Search results for: methods for inverse problems

Authors: H. Li, W. Qin, Ben Ye

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Friction Push Plug Welding (FPPW) is a solid phase welding suitable for repairing defective welds and filling self-reacting weld keyholes in Friction Stir Welds. In FPPW process, a tapered shaped plug is rotated at high speed and forced into a tapered hole in the substrate. The plug and substrate metal is softened by the increasing temperature generated by friction and material plastic deformation. This paper aims to investigate the effect of process parameters on the quality of the weld. Orthogonal design methods were employed to reduce the amount of experiment. Three values were selected for each process parameter, rotation speed (1500r/min, 2000r/min, 2500r/min), plunge depth (2mm, 3mm, 4mm) and plunge speed (60mm/min, 90mm/min, 120r/min). AA6061aluminum alloy plug and substrate plate was used in the experiment. In a trial test with the plunge depth of 1mm, a noticeable defect appeared due to the short plunge time and insufficient temperature. From the recorded temperature profiles, it was found that the peak temperature increased with the increase of the rotation speed, plunge speed and plunge depth. In the initial stage, the plunge speed was the main factor affecting heat generation, while in the steady state welding stage, the rotation speed played a more important role. The FPPW weld defect includes flash and incomplete penetration in the upper, middle and bottom interface with the substrate. To obtain defect free weld, the higher rotation speed and proper plunge depth were recommended.

Keywords: friction push plug welding, process parameter, weld defect, orthogonal design

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Authors: Sakshi Saxena

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Bangalore is an IT industry-based metropolitan city in the state of Karnataka in India. It has experienced tremendous urbanization at the expense of the environment. The reasons behind development over and near ecologically sensitive areas have been raised by several instances of disappearing lakes. Lakes in Bangalore can be considered commons on both a local and a regional scale and these water bodies are becoming less interconnected because of encroachment in the catchment area. Other sociocultural environmental risks that have led to social issues are now a source of concern. They serve as an example of the transformations in commons, a dilemma that as is transformed from rural to urban areas, as well as the complicated institutional issues associated with governance. According to some scholarly work and ecologists, a nexus of public and commercial institutions is primarily responsible for the depletion of water tanks and the inefficiency of the planning process. It is said that Bangalore's growth as an urban centre, together with the demands it created, particularly on land and water, resulted in the emergence of a middle and upper class that was demanding and self-assured. For the report in focus, it is evident to understand the issues and problems which led to these encroachments and captured violations if any around these lakes and tanks which arose during these decades. To claim watersheds and lake edges as properties, institutional arrangements (organizations, laws, and policies) intersect with planning authorities. Because of unregulated or indiscriminate forms of urbanization, it is claimed that the engagement of actors and negotiations of the process, including government ignorance, are allowing this problem to flourish. In general, the governance of natural resources in India is largely state-based. This is due to the constitutional scheme, which since the Government of India Act, of 1935 has in principle given the power to the states to legislate in this area. Thus, states have the exclusive power to regulate water supplies, irrigation and canals, drainage and embankments, water storage, hydropower, and fisheries. Thus, The main aim is to understand institutional arrangements and the master planning processes behind these arrangements. To understand the ambiguity through an example, it is noted that, Custodianship alone is a role divided between two state and two city-level bodies. This creates regulatory ambiguity and the effects on the environment are such as changes in city temperature, urban flooding, etc. As established, the main kinds of issues around lakes/tanks in Bangalore are encroachment and depletion. This study will further be enhanced by doing a physical survey of three of these lakes focusing on the Bellandur site and the stakeholders involved. According to the study's findings thus far, corrupt politicians and dubious land transaction tools are involved in the real estate industry. It appears that some destruction could have been stopped or at least mitigated in this case if there had been a robust system of urban planning processes involved along with strong institutional arrangements to protect lakes.

Keywords: wetlands, lakes, urbanization, bangalore, politics, reservoirs, municipal jurisdiction, lake connections, institutions

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Authors: Bartlomiej Przybyszewski, Rafal Kozera, Katarzyna Zolynska, Anna Boczkowska, Daria Pakula

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The build-up and accumulation of dirt, ice, and snow on structural elements and vehicles is an unfavorable phenomenon, leading to economic losses and often also posing a threat to people. This problem occurs wherever the use of polymer coatings has become a standard, among others in photovoltaic farms, aviation, wind energy, and civil engineering. The accumulated pollution on the photovoltaic modules can reduce their efficiency by several percent, and snow stops power production. Accumulated ice on the blades of wind turbines or the wings of airplanes and drones disrupts the airflow by changing their shape, leading to increased drag and reduced efficiency. This results in costly maintenance and repairs. The goal of the work is to reduce or completely eliminate the accumulation of dirt, snow, and ice build-up on polymer coatings by achieving self-cleaning and icephobic properties. It is done by the use of a multi-step surface modification of the polymer nanocoatings. For this purpose, two methods of surface structuring and the preceding volumetric modification of the chemical composition with proprietary organosilicon compounds and/or mineral additives were used. To characterize the surface topography of the modified coatings, light profilometry was utilized. Measurements of the wettability parameters (static contact angle and contact angle hysteresis) on the investigated surfaces allowed to identify their wetting behavior and determine relation between hydrophobic and anti-icing properties. Ice adhesion strength was measured to assess coatings' anti-icing behavior.

Keywords: anti-icing properties, self-cleaning, polymer coatings, icephobic coatings

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Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Tina Naser Torabi

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Prevalence of allergy is affected by different factors according to its base and seasonal weather changes, and it also needs various treatments.Although reasons of allergy existence are not clear but generally, allergens cause reaction between antigen and antibody because of their antigenic traits. In this state, allergens cause immune system to make mistake and identify safe material as threat, therefore function of immune system impaired because of histamine secretion. There are different reasons for allergy, but herbal reasons are on top of the list, although animal causes cannot be ignored. Important point is that allergenic compounds, cause making dedicated antibody, so in general every kind of allergy is different from the other one. Therefore, most of the plants in herbal allergenic category can cause various allergies for human beings, such as respiratory allergies, nutritional allergies, injection allergies, infection allergies, touch allergies, that each of them show different symptoms based on the reason of allergy and also each of them requires different prevention and treatment. Geographical condition is another effective factor in allergy. Seasonal changes, weather condition, herbal coverage variety play important roles in different allergies. It goes without saying that humid climate and herbal coverage variety in different seasons especially spring cause most allergies in human beings in Iran and India that are discussed in this article. These two countries are good choices for allergy prevalence because of their condition, various herbal coverage, human and animal factors. Hay fever is one of the allergies, although the reasons of its prevalence are unknown yet. It is one of the most popular allergies in Iran and India because of geographical, human, animal and herbal factors. Hay fever is on top of the list in these two countries. Significant point about these two countries is that herbal factor is the most important factor in prevalence of hay fever. Variety of herbal coverage especially in spring during herbal pollination is the main reason of hay fever prevalence in these two countries. Based on the research result of Pharmacognosy and Phytochemistry, pollination of some plants in spring is major reason of hay fever prevalence in these countries. If airborne pollens in pollination season enter the human body through air, they will cause allergic reactions in eyes, nasal mucosa, lungs, and respiratory system, and if these particles enter the body of potential person through food, they will cause allergic reactions in mouth, stomach, and other digestive systems. Occasionally, chemical materials produced by human body such as Histamine cause problems like: developing of nasal polyps, nasal blockage, sleep disturbance, risk of asthma developing, blood vasodilation, sneezing, eye tears, itching and swelling of eyes and nasal mucosa, Urticaria, decrease in blood pressure, and rarely trauma, anesthesia, anaphylaxis and finally death. This article is going to study the reasons of hay fever prevalence in Iran and India and presents prevention and treatment Method from Phytochemistry and Pharmocognocy point of view by using local natural products in these two countries.

Keywords: hay fever, India, Iran, natural treatment, phytochemistry

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Authors: Armin Khaghani Boroujeni, Leila Dehghani, Parham Talebi Boroujeni, Sahar Rostamian, Ali Asilian

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Background: Hair loss is a common complaint observed in both genders. Androgenetic alopecia is known pattern for hair loss. To assess new regenerative strategies (PRP, A-SC-BT, conditioned media, exosome-based treatments) compared to conventional therapies for hair loss or hair regeneration, an updated review was undertaken. To address this issue, we carried out this systematic review to comprehensively evaluate the efficacy of cell-based therapies on hair loss. Methods: The available online databases, including ISI Web of Science, Scopus, and PubMed, were searched systematically up to February 2022. The quality assessment of included studies was done using the Cochrane Collaboration's tool. Results: As a result, a total of 90 studies involving 2345 participants were included in the present study. The enrolled studies were conducted between 2010 and 2022. The subjects’ mean age ranged from 19 to 55.11 years old. Approaches using platelet rich plasma (PRP) provide a beneficial impact on hair regrowth. However, other cell-based therapies, including stem cell transplant, stem cell-derived conditioned medium, and stem cell-derived exosomes, revealed conflicting evidence. Conclusion: However, cell-based therapies for hair loss are still in their infancy, and more robust clinical studies are needed to better evaluate their mechanisms of action, efficacy, safety, benefits, and limitations. In this review, we provide the resources to the latest clinical studies and a more detailed description of the latest clinical studies concerning cell-based therapies in hair loss.

Keywords: cell-based therapy, exosome, hair restoration, systematic review

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Authors: Gabriel Sunday Ayayia

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Food waste has reached alarming levels worldwide, contributing to food insecurity, resource depletion, and environmental degradation. While numerous strategies exist to mitigate this issue, the role of traditional practices and indigenous knowledge remains underexplored. There is a need to investigate how these age-old practices can contribute to sustainable food waste reduction, particularly in the African context. This study explores the potential of traditional practices and indigenous knowledge in Africa to address this challenge sustainably. The study examines traditional African food management practices and indigenous knowledge related to food preservation and utilization; assess the impact of traditional practices on reducing food waste and its broader implications for sustainable development, and identify key factors influencing the continued use and effectiveness of traditional practices in contemporary African societies. Thus, the study argues that traditional practices and indigenous knowledge in Africa offer valuable insights and strategies for sustainable food waste reduction that can be adapted and integrated into global initiatives This research will employ a mixed-methods approach, combining qualitative and quantitative research techniques. Data collection will involve in-depth interviews, surveys, and participant observations in selected African communities. Moreover, a comprehensive review of literature on traditional food management practices and their impact on food waste reduction will be conducted. The significance of this study lies in its potential to bridge the gap between traditional knowledge and modern sustainability efforts. By uncovering the value of traditional practices in reducing food waste, this research can inform policies, interventions, and awareness campaigns aimed at achieving sustainable food systems worldwide.

Keywords: traditional practices, indigenous knowledge, food waste reduction, sustainability

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Authors: Charlotte Dreger, Erik Bollaert

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This paper presents two environmentally-friendly coastal structures realized on the Lake of Neuchâtel. Both structures reflect current environmental issues of concern on the lake and have been strongly affected by extreme meteorological conditions between their period of design and their actual operational period. The Lake of Neuchatel is one of the biggest Swiss lakes and measures around 38 km in length and 8.2 km in width, for a maximum water depth of 152 m. Its particular topographical alignment, situated in between the Swiss Plateau and the Jura mountains, combines strong winds and large fetch values, resulting in significant wave heights during storm events at both north-east and south-west lake extremities. In addition, due to flooding concerns, historically, lake levels have been lowered by several meters during the Jura correction works in the 19th and 20th century. Hence, during storm events, continuous erosion of the vulnerable molasse shorelines and sand banks generate frequent and abundant littoral transport from the center of the lake to its extremities. This phenomenon does not only cause disturbances of the ecosystem, but also generates numerous problems at natural or man-made infrastructures located along the shorelines, such as reed plants, harbor entrances, canals, etc. A first example is provided at the southwestern extremity, near the city of Yverdon, where an ensemble of 11 small islands, the Iles des Vernes, have been artificially created in view of enhancing biological conditions and food availability for bird species during their migration process, replacing at the same time two larger islands that were affected by lack of morphodynamics and general vegetalization of their surfaces. The article will present the concept and dimensioning of these islands based on 2D numerical modelling, as well as the realization and follow-up campaigns. In particular, the influence of several major storm events that occurred immediately after the works will be pointed out. Second, a sediment retention dike is discussed at the northeastern extremity, at the entrance of the Canal de la Broye into the lake. This canal is heavily used for navigation and suffers from frequent and significant sedimentation at its outlet. The new coastal structure has been designed to minimize sediment deposits around the exutory of the canal into the lake, by retaining the littoral transport during storm events. The article will describe the basic assumptions used to design the dike, as well as the construction works and follow-up campaigns. Especially the huge influence of changing meteorological conditions on the littoral transport of the Lake of Neuchatel since project design ten years ago will be pointed out. Not only the intensity and frequency of storm events are increasing, but also the main wind directions alter, affecting in this way the efficiency of the coastal structure in retaining the sediments.

Keywords: meteorological evolution, sediment transport, lake of Neuchatel, numerical modelling, environmental measures

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Authors: Lalanthica Yogendran, Manassa Hany, Saira Pasha, Benjamin Chaucer, Simarpreet Kaur, Christopher Janusz

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Children and adolescent patients visit the Psychiatric Emergency Department (ED) for multiple reasons. Visiting the Psychiatric ED itself can be a traumatic experience that can affect an adolescents mental well-being, regardless of a history of mental illness. Despite this, limited research exists in this domain. Prospective studies have correlated adverse psychosocial determinants among adolescents to risk factors for poor well-being and unfavorable behavior outcomes. Studies have also shown that physiological stress is a contributor in the development of health problems and an increase in substance abuse in adolescents. This study aimed to retrospectively determine which psychosocial factors are associated with an increase in psychiatric ED visits. 600 charts of patients who had a psychiatric ED and inpatient admission visit from January 2014 through December 2014 were reviewed. Sociodemographics, diagnoses, ED visits and inpatient admissions were collected. Descriptive statistics, chi-square tests and independent t-test analyses were utilized to examine differences in the sample to determine which factors affected ED visits and admissions. The sample was 50% female, 35.2% self-identified black, and had a mean age of 13 years. The majority, 85%, went to public school and 17% were in special education. Attention Deficit Hyperactivity Disorder was the most common admitting diagnosis, found in 132(23%) responders. Most patients came from single parent household 305 (53%). The mean ages of patients that were sexually active, with legal issues, and reporting marijuana substance abuse were 15, 14.35, and 15 years respectively. Patients from two biological parent households had significantly fewer ED visits (1.2 vs. 1.7, p < 0.01) and admissions (0.09 vs. 0.26, p < 0.01). Among social factors, those who reported sexual, physical or emotional abuse had a significantly greater number of ED visits (2.1 vs. 1.5, p < 0.01) and admissions (0.61 vs. 0.14, p < 0.01) than those who did not. Patients that were sexually active or had legal issues or substance abuse with marijuana had a significantly greater number of admissions (0.43 vs. 0.17, p < 0.01), (0.54 vs. .18, p < 0.01) and (0.46 vs. 0.18, p < 0.01) respectively. This data supports the theory of the stability of a two parent home. Dual parenting plays a role in creating a safe space where a child can develop; this is shown by subsequent decreases in psychiatric ED visits and admissions. This may highlight the psychological protective role of a two parent household. Abuse can exacerbate existing psychiatric illness or initiate the onset of new disease. Substance abuse and legal issues result in early induction to the criminal system. Results show that this causes an increase in frequency of visits and severity of symptoms. Only marijuana, but not other illicit substances, correlated with higher incidence of psychiatric ED visits. This may speak to the psychotropic nature of tetrahydrocannabinols and their role in mental illness. This study demonstrates the array of psychosocial factors that lead to increased ED visits and admissions in children and adolescents.

Keywords: adolescent, child psychiatry, emergency department, substance abuse

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Authors: M. Abdullah Al Faruque, Rechana Remadevi, Abu Naser M. Ahsanul Haque, Joselito Razal, Xungai Wang, Maryam Naebe

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Generally, the colouration of textile fibres is performed by using synthetic colourants in dope dyeing or conventional dyeing methods. However, the toxic effect of some synthetic colorants due to long-term exposure can cause several health threats including cancer, asthma and skin diseases. Moreover, in colouration process, these colourants not only consume a massive amount of water but also generates huge proportion of wastewater to the environment. Despite having the environmentally friendly characteristics, current natural colourants have downsides in their yield and need chemical extraction processes which are water consuming as well. In view of this, the present work focuses to develop a chemical-free biocompatible and natural pigment based colouration technique to colour regenerated fibres. Waste alpaca fibre was used as a colourant and the colour properties, as well as the mechanical properties, of the regenerated fibres were investigated. The colourant from waste alpaca was fabricated through mechanical milling process and it was directly applied to the polyacrylonitrile (PAN) dope solution in different ratios of alpaca: PAN (10:90, 20:80, 30:70). The results obtained from the chemical structure characterization suggested that all the coloured regenerated fibres exhibited chemical functional groups of both PAN and alpaca. Furthermore, the color strength was increased gradually with the increment of alpaca content and showed excellent washing fastness properties. These results reveal a potential new pathway for chemical-free dyeing technique for fibres with improved properties.

Keywords: alpaca, chemical-free coloration, natural colorant, polyacrylonitrile, water consumption, wet spinning

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Authors: Han Xiao, Zhang Lei, Huang Hai, Lv Shizeng

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Space environment simulator is a device for spacecraft test. KM8 large space environment simulator built in Tianjing Space City is the largest as well as the most advanced space environment simulator in China. Large deviation of spacecraft level will lead to abnormally work of the thermal control device in spacecraft during the thermal vacuum test. In order to avoid thermal vacuum test failure, level adjusting mechanism system is developed in the KM8 large space environment simulator as one of the most important subsystems. According to the level adjusting requirements of spacecraft’s thermal vacuum tests, the four fulcrums adjusting model is established. By means of collecting level instruments and displacement sensors data, stepping motors controlled by PLC drive four supporting legs simultaneous movement. In addition, a PID algorithm is used to control the temperature of supporting legs and level instruments which long time work under the vacuum cold and black environment in KM8 large space environment simulator during thermal vacuum tests. Based on the above methods, the data acquisition and processing, the analysis and calculation, real time adjustment and fault alarming of the level adjusting mechanism system are implemented. The level adjusting accuracy reaches 1mm/m, and carrying capacity is 20 tons. Debugging showed that the level adjusting mechanism system of KM8 large space environment simulator can meet the thermal vacuum test requirement of the new generation spacecraft. The performance and technical indicators of the level adjusting mechanism system which provides important support for the development of spacecraft in China have been ahead of similar equipment in the world.

Keywords: space environment simulator, thermal vacuum test, level adjusting, spacecraft, parallel mechanism

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Authors: Christina Killian, Katie Wall, Séamus Fanning, Guerrino Macori

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Deep-level metagenomics offers a useful technical approach to explore the three dynamic One Health axes: healthcare, domiciliary and veterinary. There is currently limited understanding of the composition of complex biofilms, natural abundance of AMR genes and gene transfer occurrence in these ecological niches. By using a newly established small-scale complex biofilm model, COMBAT has the potential to provide new information on microbial diversity, antimicrobial resistance (AMR)-encoding gene abundance, and their transfer in complex biofilms of importance to these three One Health axes. Shotgun metagenomics has been used to sample the genomes of all microbes comprising the complex communities found in each biofilm source. A comparative analysis between untreated and biocide-treated biofilms is described. The basic steps include the purification of genomic DNA, followed by library preparation, sequencing, and finally, data analysis. The use of long-read sequencing facilitates the completion of metagenome-assembled genomes (MAG). Samples were sequenced using a PromethION platform, and following quality checks, binning methods, and bespoke bioinformatics pipelines, we describe the recovery of individual MAGs to identify mobile gene elements (MGE) and the corresponding AMR genotypes that map to these structures. High-throughput sequencing strategies have been deployed to characterize these communities. Accurately defining the profiles of these niches is an essential step towards elucidating the impact of the microbiota on each niche biofilm environment and their evolution.

Keywords: COMBAT, biofilm, metagenomics, high-throughput sequencing

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Authors: Zelda Jansen Van Rensburg

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Purpose: This study investigates the perceived disparities between Quantity Surveying and Commercial Management in the construction industry, questioning if these differences are substantive or merely semantic. It aims to challenge the conventional notion of Commercial Managers’ superiority by critically evaluating QS and CM roles, exploring CM integration possibilities, examining qualifications for aspiring Commercial Managers, assessing regulatory frameworks, and considering terminology redefinition for global QS professional enhancement. Design: Utilizing mixed methods like literature reviews, surveys, interviews, and document analyses, this research examines the QS-CM relationship. Insights from industry professionals, academics, and regulatory bodies inform the investigation into changing QS roles. Findings: Empirical data highlight evolving roles, showcasing areas of convergence and divergence between QSs and CM. Potential CM integration into QS practice and qualifications for aspiring Commercial Managers are identified. Limitations/Implications: Limitations include potential bias in self-reported data and findings. Nevertheless, the research informs future practices and educational approaches in QS and CM, reflecting the changing roles and responsibilities of Quantity Surveyors. Practical Implications: Findings inform industry practitioners, educators, and regulators, stressing the need to adapt to changing QS roles and integrate CM principles where applicable. Value to the Conference Theme: Aligned with ‘Evolving roles and responsibilities of Quantity Surveyors,’ this research offers insights crucial for understanding the changing dynamics within the QS profession and informs strategies to navigate these shifts effectively.

Keywords: quantity surveying, commercial management, cost engineering, quantity survey

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Authors: Kh. Dehkordi, R. Sharifi Gholam, S. Arshadi

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Objective: Oxidative stress is produced under diabetic conditions and possibly causes various forms of tissue damage inpatients with diabetes. Antioxidants defend against the harmful effect of free radicals, which are associated with heart disease, cancer, arthritis, aging and many other diseases1). Antioxidants are very stable molecules capable of neutralizing free radicals by donating an electron to them.The aim of this study was to examine the effect of swimming training, fenugreek seed extract and glibenclamide on plasma glucose and cardiac antioxidants activity in diabetic rats. Design: For this purpose, fifty male wistar rats were divided into five groups, two groups of control rats (diabetic control [DC] and healthy control [HC]), one group of endurance swimming training (EST), one group of fenugreek seed extract highdose (F1, 1.74 g/kg b.w), one group of fenugreek seed extract middle dose (F2, 0.87 g/kg b.w), one group of glibenclamide (G, 0.5 mg/kg b.w). Materials and Methods: Diabetes induced by streptozotocine (STZ), data was analyzed using the one-way ANOVA followed by a Tukey test. Significance level was 0.05. Results: All of the groups' exception of HC showed significant decrease in body weight (P < 0.05), but the diabetic control and swimming training group exhibited a more decrease. All of the groups have shown a significant decrease in plasma glucose than DC group (P < 0.05) but this reduction was more in G group than DC no HC group. S, G and HC groups have shown significant increase in cardiac antioxidant than DC group (P < 0.05) but there wasn't significant difference in other groups (P > 0.05). Conclusion: The present results indicate that regular swimming training lead to decrease in plasma glucose and enhanced cardiac antioxidants in diabetic rats.

Keywords: swimming, glucose, cardiac, antioxidants

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Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Afsaneh Bayat, Amin Asadi Hieh

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The purpose of this research was to investigate the pattern of structural relationships of quality of life based on anxiety and rumination with the mediation of personality types in psoriasis patients. Methods: The community of this research is made up of the members of Psoriasis Society of Iran - Sadafak. In the sample size of 2266 people, according to Morgan's table, 327 people will be considered as a statistical sample. To assess the quality of life, the 26-item questionnaire of the World Health Organization, anxiety with software SPSS and appropriate to the conditions were used to test the hypotheses, correlation matrix tests and factor analysis. Results: There is a relationship between quality of life with anxiety and rumination in psoriasis patients. The mediating role of personality types showed Psychotic annoyance has a significant relationship with anxiety (physical and emotional symptoms). Extraversion, agreeing and being conscientious play a mediating role in a significant relationship between quality of life in psoriasis patients. Also, irritability plays a mediating role in a meaningful relationship between rumination in psoriasis patients. Conclusion: According to the obtained results, it can be said that psoriasis patients with physical and emotional symptoms of anxiety and rumination have a low quality of life. Also, negative personality types (perfectionism and neuroticism) can cause or aggravate skin disorders in these patients. In other words, psychological factors are considered predisposing, accelerating and perpetuating factors in psoriasis skin disorders, so it is suggested to pay attention to these variables in the success of treating patients with psoriasis.

Keywords: quality of life, anxiety, rumination, personality types, psoriasis.

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Authors: Ghadeer A.Al-Jabaree, Husam Aldeen Al-Khadash, M. Nassar

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This study aimed at investigating the effect of well-designed corporate governance system on the financial stability of insurance companies listed in ASE. Further, this study provides a comprehensive model for evaluating and analyzing insurance companies' financial position and prospective for comparing the degree of corporate governance application provisions among Jordanian insurance companies. In order to achieve the goals of the study, a whole population that consist of (27) listed insurance companies was introduced through the variables of (board of director, audit committee, internal and external auditor, board and management ownership and block holder's identities). Statistical methods were used with alternative techniques by (SPSS); where descriptive statistical techniques such as means, standard deviations were used to describe the variables, while (F) test and ANOVA analysis of variance were used to test the hypotheses of the study. The study revealed the existence of significant effect of corporate governance variables except local companies that are not listed in ASE on financial stability within control variables especially debt ratio (leverage),where it's also showed that concentration in motor third party doesn't have significant effect on insurance companies' financial stability during study period. Moreover, the study concludes that Global financial crisis affect the investment side of insurance companies with insignificant effect on the technical side. Finally, some recommendations were presented such as enhancing the laws and regulation that help the appropriate application of corporate governance, and work on activating the transparency in the disclosures of the financial statements and focusing on supporting the technical provisions for the companies, rather than focusing only on profit side.

Keywords: corporate governance, financial stability and solvency margin, insurance companies, Jordan

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Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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Authors: L. Lamola, E. Manolas, A. Krause

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Background: The incidence of childhood cancer incidence is increasing gradually in low-middle income countries, such as South Africa. Globally, there is an extensive range of familial- and hereditary-cancer syndromes, where underlying germline variants increase the likelihood of developing cancer in childhood. Next-Generation Sequencing (NGS) technologies have been key in determining the occurrence and genetic contribution of germline variants to paediatric cancer development. We aimed to design and evaluate a candidate gene panel specific to inherited cancer-predisposing genes to provide a comprehensive insight into the contribution of germline variants to childhood cancer. Methods: 32 paediatric patients (aged 0-18 years) diagnosed with a malignant tumour were recruited, and biological samples were obtained. After quality control, DNA was sequenced using an ion Ampliseq 50 candidate gene panel design and Ion Torrent S5 technologies. Sequencing variants were called using Ion Torrent Suite software and were subsequently annotated using Ion Reporter and Ensembl's VEP. High priority variants were manually analysed using tools such as MutationTaster, SIFT-INDEL and VarSome. Putative identified candidates were validated via Sanger Sequencing. Results: The patients studied had a variety of cancers, the most common being nephroblastoma (13), followed by osteosarcoma (4) and astrocytoma (3). We identified 10 pathogenic / likely pathogenic variants in 10 patients, most of which were novel. Conclusions: According to the literature, we expected ~10% of our patient population to harbour pathogenic or likely pathogenic germline variants, however, we reported about 3 times (~30%) more than we expected. Majority of the identified variants are novel; this may be because this is the first study of its kind in an understudied South African population.

Keywords: Africa, genetics, germline-variants, paediatric-cancer

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Authors: Hiba El Assibi

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This study aims to weakly solve Kalah, a two-player board game, by developing a start-to-finish winning strategy using an optimized Minimax algorithm with Alpha-Beta Pruning. In weakly solving Kalah, our focus is on creating an optimal strategy from the game's beginning rather than analyzing every possible position. The project will explore additional enhancements like symmetry checking and code optimizations to speed up the decision-making process. This approach is expected to give insights into efficient strategy formulation in board games and potentially help create games with a fair distribution of outcomes. Furthermore, this research provides a unique perspective on human versus Artificial Intelligence decision-making in strategic games. By comparing the AI-generated optimal moves with human choices, we can explore how seemingly advantageous moves can, in the long run, be harmful, thereby offering a deeper understanding of strategic thinking and foresight in games. Moreover, this paper discusses the evaluation of our strategy against existing methods, providing insights on performance and computational efficiency. We also discuss the scalability of our approach to the game, considering different board sizes (number of pits and stones) and rules (different variations) and studying how that affects performance and complexity. The findings have potential implications for the development of AI applications in strategic game planning, enhancing our understanding of human cognitive processes in game settings, and offer insights into creating balanced and engaging game experiences.

Keywords: minimax, alpha beta pruning, transposition tables, weakly solving, game theory

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Authors: Pratima Tatke, Archana Avhad, Bhanu Duggal, Meeta Rajivlochan, Sujata Saunik, Pradip Vyas, Nidhi Pandey, Aditee Dalvi, Jyothi Subramanian

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Background: Smoking is well established risk factor for the development and progression of coronary artery disease. It is strongly related to morbidity and mortality from cardiovascular causes. The aim of this study is to observe effect of smoking status on percutaneous coronary intervention(PCI) after 1 year. Methods: 2527 patients who underwent PCI at different hospital of Maharashtra(India) from 2012 to 2015 under the health insurance scheme which is launched by Health department, Government of Maharashtra for below poverty line(BPL) families which covers cardiology. Informed consent of patients was taken .They were followed by telephonic survey after 6months to 1year of PCI . Outcomes of interest included myocardial infarction, restenosis, cardiac rehospitalization, death, and a composite of events after PCI. Made group of two non smokers-1861 and smokers (including patients who quit at time of PCI )-659. Results: Statistical Analysis using Pearson’s chi square test revealed that there was trend seen of increasing incidence of death, Myocardial infarction and Restenosis in smokers than non smokers .Smokers had a greater death risk compared to nonsmoker; 5.7% and 5.1% respectively p=0.518. Also Repeat procedures (2.1% vs. 1.5% p=0.222), breathlessness (17.8% vs. 18.20% p=0.1) and Myocardial Infarction (7.3% vs. 10%) high in smoker than non smokers. Conclusion: Major adverse cardiovascular events (MACE) were observed even after successful PCI in smokers. Patients undergoing percutaneous coronary intervention should be encouraged to stop smoking.

Keywords: coronary artery diseases, major adverse cardiovascular events, percutaneous coronary intervention, smoking

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Authors: Mark Linden, Trisha Forbes, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes

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Background The COVID-19 pandemic resulted in a reduction of health care services for many family carers of people with profound and multiple intellectual disabilities (PMID). Due to lack of services, family carers turned to charities for support during the pandemic. We explored the views of charity workers across the UK and Ireland who supported family carers during the COVID-19 pandemic and explored their views on effective online support programmes for family carers. Methods This was a qualitative study using online focus groups with participants (n = 24) from five charities across the UK and Ireland. Questions focused on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were audio recorded, transcribed verbatim, and analysed through thematic analysis. Findings Four themes were identified (i) ‘mental and emotional health’, (ii) ‘they who shout the loudest’ (fighting for services), (iii) ‘lack of trust in statutory services’ and (iv) ‘creating an online support programme’. Mental and emotional health emerged as the most prominent theme and included three subthemes named as ‘isolation’, ‘fear of COVID-19’ and ‘the exhaustion of caring’. Conclusions The withdrawal of many services during the COVID-19 pandemic further isolated and placed strain on family carers. Even after the end of the pandemic family cares continue to report on the struggle to receive adequate support. There is a critical need to design services, including online support programmes, in partnership with family carers which adequately address their needs.

Keywords: intellectual disability, family carers, COVID-19, charities

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Authors: Basant H. El-Refay, Nabeel T. Faiad

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Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.

Keywords: children, hypocaloric diet, lower body positive pressure supported treadmill, obesity

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Authors: Motoki Seguchi, Fumiko Harada, Hiromitsu Shimakawa

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There have been many local companies in countryside that carefully produce and sell products, which include crafts and foods produced with traditional methods. These companies are likely to use commercials to advertise their products. However, it is difficult for companies to judge whether the commercials they create are having an impact on consumers. Therefore, to create effective commercials, this study researches what kind of gimmicks in commercials affect what kind of consumers. This study proposes a method for extracting psychological change points from the physiological characteristics of consumers while they are watching commercials and estimating the gimmicks in the commercial that affect consumer engagement. In this method, change point detection is applied to pupil size for estimating gimmicks that affect consumers’ emotional engagement, and to EDA for estimating gimmicks that affect cognitive engagement. A questionnaire is also used to estimate the commercials that influence behavioral engagement. As a result of estimating the gimmicks that influence consumer engagement using this method, it was found that there are some common features among the gimmicks. To influence cognitive engagement, it was found that it was useful to include flashback scenes, messages to be appealed to, the company’s name, and the company’s logos as gimmicks. It was also found that flashback scenes and story climaxes were useful in influencing emotional engagement. Furthermore, it was found that the use of storytelling commercials may or may not be useful, depending on which consumers are desired to take which behaviors. It also estimated the gimmicks that influence consumers for each target and found that the useful gimmicks are slightly different for students and working adults. By using this method, it can understand which gimmicks in the commercial affect which engagement of the consumers. Therefore, the results of this study can be used as a reference for the gimmicks that should be included in commercials when companies create their commercials in the future.

Keywords: change point detection, estimating engagement, physiological characteristics, psychological changes, watching commercials

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Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos

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Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.

Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing

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Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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Authors: Wesam Darawsheh

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Purpose: There is an absence of studies directed to evaluate the effectiveness of Community Based Rehabilitation (CBR) programs in Jordan. This research study is aimed at investigating the effectiveness of the services of CBR programmes in Jordan. Method: A questionnaire anonymized survey was carried out with forty-seven participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised eighteen questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The survey assessed participants’ knowledge of CBR and perception of the effectiveness of services provided. The quantitative data were analyzed using SPSS Version 22.0 (2016, IBM Corporation New York). Qualitative data were analyzed through thematic content and analysis and open coding to identify emergent themes. Results: The ROC curve revealed that the AUC for questions of the survey to be (AUC=0.846) which indicated a good specificity and sensitivity of the questions of the survey. The MANOVA revealed insignificant results in the effect of the CBR site (p= 0.157), and the level of education of participants (p=0.549), on the perception of the effectiveness of CBR services. There were insignificant differences between the scores of PWDs and volunteers (p=0.781). 40.4% evaluated the effectiveness of CBR services to be low. This mainly stemmed out from the lack of efforts of the CBR programmes to raise the knowledge of the local community about CBR, disability and the role toward PWDs. Conclusions: A speculation for priorities of CBR programmes in Jordan was offered where efforts need to be directed at promoting livelihood and the empowerment components, in order to actualize the main three principles of CBR mainly by promoting multispectral collaboration as a way of operation.

Keywords: community based rehabilitation (CBR), people with disabilities (PWDS), CBR centres, rehabilitation services, Jordan, mixed-methods, evaluative study

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Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

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Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

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Authors: Hanan Yousef, Nisreen Naji Al-Khawaldeh

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The present study investigates the use of the expression of refusal by native speakers of Jordanian Arabic (NSsJA) in different social situations (i.e. invitations, suggestions, and offers). It also investigates the influence of gender on the refusal realization patterns within the Jordanian culture to provide a better insight into the relation between situations, strategies and gender in the Jordanian culture. To that end, a group of 70 participants, including 35 male and 35 female students from different departments at the Hashemite University (HU) participated in this study using mixed methods (i.e. Discourse Completion Test (DCT), interviews and naturally occurring data). Data were analyzed in light of a developed coding scheme. The results showed that NSsJA preferred indirect strategies which mitigate the interaction such as "excuse, reason and, explanation" strategy more than other strategies which aggravate the interaction such as "face-threatening" strategy. Moreover, the analysis of this study has revealed a considerable impact of gender on the use of linguistic forms expressing refusal among NSsJA. Significant differences in the results of the Chi-square test relating the effect of participants' gender indicate that both males and females were conscious of the gender of their interlocutors. The findings provide worthwhile insights into the relation amongst types of communicative acts and the rapport between people in social interaction. They assert that refusal should not be labeled as face threatening act since it does not always pose a threat in some cases especially where refusal is expressed among friends, relatives and family members. They highlight some distinctive culture-specific features of the communicative acts of refusal.

Keywords: gender, Jordanian Arabic, politeness, refusals, speech act

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Authors: Nashed Atef Nashed Farag

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Introduction: Reporting adverse events following vaccination remains a challenge. WHO has mandated pharmacovigilance centers around the world to submit Adverse Events Following Immunization (AEFI) reports from different countries to a large electronic database of adverse drug event data called Vigibase. Despite sufficient information about AEFIs on Vigibase, they are not available to the general public. However, the WHO has an alternative website called VigiAccess, an open-access website that serves as an archive for reported adverse reactions and AEFIs. The aim of the study was to establish a reporting model for a number of commonly used vaccines in the VigiAccess system. Methods: On February 5, 2018, VigiAccess comprehensively searched for ESSI reports on the measles vaccine, oral polio vaccine (OPV), yellow fever vaccine, pneumococcal vaccine, rotavirus vaccine, meningococcal vaccine, tetanus vaccine, and tuberculosis vaccine (BCG). These are reports from all pharmacovigilance centers around the world since they joined the WHO Drug Monitoring Program. Results: After an extensive search, VigiAccess found 9,062 AEFIs from the measles vaccine, 185,829 AEFIs from the OPV vaccine, 24,577 AEFIs from the yellow fever vaccine, 317,208 AEFIs from the pneumococcal vaccine, 73,513 AEFIs from the rotavirus vaccine, and 145,447 AEFIs from meningococcal cal vaccine, 22,781 EI FI vaccines against tetanus and 35,556 BCG vaccines against AEFI. Conclusion: The study found that among the eight vaccines examined, pneumococcal vaccines were associated with the highest number of AEFIs, while measles vaccines were associated with the fewest AEFIs.

Keywords: surgical approach, anatomical approach, decompression, axillary nerve, quadrangular space adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK vaccines, adverse reactions, VigiAccess, adverse event reporting

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