Search results for: multiple roman domination function

Authors: Somnath Bhattachryya, Montree Bunruangses, Somchat Sonasang, Preecha Yupapin

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In this study and research on meditation and insight, the design and experiment with electronic circuits to manipulate the meditators' mental circles that call the chakras to have the same size is proposed. The shape of the circuit is 4-ports, called an add-drop multiplexer, that studies the meditation structure called the four-mindfulness foundation, then uses an AC power signal as an input instead of the meditation time function, where various behaviors with the method of re-filtering the signal (successive filtering), like eight noble paths. Start by inputting a signal at a frequency that causes the velocity of the wave on the perimeter of the circuit to cause particles to have the speed of light in a vacuum. The signal changes from electromagnetic waves and matter waves according to the velocity (frequency) until it reaches the point of the relativistic limit. The electromagnetic waves are transformed into photons with properties of wave-particle overcoming the limits of the speed of light. As for the matter wave, it will travel to the other side and cannot pass through the relativistic limit, called a shadow signal (echo) that can have power from increasing speed but cannot create speed faster than light or insight. In the experiment, the only the side where the velocity is positive, only where the speed above light or the corresponding frequency indicates intelligence. Other side(echo) can be done by changing the input signal to the other side of the circuit to get the same result. But there is no intelligence or speed beyond light. It is also used to study the stretching, contraction of time and wormholes that can be applied for teleporting, Bose-Einstein condensate and teleprinting, quantum telephone. The teleporting can happen throughout the system with wave-particle and echo, which is when the speed of the particle is faster than the stretching or contraction of time, the particle will submerge in the wormhole, when the destination and time are determined, will travel through the wormhole. In a wormhole, time can determine in the future and the past. The experimental results using the microstrip circuit have been found to be by the principle of quantum relativity, which can be further developed for both tools and meditation practitioners for quantum technology.

Keywords: quantu meditation, insight picture, quantum circuit, absolute time, teleportation

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Authors: Sujayeva V. A., Karpova I. S., Koslataya O. V., Kolyadko M. G., Russkikh I. I., Vankovich E. A.

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Objective: The goal of this study is to develop a method for the prevention of the progression of heart failure (HF) in patients with post-infarction cardiosclerosis who have suffered coronavirus infection. Methods: 135 patients with post-infarction cardiosclerosis were divided into 2 groups: Group I - patients who had suffered COVID-19 - 85 people, and Group II - patients who had not suffered COVID-19 - 50 people. Patients of group I, depending on the level of N-terminal fragment of natriuretic peptide (NTproBNP), were divided into 2 subgroups - subgroup A - with HF - 40 people, subgroup B - without HF - 45 people. All patients underwent a clinical examination, echocardiography, electrocardiotopography in 60 leads, computed angiography of the coronary arteries, heart magnetic resonance imaging, NTproBNP. Results: In the post-Covid period, in patients with post-infarction cardiosclerosis, remodeling of the left ventricle and right parts of the heart, deterioration of the systolic-diastolic function of both ventricles, increased pressure in the pulmonary artery, progression of coronary artery atherosclerosis, and an increase in the size of myocardial fibrosis were revealed. The consequence of these changes was the progression of heart failure. The developed method of medical prevention made it possible to improve the clinical course of coronary artery disease and prevent the progression of chronic heart failure in patients with post-infarction cardiosclerosis. Conclusions: In patients with post-infarction cardiosclerosis who initially had HF, after 1 year, according to laboratory and instrumental data, a slight decrease in its severity was revealed. In patients with post-infarction cardiosclerosis who did not have HF before COVID-19, HF developed 1 year after the coronavirus disease, which may be due to the identified process of myocardial fibrosis, which dictates the need to prevent the development of HF in patients with post-infarction cardiosclerosis, even those who did not initially have HF. The proposed method of medical prevention made it possible to improve the clinical course of coronary artery disease in patients with post-infarction cardiosclerosis after COVID-19, both in persons with and without HF, when included in the study. A method of medical prevention in people with post-infarction cardiosclerosis after COVID-19 infection, including spironolactone, loop diuretics, empagliflozin, sacubitril/valsartan, helped prevent the progression of HF.

Keywords: elderly, myocardial infarction, COVID-19, prevention

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Authors: Vichayada Laohapiboolkul

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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

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Authors: A. Kaćunić, M. Ćosić, N. Kuzmanić

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Interaction between mixing and crystallization is often ignored despite the fact that it affects almost every aspect of the operation including nucleation, growth, and maintenance of the crystal slurry. This is especially pronounced in multiple impeller systems where flow complexity is increased. By choosing proper mixing parameters, what closely depends on the knowledge of the hydrodynamics in a mixing vessel, the process of batch cooling crystallization may considerably be improved. The values that render useful information when making this choice are mixing time and power consumption. The predominant motivation for this work was to investigate the extent to which radial dual impeller configuration influences mixing time, power consumption and consequently the values of metastable zone width and nucleation rate. In this research, crystallization of borax was conducted in a 15 dm3 baffled batch cooling crystallizer with an aspect ratio (H/T) of 1.3. Mixing was performed using two straight blade turbines (4-SBT) mounted on the same shaft that generated radial fluid flow. Experiments were conducted at different values of N/NJS ratio (impeller speed/ minimum impeller speed for complete suspension), D/T ratio (impeller diameter/crystallizer diameter), c/D ratio (lower impeller off-bottom clearance/impeller diameter), and s/D ratio (spacing between impellers/impeller diameter). Mother liquor was saturated at 30°C and was cooled at the rate of 6°C/h. Its concentration was monitored in line by Na-ion selective electrode. From the values of supersaturation that was monitored continuously over process time, it was possible to determine the metastable zone width and subsequently the nucleation rate using the Mersmann’s nucleation criterion. For all applied dual impeller configurations, the mixing time was determined by potentiometric method using a pulse technique, while the power consumption was determined using a torque meter produced by Himmelstein & Co. Results obtained in this investigation show that dual impeller configuration significantly influences the values of mixing time, power consumption as well as the metastable zone width and nucleation rate. A special attention should be addressed to the impeller spacing considering the flow interaction that could be more or less pronounced depending on the spacing value.

Keywords: dual impeller crystallizer, mixing time, power consumption, metastable zone width, nucleation rate

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Authors: Shan Zhang, Peter Suechting

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Predicting trade patterns is critical to decision-making in public and private domains, especially in the current context of trade disputes among major economies. In the past, U.S. recycling has relied heavily on strong demand for recyclable materials overseas. However, starting in 2017, a series of new recycling policies (bans and higher inspection standards) was enacted by multiple countries that were the primary importers of recyclables from the U.S. prior to that point. As the global trade flow of recycling shifts, some new importers, mostly developing countries in South and Southeast Asia, have been overwhelmed by the sheer quantities of scrap materials they have received. As the leading exporter of recyclable materials, the U.S. now has a pressing need to build its recycling industry domestically. With respect to the global trade in scrap materials used for recycling, the interest in this paper is (1) predicting how the export of recyclable materials from the U.S. might vary over time, and (2) predicting how international trade flows for recyclables might change in the future. Focusing on three major recyclable materials with a history of trade, this study uses data-driven and machine learning (ML) algorithms---supervised (shrinkage and tree methods) and unsupervised (neural network method)---to decipher the international trade pattern of recycling. Forecasting the potential trade values of recyclables in the future could help importing countries, to which those materials will shift next, to prepare related trade policies. Such policies can assist policymakers in minimizing negative environmental externalities and in finding the optimal amount of recyclables needed by each country. Such forecasts can also help exporting countries, like the U.S understand the importance of healthy domestic recycling industry. The preliminary result suggests that gravity models---in addition to particular selection macroeconomic predictor variables--are appropriate predictors of the total export value of recyclables. With the inclusion of variables measuring aspects of the political conditions (trade tariffs and bans), predictions show that recyclable materials are shifting from more policy-restricted countries to less policy-restricted countries in international recycling trade. Those countries also tend to have high manufacturing activities as a percentage of their GDP.

Keywords: environmental economics, machine learning, recycling, international trade

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Authors: Jui-Hsueh Hu

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This study investigated various models of refusal speech acts among three target groups: French learners of Mandarin Chinese (FM), Taiwanese native Mandarin speakers (TM), and native French speakers (NF). The refusal responses were analyzed in terms of their options, frequencies, and sequences and the contents of their semantic formulas. This study also examined differences in refusal strategies, as determined by social status and social distance, among the three groups. The difficulties of refusal speech acts encountered by FM were then generalized. The results indicated that Mandarin instructors of NF should focus on the different reasons for the pragmatic failure of French learners and should assist these learners in mastering refusal speech acts that rely on abundant cultural information. In this study, refusal policies were mainly classified according to the research of Beebe et al. (1990). Discourse completion questionnaires were collected from TM, FM, and NF, and their responses were compared to determine how refusal policies differed among the groups. This study not only emphasized the dissimilarities of refusal strategies between native Mandarin speakers and second-language Mandarin learners but also used NF as a control group. The results of this study demonstrated that regarding overall strategies, FM were biased toward NF in terms of strategy choice, order, and content, resulting in pragmatic transfer under the influence of social factors such as 'social status' and 'social distance,' strategy choices of FM were still closer to those of NF, and the phenomenon of pragmatic transfer of FM was revealed. Regarding the refusal difficulties among the three groups, the F-test in the analysis of variance revealed statistical significance was achieved for Role Playing Items 13 and 14 (P < 0.05). A difference was observed in the average number of refusal difficulties between the participants. However, after multiple comparisons, it was found that item 13 (unrecognized heterosexual junior colleague requesting contacts) was significantly more difficult for NF than for TM and FM; item 14 (contacts requested by an unrecognized classmate of the opposite sex) was significantly more difficult to refuse for NF than for TM. This study summarized the pragmatic language errors that most FM often perform, including the misuse or absence of modal words, hedging expressions, and empty words at the end of sentences, as the reasons for pragmatic failures. The common social pragmatic failures of FM include inaccurately applying the level of directness and formality.

Keywords: French Mandarin, interlanguage refusal, pragmatic transfer, speech acts

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Authors: Shahin A. Abdel-Naby, James P. Colgan, Michael S. Pindzola

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A time-dependent close-coupling method is developed to calculate a total, double and triple autoionization rates for hollow atomic ions of four-electron systems. This work was motivated by recent observations of the four-electron Auger process in near K-edge photoionization of C+ ions. The time-dependent close-coupled equations are solved using lattice techniques to obtain a discrete representation of radial wave functions and all operators on a four-dimensional grid with uniform spacing. Initial excited states are obtained by relaxation of the Schrodinger equation in imaginary time using a Schmidt orthogonalization method involving interior subshells. The radial wave function grids are partitioned over the cores on a massively parallel computer, which is essential due to the large memory requirements needed to store the coupled-wave functions and the long run times needed to reach the convergence of the ionization process. Total, double, and triple autoionization rates are obtained by the propagation of the time-dependent close-coupled equations in real-time using integration over bound and continuum single-particle states. These states are generated by matrix diagonalization of one-electron Hamiltonians. The total autoionization rates for each L excited state is found to be slightly above the single autoionization rate for the excited configuration using configuration-average distorted-wave theory. As expected, we find the double and triple autoionization rates to be much smaller than the total autoionization rates. Future work can be extended to study electron-impact triple ionization of atoms or ions. The work was supported in part by grants from the American University of Sharjah and the US Department of Energy. Computational work was carried out at the National Energy Research Scientific Computing Center (NERSC) in Berkeley, California, USA.

Keywords: hollow atoms, autoionization, auger rates, time-dependent close-coupling method

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Authors: Lingling Li, Peng Zhao, Runze Guan, Alice Jones, Tao Yu

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Background: Shoulder pain and weakness are associated with complex pathologies and often precludes weightlifters from participation in training. The role and mode of exercise training in weightlifters with shoulder pathology remains unclear. Objectives: This case report described an exercise program in management of an elite weightlifter with primary complaint of right shoulder pain and weakness. Methods: A 22-year-old weightlifter presented with 2-year duration of right shoulder pain and weakness which was worsened by routine weightlifting training, and symptoms were not relieved with steroid injection, manual therapy nor usual physiotherapy. There was a limitation in all active range of motion especially horizontal extension (13ᵒ) and external rotation (41ᵒ) with pain intensity at 4/10 and 10/10 (numeric pain rating score) respectively. Muscle weakness was most significant at supraspinatus and teres minor, 38% and 27% respectively compared to his left shoulder (hand-held dynamometry, Micro FET2). An exercise training program focusing on improving mobility was designed for this athlete following a comprehensive physical assessment. Exercises included specific stretching, muscle activating and scapular stability training; once per day, and for 60 minutes each session. All exercises were completed under instruction as pain allowed. Quantitative assessment was conducted at the end of each week for 3 weeks. Outcomes: After the program, the athlete was pain-free in all movements except the O’Brien active compression internal rotation test, the pain was however reduced from 10/10 to 3/10. The horizontal extension and external rotation range increased to 79ᵒ to 120ᵒ respectively, and strength of all rotator cuff muscles returned to normal. At 1-month follow up, the athlete was totally pain-free and had returned to normal function and weightlifting training activities. The outcomes sustained through 6-month and one year. Conclusion: This case report supports the use of a mobility-focused exercise program for management of shoulder pain and weakness in an elite weightlifter athlete.

Keywords: exercise training, mobility, rehabilitation, shoulder pain, weightlifting

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Authors: Percy Galvez, Anatoly Petukhin, Paul Somerville, Ken Miyakoshi, Kojiro Irikura, Daniel Peter

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Physics-based dynamic rupture modelling is necessary for estimating parameters such as rupture velocity and slip rate function that are important for ground motion simulation, but poorly resolved by observations, e.g. by seismic source inversion. In order to generate a large number of physically self-consistent rupture models, whose rupture process is consistent with the spatio-temporal heterogeneity of past earthquakes, we use multicycle simulations under the heterogeneous rate-and-state (RS) friction law for a 45deg dip-slip fault. We performed a parametrization study by fully dynamic rupture modeling, and then, a set of spontaneous source models was generated in a large magnitude range (Mw > 7.0). In order to validate rupture models, we compare the source scaling relations vs. seismic moment Mo for the modeled rupture area S, as well as average slip Dave and the slip asperity area Sa, with similar scaling relations from the source inversions. Ground motions were also computed from our models. Their peak ground velocities (PGV) agree well with the GMPE values. We obtained good agreement of the permanent surface offset values with empirical relations. From the heterogeneous rupture models, we analyzed parameters, which are critical for ground motion simulations, i.e. distributions of slip, slip rate, rupture initiation points, rupture velocities, and source time functions. We studied cross-correlations between them and with the friction weakening distance Dc value, the only initial heterogeneity parameter in our modeling. The main findings are: (1) high slip-rate areas coincide with or are located on an outer edge of the large slip areas, (2) ruptures have a tendency to initiate in small Dc areas, and (3) high slip-rate areas correlate with areas of small Dc, large rupture velocity and short rise-time.

Keywords: earthquake dynamics, strong ground motion prediction, seismic engineering, source characterization

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Jamboor K. Vishwanatha

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Among the potent anti-cancer agents, curcumin has been found to be very efficacious against various cancer cells. Despite multiple medicinal benefits of curcumin, poor water solubility, poor physiochemical properties and low bioavailability continue to pose major challenges in developing a formulation for clinical efficacy. To improve its potential application in the clinical area, we formulated poly lactic-co-glycolic acid (PLGA) nanoparticles. The PLGA nanoparticles were formulated using solid-oil/water emulsion solvent evaporation method and then characterized for percent yield, encapsulation efficiency, surface morphology, particle size, drug distribution within nanoparticles and drug polymer interaction. Our studies showed the successful formation of smooth and spherical curcumin loaded PLGA nanoparticles with a high percent yield of about 92.01±0.13% and an encapsulation efficiency of 90.88±0.14%. The mean particle size of the nanoparticles was found to be 145nm. The in vitro drug release profile showed 55-60% drug release from the nanoparticles over a period of 24 hours with continued sustained release over a period of 8 days. Exposure to curcumin loaded nanoparticles resulted in reduced cell viability of cancer cells compared to normal cells. We used a novel non-covalent insertion of a homo-bifunctional spacer for targeted delivery of curcumin to various cancer cells. Functionalized nanoparticles for antibody/targeting agent conjugation was prepared using a cross-linking ligand, bis(sulfosuccinimidyl) suberate (BS3), which has reactive carboxyl group to conjugate efficiently to the primary amino groups of the targeting agents. In our studies, we demonstrated successful conjugation of antibodies, Annexin A2 or prostate specific membrane antigen (PSMA), to curcumin loaded PLGA nanoparticles for targeting to prostate and breast cancer cells. The percent antibody attachment to PLGA nanoparticles was found to be 92.8%. Efficient intra-cellular uptake of the targeted nanoparticles was observed in the cancer cells. These results have emphasized the potential of our multifunctional curcumin nanoparticles to improve the clinical efficacy of curcumin therapy in patients with cancer.

Keywords: polymeric nanoparticles, cancer therapy, sustained release, curcumin

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Authors: S. Pathak, R. Lazarus

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A 25-year-old male HIV patient (CD4 cells 20/µL and HIV viral load 14200000 copies/ml) with a past medical history of duodenal ulcer, pneumocystis carinii pneumonia, oesophageal candidiasis presented with fever and a seizure to hospital. The only recent travel had been a religious pilgrimage from Singapore to Malaysia 5 days prior; during the trip he sustained skin abrasions. The patient had recently started highly active antiretroviral therapy 2 months prior. Clinical examination was unremarkable other than a temperature of 38.8°C and perianal warts. Laboratory tests showed a leukocyte count 12.5x109 cells/L, haemoglobin 9.4 g/dL, normal biochemistry and a C-reactive protein 121 mg/L. CT head and MRI head were unremarkable and cerebrospinal fluid analysis performed after a delay (due to technical difficulties) of 11 days was unremarkable. Blood cultures (three sets) taken on admission showed Gram-negative rods in the anaerobic bottles only at the end of incubation with culture result confirmed by molecular sequencing showing Helicobacter cinaedi. The patient was treated empirically with ceftriaxone for seven days and this was converted to oral co-amoxiclav for a further seven days after the blood cultures became positive. A Transthoracic echocardiogram was unremarkable. The patient made a full recovery. Helicobacter cinaedi is a gram-negative anaerobic fastidious organism affecting patients with comorbidity. Infection may manifest as cellulitius, colitis or as in this case as bloodstream infection – the latter is often attributed to faeco-oral infection. Laboratory identification requires prolonged culture. Therapeutic options may be limited by resistance to macrolides and fluoroquinolones. The likely pathogen inoculation routes in the case described include gastrointestinal translocation due to proctitis at the site of perianal warts, or breach of the skin via abrasions occurring during the pilgrimage. Such organisms are increasing in prevalence as our patient population ages and patients have multiple comorbidities including HIV. It may be necessary in patients with unexplained fever to prolong incubation of sterile sites including blood in order to identify this unusual fastidious organism.

Keywords: fastidious, Helicobacter cinaedi, HIV, immunocompromised

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Authors: Erwin Geroleo, Higinio Mappala

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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.

Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy

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Authors: Amina Unis, Samah S. El Basateeny, Noha A. H. Nassef

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Introduction: Acute Renal Failure (ARF) is one of the most common problems encountered in hospitalized critically ill patients. In recent years great effort has been focused on the introduction of herbal medicine as a novel therapeutic agent for prevention of ARF. Hence, the current study was designed to investigate the effect of Green Coffee Bean Extract (GCBE) on gentamicin induced ARF in rats. Methods: The study was conducted on 60 male rats divided into six equal groups. Group 1 served as normal control group and GCBE was administered for 7 days at a dose of 20 mg/kg/day in group 2 and 40 mg/kg/day in group 3 to test the effect of GCBE on normal kidneys. ARF was induced by a daily intraperitoneal injection of gentamicin (80 mg/kg) for 7 days in group 4 (model group), group 5 (GCBE 20 mg/kg/day) and group 6 (GCBE 20 mg/kg/day). All rats were sacrificed after 7 days and blood was withdrawn for kidney function tests. Kidneys were removed for determination of renal oxidative stress markers and histopathological examination. Results: The present study showed that rats that received oral GCBE for 7 days without induction of ARF showed no significant change in all the assessed parameters in comparison to the normal control group, while rats in the groups that received oral GCBE for 7 days with induction of ARF showed a significant improvement in kidney functions tests (decrease in serum urea, serum creatinine, and blood urea nitrogen) when compared to the ARF model group. Moreover, there was significant amelioration in renal oxidative stress markers (renal malondialdehyde, renal superoxide dismutase) and renal histopathological changes in the GCBE treated groups along induction of ARF when compared to ARF model group. The most significant improvement was reported in the group where GCBE was administered for 7 days in a dose 40 mg/kg/day, along with induction of ARF. Conclusion: GCBE has a potential role in ameliorating renal damage involved in ARF mostly through its antioxidant effect.

Keywords: green coffee bean extract, gentamicin, acute renal failure, pharmacology

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Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

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Authors: Vitor Carneiro, Augusto Barata Da Rocha, Barbara Rangel, Jorge Lino Alves

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In the European Union countries, Small and Medium-Sized Enterprises (SME’s) have an important contribution to economic activity and to the Gross Domestic Product (GDP). The implementation of design practices in SME’s is often a difficult task due to resources limitations. Unlike large companies, their product development and innovation processes frequentlylack adequate planning and systematic procedures. Design management interest has grown exponentially in recent years, but as it is a recent topic there is an absence of systematic methodologies to implement design management in SME’s with little or no design experience. This work presents a contribution to improve and optimize the process of design integration and management in SME’s. A review analysis is presented to select relevant articles on the subject, review and classify the main published contributions. Based on the selected articles content it was possible to identify five main themes related to the subject under analysis: Design Function Organization, Design Management Integration, Design Management Capabilities, Managing Design Projects, and Tools and Methods. Design management is discussed from different perspectives depending on the focus on which it is placed, whether in a design or management perspective, leading to different visions and definitions: from a more upstream strand at the intersection of design and the organization's strategic management (strategic design management) to a more downstream strand related to project management and design process (design management operational). The review analysis of the selected articles allowed the identification of a high level of complexity of connections and parameters in the design management during the product development process in the context of SME’s. Within each group of the five main themes, several sub-themes, directly or indirectly related, should be considered.Sub-connections also occur between sub-themes of different themes creating a complex and intricate web of connections. This complexity of connections is often the main obstacle to conduct design management and product development efficiently. This work proposes a formulation of a systematic methodological approach to optimize the integrated project and the management and control of the product development process among SME's. The implementation of this formulation will improve the integration of design management in the product development and innovation process in SME’s.

Keywords: design management, product development, product innovation, SME’s.

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Authors: Ayda Youssef, Tarek Rafaat, Iman zaky

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Purpose: Langerhans’ cell histiocytosis (LCH) is not uncommon pathology that implies aberrant proliferation of a specific dendritic (Langerhans) cell. These atypical but mature cells of monoclonal origin can infiltrate many sites of the body and may occur as localized lesions or as widespread systemic disease. Liver is one of the uncommon sites of affection. The twofold objective of this study is to illustrate the radiological presentation of this disease, and to compare these results with previously reported series. Methods and Materials: Between 2007 and 2012, 150 patients with biopsy-proven LCH were treated in our hospital, a paediatric cancer tertiary care center. A retrospective review of radiographic images and reports was performed. There were 33 patients with liver affection are stratified. All patients underwent imaging studies, mostly US and CT. A chart review was performed to obtain demographic, clinical and radiological data. They were analyzed and compared to other published series. Results: Retrospective assessment of 150 patients with LCH was performed, among them 33 patients were identified who had liver involvement. All these patients developed multisystemic disease; They were 12 females and 21 males with (n= 32), seven of them had marked hepatomegaly. Diffuse hypodense liver parenchyma was encountered in five cases, the periportal location has a certain predilection in cases of focal affection where three cases has a hypodense periportal soft tissue sheets, one of them associated with dilated biliary radicals, only one case has multiple focal lesions unrelated to portal tracts. On follow up of the patients, two cases show abnormal morphology of liver with bossy outline. Conclusion: LCH is a not infrequent disease. A high-index suspicion should be raised in the context of diagnosis of liver affection. A biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality. Liver histiocytosis are not disease specific features but should be interpreted in conjunction with the clinical history and the results of biopsy. Clinical Relevance/Application: Radiologist should be aware of different patterns of hepatobiliary histiocytosis, Thus early diagnosis and proper management of patient can be conducted.

Keywords: langerhans’ cell histiocytosis, liver, medical and health sciences, radiology

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Authors: Ibrahim M. I. Hamoda, Ahmed R. Z. Baghdadi, Mohammed K. Mohamed, Nawal A. Abu-Shady

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Background: Most of patients with vestibular dysfunction suffering from balance disorders, Abnormality in balance increase effort and exertion which affect the independency, so this study might be a guide in managing balance problem and consequently improve walking with less exertion and maximum function. Purpose: to analyze and discuss the effect of transcranial magnetic therapy on balance in patients with vestibular dysfunction. Methods: forty subjects from both sexes were classified to divided randomly into two equal groups; Group I study group: this group received transcranial magnetic therapy, with a selected physical therapy program for improving balance and vestibular disorders (Balance training, Cawthorne-Cooksey Exercises) and group II (control group): this group received a selected physical therapy program as group I without transcranial magnetic therapy. This treatment procedure will be applied three times weekly for three months. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and II respectively. The Biodex Balance System, Berge balances scale (BBS) and brain MRI were used for assessment. Assessments were conducted before and after treatment. The treatment program for group I included balance training, Cawthorne-Cooksey Exercises and pulsed magnetic therapy (Parameters used in the program of 20 minutes, Intensity 2 gausses, Frequency 1 Hz). This selected program was done in approximately one hour every other day for three month. The treatment program group II Patients received the same program as group A without transcranial magnetic therapy. Results: The One-way ANOVA revealed that there were no significant differences in BBS scores, overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability between both groups. Moreover, the BBS scores increased and overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability decreased significantly after treatment in group I and II compared with before treatment. Interpretation/Conclusion: Adding pulsed magnetic therapy to balance training, Cawthorne-Cooksey Exercises has no effect on static and dynamic balance in patients with balance problems due to benign positional paroxysmal vertigo.

Keywords: balance, transcranial magnetic therapy, vestibular dysfunction, biomechanic

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Authors: Shankaran Sitarama

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Teamwork is an extremely effective pedagogical tool in engineering education. New Product Development (NPD) has been an effective strategy of companies to streamline and bring innovative products and solutions to customers. Thus, Engineering curriculum in many schools, some collaboratively with business schools, have brought NPD into the curriculum at the graduate level. Teamwork is invariably used during instruction, where students work in teams to come up with new products and solutions. There is a significant emphasis of grade on the semester long teamwork for it to be taken seriously by students. As the students work in teams and go through this process to develop the new product prototypes, their effectiveness and learning to a great extent depends on how they function as a team and go through the creative process, come together, and work towards the common goal. A core attribute of a successful NPD team is their creativity and innovation. The team needs to be creative as a group, generating a breadth of ideas and innovative solutions that solve or address the problem they are targeting and meet the user’s needs. They also need to be very efficient in their teamwork as they work through the various stages of the development of these ideas resulting in a POC (proof-of-concept) implementation or a prototype of the product. The simultaneous requirement of teams to be creative and at the same time also converge and work together imposes different types of tensions in their team interactions. These ideational tensions / conflicts and sometimes relational tensions / conflicts are inevitable. Effective teams will have to deal with the Team dynamics and manage it to be resilient enough and yet be creative. This research paper provides a computational analysis of the teams’ communication that is reflective of the team dynamics, and through a superimposition of latent semantic analysis with social network analysis, provides a computational methodology of arriving at patterns of visual interaction. These team interaction patterns have clear correlations to the team dynamics and provide insights into the functioning and thus the effectiveness of the teams. 23 student NPD teams over 2 years of a course on Managing NPD that has a blend of engineering and business school students is considered, and the results are presented. It is also correlated with the teams’ detailed and tailored individual and group feedback and self-reflection and evaluation questionnaire.

Keywords: team dynamics, social network analysis, team interaction patterns, new product development teamwork, NPD teams

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Authors: Regina Rahimi, Delores Liston

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The advent of COVID-19 has heightened awareness of the need for social emotional learning (SEL) throughout all educational contexts. Given this, schools (most often p12 settings) have begun to embrace practices for addressing social-emotional learning. While there is a growing body of research and literature on common practices of SEL, there is no ‘standard’ for its implementation. Our work proposed here recognizes there is no universal approach for addressing SEL and rather, seeks to explore how SEL can be approached in and through diverse contexts. We assert that left unrecognized and unaddressed by teachers, issues with social and emotional well-being profoundly negatively affect students’ academic performance and exacerbate teacher stress. They contribute to negative student-teacher relationships, poor classroom management outcomes, and compromised academic outcomes. Therefore, teachers and administrators have increasingly turned to developing pedagogical and classroom practices that support the social and emotional dimensions of students. Substantive quantitative evidence indicates professional development training to improve awareness and foster positive teacher-student relationships can provide a protective function for psycho-social outcomes and a promotive factor for improved learning outcomes for students. Our work aims to add to the growing body of literature on improving student well-being by providing a unique examination of SEL through a lens of diverse contexts. Methodology: This presentation hopes to present findings from an edited volume that will seek to highlight works that examine SEL practices in a variety of academic settings. The studies contained within the work represent varied forms of qualitative research. Conclusion: This work provides examples of SEL in higher education/postsecondary settings, a variety of P12 academic settings (public; private; rural, urban; charter, etc.), and international contexts. This work demonstrates the variety of ways educational institutions and educators have used SEL to address the needs of students, providing examples for others to adapt to their own diverse contexts. This presentation will bring together exemplar models of SEL in diverse practice settings.

Keywords: social emotional learning, teachers, classrooms, diversity

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Authors: Dong-Gi Lee, Suyeon Cha, Yong-Sun Bahn

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Sterol lipid is essential for cell membrane structure in eukaryotic cells. In mammalian cells, sterol regulatory element binding proteins (SREBPs) act as principal regulators of cellular cholesterol which is essential for proper cell membrane fluidity and structure. SREBP and sterol regulation are related to levels of cellular oxygen because it is a major substrate for sterol synthesis. Upon cellular sterol and oxygen levels are depleted, SREBP is translocated to the Golgi where it undergoes proteolytic cleavage of N terminus, then it travels to the nucleus to play a role as transcription factor. In yeast cells, synthesis of ergosterol is also highly oxygen consumptive, and Sre1 is a transcription factor known to play a central role in adaptation to growth under low oxygen condition and sterol homeostasis in Cryptococcus neoformans. In this study, we observed phenotypes in other strains of Cryptococcus species by constructing hob1Δ and sre1Δ mutants to confirm whether the functions of both genes are conserved in most serotypes. As a result, hob1Δ showed no noticeable phenotype under treatment of antifungal drugs and most environmental stresses in R265 (C. gattii) and XL280 (C. neoformans), suggesting that Hob1 is related to sterol regulation only in H99 (serotype A). On the other hand, the function of Sre1 was found to be conserved in most serotypes. Furthermore, mating experiment of hob1Δ or sre1Δ showed dramatic defects in serotype A (H99) and D (XL280). It revealed that Hob1 and Sre1 related to mating ability in Cryptococcus species, especially cell fusion efficiency. In conclusion, HOB1 and SRE1 play crucial role in regulating sterol-homeostasis and differentiation in C. neoformans, moreover, Hob1 is specific gene in Cryptococcus neoformans. It suggests that Hob1 is considered as potent factor-targeted new safety antifungal drug.

Keywords: cryptococcus neoformans, Hob1, Sre1, sterol regulatory element binding proteins

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Authors: Pin-Wei Chiang, Wen-Liang Chang, Ruey-Huei Yeh

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This paper investigates optimal replacement and preventative maintenance policies of secondhand products under a Finite Planning Horizon (FPH). Any consumer wishing to replace their product under FPH would have it undergo minimal repairs. The replacement provided would be required to undergo periodical preventive maintenance done to avoid product failure. Then, a mathematical formula for disbursement cost for products under FPH can be derived. Optimal policies are then obtained to minimize cost. In the first of two segments of the paper, a model for initial product purchase of either new or secondhand products is used. This model is built by analyzing product purchasing price, surplus value of product, as well as the minimal repair cost. The second segment uses a model for replacement products, which are also secondhand products with no limit on usage. This model analyzes the same components as the first as well as expected preventative maintenance cost. Using these two models, a formula for the expected final total cost can be developed. The formula requires four variables (optimal preventive maintenance level, preventive maintenance frequency, replacement timing, age of replacement product) to find minimal cost requirement. Based on analysis of the variables using the expected total final cost model, it was found that the purchasing price and length of ownership were directly related. Also, consumers should choose the secondhand product with the higher usage for replacement. Products with higher initial usage upon acquisition require an earlier replacement schedule. In this case, replacements should be made with a secondhand product with less usage. In addition, preventative maintenance also significantly reduces cost. Consumers that plan to use products for longer periods of time replace their products later. Hence these consumers should choose the secondhand product with lesser initial usage for replacement. Preventative maintenance also creates significant total cost savings in this case. This study provides consumers with a method of calculating both the ideal amount of usage of the products they should purchase as well as the frequency and level of preventative maintenance that should be conducted in order to minimize cost and maintain product function.

Keywords: finite planning horizon, second hand product, replacement, preventive maintenance, minimal repair

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Authors: Swati Minz, Pradeep Munda, Ranchi Jharkhand

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Women of today’s era are well educated and they are best and proficient at their skills that are key to success anywhere. Government played a major role in uplifting women in Indian society. Through all these efforts Indian women decided to move forward and started choosing career path which was itself a challenge in their life. The people in the society had a very hatred feeling for the women who chose a career and moved forward. Women in today’s times have achieved a lot but in reality they have to still travel a long way. Women started leaving the secured domains of their home and moved out, but a harsh, cruel, exploitative world awaits them, where women have to prove their talent against the world who see women as merely vassals of producing children. In spite all modernisation, a woman has her limits and emerges to claim traditional male space, juggling with many family problems and multiple roles to excel at a level that would have been perceived as impossible a generation ago. Still a woman in India is storming traditional male fields. Even the occupation which had male monopoly life defense services, merchant navy, administrative or police services, these are the best examples for women now. If these women are taken under consideration they never had any issues while fighting a battle ,or trying to encroach into the men’s world ,but rather, they adopts themselves in the situation and are good ,trying to justify their roles and proving themselves. The last few decades there have been noticed an enormous growth in levels of education, confidence and the most importantly, ambition noticed towards in women, who all are striving their rights and claiming a dignified place in the society. Previously women were educated for the sake to get married and start new family but nowadays they utilize their skill productively. Since the time after independence, considering both women in India in general and women in Jharkhand in particular has played a very prominent role in all walks of life including the professions. Any success and achievement in any organisation depends on their contribution as well. Due to these consequences, there has always been a need to study and focus light on issues affecting women professionals, empowerment and their work life balance.

Keywords: women, work life balance, work empowerment, career, struggle, society, challenges, family, society, achievement

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Authors: Morgane Chatard, Clémentine Puech, Nathalie Perek, Frédéric Roche

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Several neurological disorders are linked to repeated hypoxia. The impact of such repeated hypoxic stress, on endothelial cells function of the blood-brain barrier (BBB) is little studied in the literature. Indeed, the study of hypoxic stress in cellular pathways is complex using hypoxia exposure because HIF 1α (factor induced by hypoxia) has a short half life. Our study presents an innovative induction method of repeated hypoxic stress, more reproducible, which allows us to study its impacts on an in vitro contact co-culture BBB model. Repeated hypoxic stress was induced by hydralazine (a mimetic agent of hypoxia pathway) during two hours and repeated during 24 hours. Then, BBB integrity was assessed by permeability measurements (transendothelial electrical resistance and membrane permeability), tight junction protein expressions (cell-ELISA and confocal microscopy) and by studying expression and activity of efflux transporters. First, this study showed that repeated hypoxic stress leads to a BBB’s dysfunction illustrated by a significant increase in permeability. This loss of membrane integrity was linked to a significant decrease of tight junctions’ protein expressions, facilitating a possible transfer of potential cytotoxic compounds in the brain. Secondly, we demonstrated that brain microvascular endothelial cells had set-up defence mechanism. These endothelial cells significantly increased the activity of their efflux transporters which was associated with a significant increase in their expression. In conclusion, repeated hypoxic stress lead to a loss of BBB integrity with a decrease of tight junction proteins. In contrast, endothelial cells increased the expression of their efflux transporters to fight against cytotoxic compounds brain crossing. Unfortunately, enhanced efflux activity could also lead to reducing pharmacological drugs delivering to the brain in such hypoxic conditions.

Keywords: BBB model, efflux transporters, repeated hypoxic stress, tigh junction proteins

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Authors: Erico R. Carmona, Lucas Hernandez-Saravia, Aliro Villacorta, Felipe Carevic

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Tailings and electronic waste (e-waste) are an important source of global contamination. Chile is one of Organisation for Economic Co-operation and Development (OECD) member countries that least recycled this kind of industrial waste, reaching only 3% of the total. Tailings and e-waste recycling offers a valuable tool to minimize the increasing accumulation of waste, supplement the scarcity of some raw materials and to obtain economic benefits through the commercialization of these. It should be noted that this type of industrial waste is an important source of valuable metals, such as copper, which allow generating new business and added value through its transformation into new materials with advanced physical and biological properties. In this sense, the development of nanotechnology has led to the creation of nanomaterials with multiple applications given their unique physicochemical properties. Among others, copper nanoparticles (CuNPs) have gained great interest due to their optical, catalytic, conductive properties, and particularly because of their broad-spectrum antimicrobial activity. There are different synthesis methods of copper nanoparticles; however, green synthesis is one of the most promising methodologies, since it is simple, low-cost, ecological, and generates stable nanoparticles, which makes it a promising methodology for scaling up. Currently, there are few initiatives that involve the development of methods for the recovery and transformation of copper from waste to produce nanoparticles with new properties and better technological benefits. Thus, the objective of this work is to show preliminary data about the develop a sustainable transformation process of tailings and e-waste that allows obtaining a copper-based nanotechnological product with potential antimicrobial applications. For this, samples of tailings and e-waste collected from Tarapacá and Antofagasta region of northern Chile were used to recover copper through efficient, ecological, and low-cost alkaline hydrometallurgical treatments, which to allow obtaining copper with a high degree of purity. On the other hand, the transformation process from recycled copper to a nanomaterial was carried out through a green synthesis approach by using vegetal organic residue extracts that allows obtaining CuNPs following methodologies previously reported by authors. Initial physical characterization with UV-Vis, FTIR, AFM, and TEM methodologies will be reported for CuNPs synthesized.

Keywords: nanomaterials, industrial waste, chile, recycling

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Authors: Bazla Manzoor, Aqsa Yasin

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Pakistan is the country which is progressing by leaps and bounds through agricultural and industrial growth. The main area, which presents the largest income rate through industrial activities, is Faisalabad from the Province of Punjab. Faisalabad’s main occupations include agriculture and industry. As these sectors i.e. agriculture and industry is developing day by day, they are earning much income for the country and generating thousands of job vacancies. On one hand the city, i.e. Faisalabad is on the way of development through industrial growth, while on the other hand this industrial growth is producing a bad impact on the environment. In return, that damaged environment is affecting badly on the people and built environment. This research is chiefly based on one of the above-mentioned factors i.e. adverse environmental impacts on the built structures. Faisalabad is an old city, therefore; it is having many old structures especially from British Era. Many of those structures are still surviving and are functioning as the government, private and public buildings. However, these structures are getting in a poor condition with the passage of time due to bad maintenance and adverse environmental impacts. Bad maintenance is a factor, which can be controlled by financial assistance and management. The factor needs to be seriously considered is the other one i.e. adverse environmental impacts on British Era structures of the city because this factor requires controlled and refined human activities and actions. For this reason, a research was required to conserve the British Era structures of Faisalabad so that these structures can function well. The other reason to conserve them is that these structures are historically important and are the heritage of the city. For doing this research, literature has been reviewed which was present in the libraries of the city. Department of Environment, Town Municipal Administration, Faisalabad Development Authority and Lyallpur Heritage Foundation were visited to collect the existing data available. Various British Era structures were also visited to note down the environmental impacts on them. From all the structures “Clock Tower,” was deeply studied as it is one of the oldest and most important heritage structures of the city because the earlier settlements of the city were planned based on its location by The British Government. The architectural and environmental analyses were done for The Clock Tower. This research study found the deterioration factors of the tower according to which suggestions have been made.

Keywords: lyallpur, heritage, architecture, environment

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Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

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Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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Authors: Xiaoming Zeng, Xiaozan Wang, Qinping Xu, Shaoxian Wang

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Research Purpose: In 2017, the high school physical education and health curriculum standard advocates modular teaching. This study aims to explore the impact of ‘sports module’ teaching on the physical quality of high school students. Research methods: 800 senior high school students (400 in the experimental group and 400 in the control group) were randomly divided into two groups. The experimental group carried out modular teaching of physical education, and the control group carried out conventional teaching mode for one semester. Before and after the experiment, the physical fitness of the subjects was tested, including vital capacity, 50 meters, standing long jump, sitting forward bending. Results: After the experiment, the vital capacity (t = -4.007, p < 0.01), 50 meters (t = 2.638, p < 0.01) and standing long jump (t = -4.067, p < 0.01) of the experimental group were significantly improved. High school sports modular teaching has special characteristics. It attaches great importance to the independent development of students' personality. Students can choose their favorite modules to develop various skills and actively participate in various sports activities in the classroom. The density and intensity of sports are greatly improved. Students' speed (50m run), cardiopulmonary endurance (vital capacity), sensitivity, and strength (standing long jump) scores are greatly improved and obviously improved in nature. But at the same time, it was found that the students' sitting forward flexion did not show significant improvement, which was caused by the lack of relevant equipment in school and the students' inattention to stretching after exercise or not doing regular exercise to promote flexibility. Conclusion: (1) ‘Sports module’ teaching can effectively improve the physical quality of high school students. It is mainly manifested in cardiopulmonary function, speed, and explosive power. (2) In the future, ‘sports module’ teaching should give full play to its advantages and add courses to improve students' flexibility.

Keywords: module teaching, physical quality, senior high school student, sports

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Authors: Maffo Maffo Nicole Liliane, Mounmemi Kpoumie Hubert, Libalah Moses, Ouandji Angele, Zapfack Louis

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Forest degradation causes biodiversity and carbon loss and thus indirectly contributes to climate change. In order to assess the contribution of forests to climate change mitigation, the present study was conducted in the Ngambe-Ndom-Nyanon Communal Forest with the main objective of assessing the floristic diversity and estimating the carbon stock in the different reservoirs of the said forest. Nine plots of 2000 m² each were installed in 3 TOSs of the forest (young secondary forests, gallery forests and fallow lands) with a total area of 18,000 m² or 1,8 ha. All trees with a Diameter at Breast Height (DBH) ≥ 5 cm were inventoried at 1.30 m from the ground in each plot. Species richness, floristic diversity indices, and structural parameters were studied. 1542 trees divided into 162 species, 122 genera and 44 families were identified. The most important families were listed: Myristicaceae (30.22%), Apocynaceae (25.20%), Fabaceae (24.41%), Euphorbiaceae (22.91%) and Phyllanthaceae (20.23%). The richest genera are: Cola, Macaranga, Oncoba (4 species each); the genera Diospyros, Trichilia, Vitex and Zanthoxylum (3 species each). The ecologically important species within the forest studied are: Funtumia africana (26.14%), Coelocaryon preussii (18.46%), Pycnanthus angolensis (15.57%), Tabernaemontana crassa (14.85%) and Olax subscorpioidea (13.04%). Assessment of carbon stocks in the six forest reservoirs studied (living trees and roots, understorey, dead wood, litter and rootlets) shows that they vary according to the land-use types. It is 119.41 t.C.ha-¹ in gallery forest, 115.2 t.C.ha-¹ in young secondary forest and 90.56 t.C.ha-¹ in fallow. The Wilcoxon statistical test shows that the carbon in the young secondary forest is identical to that in the fallow, which is identical to the carbon in the gallery forest. At the individual species level, the largest diameter class [25-35[ sequesters the most carbon (232.94 tC/ha). This work shows that the quantity of carbon sequestered by a biotope is a function of the age of the stand.

Keywords: floristic diversity, carbon stocks, evergreen forests, communal forest, Ngambé-Ndom-Nyanon

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Authors: Maria Hopkins

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Research on student engagement is founded on a desire to improve the quality of online instruction in both course design and delivery. A high level of student engagement is associated with a wide range of educational practices including purposeful student-faculty contact, peer to peer contact, active and collaborative learning, and positive factors such as student satisfaction, persistence, achievement, and learning. By encouraging student engagement, institutions of higher education can have a positive impact on student success that leads to retention and degree completion. The current research presents the results of an online student engagement survey which support faculty teaching practices to maximize the learning experience for online students. The ‘Indicators of Engaged Learning Online’ provide a framework that measures level of student engagement. Social constructivism and collaborative learning form the theoretical basis of the framework. Social constructivist pedagogy acknowledges the social nature of knowledge and its creation in the minds of individual learners. Some important themes that flow from social constructivism involve the importance of collaboration among instructors and students, active learning vs passive consumption of information, a learning environment that is learner and learning centered, which promotes multiple perspectives, and the use of social tools in the online environment to construct knowledge. The results of the survey indicated themes that emphasized the importance of: Interaction among peers and faculty (collaboration); Timely feedback on assignment/assessments; Faculty participation and visibility; Relevance and real-world application (in terms of assignments, activities, and assessments); and Motivation/interest (the need for faculty to motivate students especially those that may not have an interest in the coursework per se). The qualitative aspect of this student engagement study revealed what instructors did well that made students feel engaged in the course, but also what instructors did not do well, which could inform recommendations to faculty when expectations for teaching a course are reviewed. Furthermore, this research provides evidence for the connection between higher student engagement and persistence and retention in online programs, which supports our rationale for encouraging student engagement, especially in the online environment because attrition rates are higher than in the face-to-face environment.

Keywords: instructional design, learning effectiveness, online learning, student engagement

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