Search results for: English for secondary school students

Authors: Tapiwa Shumba

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The right to fairness and access to appeals and reviews enshrined under the South African Constitution seeks to ensure that justice is served. In essence, the constitution and the law have put in place mechanisms to ensure that a miscarriage of justice through wrongful convictions does not occur. However, once convicted and sentenced on appeal the procedural safeguards seem to resign as if to say, the accused has met his fate. The challenge with this construction is that even within an ideally perfect legal system wrongful convictions would still occur. Therefore, it is not so much of the failings of a legal system that demand attention but mechanisms to redress the results of such failings where evidence becomes available that a wrongful conviction occurred. In this context, this paper looks at the South African criminal procedural mechanisms for litigating innocence post-conviction. The discussion focuses on the role of section 327 of the South African Criminal Procedure Act and its apparent shortcomings in providing an avenue for victims of miscarriages to litigate their innocence by adducing new evidence at any stage during their wrongful incarceration. By looking at developments in other jurisdiction such as the United Kingdom, where South African criminal procedure draws much of its history, and the North Carolina example which in itself was inspired by the UK Criminal Cases Review Commission, this paper is able to make comparisons and draw invaluable lessons for the South African criminal justice system. Lessons from these foreign jurisdictions show that South African post-conviction criminal procedures need reform in line with constitutional values of human dignity, equality before the law, openness and transparency. The paper proposes an independent review of the current processes to assess the current post-conviction procedures under section 327. The review must look into the effectiveness of the current system and how it can be improved in line with new substantive legal provisions creating access to DNA evidence for post-conviction exonerations. Although the UK CCRC body should not be slavishly followed, its operations and the process leading to its establishment certainly provide a good point of reference and invaluable lessons for the South African criminal justice system seeing that South African law on this aspect has generally followed the English approach except that current provisions under section 327 are a mirror of the discredited system of the UK’s previous dispensation. A new independent mechanism that treats innocent victims of the criminal justice system with dignity away from the current political process is proposed to enable the South African criminal justice to benefit fully from recent and upcoming advances in science and technology.

Keywords: innocence, forensic law, post-conviction remedies, South African criminal justice system, wrongful conviction

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Authors: A. V. Belousov, Yakushenko

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One of the main problems of modern dentistry is development a reliable method to detect inflammation in the gums on the stages of diagnosis and assessment of treatment efficacy. We have proposed a method of gingival fluid intake, which successfully combines accessibility, excluding the impact of the annoying and damaging the gingival sulcus factors and provides reliable results (patent of RF№ 2342956 Method of gingival fluid intake). The objects of the study were students - volunteers of Dentistry Faculty numbering 75 people aged 20-21 years. Cellular composition of gingival fluid was studied using microscope "Olympus CX 31" (Japan) with the calculation of epithelial leukocyte index (ELI). Assessment of gingival micro circulation was performed using the apparatus «LAKK–01» (Lazma, Moscow). Cytological investigation noted the highly informative of epithelial leukocyte index (ELI), which demonstrated changes in the mechanisms of protection gums. The increase of ELI occurs during inhibition mechanisms of phagocytosis and activation of epithelial desquamation. The cytological data correlate with micro circulation indicators obtained by laser Doppler flowmetry. We have identified and confirmed the correlations between parameters laser Doppler flowmetry and data cytology gingival fluid in patients with gingivitis.

Keywords: gingivitis, laser doppler flowmetry, gingival fluid cytology, epithelial leukocyte index (ELI)

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Authors: Ayoola Idowu Olasebikan

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The global community has become increasingly dependent on various kinds of technologies out of which Information and Communication Technologies (ICTs) appear to be the most prominent. ICTs have become multipurpose tools which have had a revolutionary impact on how we see the world and how we live in it. Yoruba is the most widely spoken African language outside Africa but it remains one of the badly spoken language in the world as a result of its outdated teaching method in the African schools which prevented its standard version from being spoken and written. This paper conducts a critical review of the traditional methods of teaching Yoruba language. It then examines the possibility of leveraging on ICTs for improved methods of teaching Yoruba language to achieve global standard and spread. It identified key ICT platforms that can be deployed for the teaching of Yoruba language and the constraints facing each of them. The paper concludes that Information and Communication Technologies appear to provide veritable opportunity for paradigm shift in the methods of teaching Yoruba Language. It also opines that Yoruba language has the potential to transform economic fortune of Africa for sustainable development provided its teaching is taken beyond the brick and mortar classroom to the virtual classroom/global information super highway called internet or any other ICTs medium. It recommends that students and teachers of Yoruba language should be encouraged to acquire basic skills in computer and internet technology in order to enhance their ability to develop and retrieve electronic Yoruba language teaching materials.

Keywords: Africa, ICT, teaching method, Yoruba language

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Authors: Kougioumtzis Konstantin, Rylander Pär, Karlsteen Magnus

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Ball skills as a subset of fundamental motor skills are predictors for performance in sports. Currently, most tools evaluate ball skills utilizing subjective ratings. The aim of this study was to examine the psychometric properties of a newly developed instrument to objectively measure ball handling skills (BHS-test) utilizing digital instrument. Participants were a convenience sample of 213 adolescents (age M = 17.1 years, SD =3.6; 55% females, 45% males) recruited from upper secondary schools and invited to a sports hall for the assessment. The 8-item instrument incorporated both accuracy-based ball skill tests and repetitive-performance tests with a ball. Testers counted performance manually in the four tests (one throwing and three juggling tasks). Furthermore, assessment was technologically enhanced in the other four tests utilizing a ball machine, a Kinect camera and balls with motion sensors (one balancing and three rolling tasks). 3D printing technology was used to construct equipment, while all results were administered digitally with smart phones/tablets, computers and a specially constructed application to send data to a server. The instrument was deemed reliable (α = .77) and principal component analysis was used in a random subset (53 of the participants). Furthermore, latent variable modeling was employed to confirm the structure with the remaining subset (160 of the participants). The analysis showed good factorial-related validity with one factor explaining 57.90 % of the total variance. Four loadings were larger than .80, two more exceeded .76 and the other two were .65 and .49. The one factor solution was confirmed by a first order model with one general factor and an excellent fit between model and data (χ² = 16.12, DF = 20; RMSEA = .00, CI90 .00–.05; CFI = 1.00; SRMR = .02). The loadings on the general factor ranged between .65 and .83. Our findings indicate good reliability and construct validity for the BHS-test. To develop the instrument further, more studies are needed with various age-groups, e.g. children. We suggest using the BHS-test for diagnostic or assessment purpose for talent development and sports participation interventions that focus on ball games.

Keywords: ball-handling skills, ball-handling ability, technologically-enhanced measurements, assessment

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Authors: Rafikoddin Kazi

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Almost all the major religions of the world condemn the transactions based on interest which promotes self-centered and materialistic thinking. Still, it is amazing to note that it has become the tradition of transaction at world level hence it is called traditional financial system. The main feature of this system is that it considers economic aspects of the transaction only. This system supports the economic development and not the welfare of humankind. However, it is worth mentioning the fact that, except Islamic financial system no other financial system stood in front of it as a viable alternative system. Although many countries have tried to create financial infrastructure and system, still the Malaysian Islamic financial system has got its own peculiarity. It has made tremendous progress in creating sound Islamic Financial system. However, the historical aspect of this country which has passed through Islamic and traditional financial system has got its own advantages and disadvantages. The advantageous factor is that, despite having mix and heterogeneous culture, it has succeeded in creating Islamic Financial System based on the dual legal system to satisfy the needs of multi-cultural factors. This fact has proved that Islamic Financial System does not need purely Muslim population. However, due to adoption of the dual legal system, several legal issues have been taken place. According to this system, the application of Islamic Law has been limited only up to some family and religious matters. The rest of the matters are being dealt with under the traditional laws, the principles and practices of which are different from that of the Islamic Legal System. The matter becomes all the more complicated when the cases are partially or simultaneously concerned with traditional vis-à-vis Islamic Laws as it requires expertise in both the legal systems. However, the educational principles and systems are different in respect of both the systems. To face this problem, Shariah Advisory Council has been established. But the Multiplicity of Shariah authorities without judicial power has created confusion at various levels. Therefore, some experts have stressed the need for improving, empowering the Islamic financial, legal system to make it more integrated and holistic. In view of the above, an endeavor has been made in this paper to throw some light on the matters related to the adoption of the dual legal system. The paper is conceptual in nature and the method adopted is the intensive survey of literature thereby all the information has been gathered from the secondary sources.

Keywords: Islamic financial system, Islamic legal system, Islamic capital market (ICM) , traditional financial system

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Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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Authors: Mette Pedersen

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This paper outlines the criteria that assessment specialists use when they design the 'Persuasive Essay' task for the four Advanced Placement World Language and Culture Exams (AP French, German, Italian, and Spanish). The 'Persuasive Essay' is a free-response, source-based, standardized measure of presentational writing. Each 'Persuasive Essay' item consists of three sources (an article, a chart, and an audio) and a prompt, which is a statement of the topic phrased as an interrogative sentence. Due to its richness of source materials and due to the amount of time that test takers are given to prepare for and write their responses (a total of 55 minutes), the 'Persuasive Essay' is the free-response task on the AP World Language and Culture Exams that goes to the greatest lengths to unleash the test takers' proficiency potential. The author focuses on the work that goes into designing the 'Persuasive Essay' task, outlining best practices for the selection of topics and sources, the interplay that needs to be present among the sources and the thinking behind the articulation of prompts for the 'Persuasive Essay' task. Using released 'Persuasive Essay' items from the AP World Language and Culture Exams and accompanying data on test taker performance, the author shows how different passages, and features of passages, have succeeded (and sometimes not succeeded) in eliciting writing proficiency among test takers over time. Data from approximately 215.000 test takers per year from 2014 to 2017 and approximately 35.000 test takers per year from 2012 to 2013 form the basis of this analysis. The conclusion of the study is that test taker performance improves significantly when the sources that test takers are presented with express directly opposing viewpoints. Test taker performance also improves when the interrogative prompt that the test takers respond to is phrased as a yes/no question. Finally, an analysis of linguistic difficulty and complexity levels of the printed sources reveals that test taker performance does not decrease when the complexity level of the article of the 'Persuasive Essay' increases. This last text complexity analysis is performed with the help of the 'ETS TextEvaluator' tool and the 'Complexity Scale for Information Texts (Scale)', two tools, which, in combination, provide a rubric and a fully-automated technology for evaluating nonfiction and informational texts in English translation.

Keywords: advanced placement world language and culture exams, designing presentational writing assessments, large-scale standardized assessments of written language proficiency, source-based language testing

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Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

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Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

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Authors: Haruna Karamba, Nafisa Muhammad Danyaro

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The study describe the action of natural latex (extract) of two sub-aquatic macrophytes plants i.e., Cassia occidentalis and Physalis angulata which were tested against two water snail species; Bulinus globusus and Lymnaea natalensis, the intermediate host of Bilharziasis (chistosomiasis) in the tropical countries. Bilherziasis is a disease prevalent and endermic to tropical Africa, seriously undermining health status of Nigerian youth. The easiest way to eradicate the disease is to eliminate the secondary host of the pathogen, chistosoma species. Therefore we carried out a research to investigate the molluscicidal effect of the leaf extract of C. occidentalis and P. angulata on mortality rate of B. globusus and L. natalensis water snails using pond water in the laboratory of science laboratory department of Kano State Polytechnic, Nigeria. One hundred and fifty juveniles’ snails were collected from Jakara Dam in the Northeastern part of Kano, Nigeria. The snails were put inside a plastic container and transported immediately to the laboratory where they were transferred into reservoir tank containing pond water and kept for 48 hours to get acclimatized with laboratory environment. Twelve water bathes 2/3 filled with pond water were prepared and kept in the laboratory. Leaf extract of the plants were obtained by blending and homogenizing the leaf tissue from which the extract were obtained and prepared in 10, 20, 30, 40 and 50 ppm, in addition to 0 ppm, which served as control. Ten snails were placed in each of the twelve water bathes. Six water bathes for the species of C. accidentalis extract and other six for P. angulata. The treatment combinations were maintained for 2 days after which the number of living snails present in each water bathes were counted and subsequently at 2 days intervals. The result indicated that extracts from both plants were lethal to the snails as concentration of the extract increases particularly mortality rate was highest at 40 and 50 ppm. Conclusively the toxicity of the extracts from these plants proven lethal to snails and hence can be used as molluscicides for cheap and easy method of eliminating water snails and therefore reducing the incidence of Bilharziasis.

Keywords: schistosomiasis, bilharziasis, Bulinus globusus, Lymnea natalensis, Physalis angulata, Cassia occidentalis, Kano

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Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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Authors: Freddy Munzhelele

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Setting: the empirical research has shown that the life cycle theory has an impact on the firms’ financing decisions, particularly the dividend pay-outs. Accordingly, the life cycle theory posits that as a firm matures, it gets to a level and capacity where it distributes more cash as dividends. On the other hand, the young firms prioritise investment opportunities sets and their financing; thus, they pay little or no dividends. The research on firms’ financing decisions also demonstrated, among others, the adoption of trade-off and pecking order theories on the dynamics of firms capital structure. The trade-off theory talks to firms holding a favourable position regarding debt structures particularly as to the cost and benefits thereof; and pecking order is concerned with firms preferring a hierarchical order as to choosing financing sources. The case of life cycle hypothesis explaining the financial managers’ decisions as regards the firms’ capital structure dynamics appears to be an interesting link, yet this link has been neglected in corporate finance research. If this link is to be explored as an empirical research, the financial decision-making alternatives will be enhanced immensely, since no conclusive evidence has been found yet as to the dynamics of capital structure. Aim: the aim of this study is to examine the impact of life cycle theory on the capital structure dynamics trade-off and pecking order theories of firms listed in retail, industrial and mining sectors of the JSE. These sectors are among the key contributors to the GDP in the South African economy. Design and methodology: following the postpositivist research paradigm, the study is quantitative in nature and utilises secondary data obtainable from the financial statements of sampled firm for the period 2010 – 2022. The firms’ financial statements will be extracted from the IRESS database. Since the data will be in panel form, a combination of the static and dynamic panel data estimators will used to analyse data. The overall data analyses will be done using STATA program. Value add: this study directly investigates the link between the life cycle theory and the dynamics of capital structure decisions, particularly the trade-off and pecking order theories.

Keywords: life cycle theory, trade-off theory, pecking order theory, capital structure, JSE listed firms

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Authors: Elyce Cardonick, Shistri Dhar, Linsdey Seidman

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Background: When breast cancer is diagnosed during pregnancy, the prognosis is comparable to non-pregnant women matched for prognostic indicators when pregnant women receive treatment without delay. Chemotherapy, including taxanes, can be given during pregnancy with normal neonatal development in exposed fetuses. Methods: Cases of primary breast cancer were extracted from the Cancer and Pregnancy Registry and longitudinal study at Cooper Medical School, which collects cases of pregnant women diagnosed and treated for cancer into a single database. Obstetrical, oncology and pediatric records were reviewed, including annual neonatal developmental, behavioral and medical assessments. Results: 270 pregnant women were diagnosed with primary breast cancer at a mean gestational age of 14.7+9weeks. Mean maternal age at diagnosis 34.5+4.5 years. Receptor status is comparable to non-pregnant women of reproductive age. Forty-nine women were advised to terminate. Two hundred two women underwent surgery;244 women received chemotherapy in pregnancy after the first trimester; the majority of Doxorubucin/Cytoxan; 81 of the cases included a taxane. At a mean of 90 months, follow up obtained on 255 newborns.192/255 newborns are meeting developmental milestones. Respiratory illnesses, including asthma, and bronchiolitis, were reported in 64 newborns, the most common medical condition reported. Thirty-one children are undergoing treatment for GERD, 11 for urinary tract infections, and 7 are undergoing treatment for anemia. Twenty-six children with expressive or articulation language delays, 21/26 are mild. Eleven children with gross/ 7 with fine motor delays. Eight children are treated for ADHD, 4 for anxiety and 4 have social skill impairment. The majority of children with developmental, language or motor delays were born preterm. Conclusion: After chemotherapy exposure in utero for breast cancer, the majority of newborns are meeting developmental milestones and are medically healthy. The goal for treating pregnant women with breast cancer is to aim for delivery close to the term.

Keywords: breast cancer, pregnancy, chemotherapy, newborn

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Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: Joanne Hardman

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South Africa’s crisis in mathematics attainment is well documented. To meet the need to develop students’ mathematical performance in schools the government has launched various initiatives using computers to impact on mathematical attainment. While it is clear that computers can change pedagogical practices, there is a dearth of qualitative studies indicating exactly how pedagogy is transformed with Information Communication Technologies (ICTs) in a teaching activity. Consequently, this paper addresses the following question: how, along which dimensions in an activity, does pedagogy alter with the use of computer drill and practice software in four disadvantaged grade 6 mathematics classrooms in the Western Cape province of South Africa? The paper draws on Cultural Historical Activity Theory (CHAT) to develop a view of pedagogy as socially situated. Four ideal pedagogical types are identified: Reinforcement pedagogy, which has the reinforcement of specialised knowledge as its object; Collaborative pedagogy, which has the development of metacognitive engagement with specialised knowledge as its object; Directive pedagogy, which has the development of technical task skills as its object, and finally, Defensive pedagogy, which has student regulation as its object. Face-to-face lessons were characterised as predominantly Reinforcement and Collaborative pedagogy and most computer lessons were characterised as mainly either Defensive or Directive.

Keywords: computers, cultural historical activity theory, mathematics, pedagogy

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Authors: Barbora Valockova

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Scholars recommend the establishment of a multilateral coordination mechanism by ASEAN, such as an infrastructure forum, to contain the China-Japan infrastructure financing competition in the region. However, they do not systematically investigate the reasons for its absence. This paper aims to fill the gap by addressing the following question: Why has ASEAN been unable to set up any multilateral coordination mechanism to soften the China-Japan infrastructure financing competition? This paper argues that ASEAN has not been able to set up such a mechanism due to its limited centrality in connectivity. This limited centrality decreases ASEAN’s ability to manage the China-Japan competition in a more comprehensive and coordinated way. Rather, ASEAN acts as a scope setter in connectivity, although this is not completely ineffective. This paper is divided into four sections. The first section explores the key tenets of the concept of ASEAN centrality in connectivity, which is under-examined in the current literature. The second section examines the extent to which ASEAN limited centrality in connectivity is being respected by China and Japan. The third section analyses how various stakeholders, such as ASEAN member states, their leaders and bureaucracy, and foreign private companies prevent ASEAN from attaining stronger centrality. The last section concludes and offers recommendations. Data is gathered using primary sources (official ASEAN, Chinese, and Japanese documents, interviews, etc.) and secondary material. By providing a nuanced analysis of ASEAN centrality in connectivity and developing a new operationalization of the concept, this paper aims to contribute to the international relations literature on ASEAN centrality. Initial findings suggest that while ASEAN limited centrality in connectivity has some effectiveness, it is not sufficient for setting up a multilateral coordination mechanism. While it represents a solid departure point, any potential possessed by ASEAN to evolve beyond a scope setter in connectivity is hampered by stakeholders involved in infrastructure development. While these players and their interactions can have both positive and negative effects on the scope set by ASEAN, it is unlikely that they would allow ASEAN to become the real central player. There can be no stronger ASEAN centrality in connectivity without ASEAN unity and neutrality. However, the last two factors are difficult to attain in the context of infrastructure development since ASEAN member states and stakeholders all have their styles and preferences. All other things being equal, these circumstances favor a loose, vague, and quasi-prescriptive arrangement among the relevant stakeholders.

Keywords: ASEAN centrality, China-Japan infrastructure competition, connectivity, scope setter

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Swathi M. Vanniarajan

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Reading research suggests that online contextual vocabulary comprehension while reading is an interactive and integrative process. One’s success in it depends on a variety of factors including the amount and the nature of available linguistic and nonlinguistic cues, his/her analytical and integrative skills, schema memory (content familiarity), and processing speed characterized along the continuum of controlled to automatic processing. The experiment reported here, conducted with 30 native speakers as one group and 30 nonnative speakers as another group (all graduate students), hypothesized that while working on (24) tasks which required them to comprehend an unfamiliar word in real time without backtracking, due to the differences in the nature of their respective reading processes, the nonnative subjects would be less able to construct the meanings of the unknown words by integrating the multiple but sufficient contextual cues provided in the text but the native subjects would be able to. The results indicated that there were significant inter-group as well as intra-group differences in terms of the quality of definitions given. However, when given additional time, while the nonnative speakers could significantly improve the quality of their definitions, the native speakers in general would not, suggesting that all things being equal, time is a significant factor for success in nonnative vocabulary and reading comprehension processes and that accuracy precedes automaticity in the development of nonnative reading processes also.

Keywords: reading, second language processing, vocabulary comprehension

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Authors: Thaer Khaleel Swaid, Maryam Al Ahmad, Ishtiaq Ahmad

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47-year-old female, known to have a liver cyst and hemangiomas, presented to the gastroenterology clinic for chronic moderate postprandial epigastric pain, which is aggravated by food, leaning forward and relieved on lying flat. The pain was associated with nausea, vomiting, heartburn and excessive burping. She opened her bowel daily, having well-formed stools without blood or mucus. The patient denied NSAID intake, smoking or alcohol. On physical examination during the episode of pain abdomen revealed a soft, lax abdomen and mild tenderness in the epigastric region without organomegaly. Bowel sounds were audible. Her routine hematological and biochemical parameters were within normal, including CBC, Celiac serology, Lipase, Metabolic profile and H pylori stool antigen. The patient underwent an Ultrasound of the abdomen which showed multiple liver cysts, hemangioma, normal GB and biliary tree. Based on the clinical picture and to narrow our differential diagnosis, an ultrasound Doppler for the abdomen was ordered, and it showed celiac artery peak systolic velocity in expiration is 270cm/s, suggestive of median arcuate ligament syndrome. She Had computerized tomography abdomen done and showed a Narrowing of the celiac artery at the origin, likely secondary to low insertion of the median arcuate ligament. Furthermore, Gastroscopy and, later on colonoscopy were done, which was unremarkable. A laparoscopic decompression of the celiac trunk was indicated, for which the patient was referred to vascular surgery. This case confirms that Median Arcuate Ligament syndrome is an unusual diagnosis and is always challenging. Usually, patients undergo extensive workups before a final diagnosis is achieved. Our case highlights the challenge of diagnosing MALS since this entity is rare. It is a good choice to perform abdominal ultrasound with Doppler imaging on a patient with symptoms such as postprandial angina.

Keywords: Unveiling the Mystery, MALS, rare entity, Rare vascular phenomenon

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Authors: Claire Baudry, Jessica Pearson, Laura-Emilie Savage, George Tarbulsy

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Introduction: Over the last decade, researchers have implemented attachment-based interventions to promote parental interactive sensitivity and child development among vulnerable families. In the context of the present study, these interventions have been shown to be effective to enhance cognitive development when child outcome was measured shortly after the intervention. Objectives: The goal of the study was to investigate the effects of an attachment-based intervention on child cognitive development one year post-intervention. Methods: Thirty-five mother-child dyads referred by Child Protective Services in the province of Québec, Canada, were included in this study: 21 dyads who received 6 to 8 intervention sessions and 14 dyads not exposed to the intervention and matched for the following variables: duration of child protective services, reason for involvement with child protection, age, sex and family status. Child cognitive development was measured using the WPPSI-IV, 12 months after the end of the intervention when the average age of children was 54 months old. Findings: An independent-samples t-test was conducted to compare the scores obtained on the WPPSI-IV for the two groups. In general, no differences were observed between the two groups. There was a significant difference on the fluid reasoning scale between children exposed to the intervention (M = 95,13, SD = 16,67) and children not exposed (M = 81, SD = 9,90). T (23) = -2,657; p= .014 (IC :-25.13;3.12). This difference was found only for children aged between 48 and 92 months old. Other results did not show any significant difference between the two groups (Global IQ or subscales). Conclusions: This first set of analyses suggest that relatively little effects of attachment-based intervention remain on the level of cognitive functioning 12-months post-intervention. It is possible that the significant findings concerning fluid reasoning may be pertinent in that fluid reasoning is linked to the capacity to analyse, to solve problems, and remember information, which may be important for promoting school readiness. As the study is completed and as more information is gained from other assessments of cognitive and socioemotional outcome, a clearer picture of the potential moderate-term impact of attachment-based intervention will emerge.

Keywords: attachment-based intervention, child development, child protective services, cognitive development

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Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

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Agriculture is the mainstay of the Ethiopian economy; however, the sector is dominated by smallholder farmers resulting in land fragmentation and suffering from low productivity. Due to these issues, much effort has been put into the transformation of the sector to bring about more sustainable rural economic development. Technological advancements have been applied for the betterment of farmers resulting in the design of tools that are potentially capable of supporting the agricultural sector; however, their use and relevance are still alien to the local rural communities. The notion of the creating, capturing and sharing of knowledge has also been repetitively raised by many international donor agencies to transform the sector, yet the most current approaches to knowledge dissemination focus on knowledge that originates from the western view of scientific rationality while overlooking the role of indigenous knowledge (IK). Therefore, in agricultural knowledge management system (KMS) development, the integration of IKS with scientific knowledge is a critical success factor. The present study aims to contribute in the discourse on how to best integrate scientific and IK in agricultural KMS development. The conceptual framework of the research is anchored in concepts drawn from the theory of situated learning in communities of practice (CoPs): knowledge brokering. Using the KMS development practices of Ethiopian agricultural transformation agency as a case area, this research employed an interpretive analysis using primary and secondary qualitative data acquired through in-depth semi-structured interviews and participatory observations. As a result, concepts are identified for understanding the integration of the two major knowledge systems (i.e., indigenous and scientific knowledge) and participation of relevant stakeholders in particular the local farmers in agricultural KMS development through the roles of extension agent as a knowledge broker including crossing boundaries, in-between position, translation and interpretation, negotiation, and networking. The research shall have a theoretical contribution in addressing the incorporation of a variety of knowledge systems in agriculture and practically to provide insight for policy makers in agriculture regarding the importance of IK integration in agricultural KMS development and support marginalized small-scale farmers.

Keywords: communities of practice, indigenous knowledge, knowledge management system development, knowledge brokering

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Authors: M. Masroor Akhtar Khan, Moin Uddin, Lalit Varshney

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Recently, there has been a rapidly expanding interest in finding applications of natural polymers in view of value addition to agriculture. It is now being realized that radiation processing of natural polysaccharides can be beneficially utilized either to improve the existing methodologies used for processing the natural polymers or to impart value addition to agriculture by converting them into more useful form. Gamma-ray irradiation is employed to degrade and lower the molecular weight of some of the natural polysaccharides like alginates, chitosan and carrageenan into small sized oligomers. When these oligomers are applied to plants as foliar sprays, they elicit various kinds of biological and physiological activities, including promotion of plant growth, seed germination, shoot elongation, root growth, flower production, suppression of heavy metal stress, etc. Furthermore, application of these oligomers can shorten the harvesting period of various crops and help in reducing the use of insecticides and chemical fertilizers. In recent years, the oligomers of sodium alginate obtained by irradiating the latter with gamma-rays at 520 kGy dose are being employed. It was noticed that the oligomers derived from the natural polysaccharides could induce growth, photosynthetic efficiency, enzyme activities and most importantly the production of secondary metabolite in the plants like Artemisia annua, Beta vulgaris, Catharanthus roseus, Chrysopogon zizanioides, Cymbopogon flexuosus, Eucalyptus citriodora, Foeniculum vulgare, Geranium sp., Mentha arvensis, Mentha citrata, Mentha piperita, Mentha virdis, Papaver somniferum and Trigonella foenum-graecum. As a result of the application of these oligomers, the yield and/or contents of the active constituents of the aforesaid plants were significantly enhanced. The productivity, as well as quality of medicinal and aromatic plants, may be ameliorated by this novel technique in an economical way as a very little quantity of these irradiated (depolymerised) polysaccharides is needed. Further, this is a very safe technique, as we did not expose the plants directly to radiation. The radiation was used to depolymerize the polysaccharides into oligomers.

Keywords: essential oil, medicinal and aromatic plants, plant production, radiation processed polysaccharides, active constituents

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Authors: Moksha Singh

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The proponents of deinstitutionalization, including Goffman and others, in their works, have regarded institutions (orphanages to be specific) as regulated social arrangements that negatively impinge upon a resident’s development. They, therefore, propose alternative forms of care. However, even after five decades of this critique institutionalization remains the only hope for children with social, physical and mental disabilities in larger parts of the developing world such as the conflict affected state of Jammu and Kashmir in India. This paper is based on the experiences of children who lost their parents to insurgency and counter-insurgency operations and the rehabilitation process. This study is qualitative in nature and adopts descriptive-cum-exploratory research design. Using theoretical sampling, six orphanages and thirty one child residents who lost their parent(s) in the course of the armed conflict in the state of Jammu and Kashmir in India were studied in the year 2009-2010. It included interviews, observation, life histories and introspective accounts of the orphans and the management. The results were drawn through the qualitative examination, understanding, and interpretation of the primary and secondary data. The findings suggested that rehabilitation of these conflict-affected children is taking place mainly through residential child care facilities run by non-governmental bodies. Alternative forms of rehabilitation are not functional in the state because of various geopolitical and socio-cultural complexities. Even after five years of arriving at these conclusions and more, the state of Jammu and Kashmir still lacks a comprehensive rehabilitation plan for these children. This has further encouraged a mushroomed growth of legal and illegal institutions. Some of these institutions compromise the standard norms of functioning and yet remain the only hope for thousands rendered orphan. These institutions, therefore, are there to stay as other alternative forms of care are not available in the state. A comprehensive intervention policy is needed based on the cultural specifics of the state and incorporation of views of institutions offering aid, the state and the children. The paper introduces Small Group Residential Care Model through which it is expected that the restoration process can be made smooth and effective.

Keywords: armed conflict, children's rights, institutionalization, orphanages, rehabilitation

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Authors: Ismail S. Bostanci, Ebru Akkaya

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Microalgae-derived biodiesel, fertilizer or industrial chemicals' production with wastewater has great potential. Especially water from a municipal wastewater treatment plant is a very important nutrient source for biofuel production. Microalgae biomass production in open ponds system is lower cost culture systems. There are many hurdles for commercial algal biomass production in large scale. One of the important technical bottlenecks for microalgae production in open system is culture contamination. The algae culture contaminants can generally be described as invading organisms which could cause pond crash. These invading organisms can be competitors, parasites, and predators. Contamination is unavoidable in open systems. Potential contaminant organisms are already inoculated if wastewater is utilized for algal biomass cultivation. Especially, it is important to control contaminants to retain in acceptable level in order to reach true potential of algal biofuel production. There are several contamination management methods in algae industry, ranging from mechanical, chemical, biological and growth condition change applications. However, none of them are accepted as a suitable contamination control method. This experiment describes an innovative contamination control method, 'Recirculated Sedimentation Method', to manage contamination to avoid pond cash. The method can be used for the production of algal biofuel, fertilizer etc. and algal wastewater treatment. To evaluate the performance of the method on algal culture, an experiment was conducted for 90 days at a lab-scale raceway (60 L) reactor with the use of non-sterilized and non-filtered wastewater (secondary effluent and centrate of anaerobic digestion). The application of the method provided the following; removing contaminants (predators and diatoms) and other debris from reactor without discharging the culture (with microscopic evidence), increasing raceway tank’s suspended solids holding capacity (770 mg L-1), increasing ammonium removal rate (29.83 mg L-1 d-1), decreasing algal and microbial biofilm formation on inner walls of reactor, washing out generated nitrifier from reactor to prevent ammonium consumption.

Keywords: contamination control, microalgae culture contamination, pond crash, predator control

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Authors: Yu-Chi Chou

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The purpose of this study was to develop a curriculum model to enhance the containment and social-emotional abilities of students with autism spectrum disorder (ASD). The social-emotional curriculum was based on three instructional phases, as follows: (a) the first stage began with a learning plan centered on conceptualization and learning, focusing on understanding the content and strategically applying containment, including acceptance of emotions, social situations, and negative experiences, (b) in the second stage, group collaboration took place, involving learning tasks related to the instructional curriculum, where containment skills and strategies were applied through concrete collaborative actions, and (c) the third stage involved completing the key elements of social regulation, which included socially-shared cognitive and metacognitive strategies. This stage emphasized the process of collective reflection and adjustment aimed at constructing knowledge and skills, with a focus on sharing learning outcomes. Throughout the implementation of the social emotional curriculum, a cyclical teaching model (self-regulation, peer collaboration, social regulation) was designed to facilitate knowledge acquisition and task completion. Specific strategies were also incorporated to enhance the capacities to tolerate frustration and embrace change, such as mind-wandering (imagination training), tactical ignorance, and self-compassion.

Keywords: autism spectrum disorder, containment skills, social-emotional learning, social regulation

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Authors: Suneet Jagdev

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The development of the original Bauhaus occurred at a time in the beginning of the 20th century when the industrialization of Germany had reached a climax. The cities were a reflection of the new living conditions of an industrialized society. The Bauhaus can be interpreted as an ambitious attempt to find appropriate answers to the challenges by using architecture-urban development and design. The core elements of the conviction of the day were the belief in the necessary crossing of boundaries between the various disciplines and courage to experiment for a better solution. Even after 100 years, the situation in our cities is shaped by similar complexity. The urban consequences of developments are difficult to estimate and to predict. The paper critically reflected on the central aspects of the history of the Bauhaus and its role in bringing the modernism in India by comparative studies of the methodology adopted by the artists and designer in both the countries. The paper talked in detail about how the Bauhaus Exhibition in 1922 offered Indian artists a new weapon of anti-colonial resistance. The original Bauhaus fought its aesthetic and political battles in the context of economic instability and the rise of German fascism. The Indians had access to dominant global languages and in a particular English. The availability of print media and a vibrant indigenous intellectual culture provided Indian people a tool to accept technology while denying both its dominant role in culture and the inevitability of only one form of modernism. The indigenous was thus less an engagement with their culture as in the West than a tool of anti-colonial struggle. We have shown how the Indian people used Bauhaus as a critique of colonialism itself through an undermining of its typical modes of representation and as a means of incorporating the Indian desire for spirituality into art and as providing the cultural basis for a non-materialistic and anti-industrial form of what we might now term development. The paper reflected how through painting the Bauhaus entered the artistic consciousness of the sub-continent not only for its stylistic and technical innovations but as a tool for a critical and even utopian modernism that could challenge both the hegemony of academic and orientalist art and as the bearer of a transnational avant-garde as much political as it was artistic, and as such the basis of a non-Eurocentric but genuinely cosmopolitan alternative to the hierarchies of oppression and domination that had long bound India and were at that moment rising once again to a tragic crescendo in Europe. We have talked about how the Bauhaus of today can offer an innovative orientation towards discourse around architecture and design.

Keywords: anti-colonial struggle, art over architecture, Bauhaus exhibition of 1922, industrialization

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Authors: Obadiah Nwabueze

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Bodija market is classified as Central Business District (CBD) of Ibadan North Local Government Area of Oyo State (Nigeria) because of socio economic activities, so Crime is a peculiar social issue that causes insecurity. The law enforcement agencies tasked with crime prevention and control such as the Nigerian Police have insufficient manpower, and a resultant effect is the emergence of Vigilante groups as citizen’s response to crime control and prevention (self-help). The research design adopted for this study is a case study design exploring Vigilante activities in Bodija Market. The study utilizes both quantitative and qualitative approach, sources of data includes primary and secondary sources. A sample of 127 respondents randomly picked from the 4 sections of Bodija Market through questionnaire, comprising of 50 male and 77 females which alienates issues of gender bias in addition to the 4 in-depth interview, making a total of 131 respondents. Statistical package for Social Sciences (SPSS) was used. The descriptive statistics of simple frequency, percentage, charts and graphs were computed for the analysis. Finding in the study shows that the market vigilante is able to deter and disrupt criminal activities through strategic spiritual intelligence (SSI), use of charm and juju, physical presence in strategic locations vulnerable to crime occurrence. Findings in the study also show that vigilantes collaborate with the police by assisting them in surveillance, tracking down criminals, identifying black spots, acting as informants to the police, arrest and handover criminal to police. Their challenges include poor equipment, motivation, unhealthy rivalry between the vigilante and the police. The study recommends that the government should support vigilantes with logistics and training, including patrol vehicle and radio communication. The study also recommends the integration of the informal mechanism (juju and charm) of crime detection and prevention into the formal policing strategy, an office should be created in the force commands for use of SSI.

Keywords: central business district, CBD, charm, Juju, strategic spiritual intelligence, SSI

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Authors: Scarlet Tabot Enanga Longsti

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Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

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Authors: Jakkireddy Sravani

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Introduction: The maintenance of hemodynamic stability is of pivotal importance in supratentorial surgeries. Anesthesia for supratentorial tumors requires an understanding of localized or generalized rising ICP, regulation, and maintenance of intracerebral perfusion, and avoidance of secondary systemic ischemic insults. We aimed to compare the effects of the combination of ketamine and propofol with propofol alone when used as an induction and maintenance anesthetic agent during supratentorial tumors. Methodology: This prospective, randomized, double-blinded controlled study was conducted at AIIMS Raipur after obtaining the institute Ethics Committee approval (1212/IEC-AIIMSRPR/2022 dated 15/10/2022), CTRI/2023/01/049298 registration and written informed consent. Fifty-two supratentorial tumor patients posted for craniotomy and excision were included in the study. The patients were randomized into two groups. One group received a combination of ketamine and propofol, and the other group received propofol for induction and maintenance of anesthesia. Intraoperative hemodynamic stability and quality of brain relaxation were studied in both groups. Statistical analysis and technique: An MS Excel spreadsheet program was used to code and record the data. Data analysis was done using IBM Corp SPSS v23. The independent sample "t" test was applied for continuously dispersed data when two groups were compared, the chi-square test for categorical data, and the Wilcoxon test for not normally distributed data. Results: The patients were comparable in terms of demographic profile, duration of the surgery, and intraoperative input-output status. The trends in BIS over time were similar between the two groups (p-value = 1.00). Intraoperative hemodynamics (SBP, DBP, MAP) were better maintained in the ketamine and propofol combination group during induction and maintenance (p-value < 0.01). The quality of brain relaxation was comparable between the two groups (p-value = 0.364). Conclusion: Ketamine and propofol combination for the induction and maintenance of anesthesia was associated with superior hemodynamic stability, required fewer vasopressors during excision of supratentorial tumors, provided adequate brain relaxation, and some degree of neuroprotection compared to propofol alone.

Keywords: supratentorial tumors, hemodynamic stability, brain relaxation, ketamine, propofol

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Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew

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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.

Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease

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Authors: Masoumeh Shojaei, Natalie Gedayloo, Amir Sarshin

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The purpose of the present study was to investigate the effect of Isokinetic fatigue of muscles around the ankle, knee, and hip on the indicators of dynamic postural stability. Therefore, 15 female university students (age 19.7± 0.6 years old, weight 54.6± 9.4 kg, and height 163.9± 5.6 cm) participated in within-subjects design for 5 different days. In the first session, the postural stability indices (time to stabilization after jump-landing) without fatigue were assessed by force plate and in each next sessions, one of muscle groups of the lower limb including the muscles around ankles, knees, and hip was randomly exhausted by Biodex Isokinetic dynamometer and the indices were assessed immediately after the fatigue of each muscle group. The method involved landing on a force plate from a dynamic state, and transitioning balance into a static state. Results of ANOVA with repeated measures indicated that there was no significant difference between the time to stabilization (TTS) before and after Isokinetic fatigue of the muscles around the ankle, knee and hip in medial – lateral direction (p > 0.05), but in the anterior – posterior (AP) direction, the difference was statistically significant (p < 0.05). Least Significant Difference (LSD) post hoc test results also showed that there was significant difference between TTS in knee and hip muscles before and after isokinetic fatigue in AP direction. In the other hand knee and hip muscles group were affected by isokinetic fatigue only in AP surface (p < 0.05).

Keywords: dynamic balance, fatigue, lower limb muscles, postural control

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