Search results for: assessment of risk and need

Authors: Tengqin Han

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Delinquency has been a crucial factor in economics throughout the years. Commonly seen in credit card and mortgage, it played one of the crucial roles in causing the most recent financial crisis in 2008. In each case, a delinquency is a sign of the loaner being unable to pay off the debt, and thus may cause a lost of property in the end. Individually, one case of delinquency seems unimportant compared to the entire credit system. China, as an emerging economic entity, the national strength and economic strength has grown rapidly, and the gross domestic product (GDP) growth rate has remained as high as 8% in the past decades. However, potential risks exist behind the appearance of prosperity. Among the risks, the credit system is the most significant one. Due to long term and a large amount of balance of the mortgage, it is critical to monitor the risk during the performance period. In this project, about 300,000 mortgage account data are analyzed in order to develop a predictive model to predict the probability of delinquency. Through univariate analysis, the data is cleaned up, and through bivariate analysis, the variables with strong predictive power are detected. The project is divided into two parts. In the first part, the analysis data of 2005 are split into 2 parts, 60% for model development, and 40% for in-time model validation. The KS of model development is 31, and the KS for in-time validation is 31, indicating the model is stable. In addition, the model is further validation by out-of-time validation, which uses 40% of 2006 data, and KS is 33. This indicates the model is still stable and robust. In the second part, the model is improved by the addition of macroeconomic economic indexes, including GDP, consumer price index, unemployment rate, inflation rate, etc. The data of 2005 to 2010 is used for model development and validation. Compared with the base model (without microeconomic variables), KS is increased from 41 to 44, indicating that the macroeconomic variables can be used to improve the separation power of the model, and make the prediction more accurate.

Keywords: delinquency, mortgage, model development, model validation

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Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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Authors: Sewe Silvanus Odhiambo

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Globally, many governments have publicly recognized private security firms as essential services providers. The private security firms face a lot of challenges, but the COVID-19 situation also has exacerbated them to another level. This paper locates its relevance in the post-coronavirus era. The COVID-19 pandemic has redefined the world operation, which shows a higher impact on the security field. Accordingly, the purpose of the study was to examine the role of corporate governance on the performance of private security firms in a post-covid pandemic era in Kenya. The study employed a descriptive research design, which included a quantitative approach and secondary data. The study was carried in the month of July 2021 from the registered private security firms. After targeting all private security firms, only 54 firms had disclosed their annual report by the time of conducting the study. The results depicted that pandemic has affected the performance of private security firms measures unfavorably. Further, boards of directors show a positive association with security firm performance. The study recommends that there is need board of directors to enhance management’s risk assessments in the midst of COVID-19; ensure that there are business continuity plans; there is organizational resilience; there is need for the development of new digital strategies; enabling the digital workforce in the firms and have effective communication plans with both internal and external stakeholders to deal with uncertainties and develop more post-COVID practices for boards of directors to improve performance of private security firms in Kenya. The practical implications of the study are that the research outcomes might assist regulatory bodies, investors, policymakers, and the security sector in general in their formulation of public and corporate governance strategies concerning future emergency preparedness and responses. This study also provides a unique contribution to the literature of COVID-19 and security firm performance in emerging economies context.

Keywords: COVID-19, corporate governance, firm performance, private security firms

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Authors: Melake Kuflom

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European power networks involve the use of multiple overhead transmission lines to construct a highly duplicated system that delivers reliable and stable electrical energy to the distribution level. The transmission line protection applied in the existing GB transmission network are normally independent unit differential and time stepped distance protection schemes, referred to as main-1 & main-2 respectively, with overcurrent protection as a backup. The increasing penetration of renewable energy sources, commonly referred as “weak sources,” into the power network resulted in the decline of fault level. Traditionally, the fault level of the GB transmission network has been strong; hence the fault current contribution is more than sufficient to ensure the correct operation of the protection schemes. However, numerous conventional coal and nuclear generators have been or about to shut down due to the societal requirement for CO2 emission reduction, and this has resulted in a reduction in the fault level on some transmission lines, and therefore an adaptive transmission line protection is required. Generally, greater utilization of renewable energy sources generated from wind or direct solar energy results in a reduction of CO2 carbon emission and can increase the system security and reliability but reduces the fault level, which has an adverse effect on protection. Consequently, the effectiveness of conventional protection schemes under low fault levels needs to be reviewed, particularly for future GB transmission network operating scenarios. The proposed paper will evaluate the transmission line challenges under high penetration of renewable energy sources andprovides alternative viable protection solutions based on the problem observed. The paper will consider the assessment ofrenewable energy sources (RES) based on a fully rated converter technology. The DIgSILENT Power Factory software tool will be used to model the network.

Keywords: fault level, protection schemes, relay settings, relay coordination, renewable energy sources

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Authors: Mohammad Moridzadeh, Mohammad Djavid, Barry Doyle

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An assessment of the long-term stability of a cavern in Chagrin shale excavated by the sequential excavation method was performed during and after construction. During the excavation of the cavern, deformations of rock mass were measured at the surface of excavation and within the rock mass by surface and deep measurement instruments. Rock deformations were measured during construction which appeared to result from the as-built excavation sequence that had potentially disturbed the rock and its behavior. Also some additional time dependent rock deformations were observed during and post excavation. Several opinions have been expressed to explain this time dependent deformation including stress changes induced by excavation, strain softening (or creep) in the beddings with and without clay and creep of the shaley rock under compressive stresses. In order to analyze and replicate rock behavior observed during excavation, including current and post excavation elastic, plastic, and time dependent deformation, Finite Element Analysis (FEA) was performed. The analysis was also intended to estimate long term deformation of the rock mass around the excavation. Rock mass behavior including time dependent deformation was measured by means of rock surface convergence points, MPBXs, extended creep testing on the long anchors, and load history data from load cells attached to several long anchors. Direct creep testing of Chagrin Shale was performed on core samples from the wall of the Pump Room. Results of these measurements were used to calibrate the FEA of the excavation. These analyses incorporate time dependent constitutive modeling for the rock to evaluate the potential long term movement in the roof, walls, and invert of the cavern. The modeling was performed due to the concerns regarding the unanticipated behavior of the rock mass as well as the forecast of long term deformation and stability of rock around the excavation.

Keywords: Cavern, Chagrin shale, creep, finite element.

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Authors: Tambe Daniel Atem

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Background: Clinical Research is an organized research on human beings intended to provide adequate information on the drug use as a therapeutic agent on its safety and efficacy. The significance of the study is to educate the global health and life science graduates in Clinical Research in depth to perform better as it involves testing drugs on human beings. Objectives: to provide an overall understanding of the scientific approach to the evaluation of new and existing medical interventions and to apply ethical and regulatory principles appropriate to any individual research. Methodology: It is based on – Primary data analysis and Secondary data analysis. Primary data analysis: means the collection of data from journals, the internet, and other online sources. Secondary data analysis: a survey was conducted with a questionnaire to interview the Clinical Research Professionals to understand the need of training to perform clinical trials globally. The questionnaire consisted details of the professionals working with the expertise. It also included the areas of clinical research which needed intense training before entering into hardcore clinical research domain. Results: The Clinical Trials market worldwide worth over USD 26 billion and the industry has employed an estimated 2,10,000 people in the US and over 70,000 in the U.K, and they form one-third of the total research and development staff. There are more than 2,50,000 vacant positions globally with salary variations in the regions for a Clinical Research Coordinator. R&D cost on new drug development is estimated at US$ 70-85 billion. The cost of doing clinical trials for a new drug is US$ 200-250 million. Due to an increase trained Clinical Research Professionals India has emerged as a global hub for clinical research. The Global Clinical Trial outsourcing opportunity in India in the pharmaceutical industry increased to more than $2 billion in 2014 due to increased outsourcing from U.S and Europe to India. Conclusion: Assessment of training need is recommended for newer Clinical Research Professionals and trial sites, especially prior the conduct of larger confirmatory clinical trials.

Keywords: clinical research, clinical trials, clinical research professionals

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Authors: Isabel Gouveia

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Antimicrobial textile materials may significantly reduce the risk of infections and because they are able to absorb substances from the skin and release therapeutic compounds to the skin, they can also find applications as complementary therapy of skin-diseases as part of standard management. Although functional textiles may be a promising area in skin disease/injury management, as part of standard management, few offer complementary treatment even though they are well known to reduce scratching and aiding emollient absorption, reducing infection, and alleviating pruritus. The reason for this may rely on the low quality of supporting evidence and negative effect that antimicrobial agents may exert on skin microbiome, as for example additional irritation of the vulnerable skin, and by causing resistant bacteria. Several antimicrobial agents have been tested in textiles: quaternary ammonium compounds, silver, polyhexamethylene-biguanides and triclosan have been used, with success. They have powerful bactericidal activity but the majority have a reduce spectrum of microbial inhibition and may cause skin irritation, ecotoxicity and bacteria resistance. Furthermore, the rising flow of strains resistant to last-resort antibiotics rekindles interest in alternative strategies. In this regard, new functional textiles incorporating highly specific antimicrobial agents towards pathogenic bacteria, are required. Recent research has been conducted on naturally occurring antimicrobials as novel alternatives to antibiotics. Conscious of this need our team firstly reported new approaches using L-cysteine and antimicrobial peptides (AMP). Briefly, we were able to develop different immobilization processes towards 6 Log Reduction against bacteria such as S. aureus and K. pneumoniae. Therefore, here we present several innovative antimicrobial textiles incorporating AMP and L-Cysteine which may open new avenues for the medical textiles market and biomaterials in general. Team references will be discussed as an overview and for comparison purposes in terms of potential therapeutic applications.

Keywords: Antimicrobials, Antimicrobial Textiles, Biomedical Textiles, Biomimetic surface functionalization

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Authors: Ina Nasto, Denada Sota, Pudrila Haskoçelaj, Mariola Ismailaj, Hajdar Kicaj

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Most of the fishing areas of the Mediterranean Sea are considered to be overfished, consequently fishing has decreased or is static. Considering the continuous increase in demand for fish, the option of aquaculture production has had a growing development in recent decades. The environmental impact of aquaculture in the marine ecosystem has been a subject of study for several years in the Mediterranean. In the case of the Albanian waters, and in particular the Gulf of Vlora, have had a progressive growing of aquaculture activity in the last twenty years. Given the convenient and secluded location for tourist activities, the bay of Ragusa was considered as the most suitable area to install the aquaculture cage system for the breeding of sea bass and sea bream. The impact of aquaculture in on the soft bottom benthic communities has been assessed at the biggest commercial fish farm (Alb-Adriatico Sh.P.K) established in coastal waters of Ragusa bay 30–50 m deep, in the southern part of the Gulf of Vlora. In order to determine if there is a possible impact on the aquaculture cage in benthic communities, a comparative analysis was undertaken between transects and samples with differences in distances between them and with a gradient of distance from the fish cages. A total of 275 taxa were identified (1 Foraminifera, 1 Porifera, 3 Cnidaria, 2 Platyhelminthes, 2 Nemertea, 1 Bryozoa, 171 Mollusca, 39 Annelida, 35 Crustacea, 14 Echinodermata, 1 Hemichordata, and 5 Tunicata). The anaysis showed three main habitats in the area: biocoenosis of terrigenous mud, residual areas with Possidonia oceanica and also residual assemblages of algal coralligenous. Four benthic biotic indexes were calculated (Shannon H ’, BENTIX, Simpson's Diversity and Peilou’s J’) also benthic indicators as total abundance, number of taxa and species frequency to evaluate possible ecological impact of fish cages in Ragusa bay.

Keywords: Bentix index, Benthic community, invertebrates, aquaculture, Raguza bay

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Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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Authors: Joseph Omeiza Alao

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The wobbly state of waste management and the high level of environmental irresponsibility is a threat to environmental security, which invariably endangered public health, regional groundwater systems and atmospheric condition. The dumping of waste materials in water bodies and gutters and the frequent burning of waste materials heaped at dumpsites as well depict the highest level of environmental indiscipline. These unruly human factors have compelled this study to apply four different techniques for environmental impact assessment and the possible public health risks of poor waste management in Nigeria. The techniques include a geophysical survey (resistivity data acquisition), dispatched questionnaire surveys, physiochemical water analysis and a physical survey of several dumpsites. While the resistivity data indicates high-level dumpsite leachate invading the ground soil down to the water table, the physiochemical water analysis depicts high content of BOD (401 – 711) mg/l, COD (731 – 1312) mg/l, TDS (419 – 1871) mg/l and heavy metals (0.014 – 1.971) mg/l present in the regional groundwater systems, which have altered the chemistry of the regional groundwater. The resistivity data shows that the overburdened soil layer overlaying the regional groundwater systems was very low (4.5 Ωm – 151 Ωm) as against the existing data (180 Ωm – 3500 Ωm). However, the physical surveys and the dispatched questionnaire surveys explore the depth of environmental irresponsibility among the citizen. While the imprints of gross environmental indiscipline may be absolutely irreversible, adequate knowledge of the environmental implications of careless waste disposal. After a critical examination of the current waste management strategies in Nigeria, the study suggests a future direction for environmental security and sustainability. Several influential regional factors, such as geology, climatic conditions, and hydrology, were also discussed.

Keywords: groundwater, environmental indiscipline, waste management, water analysis, leachate plumes, public health

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Authors: Sudha Summarwar, Sudesh Agarwal, Deepali Lall, Nalini Kataria, Jyotsana Pandey

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Assessment of antioxidant status is an effective tool to appraise the presence of oxidative stress. A combination of assays can be used to evaluate the antioxidant status like serum catalase (CAT), superoxide dismutase (SOD) and monoamine oxidase (MAO). In human medicine pregnancy is known to be associated with oxidative stress. Oxidative stress produces harmful effects to the developing foetus. Several metabolic changes occur in the maternal body to meet the demand of energy of developing foetus. Due to these changes susceptibility of maternal body increases to oxidative stress. There is paucity of research work on this aspect in nondescript goats. Therefore, the present study was intended to appraise the oxidative stress in pregnant and non-pregnant non-descript goat. Blood samples were collected for serum separation in otherwise healthy pregnant and non-pregnant nondescript goats. Mean values of serum CAT, SOD and MAO were found on a higher side (p≤0.05) with serum SOD values showing a rise of 2.5 times higher than the control healthy value. Correlations among all the three parameters were found to be highly significant (p≤0.01) especially greatest in youngest group of pregnant animals. Illustration of result enlightened the veracity of bumped up production of free radicals in pregnant animals. Technical savoir-faire of oxidative stress supervision is essential for upholding of health status of foetus. The upshot of present study undoubtedly implied the development of oxidative stress in pregnant goats on the basis of altered antioxidant status. These findings conclude that initially the oxidative stress due to pregnancy is critically combated by the intricate defensive mechanism of natural antioxidant system of the body. It appears that this imbalance between oxidant and antioxidant must be checked in time to prevent cellular damage by regularly appraising the antioxidant status through laboratory methods.

Keywords: antioxidant, oxidative stress, pregnancy, serum catalase

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Authors: Sachin Sharma

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Sexual consent is integral to every sexual relationship. It is a process to facilitate sexual autonomy and bodily integrity. It assures complete sexual personhood and allows an individual to explore her sexual expressions independently. But the said proposition is not true for people with psychosocial disabilities. Generally, they are considered seraphic or mephistophelic and denied access to sexual autonomy. This result in institutionalizing the sexuality of disabled persons, where the eugenics-ableist narrative defines assessment and access to consent. This way, sexuality and disability are distanced apart. It is primarily due to the stigmatized socio-cultural constructs of sexuality that define sex within a “standard” and “charmed” circle. Such stigmatized expression influences the law, as it considers people with psychosocial disabilities incapable of sexual consent. The approach of legal institutions is very narrow towards interpreting their sexual rights. It echoes the modernist-ableism and strangulates the sexual choices. This way, it reflects the repressive model of sex and denies space to people with psychosocial disabilities. Moreover, judicial courts follow old and conservative methods while dealing with sexual issues. For instance, courts still practice the “standardized” norm of intelligence quotient (IQ) for determining the credibility of persons with psychosocial disabilities. Further, there is still doubt about assistive communicative techniques. This paper will try to question the normative structure of sexual consent and related laws while specifically addressing the issues of sex as desire and abuse. Considering the commitment to the United Nations Convention on the Rights of Persons with Disabilities (herein referred to as UNCRPD) and common law experience, the paper will draw a comparative study on the legal position of sexual rights in India. The paper will also analyze the role of UNCRPD in addressing sexual rights. The author will examine the position of sexual rights of people with psychosocial disabilities after the drafting of UNCRPD and specific state laws. The paper primarily follows the doctrinal method.

Keywords: sexual autonomy, institutionalized choices, overregulated laws, violation of individuality

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Authors: Vasishtha Avadhani Upadrasta, Mradul Kumar Daga, Smita Kaushik

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Background: Caffeine consumption has skyrocketed in the recent decades as we try to match pace with the machines. Studies have been conducted on animals and a few on humans, mainly on the acute effects of high-dose caffeine intake. Almost none have been conducted on the chronic effects of caffeine consumption. This study involved Medical professionals as case subjects, who consumed caffeine daily. Methods: This study, over a period of 3 months, involved 96 volunteers (chosen randomly w.r.t. gender and field in medical fraternity), including people who drank >500mg of caffeine a day to people who consumed none. People with any co-morbidities at all were excluded straight away. Two sets of blood samples were drawn and assessed. Three groups were created, Group 1 (>200mg caffeine/day) and Group 2 (15-200 mg caffeine/day) and Group 3 (<200mg Caffeine/day). Results: The result of the study found that exposure to caffeine at doses >200mg/day for more than 6 months leads to a significant difference in circulating free T3 [(-0.96 pmol/L ± 0.07) = (-18.5%), CI 95%, p = .000024] and Cortisol [(-123 nmol/L ± 9.8) = (-46.8%), CI 95%, p = .00029] hormones but shows an insignificant effect on circulating TSH [0.4 mIU/L, CI 95%, p=.37] and ACTH [(-3.2 pg/ml ± 0.3), CI 95%, p = .53) hormones, which stay within normal physiological ranges, irrespective of the daily dose of consumption. Results also highlight that women are more susceptible to decrement in fT3 than men (Relative Risk =1.58, ANOVA F-static = 7.15, p = 0.0105). Conclusions: Caffeine consumption in excess of 200mg/day, for more than or equal to 6 months, causes significant derangement in basal fT3 and Cortisol hormone levels, without affecting the TSH and ACTH (regulatory) hormone levels, indicating disturbance of action at the peripheral and/or cellular levels, possibly via the Paraventricular Nucleus –Leptin-CAR-Adenosine interactions. Women are more susceptible to decrement in fT3 levels than men (at same dose of caffeine).

Keywords: ACTH, adrenals, caffeine, cortisol, thyroid, thyroxin, TSH

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Authors: Carlos Alberto Ríos Reyes, Andrés Felipe Mejía Durán, Oscar Mauricio Castellanos Alarcón

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There is no doubt of great importance to make it known that planet Earth is an entity in constant change and transformation; processes such as construction and destruction are part of the evolution of the territory. Geoeducation workshops represent a significant contribution to the search for educational projects focused on teaching relevant geoscience topics to make natural threats known in schools through recreational and didactic activities. This initiative represents an educational alternative that must be developed with the participation of primary and secondary schools, universities, and local communities. The methodology is based on several phases, which include: diagnosis to know the best teaching method for basic concepts and establish a starting point for the topics to be taught, as well as to identify areas and concepts that need to be reinforced and/or deepened; design of activities that involve all students regardless of their ability or level; use of accessible materials and experimentation to support clear and concise explanations for all students; adaptation of the teaching-learning process to individual needs; sensitization about natural threats; and evaluation and feedback. It is expected to offer a series of activities and materials as a significant contribution to the search for educational projects focused on teaching relevant geoscientific topics such as natural threats associated with earthquakes, volcanic eruptions, floods, landslides, etc. The major findings of this study are the pedagogical strategies that primary and secondary school teachers can appropriate to face the challenge of transferring geological knowledge and to advise decision-makers and citizens on the importance of geosciences for daily life. We conclude that the knowledge of the natural threats to our planet is very important to contribute to mitigating their risk.

Keywords: workshops, geoeducation, curriculum, geosciences, natural threats

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Authors: Iva Hereitova, Miroslav Svatek, Vit Novacek

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Background and Aim: Autonomic imbalance is one of the complications for immobilized patients in the acute stage after a stroke. The predominance of sympathetic activity significantly increases cardiac activity. The technique of glenohumeral joint approximation may contribute in a non-pharmacological way to the regulation of blood pressure and heart rate in patients in this risk group. The aim of the study was to evaluate the effect of glenohumeral joint approximation on the change in heart rate and blood pressure in immobilized patients in the acute phase after a stroke. Methods: The experimental study bilaterally evaluated heart rate, systolic and diastolic pressure values before and after glenohumeral joint approximation in 40 immobilized participants (72.6 ± 10.2 years) in the acute phase after stroke. The experimental group was compared with 40 healthy participants in the control group (68.6 ± 14.2 years). An SpO2 vital signs monitor and a validated Microlife WatchBP Office blood pressure monitor were used for evaluation. Statistical processing and evaluation were performed in MATLAB R2019 (The Math Works®, Inc., Natick, MA, USA). Results: Approximation of the glenohumeral joint resulted in a statistically significant decrease in systolic and diastolic pressure. An average decrease in systolic pressure for individual groups ranged from 8.2 to 11.3 mmHg (p <0.001). For diastolic pressure, the average decrease ranged from 5.0 - 14.2 mmHg (p <0.001). There was a statistically significant reduction in heart rate (p <0.01) only in patients after ischemic stroke in the inferior cerebral artery. There was the average decrease in heart rate of 3.9 beats per minute (median 4 beats per minute). Conclusion: Approximation of the glenohumeral joint leads to a statistically significant decrease in systolic and diastolic pressure in immobilized patients in the acute phase after stroke.

Keywords: Aproximation technique, Cardiovaskular system, Glenohumeral joint, Stroke

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

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Authors: A. Pietro Rimoldi, B. Anilkumar Gopinath, C. Minimol Korulla

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Coastal engineering structure is conventionally designed for a shorter planning horizon usually 20 years. These structures are subjected to different offshore climatic externalities like waves, tides, tsunamis etc. during the design life period. The probability of occurrence of these different offshore climatic externalities varies. The impact frequently caused by these externalities on the structures is of concern because it has a significant bearing on the capital /operating cost of the project. There can also be repeated short time occurrence of these externalities in the assumed planning horizon which can cause heavy damage to the conventional coastal structure which are mainly made of rock. A replacement of the damaged portion to prevent complete collapse is time consuming and expensive when dealing with hard rock structures. But if coastal structures are made of Geo-synthetic containment systems such replacement is quickly possible in the time period between two successive occurrences. In order to have a better knowledge and to enhance the predictive capacity of these occurrences, this study estimates risk of encounter within the design life period of various externalities based on the concept of exponential distribution. This gives an idea of the frequency of occurrences which in turn gives an indication of whether replacement is necessary and if so at what time interval such replacements have to be effected. To validate this theoretical finding, a pilot project has been taken up in the field so that the impact of the externalities can be studied both for a hard rock and a Geosynthetic tube structure. The paper brings out the salient feature of a case study which pertains to a project in which Geosynthetic tubes have been used for reformation of a seawall adjacent to a conventional rock structure in Alappuzha coast, Kerala, India. The effectiveness of the Geosystem in combatting the impact of the short-term externalities has been brought out.

Keywords: climatic externalities, exponential distribution, geosystems, planning horizon

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Authors: Made Darmiati, Ni Putu Evi Wijayanti, Ni Ketut Wiwiek Agustina, Putu Gde Arie Yudhistira, Marcel Hardono

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The establishment of tourist village has been the main concern for pro-poor tourism in Indonesia especially in Bali in order to create alternative tourist destination. The case study of this research was Munduk, a tourist village located in Buleleng Regency, Bali Province. Munduk has been unstable in terms of tourist visit in 2012 until 2016. The concept of marketing strategy and its marketing mix are concepts that suitable for application in Munduk as the prime owner of trekking and other rural tour packages to increase the number of visitor in particularly during low season. The research study aims to determine the internal factors (strengths and weaknesses) and external factors (opportunities and threats) impacting the number of tourist visit so that they could formulate appropriate marketing strategy for Munduk Tourist Village. Data has been obtained by observation, interviews with stakeholders, questionnaire to 100 participants and documentation. In addition, this research study uses descriptive qualitative methods and techniques known as SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis by internal factors and external factors impacting the level of tourist visit to Munduk Tourist Village in Buleleng Regency, Bali. The sampling was done by ‘accidental sampling technique’ to obtain the participants to analyse the results of the SWOT analysis. Further assessment of internal and external weights has resulted respectively (1.84 , 1.84) which are in the first quadrant of the diagram in which S-O (Strengths-Opportunities) Strategy. As the prime owner of the trekking and other rural tour packages in the village, Munduk should maximise its strengths and take other opportunities as possible to wrap and design trekking and other rural tour packages and then offer the package to travel agents in Bali.

Keywords: marketing mix, marketing strategy, rural tourism, SWOT matrix

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Authors: Shalu Jain, Anju Bansal, Anup Kumar, Sunita Saxena

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Objectives: The novel TMPRSS2:ERG gene fusion is a common somatic event in prostate cancer that in some studies is linked with a more aggressive disease phenotype. Thus, this study aims to determine whether clinical variables are associated with the presence of TMPRSS2:ERG-fusion gene transcript in Indian patients of prostate cancer. Methods: We evaluated the clinical variables with presence and absence of TMPRSS2:ERG gene fusion in prostate cancer and BPH association of clinical patients. Patients referred for prostate biopsy because of abnormal DRE or/and elevated sPSA were enrolled for this prospective clinical study. TMPRSS2:ERG mRNA copies in samples were quantified using a Taqman chemistry by real time PCR assay in prostate biopsy samples (N=42). The T2:ERG assay detects the gene fusion mRNA isoform TMPRSS2 exon1 to ERG exon4. Results: Histopathology report has confirmed 25 cases as prostate cancer adenocarcinoma (PCa) and 17 patients as benign prostate hyperplasia (BPH). Out of 25 PCa cases, 16 (64%) were T2: ERG fusion positive. All 17 BPH controls were fusion negative. The T2:ERG fusion transcript was exclusively specific for prostate cancer as no case of BPH was detected having T2:ERG fusion, showing 100% specificity. The positive predictive value of fusion marker for prostate cancer is thus 100% and the negative predictive value is 65.3%. The T2:ERG fusion marker is significantly associated with clinical variables like no. of positive cores in prostate biopsy, Gleason score, serum PSA, perineural invasion, perivascular invasion and periprostatic fat involvement. Conclusions: Prostate cancer is a heterogeneous disease that may be defined by molecular subtypes such as the TMPRSS2:ERG fusion. In the present prospective study, the T2:ERG quantitative assay demonstrated high specificity for predicting biopsy outcome; sensitivity was similar to the prevalence of T2:ERG gene fusions in prostate tumors. These data suggest that further improvement in diagnostic accuracy could be achieved using a nomogram that combines T2:ERG with other markers and risk factors for prostate cancer.

Keywords: prostate cancer, genetic rearrangement, TMPRSS2:ERG fusion, clinical variables

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Authors: Emmanuel Kamal Aziz Saba, Gihan Abd El-Lateif Younis El-Tantawi, Mohammed Hamdy Zahran, Ibrahim Khalil Ibrahim, Mohammed Abd El-Salam Shehata, Hussein Al-Moghazy Sultan, Medhat

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Pelvic floor electrophysiological tests are essential for assessment of patients with obstructed defecation. The present study was conducted to determine the different patterns of pelvic floor electrophysiology that are associated with obstructed defecation. The present cross sectional study included 25 patients with obstructed defecation. A control group of 20 apparently healthy subjects were included. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, lateral proctography (evacuation proctography), dynamic pelvic magnetic resonance imaging, anal manometry and electrophysiological studies. Electrophysiological studies were including pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which included pudendal nerve motor conduction study, pudendo-anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristics of obstructed defecation was pudendal neuropathy, denervation and anismus of external anal sphincter and puborectalis with complete interference pattern of external anal sphincter and puborectalis at squeezing and cough and no localized defect in external anal sphincter. In conclusion, there were characteristic pelvic floor electrodiagnostic patterns associated with obstructed defecation.

Keywords: obstructed defecation, pudendal nerve terminal motor latency, pudendoanal reflex, sphincter electromyography

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Authors: Mohammad Hossein Badamchi

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In Iran as well as other developing countries instituting innovation and entrepreneurship ecosystems by government around the universities is the new imported fashion of modernization and development in the 21st century. In recent decade various statesmen, policy makers, university administrations, economists and development theorists are emphasizing excitingly about the new “start-ups” which are going to solve all economic problems and backwardness of the country. However, critical study of modernization practices in Iran implies that this new trend is suffering from conventional deficiency of modernization planning in 20th century. This article is going to depict the misunderstandings of a situation which we can name “Pseudo-innovation in a closed society” by presenting these 12 paradoxes of this new system, actually happening in Iran: (1) Innovation without freedom? Fiction of innovation in a patriarchal state (2) Entrepreneurship without free market? Fiction of entrepreneurship in a rentier-state. (3) Ecosystem or a state-glasshouse? Is it possible to make and plan an innovation? (4) Innovation; epistemic or practical? How academic innovation could happen abstractly out of context? (5) Risk and Lucre: innovation to protect power and property?! (6) Silicon-valley mirage: what is in common between American-Iranian polity? (7) Information or Communication? ICT startups to restrict the internet (8) The elite paradox: new proletariat of private sector, new governmental clerk or a new path of brain drain? (9) Innovation or commercialization? Revisiting Schumpeterian creative destruction (10) The friendship of Jungle and fire: paradox of public science and market (11) Innovation and revolution: top-down or bottom-up paradox in an Iranian experience (12) Technology instead of civil society: ultimate result of innovation in a closed society. Through explaining these paradoxes we can gradually penetrate the real rationality of Pseudo-innovation ecosystem in a closed society, which can be understood as new-Neopatriarchy reconstruction of traditional patriarchal politics, economy and culture in Iran.

Keywords: innovation, critical sociology, modernisation, Iran, closed society

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Authors: Muhammad Minhaj Khan, Jaemin Lee, Suhong Lee, Jinyoung Chung, Johoo Whang

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The Republic of Korea has been facing strong storage crisis from nuclear waste generation as At Reactor (AR) temporary storage sites are about to reach saturation. Since the country is densely populated with a rate of 491.78 persons per square kilometer, Construction of High-level waste repository will not be a feasible option. In order to tackle the storage waste generation problem which is increasing at a rate of 350 tHM/Yr. and 380 tHM/Yr. in case of 20 PWRs and 4 PHWRs respectively, the study strongly focuses on the advancement of current nuclear power plants to GEN-IV sustainable and ecological nuclear systems by burning TRUs (Pu, MAs). First, Calculations has made to estimate the generation of SNF including Pu and MA from PWR and PHWR NPPS by using the IAEA code Nuclear Fuel Cycle Simulation System (NFCSS) for the period of 2016, 2030 (including the saturation period of each site from 2024~2028), 2089 and 2109 as the number of NPPS will increase due to high import cost of non-nuclear energy sources. 2ndly, in order to produce environmentally sustainable nuclear energy systems, 4 scenarios to burnout the Plutonium and MAs are analyzed with the concentration on burning of MA only, MA and Pu together by utilizing SFR, LFR and KALIMER-600 burner reactor after recycling the spent oxide fuel from PWR through pyro processing technology developed by Korea Atomic Energy Research Institute (KAERI) which shows promising and sustainable future benefits by minimizing the HLW generation with regard to waste amount, decay heat, and activity. Finally, With the concentration on front and back end fuel cycles for open and closed fuel cycles of PWR and Pyro-SFR respectively, an overall assessment has been made which evaluates the quantitative as well as economical combativeness of SFR metallic fuel against PWR once through nuclear fuel cycle.

Keywords: GEN IV nuclear fuel cycle, nuclear waste, waste sustainability, transmutation

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Authors: Kin On Kwok, Vivian Wei, Benjamin Cowling, Steven Riley, Jonathan Read

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Background: The role of social contact behavior measured in different contact constructs in the transmission of respiratory pathogens with acute respiratory illness (ARI) remains unclear. We, therefore, aim to depict the individual pattern of ARI in the community and investigate the association between different contact dimensions and ARI in Hong Kong. Methods: Between June 2013 and September 2013, 620 subjects participated in the last two waves of recruitment of the population based longitudinal phone social contact survey. Some of the subjects in this study are from the same household. They are also provided with the symptom diaries to self-report any acute respiratory illness related symptoms between the two days of phone recruitment. Data from 491 individuals who were not infected on the day of phone recruitment and returned the symptom diaries after the last phone recruitment were used for analysis. Results: After adjusting different follow-up periods among individuals, the overall incidence rate of ARI was 1.77 per 100 person-weeks. Over 75% ARI episodes involve running nose, cough, sore throat, which are followed by headache (55%), malagia (35%) and fever (18%). Using a generalized estimating equation framework accounting for the cluster effect of subjects living in the same household, we showed that both daily number of locations visited with contacts and the number of contacts, explained the ARI incidence rate better than only one single contact construct. Conclusion: Our result suggests that it is the intertwining property of contact quantity (number of contacts) and contact intensity (ratio of subject-to-contact) that governs the infection risk by a collective set of respiratory pathogens. Our results provide empirical evidence that multiple contact constructs should be incorporated in the mathematical transmission models to feature a more realistic dynamics of respiratory disease.

Keywords: acute respiratory illness, longitudinal study, social contact, symptom diaries

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Authors: Rajkumar Ghosh

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Climate change has led to decreased water availability in the Gomti Nagar area of Uttar Pradesh, India. Climate change has reduced the amount of precipitation and increased the rate of evaporation. The region is heavily reliant on surface water sources (Gomti river, Sharda Canal) and groundwater. Efficient management of groundwater resources is crucial for addressing water shortages. These may include: Exploring alternative water sources, such as wastewater recycling and desalination, can help augment water supply and reduce dependency on rainfall-dependent sources. Promoting the use of water-efficient technologies in industries, agriculture, and water-efficient infrastructure in urban areas can contribute to reducing water demand and optimizing water use. Incorporating climate change considerations into urban planning and infrastructure development can help ensure water security in the face of future climate uncertainties. Addressing water scarcity in the Gomti Nagar area requires a multi-pronged approach that combines sustainable groundwater management practices, climate change adaptation strategies, and integrated water resource management. By implementing these measures, the region can work towards ensuring a more sustainable and reliable water supply in the context of climate change. Water is the most important natural resource for the existence of living beings in the Earth's ecosystem. On Earth, 1.2 percent of the water is drinkable, but only 0.3 percent is usable by people. Water scarcity is a growing concern in India due to the impact of climate change and over-exploitation of water resources. Excess groundwater withdrawal causes regular declines in groundwater level. Due to city boundary expansion and growing urbanization, the recharge point for groundwater tables is decreasing. Rainwater infiltration into the subsoil is also reduced by unplanned, uneven settlements in urban change.

Keywords: climate change, water scarcity, groundwater, rainfall, water supply

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Authors: Nwadioha Samuel Iheanacho, Abah Paul, Odimayo Simidele Michael

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Background: The World Health Assembly through the Global Health Sector Strategy on viral hepatitis calls for the elimination of viral hepatitis as a public health threat by 2030. All hands are on deck to actualize this goal through an effective and active vaccination and monitoring tool. Aim: To combine the Epidemiologic with Laboratory Hepatitis B Virus vaccination monitoring tools. Method: Laboratory results analysis of subjects recruited during the World Hepatitis week from July 2020 to July 2021 was done after obtaining their epidemiologic data on Hepatitis B virus risk factors, in the Medical Microbiology Laboratory of Benue State University Teaching Hospital, Nigeria. Result: A total of 500 subjects comprising males 60.0%(n=300/500) and females 40.0%(n=200/500) were recruited. A fifty-three percent majority was of the age range of 26 to 36 years. Serologic profiles were as follows, 15.0%(n=75/500) HBsAg; 7.0% (n=35/500) HBeAg; 8.0% (n=40/500) Anti-Hbe; 20.0% (n=100/500) Anti-HBc and 38.0% (n=190/500) Anti-HBs. Immune responses to vaccination were as follows, 47.0%(n=235/500) Immune naïve {no serologic marker + normal ALT}; 33%(n=165/500) Immunity by vaccination {Anti-HBs + normal ALT}; 5%(n=25/500) Immunity to previous infection {Anti-HBs, Anti-HBc, +/- Anti-HBe + normal ALT}; 8%(n=40/500) Carriers {HBsAg, Anti-HBc, Anti-HBe +normal ALT} and 7% (35/500) Anti-HBe serum- negative infections {HBsAg, HBeAg, Anti-HBc +elevated ALT}. Conclusion: The present 33.0% immunity by vaccination coverage in Central Nigeria was much lower than the 41.0% national peak in 2013, and a far cry from the global expectation of attainment of a Global Health Sector Strategy on the elimination of viral hepatitis as a public health threat by 2030. Therefore, more creative ideas and collective effort are needed to attain this goal of the World Health Assembly.

Keywords: Hepatitis B, vaccination status, laboratory tools, resource-limited settings

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Authors: J. T. Koininga, J. E. Teigen, A. Wilkinson, D. Kanneh, F. Kanneh, M. Foday, D. S. Grant, M. Leach, L. M. Moses

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Lassa fever (LF) is a severe febrile illness endemic to West Africa. While human-to-human transmission occurs, evidence suggests most LF cases originate from exposure to rodents, particularly the Natal multimammate mouse, Mastomys natalensis. Within West Africa, LF occurs primarily in rural communities where agriculture is the main economic activity. Seasonality of LF has also been linked to agricultural cycles, with peak incidence occurring in the dry season when fields are burned and plowed. To investigate this pattern of seasonality, four agricultural communities were selected for this two-year longitudinal study. Each community was to be sampled four times each year, but this was interrupted by the Ebola virus disease outbreak. Agricultural land use, forested, and fallow areas were identified through participatory mapping. Transects were plotted in each area and Sherman traps were set for four nights. Captured small mammals were identified, ear tagged, and released. Mastomys natalensis abundance was found to be highest in areas of converted fallow land and rice swamps in the dry season and upland mixed crop areas toward the onset of the rainy season. All peak times were associated with heavy perturbation of soil. All ages and genders were present during these time points. These results suggest that peak abundance of the Mastomys natalensis in agricultural areas coincides with peak incidence of LF reported in this region. Although contact with rodents may be higher in villages, our study suggests human behaviors in agricultural areas may increase risk of transmission of Lassa virus.

Keywords: agriculture, land use, Lassa Fever, rodent abundance

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Authors: Jogi Prayogo, Dwi Qaqa Prasetyatama, Rahmad Dwi Afandi, Kunto Arief Prasetyo, Viorel Herniza Leksono

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PT. Pertamina Trans Kontinental managed a fleet of 364 ships in 2018 - 2020. In that period, there were 8 incidents of ship damage, causing breakdown maintenance on 6 ships belonging to PT Pertamina Trans Kontinental throughout Indonesia's operational areas due to ropes entangled in propellers. The company's losses that were caused by the fouled propellers amounted to 306.35 Million Rupiah. Of the 8 incidents, Mooring Boat PSC I was taken as a pilot project for further analysis considering the location of the ship which is in Surabaya and Mooring Boat PSC I has experienced 2 incidents of rope entanglement that caused the company's losses due to the largest Breakdown Maintenance amounted to 200.99 Million Rupiah. After analyzing the rope entanglement in the ship's propeller based on the data of Mooring Boat PSC I related to the location of propellers that are often fouled in the conventional propulsion system, it was found that there is a suitable location for the implementation of SI KUMAN tool that serves to cut ropes to prevent the occurrence of rope entangled in ship propellers. The determination of SI KUMAN tool is based on the strength of the ship's material to be installed and a suitable design to prevent the occurrence of ropes being entangled in propellers. After the installation of the "SI KUMAN" tool and monitoring carried out for 1 year period (August 2020 - August 2021), it was found that SI KUMAN tool can eliminate the risk of fouled propeller incidents which previously occurred twice in one year so that the company's loss amounted to 200.99 Million Rupiah can be eliminated and SI KUMAN tool can still operate optimally.

Keywords: breakdown maintenance, mooring boat, fleet, fouled propeller, rope entangled, cut

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Authors: J. Wicks

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Aim: To develop a simple methodology to allow collected heart rate (HR) data from inexpensive wearable devices to be expressed in a suitable format (METs) to quantitate occupational (and recreational) activity. Introduction: Assessment of occupational activity is commonly done by utilizing questionnaires in combination with prescribed MET levels of a vast range of previously measured activities. However for any individual the intensity of performing a specific activity can vary significantly. Ideally objective measurement of individual activity is preferred. Though there are a wide range of HR recording devices there is a distinct lack methodology to allow processing of collected data to quantitate energy expenditure (EE). The HR index equation expresses METs in relation to relative HR i.e. the ratio of activity HR to resting HR. The use of this equation provides a simple utility for objective measurement of EE. Methods: During a typical occupational work period of approximately 8 hours HR data was recorded using a Polar RS 400 wrist monitor. Recorded data was downloaded to a Windows PC and non HR data was stripped from the ASCII file using ‘Notepad’. The HR data was exported to a spread sheet program and sorted by HR range into a histogram format. Three HRs were determined, namely a resting HR (the HR delimiting the lowest 30 minutes of recorded data), a mean HR and a peak HR (the HR delimiting the highest 30 minutes of recorded data). HR indices were calculated (mean index equals mean HR/rest HR and peak index equals peak HR/rest HR) with mean and peak indices being converted to METs using the HR index equation. Conclusion: Inexpensive HR recording devices can be utilized to make reasonable estimates of occupational (or recreational) EE suitable for large scale demographic screening by utilizing the HR index equation. The intrinsic value of the HR index equation is that it is independent of factors that influence absolute HR, namely fitness, smoking and beta-blockade.

Keywords: energy expenditure, heart rate histograms, heart rate index, occupational activity

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Authors: Ahmed R. Z. Baghdadi,  Mona H. Gamal Eldein

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel unsatisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for group I, II, and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed-Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months post-operatively in group I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months post-operatively in group I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: dynamic balance, functional performance, knee arthroplasty, long-term

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Authors: Venkateswar Pujari

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This study tries to investigate the complex interplay between control, awareness, and attention in human cognitive processes. The fundamental elements of cognitive functioning that play a significant role in influencing perception, decision-making, and behavior are attention, awareness, and control. Understanding how they interact can help us better understand how our minds work and may even increase our understanding of cognitive science and its therapeutic applications. The study uses an empirical methodology to examine the relationships between attention, awareness, and control by integrating different experimental paradigms and neuropsychological tests. To ensure the generalizability of findings, a wide sample of participants is chosen, including people with various cognitive profiles and ages. The study is structured into four primary parts, each of which focuses on one component of how attention, awareness, and control interact: 1. Evaluation of Attentional Capacity and Selectivity: In this stage, participants complete established attention tests, including the Stroop task and visual search tasks. 2. Evaluation of Awareness Degrees: In the second stage, participants' degrees of conscious and unconscious awareness are assessed using perceptual awareness tasks such as masked priming and binocular rivalry tasks. 3. Investigation of Cognitive Control Mechanisms: In the third phase, reaction inhibition, cognitive flexibility, and working memory capacity are investigated using exercises like the Wisconsin Card Sorting Test and the Go/No-Go paradigm. 4. Results Integration and Analysis: Data from all phases are integrated and analyzed in the final phase. To investigate potential links and prediction correlations between attention, awareness, and control, correlational and regression analyses are carried out. The study's conclusions shed light on the intricate relationships that exist between control, awareness, and attention throughout cognitive function. The findings may have consequences for cognitive psychology, neuroscience, and clinical psychology by providing new understandings of cognitive dysfunctions linked to deficiencies in attention, awareness, and control systems.

Keywords: attention, awareness, control, cognitive functioning, neuropsychological assessment

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