Search results for: anterior chamber depth

Authors: Yoones Tavoosy

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This present study concentrates on the organizational implication the Iranian students with learning difficulties (LD) experience when they write an English essay. Particularly, the present study aims at exploring students' structural problems in EFL essay writing. A mixed method research design was employed including a questionnaire and a semi-structured in-depth interview. Technical Data Analysis of findings exposed that students experience a number of difficulties in the structure of EFL essay writing. Discussion and implications of these findings are presented respectively.

Keywords: Iranian students, learning difficulties, organizational implication, writing

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Authors: Walid Chakroun, Sorour Alotaibi, Nesreen Ghaddar, Kamel Ghali

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This study aims at determining the extent to which occupant control of microenvironment influences, improves thermal sensation and comfort, and saves energy in spaces equipped with ceiling personalized ventilation (CPV) system assisted by chair fans (CF) and desk fans (DF) in 2 experiments in a climatic chamber equipped with two-station CPV systems, one that allows control of fan flow rate and the other is set to the fan speed of the selected participant in control. Each experiment included two participants each entering the cooled space from transitional environment at a conventional mixed ventilation (MV) at 24 °C. For CPV diffuser, fresh air was delivered at a rate of 20 Cubic feet per minute (CFM) and a temperature of 16 °C while the recirculated air was delivered at the same temperature but at a flow rate 150 CFM. The macroclimate air of the space was at 26 °C. The full speed flow rates for both the CFs and DFs were at 5 CFM and 20 CFM, respectively. Occupant 1 was allowed to operate the CFs or the DFs at (1/3 of the full speed, 2/3 of the full speed, and the full speed) while occupant 2 had no control on the fan speed and their fan speed was selected by occupant 1. Furthermore, a parametric study was conducted to study the effect of increasing the fresh air flow rate on the occupants’ thermal comfort and whole body sensations. The results showed that most occupants in the CPV+CFs, who did not control the CF flow rate, felt comfortable 6 minutes. The participants, who controlled the CF speeds, felt comfortable in around 24 minutes because they were preoccupied with the CFs. For the DF speed control experiments, most participants who did not control the DFs felt comfortable within the first 8 minutes. Similarly to the CPV+CFs, the participants who controlled the DF flow rates felt comfortable at around 26 minutes. When the CPV system was either supported by CFs or DFs, 93% of participants in both cases reached thermal comfort. Participants in the parametric study felt more comfortable when the fresh air flow rate was low, and felt cold when as the flow rate increased.

Keywords: PMV, thermal comfort, thermal environment, thermal sensation

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Authors: Faraj M. Elkhatri, Hana Ali Allafi

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The spatial and temporal distribution of diagenetic alterations related impact on the reservoir quality of the Sarir Formation. (present day burial depth of about 9000 feet) Depositional facies and diagenetic alterations are the main controls on reservoir quality of Sarir Formation Sirt Ba-sin Libya; these based on lithology and grain size as well as authigenic clay mineral types and their distributions. However, petrology investigation obtained on study area with five sandstone wells concentrated on main rock components and the parameters that may have impacts on reservoirs. the main authigenic clay minerals are kaolinite and dickite, these investigations have confirmed by X.R.D analysis and clay fraction. mainly Kaolinite and Dickite were extensively presented on all of wells with high amounts. As well as trace of detrital smectite and less amounts of illitized mud-matrix are possibly find by SEM image. Thin layers of clay presented as clay-grain coatings in local depth interpreted as remains of dissolved clay matrix is partly transformed into kaolinite adjacent and towards pore throat. This also may have impacts on most of the pore throats of this sandstone which are open and relatively clean with some of fine martial have been formed on occluded pores. This material is identified by EDS analysis to be collections of not only kaolinite booklets, but also small, disaggregated kaolinite platelets derived from the dis-aggregation of larger kaolinite booklets. These patches of kaolinite not only fill this pore, but also coat some of the sur-rounding framework grains. Quartz grains often enlarged by authigenic quartz overgrowths partially occlude and re-duce porosity. Scanning Electron Microscopy with Energy Dispersive Spectroscopy (SEM) was conducted on the post-test samples to examine any mud filtrate particles that may be in the pore throats. Semi-qualitative elemental data on select-ed minerals observed during the SEM study were obtained using an Energy Dispersive Spectroscopy (EDS) unit. The samples showed mostly clean open pore throats, with limited occlusion by kaolinite.

Keywords: por throat, formation damage, porosity lose, solids plugging

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Authors: Mohammad Muslim, M. Shafiq Ansari, Fazil Hasan

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Bracon hebetor Say (Hymenoptera: Braconidae) is considered as a highly cosmopolitan ecto-parasitoid of various species of order Lepidoptera. To study the influence of lepidopteran hosts on population growth of B. hebetor, the newly mated gravid females were released on various host and the eggs laid by such females on respective host were counted and a single egg was allow to develop on single host larvae. The experiment was conducted at 27 ± 1°C, 65 ± 5% RH and 14L: 10D hr in Biological Oxygen Demand (BOD) chamber. Upon hatching the tiny larvae of parasitoid pierced the body of insect host, enter into them and consumed the internal body contents of paralyzed host larvae. Present findings showed that B. hebetor took ~36 days to complete its survivorship on Corcyra cephalonica and Galleria mellonella. However, on Spodoptera littoralis the survivorship decreased to 24 days. Nevertheless, development of H. hebetor’s immature was significantly prolonged on S. littoralis and S. litura compared to other insect hosts tested. Female of B. hebetor took longer time to lay eggs on C. cephalonica and G. mellonella than other hosts tested in this study. Longevity of male and female is significantly prolonged on C. cephalonica and G. mellonella compared to others insect hosts tested. Population growth parameters like mx Ro, rm, Tc, and τ was considerably highest on C. cephalonica and lowest on S. littoralis. Based on the demographic studies C. cephalonica and H. armegera were proved to be the most suitable host for the mass rearing of B. hebetor. Nevertheless, results of present investigation could be utilized to improve the mass-breeding program of B. hebetor, so that sufficient number of B. hebetor’s adults could be provided time to time for the effective control of lepidopteran pests of various economically important crops.

Keywords: Bracon hebetor, lepidopteran hosts, demography, biology, development

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Authors: Hammam Aljabri, Hong G. Im

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Hydrogen is a promising future fuel to support the transition of the energy sector toward carbon neutrality. The direct utilization of H2 in Internal Combustion Engines (ICEs) is possible, and this technology faces mainly two challenges; high NOx emissions and severe knocking at mid to high loads. In this study, we numerically investigated the potential of H2 combustion in a truck-size engine operated in SI mode. To mitigate the knocking nature of H2 combustion, we have focused on studying the effects of three primary parameters; the compression ratio (CR), the air-fuel ratio, and the spark time. The baseline case was set using a CR of 16.5 and an equivalence ratio of 0.35. In simulations, the auto-ignition tendency was evaluated based on the maximum pressure rise rate and the local pressure fluctuations at the monitoring points set along the wall of the combustion chamber. To mitigate the auto-ignition tendency while enabling a wider range of engine operation, the effect of lowering the compression ratio was assessed. The results indicate that by lowering the compression ratio from 16.5:1 to 12.5:1, an indicated thermal efficiency of 47.5% can be achieved. Aiming to restrain the auto-ignition while maintaining good efficiency, a reduction in the equivalence ratio was examined under different compression ratios. The result indicates that higher compression ratios will require lower equivalence ratios, and due to practical limitations, a lower equivalence ratio of 0.25 was set as the limit. Using a compression ratio of 13.5 combined with an equivalence ratio of 0.3 resulted in an indicated thermal efficiency of 48.6%, that is, at a fixed spark time. It is found that under such lean conditions, the incomplete combustion losses and exhaust losses were high. Thus, advancing the spark time was assessed as a possible solution. The results demonstrated the advantages of advancing the spark time, where an indicated thermal efficiency exceeding 50% was achieved using a compression ratio of 14.5:1 and an equivalence ratio of 0.25.

Keywords: hydrogen, combustion, engine knock, SI engine

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Authors: Sujit K. Basak, Marguerite Wotto, Paul Bélanger

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This paper presents a conceptual framework on the critical success factors of e-learning implementation in higher education, derived from an in-depth survey of literature review. The aim of this study was achieved by identifying critical success factors that affect for the successful implementation of e-learning. The findings help to articulate issues that are related to e-learning implementation in both formal and non-formal higher education and in this way contribute to the development of programs designed to address the relevant issues.

Keywords: critical success factors, e-learning, higher education, life-long learning

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Authors: Mariam A. Abu-Alim

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The purpose of this study was to validate muscle activation amplitudes of two field base dynamic balance tests that are used as strengthen and motor control exercises too in the activation of selected hip and knee stabilizer muscles. Methods: Eighteen college-age females students (21±2 years; 65.6± 8.7 kg; 169.7±8.1 cm) who participated at least for 30 minutes in physical activity most days of the week volunteered. The wireless BIOPAC (MP150, BIOPAC System. Inc, California, USA) surface electromyography system was used to validate the activation of the Gluteus Medius and the Adductor Magnus of hip stabilizer muscles; and the Hamstrings, Quadriceps, and the Gastrocnemius of the knee stabilizer muscles. Surface electrodes (EL 503, BIOPAC, System. Inc) connected to dual wireless EMG BioNormadix Transmitters were place on selected muscles of participants dominate side. Manual muscle testing was performed to obtain the maximal voluntary isometric contraction (MVIC) in which all collected muscle activity data during the three reaching direction: anterior, posteromedial, posterolateral of the Star Excursion Balance Test (SEBT) and the Y-balance Test (YBT) data could be normalized. All participants performed three trials for each reaching direction of the SEBT and the YBT. The domanial leg trial for each participant was selected for analysis which was also the standing leg. Results: the selected hip stabilizer muscles (Gluteus Medius, Adductor Magnus) were both greater than 100%MVIC during the performance of the SEBT and in all three directions. Whereas, selected knee stabilizer muscles had greater activation 0f 100% MVIC and were significantly more activated during the performance of the YBT test in all three reaching directions. The results showed that the posterolateral and the postmedial reaching directions for both dynamic balance tests had greater activation levels and greater than 200%MVIC for all tested muscles expect of the hamstrings. Conclusion: the results of this study showed that the SEBT and the YBT had validated high levels of muscular activity for the hip and the knee stabilizer muscles; which can be used to represent the improvement, strength, control and the decreasing in the injury levels. Since these selected hip and knee stabilizer muscles, represent 35% of all athletic injuries depending on the type of sport.

Keywords: dynamic balance tests, electromyography, hip stabilizer muscles, nee stabilizer muscles

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Authors: F. Gheldane, S. Bouras

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Crack propagation behaviour of alumina mullite zirconia ceramic is investigated under monotonic and cyclic loading by means SENB bending method. This material show R-curve effects, i.e. an increase in crack growth resistance with increasing crack depth. The morphological study showed that the resistance of the crack propagation is mainly connected to the crack bridging. The value of bridging stress is in good agreement with the literature. Furthermore, cyclic-loading fatigue is caused by a decrease in the stress-shielding effect, due to degradation of bridging sites under cyclic loading.

Keywords: alumina mullite zirconia, R-curve, bridging, toughening, crack

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Authors: Andri Ottesen, Sam Toglaw, Mirna Safa

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Entrepreneurial companies on their developing path from an idea to a corporation go through a similar six-step process. Each of these six development steps is supported by a distinctive financing path. This paper explores the Kuwait model for Entrepreneurial Finance and Development through in-depth interviews with ten successful Kuwaiti entrepreneurs. This paper offers insight into the development and financing of entrepreneurial companies in this oil-rich, predominantly Islamic country that are in many ways different from the steps. Western entrepreneurial companies go through. This model could be used to understand the commonalities and the difference between entrepreneurial development and financing and could be used to bridge the gap.

Keywords: entrepreneurial-financing, entrepreneurial-developing, Kuwait, Vancouver school

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Authors: Destriyanti Sugiarti, Ririn A Wulandari

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Background: Malaria disease was widespread in many countries, both tropical and sub-tropical. Tasikmalaya is a region that experienced an increase in malaria cases over the last 5 years and highest in 2013, a total of 168 positive cases of malaria. Tasikmalaya region consists of coastal and mountain areas, it has a potential place for Anopheles mosquito breeding, i.e swamp, lagoon, andrice fields.The purpose of this study was to determine the correlation of environmental risk factors with the incidence of malaria in Tasikmalaya. Methods: The design of the study is case control study with 140 samples in 5 sub-district (Cineam, Cikatomas, Cipatujah, Salopa, and Jatiwaras). This study examines the environmental factors that influence the incidence of malaria in Tasikmalaya District in 2013. The research used 14 variables: individual characteristics (education, knowledge, occupation) and environmental risk factors (mobility to endemic areas, use mosquito nets, use of wire gauze at home, use mosquito repellent, repellent use, the presence of a large animal in a cage, breeding place, the presence of larvae, temperature and humidity chamber). Results: Results demonstrated an association between occupation (0.22; 0.10-0.47), the mobility of the population to the endemic areas (37.4; 14.29-98.18) ,the presence of larvae (5.26; 1.41-19.74), and the room temperature with optimum temperature for mosquito breeding is 25-30oC (3.25; 1.62- 6.50). Conclusion: The dominant factor affecting the spread of malaria in Tasikmalaya is the mobility of the population to endemic areas. The results of the study suggest migration survey conducted activity and health promotion for preventive efforts against malaria in malaria-endemic areas, and to encourage people to behave healthy life by freeing environment of mosquito larvae and protect themselves from mosquito bites.

Keywords: Environmental risk factors, malaria, correlation, Anopheles

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Authors: Tetiana Boriak

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The study is called to test correlation between official sources, preserved in the archives, and “unofficial” oral history regarding the Great Famine of 1932–1933 in Ukraine. The research shows poor preservation of the sources, being deliberately destroyed by the totalitarian regime. It involves analysis of five stages of Holodomor oral history development. It is oral history that provides the mechanism of mass killing. The research proves that using only one type of historical sources leads to a certain line of reading history of the Holodomor, while usage of both types provides in-depth insight in the history of the famine.

Keywords: the Holodomor (the Great Famine), oral history, historical source, historical memory, totalitarianism.

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Authors: Elham Azimzadeh, Saeedeh Sepehri, Hamidollah Hassanlouei

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Obesity is associated with postural instability, might influence the quality of daily life, and could be considered a potential factor for falling in obese people. The fat body mass especially in the abdominal area may increase body sway. Furthermore, loss of visual feedback may induce a larger postural sway in obese people. Moreover, Muscle fatigue may impair the work capacity of the skeletal muscle and may alter joint proprioception. So, the purpose of this study was to investigate the effect of physical fatigue and visual feedback on body sway and strength of lower extremities in obese people. 12 obese (4 female, 8 male; BMI >30 kg/m2), and 12 normal weight (4 female, 8 male; BMI: 20-25 kg/m2) subjects aged 37- 47 years participated in this study. The postural stability test on the Biodex balance system was used to characterize postural control along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions and maximal voluntary contraction (MVC) of knee extensors and flexors were measured before and after the high-intensity exhausting exercise protocol on the ergometer bike to confirm the presence of fatigue. Results indicated that the obese group demonstrated significantly greater body sway, in all indices (ML, AP, overall) compared with the normal weight group (eyes open). However, when visual feedback was eliminated, fatigue impaired the balance in the overall and AP indicators in both groups; ML sway was higher only in the obese group after exerting the fatigue in the eyes closed condition. Also, maximal voluntary contraction of knee extensors was impaired in the fatigued normal group but, there was no significant impairment in knee flexors MVC in both group. According to the findings, peripheral fatigue was associated with altered postural control in upright standing when eyes were closed, and that mechanoreceptors of the feet may be less able to estimate the position of the body COM over the base of support in the loss of visual feedback. This suggests that the overall capability of the postural control system during upright standing especially in the ML direction could be lower due to fatigue in obese individuals and could be a predictor of future falls.

Keywords: maximal voluntary contraction, obesity, peripheral fatigue, postural control, visual feedback

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Authors: Gabrielle Brand, Christopher Etherton-Beer

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The learning landscape of higher education environment is changing, with an increased focus over the past decade on how educators might begin to cultivate reflective skills in health professions students. In addition, changing professional requirements demand that health professionals are adequately prepared to practice in today’s complex Australian health care systems, including responding to changing demographics of population ageing. To counteract a widespread perception of health professions students’ disinterest in caring for older persons, the authors will report on an exploratory, mixed method research study that used photographs, narrative and small group work to enhance medical and nursing students’ reflective learning experience. An innovative photo-elicitation technique and reflective questioning prompts were used to increase engagement, and challenge students to consider new perspectives (around ageing) by constructing shared storylines in small groups. The qualitative themes revealed how photographs, narratives and small group work created learning spaces for reflection whereby students could safely explore their own personal and professional values, beliefs and perspectives around ageing. By providing the space for reflection, the students reported how they found connection and meaning in their own learning through a process of self-exploration that often challenged their assumptions of both older people and themselves as future health professionals. By integrating cognitive and affective elements into the learning process, this research demonstrates the importance of embedding visual methodologies that enhance reflection and transformative learning. The findings highlight the importance of integrating the arts into predominantly empirically driven health professional curricula and can be used as a catalyst for individual and/or collective reflection which can potentially enhance empathy, insight and understanding of the lived experiences of older patients. Based on these findings, the authors have developed ‘Depth of Field: Exploring Ageing’ an innovative, interprofessional, digital reflective learning resource that uses Prezi Inc. software (storytelling tool that presents ideas on a virtual canvas) to enhance students’ reflective capacity in the higher education environment.

Keywords: narrative, photo-elicitation, reflective learning, qualitative research

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Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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Authors: Altoumi Alndalusi

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High-temperature hydrogen attack (HTHA) failure is the common phenomena at elevated temperature in hydrogen environment in oil and gas field. The failure occurred once after four years at the internal surface of Platforming elbow. Both visual and microscopic examinations revealed that the failure was initiated due to blistering forming followed by large cracking at the inner surface. Crack morphology showed that the crack depth was about 50% of material wall thickness and its behavior generally was intergranular. This study concluded that the main reason led to failure due to incorrect material selection comparing to the platforming conditions.

Keywords: decarburization, failure, heat affected zone, morphology, partial pressure, plate form

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Authors: Mohammad Arshad Ikram

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We report three cases of challenging fractures in children treated by intramedullary fixation using the Metaizeau method and achieved anatomical reduction with excellent clinical results. Jean-Paul Metaizeau described the centromedullary fixation for the radial neck in 1980 using K-wires Radial neck fractures are uncommon in children. Treatment of severely displaced fractures is always challenging. Closed reduction techniques are more popular as compared to open reduction due to the low risk of complications. Metaizeau technique of closed reduction with centromedullary pinning is a commonly preferred method of treatment. We present two cases with a severely displaced radial neck fracture, treated by this method and achieved sound union; anatomical position of the radial head and full function were observed two months after surgery. Proximal humerus fractures are another uncommon injury in children accounting for less than 5% of all pediatric fractures. Most of these injuries occur through the growth plate because of its relative weakness. Salter-Harris type I is commonly seen in the younger age group, whereas type II & III occurs in older children and adolescents. In contrast to adults, traumatic glenohumeral dislocation is an infrequently observed condition among children. A combination of proximal humerus fracture and glenohumeral dislocation is extremely rare and occurs in less than 2% of the pediatric population. The management of this injury is always challenging. Treatment ranged from closed reduction with and without internal fixation and open reduction with internal fixation. The children who had closed reduction with centromedullary fixation by the Metaizeau method showed excellent results with the return of full movements at the shoulder in a short time without any complication. We present the case of a child with anterior dislocation of the shoulder associated with a complete displaced proximal humerus metaphyseal fracture. The fracture was managed by closed reduction and then fixation by two centromedullary K-wires using the Metaizeau method, achieving the anatomical reduction of the fracture and dislocation. This method of treatment enables us to achieve excellent radiological and clinical results in a short time.

Keywords: glenohumeral, Metaizeau method, pediatric fractures, radial neck

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Authors: Dhekra Khazri, Hakim Gabtni

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Because of Sidi Bouzid water table overexploitation, this study aims at integrating geophysical methods to determinate aquifers geometry assessing their geological situation and geophysical characteristics. However in highly tectonic zones controlled by Atlassic structural features with NE-SW major directions (central Tunisia), Bouguer gravimetric responses of some areas can be as much dominated by the regional structural tendency, as being non-identified or either defectively interpreted such as the case of Sidi Bouzid basin. This issue required a residual gravity anomaly elaboration isolating the Sidi Bouzid basin gravity response ranging between -8 and -14 mGal and crucial for its aquifers geometry characterization. Several gravity techniques helped constructing the Sidi Bouzid basin's residual gravity anomaly, such as Upwards continuation compared to polynomial regression trends and power spectrum analysis detecting deep basement sources at (3km), intermediate (2km) and shallow sources (1km). A 3D Euler Deconvolution was also performed detecting deepest accidents trending NE-SW, N-S and E-W with depth values reaching 5500 m and delineating the main outcropping structures of the study area. Further gravity treatments highlighted the subsurface geometry and structural features of Sidi Bouzid basin over Horizontal and vertical gradient, and also filters based on them such as Tilt angle and Source Edge detector locating rooted edges or peaks from potential field data detecting a new E-W lineament compartmentalizing the Sidi Bouzid gutter into two unequally residual anomaly and subsiding domains. This subsurface morphology is also detected by the used 2D seismic reflection sections defining the Sidi Bouzid basin as a deep gutter within a tectonic set of negative flower structures, and collapsed and tilted blocks. Furthermore, these structural features were confirmed by forward gravity modeling process over several modeled residual gravity profiles crossing the main area. Sidi Bouzid basin (central Tunisia) is also of a big interest cause of the unknown total thickness and the undefined substratum of its siliciclastic Tertiary package, and its aquifers unbounded structural subsurface features and deep accidents. The Combination of geological, hydrogeological and geophysical methods is then of an ultimate need. Therefore, a geophysical methods integration based on gravity survey supporting available seismic data through forward gravity modeling, enhanced lateral and vertical extent definition of the basin's complex sedimentary fill via 3D gravity models, improved depth estimation by a depth to basement modeling approach, and provided 3D isochronous seismic mapping visualization of the basin's Tertiary complex refining its geostructural schema. A subsurface basin geomorphology mapping, over an ultimate matching between the basin's residual gravity map and the calculated theoretical signature map, was also displayed over the modeled residual gravity profiles. An ultimate multidisciplinary geophysical study of the Sidi Bouzid basin aquifers can be accomplished via an aeromagnetic survey and a 4D Microgravity reservoir monitoring offering temporal tracking of the target aquifer's subsurface fluid dynamics enhancing and rationalizing future groundwater exploitation in this arid area of central Tunisia.

Keywords: aquifer geometry, geophysics, 3D gravity modeling, improved depths, source edge detector

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Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

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Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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Authors: Lubna M. Zakaryia Mahmoud, Mohammed A. Dawood, Doaa A. Heiba

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A prospective double-blind placebo controlled trial carried out on 60 children known to be asthmatic who presented to the emergency department at Alexandria University of Children’s Hospital at El-Shatby with acute asthma exacerbations to assess the efficacy of adding inhaled magnesium sulfate to β-agonist, compared with β-agonist in saline, in the management of acute asthma exacerbations in children. The participants in the study were divided in two groups; Group A (study group) received inhaled salbutamol solution (0.15 ml/kg) plus isotonic magnesium sulfate 2 ml in a nebulizer chamber. Group B (control group): received nebulized salbutamol solution (0.15 ml/kg) diluted with placebo (2 ml normal saline). Both groups received inhaled solution every 20 minutes that was repeated for three doses. They were evaluated using the Pediatric Asthma Severity Score (PASS), oxygen saturation using portable pulse oximetry and peak expiratory flow rate using a portable peak expiratory flow meter at initially recorded as zero-minute assessment and every 20 minutes from the end of each nebulization (nebulization lasts 5-10 minutes) recorded as 20, 40 and 60-minute assessments. Regarding PASS, comparison showed non-significant difference with p-value 0.463, 0.472, 0.0766 at 20, 40 and 60 minutes. Regarding oxygen saturation, improvement was more significant towards group A starting from 40 min with significant p-value=0.000. At 60 min p-value=0.000. Although mean PEFR significantly improved from zero-min in both groups; however, improvement was more significant in group A with significant p-value = 0.015, 0.001, 0.001 at 20 min, 40 min and 60 min, respectively. The conclusion this study suggests is that inhaled magnesium sulfate is an efficient add on drug to standard β- agonist inhalation used in the treatment of moderate to severe asthma exacerbations.

Keywords: nebulized, magnesium sulfate, acute asthma , pediatric

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Authors: Deborah Zelinsky

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The retina filters millions of incoming signals into a smaller amount of exiting optic nerve fibers that travel to different portions of the brain. Most of the signals are for eyesight (called "image-forming" signals). However, there are other faster signals that travel "elsewhere" and are not directly involved with eyesight (called "non-image-forming" signals). This article centers on the neurons of the optic nerve connecting to parts of the limbic system. Eye care providers are currently looking at parvocellular and magnocellular processing pathways without realizing that those are part of an enormous "galaxy" of all the body systems. Lenses are modifying both non-image and image-forming pathways, taking A.M. Skeffington's seminal work one step further. Almost 100 years ago, he described the Where am I (orientation), Where is It (localization), and What is It (identification) pathways. Now, among others, there is a How am I (animation) and a Who am I (inclination, motivation, imagination) pathway. Classic eye testing considers pupils and often assesses posture and motion awareness, but classical prescriptions often overlook limbic involvement in visual processing. The limbic system is composed of the hippocampus, amygdala, hypothalamus, and anterior nuclei of the thalamus. The optic nerve's limbic connections arise from the intrinsically photosensitive retinal ganglion cells (ipRGC) through the "retinohypothalamic tract" (RHT). There are two main hypothalamic nuclei with direct photic inputs. These are the suprachiasmatic nucleus and the paraventricular nucleus. Other hypothalamic nuclei connected with retinal function, including mood regulation, appetite, and glucose regulation, are the supraoptic nucleus and the arcuate nucleus. The retino-hypothalamic tract is often overlooked when we prescribe eyeglasses. Each person is different, but the lenses we choose are influencing this fast processing, which affects each patient's aiming and focusing abilities. These signals arise from the ipRGC cells that were only discovered 20+ years ago and do not address the campana retinal interneurons that were only discovered 2 years ago. As eyecare providers, we are unknowingly altering such factors as lymph flow, glucose metabolism, appetite, and sleep cycles in our patients. It is important to know what we are prescribing as the visual processing evaluations expand past the 20/20 central eyesight.

Keywords: neuromodulation, retinal processing, retinohypothalamic tract, limbic system, visual processing

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Authors: Aime P. Lampad-Dela Pena, Rhodora V. Azanza, Cesar L. Villanoy, Ephrime B. Metillo, Aletta T. Yniguez

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Phytoplankton community changes in relation to environmental parameters were compared between and within, the three interconnected basins. Phytoplankton samples were collected from thirteen stations of Baler Bay and Casiguran Sound, Aurora last May 2013 by filtering 10 L buckets of surface water and 5 L Niskin samples at 20 meters and at 30 to 40 meters depths through a 20um sieve. Duplicate samples per station were preserved, counted, and identified up to genus level, in order to determine the horizontal and vertical spatial variation of different phytoplankton functional groups during the summer ebb and flood flow. Baler Bay, Outer and Inner Casiguran Sound had a total of 89 genera from four phytoplankton groups: Diatom (62), Dinoflagellate (25), Silicoflagellate (1) and Cyanobacteria (1). Non-toxic diatom Chaetoceros spp. bloom (averaged 2.0 x 105 to 2.73 x 106 cells L⁻¹) co-existed with Bacteriastrum spp. at surface waters in Inner and Outer Casiguran. Pseudonitzschia spp. (1.73 x 106 cells L⁻¹) bloomed at bottom waters of the innermost embayment near Casiguran mangrove estuary. Cyanobacteria Trichodesmium spp. significantly increased during ebb tide at the mid-water layers (20 meters depth) in the three basins (ranged from 6, 900 to 15, 125 filaments L⁻¹), forming another bloom. Gonyaulax spp. - dominated dinoflagellate did not significantly change with depth across the three basins. Overall, diatoms and dinoflagellates community assemblages significantly changed between sites (p < 0.001) while diatoms and cyanobacteria varied within Casiguran outer and inner sites (p < 0.001) only. Tidal fluctuations significantly affected dinoflagellates and diatom groups (p < 0.001) in inner and baler sites. Chlorophyll significantly varied between (KW, p < 0.001) and within each basins (KW, p < 0.05), no tidal influence, with the highest value at inner Casiguran and at deeper waters indicating deep chlorophyll maxima. Aurora’s distinct shelf morphology favoring counterclockwise circulation pattern, advective transport, and continuous stratification of the water column could basically affect the phytoplankton assemblages and water quality of Baler Bay and Casiguran inner and outer basins. Observed spatial phytoplankton community changes with multi-species diatom and cyanobacteria bloom at different water layers of the three inter-connected embayments would be vital for any environmental management initiatives in Aurora.

Keywords: aurora fronting Philippines Rise, intermonsoon, multi-species diatom bloom, spatial variability

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Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes

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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.

Keywords: gender, men with disabilities, perpetration of violence, victimization

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Authors: M. Ismail, E. Grifell-Tatjé, A. Paz

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A significant discussion on the topic of blockchain as a solution to the issues of intellectual property highlights the relevance that this topic holds. Some experts label this technology as destructive since it holds immense potential to change course of traditional practices. The extent and areas to which this technology can be of use are still being researched. This paper provides an in-depth review on the intellectual property and blockchain technology. Further it explores what makes blockchain suitable for intellectual property, the practical solutions available and the support different governments are offering. This paper further studies the framework of universities in context of its outputs and how can they be streamlined using blockchain technology. The paper concludes by discussing some limitations and future research question.

Keywords: blockchain, decentralization, open innovation, intellectual property, patents, university-industry relationship

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Authors: Alaa T. Ali, Nevine H. Kheir El Din, Ehab S. Abdelhamid, Ahmed E. Amr

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Objective: Severe alveolar bone resorption is usually associated with a deficient amount of soft tissues. soft tissue expansion is introduced to provide an adequate amount of soft tissue over the grafted area. This study aimed to assess the efficacy of sub-periosteal self-inflating osmotic tissue expanders used as preparatory surgery before horizontal alveolar ridge augmentation using autogenous onlay block bone graft. Methods: A prospective randomized controlled clinical trial was performed. Sixteen partially edentulous patients demanding horizontal bone augmentation in the anterior maxilla were randomly assigned to horizontal ridge augmentation with autogenous bone block grafts harvested from the mandibular symphysis. For the test group, soft tissue expanders were placed sub-periosteally before horizontal ridge augmentation. Impressions were taken before and after STE, and the cast models were optically scanned and superimposed to be used for volumetric analysis. Horizontal ridge augmentation was carried out after STE completion. For the control group, a periosteal releasing incision was performed during bone augmentation procedures. Implants were placed in both groups at re-entry surgery after six months period. A core biopsy was taken. Histomorphometric assessment for newly formed bone surface area, mature collagen area fraction, the osteoblasts count, and blood vessel count were performed. The change in alveolar ridge width was evaluated through bone caliper and CBCT. Results: Soft tissue expander successfully provides a Surplus amount of soft tissues in 5 out of 8 patients in the test group. Complications during the expansion period were perforation through oral mucosa occurred in two patients. Infection occurred in one patient. The mean soft tissue volume gain was 393.9 ± 322mm. After 6 months. The mean horizontal bone gains for the test and control groups were 3.14 mm and 3.69 mm, respectively. Conclusion: STE with a sub-periosteal approach is an applicable method to achieve an additional soft tissue and to reduce bone block graft exposure and wound dehiscence.

Keywords: soft tissue expander, ridge augmentation, block graft, symphysis bone block

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Authors: Yuandi Hu, Gang Yang

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In order to study the business ethics of the international enterprise, the thirteenth-largest car manufacturer and second-largest truck manufacturer in the world, Daimler AG was taken as research object. At first, Daimler AG is briefly introduced and the bribery affairs of Daimler AG in China are simply reviewed. Subsequently, the causes of the bribery are discussed in depth and the manifestations of the value conflict are analyzed in detail. Based on the analyzed results, the reasons why they bribe are investigated. Furthermore, some proposals for improving business ethics of international enterprises are put forward based on the study of Daimler bribery case.

Keywords: business ethics, Daimler AG, bribe, cultural conflict

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Authors: Morteza Malek Yarand, Hadi Saebi Monfared

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This study aimed at designing and developing a mechanical force gauge for the square watermelon mold for the first time. It also tried to introduce the square watermelon characteristics and its production limitations. The mechanical force gauge performance and the product itself were also described. There are three main designable gauge models: a. hydraulic gauge, b. strain gauge, and c. mechanical gauge. The advantage of the hydraulic model is that it instantly displays the pressure and thus the force exerted by the melon. However, considering the inability to measure forces at all directions, complicated development, high cost, possible hydraulic fluid leak into the fruit chamber and the possible influence of increased ambient temperature on the fluid pressure, the development of this gauge was overruled. The second choice was to calculate pressure using the direct force a strain gauge. The main advantage of these strain gauges over spring types is their high precision in measurements; but with regard to the lack of conformity of strain gauge working range with water melon growth, calculations were faced with problems. Finally the mechanical pressure gauge has advantages, including the ability to measured forces and pressures on the mold surface during melon growth; the ability to display the peak forces; the ability to produce melon growth graph thanks to its continuous force measurements; the conformity of its manufacturing materials with the required physical conditions of melon growth; high air conditioning capability; the ability to permit sunlight reaches the melon rind (no yellowish skin and quality loss); fast and straightforward calibration; no damages to the product during assembling and disassembling; visual check capability of the product within the mold; applicable to all growth environments (field, greenhouses, etc.); simple process; low costs and so forth.

Keywords: mechanical force gauge, mold, reshaped fruit, square watermelon

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Authors: Nuruddin Mohammod Zahangir, Syed Tanvir Ahmady, Firoz Ahmed, Mainul Kabir, Tamjid Mohammad Najmus Sakib Khan, Nazmul Hossain, Niaz Ahmed, Madhava Janardhan Naik

Abstract:

The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas.The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and bilateral superficial femoral arteries. Operation was done on 11.03.14. The The Left Internal Mammary Artery (LIMA) and the Right Internal Mammary Artery (RIMA) were harvested in skeletonized manner. The free RIMA was then anastomosed with LIMA to make LIMA-RIMA Y. Cardio Pulmonary Bypass was then established and coronary artery bypass grafts performed. LIMA was anastomosed to the Left Anterior Descending artery. RIMA was anastomosed to Posterior Descending Artery, 1st and 2nd Obtuse Marginal arteries in a sequential manner. Abdomen was opened by midline incision. The infrarenal aorta exposed and was found to be severely diseased. A Vascular Clamp was applied infrarenally, aortotomy done and limited endarterectomy performed. An end-to-side anastomosis was done with upper end of PTFE synthetic Y-graft (14/7 mm) to the infarenal Aorta and the Clamp released. Good flow noted in both limbs of the graft. Patient was then slowly weaned off from Cardio Pulmonary Bypass without difficulty. The distal two limbs of the Y graft were passed to the groin through retroperitoneal tunnels and anastomosed end-to-side with the common femoral arteries. Saphenous vein was interposed between common femoral and popliteal arteries bilaterally through subfascial tunnels in both thigh. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 3 months of operation the patient is doing good and free of chest pain and claudication pain.

Keywords: total arterial, coronary revascularization, aorto-bifemoral bypass, bifemoro-bipopliteal bypass

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Authors: M. J. Baum, B. Gibbes, A. Grinham, S. Albert, D. Gale, P. Fisher

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Alongside the rapid expansion of Seawater Reverse Osmosis technologies there is a concurrent increase in the production of hypersaline brine by-products. To minimize environmental impact, these by-products are commonly disposed into open-coastal environments via submerged diffuser systems as inclined dense jet outfalls. Despite the widespread implementation of this process, diffuser designs are typically based on small-scale laboratory experiments under idealistic quiescent conditions. Studies concerning diffuser performance in the field are limited. A set of experiments were conducted to assess the near field characteristics of brine disposal at the Gold Coast Desalination Plant offshore multiport diffuser. The aim of the field experiments was to determine the trajectory and dilution characteristics of the plume under various discharge configurations with production ranging 66 – 100% of plant operative capacity. The field monitoring system employed an unprecedented static array of temperature and electrical conductivity sensors in a three-dimensional grid surrounding a single diffuser port. Complimenting these measurements, Acoustic Doppler Current Profilers were also deployed to record current variability over the depth of the water column and wave characteristics. Recorded data suggested the open-coastal environment was highly active over the experimental duration with ambient velocities ranging 0.0 – 0.5 m∙s^-1, with considerable variability over the depth of the water column observed. Variations in background electrical conductivity corresponding to salinity fluctuations of ± 1.7 g∙kg^-1 were also observed. Increases in salinity were detected during plant operation and appeared to be most pronounced 10 – 30 m from the diffuser, consistent with trajectory predictions described by existing literature. Plume trajectories and respective dilutions extrapolated from salinity data are compared with empirical scaling arguments. Discharge properties were found to adequately correlate with modelling projections. Temporal and spatial variation of background processes and their subsequent influence upon discharge outcomes are discussed with a view to incorporating the influence of waves and ambient currents in the design of brine outfalls into the future.

Keywords: brine disposal, desalination, field study, negatively buoyant discharge

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Authors: Arpan Upadhyaya, Sunaina Kuknor

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The paper examines the succession management strategies and the preparation level of heirs in the context of family-owned educational institutions in Nepal. Sixteen in-depth, semi-structured interviews with the institution's leader were conducted. The study's findings show the lack of awareness about the importance of succession planning among the institution owners due to the availability of limited resources. The paper also provides some insights into how family ownership and management are done and the lack of formal processes in succession management strategies. It will aid researchers in considering the societal perspective of the successor, which is also a significant worry.

Keywords: effective plans, family business, interest, leadership, successor

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Authors: Chengcao Sun, Cuili Yang, Shujun Li, Ruilin Xue, Liang Wang, Yongyong Xi, Dejia Li

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Backgrounds: Sulforaphane, one of the most important isothiocyanates in the human diet, is known to have chemopreventive and antioxidant activities in different tissues via activation of NF-E2-related factor 2 (Nrf2)-mediated induction of antioxidant/phase II enzymes, such as heme oxygenase-1 (HO-1) and NAD(P)H quinone oxidoreductase 1 (NQO1). However, its effects on muscular dystrophy remain unknown. This work was undertaken to evaluate the effects of Sulforaphane on Duchenne muscular dystrophy (DMD). Methods: 4-week-old mdx mice were treated with SFN by gavage (2 mg/kg body weight per day) for 8 weeks. Blood was collected from eye socket every week, and tibial anterior, extensor digitorum longus, gastrocnemius, soleus, triceps brachii muscles and heart samples were collected after 8-week gavage. Force measurements and mice exercise capacity assays were detected. GSH/GSSG ratio, TBARS, CK and LDH levels were analyzed by spectrophotometric methods. H&E staining was used to analyze histological and morphometric of skeletal muscles of mdx mice, and Evas blue dye staining was made to detect sarcolemmal integrity of mdx mice. Further, the role of Sulforaphane on Nrf2/ARE signaling pathway was analyzed by ELISA, western blot and qRT-PCR. Results: Our results demonstrated that SFN treatment increased the expression and activity of muscle phase II enzymes NQO1 and HO-1 with Nrf2 dependent manner. SFN significantly increased skeletal muscle mass, muscle force (~30%), running distance (~20%) and GSH/GSSG ratio (~3.2 folds) of mdx mice, and decreased the activities of plasma creatine phosphokinase (CK) (~45%) and lactate dehydrogenase (LDH) (~40%), gastrocnemius hypertrophy (~25%), myocardial hypertrophy (~20%) and MDA levels (~60%). Further, SFN treatment also reduced the central nucleation (~40%), fiber size variability, inflammation and improved the sarcolemmal integrity of mdx mice. Conclusions: Collectively, these results show that SFN can improve muscle function, pathology and protect dystrophic muscle from oxidative damage in mdx mice through Nrf2 signaling pathway, which indicate Nrf2 may have clinical implications for the treatment of patients with muscular dystrophy.

Keywords: sulforaphane, duchenne muscular dystrophy, Nrf2, oxidative stress

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