Search results for: white spot lesion

Authors: Ahmed Gonnah, Omar Masoud, Mohamed Abdel-Wahab, Ahmed ElMosalamy, Abdulrahman Al-Naseem

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Introduction: Fibroadenomas are solid, mobile, and non-tender benign breast lumps, with the highest prevalence amongst young women aged between 15 and 35. Symptoms can include discomfort, and they can become problematic, particularly when they enlarge, resulting in many referrals for biopsies, with fibroadenomas accounting for 30-75% of the cases. Diagnosis is based on triple assessment that involves a clinical examination, ultrasound imaging and mammography, as well as core needle biopsies. Current management includes observation for 6-12 months, with the indication of definitive surgery, in cases that are older than 35 years or with fibroadenoma persistence. Serious adverse effects of surgery might include nipple-areolar distortion, scarring and damage to the breast tissue, as well as the risks associated with surgery and anesthesia, making it a non-feasible option. Methods: A literature search was performed on the databases EMBASE. MEDLINE/PubMed, Google scholar and Ovid, for English language papers published between 1st of January 2000 and 17th of March 2021. A structured protocol was employed to devise a comprehensive search strategy with keywords and Boolean operators defined by the research question. The keywords used for the search were ‘HIFU’, ‘High-Intensity Focused Ultrasound’, ‘Fibroadenoma’, ‘Breast’, ‘Lesion’. This review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Recently, a thermal ablative technique, High Intensity Focused Ultrasound (HIFU), was found to be a safe, non-invasive, and technically successful alternative, having displayed promising outcomes in reducing the volume of fibroadenomas, pain experienced by patients, and the length of hospitalization. Quality of life improvement was also evidenced, exhibited by the disappearance of symptoms, and enhanced physical activity post-intervention, in addition to patients’ satisfaction with the cosmetic results and future recommendation of the procedure to other patients. Conclusion: Overall, HIFU is a well-tolerated treatment associated with a low risk of complications that can potentially include erythema, skin discoloration and bruising, with the majority of this self-resolving shortly after the procedure.

Keywords: ultrasound, HIFU, breast, efficacy, side effects, fibroadenoma

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Authors: Prasenjit Panda

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Jean Rhys’s Wide Sargasso Sea, a prequel to Bronte’s Jane Eyre, explores the history of the other and gives voices to the people who were silenced and kept under the darkness of negation and denial for a long time. Jean Wide Sargasso Sea provides an alternative understanding of Charlotte Brontë’s mad Creole woman, i.e., Bertha Mason of Jane Eyre in the postcolonial context. Rhys transforms Charlotte Bronte’s Victorian romance into a realistic narrative. In doing so, she re-reads Bertha as Antoinette, the unspeakable figure of otherness, into an unnameable self, and creates a new stage for the inner self. She in the novel is no longer a lunatic heiress in Rochester’s attic rather in this novel she finds her fantasy, dream and most importantly, voice. Rhys peeps through the character of Antoinette through her fragmented memories, dreams, and identity. Antoinette’s identity is mutilated constantly in the conflicts between colonizers and colonized, male and female, black and white. We shall use postcolonial theories like Bhaba’s hybridity and third space as a methodology to reveal the dialectics of struggle of a doubly colonized woman.We shall see that Bertha Mason was neglected by Bronte because of her madness and was locked in the Rochester’s Attic, but here Rhys beautifully converts her madness as a language of Antoinette, a language for her protest, a language for her liberation, a language for her dreams. In this present paper, we shall try to show how Antoinette tries to free her soul and body from the clutches of her multiple existences, identity, and narratives.

Keywords: colonizer, dislocation, fragmented memories, identity, narratives

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Authors: Yao Song, Danni Cheng, Jianjun Ren

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Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.

Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR

Procedia PDF Downloads 183

Authors: Naveed Ahmad Fazili

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More than 20 human diseases involve the fibrillation of a specific protein/peptide which forms pathological deposits at various sites. Hereditary lysozyme amyloidosis is a systemic disorder which mostly affects liver, spleen and kidney. This conformational disorder is featured by lysozyme fibril formation. In vivo lysozyme fibrillation was simulated under in vitro conditions using a strong denaturant GdHCl at 3M concentration. Sharp decline in the ANS fluorescence intensity compared to the partially unfolded states, almost 20 fold increase in ThT fluorescence intensity, increase in absorbance at 450 nm suggesting turbidity, negative ellipticity peak in the far-UVCD at 217 nm, red shift of 50 nm compared to the native state in congo red assay and appearance of a network of long rope like fibrils in TEM analysis suggested HEWL fibrillation. Anti-fibrillation potency of baicalein against the preformed fibrils of HEWL was investigated following ThT assay in which there was a dose dependent decrease in ThT fluorescence intensity compared to the fibrillar state of HEWL with the maximum effect observed at 150 μM baicalein concentration, loss of negative ellipticity peak in the far-UVCD region, dip in the Rayleigh scattering intensity and absorbance at 350 nm and 450 nm respectively together with a reduction in the density of fibrillar structure in TEM imaging. Thus, it could be suggested that baicalein could prove to be a positive therapeutics for hereditary human lysozyme amyloidosis.

Keywords: amyloid fibrils, baicalein, congo red, negative ellipticity, therapeutics

Procedia PDF Downloads 294

Authors: Mariam Shah

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‘Honour’ crime has commonly been perceived in the UK as being a ‘domestic violence’ related issue due to incidents perceived to take place within a domestic context, and commonly by familial perpetrators. The lack of differentiation between domestic violence and ‘honour’ related incidents has several negative implications. Firstly, the prevalence and extent of ‘honour’ related crime within the UK cannot be accurately quantified due to ‘honour’ incidents being classed statistically as domestic violence incidents. Secondly, lack of differentiation means that the negative stereotypical attitudes ascribed to domestic violence which has resulted in lower criminal conviction rates that are also impacting the conviction of perpetrators of ‘honour’ crime. Thirdly, ‘honour’ related crime is innately distinct from domestic violence due to the perpetrator’s resolute intent of cleansing perceived ‘shame’ in any way possible, often with the involvement and collusion of multiple perpetrators from within the family and/or community. Domestic violence is typically restricted to the ‘home’, but ‘honour’ crime can operate between national and international boundaries. This paper critically examines the current academic literature and concludes that the few similarities between domestic violence and ‘honour’ related crime are not sufficient to warrant identical treatment under UK criminal law. ‘Honour’ related crime is a distinct and stand-alone offence which should be recognised as such. The appropriate identification and treatment of ‘honour’ crime are crucial, particularly in light of the UK’s first ‘white’ honour killing which saw a young English woman murdered after being deemed to have brought ‘shame’ on her ex-boyfriend’s family. This incident highlights the possibility of ‘honour’ crime extending beyond its perceived ‘ethnic minority’ roots and becoming more of a ‘mainstream’ issue for the multi-cultural and multi-racial UK.

Keywords: differentiation, domestic violence, honour crime, United Kingdom

Procedia PDF Downloads 235

Authors: Dario Basile, Manuela De Maddis, Raffaella Sesana, Pasquale Russo Spena, Roberto Maiorano

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Nowadays, the reduction of CO₂ emissions and the decrease in energy consumption are the main aims of several industries, especially in the automotive sector. To comply with the increasingly restrictive regulations, the automotive industry is constantly looking for innovative techniques to produce lighter, more efficient, and less polluting vehicles. One of the latest technologies, and still developing, is based on the fabrication of the body-in-white and car parts through the stamping of Aluminum Tailor Welded Blanks. Tailor Welded Blanks (TWBs) are generally the combination of two/three metal sheets with different thicknesses and/or mechanical strengths, which are commonly butt-welded together by laser sources. The use of aluminum TWBs has several advantages such as low density and corrosion resistance adequate. However, their use is still limited by the lower formability with respect to the parent materials and the more intrinsic difficulty of laser welding of aluminum sheets (i.e., internal porosity) that, although its use in automated industries is constantly growing, remains a process to be further developed and improved. This study has investigated the effect of the main laser welding process parameters (laser power, welding speed, and focal distance) on the mechanical properties of aluminum TWBs made of 6xxx series. The research results show that a narrow weldability window can be found to ensure welded joints with high strength and limited or no porosity.

Keywords: aluminum sheets, automotive industry, laser welding, mechanical properties, tailor welded blanks

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Authors: Rasha Ali Dheyab, Edurad Vlad

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Migration is associated with other important global issues, including development, poverty, and human rights. Migrants are often the most dynamic members of society; historically, migration has supported economic development and the rise of nations and enriched cultures. It also presents significant challenges. The word ‘racism’ is not just about beliefs or statements; it also contains the ability to force those beliefs or world views as hegemonic and as a basis for the refusal of rights or equality. For this reason, racism is embedded in power relations of different types. Racism is not only an awareness of distinction and groups, but it also has extremely practical roles in maintaining: First, inequitable social power arrangements; and second, racist behavioral manifestations such as verbal rejection, avoidance, discrimination, physical attack, and elimination. The focus is on aspects of racism in the media to deal with the migration phenomenon. The reproduction and promotion of racism by certain areas of the media is not a simple and straightforward process. It is important to see how the media serves in the reproduction of racism. This article shows attitudes to migration as they have appeared in British periodicals over the last few years. One might conclude that the reproduction of racism by the media is not a simple and straightforward process. It has become obvious that the role of the media in the reproduction of racism is inextricably linked to the general characteristics of racism and white domination in society, particularly the structural and ideological structuring of that kind of group power. This highlights the press's function as a business, social, and cultural institution. The press has to be examined in connection to the institutions of the economic and political as well.

Keywords: British periodicals, culture studies, migration, racism

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Authors: Fabiana Souza Orlandi, Izabel Cristina Chavez Gomes, Barbara Isabela De Paula Morais, Ana Carolina Ottaviani

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Chronic Kidney Disease (CKD) is considered a public health problem. Patients who present CKD in their more advanced stages usually present several biopsychosocial changes, which may include pain. Pain can be considered subjective and personal, and its perception is characterized as a multidimensional experience. The objective of this study was to evaluate the level and descriptors of pain of adults and elderly patients with chronic kidney disease, through the Multidimensional Pain Evaluation Scale (EMADOR). This is a descriptive cross-sectional study with a quantitative approach. The sample consisted of 100 subjects with CKD in hemodialysis treatment at a Renal Replacement Therapy Service in the interior of the state of São Paulo. Data were collected through an individual interview, using a Sociodemographic Characterization and Multidimensional Pain Evaluation Scale (EMADOR). All ethical precepts were respected. The majority of the respondents were men (61.0%), white (56.0%) and with a high school education (34.0%). Regarding the pain of the individuals, 89 patients reported pain, with Chronic Pain predominating (50.0%, n = 50), followed by Acute Pain (39.0%, n = 39). Of the subjects who presented acute pain most of the 89.0% described the pain felt as unbearable, and of those who presented chronic pain, 35.0% described the pain felt as painful, unbearable and uncomfortable. It was concluded that there was a significant presence of pain, being the chronic pain dominant in the studied population. Faced with such factors, the present study motivates researches in this population, in order to establish interventions with the objective of improving the quality of life of these individuals.

Keywords: pain, chronic kidney disease, dialysis, evaluation

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Authors: Hossein Barri Ghazani

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Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

Procedia PDF Downloads 163

Authors: Ana-Maria Gheldiu, Bianca M. Abrudan, Maria A. Neag, Laurian Vlase, Dana M. Muntean

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Background information: The objective of this study was to investigate the effect of multiple-dose fluvoxamine on the pharmacokinetic profile of single-dose carvedilol in rats, in order to evaluate this possible drug-drug pharmacokinetic interaction. Methods: A preclinical study, in 28 white male Wistar rats, was conducted. Each rat was cannulated on the femoral vein, prior to being connected to BASi Culex ABC®. Carvedilol was orally administrated in rats (3.57 mg/kg body mass (b.m.)) in the absence of fluvoxamine or after a pre-treatment with multiple oral doses of fluvoxamine (14.28 mg/kg b.m.). The plasma concentrations of carvedilol were estimated by high performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters of carvedilol were analyzed by non-compartmental method. Results: After carvediol co-administration with fluvoxamine, an approximately 2-fold increase in the exposure of carvedilol was observed, considering the significantly elevated value of the total area under the concentration versus time curve (AUC₀₋∞). Moreover, an increase by approximately 145% of the peak plasma concentration was found, as well as an augmentation by approximately 230% of the half life time of carvedilol was observed. Conclusion: Fluvoxamine co-administration led to a significant alteration of carvedilol’s pharmacokinetic profile in rats, these effects could be explained by the existence of a drug-drug interaction mediated by CYP2D6 inhibition. Acknowledgement: This work was supported by CNCS Romania – project PNII-RU-TE-2014-4-0242.

Keywords: carvedilol, fluvoxamine, drug-drug pharmacokinetic interaction, rats

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Authors: Anjali Roy, Mirza S. Baig

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Atherosclerosis is a chronic inflammatory disease characterized by the formation of lipid rich plaque enriched with necrotic core, modified lipid accumulation, smooth muscle cells, endothelial cells, leucocytes and macrophages. Macrophage foam cells play a critical role in the occurrence and development of inflammatory atherosclerotic plaque. Foam cells are the fat-laden macrophages in the initial stage atherosclerotic lesion formation. Foam cells are an indication of plaque build-up, or atherosclerosis, which is commonly associated with increased risk of heart attack and stroke as a result of arterial narrowing and hardening. The mechanisms that drive atherosclerotic plaque progression remain largely unknown. Dissecting the molecular mechanism involved in process of macrophage foam cell formation will help to develop therapeutic interventions for atherosclerosis. To investigate the mechanism, we studied the role of nitric oxide synthase 1(NOS1)-mediated nitric oxide (NO) on low-density lipoprotein (LDL) uptake by bone marrow derived macrophages (BMDM). Using confocal microscopy, we found that incubation of macrophages with NOS1 inhibitor, TRIM (1-(2-Trifluoromethylphenyl) imidazole) or L-NAME (N omega-nitro-L-arginine methyl ester) prior to LDL treatment significantly reduces the LDL uptake by BMDM. Further, addition of NO donor (DEA NONOate) in NOS1 inhibitor treated macrophages recovers the LDL uptake. Our data strongly suggest that NOS1 derived NO regulates LDL uptake by macrophages and foam cell formation. Moreover, we also checked proinflammatory cytokine mRNA expression through real time PCR in BMDM treated with LDL and copper oxidized LDL (OxLDL) in presences and absences of inhibitor. Normal LDL does not evoke cytokine expression whereas OxLDL induced proinflammatory cytokine expression which significantly reduced in presences of NOS1 inhibitor. Rapid NOS-1-derived NO and its stable derivative formation act as signaling agents for inducible NOS-2 expression in endothelial cells, leading to endothelial vascular wall lining disruption and dysfunctioning. This study highlights the role of NOS1 as critical players of foam cell formation and would reveal much about the key molecular proteins involved in atherosclerosis. Thus, targeting NOS1 would be a useful strategy in reducing LDL uptake by macrophages at early stage of disease and hence dampening the atherosclerosis progression.

Keywords: atherosclerosis, NOS1, inflammation, oxidized LDL

Procedia PDF Downloads 127

Authors: Mary Anthony Oguike, Ilouno, Amaduruonye

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A completely randomized design experiment with 3 treatments was conducted to study the effects of garlic on intestine characteristics, haematology and serum biochemistry of Marshal broilers. Thirty three (33) broiler chicks were randomly allotted to each treatment designated T1, T2 and T3. The birds in each treatment were replicated 3 times with 11 broilers per replicate. They were fed diets supplemented with garlic at 0, 1.5 and 2.5 % /kg feed for t1, T2 and T3, respectively with T1 as control. Data were collected on intestine parameters, serum biochemical parameters and haematological indices. The results showed significant (P>0.05) dose-dependent decrease in intestine weight and caeca microbial load of the broilers. The intestine of broilers in the treatments showed normal histological architecture in all the treatments. The red blood cell (RBC), white blood cell (WBC), haemoglobin (Hb) and other haematological indices showed no significant differences (P<0.05) among the treatments. Cholesterol, globulin, glucose and alanin aminotransferase (ALT) were significantly different (P<0.05) among the treatment groups. Serum biochemical parameters such as, total protein albumin, bilirubin and others were not significant among the treatments. All the blood parameters studied fall within the normal range for broilers. Garlic supplementation in the diets of broilers did not have any detrimental effects on the treated birds since their serum biochemistry and haematology fall within the normal range for broilers birds. The microbial examination of intestine and caeca, as well as the histopathological studies of the intestine confirmed antimicrobial properties of garlic.

Keywords: broiler, biochemistry and haematology, garlic, intestine

Procedia PDF Downloads 96

Authors: Grace C. Kuroki, Yixin Hu, Bailey Surtees, Rebecca Krimins, Nicholas J. Durr, Dara L. Kraitchman

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The purpose of this study was to perform a Phase I veterinary clinical trial with a low-cost, carbon-dioxide-based, passive thaw cryoablation device as proof-of-principle for application in pets and translation to third-world treatment of breast cancer. This study was approved by the institutional animal care and use committee. Client-owned dogs with subcutaneous masses, primarily lipomas or mammary cancers, were recruited for the study. Inclusion was based on clinical history, lesion location, preanesthetic blood work, and fine needle aspirate or biopsy confirmation of mass. Informed consent was obtained from the owners for dogs that met inclusion criteria. Ultrasound assessment of mass extent was performed immediately prior to mass cryoablation. Dogs were placed under general anesthesia and sterilely prepared. A stab incision was created to insert a custom 4.19 OD x 55.9 mm length cryoablation probe (Kubanda Cryotherapy) into the mass. Originally designed for treating breast cancer in low resource settings, this device has demonstrated potential in effectively necrosing subcutaneous masses. A dose escalation study of increasing freeze-thaw cycles (5/4/5, 7/5/7, and 10/7/10 min) was performed to assess the size of the iceball/necrotic extent of cryoablation. Each dog was allowed to recover for ~1-2 weeks before surgical removal of the mass. A single mass was treated in seven dogs (2 mammary masses, a sarcoma, 4 lipomas, and 1 adnexal mass) with most masses exceeding 2 cm in any dimension. Mass involution was most evident in the malignant mammary and adnexal mass. Lipomas showed minimal shrinkage prior to surgical removal, but an area of necrosis was evident along the cryoablation probe path. Gross assessment indicated a clear margin of cryoablation along the cryoprobe independent of tumor type. Detailed histopathology is pending, but complete involution of large lipomas appeared to be unlikely with a 10/7/10 protocol. The low-cost, carbon dioxide-based cryotherapy device permits a minimally invasive technique that may be useful for veterinary applications but is also informative of the unlikely resolution of benign adipose breast masses that may be encountered in third world countries.

Keywords: cryoablation, cryotherapy, interventional oncology, veterinary technology

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Authors: Dinesh Pathaka, Tomas Wagnera, J. M. Nunzib

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We investigated blends of MdPVV.PCBM.AIS for photovoltaic application. AgInSe2 powder was synthesized by sealing and heating the stoichiometric constituents in evacuated quartz tube ampule. Fine grinded AIS powder was dispersed in MD-MOPVV and PCBM with and without surfactant. Different concentrations of these particles were suspended in the polymer solutions and spin casted onto ITO glass. Morphological studies have been performed by atomic force microscopy and optical microscopy. The blend layers were also investigated by various techniques like XRD, UV-VIS optical spectroscopy, AFM, PL, after a series of various optimizations with polymers/concentration/deposition/ suspension/surfactants etc. XRD investigation of blend layers shows clear evidence of AIS dispersion in polymers. Diode behavior and cell parameters also revealed it. Bulk heterojunction hybrid photovoltaic device Ag/MoO3/MdPVV.PCBM.AIS/ZnO/ITO was fabricated and tested with standard solar simulator and device characterization system. The best performance and photovoltaic parameters we obtained was an open-circuit voltage of about Voc 0.54 V and a photocurrent of Isc 117 micro A and an efficiency of 0.2 percent using a white light illumination intensity of 23 mW/cm2. Our results are encouraging for further research on the fourth generation inorganic organic hybrid bulk heterojunction photovoltaics for energy. More optimization with spinning rate/thickness/solvents/deposition rates for active layers etc. need to be explored for improved photovoltaic response of these bulk heterojunction devices.

Keywords: thin films, photovoltaic, hybrid systems, heterojunction

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Authors: Huei Lin Lee, Wee Sim Choo

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The effects of blanching, boiling and steaming on the ascorbic acid content, total phenolic content and colour in cauliflower (Brassica oleraceavar. Botrytis) was investigated. It was found that blanching was the best thermal processing to be applied on cauliflower compared to boiling and steaming processes. Blanching and steaming processes on cauliflower retained most of the ascorbic acid content (AAC) compared to those of boiling. As for the total phenolic content (TPC), blanching process retained a higher TPC in cauliflower compared to those of boiling and steaming processes. There were no significant differences between the TPC of boiled and steamed cauliflowers. As for the colour measurement, there were no significant differences in the colour of the cauliflower at different lead time (after processing to the point of consumption) of 30 minutes interval up to 3 hours but there were slight variations in L*, a*, and b* values among the thermal processed cauliflowers (blanched, boiled and steamed). The cauliflowers in this study were found to give a desirable white colour (L* value in the range of 77-83) in all the three thermal processes (blanching, boiling and steaming). There was no significant difference on the effect of lead time (30-minutes interval up to 3 hours) in raw and all the three thermal processed (blanched, boiled and steamed) cauliflowers.

Keywords: ascorbic acid, cauliflower, colour, phenolics

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Authors: Tiah Rachmatiah, Subaryanti

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Plants of Lauraceae family are known to contain many chemical compounds which have potential bioactivity such as alkaloids, flavonoids, lactones, terpenes, etc. Actinodaphne macrophylla and Nectandra angustifolia are two species from Lauraceae. A previous study on the crude alkaloidal extract from the bark of Act. macrophylla and n-hexane extract from the bark of N. angustifolia showed antiplasmodial activity against Plasmodium falciparum. The study was continued to find antiplasmodial active compounds from the two extracts. The materials were obtained from Bogor Botanical Garden, West Java, Indonesia. Crude alkaloidal extract of Act. macrophylla was prepared by maceration in dichloromethane after moistened with NH4OH 25% and n-hexane extract of N. angustifolia was prepared by maceration in n-hexane. A major compound was isolated by column chromatography using silica gel and a mixture of CH2Cl2 and methanol as a gradient solvent system for the alkaloidal extract and mixture of n-hexane and ethyl acetate for n-hexane extract. Fine white needle crystals were obtained from the alkaloidal extract and rod crystals from n-hexane extract. Molecular structure of the compounds was determined by analysis of spectra of NMR, IR, MS and compared by references. In vitro bioactivity test of the compound was performed against Plasmodium falciparum. The results showed that the bark of Act. macrophylla contained an aporphine alkaloid, actinodaphnine, that had activity against P. falciparum with IC50 value of 0.095 µg/mL and the bark of N. angustifolia contained a lignan compound, sesamine, with IC50 of 0.122 µg/mL.

Keywords: actinodaphne macrophylla, alkaloid, antiplasmodial, lauraceae, lignan, nectandra angustifolia

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Authors: B. S. Chandrashekar, M. K. Prasannakumar, P. Buela Parivallal, Sahana N. Banakar, Swathi S. Patil, H. B. Mahesh, D. Pramesh

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Bacterial soft rot is one of the most often seen diseases in many plant species globally, resulting in considerable yield loss. Radish roots with dark water-soaked lesions, maceration of tissue, and a foul odour were collected in the Kolar region, India. Two isolates were obtained from rotted samples that demonstrated morphologically unpigmented, white mucoid convex colonies on nutrient agar medium. The isolated bacteria (RDH1 and RDH3) were gram-negative, rod-shaped bacteria with biochemically distinct characteristics similar to the type culture of Enterobacter cloacae ATCC13047 and Bergy's handbook of determinative bacteriology. The 16s rRNA gene was used to identify Enterobacter species. On carrot, potato, tomato, chilli, bell pepper, knolkhol, cauliflower, cabbage, and cucumber slices, the Koch′s postulates were fulfilled, and the pathogen was also pathogenic on radish, cauliflower, and cabbage seedlings were grown in a glasshouse. After 36 hours, both isolates exhibited a hypersensitive sensitivity to Nicotianatabacum. Semi-quantitative analysis revealed that cell wall degrading enzymes (CWDEs) such as pectin lyase, polygalacturonase, and cellulase (p=1.4e09) contributed to pathogenicity, whereas isolates produced biofilms (p=4.3e-11) that help in host adhesion. This is the first report in India of radish soft rot caused by E. cloacae.

Keywords: soft rot, enterobacter cloacae, 16S rRNA, nicotiana tabacum, and pathogenicity

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Authors: T. M. Agbede, A. O. Adekiya

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Field experiments were conducted during 2013, 2014 and 2015 cropping seasons at Rufus Giwa Polytechnic, Owo, Ondo State, southwest Nigeria. The objective of the investigation was to determine the effect of Cocoa Pod Ash (CPA) and Poultry Manure (PM) applied solely and their combined form, as sources of fertilizers on soil properties, leaf nutrient composition, growth and yield of yam. Three soil amendments: CPA, PM (sole forms), CPA and PM (mixture), were applied at 20 t ha^-1 with an inorganic fertilizer (NPK 15-15-15) at 400 kg ha^-1 as a reference and a natural soil fertility, NSF (control). The five treatments were arranged in a randomized complete block design with three replications. The test soil was slightly acidic, low in organic carbon (OC), N, P, K, Ca and Mg. Results showed that soil amendments significantly increased (p = 0.05) tuber weights and growth of yam, soil and leaf N, P, K, Ca and Mg, soil pH and OC concentrations compared with the NSF (control). The mixture of CPA+PM treatment increased tuber weights of yam by 36%, compared with inorganic fertilizer (NPK) and 19%, compared with PM alone. Sole PM increased tuber weight of yam by 15%, compared with NPK. Sole or mixed forms of soil amendments showed remarkable improvement in soil physical properties, nutrient availability, compared with NPK and the NSF (control). Integrated application of CPA at 10 t ha^-1 + PM at 10 t ha^-1 was the most effective treatment in improving soil physical properties, increasing nutrient availability and yam performance than sole application of any of the fertilizer materials.

Keywords: cocoa pod ash, leaf nutrient composition, poultry manure, soil properties, yam

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Authors: R. M. Korzerzer, J. O. Hambolu, S. O. Salami, S. B. Oladele

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The grasscutter (Thryonomys swinderianus) has become an important source of protein and income to rural dwellers in most West African countries including Nigeria. Twelve apparently healthy grasscutters consisting of six males and six females between the ages of three and seven months were obtained from rural dwellers in Benue state and used for this study. The animals were transported by means of constructed cages to the Department of Veterinary Anatomy, Ahmadu Bello University, Zaria and sacrificed using chloroform inhalation gaseous anaesthesia by suffocation. The spleen and mesenteric lymph nodes were extirpated and the tissues prepared using standard methods, haematoxilin and eosin stain was used for routine histology, while Rhodamine B-aniline-methylene blue stain was used for staining reticular and elastic fibres. The spleen was dark red in colour and roughly triangular in outline, and was observed to increase consistently with age, maximum values were recorded at seven months of age in both males and females. Mean ± SEM values for splenic weights were 0.67 ± 0.09 g, 1.65 ± 0.35 g and 2.31 ± 0.06 g at three, five and seven months of age, respectively. The percentage ratio of splenic weight to body weight was 0.1%. Histologically, the germinal centres revealed three zones; the germinal centre, cortical layer and the marginal zone. The mesenteric lymph nodes were constantly bean shaped and appeared as opaque white masses which resemble fat but were distinguished from fat by their pearly glossy nature. The mean ± SEM values for mesenteric lymph node weights were 0.056 ± 0.005 g, 0.143 ± 0.034 g and 0.1600 ± 0.023 g at three, five and seven months of age, respectively.

Keywords: anatomical, spleen, mesenteric lymph node, grasscutter

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Authors: Hernando Santamaría-García, Sandra Báez, Pablo Reyes, José Santamaría-García, Diana Matallana, Adolfo García, Agustín Ibañez

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The study of moral emotions (i.e., Schadenfreude and envy) is critical to understand the ecological complexity of everyday interactions between cognitive, affective, and social cognition processes. Most previous studies in this area have used correlational imaging techniques and framed Schadenfreude and envy as monolithic domains. Here, we profit from a relevant neurodegeneration model to disentangle the brain regions engaged in three dimensions of Schadenfreude and envy: deservingness, morality, and legality. We tested 20 patients with behavioral variant frontotemporal dementia (bvFTD), 24 patients with Alzheimer’s disease (AD), as a contrastive neurodegeneration model, and 20 healthy controls on a novel task highlighting each of these dimensions in scenarios eliciting Schadenfreude and envy. Compared with the AD and control groups, bvFTD patients obtained significantly higher scores on all dimensions for both emotions. Interestingly, the legal dimension for both envy and Schadenfreude elicited higher emotional scores than the deservingness and moral dimensions. Furthermore, correlational analyses in bvFTD showed that higher envy and Schadenfreude scores were associated with greater deficits in social cognition, inhibitory control, and behavior. Brain anatomy findings (restricted to bvFTD and controls) confirmed differences in how these groups process each dimension. Schadenfreude was associated with the ventral striatum in all subjects. Also, in bvFTD patients, increased Schadenfreude across dimensions was negatively correlated with regions supporting social-value rewards, mentalizing, and social cognition (frontal pole, temporal pole, angular gyrus and precuneus). In all subjects, all dimensions of envy positively correlated with the volume of the anterior cingulate cortex, a region involved in processing unfair social comparisons. By contrast, in bvFTD patients, the intensified experience of envy across all dimensions was negatively correlated with a set of areas subserving social cognition, including the prefrontal cortex, the parahippocampus, and the amygdala. Together, the present results provide the first lesion-based evidence for the multidimensional nature of the emotional experiences of envy and Schadenfreude. Moreover, this is the first demonstration of a selective exacerbation of envy and Schadenfreude in bvFTD patients, probably triggered by atrophy to social cognition networks. Our results offer new insights into the mechanisms subserving complex emotions and moral cognition in neurodegeneration, paving the way for groundbreaking research on their interaction with other cognitive, social, and emotional processes.

Keywords: social cognition, moral emotions, neuroimaging, frontotemporal dementia

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

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Authors: Eric Berry White

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The paper examines the causality between solid waste pollution and lockdown. Particularly in 2020, the world experiences the takeover of the Corona virus pandemic, and most countries decided to adopt lockdown measure as the best solution to curtail the spread of the virus. On March 20, 2020, the Government of Liberia implemented a curfew that starts from 3:00PM to 6:00AM. This means that no unauthorized person is allowed to be in the streets during this time. In most developing countries, the issue of public waste and environmental hazard pollution tend to have a high effect among the slum communities where there are markets. This research covers 6 slums communities around the two biggest market hubs within Monrovia, and the result shows that the lockdown measure significantly reduced public waste pollution by reducing the movement of marketers in slum communities , where limited educational and sensitization for young people is reflected on their job market exclusion, jobless circle, and youth workforce concentration in informal work market. The study discovered that with public awareness and sensitization with females, solid waste could be reduced by 13 percentage point. But there is no evidence that awareness among male conduce pollution. within affected communities, Despite the impact of the lockdown on food consumption, these results emphasized that with the right monitoring of waste and aware, pollution could be reduce. By understanding these results and implementing the best policy, the paper recommends that dump sites be close at certain hours.

Keywords: lockdown, environmental, pollution, waste

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Authors: M. Dieb, T. Hodairi

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In the Southwest Libya area, the Palaeozoic deposits are an important petroleum system, with Silurian shale considered a hydrocarbon source rock and Cambro-Ordovician recognized as a good reservoir. The Palaeozoic petroleum system has the greatest potential for conventional and is thought to represent the significant prospect of unconventional petroleum resources in Southwest Libya. Until now, the lateral and vertical heterogeneity of the source rock was not well evaluated, and oil-source correlation is still a matter of debate. One source rock, which is considered the main source potential in Marzuq Basin, was investigated for its uranium contents using gamma-ray logs, rock-eval pyrolysis, and organic petrography for their bulk kinetic characteristics to determine the petroleum potential qualitatively and quantitatively. Thirty source rock samples and fifteen oil samples from the Tannezzuft source rock were analyzed by Rock-Eval Pyrolysis, microscopely investigation, GC, and GC-MS to detect acyclic isoprenoids and aliphatic, aromatic, and NSO biomarkers. Geochemistry tools were applied to screen source and age-significant biomarkers to high-spot genetic relationships. A grating heterogeneity exists among source rock zones from different levels of depth with varying uranium contents according to gamma-ray logs, rock-eval pyrolysis results, and kinetic features. The uranium-rich Tannezzuft Formations (Hot Shales) produce oils and oil-to-gas hydrocarbons based on their richness, kerogen type, and thermal maturity. Biomarker results such as C₂₇, C₂₈, and C₂₉ steranes concentrations and C₂₄ tetracyclic terpane/C₂₉ tricyclic terpane ratios, with sterane and hopane ratios, are considered the most promising biomarker information in differentiating within the Silurian Shale Tannezzuft Formation and in correlating with its expelled oils. The Tannezzuft Hot Shale is considered the main source rock for oil and gas accumulations in the Cambro-Ordovician reservoirs within the Marzuq Basin. Migration of the generated and expelled oil and gas from the Tannezzuft source rock to the reservoirs of the Cambro-Ordovician petroleum system was interpreted to have occurred along vertical and lateral pathways along the faults in the Palaeozoic Strata. The Upper Tannezzuft Formation (cold shale) is considered the primary seal in the Marzuq Basin.

Keywords: heterogeneity, hot shale, kerogen, Silurian, uranium

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Authors: Jin Koo

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During the coronavirus pandemic, there has been a further increasing demand for computer-based tests (CBT), and now it has become an important test mode. The main purpose of this study is to investigate the comparability of student scores obtained from computerized-based formats of a standardized test in the two subject areas of reading and mathematics. Also, this study investigates whether there is an interaction effect between test modes of CBT and paper-based tests (PBT) and gender/ability level in each subject area. The test used in this study is a multiple-choice standardized test for students in grades 8-11. For this study, data were collected during four test administrations: 2015-16, 2017-18, and 2020-21. This research used a one-factor between-subjects ANOVA to compute the PBT and CBT groups’ test means for each subject area (reading and mathematics). Also, 2-factor between-subjects ANOVAs were conducted to investigate examinee characteristics: gender (male and female), ethnicity (African-American, Asian, Hispanic, multi-racial, and White), and ability level (low, average, and high-ability groups). The author found that students’ test scores in the two subject areas varied across CBT and PBT by gender and ability level, meaning that gender, ethnicity, and ability level were related to the score difference. These results will be discussed according to the current testing systems. In addition, this study’s results will open up to school teachers and test developers the possible influence that gender, ethnicity, and ability level have on a student’s score based on whether they take the CBT or PBT.

Keywords: ability level, computer-based, gender, paper-based, test

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Authors: Aman Upaganlawar, Upasana Khairnar, Chandrashekhar Upasani

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The present study was designed to evaluate the protective effects of protocatechuic acid alone and in combination with ascorbic acid in aniline hydrochloride-induced spleen toxicity in rats. Male Wistar rats of either sex (200-250g) were used and divided into different groups. Spleen toxicity was induced by aniline hydrochloride (100 ppm) in drinking water for 28 days. Treatment group received protocatechuic acid (40 mg/kg/day, p.o), ascorbic acid (40 mg/kg/day, p.o), and combination of protocatechuic acid (20 mg/kg/day, p.o) and ascorbic acid (20 mg/kg/day, p.o) followed by aniline hydrochloride. At the end of treatment period, serum and tissue parameters were evaluated. Rats supplemented with aniline hydrochloride showed a significant alteration in body weight, spleen weight, feed consumption, water intake, hematological parameters (Hemoglobin content, Red Blood Cells, White Blood Cells and Total iron content), tissue parameters (Lipid peroxidation, Reduced glutathione, Nitric oxide content) compared to control group. Histopathology of aniline hydrochloride-induced spleen showed significant damage compared to control rats. Treatment with Protocatechuic acid along with ascorbic acid showed better protection as compared to protocatechuic acid or ascorbic acid alone in aniline hydrochloride-induced spleen toxicity. In conclusion Treatment with protocatechuic acid and ascorbic acid in combination showed significant protection in aniline hydrochloride-induced splenic toxicity in rats.

Keywords: aniline, spleen toxicity, protocatechuic acid, ascorbic acid, antioxidants

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Authors: Sourabh Jain, S. S. Jain

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Intelligent transportation system (ITS) is the application of technologies for developing a user–friendly transportation system to extend the safety and efficiency of urban transportation systems in developing countries. These systems involve vehicles, drivers, passengers, road operators, managers of transport services; all interacting with each other and the surroundings to boost the security and capacity of road systems. The goal of urban corridor management using ITS in road transport is to achieve improvements in mobility, safety, and the productivity of the transportation system within the available facilities through the integrated application of advanced monitoring, communications, computer, display, and control process technologies, both in the vehicle and on the road. Intelligent transportation system is a product of the revolution in information and communications technologies that is the hallmark of the digital age. The basic ITS technology is oriented on three main directions: communications, information, integration. Information acquisition (collection), processing, integration, and sorting are the basic activities of ITS. In the paper, attempts have been made to present the endeavor that was made to interpret and evaluate the performance of the 27.4 Km long study corridor having eight intersections and four flyovers. The corridor consisting of six lanes as well as eight lanes divided road network. Two categories of data have been collected such as traffic data (traffic volume, spot speed, delay) and road characteristics data (no. of lanes, lane width, bus stops, mid-block sections, intersections, flyovers). The instruments used for collecting the data were video camera, stop watch, radar gun, and mobile GPS (GPS tracker lite). From the analysis, the performance interpretations incorporated were the identification of peak and off-peak hours, congestion and level of service (LOS) at midblock sections and delay followed by plotting the speed contours. The paper proposed the urban corridor management strategies based on sensors integrated into both vehicles and on the roads that those have to be efficiently executable, cost-effective, and familiar to road users. It will be useful to reduce congestion, fuel consumption, and pollution so as to provide comfort, safety, and efficiency to the users.

Keywords: ITS strategies, congestion, planning, mobility, safety

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Authors: A. D. Loureiro, L. Ventura

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Exposure to high-energy blue light has been strongly linked to the development of some eye diseases, such as age-related macular degeneration. Over the past few years, people have become more and more concerned about eye damage from blue light and how it can be prevented. We developed a prototype that allows users to self-check the blue light protection of their sunglasses and determines if the protection is adequate. Weighting functions approximating those defined in ISO 12312-1 were used to measure the luminous transmittance and blue light transmittance of sunglasses. The blue light transmittance value must be less than 1.2 times the luminous transmittance to be considered adequate. The prototype consists of a Golden Dragon Ultra White LED from OSRAM and a TCS3472 photodetector from AMS TAOS. Together, they provide four transmittance values weighted with different functions. These four transmittance values were then linearly combined to produce transmittance values with weighting functions close to those defined in ISO 12312-1 for luminous transmittance and for blue light transmittance. To evaluate our prototype, we used a VARIAN Cary 5000 spectrophotometer, a gold standard in the field, to measure the luminous transmittance and the blue light transmittance of 60 sunglasses lenses. (and Bland-Altman analysis was performed) Bland-Altman analysis was performed and showed non-significant bias and narrow 95% limits of agreement within predefined tolerances for both luminous transmittance and blue light transmittance. The results show that the prototype is a viable means of providing blue light protection information to the general public and a quick and easy way for industry and retailers to test their products. In addition, our prototype plays an important role in educating the public about a feature to look for in sunglasses before purchasing.

Keywords: blue light, sunglasses, eye protective devices, transmittance measurement, standards, ISO 12312-1

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Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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Authors: Esther Chiramal, Kelvin Soh Boon Kai

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Explainable AI is a strong strategy implemented to understand complex black-box model predictions in a human-interpretable language. It provides the evidence required to execute the use of trustworthy and reliable AI systems. On the other hand, however, it also opens the door to locating possible vulnerabilities in an AI model. Traditional adversarial text attack uses word substitution, data augmentation techniques, and gradient-based attacks on powerful pre-trained Bidirectional Encoder Representations from Transformers (BERT) variants to generate adversarial sentences. These attacks are generally white-box in nature and not practical as they can be easily detected by humans e.g., Changing the word from “Poor” to “Rich”. We proposed a simple yet effective Grey-box cum Black-box approach that does not require the knowledge of the model while using a set of surrogate Transformer/BERT models to perform the attack using Explainable AI techniques. As Transformers are the current state-of-the-art models for almost all Natural Language Processing (NLP) tasks, an attack generated from BERT1 is transferable to BERT2. This transferability is made possible due to the attention mechanism in the transformer that allows the model to capture long-range dependencies in a sequence. Using the power of BERT generalisation via attention, we attempt to exploit how transformers learn by attacking a few surrogate transformer variants which are all based on a different architecture. We demonstrate that this approach is highly effective to generate semantically good sentences by changing as little as one word that is not detectable by humans while still fooling other BERT models.

Keywords: BERT, explainable AI, Grey-box text attack, transformer

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Authors: Peter Crow

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Boards and directors have been subjects of much scholarly research and public interest over several decades, more so since the succession of high profile company failures of the early 2000s. An array of research outputs including information, correlations, descriptions, models, hypotheses and theories have been reported. While some of this research has shed light on aspects of the board–performance relationship and on board tasks and behaviours, the nature and characteristics of the supposed board–performance relationship remain undetermined. That satisfactory explanations of how boards influence company performance have yet to emerge is a significant blind spot. Yet the board is ultimately responsible for company performance, in accordance with the wishes of shareholders. The aim of this paper is to explore corporate governance and board practice through the lens of strategic management, and to take tentative steps towards a new conception of corporate governance. The findings of a recent longitudinal multiple-case study designed to explore the board’s involvement in strategic management are reported. Qualitative and quantitative data was collected from two quasi-public large companies in New Zealand including from first-hand observations of boards in session, semi-structured interviews with chief executives and chairmen and the inspection of company and board documentation. A synthetic timeline framework was used to collate the financial, board structure, board activity and decision-making data, in order to provide a holistic perspective. Decision sequences were identified, and realist techniques of abduction and retroduction were iteratively applied to analyse the multi-year data set. Using several models previously proposed in the literature as a guide, conjectures were formed, tested and refined—the culmination of which was a provisional model of how boards can influence performance via strategic management. The model builds on both existing theoretical perspectives and theoretical models proposed in the corporate governance and strategic management literature. This paper seeks to add to the understanding of how boards can make meaningful contributions to value creation via strategic management, and to comment on the qualities of directors, social interactions in boardrooms and other circumstances within which influence might be possible given the highly contingent relationship between board activity and business performance outcomes.

Keywords: board practice, case study, corporate governance, strategic management

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