to the sequences of acquisition of the English article, it is showed that the zero article is first acquired and in high inaccuracy. The zero article is often overused in the early stages of L2 acquisition. Although learners at the intermediate level move to underuse the zero article for they realize that the zero article does not cover any case, overproduction of the zero article even occurs among advanced L2 learners. The aim of the study is to investigate noun-phrase factors which give rise to incorrect usage or overuse of the zero article, thus providing suggestions for L2 English acquisition. Moreover, it enables teachers to carry out effective instruction that activate conscious learning of students. The research question will be answered through a corpus-based, data- driven approach to analyze the noun-phrase elements from the semantic context and countability of noun-phrases. Based on the analysis of the International Thurber Thesis corpus, the results show that: (1) Although context of [-definite,-specific] favored the zero article, both[-definite,+specific] and [+definite,-specific] showed less influence. When we reflect on the frequency order of the zero article , prototypicality plays a vital role in it .(2)EFL learners in this study have trouble classifying abstract nouns as countable. We can find that it will bring about overuse of the zero article when learners can not make clear judgements on countability altered from (+definite ) to (-definite).Once a noun is perceived as uncountable by learners, the choice would fall back on the zero article. These findings suggest that learners should be engaged in recognition of the countability of new vocabulary by explaining nouns in lexical phrases and explore more complex aspects such as analysis dependent on discourse.

Keywords: noun phrase, zero article, corpus, second language acquisition

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Authors: Valeria Aman

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The presented study examines the impact of international mobility on knowledge production among mobile scientists and within the sending and receiving research groups. Scientists are relevant to the dynamics of knowledge production because scientific knowledge is mainly characterized by embeddedness and tacitness. International mobility enables the dissemination of scientific knowledge to other places and encourages new combinations of knowledge. It can also increase the interdisciplinarity of research by forming synergetic combinations of knowledge. Particularly innovative ideas can have their roots in related research domains and are sometimes transferred only through the physical mobility of scientists. Diversity among scientists with respect to their knowledge base can act as an engine for the creation of knowledge. It is therefore relevant to study how knowledge acquired through international mobility affects the knowledge production process. In certain research domains, international mobility may be essential to contextualize knowledge and to gain access to knowledge located at distant places. The knowledge production process contingent on the type of international mobility and the epistemic culture of a research field is examined. The production of scientific knowledge is a multi-faceted process, the output of which is mainly published in scholarly journals. Therefore, the study builds upon publication and citation data covered in Elsevier’s Scopus database for the period of 1996 to 2015. To analyse these data, bibliometric and social network analysis techniques are used. A basic analysis of scientific output using publication data, citation data and data on co-authored publications is combined with a content map analysis. Abstracts of publications indicate whether a research stay abroad makes an original contribution methodologically, theoretically or empirically. Moreover, co-citations are analysed to map linkages among scientists and emerging research domains. Finally, acknowledgements are studied that can function as channels of formal and informal communication between the actors involved in the process of knowledge production. The results provide better understanding of how the international mobility of scientists contributes to the production of knowledge, by contrasting the knowledge production dynamics of internationally mobile scientists with those being nationally mobile or immobile. Findings also allow indicating whether international mobility accelerates the production of knowledge and the emergence of new research fields.

Keywords: bibliometrics, diversity, interdisciplinarity, international mobility, knowledge production

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Authors: Niaz Gharavi, Hexin Zhang

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In the structural timber design, the shear modulus of the timber beam is an important factor that needs to be determined accurately. According to BS EN 408, shear modulus can be determined using torsion test or shear field test method. Although torsion test creates pure shear status in the beam, it does not represent the real-life situation when the beam is in the service. On the other hand, shear field test method creates similar loading situation as in reality. The latter method is based on shear distortion measurement of the beam at the zone with the constant transverse load in the standardized four-point bending test as indicated in BS EN 408. Current testing practice code advised using two metallic arms act as an instrument to measure the diagonal displacement of the constructing square. Timber is not a homogenous material, but a heterogeneous and this characteristic makes timber to undergo a non-uniform deformation. Therefore, the dimensions and the location of the constructing square in the area with the constant transverse force might alter the shear modulus determination. This study aimed to investigate the impact of the shape, size, and location of the square in the shear field test method. A binocular stereo vision system was developed to capture the 3D displacement of a grid of target points. This approach is an accurate and non-contact method to extract the 3D coordination of targeted object using two cameras. Two group of three glue laminated beams were produced and tested by the mean of four-point bending test according to BS EN 408. Group one constructed using two materials, laminated bamboo lumber and structurally graded C24 timber and group two consisted only structurally graded C24 timber. Analysis of Variance (ANOVA) was performed on the acquired data to evaluate the significance of size and location of the square in the determination of shear modulus of the beam. The results have shown that the size of the square is an affecting factor in shear modulus determination. However, the location of the square in the area with the constant shear force does not affect the shear modulus.

Keywords: shear field test method, BS EN 408, timber shear modulus, photogrammetry approach

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Authors: Ashneel Ajay Singh, Anish Maharaj, Havish Naidu, Michelle Kumar

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Mangrove patches are the foundation species located in the estuarine land areas. These patches provide a nursery, food source and protection for numerous aquatic, intertidal and well as land-based organisms. Mangroves also help in coastal protection, maintain water clarity and are one of the biggest sinks for blue carbon sequestration. In the Pacific Island countries, numerous coastal communities have a heavy socioeconomic dependence on coastal resources and mangroves play a key ecological and economical role in structuring the availability of these resources. Fiji has a large mangrove patch located in the Votua area of the Ba province. Globally, mangrove population continues to decline with the changes in climatic conditions and anthropogenic activities. Baseline information through wetland maps and time series change are essential references for development of effective mangrove management plans. These maps reveal the status of the resource and the effects arising from anthropogenic activities and climate change. In this study, we used remote sensing and GIS tools for mapping and temporal change detection over a period of >20 years in Votua, Fiji using Landsat imagery. Landsat program started in 1972 initially as Earth Resources Technology Satellite. Since then it has acquired millions of images of Earth. This archive allows mapping of temporal changes in mangrove forests. Mangrove plants consisted of the species Rhizophora stylosa, Rhizophora samoensis, Bruguiera gymnorrhiza, Lumnitzera littorea, Heritiera littoralis, Excoecaria agallocha and Xylocarpus granatum. Change detection analysis revealed significant reduction in the mangrove patch over the years. This information serves as a baseline for the development and implementation of effective management plans for one of Fiji’s biggest mangrove patches.

Keywords: climate change, GIS, Landsat, mangrove, temporal change

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Authors: Ioannis I. Αngeli

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Worldwide and mainly in the European Union, many standards, regulations, models and systems exists for the evaluation and identification of stakeholders’ requirements of individual universities and higher education (HE) in general. All systems are targeting to measure or evaluate the Universities’ Quality Assurance Systems and the services offered to the recipients of HE, mainly the students. Numerous surveys were conducted in the past either by each university or by organized bodies to identify the students’ satisfaction or to evaluate to what extent these requirements are fulfilled. In this paper, the main results of an ongoing 6-year joint research will be presented very briefly. This research deals with an in depth investigation of student’s satisfaction, students personal requirements, a cup analysis among these two parameters and compares different universities. Through this research an attempt will be made to address four very important questions in higher education establishments (HEE): (1) Are there any common requirements, parameters, good practices or questions that apply to a large number of universities that will assure that students’ requirements are fulfilled? (2) Up to what extent the individual programs of HEE fulfil the requirements of the stakeholders? (3) Are there any similarities on specific programs among European HEE? (4) To what extent the knowledge acquired in a specific course program is utilized or used in a specific country? For the execution of the research an internationally accepted questionnaire(s) was used to evaluate up to what extent the students’ requirements and satisfaction were fulfilled in 2012 and five years later (2017). Samples of students and or universities were taken from many European Universities. The questionnaires used, the sampling method and methodology adopted, as well as the comparison tables and results will be very valuable to any university that is willing to follow the same route and methodology or compare the results with their own HHE. Apart from the unique methodology, valuable results are demonstrated from the four case studies. There is a great difference between the student’s expectations or importance from what they are getting from their universities (in all parameters they are getting less). When there is a crisis or budget cut in HEE there is a direct impact to students. There are many differences on subjects taught in European universities.

Keywords: quality in higher education, students' requirements, education standards, student's survey, stakeholder's requirements, mechanical engineering courses

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Authors: Xinrui Zhao

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Connective actions acquired a completely different outlook of a social movement which credited with the rapid developed of social media technologies. New social movements amalgamate and mobilize around hashtags, memes, and personalized action frames. In 2017, the #MeToo movements from America spread to a variety of countries as a hashtag on social media. It attempted to demonstrate the widespread prevalence of sexual assault and harassment movement. It also encouraged Chinese women to participate by devoting and contributing their voices and acts. Furthermore, China’s #MeToo movement shows certain characteristics which are strongly shaped by particular political and cultural backgrounds, that also need to be studied. This paper serves as supplementary materials of connective action studies by addressing the #MeToo movement issues in China, which is rarely mentioned previously in the literature, it also supports a view that suggests that ideological and cultural drivers both strategically contribute to personalized action frames. This paper combines textual analysis methods, collecting attached materials from search engines in China’s social media, portrays the structure of China’s #MeToo movements by showing prominent activists, scholars, organization and the public’s action frame in China’s social media(Weibo, wechat, zhihu, douban). In doing so, it seeks to find how China’s #MeToo movements are organized and reveal diversities of social action approaches among those three subjects, digs out the correlations of their actions related to different social media platforms. This analysis suggests that while facing the government's censorship and moral judgments from the public, China’s #MeToo movement combines with few influential sexual assault and harassment events and is lead by the prominent activists who also are the victims in the events. The debates and critiques among Chinese scholars concerned the outcomes and significance of China’s #MeToo movement are divided into sides. Organizations still show less power in participating China’s movement social media. Public’s participation is varied of platforms which hugely affected by their personal experiences and knowledge.

Keywords: connective action, China, MeToo movement, social media

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Authors: Saadia Elamin

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The quasi-universal use of smart phones with internet connection available all the time makes it a reflex action for translation undergraduates, once they encounter the least translation problem, to turn to the freely available web resource: Google Translate. Like for other translator resources and aids, the use of Google Translate needs to be moderated in such a way that it contributes to developing translation competence. Here, instead of interfering with students’ learning by providing ready-made solutions which might not always fit into the contexts of use, it can help to consolidate the skills of analysis and transfer which students have already acquired. One way to do so is by training students to adhere to the basic principles of translation work. The most important of these is that analyzing the source text for comprehension comes first and foremost before jumping into the search for target language equivalents. Another basic principle is that certain translator aids and tools can be used for comprehension, while others are to be confined to the phase of re-expressing the meaning into the target language. The present paper reports on the experience of making a measured and reasonable use of Google Translate in translation teaching at Prince Sultan University (PSU), Riyadh. First, it traces the development that has taken place in the field of translation in this age of information technology, be it in translation teaching and translator training, or in the real-world practice of the profession. Second, it describes how, with the aim of reflecting this development onto the way translation is taught, senior students, after being trained on post-editing machine translation output, are authorized to use Google Translate in classwork and assignments. Third, the paper elaborates on the findings of this case study which has demonstrated that Google Translate, if used at the appropriate levels of training, can help to enhance students’ ability to perform different translation tasks. This help extends from the search for terms and expressions, to the tasks of drafting the target text, revising its content and finally editing it. In addition, using Google Translate in this way fosters a reflexive and critical attitude towards web resources in general, maximizing thus the benefit gained from them in preparing students to meet the requirements of the modern translation job market.

Keywords: Google Translate, post-editing machine translation output, principles of translation work, translation competence, translation teaching, translator aids and tools

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Authors: Godfrey Muiya Mukala

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This research looks at an array of fields in Sub-Saharan Africa comprising agriculture, food enterprises, medicine, organisms genetically modified, microbiology, and nanotechnology that can be gained from biotechnological research and development. Findings into dangerous organisms, mainly bacterial germs, rickettsia, fungi, parasites, or organisms that are genetically engineered, have immensely posed questions attributed to the biological danger they bring forth to human beings and the environment because of their uncertainties. In addition, the recurrence of previously managed diseases or the inception of new diseases are connected to biosafety challenges, especially in rural set-ups in low and middle-income countries. Notably, biotechnology laboratories are required to adopt biosafety measures to protect their workforce, community, environment, and ecosystem from unforeseen materials and organisms. Sensitization and inclusion of educational frameworks for laboratory workers are essential to acquiring a solid knowledge of harmful biological agents. This is in addition to human pathogenicity, susceptibility, and epidemiology to the biological data used in research and development. This article reviews and analyzes research intending to identify the proper implementation of universally accepted practices in laboratory safety and biological hazards. This research identifies ideal microbiological methods, adequate containment equipment, sufficient resources, safety barriers, specific training, and education of the laboratory workforce to decrease and contain biological hazards. Subsequently, knowledge of standardized microbiological techniques and processes, in addition to the employment of containment facilities, protective barriers, and equipment, is far-reaching in preventing occupational infections. Similarly, reduction of risks and prevention may be attained by training, education, and research on biohazards, pathogenicity, and epidemiology of the relevant microorganisms. In this technique, medical professionals in rural setups may adopt the knowledge acquired from the past to project possible concerns in the future.

Keywords: sub-saharan africa, biotechnology, laboratory, infections, health

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Authors: Betty Kibirige

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Students entering the University of Zululand (UNIZULU) Science Faculty mostly come with skills that allow them to prepare for exams and pass them in order to satisfy requirements for entry into a tertiary Institution. Some students hail from deep rural schools with limited facilities, while others come from well-resourced schools. Personal experience has shown that it may take a student the whole time at a tertiary institution following the same skills as those acquired in high school as a sure means of entering the next level in their development, namely a postgraduate program. While it is apparent that at this point in human history, it is totally impossible to teach all the possible content in any one subject, many academics approach teaching and learning from the traditional point of view. It therefore became apparent to explore ways of developing a graduate that will be able to approach life with skills that allows them to navigate knowledge by applying conceptual and critical thinking skills. Recently, the Science Faculty at the University of Zululand introduced two Engineering programs. In an endeavour to approach the development of the Engineering graduate in this institution to be able to tackle problem-solving in the present-day excessive information availability, it became necessary to study and review approaches used by various academics in order to settle for a possible best approach to the challenge at hand. This paper focuses on the development of a deep rural child in a graduate with conceptual and critical thinking skills as major attributes possessed upon graduation. For this purpose, various approaches were studied. A combination of these approaches was repackaged to form an approach that may appear novel to UNIZULU and the rural child, especially for the Engineering discipline. The approach was checked by offering quiz questions to students participating in an engineering module, observing test scores in the targeted module and make comparative studies. Test results are discussed in the article. It was concluded that students’ graduate attributes could be tailored subconsciously to indeed include conceptual and critical thinking skills, but through more than one approach depending mainly on the student's high school background.

Keywords: graduate attributes, conceptual skills, critical thinking skills, traditional approach

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Authors: Salahud Din, Saima Masood, Hafsa Zaneb, Habib-Ur Rehman, Imad Khan, Muqader Shah

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The present study was carried out on the gross anatomy, biometery and radiographic analysis of tarsal bones in twenty specimens of adult chinkara (Gazella bennettii). The desired bones were collected from the graveyards present in the locality of the different safari parks and zoos in Pakistan. To observe the edges and articulations between the bones, the radiographic images were acquired in craniocaudals and mediolateral views of the intact limbs. The gross and radiographic studies of the tarsus of adult Chinkara were carried out in University of Veterinary and Animal Sciences, Lahore, Pakistan. The tarsus of chinkara comprised of five bones both grossly and radiographically, settled in three transverse rows: tibial and fibular tarsal in the proximal, central and fourth fused tarsal in the middle row, the first, second and third fused tarsal in the distal row. The fibular tarsal was the largest and longest bone of the hock, situated on the lateral side and had a bulbous tuber calcis 'point of the hock' at the proximal extremity which projects upward and backward. The average maximum height and breadth for fibular tarsal was 5.61 ± 0.23 cm and 2.06 ± 0.13 cm, respectively. The tibial tarsal bones were the 2nd largest bone of the proximal row and lie on the medial side of the tarsus bears trochlea at either end. The average maximum height and breadth for tibial tarsal was 2.79 ± 0.05 cm and 1.74 ± 0.01 cm, respectively. The central and the fourth tarsals were fused to form a large bone which extends across the entire width of the tarsus and articulates with all bones of the tarsus. A nutrient foramen was present in the center of the non auricular area, more prominent on the ventral surface. The average maximum height and breadth for central and fourth fused tarsal was 1.51 ± 0.13 cm and 2.08 ± 0.07 cm, respectively. The first tarsal was a quadrilateral piece of bone placed on the poteriomedial surface of the hock. The greatest length and maximum breadth of the first tarsal was 0.94 ± 0.01 cm and 1.01 ± 0.01 cm, respectively. The second and third fused tarsal bone resembles the central but was smaller and triangular in outline. It was situated between the central above and the large metatarsal bone below. The greatest length and maximum breadth of second and third fused tarsal was 0.98 ± 0.01 cm and 1.49 ± 0.01 cm.

Keywords: chinkara, morphometry, radiography, tarsal bone

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Authors: Yifat Koren Carmi, Abed Agbarya, Hazem Khamaisi, Raymond Farah, Yelena Shechtman, Roman Korobochka, Jacob Gopas, Jamal Mahajna

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Ovarian cancer (OC), the second most common form of gynecological malignancy, has a poor prognosis and is frequently identified in its late stages. The recommended treatment for OC typically includes a platinum-based chemotherapy, like carboplatin. Nonetheless, OC treatment has proven challenging due to toxicity and development of acquired resistance to therapy. Chemoresistance is a significant obstacle to a long-lasting response in OC patients, believed to arise from alterations within the cancer cells as well as within the tumor microenvironments (TME). Malignant ascites is a presenting feature in more than one-third of OC patients. It serves as a reservoir for a complex mixture of soluble factors, metabolites, and cellular components, providing a pro-inflammatory and tumor-promoting microenvironment for the OC cells. Malignant ascites is also associated with metastasis and chemoresistance. In an attempt to elucidate the role of TME in chemoresistance of OC, we monitored the ability of soluble factors derived from ascites fluids to affect platinum sensitivity of OC cells. This research, compared ascites fluids from non-malignant cirrhotic patients to those from OC patients in terms of their ability to alter the platinum sensitivity of OC cells. Our findings indicated that exposure to OC ascites induces platinum chemoresistance on OC cells in 11 out of 13 cases (85%). In contrast, 75% of cirrhosis ascites (3 out of 4) failed to confer platinum chemoresistance to OC cells. Cytokine array analysis revealed that IL-6, and to a lesser extent HGF were enriched in OC ascites, whereas IL-22 was enriched in cirrhosis ascites. Pharmaceutical inhibitors that target the IL-6/JAK signaling pathway were mildly effective in overcoming the platinum chemoresistance induced by malignant ascites. In contrast, Crizotinib an HGF/c-MET inhibitor, and 2-hydroxyestradiol (2HE2) were effective in restoring platinum chemoresistance to OC. Our findings demonstrate the importance of OC ascites in supporting platinum chemoresistance as well as the potential of a combination therapy with Crizotinib and the estradiol metabolite 2HE2 to regain OC cells chemosensitivity.

Keywords: ovarian cancer, platinum chemoresistance, malignant ascites, tumor microenvironment, IL-6, 2-hydroxyestradiol, HGF, crizotinib

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Authors: Hans Tjio, Wee Meng Seng

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The interaction of contract and property has always been a concern in corporate and commercial law, where there are internal structures created that may not match the externally perceived image generated by the labels attached to those structures. We will focus, in particular, on the priority structures created by affirmative asset partitioning, which have increasingly come under challenge by those attempting to negotiate around them. The most prominent has been the AT1 bonds issued by Credit Suisse which were wiped out before its equity when the troubled bank was acquired by UBS. However, this should not have come as a surprise to those whose “bonds” had similarly been “redeemed” upon the occurrence of certain reference events in countries like Singapore, Hong Kong and Taiwan during their Minibond crisis linked to US sub-prime defaults. These were derivatives classified as debentures and sold as such. At the same time, we are again witnessing “liabilities” seemingly ranking higher up the balance sheet ladder, finding themselves lowered in events of default. We will examine the mechanisms holders of perpetual securities or preference shares have tried to use to protect themselves. This is happening against a backdrop that sees a rise in the strength of private credit and inter-creditor conflicts. The restructuring regime of the hybrid scheme in Singapore now, while adopting the absolute priority rule in Chapter 11 as the quid pro quo for creditor cramdown, does not apply to shareholders and so exempts them from cramdown. Complicating the picture further, shareholders are not exempted from cramdown in the Dutch scheme, but it adopts a relative priority rule. At the same time, the important UK Supreme Court decision in BTI 2014 LLC v Sequana [2022] UKSC 25 has held that directors’ duties to take account of creditor interests are activated only when a company is almost insolvent. All this has been complicated by digital assets created by businesses. Investors are quite happy to have them classified as property (like a thing) when it comes to their transferability, but then when the issuer defaults to have them seen as a claim on the business (as a choice in action), that puts them at the level of a creditor. But these hidden interests will not show themselves on an issuer’s balance sheet until it is too late to be considered and yet if accepted, may also prevent any meaningful restructuring.

Keywords: asset partitioning, creditor priority, restructuring, BTI v Sequana, digital assets

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Authors: Akinsola Oluwatosin, Udofia Samuel, Odofin Mayowa

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The study is aimed at assessing the Geographic Information System (GIS)-based spatial analysis of Survival Pattern and Treatment Outcomes of Multi-Drug Resistant Tuberculosis (MDR-TB) cases for Lagos, Nigeria, with an objective to inform priority areas for public health planning and resource allocation. Multi-drug resistant tuberculosis (MDR-TB) develops due to problems such as irregular drug supply, poor drug quality, inappropriate prescription, and poor adherence to treatment. The shapefile(s) for this study were already georeferenced to Minna datum. The patient’s information was acquired on MS Excel and later converted to . CSV file for easy processing to ArcMap from various hospitals. To superimpose the patient’s information the spatial data, the addresses was geocoded to generate the longitude and latitude of the patients. The database was used for the SQL query to the various pattern of the treatment. To show the pattern of disease spread, spatial autocorrelation analysis was used. The result was displayed in a graphical format showing the areas of dispersing, random and clustered of patients in the study area. Hot and cold spot analysis was analyzed to show high-density areas. The distance between these patients and the closest health facility was examined using the buffer analysis. The result shows that 22% of the points were successfully matched, while 15% were tied. However, the result table shows that a greater percentage of it was unmatched; this is evident in the fact that most of the streets within the State are unnamed, and then again, most of the patients are likely to supply the wrong addresses. MDR-TB patients of all age groups are concentrated within Lagos-Mainland, Shomolu, Mushin, Surulere, Oshodi-Isolo, and Ifelodun LGAs. MDR-TB patients between the age group of 30-47 years had the highest number and were identified to be about 184 in number. The outcome of patients on ART treatment revealed that a high number of patients (300) were not ART treatment while a paltry 45 patients were on ART treatment. The result shows the Z-score of the distribution is greater than 1 (>2.58), which means that the distribution is highly clustered at a significance level of 0.01.

Keywords: tuberculosis, patients, treatment, GIS, MDR-TB

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Authors: Alexander A. Karabutov, Natalia B. Podymova, Elena B. Cherepetskaya

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The theoretical analysis is carried out to get the relation between the ultrasonic wave velocity and the value of residual stresses. The laser-ultrasonic method is developed to evaluate the residual stresses and subsurface defects in metals. The method is based on the laser thermooptical excitation of longitudinal ultrasonic wave sand their detection by a broadband piezoelectric detector. A laser pulse with the time duration of 8 ns of the full width at half of maximum and with the energy of 300 µJ is absorbed in a thin layer of the special generator that is inclined relative to the object under study. The non-uniform heating of the generator causes the formation of a broadband powerful pulse of longitudinal ultrasonic waves. It is shown that the temporal profile of this pulse is the convolution of the temporal envelope of the laser pulse and the profile of the in-depth distribution of the heat sources. The ultrasonic waves reach the surface of the object through the prism that serves as an acoustic duct. At the interface ‚laser-ultrasonic transducer-object‘ the conversion of the most part of the longitudinal wave energy takes place into the shear, subsurface longitudinal and Rayleigh waves. They spread within the subsurface layer of the studied object and are detected by the piezoelectric detector. The electrical signal that corresponds to the detected acoustic signal is acquired by an analog-to-digital converter and when is mathematically processed and visualized with a personal computer. The distance between the generator and the piezodetector as well as the spread times of acoustic waves in the acoustic ducts are the characteristic parameters of the laser-ultrasonic transducer and are determined using the calibration samples. There lative precision of the measurement of the velocity of longitudinal ultrasonic waves is 0.05% that corresponds to approximately ±3 m/s for the steels of conventional quality. This precision allows one to determine the mechanical stress in the steel samples with the minimal detection threshold of approximately 22.7 MPa. The results are presented for the measured dependencies of the velocity of longitudinal ultrasonic waves in the samples on the values of the applied compression stress in the range of 20-100 MPa.

Keywords: laser-ultrasonic method, longitudinal ultrasonic waves, metals, residual stresses

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Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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Authors: Ilana Margalith, Adaya Meirowitz, Sigalit Cohavi

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Violence against health professionals by patients and their families have recently become a disturbing phenomenon worldwide, exacting psychological as well as economic tolls. Health workplaces in Israel (e.g. hospitals and H.M.O clinics) provide workshops for their employees, supplying them with coping strategies. However, these workshops do not focus on nursing students, who are also subjected to this violence. Their learning environment is no longer as protective as it used to be. Furthermore, coping with violence was not part of the curriculum for Israeli nursing students. Thus, based on human aggression theories which depict the pivotal role of the professional's correct response in preventing the onset of an aggressive response or the escalation of violence, a workshop was developed for undergraduate nursing students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel. The workshop aimed at reducing students' anxiety vis a vis the aggressive patient or family in addition to strengthening their ability to cope with such situations. The students practiced interpersonal skills, especially relevant to early detection of potential violence, as well as ‘a correct response’ reaction to the violence, thus developing the necessary steps to be implemented when encountering violence in the workplace. In order to assess the efficiency of the workshop, the participants filled out a questionnaire comprising knowledge and self-efficacy scales. Moreover, the replies of the 23 participants in this workshop were compared with those of 24 students who attended a standard course on interpersonal communication. Students' self-efficacy and knowledge were measured in both groups before and after the course. A statistically significant interaction was found between group (workshop/standard course) and time (before/after) as to the influence on students' self-efficacy (p=0.004) and knowledge (p=0.007). Nursing students, who participated in this ‘coping with workplace violence’ workshop, gained knowledge, confidence and a sense of self-efficacy with regard to workplace violence. Early detection of signs of imminent violence amongst patients or families and the prevention of its escalation, as well as the ability to manage the threatening situation when occurring, are acquired skills. Encouraging nursing students to learn and practice these skills may enhance their ability to cope with these unfortunate occurrences.

Keywords: early detection of violence, nursing students, patient aggression, self-efficacy, workplace violence

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Authors: Marine Reymond, Michael Descostes, Marie Muguet, Clemence Besancon, Martine Leermakers, Catherine Beaucaire, Sophie Billon, Patricia Patrier

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²²⁶Ra is one of the radionuclides resulting from the disintegration of ²³⁸U. Due to its half-life (1600 y) and its high specific activity (3.7 x 1010 Bq/g), ²²⁶Ra is found at the ultra-trace level in the natural environment (usually below 1 Bq/L, i.e. 10-13 mol/L). Because of its decay in ²²²Rn, a radioactive gas with a shorter half-life (3.8 days) which is difficult to control and dangerous for humans when inhaled, ²²⁶Ra is subject to a dedicated monitoring in surface waters especially in the context of uranium mining. In natural waters, radionuclides occur in dissolved, colloidal or particular forms. Due to the size of colloids, generally ranging between 1 nm and 1 µm and their high specific surface areas, the colloidal fraction could be involved in the transport of trace elements, including radionuclides in the environment. The colloidal fraction is not always easy to determine and few existing studies focus on ²²⁶Ra. In the present study, a complete multidisciplinary approach is proposed to assess the colloidal transport of ²²⁶Ra. It includes water sampling by conventional filtration (0.2µm) and the innovative Diffusive Gradient in Thin Films technique to measure the dissolved fraction (<10nm), from which the colloidal fraction could be estimated. Suspended matter in these waters were also sampled and characterized mineralogically by X-Ray Diffraction, infrared spectroscopy and scanning electron microscopy. All of these data, which were acquired on a rehabilitated former uranium mine, allowed to build a geochemical model using the geochemical calculation code PhreeqC to describe, as accurately as possible, the colloidal transport of ²²⁶Ra. Colloidal transport of ²²⁶Ra was found, for some of the sampling points, to account for up to 95% of the total ²²⁶Ra measured in water. Mineralogical characterization and associated geochemical modelling highlight the role of barite, a barium sulfate mineral well known to trap ²²⁶Ra into its structure. Barite was shown to be responsible for the colloidal ²²⁶Ra fraction despite the presence of kaolinite and ferrihydrite, which are also known to retain ²²⁶Ra by sorption.

Keywords: colloids, mining context, radium, transport

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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Authors: C. E. Laburu, M. A. Barros, A. F. Zompero, O. H. M. Silva

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The work presents a teaching strategy that employs syntagmatic and paradigmatic linguistic relations in order to monitor the understanding of physics students’ concepts. Syntagmatic and paradigmatic relations are theoretical elements of semiotics studies and our research circumstances and justified them within the research program of multi-modal representations. Among the multi-modal representations to learning scientific knowledge, the scope of action of syntagmatic and paradigmatic relations belongs to the discursive writing form. The use of such relations has the purpose to seek innovate didactic work with discourse representation in the write form before translate to another different representational form. The research was conducted with a sample of first year high school students. The students were asked to produce syntagmatic and paradigmatic of Newton’ first law statement. This statement was delivered in paper for each student that should individually write the relations. The student’s records were collected for analysis. It was possible observed in one student used here as example that their monemes replaced and rearrangements produced by, respectively, syntagmatic and paradigmatic relations, kept the original meaning of the law. In paradigmatic production he specified relevant significant units of the linguistic signs, the monemas, which constitute the first articulation and each word substituted kept equivalence to the original meaning of original monema. Also, it was noted a number of diverse and many monemas were chosen, with balanced combination of grammatical (grammatical monema is what changes the meaning of a word, in certain positions of the syntagma, along with a relatively small number of other monemes. It is the smallest linguistic unit that has grammatical meaning) and lexical (lexical monema is what belongs to unlimited inventories; is the monema endowed with lexical meaning) monemas. In syntagmatic production, monemas ordinations were syntactically coherent, being linked with semantic conservation and preserved number. In general, the results showed that the written representation mode based on linguistic relations paradigmatic and syntagmatic qualifies itself to be used in the classroom as a potential identifier and accompanist of meanings acquired from students in the process of scientific inquiry.

Keywords: semiotics, language, high school, physics teaching

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Authors: Neelam Patel

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Farmers in peri-urban areas of developing countries depend on wastewater for Irrigation but with great environmental and health hazards. Since, irrigation with wastewater is growing in the developing countries but its suitability to environment and other health factors should be checked. Metal pollution is a very serious issue these days, various neuro, physical and mental disorders are prevailing due to the metal pollution. Waste water contaminated with heavy metals got accumulated in the soil and then bioaccumulated in the vegetables irrigated with waste water. A 3-year field experiment on cauliflower has been done by using wastewater with two different methods of irrigation i.e. Drip and Flood irrigation and checked the impact on the cauliflower and soil quality. Heavy metals (Cr, Cu, Ni, Zn and Pb) have been studied in wastewater used for the irrigation and their accumulation in the soil and vegetable was studied. The study reveals that the concentration of heavy metals increases by 100 times from initial in soil. After 3 years, the concentration of Copper(41 ppm) Chromium(39.4 ppm) Lead(62.2ppm) Zinc(100.5 ppm) and Nickel(75.7 ppm) in Flood irrigated soil while in Drip irrigated soil , Copper (36.4 ppm) Chromium(36.8 ppm) Lead(53.7 ppm) Zinc(70.3 ppm) and Nickel (53.9 ppm). In vegetable, the wastewater irrigated shows an increase in the concentration of metals with the time and the accumulation of Nickel (6.98ppm), Lead (30.18 ppm) and Zinc (55.83 ppm) in drip irrigated while in flood irrigated, Nickel (30.58 ppm), Lead (73.95ppm) Zinc (93.50 ppm) and Copper (54.58 ppm) in edible part of cauliflower which is above the permissible limits suggested by different international agencies. On other hand, the nutrients content i.e. Nitrogen, Phosphorus and Potassium in soil was increased in concentration with time. The study pointed out that the metal contaminated waste water consisting the nutrients in it but also heavy metals which causes health issues in human. While the increase in concentration of nutrients in the soil indirectly helpful to the farmers economically by restricting the use of fertilizers. But the metal pollution directly affects the health of human being. The different method of irrigation suggested that the drip irrigated vegetable acquired less metal then the flood one and is a better combo with the waste water for the irrigation.

Keywords: drip irrigation, heavy metals, metal contamination, waste water

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Authors: Avani Jain, S. Shelley, M. Indirani, Shilpa Kalal, Jaykanth Amalachandran

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Aim: To evaluate the prevalence of gall bladder dysfunction in patients with dyspepsia using In-House fatty meal cholescintigraphy. Materials & Methods: This study is a prospective cohort study. 59 healthy volunteers with no dyspeptic complaints and negative ultrasound and endoscopy were recruited in study. 61 patients having complaint of dyspepsia for duration of more than 6 months were included. All of them underwent 99mTc-Mebrofenin fatty meal cholescintigraphy following a standard protocol. Dynamic acquisitions were acquired for 120 minutes with an In-House fatty meal being given at 45th minute. Gall bladder emptying kinetics was determined with gall bladder ejection fractions (GBEF) calculated at 30minutes, 45minutes and at 60 minutes (30min, 45min & 60 min). Standardization of fatty meal was done for volunteers. Receiver operating characteristic (ROC) analysis was used assess the diagnostic accuracy of 3 time points (30min, 45min & 60 min) used for measuring gall bladder emptying. On the basis of cut off derived from volunteers, the patients were assessed for gall bladder dysfunction. Results: In volunteers, the GBEF at 30 min was 74.42±8.26 % (mean ±SD), at 45 min was 82.61 ± 6.5 % and at 60 min was 89.37±4.48%, compared to patients where at 30min it was 33.73±22.87%, at 45 min it was 43.03±26.97% and at 60 min it was 51.85±29.60%. The lower limit of GBEF in volunteers at 30 min was 60%, 45 min was 69% and at 60 min was 81%. ROC analysis showed that area under curve was largest for 30 min GBEF (0.952; 95% CI = 0.914-0.989) and that all the 3 measures were statistically significant (p < 0.005). Majority of the volunteers had 74% of gall bladder emptying by 30 minutes; hence it was taken as an optimum cutoff time to assess gall bladder contraction. > 60% GBEF at 30 min post fatty meal was considered as normal and < 60% GBEF as indicative of gall bladder dysfunction. In patients, various causes for dyspepsia were identified: GB dysfunction (63.93%), Peptic ulcer (8.19 %), Gastroesophageal reflux disease (8.19%), Gastritis (4.91%). In 18.03% of cases GB dysfunction coexisted with other gastrointestinal conditions. The diagnosis of functional dyspepsia was made in 14.75% of cases. Conclusions: Gall bladder dysfunction contributes significantly to the causation of dyspepsia. It could coexist with various other gastrointestinal diseases. Fatty meal was well tolerated and devoid of any side effects. Many patients who are labeled as functional dyspeptics could actually have gall bladder dysfunction. Hence as an adjunct to ultrasound and endoscopy, fatty meal cholescintigraphy can also be used as a screening modality in characterization of dyspepsia.

Keywords: in-house fatty meal, choescintigraphy, dyspepsia, gall bladder ejection fraction, functional dyspepsia

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Authors: M. Zareh, H. Mohammadi, B. Naser

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Atherosclerotic plaque rupture is the main trigger of heart attack and brain stroke which are the leading cause of death in developed countries. Better understanding of rupture-prone plaque can help clinicians detect vulnerable plaques- rupture prone or instable plaques- and apply immediate medical treatment to prevent these life-threatening cardiovascular events. Therefore, there are plenty of studies addressing disclosure of vulnerable plaques properties. Necrotic core and fibrous tissue are two major tissues constituting atherosclerotic plaque; using histopathological and numerical approaches, many studies have demonstrated that plaque rupture is strongly associated with a large necrotic core and a thin fibrous cap, two morphological characteristic which can be acquired by two-dimensional imaging of atherosclerotic plaque present in coronary and carotid arteries. Plaque rupture is widely considered as a mechanical failure inside plaque tissue; this failure occurs when the stress within plaque excesses the strength of tissue material; hence, finite element method, a strong numerical approach, has been extensively applied to estimate stress distribution within plaques with different compositions which is then used for assessment of various vulnerability characteristics including plaque morphology, material properties and blood pressure. This study aims to evaluate significance of three-dimensional morphology on vulnerability degree of atherosclerotic plaque. To reach this end, different two-dimensional geometrical models of atherosclerotic plaques are considered based on available data and named Main 2D Models (M2M). Then, for each of these M2Ms, two three-dimensional idealistic models are created. These two 3D models represent two possible three-dimensional morphologies which might exist for a plaque with similar 2D morphology to one of M2Ms. Finite element method is employed to estimate stress, von-Mises stress, within each 3D models. Results indicate that for each M2Ms stress can significantly varies due to possible 3D morphological changes in that plaque. Also, our results show that an atherosclerotic plaque with thick cap may experience rupture if it has a critical 3D morphology. This study highlights the effect of 3D geometry of plaque on its instability degree and suggests that 3D morphology of plaque might be necessary to more effectively and accurately assess atherosclerotic plaque vulnerability.

Keywords: atherosclerotic plaque, plaque rupture, finite element method, 3D model

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Authors: Mokgophana Ramasobana

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Background: At the core of the demand to utilize evidence-based approaches in the policy-making cycle, prioritization of limited financial resources and results driven initiatives is the urgency to develop a cohort of competent Monitoring and Evaluation (M&E) practitioners and public servants. The ongoing strides in the evaluation capacity building (ECB) initiatives are a direct response to produce the highly-sought after M&E skills. Notwithstanding the rapid growth of M&E short courses, participants perceived value and expectation of M&E short courses as a panacea for ECB have not been empirically quantified or measured. The objective of this article is to explicitly illustrate the importance of measuring ECB interventions and understanding what works in ECB and why it works. Objectives: This article illustrates the importance of establishing empirical ECB measurement tools to evaluate ECB interventions in order to ascertain its contribution to the broader evaluation practice. Method: The study was primarily a desktop review of existing literature, juxtaposed by a survey of the participants across the African continent based on the 43 M&E short courses hosted by the Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) in collaboration with the Department of Planning Monitoring and Evaluation (DPME) Results: The article established that participants perceive short course training as a panacea to improve their M&E practical skill critical to executing their organizational duties. In tandem, participants are likely to demand customized training as opposed to general topics in Evaluation. However, the organizational environments constrain the application of the newly acquired skills. Conclusion: This article aims to contribute to the 'how to' measure ECB interventions discourse and contribute towards the improvement to evaluate ECB interventions. The study finds that participants prefer training courses with longer duration to cover more topics. At the same time, whilst organizations call for customization of programmes, the study found that individual participants demand knowledge of generic and popular evaluation topics.

Keywords: evaluation capacity building, effectiveness and training, monitoring and evaluation (M&E) short course training, perceptions and expectations

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Authors: Emily Jin, Harry Sharples, Anne Weist

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Introduction: NICE Evidence Search Student Champion Scheme is a peer-assisted learning scheme that aims to improve the routine use of evidence-based information by future health and social care staff. The focus is on the NICE evidence search portal that provides selected information from more than 800 reliable health, social care, and medicines sources, including up-to-date guidelines and information for the public. This paper aims to evaluate the effectiveness of the scheme when implemented in Liverpool School of Medicine and to understand the experiences of those attending. Methods: Twelve student champions were recruited and trained in February 2020 as peer tutors during a workshop facilitated by NICE. Cascade sessions were then organised and delivered on an optional basis for students, in small groups of < 10 to approximately 70 attendees. Surveys were acquired immediately before and 8-12 weeks after cascade sessions (n=47 and 45 respectively). Data from these surveys facilitated the analysis of the scheme. Results: Surveys demonstrated 74% of all attendees frequently searched for health and social care information online as a part of their studies. However, only 15% of attendees reported having prior formal training on searching for health information, despite receiving such training earlier on in the curriculum. After attending cascade sessions, students reported a 58% increase in confidence when searching for information using evidence search, from a pre-session a baseline of 36%. Conclusion: NICE Evidence Search Student Champion Scheme provided clear benefits for attending students, increasing confidence in searching for peer-reviewed, mainly secondary sources of health information. The lack of reported training represents the unmet need that the champion scheme satisfies, and this likely benefits student champions as well as attendees. Increasing confidence in searching for healthcare information online may support future evidence-based decision-making.

Keywords: evidence-based medicine, NICE, medical education, medical school, peer-assisted learning

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

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