Search results for: post mortem interval

Authors: Mohamed Ahmed Fouad

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Background: Stroke is the most leading cause to functional disability and gait problems. Objectives: The purpose of this study was to determine the effect of rhythmic auditory stimulation combined with treadmill training on selected gait kinematics in stroke patients. Methods: Thirty male stroke patients participated in this study. The patients were assigned randomly into two equal groups, (study and control). Patients in the study group received treadmill training combined with rhythmic auditory stimulation in addition to selected physical therapy program for hemiparetic patients. Patients in the control group received treadmill training in addition to the same selected physical therapy program including strengthening, stretching, weight bearing, balance exercises and gait training. Biodex gait trainer 2 TM was used to assess selected gait kinematics (step length, step cycle, walking speed, time on each foot and ambulation index) before and after six weeks training period (end of treatment) for both groups. Results: There was a statistically significant increase in walking speed, step cycle, step length, percent of the time on each foot and ambulation index in both groups post-treatment. The improvement in gait parameters post-treatment was significantly higher in the study group compared to the control. Conclusion: Rhythmic auditory stimulation combined with treadmill training is effective in improving selected gait kinematics in stroke patients when added to the selected physical therapy program.

Keywords: stroke, rhythmic auditory stimulation, treadmill training, gait kinematics

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Authors: Ernest Nweke

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This paper examines the changing trend in ownership of Mongolian companies and how this trend has influenced corporate governance mechanisms in Mongolian companies. A study of this magnitude is essential as it x-rays the systematic transformation of Mongolia’s corporate world from the public to private ownership and the tremendous impact it has had on firm governance mechanisms. Owing to Mongolia’s Soviet past, much of the companies in Mongolia were state-owned, state-directed and state-controlled resulting in serious inefficiencies in these companies. This scenario is antithetical to the economic growth and development of any nation as it is grossly at variance with the fundamental principles of good corporate governance that drive prosperity. Consequently, the Mongolian government has in the past decades fine-tuned government policy to prioritize private ownership, establishing various frameworks that will strengthen corporate governance structures in Mongolia. These efforts have paid off and gone a long way in changing the trend in the ownership of companies in Mongolia reversing the old order. The expectation locally and internationally is that companies in post-socialist Mongolia will be more closely aligned to generally accepted corporate governance mechanisms, generally improving company performance and ultimately returns to shareholders. To achieve the research objectives, the survey research method was employed utilizing a sample of seventy randomly selected listed companies representing 22% of Mongolian Stock Exchange listings. Research hypotheses formulated to guide the conduct of the study were tested using Chi-Square analysis, and results show that ownership trend has drastically changed in the post-socialist Mongolia leading to better corporate governance practices in Mongolian companies. This result has important policy implications.

Keywords: corporate disclosure, free market, private ownership, Mongolia

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Authors: Andriana Purnama, Reno Rudiman, Kezia Christy

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Anal stenosis which develops due to anoderm scarring usually caused by secondary to surgical trauma, has become common, causing significant decrease patient’s quality of life. Even though mild anal stenosis was treated with non-surgical treatment, but surgical reconstruction in unavoidable for moderate to severe anal stenosis that cause distressing, severe anal pain and inability to defecate. In our study, we intend to share our result with the use of diamond flap in treatment of anal stenosis. This case report illustrates a 57-year-old male patient who presented with difficulty and discomfort in defecation caused by anal stenosis after 2 years of open hemorrhoidectomy surgery. At physical examination, there was requirement of forceful dilatation when the index finger was inserted or precisely 6mm as measured by hegar dilator (moderate anal stenosis). Blood test result was within normal limits. The patient underwent anal repair and diamond flap where the scar tissue at 6 and 9 o’clock directions was excised and diamond graft was incised carefully while paying attention to the vascular supply. Finally, the graft was fixated without any tension to the anal canal, resulting in diameter of 2 cm after operation. After 2 days post operation, the patient was in stable condition, without any complication, and discharged. There was no abnormality concerning the stool. Ten days after the operation, diamond flap was in normal condition and without any complication. He was scheduled for futher follow up at the Digestive Surgery Department. Anal stenosis due to overzealous hemorrhoidectomy is a complication that is preventable when performed in experienced hands. Diamond flap was one of the options for the anal stenosis treatment with less complication.

Keywords: anal stenosis, diamond flap, post hemorrhoidectomy, anal repair

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Authors: Izabela Kapsa

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Civic participation is an important aspect of democracy. The contemporary model of democracy is based on citizens' participation in political decision-making (deliberative democracy, participatory democracy). This participation takes many forms of activities like display of slogans and symbols, voting, social consultations, political demonstrations, membership in political parties or organizing civil disobedience. The countries of Central and Eastern Europe after 1989 are characterized by great social, economic and political diversity. Civil society is also part of the process of democratization. Civil society, funded by the rule of law, civil rights, such as freedom of speech and association and private ownership, was to play a central role in the development of liberal democracy. Among the many interpretations of concepts, defining the concept of contemporary democracy, one can assume that the terms civil society and democracy, although different in meaning, nowadays overlap. In the post-communist countries, the process of shaping and maturing societies took place in the context of a struggle with a state governed by undemocratic power. State fraud or repudiation of the institution is a representative state, which in the past was the only way to manifest and defend its identity, but after the breakthrough became one of the main obstacles to the development of civil society. In Central and Eastern Europe, there are many obstacles to the development of civil society, for example, the elimination of economic poverty, the implementation of educational campaigns, consciousness-related obstacles, the formation of social capital and the deficit of social activity. Obviously, civil society does not only entail an electoral turnout but a broader participation in the decision-making process, which is impossible without direct and participative democratic institutions. This article considers such broad forms of civic participation and their characteristics in Central and Eastern Europe. The paper is attempts to analyze the functioning of electronic forms of civic participation in Central and Eastern European states. This is not accompanied by a referendum or a referendum initiative, and other forms of political participation, such as public consultations, participative budgets, or e-Government. However, this paper will broadly present electronic administration tools, the application of which results from both legal regulations and increasingly common practice in state and city management. In the comparative analysis, the experiences of post-communist bloc countries will be summed up to indicate the challenges and possible goals for further development of this form of citizen participation in the political process. The author argues that for to function efficiently and effectively, states need to involve their citizens in the political decision-making process, especially with the use of electronic tools.

Keywords: Central and Eastern Europe, e-participation, e-government, post-communism

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Authors: Wern-Yarng Shieh, Chao Qian, Bingnan Pei

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A design of communication area for infrared electronic-toll-collection systems to provide an extended communication interval in the vehicle traveling direction and regular boundary between contiguous traffic lanes is proposed. By utilizing two typical low-cost commercial infrared LEDs with different half-intensity angles Φ1/2 = 22° and 10°, the radiation pattern of the emitter is designed to properly adjust the spatial distribution of the signal power. The aforementioned purpose can be achieved with an LED array in a three-piece structure with appropriate mounting angles. With this emitter, the influence of the mounting parameters, including the mounting height and mounting angles of the on-board unit and road-side unit, on the system performance in terms of the received signal strength and communication area are investigated. The results reveal that, for our emitter proposed in this paper, the ideal "long-and-narrow" characteristic of the communication area is very little affected by these mounting parameters. An optimum mounting configuration is also suggested.

Keywords: dedicated short-range communication (DSRC), electronic toll collection (ETC), infrared communication, intelligent transportation system (ITS), multilane free flow

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Authors: Saba Hasanvandi, Molok Khademi Ashkezari, Niloofar Esmaieli

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The research purpose was to assess the effectiveness of metacognitive therapy in metacognitive beliefs, anxiety and social phobia of male students studying in the high schools of Dargaz City. The sample comprised 30 students who were randomly selected and assigned to the experimental and control groups. The kind of this study was experimental study with pre-ops and follow-up stages. Subjects filled out metacognitive beliefs, anxiety and social phobia questionnaires. The experimental group underwent 10 sessions of therapeutic metacognitive sessions. The group therapy was conducted for ten, weekly, 90-minute sessions. Mankova analysis was utilized to analyze the data. Results revealed that metacognitive group therapy decreased metacognitive beliefs (P=0.007), anxiety (P<0.001) and social phobia (P=<0.017) in the experimental group as compared to the control group. Furthermore, the effectiveness of group metacognitive therapy was stable and consistent after one month of time interval. The results of present study can be effective for mental health professional in reaching a better understanding of anxiety and social phobia.

Keywords: group metacognitive therapy, metacognitive beliefs, anxiety, social phobia, high school students

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Authors: Pavan K. Emani, Shashank Kothari, V. S. Phanikanth

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The ultimate load analysis of RC pile groups has assumed a lot of significance under liquefying soil conditions, especially due to post-earthquake studies of 1964 Niigata, 1995 Kobe and 2001 Bhuj earthquakes. The present study reports the results of numerical simulations on pile groups subjected to monotonically increasing lateral loads under design amounts of pile axial loading. The soil liquefaction has been considered through the non-linear p-y relationship of the soil springs, which can vary along the depth/length of the pile. This variation again is related to the liquefaction potential of the site and the magnitude of the seismic shaking. As the piles in the group can reach their extreme deflections and rotations during increased amounts of lateral loading, a precise modeling of the inelastic behavior of the pile cross-section is done, considering the complete stress-strain behavior of concrete, with and without confinement, and reinforcing steel, including the strain-hardening portion. The possibility of the inelastic buckling of the individual piles is considered in the overall collapse modes. The model is analysed using Riks analysis in finite element software to check the post buckling behavior and plastic collapse of piles. The results confirm the kinds of failure modes predicted by centrifuge test results reported by researchers on pile group, although the pile material used is significantly different from that of the simulation model. The extension of the present work promises an important contribution to the design codes for pile groups in liquefying soils.

Keywords: collapse load analysis, inelastic buckling, liquefaction, pile group

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Authors: Obradith Caicedo, Paola Devia

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Methylene blue (MB) and malachite green (MG) are substances commonly used in classrooms for academic purposes. Nevertheless, in most cases, there is no adequate disposal of this type of waste, their presence in the environment affects ecosystems due to the presence of color and the reduction of photosynthetic processes. In this work, we evaluated properties of fibers of Luffa cylindrica in removal from dyes of aqueous solutions through an adsorption process. The point of zero charge, acid and basic sites was also investigated. The best conditions of the adsorption process were determined under a discontinuous system, evaluating an interval of the variables 2 3 : pH value, particle size of the adsorbent and contact time. The temperature (18ºC), agitation (220 rpm) and adsorbent dosage (10g/L) were constant. Measurements were made using UV- Visible spectrophotometry. The point of zero charge for Luffa cylindrica was 4,3. The number of acidic and basic sites was 2.441 meq/g and 1,009 meq/g respectively. These indicate a prevalence of acid groups. The maximum dye sorption was found to be at a pH of 5,5 (97,1 % for MB) and 5,0 (97,7% for MG) and particle size of the adsorbent 850 µm. The equilibrium uptake was attained within 60 min. With this study, it has been shown that Luffa cylindrica can be used as efficient adsorbent for the removal of methylene blue, and malachite green from aqueous solution in classrooms.

Keywords: adsorption, dye removal, low-cost adsorbents, Luffa cylindrical

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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Authors: Shwadhin Sharma

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As there has been increasing focus on the shorter attention span of the millennials students, there is a relative absence of instructional tools on behavioral assessments in learning information technology skills within the information systems field and textbooks. This study uses project-based learning in which students gain knowledge and skills related to information technology by working on an extended project that allows students to find a real business problem design information systems based on information collected from the company and develop an information system that solves the problem of the company. Eighty students from two sections of the same course engage in the project from the first week of the class till the sixteenth week of the class to deliver a small business information system that allows them to employ all the skills and knowledge that they learned in the class into the systems they are creating. Computer Information Systems related courses are often difficult to understand and process especially for the Under Representative Minorities students who have limited computer or information systems related (academic) experiences. Project-based learning demands constant attention of the students and forces them to apply knowledge learned in the class to a project that helps retaining knowledge. To make sure our assumption is correct, we started with a pre-test and post-test to test the students learning (of skills) based on the project. Our test showed that almost 90% of the students from the two sections scored higher in post-test as compared to pre-test. Based on this premise, we conducted a further survey that measured student’s job-search preparation, knowledge of data analysis, involved with the course, satisfaction with the course, student’s overall reaction the course and students' ability to meet the traditional learning goals related to the course.

Keywords: project-based learning, job-search preparation, satisfaction with course, traditional learning goals

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Authors: Wen-Wen Wang, Qian Ye, Yi-Feng Lin

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Carbon dioxide emissions are expected to increase continuously, resulting in climate change and global warming. As a result, CO₂ capture has attracted a large amount of research attention. Among the various CO₂ capture methods, membrane technology has proven to be highly efficient in capturing CO₂, because it can be scaled up, low energy consumptions and small area requirements for use by the gas separation. Various nanofibrous membranes were successfully prepared by a simple electrospinning process. The membrane contactor combined with chemical absorption and membrane process in the post-combustion CO₂ capture is used in this study. In a membrane contactor system, the highly porous and water-repellent nanofibrous membranes were used as a gas-liquid interface in a membrane contactor system for CO₂ absorption. In this work, we successfully prepared the polyvinylidene fluoride (PVDF) porous membranes with an electrospinning process. Afterwards, the as-prepared water-repellent PVDF porous membranes were used for the CO₂ capture application. However, the pristine PVDF nanofibrous membranes were wetted by the amine absorbents, resulting in the decrease in the CO₂ absorption flux, the hydrophobic polydimethylsiloxane (PDMS) materials were added into the PVDF nanofibrous membranes to improve the solvent resistance of the membranes. To increase the hydrophobic properties and CO₂ absorption flux, more hydrophobic surfaces of the PDMS/PVDF nanofibrous membranes are obtained by the grafting of fluoroalkylsilane (FAS) on the membranes surface. Furthermore, the highest CO₂ absorption flux of the PDMS/PVDF nanofibrous membranes is reached after the FAS modification with four times. The PDMS/PVDF nanofibrous membranes with 60 wt% PDMS addition can be a long and continuous operation of the CO₂ absorption and regeneration experiments. It demonstrates the as-prepared PDMS/PVDF nanofibrous membranes could potentially be used for large-scale CO₂ absorption during the post-combustion process in power plants.

Keywords: CO₂ capture, electrospinning process, membrane contactor, nanofibrous membranes, PDMS/PVDF

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Authors: Avinash Kharel

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Background: - Linear sprint training is one possible approach to developing sprint performance, a crucial skill to focus on in soccer. Numerous methods, including various on-field training options, can be employed to attain this goal. However, the effect of In-season linear sprint training on sprint performance and related kinetics changes are unknown in a professional setting. The study aimed to investigate the effect of in-season linear sprint training on the sprint kinematics of amateur soccer players. Methods: - After familiarization, a 4-week training protocol was completed with sprint performance and Force Velocity (FV) profiles was compared before and after the training. Eighteen amateur soccer male players (Age 22 ± 2 years: Height: 178 ± 7cm; body-mass: 74 ± 8 Kg, 30-m split-time: 4.398 ± s) participated in the study. Sprint kinematics variables, including maximum Sprint Velocity (V0), Theoretical Maximum Force (F0), Maximum Force Output per kilogram of body weight (N/KG), Maximum Velocity (V(0)), Maximum Power Output (P MAX (W)), Ratio of Force to Velocity (FV), and Ratio of Force to Velocity at Peak power were measured. Results: - Results showed significant improvements in Maximum Sprint Velocity (p<0.01, ES=0.89), Theoretical Maximum Force (p<0.05, ES=0.50), Maximum Force Output per kilogram of body weight (p<0.05, ES=0.42), Maximum Power Output (p<0.05, ES=0.52), and Ratio of Force to Velocity at Peak Power (RF PEAK) (p<0.05, ES=0.44) post-training. There were no significant changes in the ratio of Force to Velocity (FV) and Maximum Velocity V (0) post-training (p>0.05). Conclusion: - These findings suggest that In-season linear sprint training can effectively improve certain sprint kinematics variables in amateur soccer players. Coaches and players should consider incorporating linear sprint training into their in-season training programs to improve sprint performance.

Keywords: sprint performance, training intervention, soccer, kinematics

Procedia PDF Downloads 75

Authors: Thobela Conco, Sheena Kumari, Chika Nnadozie, Mahmoud Nasr, Thor A. Stenström, Mushal Ali, Arshad Ismail, Faizal Bux

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The discharge of antibiotics and its residues into the wastewater treatment plants (WWTP’s) create a conducive environment for the development of antibiotic resistant pathogens. This presents a risk of potential dissemination of antibiotic resistant pathogens and antibiotic resistance genes into the environment. It is, therefore, necessary to study the level of antibiotic resistance genes (ARG’s) among bacterial pathogens that proliferate in biological wastewater treatment systems. In the current study, metagenomic and meta-transcriptomic sequences of samples collected from the influents, secondary effluents and post chlorinated effluents of three wastewater treatment plants treating domestic and hospital effluents in Durban, South Africa, were analyzed for profiling of ARG’s among bacterial pathogens. Results show that a variety of ARG’s, mostly, aminoglycoside, β-lactamases, tetracycline and sulfonamide resistance genes were harbored by diverse bacterial genera found at different stages of treatment. A significant variation in diversity of pathogen and ARGs between the treatment plant was observed; however, treated final effluent samples from all three plants showed a significant reduction in bacterial pathogens and detected ARG’s. Both pre- and post-chlorinated samples showed the presence of mobile genetic elements (MGE’s), indicating the inefficiency of chlorination to remove of ARG’s integrated with MGE’s. In conclusion, the study showed the wastewater treatment plant efficiently caused the reduction and removal of certain ARG’s, even though the initial focus was the removal of biological nutrients.

Keywords: antibiotic resistance, mobile genetic elements, wastewater, wastewater treatment plants

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Authors: Tugba Altin

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In an era where the impacts of climate change resonate more pronouncedly than ever, communities globally grapple with events bearing both tangible and intangible ramifications. Situating this within the evolving landscapes of Psychological and Behavioral Sciences, this research probes the profound psychological and behavioral responses evoked by such events. The Lytton Creek Fire of 2021 epitomizes these challenges. While tangible destruction is immediate and evident, the intangible repercussions—emotional distress, disintegration of cultural landscapes, and disruptions in place attachment (PA)—require meticulous exploration. PA, emblematic of the emotional and cognitive affiliations individuals nurture with their environments, emerges as a cornerstone for comprehending how environmental cataclysms influence cultural identity and bonds to land. This study, harmonizing the core tenets of an interpretive phenomenological approach with a hermeneutic framework, underscores the pivotal nature of this attachment. It delves deep into the realm of individuals' experiences post the Lytton Creek Fire, unraveling the intricate dynamics of PA amidst such calamity. The study's methodology deviates from conventional paradigms. Instead of traditional interview techniques, it employs walking audio sessions and photo elicitation methods, granting participants the agency to immerse, re-experience, and vocalize their sentiments in real-time. Such techniques shed light on spatial narratives post-trauma and capture the otherwise elusive emotional nuances, offering a visually rich representation of place-based experiences. Central to this research is the voice of the affected populace, whose lived experiences and testimonies form the nucleus of the inquiry. As they renegotiate their bonds with transformed environments, their narratives reveal the indispensable role of cultural landscapes in forging place-based identities. Such revelations accentuate the necessity of integrating both tangible and intangible trauma facets into community recovery strategies, ensuring they resonate more profoundly with affected individuals. Bridging the domains of environmental psychology and behavioral sciences, this research accentuates the intertwined nature of tangible restoration with the imperative of emotional and cultural recuperation post-environmental disasters. It advocates for adaptation initiatives that are rooted in the lived realities of the affected, emphasizing a holistic approach that recognizes the profundity of human connections to landscapes. This research advocates the interdisciplinary exchange of ideas and strategies in addressing post-disaster community recovery strategies. It not only enriches the climate change discourse by emphasizing the human facets of disasters but also reiterates the significance of an interdisciplinary approach, encompassing psychological and behavioral nuances, for fostering a comprehensive understanding of climate-induced traumas. Such a perspective is indispensable for shaping more informed, empathetic, and effective adaptation strategies.

Keywords: place attachment, community recovery, disaster response, restorative landscapes, sensory response, visual methodologies

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Authors: Biju Lukose

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The objective of the study was to identify the isolated and combined effect of multi-media computer assisted coaching and traditional coaching on selected motor ability component and physiological variables among sports school basketball players. Forty male basketball players aged between 14 to 18 years were selected randomly. They were divided into four groups of three experimental and one control. Isolated multi-media computer assisted coaching, isolated traditional coaching and combined coaching (multimedia computer assisted coaching and traditional coaching) are the three experimental groups. All the three experimental groups were given coaching for 24 weeks and control group were not allowed to participate in any coaching programme. The subjects were tested dependent variables such as speed and cardio vascular endurance; at the beginning (pre-test) in middle 12 week (mid-test) and after the coaching 24 week (post-test). The coaching schedule was for a period of 24 weeks. The data were collected two days before and after the coaching schedule and mid test after the 12 weeks of the coaching schedule. The data were analysed by applying ANCOVA and Scheffe’s Post hoc test. The result showed that there were significant changes in dependent variables such as speed and cardio vascular endurance. The results of the study showed that combined coaching (multimedia computer assisted coaching and traditional coaching) is more superior to traditional coaching and multimedia computer assisted coaching groups and no significant change in speed in the case of isolated multimedia computer assisted coaching group.

Keywords: computer, computer-assisted coaching, multimedia coaching, traditional coaching

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Authors: Chechen Liao, Pui-Lai To, Chuang-Chun Liu

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Online shopping has become very popular recently. In today’s highly competitive online retail environment, retaining existing customers is a necessity for online retailers. This study focuses on the antecedents and consequences of Internet buyer regret and satisfaction in the online consumer purchasing process. This study examines the roles that online consumer’s purchasing process evaluations (i.e., search experience difficulty, service-attribute evaluations, product-attribute evaluations and post-purchase price perceptions) and alternative evaluation (i.e., alternative attractiveness) play in determining buyer regret and satisfaction in e-commerce. The study also examines the consequences of regret, satisfaction and habit in regard to repurchase intention. In addition, this study attempts to investigate the moderating role of habit in attaining a better understanding of the relationship between repurchase intention and its antecedents. Survey data collected from 431 online customers are analyzed using structural equation modeling (SEM) with partial least squares (PLS) and support provided for the hypothesized links. These results indicate that online consumer’s purchasing process evaluations (i.e., search experience difficulty, service-attribute evaluations, product-attribute evaluations and post-purchase price perceptions) have significant influences on regret and satisfaction, which in turn influences repurchase intention. In addition, alternative evaluation (i.e., alternative attractiveness) has a significant positive influence on regret. The research model can provide a richer understanding of online customers’ repurchase behavior and contribute to both research and practice.

Keywords: online shopping, purchase evaluation, regret, satisfaction

Procedia PDF Downloads 284

Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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Authors: Bryce R. Jolley, Michael Uchic

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This study presents initial results toward the correlative characterization of inherent defects of Ti-6Al-4V additive manufacture (AM). X-Ray Computed Tomography (CT) defect data are compared and correlated with microscopic photographs obtained via automated serial sectioning. The metal AM specimen was manufactured out of Ti-6Al-4V virgin powder to specified dimensions. A post-contour was applied during the fabrication process with a speed of 1050 mm/s, power of 260 W, and a width of 140 µm. The specimen was stress relief heat-treated at 16°F for 3 hours. Microfocus CT imaging was accomplished on the specimen within a predetermined region of the build. Microfocus CT imaging was conducted with parameters optimized for Ti-6Al-4V additive manufacture. After CT imaging, a modified RoboMet. 3D version 2 was employed for serial sectioning and optical microscopy characterization of the same predetermined region. Automated montage capture with sub-micron resolution, bright-field reflection, 12-bit monochrome optical images were performed in an automated fashion. These optical images were post-processed to produce 2D and 3D data sets. This processing included thresholding and segmentation to improve visualization of defect features. The defects observed from optical imaging were compared and correlated with the defects observed from CT imaging over the same predetermined region of the specimen. Quantitative results of area fraction and equivalent pore diameters obtained via each method are presented for this correlation. It is shown that Microfocus CT imaging does not capture all inherent defects within this Ti-6Al-4V AM sample. Best practices for this correlative effort are also presented as well as the future direction of research resultant from this current study.

Keywords: additive manufacture, automated serial sectioning, computed tomography, nondestructive evaluation

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Authors: Muslihatus Syarifah

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Introduction: Rosella flower petals can be used as an antibacterial because it contains alkaloids, flavonoids, phenolics, and terpenoids) for the . Bacteria activity is S. aureus can cause skin infections and pengobatanya most appropriate use of topical preparations. Ointment is a topical preparation comprising the active substance and ointment base. Not all the base matches the active substances or any type of disease. In this study using flavonoid active substances contained in rosella flower petals (Hibiscus sabdariffa) to be made ointment by testing a variety of different bases in order to obtain a suitable basis for the formulation of ointment extract rosella flower petals. Methods: Experimental research with research methods Post test control group design using the ointment is hydrocarbon sample, absorption, leached water and dissolved water. Then tested for bacteria S. aureus with different concentrations of 1%, 2%, 4%, 8%, 16, 32%. Data were analyzed using One Way ANOVA followed by Post Hoc test. Results: Ointment with a hydrocarbon base, absorption, leached water and dissolved water having no change in physical properties during storage. Base affect the physical properties of an ointment that adhesion, dispersive power and pH. The physical properties of the ointment with different concentrations produce different physical properties including adhesion, dispersive power and pH. The higher the concentration the higher dispersive power, but the smaller the adhesion and pH. Conclusion: Differences bases, storage time, the concentration of the extract can affect the physical properties of the ointment. Concentration of extract in the ointment extract rosella flower petals is 32%.

Keywords: rosella, physical properties, ointments, antibacterial

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Authors: Hina Javed

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This study investigated the different strategies used by Pakistani students learning English as a second language at secondary level school. The basic premise of the study is that ESL students face tremendous difficulty while they are reading a text in English. It also purports to dig into the different causes of their slow reading. They might range from word reading accuracy, mental translation, lexical density, cultural gaps, complex syntactic constructions, and back skipping. Sixty Grade 7 students from two secondary mainstream schools in Lahore were selected for the study, thirty being boys and thirty girls. They were administered reading-related and reading speed pre and post-tests. The purpose of the tests was to gauge their performance on different reading tasks so as to be able to see how they used strategies, if any, and also to ascertain the causes hampering their performance on those tests. In the pretests, they were given simple texts with considerable lexical density and moderately complex sentential layout. In the post-tests, the reading tasks contained comic strips, texts with visuals, texts with controlled vocabulary, and an evenly distributed varied range of simple, compound, and complex sentences. Both the tests were timed. The results gleaned through the data gathered corroborated the researchers’ basic hunch that they performed significantly better than pretests. The findings suggest that the morphological structure of words and lexical density are the main sources of reading comprehension difficulties in poor ESL readers. It is also confirmed that if the texts are accompanied by pictorial visuals, it greatly facilitates students’ reading speed and comprehension. There is no substantial evidence that ESL readers adopt any specific strategy while reading in English.

Keywords: slow ESL reading speed, mental translation, complex syntactic constructions, back skipping

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Authors: Sankaran Rajendran

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Remote sensing plays a vital role in mapping of resources and monitoring of environments of the earth. In the present research study, mapping and monitoring of clay siltations occurred in the Alkhod Dam of Muscat, Sultanate of Oman are carried out using low-cost multispectral Landsat and ASTER data. The dam is constructed across the Wadi Samail catchment for ground water recharge. The occurrence and spatial distribution of siltations in the dam are studied with five years of interval from the year 1987 of construction to 2014. The deposits are mainly due to the clay, sand, and silt occurrences derived from the weathering rocks of ophiolite sequences occurred in the Wadi Samail catchment. The occurrences of clays are confirmed by minerals identification using ASTER VNIR-SWIR spectral bands and Spectral Angle Mapper supervised image processing method. The presence of clays and their spatial distribution are verified in the field. The study recommends the technique and the low-cost satellite data to similar region of the world.

Keywords: Alkhod Dam, ASTER siltation, Landsat, remote sensing, Oman

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Authors: Muhammad Solikhudin Nafi, Wahyu Afif Mufida, Mita Erna Wati, Fitri Setyani Rokim, M. Al-Rizqi Dharma Fauzi

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High dose activity without any pre-exercise will impact Delayed Onset Muscle Soreness (DOMS). DOMS known as delayed pain post-exercise and induce skeletal injury which will decrease athletes’ performances. From now on, post-exercise muscle damage can be detected by measuring skeletal troponin I (sTnI) concentration in serum using ELISA but this method needs more time and cost. To prevent decreased athletes performances, screening need to be done rapidly. We want to introduce our new prototype to detect DOMS acutely. Rapid detection tests are based on immunological reaction between skeletal troponin I antibodies and sTnI in human serum or whole blood. Chemical methods that are used in the manufacture of diagnostic test is lateral flow immunoassay. The material used is rat monoclonal antibody sTnI, colloidal gold, anti-mouse IgG, nitrocellulose membrane, conjugate pad, sample pad, wick and backing card. The procedure are made conjugate (colloidal gold and mAb sTnI) and insert into the conjugate pad, gives spray sTnI mAb and anti-mouse IgG into nitrocellulose membrane, and assemble RDT. RDT had been evaluated by measuring the sensitivity of positive human serum (n = 30) and negative human serum (n = 30). Overall sensitivity value was 93% and specificity value was 90%. ADCOR as the first rapid detection test qualitatively showed antigen-antibody reaction and showed good overall performances for screening of muscle damage. Furthermore, these finding still need more improvements to get best results.

Keywords: DOMS, sTnI, rapid detection test, ELISA

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Authors: Medan Isaeva, Anna Degtyareva

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Context: Biliary atresia is a common reason for liver transplants in children, and the Kasai procedure can potentially be successful in avoiding the need for transplantation. However, it is important to identify factors that influence surgical outcomes in order to optimize treatment and improve patient outcomes. Research aim: The aim of this study was to develop prognostic models to assess the outcomes of the Kasai procedure in children with biliary atresia. Methodology: This retrospective study analyzed data from 166 children with biliary atresia who underwent the Kasai procedure between 2002 and 2021. The effectiveness of the operation was assessed based on specific criteria, including post-operative stool color, jaundice reduction, and bilirubin levels. The study involved a comparative analysis of various parameters, such as gestational age, birth weight, age at operation, physical development, liver and spleen sizes, and laboratory values including bilirubin, ALT, AST, and others, measured pre- and post-operation. Ultrasonographic evaluations were also conducted pre-operation, assessing the hepatobiliary system and related quantitative parameters. The study was carried out by two experienced specialists in pediatric hepatology. Comparative analysis and multifactorial logistic regression were used as the primary statistical methods. Findings: The study identified several statistically significant predictors of a successful Kasai procedure, including the presence of the gallbladder and levels of cholesterol and direct bilirubin post-operation. A detectable gallbladder was associated with a higher probability of surgical success, while elevated post-operative cholesterol and direct bilirubin levels were indicative of a reduced chance of positive outcomes. Theoretical importance: The findings of this study contribute to the optimization of treatment strategies for children with biliary atresia undergoing the Kasai procedure. By identifying early predictive signs of success, clinicians can modify treatment plans and manage patient care more effectively and proactively. Data collection and analysis procedures: Data for this analysis were obtained from the health records of patients who received the Kasai procedure. Comparative analysis and multifactorial logistic regression were employed to analyze the data and identify significant predictors. Question addressed: The study addressed the question of identifying predictive factors for the success of the Kasai procedure in children with biliary atresia. Conclusion: The developed prognostic models serve as valuable tools for early detection of patients who are less likely to benefit from the Kasai procedure. This enables clinicians to modify treatment plans and manage patient care more effectively and proactively. Potential limitations of the study: The study has several limitations. Its retrospective nature may introduce biases and inconsistencies in data collection. Being single centered, the results might not be generalizable to wider populations due to variations in surgical and postoperative practices. Also, other potential influencing factors beyond the clinical, laboratory, and ultrasonographic parameters considered in this study were not explored, which could affect the outcomes of the Kasai operation. Future studies could benefit from including a broader range of factors.

Keywords: biliary atresia, kasai operation, prognostic model, native liver survival

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Authors: Emmanuel Adu-Ofori, Richard Amfo-Otu, Isaac O. A. Hodgson

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The study was conducted to determine the treatment performance of waste stabilization ponds in Akosombo. A total of 15 samples were taken for four consecutive months from the inlet, facultative pond and outlet of maturation pond. The samples were preserved and transported to Water Research Institute for laboratory analysis. The wastewater quality parameters analysed to assess the treatment performance were total suspended solids (TSS), biochemical oxygen demand (BOD), chemical oxygen demand (COD), ammonia and phosphate. The results of the laboratory analysis showed that the ponds achieved TSS, BOD and COD removals of about 30, 82 and 75 per cent respectively. Statistically, the BOD (t = 10.27, p = 6.68 x 10-6) and COD (t = 4.23, p = 0.0029) of the raw sewage were significantly different from the total effluent at 95% confidence interval. The ammonia and phosphate removal was as high as 92% and 84% respectively. The quality parameters analysed for the final effluent from the Waste Stabilisation Pond was within the EPA guideline values. The general treatment performances were very good with respect to the parameters studied and does not pose threat to the receiving water body. A further study to examine the bacteriological treatment performance was recommended.

Keywords: waste stabilization pond, wast water, treatment performance, nutrient, Ghana

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Authors: Asanka U. K. Godamunne

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Road traffic accidents (RTA) are a leading cause of death globally as well as in Sri Lanka and results in a large proportion of disability especially among young people. Ninety-percent of world’s road traffic deaths occur in low- and middle-income countries. The gross disparities in injury outcomes relate to immediate post-crash and hospital management. Emergency management, methods of patient transportation following road traffic accidents and safety measures are important factors to reduce mortality and morbidity. Studies in this area are limited in Sri Lanka. The main objective of this research was to assess the emergency management and proper method of transportation of road traffic accident victims. This offers the best way to explore the ways to reduce the mortality and morbidity and raise the public awareness. This study was conducted as a descriptive cross-sectional study. All the consecutive road traffic accident victims admitted to surgical wards at District General Hospital, Matale, Sri Lanka, over a period of three months were included in the study. Data from 387 victims were analyzed. The majority were in the 20-30 year age group. Seventy six percent of the patients were males. Motorcycles and trishaws were most affected. First-aid was given to only 2% of patients and it was given by non-medical persons. A significant proportion of patients (75%) were transported to the hospital by trishaws and only 1% transported by ambulance. About 86% of the patients were seated while transport and 14% were flat. Limbs and head were the most affected areas of the body. As per this study, immediate post-crash management and patient transportation were not satisfactory. There is a need to strengthen certain road safety laws and make sure people follow them.

Keywords: emergency management, patient transportation, road traffic accident victims, Sri Lanka

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Authors: P. V. Krupakara

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This paper deals with the high corrosion resistance developed by the hybrid metal matrix composites when compared with that of matrix alloy. Matrix selected is Al6061. Reinforcements selected are graphite and red mud particulates. The composites are prepared using liquid melt metallurgy technique using vortex method. Metal matrix composites containing 2 percent graphite and 2 percent red mud, 2 percent graphite and 4 percent red mud, 2 percent graphite and 6 percent of red mud are prepared. Bar castings are cut into cylindrical discs of 20mm diameter and 20mm thickness. Corrosion tests were conducted at room temperature (230 °C) using conventional weight loss method according to ASTM G69-80. The corrodents used for the test were hydrochloric acid solution of different concentrations. Specimens were tested for every 24 hours interval up to 96 hours. Four specimens for each condition and time were immersed in corrodent. In each case the corrosion rate decreases with increase in exposure time for matrix and metal matrix composites whatever may be the concentration of hydrochloric acid. This may be due to aluminium, which may induce passivation due to development of non-porous layer. As red mud content increases the composites become corrosion resistant due to insulating nature of ceramic material red mud and less exposure of matrix alloy in those metal matrix composites.

Keywords: Al6061, graphite, passivation, red mud, vortex

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Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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Authors: Burcu Babadağ Savaş, Nihal Orlu, Güler Balcı Alparslan, Ertuğrul Çolak, Cengiz Korkmaz

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Introduction/objectives: We aimed to investigate the effect of humor on pain and state anxiety in patients with rheumatoid arthritis (RA) receiving biologic intravenous (IV) infusion therapy. Method: The study sample consisted of 36 patients who met the classification criteria for RA and inclusion criteria in a rheumatology outpatient clinic at a university hospital between September 2020 and November 2021. Two sample groups were formed: the intervention group (watching a comedy movie) (n=18) and the control group (n=18). The intervention group consisted of the patient watching a comedy movie of his/her choice from an archive created by the researchers during the biological IV infusion therapy (approximately 90-120 minutes). The data collection instruments used before and after the test were the descriptive identification form, the visual analog scale (VAS), and the state anxiety scale. Results: The mean VAS scores of patients in the intervention group were 5.05 ± 2.01 in the pre-test and 2.61 ± 1.91 in the post-test. The mean state anxiety scores of patients in the intervention group were 45.94 ± 9.97 in the pre-test and 34.22 ± 6.57 in the post-test. Thus, patients who watched comedy movies during biologic IV infusion therapy in the infusion center had a greater reduction in pain scores than the control group and the effect size was small. Although there was a decrease in state anxiety scores in both groups, there was no significant difference between groups and the effect size was not relevant. Conclusions: During IV infusion therapy, watching comedy movies is recommended as a nursing care intervention for reducing pain in patients with RA in cooperation with other health professionals.

Keywords: watching comedy movie, humor, pain, anxiety, nursing, care

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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Authors: Kamille Beye

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Critical thinking is a topic that has been disputed in the field of education for decades, but many resulting debates have centered around strengthening critical thinking capabilities in the societies, workforces, and educational centers of the global north. In contrast, this paper provides an analysis of the teaching of critical thinking in Liberia, which has been ravaged by years of war and a recent Ebola outbreak. These crises have decimated the Liberian education sector, leading to a loss of teaching capacities that are essential to providing critical thinking education. Until recently, critical thinking had no seat at the table when the future needs of the country were discussed by the government and non-governmental agencies. Now, the University of Liberia has a bold goal to become one of the top twenty universities in West Africa in the next seven years, which has led to a focus on teaching critical thinking skills to improve learning. This paper argues that critical thinking is essential to strengthening not only the Liberian education system, but for promoting peace amongst community members, and yet it suggests that commitments to the teaching of critical thinking in Liberia have hitherto been overly superficial. Based on an initial scoping study, this paper will examine the potential impacts of teaching critical thinking skills to undergraduate students in the William V. S. Tubman School of Education at the University of Liberia on continued peacebuilding and reconstruction efforts of the country. The research contends that if critical thinking skills are taught, practiced and continually utilized, teachers and students will have the ability to engage with information and negotiate challenges to solutions in ways that are beneficial to the communities in which they live. The research will use a variety of methods, that include the California Critical Thinking Disposition Inventory. This research will demonstrate that critical thinking skills are not only needed for entering the workforce, but necessary for negotiating and expressing the needs and desires of local communities in a peaceful way.

Keywords: critical thinking, higher education, Liberia, peacebuilding, post-conflict

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