Search results for: standard form of contract

Authors: Sujata Gupta Kedar, J. N. Tulika

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Early researchers suggested that imprisonment had negative psychological and physical effects on its inmates, leading to psychological deterioration. The term “prisons” in the Consensus Statement of WHO is intended to denote, as those institutions which hold people who have been sentenced to a period of imprisonment by the courts for offences against the law. Thus “prisons” if local circumstances justify it, may also be taken to include secure institutions holding on a compulsory basis on any of the following categories of people: remand prisoners; civil prisoners; juvenile detainees; immigration detainees; some categories of mentally disordered patients; asylum seekers; refugees; people detained pending expulsion, deportation, exile, exclusion or any other form of compulsory transfer to other countries or areas of the country; people detained in police cells; and any other compulsorily detained group. Prisons are aimed to cure the criminal and their behavior but their records are not encouraging. Instead the imprisonment affects all prisoners in different way. From withstanding the shock of entry to the new culture, which is very different from their own, prisoners must try to determine how to spend the time in prison, since the hours appears to be endless in prisons. There is also the fear of deterioration. This article aims to provide an overview of the psychological well being of female prisoners in the prison environment in five areas- satisfaction, efficiency, sociability, mental health and interpersonal relations. Research was done on two different types of imprisonment- under trial prisoner and convict. Total sample included 22 female prisoners of Nagaon Special Jail of Assam. The instrument used for the study was based on Psychological Well Being Scale. Statistical analysis was done with t-test and one way anova test. The result demonstrated that there is no significant difference in the psychological wellbeing of female prisoners in the prison and that there is no significant difference in the psychological well being of different types of female prisoners involved in different crimes but there is significant difference in the mental health of the female prisoners in prison.

Keywords: psychological effect, female prisoners, prison, well being of prisoners

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Authors: Elżbieta Turska

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Introduction: One of the most difficult times in a person’s life is adolescence. The experiences in this period may shape the future life of this person to a large extent. This is the reason why many young people experience sadness, dejection, hopelessness, sense of worthlessness, as well as losing interest in various activities and social relationships, all of which are often classified as mood disorders. As many as 15-40% adolescents experience depressed moods and for most of them they resolve and are not carried into adulthood. However, (5-6%) of those affected by mood disorders develop the depressive syndrome and as many as (1-3%) develop full-blown clinical depression. Materials: A large questionnaire was given to 2508 students, aged 13–16 years old, and one of its parts was the Burns checklist, i.e. the standard test for identifying depressed mood. The questionnaire asked about many aspects of the student’s life, it included a total of 53 questions, most of which had subquestions. It is important to note that the data suffered from many problems, the most important of which were missing data and collinearity. Aim: In order to identify the correlates of mood disorders we built predictive models which were then trained and validated. Our aim was not to be able to predict which students suffer from mood disorders but rather to explore the factors influencing mood disorders. Methods: The problems with data described above practically excluded using all classical statistical methods. For this reason, we attempted to use the following Artificial Intelligence (AI) methods: classification trees with surrogate variables, random forests and xgboost. All analyses were carried out with the use of the mlr package for the R programming language. Resuts: The predictive model built by classification trees algorithm outperformed the other algorithms by a large margin. As a result, we were able to rank the variables (questions and subquestions from the questionnaire) from the most to least influential as far as protection against mood disorder is concerned. Thirteen out of twenty most important variables reflect the relationships with parents. This seems to be a really significant result both from the cognitive point of view and also from the practical point of view, i.e. as far as interventions to correct mood disorders are concerned.

Keywords: mood disorders, adolescents, family, artificial intelligence

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Authors: Yonosuke Murayama

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We have developed and studied a metastable beta Ti alloy, which shows super-elasticity and low Young’s modulus according to the phase stability of its beta phase. The super-elasticity and low Young’s modulus are required in a wide range of applications in various industrial fields. For example, the metallic implant with low Young’s modulus and non-toxicity is desirable because the large difference of Young’s modulus between the human bone and the implant material may cause a stress-shielding phenomenon. We have investigated the role of Sn and Al in metastable beta Ti-Cr-Sn, Ti-Cr-Al, Ti-V-Sn, and Ti-V-Al alloys. The metastable beta Ti-Cr-Sn, Ti-Cr-Al, Ti-V-Sn, and Ti-V-Al alloys form during quenching from the beta field at high temperature. While Cr and V act as beta stabilizers, Sn and Al are considered as elements to suppress the athermal omega phase produced during quenching. The athermal omega phase degrades the properties of super-elasticity and Young’s modulus. Although Al and Sn as single elements are considered as an alpha stabilizer and neutral, respectively, Sn and Al acted also as beta stabilizers when added simultaneously with beta stabilized element of Cr or V in this experiment. The quenched microstructure of Ti-Cr-Sn, Ti-Cr-Al, Ti-V-Sn, and Ti-V-Al alloys shifts from martensitic structure to beta single-phase structure with increasing Cr or V. The Young’s modulus of Ti-Cr-Sn, Ti-Cr-Al, Ti-V-Sn, and Ti-V-Al alloys decreased and then increased with increasing Cr or V, each showing its own minimum value of Young's modulus respectively. The composition of the alloy with the minimum Young’s modulus is a near border composition where the quenched microstructure shifts from martensite to beta. The border composition of Ti-Cr-Sn and Ti-V-Sn alloys required only less amount of each beta stabilizer, Cr or V, than Ti-Cr-Al and Ti-V-Al alloys. This indicates that the effect of Sn as a beta stabilizer is stronger than Al. Sn and Al influenced the competitive relation between stress-induced martensitic transformation and slip deformation. Thus, super-elastic properties of metastable beta Ti-Cr-Sn, Ti-Cr-Al, Ti-V-Sn, and Ti-V-Al alloys varied depending on the alloyed element, Sn or Al.

Keywords: metastable beta Ti alloy, super-elasticity, low Young’s modulus, stress-induced martensitic transformation, beta stabilized element

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Authors: Christine O. Wangia, Jennifer A. Orwa, Francis W. Muregi, Patrick G. Kareru, Kipyegon Cheruiyot, Eric Guantai

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Ruellia (syn. Dipteracanthus) species are wild perennial creepers belonging to the Acanthaceae family. These species are reported to possess anti-inflammatory, analgesic, antioxidant, gastroprotective, anticancer, and immuno-stimulant properties. Phytochemical screening of both aqueous and methanolic extracts of Ruellia species revealed the presence of saponins. Saponins have been reported to possess anti-inflammatory, antioxidant, immuno-stimulant, antihepatotoxic, antibacterial, anticarcinogenic, and antiulcerogenic activities. The objective of this study was to quantify and analyze the Fourier transform infrared (FTIR) spectra of saponins in crude extracts of three Kenyan Ruellia species namely Ruellia prostrata (RPM), Ruellia lineari-bracteolata (RLB) and Ruellia bignoniiflora (RBK). Sequential organic extraction of the ground whole plant material was done using petroleum ether (PE), chloroform, ethyl acetate (EtOAc), and absolute methanol by cold maceration, while aqueous extraction was by hot maceration. The plant powders and extracts were mixed with spectroscopic grade KBr and compressed into a pellet. The infrared spectra were recorded using a Shimadzu FTIR spectrophotometer of 8000 series in the range of 3500 cm^-1 - 500 cm^-1. Quantitative determination of the saponins was done using standard procedures. Quantitative analysis of saponins showed that RPM had the highest quantity of crude saponins (2.05% ± 0.03), followed by RLB (1.4% ± 0.15) and RBK (1.25% ± 0.11), respectively. FTIR spectra revealed the spectral peaks characteristic for saponins in RPM, RLB, and RBK plant powders, aqueous and methanol extracts; O-H absorption (3265 - 3393 cm^-1), C-H absorption ranging from 2851 to 2924 cm^-1, C=C absorbance (1628 - 1655 cm^-1), oligosaccharide linkage (C-O-C) absorption due to sapogenins (1036 - 1042 cm^-1). The crude saponins from RPM, RLB and RBK showed similar peaks to their respective extracts. The presence of the saponins in extracts of RPM, RLB and RBK may be responsible for some of the biological activities reported in the Ruellia species.1

Keywords: Ruellia bignoniiflora, Ruellia linearibracteolata, Ruellia prostrata, Saponins

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

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

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

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Authors: Izabel Cristina Zattar, Gilberto Passos Lima, Guilherme Schünemann de Oliveira

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In Brazil, there are several institutions committed to the development of new businesses based on product innovation. Among them are business incubators, universities and science institutes. Business incubators can be defined as nurseries for new companies, which may be in the technology segment, discussed in this article. Business incubators provide services related to infrastructure, such as physical space and meeting rooms. Besides these services, incubators also offer assistance in the form of information and communication, access to finance, relationship networks and business monitoring and mentoring processes. Business incubators support not all technology companies. One of the business incubators tasks is to assess the nature and feasibility of new business proposals. To assist this goal, this paper proposes a methodology for evaluating new business using the Analytic Hierarchy Process (AHP). This paper presents the concepts used in the assessing methodology application for new business, concepts that have been tested with positive results in practice. This study counts on three main steps: first, a hierarchy was built, based on new business manuals used by the business incubators. These books and manuals relate business selection requirements, such as the innovation status and other technological aspects. Then, a questionnaire was generated, in order to guide incubator experts in the parity comparisons at all hierarchy levels. The weights of each requirement are calculated from information obtained from the questionnaire responses. Finally, the proposed method was applied to evaluate five new business proposals, which were applying to be part of a company incubator. The main result is the classification of these new businesses, which helped the incubator experts to decide what companies were more eligible to work with. This classification may also be helpful to the decision-making process of business incubators in future selection processes.

Keywords: Analytic Hierarchy Process (AHP), Brazilian companies incubators, technology companies, incubator

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Authors: Bushra Zafar, Usman Qamar

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Large data sample size and dimensions render the effectiveness of conventional data mining methodologies. A data mining technique are important tools for collection of knowledgeable information from variety of databases and provides supervised learning in the form of classification to design models to describe vital data classes while structure of the classifier is based on class attribute. Classification efficiency and accuracy are often influenced to great extent by noisy and undesirable features in real application data sets. The inherent natures of data set greatly masks its quality analysis and leave us with quite few practical approaches to use. To our knowledge first time, we present a new approach for investigation of structure and quality of datasets by providing a targeted analysis of localization of noisy and irrelevant features of data sets. Machine learning is based primarily on feature selection as pre-processing step which offers us to select few features from number of features as a subset by reducing the space according to certain evaluation criterion. The primary objective of this study is to trim down the scope of the given data sample by searching a small set of important features which may results into good classification performance. For this purpose, a heuristic for wrapper-based feature selection using genetic algorithm and for discriminative feature selection an external classifier are used. Selection of feature based on its number of occurrence in the chosen chromosomes. Sample dataset has been used to demonstrate proposed idea effectively. A proposed method has improved average accuracy of different datasets is about 95%. Experimental results illustrate that proposed algorithm increases the accuracy of prediction of different diseases.

Keywords: data mining, generic algorithm, KNN algorithms, wrapper based feature selection

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Authors: Bhenjamin Jordan L. Ona

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Weather modification is an act of altering weather systems that catches interest on scientific studies. Cloud seeding is a common form of weather alteration. On the same principle, tropical cyclone mitigation experiment follows the methods of cloud seeding with intensity to account for. This study will present the effects of aerosol to tropical cyclone cloud microphysics and intensity. The framework of Weather Research and Forecasting (WRF) model incorporated with Thompson aerosol-aware scheme is the prime host to support the aerosol-cloud microphysics calculations of cloud condensation nuclei (CCN) ingested into the tropical cyclones before making landfall over the Philippine coast. The coupled microphysical and radiative effects of aerosols will be analyzed using numerical data conditions of Tropical Storm Ketsana (2009), Tropical Storm Washi (2011), and Typhoon Haiyan (2013) associated with varying CCN number concentrations per simulation per typhoon: clean maritime, polluted, and very polluted having 300 cm-3, 1000 cm-3, and 2000 cm-3 aerosol number initial concentrations, respectively. Aerosol species like sulphates, sea salts, black carbon, and organic carbon will be used as cloud nuclei and mineral dust as ice nuclei (IN). To make the study as realistic as possible, investigation during the biomass burning due to forest fire in Indonesia starting October 2015 as Typhoons Mujigae/Kabayan and Koppu/Lando had been seeded with aerosol emissions mainly comprises with black carbon and organic carbon, will be considered. Emission data that will be used is from NASA's Moderate Resolution Imaging Spectroradiometer (MODIS). The physical mechanism/s of intensification or deintensification of tropical cyclones will be determined after the seeding experiment analyses.

Keywords: aerosol, CCN, IN, tropical cylone

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Authors: S. Sreeja, Radhakrishnan R. Nair, Noble Gracious, Sreeja S. Nair, M. Radhakrishna Pillai

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Background: Tacrolimus is a potent immunosuppressant clinically used for the long term treatment of antirejection of transplanted organs in liver and kidney transplant recipients though dose optimization is poorly managed. However, So far no study has been carried out on the South Indian kidney transplant patients. The objective of this study is to evaluate the potential influence of a functional polymorphism in CYP3A5*3 gene on tacrolimus physiological availability/dose ratio in South Indian renal transplant patients. Materials and Methods: Twenty five renal transplant recipients receiving tacrolimus were enrolled in this study. Their body weight, drug dosage, and therapeutic concentration of Tacrolimus were observed. All patients were on standard immunosuppressive regime of Tacrolimus-Mycophenolate mofetil along with steroids on a starting dose of Tac 0.1 mg/kg/day. CYP3A5 genotyping was performed by PCR followed with RFLP. Conformation of RFLP analysis and variation in the nucleotide sequence of CYP3A5*3 gene were determined by direct sequencing using a validated automated generic analyzer. Results: A significant association was found between tacrolimus per dose/kg/d and CYP3A5 gene (A6986G) polymorphism in the study population. The CYP3A5 *1/*1, *1/*3 and *3/*3 genotypes were detected in 5 (20 %), 5 (20 %) and 15 (60 %) of the 25 graft recipients, respectively. CYP3A5*3 genotypes were found to be a good predictor of tacrolimus Concentration/Dose ratio in kidney transplant recipients. Significantly higher L/D was observed among non-expressors 9.483 ng/mL(4.5- 14.1) as compared with the expressors 5.154 ng/mL (4.42-6.5 ) of CYP3A5. Acute rejection episodes were significantly higher for CYP3A5*1 homozygotes compared to patients with CYP3A5*1/*3 and CYP3A5*3/*3 genotypes (40 % versus 20 % and 13 %, respectively ). The dose normalized TAC concentration (ng/ml/mg/kg) was significantly lower in patients having CYP3A5*1/*3 polymorphism. Conclusion: This is the first study to extensively determine the effect of CYP3A5*3 genetic polymorphism on tacrolimus pharmacokinetics in South Indian renal transplant recipients and also shows that majority of our patients carry mutant allele A6986G in CYP3A5*3 gene. Identification of CYP3A5 polymorphism prior to transplantation could contribute to evaluate the appropriate initial dosage of tacrolimus for each patient.

Keywords: kidney transplant patients, CYP3A5 genotype, tacrolimus, RFLP

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Authors: Ahilya Singh, Brad Carte, Ramesh Subramani, William Aalbersberg

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A total of 37 actinomycete strains were purified from 25 Solomon Islands marine sediments using four different types of isolation media. Among them, 54% of the strains had obligate requirement of seawater for growth. The ethyl acetate extract of 100 ml fermentation product of each strain was screened for antimicrobial activity against multidrug resistant human pathogens and cytotoxic activity against brine shrimps. A total of 67% of the ethyl acetate extracts showed antimicrobial and/or cytotoxic activities. A strain F-1915 was selected for isolation and evaluation of bioactive compound(s) based on its bioactive properties and chemical profile analysis using the LC-MS. The strain F-1915 was identified to have 96% sequence similarity to Streptomyces violaceusniger on the basis of 16S rDNA sequences using BLAST analysis. The 16S rDNA revealed that the strain F-1915 is a new member of MAR4 clade of actinomycetes. The MAR4 clade is an interesting clade of actinomycetes known for the production of pharmaceutically important hybrid isoprenoid compounds. The ethyl acetate extract of the fermentation product of this strain was purified by silica gel column chromatography and afforded the isolation of one bioactive pure compound. Based on the 1D and 2D NMR spectral data of compound 1 it was identified as a new mono-brominated phenazinone, Marinophenazimycin A, a structure which has already been studied by external collaborators at Scripps Institution of Oceanography but is yet to be published. Compound 1 displayed significant antimicrobial activity against drug resistant human pathogens. The minimum inhibitory concentration (MIC) of compound 1 was against Methicillin Resistant Staphylococcus aureus (MRSA) was about 1.9 μg/ml and MIC recorded against Amphotericin Resistant Candida albicans (ARCA) was about 0.24 μg/ml. The bioactivity of compound 1 against ARCA was found to be better than the standard antifungal agent amphotericin B. Compound 1 however did not show any cytotoxic activity against brine shrimps.

Keywords: actinomycetes, antimicrobial activity, brominated phenazine, MAR4 clade, marine natural products, multidrug resistent, 1D and 2D NMR

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Authors: Gülşen Kocaevli

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This paper aims to conduct a comparative analysis on the reflections of cultural elements such as language, festival, and food both in the case of Turkish immigrants in Germany and Mexican immigrants in the United States within a historical perspective. These reflections will be studied first by giving a certain background information on the migratory history of the two nations, Mexican immigration to the US, and Turkish immigration to Germany, respectively. These two cases were picked as the analytical subjects of this paper because both nations first migrated to the related country to constitute a labor force since there was a huge need for that due to several reasons such as the loss of manpower after certain wars or revolutions. At the end of this comparative study, it is speculated to be found that there are certain parallels between these two immigrant societies in the way that they reflect their cultures in the receiving country since both nations have a conventionalist nature which makes them tend more to protect their cultures and pay less effort to integrate into the society in which they are living. Even though this integration might be realized in certain fields like economic status and exogamy, it does not cover all segments nor is there any desire of the receiving government to integrate the immigrants but rather they make policies to assimilate them. This research paper will use a qualitative method which is fundamentally based on the interpretative data drawn from several sociological or ethnographic studies conducted in the related field. The primary and secondary resources of this paper will cover academic books, journal articles, particularly those reporting interviews with the immigrants, and certain governmental documents as well as publicized statistics regarding the subject of analysis. By the use of the aforementioned methodology and resources, the conventionalist nature of the two immigrant nations is aimed to be presented as the unifying factor in the way that Mexicans in the US and Turks in Germany reflect and protect their cultures in the form of language, festivals, and food.

Keywords: assimilation, culture, German-Turks, immigration, Mexican Americans

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Authors: Sarinra Thongmee, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk, Krittaphon Prakobsaeng

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The purposes of this research and development was to develop and evaluation of clinical nursing practice guideline (CNPG) for the prevention of infection during intubation in patient withsuspected or confirmedCOVID-19 patient. This study was developed by using the evidence based practice model of Soukup (2000) as a conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patients with confirmed COVID-19, 2) development the CNPG, 3) apply the NPG to trial, and 4) evaluation of the NPG. Thesample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) CNPG, 2) the nurses anesthetist opinion questionnaire to the guideline, 3) the evaluation practice form, and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results found that this developed NPG consists of 4 sections: 1) NPG for Preventing Airborne Infection Prevention2) preparation of anesthetic and intubation equipments 3) roles and duties of the intubation team 4) guidelines for intubation in suspected or confirmed COVID-19patients. The result found that 1) provider: using NPG in providers revealed that nurse anesthetist had higher mean of knowledge scores than before using NPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% in all activities. The anesthetic team was not infected with COVID-19from intubation outside operating room.2) Client: the patient was safe, no complications from intubation. Summary CNPG to prevent infection in intubation of suspected or confirmedCOVID-19 patient was appropriate and applicable to practice.

Keywords: nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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Authors: Lim Pey Huan

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In the second half of the 19th century, Vietnam has long been influenced by Han culture, so there are many similarities in religion and folk beliefs. Even after the acceptance process of the Catholic Church introduced from Europe is quite similar. Therefore, in the spiritual life of Vietnamese civil society, Confucianism, Buddhism, Taoism, Christianity, Islam, and folk beliefs can be said to be the main trend, but in the twentieth century, two indigenous new religions were born: Caodai and He Hao Jiao, both of which are produced and developed in the south, each of which has millions of believers and become important Vietnamese religions. Their political participation has a major impact on the development of the Republic of Vietnam, and their fate is also in the north and south. Significant changes have taken place after reunification. Caodai was later approved by the colonial authorities and became the third largest religion in Vietnam. The teachings of Caodai teach the ideas of the major religions of the world. The classics used in the teachings also contain important theories of various religions, with particular emphasis on the comprehensiveness of the three sects of Confucianism, Buddhism, and Taoism. The obvious manifestation lies in the interpretation of the important proposition of 'opening the three religions and returning to the five branches.' The full name of Caodaism is 'Da Dao San Qi Pu Du Gao Tai Jiao'. This name coincides with the 'Longhua Club' and the 'San Qi Mo Jie' idea and the consistent central idea. The emerging road of Caodai advocates to lead the sentient beings back to their original missions; the sentient beings will be centered on people, and the nature of the talks is nothing more than the original mission and standard. There are many opinions about the introduction of Caodaism into southern Vietnam. Caodai believers believe that Caodaism is an emerging new religion in Vietnam. If we further explore the teachings and religious rituals of Caodai, it is not difficult to find that many Chinese sects have been introduced to Vietnam. Some of the colors can be discussed from the spread and influence of Congenital Road in Vietnam. This article will present the author's analysis of the actual process of tutoring in Vietnam's Caodai, and then compare it with the consistent religious experience, trying to explore the Yi-Kuan-Tao and consistent Yi-Kuan-Tao rituals, religious organization, religious teachings, religious life care, and Funeral rituals and other comparative studies.

Keywords: Vietnam, Caodaism, Yi-Kuan-Tao, religious rituals

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Authors: Rudolf Hrach, Stanislav Novak, Vera Hrachova

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Composite and nanocomposite films represent the class of promising materials and are often objects of the study due to their mechanical, electrical and other properties. The most interesting ones are probably the composite metal/dielectric structures consisting of a metal component embedded in an oxide or polymer matrix. Behaviour of composite films varies with the amount of the metal component inside what is called filling factor. The structures contain individual metal particles or nanoparticles completely insulated by the dielectric matrix for small filling factors and the films have more or less dielectric properties. The conductivity of the films increases with increasing filling factor and finally a transition into metallic state occurs. The behaviour of composite films near a percolation threshold, where the change of charge transport mechanism from a thermally-activated tunnelling between individual metal objects to an ohmic conductivity is observed, is especially important. Physical properties of composite films are given not only by the concentration of metal component but also by the spatial and size distributions of metal objects which are influenced by a technology used. In our contribution, a study of composite structures with the help of methods of computational physics was performed. The study consists of two parts: -Generation of simulated composite and nanocomposite films. The techniques based on hard-sphere or soft-sphere models as well as on atomic modelling are used here. Characterizations of prepared composite structures by image analysis of their sections or projections follow then. However, the analysis of various morphological methods must be performed as the standard algorithms based on the theory of mathematical morphology lose their sensitivity when applied to composite films. -The charge transport in the composites was studied by the kinetic Monte Carlo method as there is a close connection between structural and electric properties of composite and nanocomposite films. It was found that near the percolation threshold the paths of tunnel current forms so-called fuzzy clusters. The main aim of the present study was to establish the correlation between morphological properties of composites/nanocomposites and structures of conducting paths in them in the dependence on the technology of composite films.

Keywords: composite films, computer modelling, image analysis, nanocomposite films

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Authors: Kerem Rızvanoğlu, Serhat Güney, Emre Kızılkaya, Betül Aydoğan, Ayşegül Boyalı, Onurcan Güden

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This study addresses the re-construction and implementation process of the methodological framework developed to evaluate how locative media applications accompany the urban experiences of international students coming to Istanbul with exchange programs in 2022. The research design was built on a three-stage model. The research team conducted a qualitative questionnaire in the first stage to gain exploratory data. These data were then used to form three persona groups representing the sample by applying cluster analysis. In the second phase, a semi-structured digital diary study was carried out on a gamified task list with a sample selected from the persona groups. This stage proved to be the most difficult to obtaining valid data from the participant group. The research team re-evaluated the design of this second phase to reach the participants who will perform the tasks given by the research team while sharing their momentary city experiences, to ensure the daily data flow for two weeks, and to increase the quality of the obtained data. The final stage, which follows to elaborate on the findings, is the “Walk & Talk,” which is completed with face-to-face and in-depth interviews. It has been seen that the multiple methods used in the research process contribute to the depth and data diversity of the research conducted in the context of urban experience and locative technologies. In addition, by adapting the research design to the experiences of the users included in the sample, the differences and similarities between the initial research design and the research applied are shown.

Keywords: digital diary study, gamification, multi-model research, persona analysis, research design for urban experience, user-centered research, “Walk & Talk”

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Authors: Sanja O. Podunavac-Kuzmanović, Strahinja Z. Kovačević, Lidija R. Jevrić

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Prion is a protein substance whose certain form is considered as infectious agent. It is presumed to be the cause of the transmissible spongiform encephalopathies (TSEs). The protein it is composed of, called PrP, can fold in structurally distinct ways. At least one of those 3D structures is transmissible to other prion proteins. Prions can be found in brain tissue of healthy people and have certain biological role. The structure of prions naturally occurring in healthy organisms is marked as PrPc, and the structure of infectious prion is labeled as PrPSc. PrPc may play a role in synaptic plasticity and neuronal development. Also, it may be required for neuronal myelin sheath maintenance, including a role in iron uptake and iron homeostasis. PrPSc can be considered as an environmental pollutant. The main aim of this study was to carry out the molecular modeling and calculation of molecular descriptors (lipophilicity, physico-chemical and topological descriptors) of structurally diverse compounds which can be considered as anti-prion agents. Molecular modeling was conducted applying ChemBio3D Ultra version 12.0 software. The obtained 3D models were subjected to energy minimization using molecular mechanics force field method (MM2). The cutoff for structure optimization was set at a gradient of 0.1 kcal/Åmol. The Austin Model 1 (AM-1) was used for full geometry optimization of all structures. The obtained set of molecular descriptors is applied in analysis of similarities and dissimilarities among the tested compounds. This study is an important step in further development of quantitative structure-activity relationship (QSAR) models, which can be used for prediction of anti-prion activity of newly synthesized compounds.

Keywords: chemometrics, molecular modeling, molecular descriptors, prions, QSAR

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Authors: Haris Karnezi, Kevin Tierney

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Cognitive Behaviour Drama is a research-based intervention model that brought together the science of psychology with the art form of drama to create an unobtrusive and exciting approach that would provide children on the higher end of the autism spectrum the motivation to explore the rules of social interaction and develop competencies associated with communicative success. The method involves engaging the participants in exciting fictional scenarios and encouraging them to seek various solutions on a number of problems that will lead them to an understanding of causal relationships and how a different course of action may lead to a different outcome. The sessions are structured to offer opportunities to the participants to practice target behaviours and understand the functions they serve. The study involved six separate interventions and employed both single case and group designs. Overall 8 children aged between 6 to 13 years, diagnosed with ASD participated in the study. Outcomes were measured using theory of mind tests, executive functioning tests, behavioural observations, pre and post intervention standardised social competence questionnaires for parents and teachers. Collectively, the results indicated positive changes in the self esteem and behaviour of all eight participants. In particular, improvements in the ability to solve theory of mind tasks were noted in the younger group; and qualitative improvements in social communication, in terms of verbal (content) and non verbal expression (body posture, vocal expression, fluency, eye contact, reduction of ritualistic mannerisms) were noted in the older group. The need for reliable impact measures to assess the effectiveness of the model in generating global changes in the participants’ behaviour outside the therapeutic context was identified.

Keywords: autism, drama, intervention, social skills

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Authors: Shannon Hearney, Jeffrey Hoch

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Pancreatic cancer is a notoriously costly and deadly form of cancer. Many types of treatment centers exist for patients to seek care from, including high-volume centers which have shown promise to provide the highest quality of care. While it may be true that this type of center provides the best care it is unclear if that care is cost-effective. Studies in the US have confirmed that high-volume hospitals do provide higher quality of care but have shown inconsistencies in the cost-effectiveness of that care. Other studies, like those from Finland have shown that high-volume centers had lower mortality and lower costs than low-volume centers. This paper thus seeks to review the current scientific literature to better understand if high-volume centers are cost-effective in delivering care in both a European setting and in the US. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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Authors: Sumayya S.

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Making cities adaptive and inclusive is one among the inherent goal and challenge for contemporary cities. This is a serious concern when the urban transformations occur in varying magnitude due to visible and invisible factors. One type of visibly invisible factor is ecommerce and its expanding operation that is understood to cause changes to the conventional spatial structure positively and negatively. With the continued growth in e-commerce activities and its future potential, market analysts, media, and even retailers have questioned the importance of a future presence of traditional Brick-and-mortar stores in cities as a critical element, with some even referring to the repeated announcement of the closure of some store chains as the end of the online shopping era. Essentially this raises the question of how adaptive and inclusive the cities are to the dynamics of transformative changes that are often unseen. People have become more comfortable with seating inside and door delivery systems, and this increased change in usage of public spaces, especially the commercial corridors. Through this research helped in presetting a new approach for planning and designing commercial activities centers and also presents the impact of ecommerce on the urban fabric, such as division and fragmentation of space, showroom syndrome, reconceptualization of space, etc., in a critical way. The changes are understood by analyzing the e-commerce logistic process. Based on the inferences reach at the conclusion for the need of an integrated approach in the field of planning and designing of public spaces for the sustainable omnichannel retailing. This study was carried out with the following objectives Monitoring the impact of e commerce on the traditional shopping space. Explore the new challenges and opportunities faced by the urban form. Explore how adaptive and inclusive our cities are to the dynamics of transformative changes caused by ecommerce.

Keywords: E-commerce, shopping streets, online environment, offline environment, shopping factors

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Authors: Akbar Jamali

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Many scholars consider Hegel’s philosophy of art as the greatest theory of aesthetics since Aristotle’s Poetics. ‘Freedom’ distinguishes modern, especially German Idealism with Greek philosophy. Therefore, introducing and contemplating on Hegel’s Aesthetics as a whole, freedom as the essence of art, Hegel’s controversial claim on the end of art, and the relation of art and state is the main theme of this study. Hegel’s aesthetics is to be understood in his whole system. According to Hegel’s speculative philosophy, being is to be understood as self-determining Reason or Idea. The self-determining Reason actualizes and realizes himself in the course of history. Idea in the process of self-actualization becomes more and more rational. It first actualizes itself in matter, then in non-conscious life, finally in conscious and self-conscious life. Self-conscious life is the most rational stage of development of Idea in which the subject can think and imagine, use language and exercise freedom. Hegel calls this self-conscious life Spirit (Geist). Therefore, emergence of human being is an essential moment in the process of self-determination of Reason. It is not accidental rather a necessity. The essence of spirit is freedom. Since the history is the process of the self-actualization if spirit, humankind becomes more and more, free. Spirit in its ‘Absolute’ form manifests itself into three forms; Art, Religion and philosophy. Art is the first stage in which Spirit understands itself. In fact, Art is the expression of human spirit, which is comprehended by our senses. Beauty is defined as the sensuous expression of free Spirit. The purpose of art is, therefore, to express, enjoy and contemplate on our freedom. State belongs to the realm of Objective spirit, while Art along with Religion and philosophy belong to the realm of Absolute Spirit. Absolute spirit is superior to Objective Spirit; therefore, state must not interfere in the realm of art. Limitation on art by state directly violates freedom and prevents development of national spirit. Genuine art leads us to freedom and richness of (national) Spirit. Using Hegel’s philosophy of art, we can comprehend why totalitarian states try to limit art and, why artists are the enemy of totalitarian states. In this philosophical system, we contemplate on art as a way to freedom and emancipation.

Keywords: aesthetics, freedom, spirit, state

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Authors: G. Gevorgyan, S. Khudaverdyan, A. Vaseashta

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The Lake Sevan basin is situated in the eastern part of the Republic of Armenia (Gegharquniq marz/district). The heavy metal pollution of the some tributaries of Lake Sevan was investigated. Water sampling was performed in August and December, 2014 from the 4 observation sites: 1) Sotq river upstream (about 600 meters upstream from the Sotq gold mine); 2) Sotq river mouth; 3) Masrik river mouth; 4) Dzknaget river mouth. Heavy metal (V, Fe, Ni, Cu, As, Mo, Pb) concentrations in the water samples were determined by the standard methods using an atomic absorption spectrophotometer. The results of the study showed that heavy metal content mainly increased from the upstream of the Sotq river to the mouth of the Masrik river which may have been conditioned by the influence of gold mining activity as the Masrik and its tributary-Sotq rivers passing through the gold mining area were exposed to heavy metal pollution. The observation sites can be ranked by pollution degree as follows: №3> №2> №1> №4. The highest heavy metal pollution degree was observed in the Masrik river mouth which may have been conditioned by the direct impact of gold mining activity and the pressure of its tributary–the Sotq river which flows through the gold mining area. The lowest heavy metal pollution degree was registered in the Dzknaget river mouth which flowing through rural areas wasn’t subject to significant heavy metal pollution. According to the observation sites of the Sotq and Masrik rivers, high positive correlation was mainly observed between the concentrations of the investigated heavy metals (except nickel) which indicated that all the heavy metals except the nickel had the same anthropogenic pollution source which was the activity of the Sotq gold mine. In general, it is possible to state that the activity of the Sotq gold mine in the Lake Sevan basin caused the heavy metal pollution of the Sotq and Masrik rivers which may have posed environmental hazards. Heavy metals are nondegradable substances, and heavy metal pollution of freshwater systems may pose risks to the environment and human health through accumulation in the tissues of aquatic organisms, water-food chain as well as oral ingestion and dermal contact.

Keywords: Armenia, Lake Sevan basin, gold mining activity, river ecosystems, heavy metal pollution

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Authors: Leizhang Wang, Baocang Wang

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General Sieve Kernel (G6K) is considered as currently the fastest algorithm for the shortest vector problem (SVP) and record holder of open SVP challenge. We study the lattice basis quality improvement effects of the Workout proposed in G6K, which is composed of a series of pumps to solve SVP. Firstly, we use a low-dimensional pump output basis to propose a predictor to predict the quality of high-dimensional Pumps output basis. Both theoretical analysis and experimental tests are performed to illustrate that it is more computationally expensive to solve the LWE problems by using a G6K default SVP solving strategy (Workout) than these lattice reduction algorithms (e.g. BKZ 2.0, Progressive BKZ, Pump, and Jump BKZ) with sieving as their SVP oracle. Secondly, the default Workout in G6K is optimized to achieve a stronger reduction and lower computational cost. Thirdly, we combine the optimized Workout and the Pump output basis quality predictor to further reduce the computational cost by optimizing LWE instances selection strategy. In fact, we can solve the TU LWE challenge (n = 65, q = 4225, = 0:005) 13.6 times faster than the G6K default Workout. Fourthly, we consider a combined two-stage (Preprocessing by BKZ- and a big Pump) LWE solving strategy. Both stages use dimension for free technology to give new theoretical security estimations of several LWE-based cryptographic schemes. The security estimations show that the securities of these schemes with the conservative Newhope’s core-SVP model are somewhat overestimated. In addition, in the case of LAC scheme, LWE instances selection strategy can be optimized to further improve the LWE-solving efficiency even by 15% and 57%. Finally, some experiments are implemented to examine the effects of our strategies on the Normal Form LWE problems, and the results demonstrate that the combined strategy is four times faster than that of Newhope.

Keywords: LWE, G6K, pump estimator, LWE instances selection strategy, dimension for free

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Authors: Nindyo Cahyo Kresnanto, Muhamad Willdan, Wika Harisa Putri

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Gunungkidul is one of the emerging tourism industry areas in Yogyakarta Province, Indonesia. This article describes how GIS can predict the development of tourism potential in Gunungkidul. The tourism sector in Gunungkidul Regency contributes 3.34% of the total gross regional domestic product and is the economic sector with the highest growth with a percentage of 18.37% in the post-Covid-19 period. This contribution makes researchers consider that several tourist sites need to be explored more to increase regional economic development gradually. This research starts by collecting spatial data from tourist locations tourists want to visit in Gunungkidul Regency based on survey data from 571 respondents. Then the data is visualized with ArcGIS software. This research shows an overview of tourist destinations interested in travellers depicted from the lowest to the highest from the data visualization. Based on the data visualization results, specific tourist locations potentially developed to influence the surrounding economy positively. The visualization of the data displayed is also in the form of a desire line map that shows tourist travel patterns from the origin of the tourist to the destination of the tourist location of interest. From the desire line, the prediction of the path of tourist sites with a high frequency of transportation activity can figure out. Predictions regarding specific tourist location routes that high transportation activities can burden can consider which routes will be chosen. The route also needs to be improved in terms of capacity and quality. The goal is to provide a sense of security and comfort for tourists who drive and positively impact the tourist sites traversed by the route.

Keywords: tourism development, GIS and survey, transportation, potential desire line

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Authors: Shaho Ghafur Ahmed

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The right to self-determination of peoples is a fundamental human right recognized by the principles of international law. It could be embodied in the internal level in the form of federalism. Most federal constitutions prevented the secession of constituent entities, while some remained silent, as the case of Iraq, and rare instances of them recognize it. But, after the failure of federalism, these entities seek to separate whenever the opportunity arises. In several cases, they have resort to peaceful methods in some others they resort to force. The constitutional Supreme Court, which guaranty the unity and integrity of the State, often prevent these attempts. After not a commitment of federalism in Iraq, which has been founded since 2004, the Kurdistan region, as the only federated entity, has conducted a unilateral referendum on 25 September 2017 for its independence. The Iraqi government refused it. The Iraqi Federal Supreme Court, through interpreting the constitutional provisions, decided that this referendum and it’s purposes, which was the independence of the region, was unconstitutional. Subsequently, the Iraqi government used forces and blockaded the region so as to force it to turn off this process. So, in this paper, the right to self-determination of the peoples in federated entities and its obstacles will be discussed through the comparative legal basis and analyzing the decisions of the Federal Constitutional Courts. We will compare the role that the Supreme Court of Canada played regarding the referendum that operated in Quebec in 1995, in which it refused only the unilaterally attempts for the independence of this province. While, in the case of the Kurdistan region, the Iraqi Federal Supreme Court has definitively refused this right. No measures were taken by this Court to protect the region from the Iraqi government reactions. This decision led to the questioning of the neutrality of this Court. So, from the point of view of the Kurdistan region, this Court became a political instrument to prevent it to be independent in the international community, in the absence of a clear constitutional provision, through an abstract and an incomplete interpretation of federal constitutional provisions.

Keywords: right of self-determination, federal supreme court, supremacy of federal constitution

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Authors: Dean J. Hill

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This paper undertakes the task of conducting an in-depth textual analysis of the cli-fi genre. It examines how writing in the genre contributes to expressing and facilitating the articulation of environmental consciousness through the form of narrative. The paper begins by situating cli-fi within the literary continuum of ecological narratives and identifying the unique textual characteristics and thematic preoccupations of this area. The paper unfolds how cli-fi transforms the esoteric nature of climate science into credible narrative forms by drawing on language use, metaphorical constructs, and narrative framing. It also involves how descriptive and figurative language in the description of nature and disaster makes climate change so vivid and emotionally resonant. The work also points out the dialogic nature of cli-fi, whereby the characters and the narrators experience inner disputes in the novel regarding the ethical dilemma of environmental destruction, thus demanding the readers challenge and re-evaluate their standpoints on sustainability and ecological responsibilities. The paper proceeds with analysing the feature of narrative voice and its role in eliciting empathy, as well as reader involvement with the ecological material. In looking at how different narratorial perspectives contribute to the emotional and cognitive reaction of the reader to text, this study demonstrates the profound power of perspective in developing intimacy with the dominating concerns. Finally, the emotional arc of cli-fi narratives, running its course over themes of loss, hope, and resilience, is analysed in relation to how these elements function to marshal public feeling and discourse into action around climate change. Therefore, we can say that the complexity of the text in the cli-fi not only shows the hard edge of the reality of climate change but also influences public perception and behaviour toward a more sustainable future.

Keywords: cli-fi genre, ecological narratives, emotional arc, narrative voice, public perception

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Authors: T. S. Soliman, A. G. Galyas, E. V. Rusinova, S. A. Vshivkov

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The liquid crystals combining properties of a liquid and an anisotropic crystal substance play an important role in a science and engineering. Molecules of cellulose and its derivatives have rigid helical conformation, stabilized by intramolecular hydrogen bonds. Therefore the macromolecules of these polymers are capable to be ordered at dissolution and form liquid crystals of cholesteric type. Phase diagrams of solutions of some cellulose derivatives are known. However, little is known about the effect of a magnetic field on the viscosity of polymer solutions. The systems hydroxypropyl cellulose (HPC) – ethanol, HPC – ethylene glycol, HPC–DМАA, HPC–DMF, ethyl cellulose (EC)–ethanol, EC–DMF, were studied in the presence and absence of magnetic field. The solution viscosity was determined on a Rheotest RN 4.1 rheometer. The effect of a magnetic field on the solution properties was studied with the use of two magnets, which induces a magnetic-field-lines directed perpendicularly and parallel to the rotational axis of a rotor. Application of the magnetic field is shown to be accompanied by an increase in the additional assembly of macromolecules, as is evident from a gain in the radii of light scattering particles. In the presence of a magnetic field, the long chains of macromolecules are oriented in parallel with field lines. Such an orientation is associated with the molecular diamagnetic anisotropy of macromolecules. As a result, supramolecular particles are formed, especially in the vicinity of the region of liquid crystalline phase transition. The magnetic field leads to the increase in viscosity of solutions. The results were used to plot the concentration dependence of η/η0, where η and η0 are the viscosities of solutions in the presence and absence of a magnetic field, respectively. In this case, the values of viscosity corresponding to low shear rates were chosen because the concentration dependence of viscosity at low shear rates is typical for anisotropic systems. In the investigated composition range, the values of η/η0 are described by a curve with a maximum.

Keywords: rheology, liquid crystals, magnetic field, cellulose ethers

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Authors: Sharareh Khodami, Misni Surif, Wan Maznah Wan Omar, Parto Bahreini

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Over the past three decades, Penang Island, Malaysia, has experienced rapid development across the industrial, urban, tourism, and aquaculture sectors. Consequently, wastewater from the Bayan Lepas Free Industrial Zone (FIZ) is discharged into a network of drainage canals and the Keluang River, which ultimately releases into the open sea near Jerjak Island. Among these waterways, the Keluang River is the largest canal receiving effluent from the Bayan Lepas FIZ. This study investigated the spatial and temporal variability of key physicochemical parameters water temperature, dissolved oxygen, salinity, pH, and nutrients (NO₃⁻, NO₂⁻, NH₄⁺, and PO₄³⁻) in the Bayan Lepas area. Water samples were collected from ten sampling stations (upstream, housing area, factory area, and coast) during low tide under both wet and dry seasonal conditions. The parameters were analyzed, and the spatial distribution of them were mapped using Geographic Information System (GIS) techniques. The observed ranges were 26–31.7 °C for water temperature, 0.3–9 mg/L for dissolved oxygen, 6.95–8.56 for pH, 0–30.1 ppt for salinity, 0.2–0.820 mg/L for nitrate, 0.002–0.090 mg/L for nitrite, 0.4–6.33 mg/L for ammonia, and 0.033–1.110 mg/L for phosphate. The selected stations exhibited characteristics ranging from fresh to saline water. One-way ANOVA showed that each parameter significantly differed among the stations during the two seasons (P < 0.05). The parameter values were evaluated against Malaysia's National Water Quality Standards (NWQS) and Marine Water Quality Criteria and Standards (MWQCS), and stations for each parameter were categorized from Class I to V. Results indicated that the Keluang River is polluted with high levels of ammonia and phosphate and low dissolved oxygen. The phosphate and ammonium concentrations at the river mouth of the Keluang River were 47.60 and 18.8 times higher than the standard values (0.056 mg/L and 0.024 mg/L), respectively. In light of the ongoing industrial expansion in the Bayan Lepas area, it is imperative to prioritize environmental protection and sustainable development practices to mitigate nutrient pollution and preserve the ecological health of the Keluang River and adjacent coastal regions.

Keywords: industrial impact, Keluang River, nutrient pollution, water quality

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Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

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Authors: Jayakant Singh, Enu Anand

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Background: Child marriage is widely prevalent in India. It is a form of gross human right violation that succumbs a child bride to be subservient to her husband within a marital relation. We investigated the relationship between age at marriage of women and her level of empowerment with physical violence experienced 12 months preceding the survey among young women aged 20-24 in two culturally distinct states- Bihar and Tamil Nadu of India. Methods: We used the information collected from 10514 young married women (20-24 years) at all India level, 373 in Bihar and 523 in Tamil Nadu from the third round of National Family Health Survey. Empowerment index was calculated using different parameters such as mobility, economic independence and decision making power of women using Principal Component Analysis method. Bivariate analysis was performed primarily using chi square for the test of significance. Logistic regression was carried out to assess the effect of age at marriage and empowerment on physical violence. Results: Lower level of women empowerment was significantly associated with physical violence in Tamil Nadu (OR=2.38, p<0.01) whereas child marriage (marriage before age 15) was associated with physical violence in Bihar (OR=3.27, p<0.001). The mean difference in age at marriage between those who experienced physical violence and those who did not experience varied by 7 months in Bihar and 10 months in Tamil Nadu. Conclusion: Culture specific intervention may be a key to reduction of violence against women as the results showed association of different factors contributing to physical violence in Bihar and Tamil Nadu. Marrying at an appropriate age perhaps is protective of abuse because it equips a woman to assert her rights effectively. It calls for an urgent consideration to curb both violence and child marriage with stricter involvement of family, civil society and the government. In the meanwhile physical violence may be recognized as a public health problem and integrate appropriate treatment to the victims within the health care institution.

Keywords: child marriage, empowerment, India, physical violence

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Authors: Murat Emre, Zeynep Tufekcioglu

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Objective: We describe a patient with late onset phenylketonuria which presented with rapidly progressive dementia and parkinsonism that were reversible after management. Background: Phenylketonuria is an autosomal recessive disorder due to mutations in the phenylalanine hydroxlase gene. It normally presents in childhood, in rare cases, however, it may have its onset in adulthood and may mimic other neurological disorders. Case description: A previously normal functioning, 59 year old man was admitted for blurred vision, cognitive impairment and gait difficulty which emerged over the past eight months. In neurological examination he had brisk reflexes, slow gait and left-dominant parkinsonism. Mini-mental state examination score was 25/30, neuropsychological testing revealed a dysexecutive syndrome with constructional apraxia and simultanagnosia. In cranial MRI there were bilateral diffuse hyper-intense lesions in parietal and occipital white matter with no significant atrophy. Electroencephalography showed diffuse slowing with predominance of teta waves. In cerebrospinal fluid examination protein level was slightly elevated (61mg/dL), oligoclonal bands were negative. Electromyography was normal. Routine laboratory examinations for rapidly progressive dementia and parkinsonism were also normal. Serum amino acid levels were determined to explore metabolic leukodystrophies and phenylalanine level was found to be highly elevated (1075 µmol/L) with normal tyrosine (61,20 µmol/L). His cognitive impairment and parkinsonian symptoms improved following three months of phenylalanine restricted diet. Conclusions: Late onset phenylketonuria is a rare, potentially reversible cause of rapidly progressive parkinsonism with dementia. It should be considered in the differential diagnosis of patients with suspicious features.

Keywords: dementia, neurology, Phenylketonuria, rapidly progressive parkinsonism

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