Search results for: history of sexuality

Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

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Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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Authors: Piyanee Khumpao

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Under the Thai Penal Code and Customs Act, sex toys are criminalized and completely prohibited through the legal interpretation as obscene objects by law enforcement, despite there is no explicit legal sanction against them. The purpose of preventing people from accessing sex toys is to preserve public morals. However, sex toys are still available, exposed, and sold publicly in main cities throughout Thailand. They are easily observed by people of any age. This paper argues that sexuality is human nature and human right. Human deserves sexual pleasure as long as getting sexual pleasure does not inflict any harm on others. Using sex toys in private (individually and/or as a couple with mutual consent) does not constitute any harm nor degrade public moral. Therefore, the complete ban of sex toys shall be lifted and decriminalized. Nevertheless, the economic analysis illustrates that criminalization and prohibition of sex toys would lead to its black market – higher price and lower quantity. Although it is socially desirable to have fewer sex toys in the market, there will usually be high demand for them because sexual pleasure is natural and, hence, people have a lower price elasticity of demand for such things, including pornography. Thus, its deterrent effect is not very effective. Moreover, sex toys vendors still always exist because higher price incentivizes them to act illegally and may gain benefits from selling low-quality sex toys. Consequently, consumers do not have a choice to select high-quality sex toys at a reasonable price. Then, they are forced to purchase low quality sex toys at a higher price. They also may suffer from health issues as well as other harms from its dangerous/toxic substances since lower quality products are manufactured poorly to save costs. A law and economics approach supports the decriminalization of sex toys in Thailand. Other measures to control its availability shall be adopted to protect the vulnerable, such as children. Options are i) zoning or regulation on-premises selling sex toys as in Singapore, Japan, and China, ii) regulations of sex toys as medical apparatus like in the state of Alabama, and iii) the prevention of sex toys exposure in the real (physical) appearance (i.e., allowing virtual exposure of sex toys) like in India.

Keywords: human nature, law and economics approach, sex toys, sexual pleasure

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Authors: Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, A. C. Dhariwal, Pawana Murthy

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Burden of Dengue in Northern India Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, AC Dhariwal, Pawana Murthy. All India Institute of Medical Sciences, NVBDCP,WHO New Delhi, India Aim: This study was conducted to estimate the burden of dengue in capital region of India. Methodology:Seropositivity of Dengue for IgM Ab, NS1 Ag and IgG Ab were performed among the blood donors’ samples from blood bank, those who were coming to donate blood for the requirement of blood for the admitted patients in hospital. Blood samplles were collected through out the year to estimate seroprevalance of dengue with or without outbreak season. All the subjects were asymptomatic at the time of blood donation. Results: A total of 1558 donors were screened for the study. On the basis of inclusion/ exclusion criteria, we enrolled 1531subjects for the study.Twenty seven donors were excluded from the study, out of which 6 were detected HIV +ve, 11 were positive for HBsAg and 10 were found positive for HCV.Mean age was 30.51 ± 7.75 years.Of 1531subjects, 18 (1.18%) had a past history of typhoid fever, 28 (1.83%) had chikungunya fever, 9 (0.59%) had malaria and 43 subjects (2.81%) had a past history of symptomatic dengue infection.About 2.22% (34) of subjects were found to have sero-positive for NS1 Ag with a peak point prevalence of 7.14% in the month of October and sero-positive of IgM Ab was observed about 5.49% (84)with a peak point prevalence of 14.29% in the month of October. Sero-prevalnce of IgGwas detected in about 64.21% (983) of subjects. Conclusion: Acute asymptomatic dengue (NS1 Ag+ve) was observed in 7.14%, as the subjects were having no symptoms at the time of sampling. This group of subjects poses a potential public health threat for transmitting dengue infection through blood transfusion (TTI) in the community as evident by presence of active viral infection due to NS1Ag +VE. Therefore a policy may be implemented in the blood bank for testing NS1 Ag to look for active dengue infection for preventing dengue transmission through blood transfusion (TTI). Acute or Subacute dengue infection ( IgM Ab+ve) was observed from 5.49% to 14.29% which is a peak point prevalence in the month of October. About 64.21% of the population were immunized by natural dengue infection ( IgG Ab+ve) in theNorthern province of India. This might be helpful for implementing the dengue vaccine in a region. Blood samples in blood banks should be tested for dengue before transfusion to any other person to prevent transfusion transmitted dengue infection as we estimated upto 7.14% positivity of NS1 Ag in our study which indicates presence of dengue virus in blood donors’ samples.

Keywords: Dengue Burden, Seroprevalance, Asymptomatic dengue, Dengue transmission through blood transfusion

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Authors: Axel Thallemer, Aleksandar Kostadinov, Abel Fam, Alex Teo

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For centuries, the forming processes in nature served as a source of inspiration for both architects and designers. It seems as most human artifacts are based on ideas which stem from the observation of the biological world and its principles of growth. As a fact, in the cultural history of Homo faber, materials have been mostly used in their solid state: From hand axe to computer mouse, the principle of employing matter has not changed ever since the first creation. In the scope of history only recently and by the help of additive-generative fabrication processes through Computer Aided Design (CAD), designers were enabled to deconstruct solid artifacts into an outer skin and an internal lattice structure. The intention behind this approach is to create a new topology which reduces resources and integrates functions into an additively manufactured component. However, looking at the currently employed lattice structures, it is very clear that those lattice structure geometries have not been thoroughly designed, but rather taken out of basic-geometry libraries which are usually provided by the CAD. In the here presented study, a group of 20 industrial design students created new and unique lattice structures using natural paragons as their models. The selected natural models comprise both the animate and inanimate world, with examples ranging from the spiraling of narwhal tusks, off-shooting of mangrove roots, minimal surfaces of soap bubbles, up to the rhythmical arrangement of molecular geometry, like in the case of SiOC (Carbon-Rich Silicon Oxicarbide). This ideation process leads to a design of a geometric cell, which served as a basic module for the lattice structure, whereby the cell was created in visual analogy to its respective natural model. The spatial lattices were fabricated additively in mostly [X]3 by [Y]3 by [Z]3 units’ volumes using selective powder bed melting in polyamide with (z-axis) 50 mm and 100 µm resolution and subdued to mechanical testing of their elastic zone in a biomedical laboratory. The results demonstrate that additively manufactured lattice structures can acquire different properties when they are designed in analogy to natural models. Several of the lattices displayed the ability to store and return kinetic energy, while others revealed a structural failure which can be exploited for purposes where a controlled collapse of a structure is required. This discovery allows for various new applications of functional lattice structures within industrially created objects.

Keywords: bio-inspired, biomimetic, lattice structures, additive manufacturing

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Authors: P. Mounnarath, U. Schmitz, Ch. Zhang

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Fragility analysis is an effective tool for the seismic vulnerability assessment of civil structures in the last several years. The design of the expansion joints according to various bridge design codes is almost inconsistent, and only a few studies have focused on this problem so far. In this study, the influence of the expansion joint clearances between the girder ends and the abutment backwalls on the seismic fragility assessment of continuous integral bridge frames is investigated. The gaps (ranging from 60 mm, 150 mm, 250 mm and 350 mm) are designed by following two different bridge design code specifications, namely, Caltrans and Eurocode 8-2. Five bridge models are analyzed and compared. The first bridge model serves as a reference. This model uses three-dimensional reinforced concrete fiber beam-column elements with simplified supports at both ends of the girder. The other four models also employ reinforced concrete fiber beam-column elements but include the abutment backfill stiffness and four different gap values. The nonlinear time history analysis is performed. The artificial ground motion sets, which have the peak ground accelerations (PGAs) ranging from 0.1 g to 1.0 g with an increment of 0.05 g, are taken as input. The soil-structure interaction and the P-Δ effects are also included in the analysis. The component fragility curves in terms of the curvature ductility demand to the capacity ratio of the piers and the displacement demand to the capacity ratio of the abutment sliding bearings are established and compared. The system fragility curves are then obtained by combining the component fragility curves. Our results show that in the component fragility analysis, the reference bridge model exhibits a severe vulnerability compared to that of other sophisticated bridge models for all damage states. In the system fragility analysis, the reference curves illustrate a smaller damage probability in the earlier PGA ranges for the first three damage states, they then show a higher fragility compared to other curves in the larger PGA levels. In the fourth damage state, the reference curve has the smallest vulnerability. In both the component and the system fragility analysis, the same trend is found that the bridge models with smaller clearances exhibit a smaller fragility compared to that with larger openings. However, the bridge model with a maximum clearance still induces a minimum pounding force effect.

Keywords: expansion joint clearance, fiber beam-column element, fragility assessment, time history analysis

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Authors: N. C. van der Merwe, J. Oosthuizen, M. F. Makhetha, J. Adams, B. K. Dajee, S-R. Schneider

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Women representing high-risk breast cancer families, who tested negative for pathogenic mutations in BRCA1 and BRCA2, are four times more likely to develop breast cancer compared to women in the general population. Sequencing of genes involved in genomic stability and DNA repair led to the identification of novel contributors to familial breast cancer risk. These include BLM and PALB2. Bloom's syndrome is a rare homozygous autosomal recessive chromosomal instability disorder with a high incidence of various types of neoplasia and is associated with breast cancer when in a heterozygous state. PALB2, on the other hand, binds to BRCA2 and together, they partake actively in DNA damage repair. Archived DNA samples of 66 BRCA1/2 negative high-risk breast cancer patients were retrospectively selected based on the presence of an extensive family history of the disease ( > 3 affecteds per family). All coding regions and splice-site boundaries of both genes were screened using High-Resolution Melting Analysis. Samples exhibiting variation were bi-directionally automated Sanger sequenced. The clinical significance of each variant was assessed using various in silico and splice site prediction algorithms. Comprehensive screening identified a total of 11 BLM and 26 PALB2 variants. The variants detected ranged from global to rare and included three novel mutations. Three BLM and two PALB2 likely pathogenic mutations were identified that could account for the disease in these extensive breast cancer families in the absence of BRCA mutations (BLM c.11T > A, p.V4D; BLM c.2603C > T, p.P868L; BLM c.3961G > A, p.V1321I; PALB2 c.421C > T, p.Gln141Ter; PALB2 c.508A > T, p.Arg170Ter). Conclusion: The study confirmed the contribution of pathogenic mutations in BLM and PALB2 to the familial breast cancer burden in South Africa. It explained the presence of the disease in 7.5% of the BRCA1/2 negative families with an extensive family history of breast cancer. Segregation analysis will be performed to confirm the clinical impact of these mutations for each of these families. These results justify the inclusion of both these genes in a comprehensive breast and ovarian next generation sequencing cancer panel and should be screened simultaneously with BRCA1 and BRCA2 as it might explain a significant percentage of familial breast and ovarian cancer in South Africa.

Keywords: Bloom Syndrome, familial breast cancer, PALB2, South Africa

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Authors: Liping Qiu, Xiaofeng Zhang

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In its long history, precious tomb murals suffered from various diseases due to natural and man-made destruction. The key to how to protect tomb murals is how to strengthen and protect the tomb murals. In order to maximize the life of the tomb murals, the artistic, historic, and scientific values of the tomb murals can be continued. In this paper, four kinds of traditional reinforcement materials (silicone acrylic lotion, pure acrylic lotion, polyvinyl acetate lotion, and B72) are selected to reinforce the ground support layer of tomb murals, and the reinforcement effect of each reinforcement material on the ground support layer of murals is compared and analyzed, and the best protection material is obtained.

Keywords: mural, destruction cycle, reinforcement material, disease

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Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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Authors: Sandra Adarve, Jhon Osorio

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Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

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Authors: Bashaiar Alsanaa

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The advent of new forms of media has always led to a change in the way existing media deliver content. No medium has been replaced by another yet over the course of history. Whether this fact changes with the introduction of new age technology and social media remains to be seen. Snapchat may be the first application, to seriously challenge TV. It is perhaps the new face of television. The individualistic nature of Snapchat, whereby users control who, when, and in what order to watch, assesses user freedom from traditional broadcasters’ control. This study aims to fill the void in research conducted around such topic. The research explores how Snapchat maybe slowly but replacing TV. The study surveys users in Kuwait in order to present an overview of the topic. It also draws a framework through which implications and suggestions for future research may be discussed to better serve the advancement of media research.

Keywords: Kuwait, media, Snapchat, television

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Authors: A. S. Grewal, Sh. Dharambir, R. S. Sangwan, Vikas Dhanda

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Every Scene of Crime is of different kind in nature. Sometimes we see such type of circumstances that we become confused to judge whether the case is of homicide or suicide. In such circumstances a doyen is asked for the option. On the basis of his esoteric knowledge he finds such clues which force the sleuth to change the under sections of Indian penal Code. Here we have examined a case by visiting Scene of Crime and found that a person was found lying dead in a room. There was only one passage which was found opened, the pistol along with the fired cartridge case, misfired cartridge were lying on the spot. Observation method, mathematical calculations, chemical examination and other aspects were considered.

Keywords: country-made pistol, misfired cartridge, fired cartridge case, blackening, nitrite

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Authors: Meszár Tárik

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The aim of the study is to introduce the minority groups living in Iraq and to shed light on their current situation. The Middle East is a rather heterogeneous region in ethnic terms. It includes many ethnic, national, religious, linguistic, or ethnoreligious groups. The relationship between the majority and minority is the main cause of various conflicts in the region. It seems that most of the post-Ottoman states have not yet developed a unified national identity capable of integrating their multi-ethnic societies. The issue of minorities living in the Middle East is highly politicized and controversial, as the various Arab states consider the treatment of minorities as their internal affair, do not recognize discrimination or even deny the existence of any kind of minorities on their territory. This attitude of the Middle Eastern states may also be due to the fact that the minority issue can be abused and can serve as a reference point for the intervention policies of Western countries at any time. Methodologically, the challenges of these groups are perceived through the manifestos of prominent individuals and organizations belonging to minorities. The basic aim is to present the minorities’ own history in dealing with the issue. It also introduces the different ethnic and religious minorities in Iraq and analyzes their situation during the operation of the terrorist organization „Islamic State” and in the aftermath. It is clear that the situation of these communities deteriorated significantly with the advance of ISIS, but it is also clear that even after the expulsion of the militant group, we cannot necessarily report an improvement in this area, especially in terms of the ability of minorities to assert their interests and physical security. The emergence of armed militias involved in the expulsion of ISIS sometimes has extremely negative effects on them. Until the interests of non-Muslims are adequately represented at the local level and in the legislature, most experts and advocates believe that little will change in their situation. When conflicts flare, many Iraqi citizens usually leave Iraq, but because of the poor public security situation (threats from terrorist organizations, interventions by other countries), emigration causes serious problems not only outside the country’s borders but also within the country. Another ominous implication for minorities is that their communities are very slow if ever, to return to their homes after fleeing their own settlements. An important finding of the study is that this phenomenon is changing the face of traditional Iraqi settlements and threatens to plunge groups that have lived there for thousands of years into the abyss of history. Therefore, we not only present the current situation of minorities living in Iraq but also discuss their future possibilities.

Keywords: Middle East, Iraq, Islamic State, minorities

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Authors: Lynn Ruggieri

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The worldwide pandemic has only increased sustainability awareness. The public is demanding that businesses be held accountable for their impact on the environment. While financial data enjoys uniformity in reporting requirements, there are no uniform reporting requirements for non-financial data. Europe is leading the way with some standards being implemented for reporting non-financial sustainability data; however, there is no uniformity globally. And without uniformity, there is not a clear understanding of what information to include and how to disclose it. Sustainability reporting will provide important information to stakeholders and will enable businesses to understand their impact on the environment. Therefore, there is a crucial need for this data. This paper looks at the history of sustainability reporting in the countries of the European Union and throughout the world and makes a case for worldwide reporting requirements for sustainability.

Keywords: financial reporting, non-financial data, sustainability, global financial reporting

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Authors: Charles Ruffner, Michael Manton, Gintautas Kibirkstis, Gediminas Brazaitas, Vitas Marozas, Ekaterine Makrickiene, Rutile Pukiene, Per Angelstam

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In dynamic boreal forests, fire is an important natural disturbance, which drives regeneration and mortality of living and dead trees, and thus successional trajectories. However, current forest management practices focusing on wood production only have effectively eliminated fire as a stand-level disturbance. While this is generally well studied across much of Europe, in Lithuania, little is known about the historic fire regime and the role fire plays as a management tool towards the sustainable management of future landscapes. Focusing on Scots pine forests, we explore; i) the relevance of fire disturbance regimes on forestlands of Lithuania; ii) fire occurrence in the Dzukija landscape for dry upland and peatland forest sites, and iii) correlate tree-ring data with climate variables to ascertain climatic influences on growth and fire occurrence. We sampled and cross-dated 132 Scots pine samples with fire scars from 4 dry pine forest stands and 4 peatland forest stands, respectively. The fire history of each sample was analyzed using standard dendrochronological methods and presented in FHAES format. Analyses of soil moisture and nutrient conditions revealed a strong probability of finding forests that have a high fire frequency in Scots pine forests (59%), which cover 34.5% of Lithuania’s current forestland. The fire history analysis revealed 455 fire scars and 213 fire events during the period 1742-2019. Within the Dzukija landscape, the mean fire interval was 4.3 years for the dry Scots pine forest and 8.7 years for the peatland Scots pine forest. However, our comparison of fire frequency before and after 1950 shows a marked decrease in mean fire interval. Our data suggest that hemi-boreal forest landscapes of Lithuania provide strong evidence that fire, both human and lightning-ignited fires, has been and should be a natural phenomenon and that the examination of biological archives can be used to guide sustainable forest management into the future. Currently, fire use is prohibited by law as a tool for forest management in Lithuania. We recommend introducing trials that use low-intensity prescribed burning of Scots pine stands as a regeneration tool towards mimicking natural forest disturbance regimes.

Keywords: biodiversity conservation, cultural burning, dendrochronology, forest dynamics, forest management, succession

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Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

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Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

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Authors: Shabnam Dadparvar, Laijin Shen, Farzad Ravanbod

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Nowadays, the political phenomenon of terrorism is considered as an effective factor on political, social, and economic changes. It has replaced the recognized political phenomena such as revolutions, wars (total war among two or more political units with distinct identities in the form of national states), coups d’état, insurgencies and etc. and has challenged political life in all its levels (sub national, national, and international political groups). In this paper by using descriptive-analytical method, the authors try to explain the spread of this political phenomenon across the world, its definition and types, also analyze different approaches to understand it. The authors believe that the Logical-Rational approach is the best way to explain and understand this phenomenon.

Keywords: logical approach, psychological- social approach, religious approach, terrorism

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Authors: Christian Ihwiwhu, Nnamdi Obioha, Udeme John, Edward Bobade, Oghenerunor Bekibele, Adedeji Awujoola, Ibi-Ada Itotoi

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Understanding the complexity in the distribution of hydrocarbon in a simple structure with flow baffles and connectivity issues is critical in targeting and developing the remaining pay in a mature asset. Subtle facies changes (heterogeneity) can have a drastic impact on reservoir fluids movement, and this can be crucial to identifying sweet spots in mature fields. This study aims to evaluate selected reservoirs in Ovhor Field, Niger Delta, Nigeria, with the objective of optimising production from the field by targeting undeveloped oil reserves, bypassed pay, and gaining an improved understanding of the selected reservoirs to increase the company’s reservoir limits. The task at the Ovhor field is complicated by poor stratigraphic seismic resolution over the field. 3-D geological (sedimentology and stratigraphy) interpretation, use of results from quantitative interpretation, and proper understanding of production data have been used in recognizing flow baffles and undeveloped compartments in the field. The full field 3-D model has been constructed in such a way as to capture heterogeneities and the various compartments in the field to aid the proper simulation of fluid flow in the field for future production prediction, proper history matching and design of good trajectories to adequately target undeveloped oil in the field. Reservoir property models (porosity, permeability, and net-to-gross) have been constructed by biasing log interpreted properties to a defined environment of deposition model whose interpretation captures the heterogeneities expected in the studied reservoirs. At least, two scenarios have been modelled for most of the studied reservoirs to capture the range of uncertainties we are dealing with. The total original oil in-place volume for the four reservoirs studied is 157 MMstb. The cumulative oil and gas production from the selected reservoirs are 67.64 MMstb and 9.76 Bscf respectively, with current production rate of about 7035 bopd and 4.38 MMscf/d (as at 31/08/2019). Dynamic simulation and production forecast on the 4 reservoirs gave an undeveloped reserve of about 3.82 MMstb from two (2) identified oil restoration activities. These activities include side-tracking and re-perforation of existing wells. This integrated approach led to the identification of bypassed oil in some areas of the selected reservoirs and an improved understanding of the studied reservoirs. New wells have/are being drilled now to test the results of our studies, and the results are very confirmatory and satisfying.

Keywords: facies, flow baffle, bypassed pay, heterogeneities, history matching, reservoir limit

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Authors: N. Gelovani, D. Ismailov, S. Bochorishvili

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Religious minorities of Georgia include Muslims. Their composition is sufficiently miscellaneous, enclosing both ethnical viewpoint and belonging to the inner Islamic denomination. A majority of Muslims represent Azerbaijanis, who chiefly live in Kvemo Kartli (Bolnisi, Gardabani, Dmanisi, Tetri Tskaro, Marneuli and Tsalka). The catalyst for researchers of Islamic History is the geopolitical interests of Georgia, centuries-old contacts with the Islamic world, the not entirely trivial portion of Islam confessor population, the increasing influence of the Islamic factor in current religious-political processes in the world, the elevating procedure of Muslim religious self-consciousness in the Post-Soviet states, significant challenges of international terrorism, and perspectives of rapid globalization. The rise in the level of religious identity of Muslim citizens of Georgia (first of all of those who are not ethnic Georgians) is noticeable. New mosques have been constructed and, sometimes, even young people are being sent to the religious educational institutions of Muslim countries to gain a higher Islamic education. At a time when gender studies are substantive, the goal of which is to eliminate gender-based discrimination and violence in societies, it is essential in Georgia to conduct researches around the concrete problem – Islamic tradition, woman and education in Georgia. A woman’s right to education is an important indicator of women’s general status in a society. The appropriate resources, innovative analysis of Georgian ethnological materials, and surveying of the population (quantitative and qualitative research reports, working papers), condition the success of these researches. In the presented work, interrelation matters of Islam, gender and education in contemporary Georgia by the example of the Azerbaijani population in Kvemo Kartli during period 1992-2016 are studied. We researched the history of Muslim religious education centers in Tbilisi and Kvemo Kartli (Bolnisi, Gardabani, Dmanisi, Tetri Tskaro, Marneuli and Tsalka) in 1992-2016, on the one hand, and the results of sociological interrogation, on the other. As a result of our investigation, we found that Azeri women in the Kvemo Kartli (Georgia) region mostly receive their education in Georgia and Azerbaijan. Educational and Cultural Institutions are inaccessible for most Azeri women. The main reasons are the absence of educational and religious institutions at their places of residence and state policies towards Georgia’s Muslims. 

Keywords: Islam, gender, Georgia, education

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Wassim Bekai

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Code switching, as its name states, is altering between two or more languages in one sentence. The speaker tends to use code switching in his/her speech for better clarification of his/her message to the receiver. It is commonly used in sociocultural countries such as Lebanon because of the various cultures that have come across its lands through history, considering Lebanon is geographically located in the heart of the world, and hence between many cultures and languages. In addition, Lebanon was occupied by Turkish authorities for about 400 years, and later on by the French mandate, where both of these countries forced their languages in official papers and in the Lebanese educational system. In this paper, the importance of code switching in the Lebanese workplace will be examined, stressing the efficiency and amount of the production resulting from code switching in the workplace (factories, universities among other places) in addition to exploring the social, education, religious and cultural factors behind this phenomenon in Lebanon.

Keywords: code switching, Lebanon, cultural, factors

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Authors: Mehmet Eren Çelik

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Values are notions that help people to decide what is good or not and to direct their attitude. Teaching values has always been very important throughout the history. Values should be thought in younger ages to get more efficiency. Therefore military schools are the last stop to learn values effectively. That’s why values education in military schools has vital importance. In this study the military side of values education is examined. The purpose of the study is to show how important values education is and why military students need values education. First of all what value is and what values education means is clearly explained and values education in schools and specifically in military schools is stated. Then values education in Işıklar Air Force High School exemplifies the given information.

Keywords: Işıklar Air Force High School, military school, values, values education

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Authors: Youlu Huang, Huanjun Jiang

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A large number of old masonry buildings built in the last century still remain in the city. It generates the problems of unsafety, obsolescence, and non-habitability. In recent years, many old buildings have been reconstructed through renovating façade, strengthening, and adding floors. However, most projects only provide a solution for a single problem. It is difficult to comprehensively solve problems of poor safety and lack of building functions. Therefore, a comprehensive functional renovation program of adding reinforced concrete frame story at the bottom via integrally lifting the building and then strengthening the building was put forward. Based on field measurement and YJK calculation software, the seismic performance of an actual three-story masonry structure in Shanghai was identified. The results show that the material strength of masonry is low, and the bearing capacity of some masonry walls could not meet the code requirements. The elastoplastic time history analysis of the structure was carried out by using SAP2000 software. The results show that under the 7 degrees rare earthquake, the seismic performance of the structure reaches 'serious damage' performance level. Based on the code requirements of the stiffness ration of the bottom frame (lateral stiffness ration of the transition masonry story and frame story), the bottom frame story was designed. The integral lifting process of the masonry building was introduced based on many engineering examples. The reinforced methods for the bottom frame structure strengthened by the steel-reinforced mesh mortar surface layer (SRMM) and base isolators, respectively, were proposed. The time history analysis of the two kinds of structures, under the frequent earthquake, the fortification earthquake, and the rare earthquake, was conducted by SAP2000 software. For the bottom frame structure, the results show that the seismic response of the masonry floor is significantly reduced after reinforced by the two methods compared to the masonry structure. The previous earthquake disaster indicated that the bottom frame is vulnerable to serious damage under a strong earthquake. The analysis results showed that under the rare earthquake, the inter-story displacement angle of the bottom frame floor meets the 1/100 limit value of the seismic code. The inter-story drift of the masonry floor for the base isolated structure under different levels of earthquakes is similar to that of structure with SRMM, while the base-isolated program is better to protect the bottom frame. Both reinforced methods could significantly improve the seismic performance of the bottom frame structure.

Keywords: old buildings, adding story, seismic strengthening, seismic performance

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Authors: S. Ait Ali Yahia

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One of the main features of the Maghreb is its linguistic richness. The multilingualism is a fact which always marked the Maghreb since the beginning of the history up to know. Since the arrival of the Phoenicians, followed by the Carthaginians, Romans, and Arabs, etc, there was a social group in the Maghreb which controlled two kinds of idioms. The libyc one remained, despite everything, the local language used by the major part of the population. This language had a support of written transmission attested by many inscriptions. Among all the forms of the Maghreb writing, this alphabet, however, continues to cause a certain number of questions about the origin and the date of its appearance. The archaeological, linguistic and historical data remain insufficient to answer these questions. This did not prevent the researchers from giving an opinion. In order to answer these questions we will expose here the various assumptions adopted by various authors who are founded on more or less explicit arguments. We will also speak about the various forms taken by the libyc writing during antiquity.

Keywords: the alphabet libyc, Eastern libyc, Western libyc, multilingualism

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Authors: Abuzar Baloach

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Spinal cord stimulators (SCS) are increasingly used for managing chronic pain, but their presence requires careful anesthetic planning. This review explores critical anesthetic considerations for patients with SCS, encompassing preoperative, intraoperative, and acute pain management, as well as specific considerations for obstetric and out-of-operating-room procedures. Preoperative Evaluation: Thorough assessment is essential, including a detailed medical history of the SCS device, such as type, manufacturer, and settings. Additionally, a complete pain history and a physical exam are necessary to understand the patient’s baseline neurological function and assess mobility, which can impact anesthesia management. Intraoperative Considerations: Electrocautery poses a risk for patients with SCS due to potential interference. Monopolar electrocautery is discouraged, but if needed, the grounding pad should be positioned away from the device, and the device itself should be turned off. The SCS device can introduce ECG artifacts and potentially interfere with pacemakers and defibrillators (ICD), which may result in inappropriate pacing or shocks. Precautions, including baseline ECG and interrogation, are recommended if both devices are present. Furthermore, lithotripsy, though generally avoided, can be performed under certain conditions with caution. Obstetric Anesthesia: While SCS devices are generally turned off during pregnancy, they have shown no interference with fetal cardiotocography, and epidural placement can be safely achieved with a sterile technique below the SCS leads. Acute Pain Considerations: SCS placement is taken into account in pain management plans, especially with neuraxial anesthesia, as potential risks include infection, limited spread due to fibrous sheaths, and damage to the SCS leads. Out-of-Operating Room Procedures: MRI, previously contraindicated, is now conditionally safe with SCS devices, depending on manufacturer specifications. CT scans are generally safe, though radiation should be minimized to prevent device malfunction. For radiation therapy, specific safety measures are recommended, such as keeping the beam at least 1 cm away from the device and limiting the dose to prevent damage. In conclusion, anesthetic management for SCS patients requires meticulous planning across all stages of care. By understanding the unique interactions and potential risks associated with SCS and other devices, healthcare providers can enhance patient safety and improve outcomes. Further research and the establishment of standardized guidelines are essential to optimize perioperative care for this growing patient population.

Keywords: anesthesia, chronic pain, spinal cord stimulator, SCS

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Authors: Kirk Johnson, Gabriel Rubin

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The January 6th Insurrection on the United States Capitol Building has been one of the most disturbing expressions of violence in American history. While there are numerous reasons that led to such aggression, there are destructive politico-religious ideologies and understandings, known as Christian Nationalism, White Christian Nationalism, and Christian Dominionism that influenced the actions of the January 6th insurrectionists. Such ideas are deeply rooted in the unification of church and state, a theocracy, embedded within the understanding that Biblical scripture is the blueprint on which the functioning of the American government should follow. In addition, the concept of racial hierarchy is embedded in politico-religious principles of White Christian Nationalism. This paper will examine how Christian Dominionism is one factor that influenced the January 6th Insurrection.

Keywords: January 6th insurrection, dominionism, Christian nationalism, polygenism

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Authors: Gudrun Görlitz, Christian Schölzel, Alexander Vollmar

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Sites of Jewish Life in Berlin 1933-1945. Between Persecution and Self-assertion” was realized in a project funded by the European Regional Development Fund. A smartphone app, and a associated web site enable tourists and other participants of this educational offer to learn in a serious way more about the life of Jews in the German capital during the Nazi era. Texts, photos, video and audio recordings communicate the historical content. Interactive maps (both current and historical) make it possible to use predefined or self combined routes. One of the manifold challenges was to create a broad ranged guide, in which all detailed information are well linked with each other. This enables heterogeneous groups of potential users to find a wide range of specific information, corresponding with their particular wishes and interests. The multitude of potential ways to navigate through the diversified information causes (hopefully) the users to utilize app and web site for a second or third time and with a continued interest. Therefore 90 locations, a lot of them situated in Berlin’s city centre, have been chosen. For all of them text-, picture and/or audio/video material gives extensive information. Suggested combinations of several of these “site stories” are leading to the offer of detailed excursion routes. Events and biographies are also presented. A few of the implemented biographies are especially enriched with source material concerning the aspect of (forced) migration of these persons during the Nazi time. All this was done in a close and fruitful interdisciplinary cooperation of computer scientists and historians. The suggested conference paper aims to show the challenges shaping complex source material for practical use by different user-groups in a proper technical and didactic way. Based on the historical research in archives, museums, libraries and digital resources the quantitative dimension of the project can be sized as follows: The paper focuses on the following historiographical and technical aspects: - Shaping the text material didactically for the use in new media, especially a Smartphone-App running on differing platforms; - Geo-referencing of the sites on historical and current map material; - Overlay of old and new maps to present and find the sites; - Using Augmented Reality technologies to re-visualize destroyed buildings; - Visualization of black-/white-picture-material; - Presentation of historical footage and the resulting problems to need too much storage space; - Financial and juridical aspects in gaining copyrights to present archival material.

Keywords: smartphone app, history, tourists, German

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Authors: Buddhiprabha D. D. Pathirana

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Despite a rapid increase in the number of school counselors in the recent past; procuring the service of school counselors is a luxury that many Sri Lankan schools cannot afford. In addition, school counseling in Sri Lanka also faces new challenges in implementation due to the fact that a generally agreed consensus on training, ethical standards, role identity, counseling model, and structures for school counselors has not been reached. Therefore, this paper has several objectives. First, it reviews a brief history of school counseling in Sri Lanka and describes its current status. Second, it describes current trends/ problems specific to Sri Lankan school counseling milieu which have limited the progress of school counseling as a practice. Third, it discusses societal and cultural issues that are important to consider when implementing school counseling as a practices in Sri Lanka and provides recommendations to improve it.

Keywords: school counseling, Sri Lanka, current situation, recommendations

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Authors: Rich Murphy

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‘The Racism Found in Capitalism’s Poetry’ claims that since the death of philosophy and the end of art modern poetry has been upstaged by capitalist poetry using similar strategies and techniques; while both sublime moments use spectacle one is more effective. The essay also claims that capitalist poetry is open to racism and analyzes KFC advertising campaign to produce evidence of wide spread acceptance in an era of ‘micro-aggressions’ and confederate flag removals. The essay spends considerable time outlining the history of advertising and the weak literary counters to it that inevitably lent its assistance in education. The essay also suggests that the concept of ‘Enormous Irony’ may be the only way to counter. However, as long as capitalism is the method of the economy and governance, the essay suggests, there was little hope in spite of Obama’s election.

Keywords: modern poetry, advertising, Kentucky fried chicken, capitalism, poetry

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Authors: Alireza Lavaei, Alireza Lohrasbi, Mohammadali M. Shahlaei

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To reduce the overall time of structural optimization for earthquake loads two strategies are adopted. In the first strategy, a neural system consisting self-organizing map and radial basis function neural networks, is utilized to predict the time history responses. In this case, the input space is classified by employing a self-organizing map neural network. Then a distinct RBF neural network is trained in each class. In the second strategy, an improved genetic algorithm is employed to find the optimum design. A 72-bar space truss is designed for optimal weight using exact and approximate analysis for the El Centro (S-E 1940) earthquake loading. The numerical results demonstrate the computational advantages and effectiveness of the proposed method.

Keywords: optimization, genetic algorithm, neural networks, self-organizing map

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Authors: Emma Plante, Charles Ekwunwa, Diego Illanes

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Introduction: Serum Sickness-Like Reaction (SSLR) is an inflammatory immune response characterized by a rash, polyarthralgias, and fever. SSLR usually occurs in response to a new medication (most commonly antibiotics, anticonvulsants, or antiinflammatory agents) and is believed to involve the formation of drug-specific immune complexes. Here we present a case of a 16-year-old female patient who developed an SSLR in response to the D-mannose-containing over-the-counter supplement, Uqora, used to promote bladder health. Methodology: The methodology for this study included a thorough literature search for other cases of SSLR associated with D-Mannose containing products. Data collection was performed through a review of the patient’s medical record, including history, physical examination, relevant laboratory results, and treatment plan. Findings: A 16-year-old female with a history of overactive bladder and anemia presented with a diffuse urticarial rash, headaches, joint pain, and swelling for three days. Her medications included oral contraceptive pills, iron, mirabegron, UQora, and a probiotic. Physical examination revealed a diffuse urticarial rash, and her musculoskeletal exam revealed swelling and tenderness in her wrists. Her CBC, basic metabolic panel, liver function panel, lyme titers, and urinalysis were all within normal limits. The patient was referred to an allergist, who diagnosed her with SSLR. All medications were discontinued, and she was treated with a 7-day course of prednisone and cetirizine. Her symptoms resolved, and her medications were slowly resumed sequentially over several months. However, UQora triggered a recurrence of her symptoms, and it was identified as the culprit medication. Consequently, UQora was permanently discontinued, and the patient has remained symptom-free. Conclusion: This case report describes the first documented case of SSLR caused by UQora (active ingredient D-mannose). D-Mannose is a monosaccharide found in many plants and fruits, and it is commonly used to prevent urinary tract infections. While the clinical features and timeline, in this case, were typical of SSLR, UQora as the trigger was highly unusual. Clinicians should be aware of the diverse triggers of SSLR and the importance of prompt identification and management to enhance patient safety. It is possible D-mannose was not the trigger, and further research is necessary to better understand the potential therapeutic applications of D-mannose, as well as the potential risks and interactions.

Keywords: serum sickness-like reaction, d-mannose, hypersensitivity reaction, urticaria

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