Search results for: process group

Authors: Yannis Stavrakakis, Damian Gordon

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Critical Thinking and Reflective Practice are two vital skills that students undertaking postgraduate studies should ideally possess. To help students develop and enhance these skills, this research developed several authentic activities to be undertaken as part of a module that is delivered early in a taught MSc to enhance these skills. One of the challenges of these topics is that they are somewhat ill-defined in terms of precisely what they mean, and also, there is no clear route to operationalizing the teaching of these skills. This research focuses on identifying suitable models of these skills and delivering them in a manner that is both clear and highly motivating. To achieve this, a class of 22 Master's students was divided into two groups, one was provided with a presentation and checklist about critical thinking skills, and the other group was given the same materials on the reflective practice process. The groups were given two scenarios each to analyze using their respective checklists and were asked to present their outcomes to each other and give peer review. The results were coded and compared, and key differences were noted, including the fact that the Critical Thinking outcomes were more future-focused, and the Reflective Practice outcomes were more past-focused and present-focused, as well as the fact that the Reflective Practice process generated a significantly wider range of perspectives on the scenarios.

Keywords: critical thinking, ethical scenarios, formative assessment, reflective practice

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Authors: Firas Rashad Al-Samarai

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Introduction: Benign prostatic hyperplasia (BPH) is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract, or kidney problems. Objective: to evaluate the efficacy and interaction of tamsulosin with finasteride treatment on induced benign prostate hyperplasia (BPH) in mice. Methods: BPH was induced by subcutaneous injection of testosterone propionate (20 mg/kg) for 30 days. Eighty-five mice were divided into five groups. The first group (G1): twenty-five mice induced BPH treated with tamsulosin orally and divided into five equal subgroups with doses (0.017, 0.052, 0.087, 0. 123, and 0.158) mg/kg, the second group (G2): twenty-five mice induced BPH treated with finasteride orally and divided into five equal subgroups with doses (0.175, 0.527, 0.878, 1.23, and 1.580) mg/kg. the third group (G3): twenty-five mice induced BPH treated with a combination of tamsulosin with finasteride orally, and divided into five equal subgroups with doses (0.0085, 0.0875), (0.026, 0.2635), (0.0435, 0.439) , (0.0615, 0.615) and ( 0.079 , 0.790 ) mg/kg respectively. Fourth group (G4): five mice induced BPH and treated distilled water. Fifth group (G5): five mice were not inducing BPH and without any treatment. Results: The results showed a gradual significant increase in prostate weight % and prostate index % Inhibitions until reached saturation in the last two doses of tamsulosin, finasteride, and combination groups, the maximum effective dose of tamsulosin and finasteride were (0.156) and (1.495) mg/kg respectively. Moreover, the effective dose of the combination (tamsulosin and finasteride) was estimated (0.06876, 0.6876) mg/kg, respectively, as well as the type of interaction was synergism and the value of the combination index was 0.046. Conclusions: We concluded that the combination of tamsulosin with finasteride showed a synergistic effect in BPH treatment by minimizing the side effect of each drug as s result of decreasing the dose of each one.

Keywords: Tamsulosin, Finasteride, combination, BPH

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Authors: E. T. Svahn

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Knowledge about the factors that influence the exchange between research and society is of the utmost importance for developing collaboration between different actors, especially in future science policy development and the creation of support structures for researchers. Among other things, how researchers look at the surrounding open science policy environment and what conditions and attitudes they have for interacting with it. This paper examines the Finnish researchers' attitudes towards open science policies in 2020. Open science is an integrated part of researchers' daily lives and supports not only the effectiveness of research outputs but also the quality of research. Open science policy in ideal situation is seen as a supporting structure that enables the exchange between research and society, but in other situation, it can end up being red tape generating obstacles and hindering possibilities of making science in an efficient way. Results of this study were carried out through focus group interviews. This qualitative research method was selected because it aims to understand the phenomenon under study. In addition, focus group interviews produce diverse and rich material that would not be available with other research methods. Focus group interviews have well-established applications in social science, especially in understanding the perspectives and experiences of research subjects. In this study, focus groups were used in studying the mindset and actions of researchers. Each group's size was between 4-10 people, and the aim was to bring out different perspectives on the subject. The interviewer enabled the presentation of different perceptions and opinions, and the focus group interviews were recorded and written as text. The material was analysed using grounded theory method. The results are presented as thematic areas, theoretical model, and as direct quotations. Attitudes towards open science policy can vary greatly depending on the research area. This study shows that the open science policy demands in medicine, technology, and natural sciences compared to social sciences, educational sciences, and the humanities, varies somewhat. The variation in attitudes between different research areas can thus be largely explained by the fact that the research output and ethical code vary significantly between certain subjects. This study aims to increase understanding of the nuances to what extent open science policies should be tailored for different disciplines and research areas.

Keywords: focus group interview, grounded theory, open science policy, science policy

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Authors: Abioye A. Oyenuga, Rao Bhamidiarri

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Hurling a successful Construction and Demolition Waste (C&DW) recycling operation around the globe is a challenge today, predominantly because secondary materials markets are yet to be integrated. Reducing, Reusing and recycling of (C&DW) have been employed over the years, and various techniques have been investigated. However, the economic and environmental viability of its application seems limited. This paper discusses the costs and benefits in using secondary materials and focus on investigating reuse and recycling process for five major types of construction materials: concrete, metal, wood, cardboard/paper, and plasterboard. Data obtained from demolition specialist and contractors are considered and evaluated. With the date source, the research paper found that construction material recovery process fully incorporate the 3R’s process and shows how energy recovery by means of 3R's principles can be evaluated. This scrutiny leads to the empathy of grand challenges in construction material recovery process. Recommendations to deepen material recovery process are also discussed.

Keywords: construction and demolition waste (C&DW), 3R concept, recycling, reuse, waste management, UK

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Authors: Lawrence Gumbe

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Kenya Vision 2030 is the country's programme for transformation covering the period 2008 to 2030. Its objective is to help transform Kenya into a newly industrializing, middle-income, exceeding US$10000, country providing a high quality of life to all its citizens by 2030, in a clean and secure environment. Increased agricultural and production and productivity is crucial for the realization of Vision 2030. Mechanization of agriculture in order to achieve greater yields is the only way to achieve these objectives. There are contending groups and views on the strategy for agricultural mechanization. The first group are those who oppose the widespread adoption of advanced technologies (mostly internal combustion engines and tractors) in agricultural mechanization as entirely inappropriate in most situations in developing countries. This group argues that mechanically powered -agricultural mechanization often leads to displacement of labour and hence increased unemployment, and this results in a host of other socio-economic problems, amongst them, rural-urban migration, inequitable distribution of wealth and in many cases an increase in absolute poverty, balance of payments due to the need to import machinery, fuel and sometimes technical assistance to manage them. The second group comprises of those who view the use of the improved hand tools and animal powered technology as transitional step between the most rudimentary step in technological development (characterized by entire reliance on human muscle power) and the advanced technologies (characterized 'by reliance on tractors and other machinery). The third group comprises those who regard these intermediate technologies (ie. improved hand tools and draught animal technology in agriculture) as a ‘delaying’ tactic and they advocate the use of mechanical technologies as-the most appropriate. This group argues that alternatives to the mechanical technologies do not just exist as a practical matter, or, if they are available, they are inefficient and they cannot be compared to the mechanical technologies in terms of economics and productivity. The fourth group advocates a compromise between groups two and third above. This group views the improved hand tools and draught animal technology as more of an 18th century technology and the modem tractor and combine harvester as too advanced for developing countries. This group has been busy designing an ‘intermediate’, ‘appropriate’, ‘mini’, ‘micro’ tractor for use by farmers in developing countries. This paper analyses and concludes on the different agricultural mechanization strategies available to Kenya and other third world countries

Keywords: agriculture, mechanazation, transformation, industrialization

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Authors: Jakub Elbl, Lukáš Plošek, Antonín Kintl, Jaroslav Hynšt, Soňa Javoreková, Jaroslav Záhora, Libor Kalhotka, Olga Urbánková, Ivana Charousová

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This work presents the first results from the long-term laboratory experiment dealing with impact of drought on soil properties. Three groups of the treatment (A, B and C) with different regime of irrigation were prepared. The soil water content was maintained at 70 % of soil water holding capacity in group A, at 40 % in group B. In group C, soil water regime was maintained in the range of wilting point. Each group of the experiment was divided into three variants (A1 = B1, C1; A2 = B2, C2 etc.) with three repetitions: Variants A1 (B1, C1) were controls without addition of another fertilizer. Variants A2 (B2, C2) were fertilized with mineral nitrogen fertilizer DAM 390 (0.140 Mg of N per ha) and variants A3 (B3, C3) contained 45 g of Cp per a pot. The significant differences (ANOVA, P<0.05) in the leaching of mineral nitrogen and values of saturated hydraulic conductivity (Ksat) were found. The highest values of Ksat were found in variants (within each group) with addition of compost (A3, B3, C3). Conversely, the lowest values of Ksat were found in variants with addition of mineral nitrogen. Low values of Ksat indicate an increased level of hydrophobicity in individual groups of the experiment. Moreover, all variants with compost addition showed lower amount of mineral nitrogen leaching and high level of microbial activity than variants without. This decrease of mineral nitrogen leaching was about 200 % in comparison with the control variant and about 300 % with variant, where mineral nitrogen was added. Based on these results, we can conclude that changes of soil water content directly have impact on microbial activity, soil hydrophobicity and loss of mineral nitrogen from the soil.

Keywords: drought, microbial activity, mineral nitrogen, soil hydrophobicity

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Authors: V. K. Arora, Suraj Prakash

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Pile foundations are provided to transfer the vertical and horizontal loads of superstructures like high rise buildings, bridges, offshore structures etc. to the deep strata in the soil. These vertical and horizontal loads are due to the loads coming from the superstructure and wind, water thrust, earthquake, and earth pressure, respectively. In a pile foundation, piles are used in groups. Vertical piles in a group of piles are more efficient to take vertical loads as compared to horizontal loads and when the horizontal load per pile exceeds the bearing capacity of the vertical piles in that case batter piles are used with vertical piles because batter piles can take more lateral loads than vertical piles. In this paper, a model study was conducted on three vertical pile group with single positive and negative battered pile subjected to lateral loads. The batter angle for battered piles was ±35◦ with the vertical axis. Piles were spaced at 2.5d (d=diameter of pile) to each other. The soil used for model test was cohesionless soil. Lateral loads were applied in three stages on all the pile groups individually and it was found that under the repeated action of lateral loading, the deflection of the piles increased under the same loading. After comparing the results, it was found that the pile group with positive batter pile fails at 28 kgf and the pile group with negative batter pile fails at 24 kgf so it shows that positive battered piles are stronger than the negative battered piles.

Keywords: vertical piles, positive battered piles, negative battered piles, cohesionless soil, lateral loads, model test

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Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

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Authors: Lenka Krsnakova, Petr Jirsak

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Prior research on facility location in supply chain is mostly focused on improvement of mathematical models. It is due to the fact that supply chain design has been for the long time the area of operational research that underscores mainly quantitative criteria. Qualitative criteria are still highly neglected within the supply chain design research. Facility location in the supply chain has become multi-criteria decision-making problem rather than single criteria decision due to changes of market conditions. Thus, both qualitative and quantitative criteria have to be included in the decision making process. The aim of this study is to emphasize the importance of qualitative criteria as key parameters of relevant mathematical models. We examine which criteria are taken into consideration when Czech companies decide about their facility location. A literature review on criteria being used in facility location decision making process creates a theoretical background for the study. The data collection was conducted through questionnaire survey. Questionnaire was sent to manufacturing and business companies of all sizes (small, medium and large enterprises) with the representation in the Czech Republic within following sectors: automotive, toys, clothing industry, electronics and pharmaceutical industry. Comparison of which criteria prevail in the current research and which are considered important by companies in the Czech Republic is made. Despite the number of articles focused on supply chain design, only minority of them consider qualitative criteria and rarely process supply chain design as a multi-criteria decision making problem. Preliminary results of the questionnaire survey outlines that companies in the Czech Republic see the qualitative criteria and their impact on facility location decision as crucial. Qualitative criteria as company strategy, quality of working environment or future development expectations are confirmed to be considered by Czech companies. This study confirms that the qualitative criteria can significantly influence whether a particular location could or could not be right place for a logistic facility. The research has two major limitations: researchers who focus on improving of mathematical models mostly do not mention criteria that enter the model. Czech supply chain managers selected important criteria from the group of 18 available criteria and assign them importance weights. It does not necessarily mean that these criteria were taken into consideration when the last facility location was chosen, but how they perceive that today. Since the study confirmed the necessity of future research on how qualitative criteria influence decision making process about facility location, the authors have already started in-depth interviews with participating companies to reveal how the inclusion of qualitative criteria into decision making process about facility location influence the company´s performance.

Keywords: criteria influencing facility location, Czech Republic, facility location decision-making, qualitative criteria

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Authors: Zahra Ebrahimi, Abbas Moradan

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This study investigated the effect of applying different layers of activity for different Iranian intermediate EFL learner’s oral proficiency and two of its components (fluency and accura-cy) for the beneficial use of films within speaking classes. For this purpose, thirty Iranian EFL intermediate learners were selected based on availability sampling, they were divided into one experimental group and one control group, each consisting of 15 participants, who were proved to be homogeneous based on the results obtained from IELTS oral proficien-cy test prior to the treatment. Experimental Group received the treatment which was apply-ing different layers of speaking tasks according to learners’ level of fluency and accuracy. Control group received ordinal treatment of speaking classrooms. The materials for this study consisted of 11 English movies for each session, voice-recorder device, and IELTS oral proficiency tests as well as two interviews based on Ur’s oral scale for measuring fluen-cy and accuracy. The treatment was run for 12 sessions in six weeks. At the end of the treatment, all the students both in experimental and control group were given a post-test interview based on Ur’s scale. To compare and contrast the amount of progress of the learners in different groups the results of the pre-test and post-test of speaking were analysed by using T-tests. Moreover, Multivariate analysis of variance was also used to check the hypotheses. Results showed that application of different layers of activity with regard to students’ level, led to a significantly superior performance in experimental group. Thus, this study verified the positive effect of implementation of different layers of activity and tasks to achieve progress in speaking skill. It can also help to create a less stressful at-mosphere of learning in which all the students will be given specific time to speak and lead them to be autonomous learners.

Keywords: differentiated instruction, learners’ style, multiple intelligence, speaking skill, task-based activities

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Authors: H. Z. Ulukan, E. Demircioğlu, M. Erol Genevois

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The scope of this paper and the aim of proposed model were to apply monetary Input –Output (I-O) analysis to point out the importance of reusing know-how and other requirements in order to reduce the production costs in a manufacturing process for a laptop computer. I-O approach using the monetary input-output model is employed to demonstrate the impacts of different factors in a manufacturing process. A sensitivity analysis showing the correlation between these different factors is also presented. It is expected that the recommended model would have an advantageous effect in the cost minimization process.

Keywords: input-output analysis, monetary input-output model, manufacturing process, laptop computer

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Authors: Syed Faizan Hassan Shah

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Introduction: Burn injuries are among the most devastating of all injuries. Burns is the fourth most common type of trauma worldwide. Ap?proximately 90 percent of burns occur in low to middle-income countries. Nearly half a million Americans each year, with approximately 40,000 hospitalizations and 3,400 deaths annually, suffer burns. The survival rate for admitted burn patients has improved consistently over the past four decades, largely attributed to national decreases in burn size, improvements in burn critical care, and advancements in burn wound care. Objectives: The present study was conducted to compare the efficacy of Honey dressing versus Silver Sulfadiazine dressing for complete wound healing in the 2nd-degree thermal burn. Study Design: A Randomized controlled trial was carried out in the Department of General Surgery/burn unit of Ayub Teaching Hospital Abbottabad from July to December 2018. The study population included thermal burn patients presenting with ASA-I, ASA-II, and body surface area less than 50% of the age group above 12 to 60 years of either gender. All the patients were randomly divided into two equal groups of patients by blocked randomization using permuted block g 6. In group ‘A,’ patients underwent dressing by honey method, and patients in group ‘B’ had silver sulfadiazine dressing. The dressing was changed every 48 hours by a senior sur?geon, and the condition of the wound was observed. Time duration till complete wound healing was noted in the Proforma. Results: A total of 100 patients were selected and divided into two groups of 50 patients in each two groups. The mean age of the patients was 27.66±13.388 ran?ging from 12 to 60 years of age, and the mean duration of complete healing of wound in days was 20.20±6.251, ranging from 2 to 30 days. Mean comparison of age with both groups, age of the patients was 21.24±3.761 (n=50) in group ‘A,’ i.e., honey dressing, and 19.16±7.911 (n=50) was in group ‘B,’ i.e., silver sulfadiazine dressing. Efficacy in the honey dressing group was found effective in 48(75.0%) and ineffect? ive in 2(5.6%) out of 50 patients. Efficacy in silver sulfadiazine dressing group 16(25.0%) was three found effective and in 34(94.4%) was inef?fective out of 50 patients. There was a statistically significant difference between both groups. (P=0.000) . Conclusion: honey dressing is more effective as compared to silver sulfadiazine dressing in terms of complete wound healing in second-degree thermal burn patients; our study also concluded the same.

Keywords: efficacy, honey dressing, silver sulfadiazine dressing, wound healing

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Authors: Kaveh Azadeh, Saeid Fazelifar

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The main purpose of the present study was to examine the effect of 12 weeks (3 days/week) concurrent training followed by 4 weeks detraining on insulin resistance in obese boys without dietary intervention. Methods: 24 obese children boys (body mass index> 28, age= 11- 13year old) voluntarily participated in the study. Biochemical factors, body composition, and functional physical fitness were assessed in three stages [baseline, after 12 week’s combined endurance and resistance training and 4 week’s detraining in the experimental group (n=12); baseline and after 12 weeks in control group (n=12)]. Results: Indepented - Sample T test revealed that in experimental group after 12weeks trainings the insulin resistance, and body fat mass were significantly declined, whereas endurance and strength of abdominal muscles significantly increased compared to control group (p<0/05). One-way ANOVA for three different periods showed that insulin resistance, body fat mass, strength of abdominal muscles after 12week training was significantly improved in the experimental group compared with the baseline. Following 4weeks detraining insulin resistance again significantly increased (p<0/05). After detraining disturbances of physiological adaptation in obese children have more rapid course in comparison with those anthropological and functional indices. Conclusion: Results showed that participation in the regular concurrent trainings provides a decrease of insulin resistance in obese children. It may serve as a strategy in treatment of obesity and management on insulin resistance, as well as to increase endurance and strength muscles in obese children. Adaptations resulting from regular exercises following detraining are reversible.

Keywords: endurance and resistance trainings, detraining, insulin resistance, obese children

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Authors: Panagodage Janaka Sampath Fernando

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Brain circulation has become a buzzword in the skilled migration literature. However, promoting brain circulation; returning of skilled migrants is challenging. Success stories in Asia, for instances, Taiwan, and China, are results of rigorous policy interventions of the respective governments. Nonetheless, the same policy mix has failed in other countries making it skeptical to attribute the success of brain circulation to the policy interventions per se. The paper seeks to answer whether the success of brain circulation within the Knowledge Services Industry (KSI) in Sri Lanka is a policy driven or a market driven process. Mixed method approach, which is a combination of case study and survey methods, was employed. Qualitative data derived from ten case studies of returned entrepreneurs whereas quantitative data generated from a self-administered survey of 205 returned skilled migrants (returned skilled employees and entrepreneurs) within KSI. The pull factors have driven the current flow of brain circulation within KSI but to a lesser extent, push factors also have influenced. The founding stone of the industry has been laid by a group of returned entrepreneurs, and the subsequent growth of the industry has attracted returning skilled employees. Sri Lankan government has not actively implemented the reverse brain drain model, however, has played a passive role by creating a peaceful and healthy environment for the industry. Therefore, in contrast to the other stories, brain circulation within KSI has emerged as a market driven process with minimal government interventions. Entrepreneurs play the main role in a market-driven process of brain circulation, and it is free from the inherent limitations of the reverse brain drain model such as discriminating non-migrants and generating a sudden flow of low-skilled migrants. Thus, to experience a successful brain circulation, developing countries should promote returned entrepreneurs by creating opportunities in knowledge-based industries.

Keywords: brain circulation, knowledge services industry, return migration, Sri Lanka

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Authors: Naveen Kumar Challa, Pavan Verıkıcherla, Madhubalan, Ashısh Sharma

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Aim: Aim of the study was to find whether any difference exists in pupil mydriasis measured with Orbscan in non-diabetic and type 2 diabetic patients at various intervals after installation of Tropicamide 0.8% and Phenylephrine 5%. Methods: the Observational study conducted at a tertiary care eye hospital during September 2014 to March 2015. 240 eyes from 120 patients (40 non-diabetic, 80 diabetic) were dilated with Tropicamide 0.8% and Phenylephrine 5%. One drop of a drug was installed twice. The second drop is installed at 20 minutes after installation of the first drop. In two groups’ pupil diameter was measured before installation of drops and also at 15, 30, 45 and 60 minutes after installation of the first drop using both Orbscan. Result: Mean age of the non-diabetic group is 48.67 ± 7.93 years; Diabetic group is 59.97 ± 8.77 years. Mean duration of Diabetes was 7.01 ± 5.05 years. Mean pupil diameter measured with Orbscan before installation of the drops and also at 15, 30, 45 and 60 minutes after installation of first drop in non-diabetic group was 4.18 ± 0.64mm, 6.15 ± 0.41mm, 7.76 ±0.34, 9.59 ± 0.30, and 9.97 ± 0.10 mm respectively and for the diabetic group it was 4.00 ± 0.56 mm, 5.53 ± 0.52 mm, 7.018 ± 0.58mm, 8.25±0.51mm and 9.18 ± 0.46mm respectively. The mean difference between the mean pupil diameters of the non-diabetic and diabetic group shows a significant difference (P< 0.01) at all intervals except before dilatation. There is a significant negative correlation (r = 0.78 – 0.92) between the duration of diabetes and pupil dilatation at all intervals after installation of the drops. There is also significant difference (P< 0.005) in the mean values of pupil diameter between non retinopathy diabetic subjects and diabetic retinopathy subjects at all intervals after installation of drops. Conclusion: People attending eye clinic, whose pupil mydriasis values falls below the normal may be referred for diabetic evaluation. If normative data is established for the pupil size in Indian population using Orbscan then the values fall under normative data could be a predictor for diabetes. This would in turn help ophthalmologist to detect the diabetes at an early stage and prevent the complications resulting from the diabetes.

Keywords: diabetes mellitus, pupil diameter, orbscan, tropicamide

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Authors: Anu Vinod Ranade

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Aim: To evaluate and compare the effects of Vitamin C and Vitamin E on experimentally induced testicular torsion and detorsion in rats. Methods: Forty Male Wistar Albino rats were divided into five groups. Animals in the Group I underwent Sham operation, Group II consisted of animals that were subjected to torsion for three hours followed by detorsion for 24 hours without any treatment. While Group III, IV and V were orally pretreated with Vitamin C (40mg/kg.bw), vitamin E (100mg/kg.bw) and a combination of Vitamin C and vitamin E respectively for a period of 30 days. The testes of the experimental groups were manually rotated to 720° clockwise for three hours and counter rotated for 24 hours to induce ischemia and reperfusion. Sequential biopsies were performed and the testes were collected at the end of 24 hours of detrosion for morphological evaluation. Result: There was a significant decrease in the standard tubular diameter and the epithelial height of the seminiferous tubules in the untreated group when compared to Sham controls. The standard tubular diameter and seminiferous epithelial height showed near normal values when animals were pretreated with Vitamin C and Vitamin E individually or in combination. Conclusion: The results showed that pretreatment of with antioxidants vitamin E and vitamin C when administered prior to testicular torsion in rats significantly reduced the torsion and detorsion induced histopathlogical injury.

Keywords: vitamin C, vitamin E, standard tubular diameter, standard epithelial height, testicular torsion

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Authors: Chen-Sheng Chen, Tsung-Yi Huang, Pi-Chang Sun

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Chronic stroke patients often have complaints about hand dysfunction due to flexor hypertonia and extensor weakness, which makes it difficult to open their affected hand for functional grasp. Hand rehabilitation after stroke is essential for restoring functional independence. Constraint-induced movement therapy has shown to be a successful treatment for patients who have acquired certain level of wrist and finger extension. The goal of this study was to investigate the feasibility of task-oriented approach incorporating 3D-printed dynamic hand device by evaluating hand functional performance. This study manufactured a hand device using 3d printer for chronic stroke. The experimental group engaged task-oriented approach with dynamic hand device, but the control group only received task-oriented approach. Outcome measurements include palmar pinch force (PPF), lateral pinch force (LPF), grip force (GF), and Box and Blocks Test (BBT). The results of study revealed the improvement of PPF in experimental group but not in control group. Meanwhile, improvement in LPF, GF and BBT can be found in both groups. This study demonstrates that the 3D-printed dynamic hand device is an effective therapeutic assistive device to improve pinch force, grasp force, and dexterity and facilitate motivation during home program in individuals with chronic stroke.

Keywords: 3D printing, biomechanics, hand orthosis, stroke

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Authors: Mayurachat Kanyamee, Srisuda Rassameepong, Narunest Chulakarn

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This experimental pretest-posttest control group design aimed to examine the effects of a family-based intervention on increasing fruit and vegetable intake and reduce fat and sugar intake and nutritional status among school-age children. Children were randomized to experimental 68 children and control 68 children. The experimental group received the intervention based on Social Cognitive Theory. The control group received the school’s usual educational program regarding healthy eating behavior. Data were collected via three questionnaires including: demographic characteristics; fruit and vegetable intake; and fat and sugar intake at baseline, sixteen weeks after baseline. Analysis of the data included the use of descriptive statistic and independent t-test. Results revealed the significant differences between the experimental and control group, regarding: fruit and vegetable intake, fat and sugar intake and nutritional status at sixteenth week after baseline. The findings suggest a family-based intervention, based on SCT, appears to be effective to improve eating behavior, and nutritional status of school -age children. So, the intervention can be applied to improve eating behavior among other groups of children.

Keywords: family-based intervention, children, unhealthy food, food safety

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Authors: Swati Bajpai, S. P. K Jena

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Background: There is dramatic increase in the prevalence and severity of overweight in adolescents, raising concerns about their psychosocial and cognitive consequences, thereby indicating the immediate need to understand the effects of increased weight on scholastic performance. Although the body of research is currently limited, available results have identified an inverse relationship between obesity and cognition in adolescents. Aim: to examine the association between increased Body Mass Index in adolescents and their neurocognitive functioning. Methods: A case –control study of 28 subjects in the age group of 11-17 years (14 Males and 14 females) was taken on the basis of main inclusion criteria (Body Mass Index). All of them were randomized to (experimental group: overweight) and (control group: normal weighted). A complete neurocognitive assessment was carried out using validated psychological scales namely, Color Progressive Matrices (to assess intelligence); Bender Visual Motor Gestalt Test (Perceptual motor functioning); PGI-Memory Scale for Children (memory functioning) and Malin’s Intelligence Scale Indian Children (verbal and performance ability). Results: statistical analysis of the results depicted that 57% of the experimental group lack in cognitive abilities, especially in general knowledge (99.1±12.0 vs. 102.8±6.7), working memory (91.5±8.4 vs. 93.1±8.7), concrete ability (82.3±11.5 vs. 92.6±1.7) and perceptual motor functioning (1.5±1.0 vs. 0.3±0.9) as compared to control group. Conclusion: Our investigations suggest that weight gain results, at least in part, from a neurological predisposition characterized by reduced executive function, and in turn obesity itself has a compounding negative impact on the brain. Though, larger sample is needed to make more affirmative claims.

Keywords: adolescents, body mass index, neurocognition, obesity

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Authors: Neerja Bharti, Drishya P.

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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.

Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption

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Authors: Sawsan J. Al-Husseini, Talib A. Dosa

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Transformational leadership has been identified as the most important factor affecting innovation and knowledge sharing; it leads to increased goal-directed behavior exhibited by followers and thus to enhanced performance and innovation for the organization. However, there is a lack of models linking transformational leadership, knowledge sharing, and process innovation within higher education (HE) institutions in general within developing countries, particularly in Iraq. This research aims to examine the mediating role of knowledge sharing in the transformational leadership and process innovation relationship. A quantitative approach was taken and 254 usable questionnaires were collected from public HE institutions in Iraq. Structural equation modelling with AMOS 22 was used to analyze the causal relationships among factors. The research found that knowledge sharing plays a pivotal role in the relationship between transformational leadership and process innovation, and that transformational leadership would be ideal in an educational context, promoting knowledge sharing activities and influencing process innovation in the public HE in Iraq. The research has developed some guidelines for researchers as well as leaders and provided evidence to support the use of TL to increase process innovation within HE environment in developing countries, particularly in Iraq.

Keywords: transformational leadership, knowledge sharing, process innovation, structural equation modelling, developing countries

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Authors: Hidayah Triana, Mahir S. Gani, Asmi Citra Malina, Hamka

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This study was conducted to determine genetic diversity of tiger groupers that are resistant to V. parahaemolyticus and tolerant to low extreme salinities. This research is useful to obtain superior broodstock of fish. Tiger grouper used were 6 to 8 cm obtained from Brackish Water Aquaculture Research Center Gondol (Bali). This study consists of four stages: preliminary stage was adaptation of fish exposed to several concentrations of V. parahaemolyticus (103, 104, 105, 106, and 107 CFU / ml); second stage was test of Lethal Concentration (LC50) of bacteria to fish; third stage was salinity tolerance test (low salinity 12, 14 and 16 ppt) and fourth stage was analysis of DNA profiles. For DNA profiles analysis, genomic DNA of fish were extracted for PCR using primers YNZ-22 and UBC-122 and visualized by electrophoresis method. The results showed that Lethal concentration of bacteria (LC50) to fish was 1,56x106 CFU/ml. Furthermore, survival rate of groupers exposed with low salinities (12, 14, 16 ppt) survival rates were found to be 54,17 %, 66,67 % and 79,16 % respectively. Average of DNA fragment (5 fragments) generated from primer UBC-122 in the group of fish resistant to V.parahaemolyticus and tolerant to low salinities was similar to group of susceptible to low salinities. Primer YNZ-22 generated more diverse of DNA fragments (8,0 and 5,8 fragments) both in the group of fish tolerant and susceptible to low salinities compared to primer UBC-122 (5,0 fragments). Size of DNA 1.5 kb resulted from primer YNZ-22. Primer YNZ-22 generated 4 (50 %) and 3 (42,8 %) polymorfic fragments in the group of fish tolerant and susceptible to low salinities, respectively. Four (4) monomorfic fragments were found both in the group of fish tolerant and susceptible to low salinities. Primer UBC-122 generated 6 (85,7 %) and 9 (90,0 %) polymorfic fragments in the fish tolerant and susceptible to low salinities, respectively.

Keywords: genetic diversity, epinephelus fuscoguttatus, V. parahaemolyticus, PCR-RAPD, low extreme salinity

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Authors: Donghee Kang

Abstract:

Background: Cancer pain is very difficult to control as the mechanism of pain is varied, and the patient has several co-morbidities. The use of Intravenous Patient-Controlled Analgesia (IV-PCA) can effectively control underlying pain and breakthrough pain. Ketamine is used in many pain patients due to its unique analgesic effect. In this study, it was checked whether there was a difference in the amount of analgesic usage, pain control degree, and side effects between patients who controlled pain with fentanyl-based IV-PCA and those who added Ketamine for pain control. Methods: Among the patients referred to this department for cancer pain, IV-PCA was applied to patients who were taking sufficient oral analgesics but could not control them or had blood clotting disorders that made the procedure difficult, and this patient group was targeted. In IV-PCA, 3000 mcg of Fentanyl, 160 mg of Nefopam, and 0.3 mg of Ramosetrone were mixed with normal saline to make a total volume of 100 ml. Group F used this IV-PCA as it is, and group K mixed 250 mg of Ketamine with normal saline to make a total volume of 100 ml. For IV-PCA, the basal rate was 0.5ml/h, the bolus was set to 1ml when pressed once, and the lockout time was set to 15 minutes. If pain was not controlled after IV-PCA application, 500 mcg of Fentanyl was added, and if excessive sedation or breathing difficulties occurred, the use was stopped for one hour. After that, the degree of daily pain control, analgesic usage, and side effects were investigated for seven days using this IV-PCA. Results: There was no difference between the two groups in the demographic data. Both groups had adequate pain control. Initial morphine milligram equivalents did not differ between the two groups, but the total amount of Fentanyl used for seven days was significantly different between the two groups [p=0.014], and group F used more Fentanyl through IV-PCA. In addition, the amount of sleeping pills used during the seven days was higher in Group F [p<0.01]. Overall, there was no difference in the frequency of side effects between the two groups, but the nausea was more frequent in Group F [p=0.031]. Discussion: When the two groups were compared, pain control was good in both groups. This seems to be because Fentanyl-based IV-PCA showed an adequate pain control effect. However, there was a significant difference in the total amount of opioid (Fentanyl) used, which is thought to be the opioid-sparing effect of Ketamine. Also, among the side effects, nausea was significantly less, which is thought to be possible because the amount of opioids used in the Ketamine group was small. The frequency of requesting sleeping pills was significantly less in the group using Ketamine, and it seems that Ketamine also helped improve sleep quality. In conclusion, using Ketamine with an opioid to control pain seems to have advantages. IV-PCA, which can be used effectively when other procedures are difficult, is more effective and safer when used together with Ketamine than opioids alone.

Keywords: cancer pain, intravenous patient-controlled analgesia, Ketamine, opioid

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Authors: A. Buruzs, M. F. Hatwágner, A. Torma, L. T. Kóczy

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Recently, an increasing number of researchers have been focusing on working out realistic solutions to sustainability problems. As sustainability issues gain higher importance for organisations, the management of such decisions becomes critical. Knowledge representation is a fundamental issue of complex knowledge based systems. Many types of sustainability problems would benefit from models based on experts’ knowledge. Cognitive maps have been used for analyzing and aiding decision making. A cognitive map can be made of almost any system or problem. A fuzzy cognitive map (FCM) can successfully represent knowledge and human experience, introducing concepts to represent the essential elements and the cause and effect relationships among the concepts to model the behavior of any system. Integrated waste management systems (IWMS) are complex systems that can be decomposed to non-related and related subsystems and elements, where many factors have to be taken into consideration that may be complementary, contradictory, and competitive; these factors influence each other and determine the overall decision process of the system. The goal of the present paper is to construct an efficient IWMS which considers various factors. The authors’ intention is to propose an expert based system design approach for implementing expert decision support in the area of IWMSs and introduces an appropriate methodology for the development and analysis of group FCM. A framework for such a methodology consisting of the development and application phases is presented.

Keywords: factors, fuzzy cognitive map, group decision, integrated waste management system

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Authors: A. Goma Amira, U. E. Mahrous

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Measuring the effect of perinatal lead exposure on learning ability of offspring is considered as a sensitive and selective index for providing an early marker for central nervous system damage produced by this toxic metal. A total of 35 Sprague-Dawley adult rats were used to investigate the effect of lead acetate toxicity on behavioral patterns of adult female rats and learning ability of offspring. Rats were allotted into 4 groups, group one received 1g/l lead acetate (n=10), group two received 1.5g/l lead acetate (n=10), group three received 2g/l lead acetate in drinking water (n=10), and control group did not receive lead acetate (n=5) from 8th day of pregnancy till weaning of pups. The obtained results revealed a dose-dependent increase in the feeding time, drinking frequency, licking frequency, scratching frequency, licking litters, nest building, and retrieving frequencies, while standing time increased significantly in rats treated with 1.5g/l lead acetate than other treated groups and control. On the contrary, lying time decreased gradually in a dose-dependent manner. Moreover, movement activities were higher in rats treated with 1g/l lead acetate than other treated groups and control. Furthermore, time spent in closed arms was significantly lower in rats given 2g/l lead acetate than other treated groups, while they spent significantly much time spent in open arms than other treated groups which could be attributed to occurrence of adaptation. Furthermore, number of entries in open arms was-dose dependent. However, the ratio between open/closed arms revealed a significant decrease in rats treated with 2g/l lead acetate than the control group.

Keywords: lead toxicity, rats, learning ability, behavior

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Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Aliya K. Salahova

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Scientific thinking is a fundamental cognitive skill that plays a crucial role in preparing young minds for an increasingly complex world. This study explores the connection between scientific thinking and the ability to ask questions in children aged 5-9. The research aims to identify and assess how questioning ability serves as an indicator of scientific thinking development in this age group. A longitudinal investigation was conducted over a span of 240 weeks, involving 72 children from diverse backgrounds. The participants were divided into an experimental group, engaging in weekly STEM activities, and a control group with no STEM involvement. The development of scientific thinking was evaluated through a comprehensive assessment of questioning skills, hypothesis formulation, logical reasoning, and problem-solving abilities. The findings reveal a significant correlation between the ability to ask questions and the level of scientific thinking in children aged 5-9. Participants in the experimental group exhibited a remarkable improvement in their questioning ability, which positively influenced their scientific thinking growth. In contrast, the control group, devoid of STEM activities, showed minimal progress in questioning skills and subsequent scientific thinking development. This study highlights the pivotal role of questioning ability as a key indicator of scientific thinking in young children. The results provide valuable insights for educators and researchers, emphasizing the importance of fostering and nurturing questioning skills to enhance scientific thinking capabilities from an early age. The implications of these findings are crucial for designing effective educational interventions to promote scientific curiosity and critical thinking in the next generation of scientific minds.

Keywords: scientific thinking, education, STEM, intervention, psychology, pedagogy, collaborative learning, longitudinal study

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Authors: Mohammad Khazaei, Reza Rostami, Hasan Gharayagh Zandi, Rouhollah Basatnia, Mahbubeh Ghayour Najafabadi

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Objective: Methylphenidate has been demonstrated to enhance attention and cognitive processes, and placebo treatments have also been found to improve attention and cognitive processes. Additionally, methylphenidate may have positive effects on motion perception and sports performance. Nevertheless, additional research is needed to fully comprehend the neural mechanisms underlying the effects of methylphenidate and placebo on cognitive and motor functions. Methods: In this randomized controlled trial, 18 young semi-professional basketball players aged 18-23 years were randomly and equally assigned to either a Ritalin or Placebo group. The participants performed 20 consecutive free throws; their scores were recorded on a 0-3 scale. The participants’ brain activity was recorded using electroencephalography (EEG) for 5 minutes seated with their eyes closed. The Ritalin group received a 10 mg dose of methylphenidate, while the Placebo group received a 10mg dose of placebo. The EEG was obtained 90 minutes after the drug was administere Results: There was no significant difference in the absolute power of brain waves between the pre-test and post-tests in the Placebo group. However, in the Ritalin group, a significant difference in the absolute power of brain waves was observed in the Theta band (5-6 Hz) and Beta band (21-30 Hz) between pre- and post-tests in Fp2, F8, and Fp1. In these areas, the absolute power of Beta waves was higher during the post-test than during the pre-test. The Placebo group showed a more significant difference in free throw scores than the Ritalin group. Conclusions: In conclusion, these results suggest that Ritalin effect on brain activity in areas associated with attention and cognitive processes, as well as improve basketball free throws. However, there was no significant placebo effect on brain activity performance, but it significantly affected the improvement of free throws. Further research is needed to fully understand the effects of methylphenidate and placebo on cognitive and motor functions.

Keywords: methylphenidate, placebo effect, electroencephalography, basketball free throw

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Authors: Aneta Binkowska, Grzegorz Michalak, Slawomir Pilip, Lukasz Bondaruk, Daniel Celinski, Robert Slotwinski

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Post-traumatic mortality rates are still very high and show an increasing tendency. Early identification of patients at high risk of severe complications has a significant impact on treatment outcomes. The aim of the study was to better understand the early pathological inflammatory response to injury and infection and to determine the usefulness of the assessment of TNF-α and sTNFR1 concentrations in the peripheral blood as early indicators of severe post-traumatic complications. The study was carried out in a group of 51 patients after trauma treated in the ED, including 32 patients that met inclusion criteria for immunological analysis. Patients were divided into two groups using the ISS scale (group A with ISS ≥20, group B with ISS <20). Serum levels of TNF-α and sTNFR1 were determined after admission to the ED and after 3, 6, 12 and 24 hours. The highest TNF-α and sTNFR1 concentrations in both groups were recorded at admission and were significantly higher in group A compared to group B (A vs B TNF-α 2.46 pg/ml vs 1.78 pg/ml; sTNFR1 1667.5 pg/ml vs 875.2 p<0.005). The concentration of sTNFR1 in patients with severe complications was significantly higher compared to patients without complications and preceded clinical symptoms of complications ( C+ vs C- 1561.5 pg/ml vs 930.6 pg/ml). Spearman's correlation showed a statistically significant positive correlation between the baseline concentrations of IL-6 (r=0.38, p<0.043) and sTNFR1 (r=0.59, p=0.001) and the ISS scores. The high diagnostic sensitivity calculated from the ROC (receiver operating characteristic) curves was found for the concentrations of both cytokines: TNF α (AUC=0.91, p=0.004) and sTNFR1 (AUC=0.86, p=0.011). Elevated levels of sTNFR1, determined in the peripheral blood shortly after injury, is significantly associated with the occurrence of later complications, which in some patients lead to death. In contrast, high levels of TNF-α shortly after injury are associated with high mortality.

Keywords: cytokine, SIRS, MODS, trauma

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Authors: Ahlam H. Mahmoud, Samir F. Zohny, Ibrahim H. Boraia, Faten S. Bayoumic, Eman Eissa

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Hepatocellular carcinoma is one of the most common cancers worldwide and is known to be resistant to conventional chemotherapy. Therefore, we aimed to assess the Salsola inermis extract as a novel chemopreventive and/or therapeutic agent against N-nitrosodiethylamine (DNE)/phenobarbital (PB)-induced hepatocarcinogenesis in rats. Adult male Wistar albino rats were divided into five groups: group1 rats were served as normal controls; group 2 rats were injected intraperitoneally with S. inermis extract (100 mg/kg body weight/day) for 20 weeks; group 3 rats were subjected to two-phase hepatocarcinogenic regimen (initiation of hepatocarcinogenesis was performed by a single intraperitoneal injection of DEN at a dose of 200 mg/kg body weight, 2 weeks later, the carcinogenic effect was promoted by supplementation of rats with 0.05% PB for 16 weeks); group 4 rats were injected intraperitoneally with S. inermis extract 2 weeks prior to the injection of DEN, the daily injection of S. inermis extract was then continued for 18 weeks along with two-phase hepatocarcinogenic regimen (chemoprevention group); and group 5 rats were subjected to the two-phase hepatocarcinogenic regimen, and then, the animals were injected intraperitoneally with S. inermis extract for 4 weeks (treatment group). The activities of serum liver enzymes and levels of total bilirubin, conjugated bilirubin, α-fetoprotein, vascular endothelial growth factor (VEGF) and soluble intercellular adhesion molecule-1 (sICAM-1) in serum were decreased in chemopreventive and treated rats compared with DEN/PB-administered rats. Interestingly, the serum levels of total protein and albumin were normalized in chemopreventive and treated rats. Moreover, the majority of chemopreventive and treated rats showed an almost normal histological pattern of liver. In conclusion, S. inermis extract possessed chemopreventive and therapeutic activities against hepatocarcinogenesis in rats partially through the inhibition of VEGF and sICAM-1.

Keywords: Salsola inermis extract, hepatocarcinogenesis, α–fetoprotein, VEGF, sICAM-1

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