Search results for: alternative medication

Authors: Derya Nizam

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An alternative understanding of "localization" has gained significance as the ecological and social issues associated with the growing pressure of agricultural homogeneity and standardization become more apparent. Through an analysis of a case study on an alternative food networks in Turkey, this research seeks to critically examine the localization movement. The results indicate that the idea of localization helps to create new niche markets by creating place-based labels, but it also strengthens local identities through social networks that connect rural and urban areas. In that context, localization manifests as a commodification movement that appropriates local and cultural values to generate capitalist profit, as well as a grassroots movement that strengthens the resilience of local communities. This research addresses the potential of community development approaches in the democratization of global agro-food networks.

Keywords: community building, local food, alternative food movements, localization

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Authors: Carolyne Ndungu, Wesley Too, Diana Kassaman

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Diabetes is a global public health problem with an increasing morbidity and mortality rate across the globe. It is reported that 422 million people worldwide have diabetes with type 2 diabetes more common in people of African descent. Whilst prevalence of diabetes is four times more than it was in the last three decades, making it the world's ninth greatest cause of mortality, treatment of complications resulting from poor glycemic control is still high, contributing to poverty level in sub-Saharan. Poor treatment adherence has also been identified as a major contributing factor poor glycemic control among diabetic patients and still remains a significant challenge especially among patients living in rural Kenya. This study therefore seeks to identify gaps, barriers and challenges towards medication non-adherence among diabetic patients on follow-up at Kiambu County Referral Hospital, Kenya. Methods: A cross- sectional descriptive study was carried out at Gatundu Level five Hospital in Kiambu County. The study population consisted of adult patients with type two diabetes mellitus (T2DM) on follow up, at the Diabetes clinic between the month of June to July 2022. Systematic sampling of 200 participants was carried out. Ethical approvals from relevant authorities were done and ethical aspects of the study were also observed. Data analysis is ongoing using logistic regression analysis. Results, recommendations -contribution of this study will be highlighted within the next one month.

Keywords: adherence, diabetes, medication, Kenya

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Authors: Berit Johannessen

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Introduction: Depression and dementia are the two most common psychiatric disorders of older people. The use of antidepressants does not always have the desired effect and serious side effects are common. Aroma therapists claim that the essential oil of Bergamot has an antidepressant effect. Aromatherapy is defined as holistic or complementary medicine and is rarely used in the Norwegian public health service, but in recent years, there has been an increasing interest in, and use of complementary and alternative therapies (CAM) in the Norwegian population, and aromatherapy is one of the most widely used. Focus for this study: How do nurses experience the use of Bergamot essential oil for patients suffering from dementia and depression? Method: Action research study including 12 patients and 8 nurses. The patients were strategically selected by the nurses and were given Bergamot in a fan diffuser every day for 12 weeks. The patients' mood and behavior patterns were reported daily and the nurse`s experiences were reported weekly. Individual interviews with the nurses were conducted at the end of the project. Results: The nurses reported that bergamot had positive impact on patients mood and wellbeing, and was considered as an effective method for six patients, four had uncertain effect and two had no effect. They also reported less use of medication and that the fan diffusers were easy and pleasant to administer. They found the use of natural remedies as Bergamot inspiring and wanted to learn more about aromatherapy and its use in nursing. Some were disturbed by the smell and some had to deal with critical and negative colleagues. Conclusion: Nurses experienced aromatherapy using bergamot oil in fan diffusers as a simple and useful procedure for patients suffering from dementia and depression. The effects were varying. Further research is needed.

Keywords: aromatherapy, bergamot, dementia, depression

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Authors: Louise Penzenstadler, Tiphaine Robet, Radu Iuga, Daniele Zullino

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Context: The outpatient clinic of the psychiatric addiction service of Geneva University Hospital has been providing support to individuals affected by various narcotics for 30 years. However, the increasing consumption of crack cocaine in Geneva has presented a new challenge for the healthcare system. Research Aim: The aim of this research is to evaluate the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder. Methodology: The research utilizes a combination of quantitative and qualitative retrospective data analysis to evaluate the effectiveness of the outreach intervention. Findings: The data collected from October 2023 to December 2023 show that the outreach program successfully made 1,071 contacts with drug users and led to 15 new requests for care and enrollment in treatment. Patients expressed high satisfaction with the intervention, citing easy and rapid access to treatment and social support. Theoretical Importance: This research contributes to the understanding of the challenges and specific needs of a complex group of drug users who face severe health problems. It highlights the importance of outreach interventions in establishing trust, connecting users with care, and facilitating medication-assisted treatment for opioid addiction. Data Collection: Data was collected through the outreach program's interactions with drug users, including street outreach interventions and presence at locations frequented by users. Patient satisfaction surveys were also utilized. Analysis Procedures: The collected data was analyzed using both quantitative and qualitative methods. The quantitative analysis involved examining the number of contacts made, new requests for care, and treatment enrollment. The qualitative analysis focused on patient satisfaction and their perceptions of the intervention. Questions Addressed: The research addresses the following questions: What is the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder? How effective is the outreach program in connecting drug users with care and initiating medication-assisted treatment? Conclusion: The outreach program has proven to be an effective intervention in establishing trust with crack users, connecting them with care, and initiating medication-assisted treatment for opioid addiction. It has also highlighted the importance of addressing the specific challenges faced by this group of drug users.

Keywords: crack addiction, outreach treatment, peer intervention, polydrug use

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Authors: P. Ninduangdee, V. I. Kuprianov

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Palm kernel shell is an important bioenergy resource in Thailand. However, due to elevated alkali content in biomass ash, this oil palm residue shows high tendency to bed agglomeration in a fluidized-bed combustion system using conventional bed material (silica sand). In this study, palm kernel shell was burned in the conical fluidized-bed combustor (FBC) using alumina and dolomite as alternative bed materials to prevent bed agglomeration. For each bed material, the combustion tests were performed at 45kg/h fuel feed rate with excess air within 20–80%. Experimental results revealed rather weak effects of the bed material type but substantial influence of excess air on the behaviour of temperature, O2, CO, CxHy, and NO inside the reactor, as well as on the combustion efficiency and major gaseous emissions of the conical FBC. The optimal level of excess air ensuring high combustion efficiency (about 98.5%) and acceptable level of the emissions was found to be about 40% when using alumina and 60% with dolomite. By using these alternative bed materials, bed agglomeration can be prevented when burning the shell in the proposed conical FBC. However, both bed materials exhibited significant changes in their morphological, physical and chemical properties in the course of the time.

Keywords: palm kernel shell, fluidized-bed combustion, alternative bed materials, combustion and emission performance, bed agglomeration prevention

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Authors: M. D. Antoine

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Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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Authors: Mariela Edith Arboit

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The main goal of the project is to explore the evolution possibilities of the morphological indicators of the built environment, including those resulting from progressive soil occupation, due to the relentless growth of the city’s population and subsequent increase in building density and solar access reduction per built unit. Two alternative normative proposals, Conventional Proposal (CP) and Alternative Proposal (AP), are compared. In addition, temporal scenarios of the city’s evolution process are analyzed, starting from the reference situation of existing, high-density built-up areas, and simulating their possible morphological outcomes on theoretical medium (30 yr.) and long (60 yr.) terms, as a result of the massive implementation of either regulation in the long run. The results obtained demonstrate that the Alternative Proposal (AP) presents higher mean values of predicted solar potential expressed by the Volumetric Insolation Factor total (VIFtot) for both time periods and services. Regarding environmental aspects, the different impacts of either alternative on the urban landscape quality seem to favor the AP proposal. Its deserved detailed assessment is also presently being developed through a quanti-qualitative methodology.

Keywords: building morphology, environmental quality, solar energy, urban sustainability

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale

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A swimming pool heating system is presented, composed of two alternative collectors with serial PVC absorber tubes that work in regimen of forced stream that is gotten through a bomb. A 500 liters reservoir was used, simulating the swimming pool, being raised some data that show the viability of the considered system. The chosen outflow was corresponding to 100 l/h. In function of the low outflow it was necessary the use of a not popular bomb, choosing the use of a low outflow alternative pumping system, using an air conditioner engine with three different rotations for the desired end. The thermal data related to each collector and their developed system will be presented. The UV and thermal degradations of the PVC exposed to solar radiation will be also boarded, demonstrating the viability of using tubes of this material as absorber elements of radiation in water heating solar collectors.

Keywords: solar energy, solar swimming pool, water heating, PVC tubes, alternative system

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Authors: Salvatore Pinna

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The growth of organic farming practices in the last few decades is continuing to stimulate the international debate about this alternative food market. As a part of a PhD project research about embeddedness in Alternative Food Networks (AFNs), this paper focuses on the promotional aspects of organic farms websites from the Madrid region. As a theoretical tool, some knowledge categories drawn on the geographic studies literature are used to classify the many ideas expressed in the web pages. By analysing texts and pictures of 30 websites, the study aims to question how and to what extent actors from organic world communicate to the potential customers their personal beliefs about farming practices, products qualities, and ecological and social benefits. Moreover, the paper raises the question of whether organic farming laws and regulations lack of completeness about the social and cultural aspects of food.

Keywords: alternative food networks, de-commoditisation, organic farming, madrid, reconnection of food

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Authors: Emmanuel U. Ohaegbulem, Felix N. Nwobi

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Alternative and simple computational arrangements in carrying out multivariate profile analysis when more than two groups (populations) are involved are presented. These arrangements have been demonstrated to not only yield equivalent results for the test statistics (the Wilks lambdas), but they have less computational efforts relative to other arrangements so far presented in the literature; in addition to being quite simple and easy to apply.

Keywords: coincident profiles, g-group profile analysis, level profiles, parallel profiles, repeated measures MANOVA

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Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim

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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.

Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure

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Authors: Satya P. Dubey, Hrushikesh A Abhyankar, Veronica Marchante, James L. Brighton, Björn Bergmann

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Aims: To develop a mathematical model that simulates the ROP of PLA taking into account the effect of alternative energy to be implemented in a continuous reactive extrusion production process of PLA. Introduction: The production of large amount of waste is one of the major challenges at the present time, and polymers represent 70% of global waste. PLA has emerged as a promising polymer as it is compostable, biodegradable thermoplastic polymer made from renewable sources. However, the main limitation for the application of PLA is the traces of toxic metal catalyst in the final product. Thus, a safe and efficient production process needs to be developed to avoid the potential hazards and toxicity. It has been found that alternative energy sources (LASER, ultrasounds, microwaves) could be a prominent option to facilitate the ROP of PLA via continuous reactive extrusion. This process may result in complete extraction of the metal catalysts and facilitate less active organic catalysts. Methodology: Initial investigation were performed using the data available in literature for the reaction mechanism of ROP of PLA based on conventional metal catalyst stannous octoate. A mathematical model has been developed by considering significant parameters such as different initial concentration ratio of catalyst, co-catalyst and impurity. Effects of temperature variation and alternative energies have been implemented in the model. Results: The validation of the mathematical model has been made by using data from literature as well as actual experiments. Validation of the model including alternative energies is in progress based on experimental data for partners of the InnoREX project consortium. Conclusion: The model developed reproduces accurately the polymerisation reaction when applying alternative energy. Alternative energies have a great positive effect to increase the conversion and molecular weight of the PLA. This model could be very useful tool to complement Ludovic® software to predict the large scale production process when using reactive extrusion.

Keywords: polymer, poly-lactic acid (PLA), ring opening polymerization (ROP), metal-catalyst, bio-degradable, renewable source, alternative energy (AE)

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Authors: Huang Gui

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There can be little doubt that our world is inexorably moving towards being execution-free. However, China is still on the way until now, in other words, China is still a retentionist state in the term of capital punishment but it is developing domestic criminal law toward that goal (eventual abolition of the capital punishment). The alternative sanction to capital punishment, which would be imposed on a criminal who should have been sentenced to death by law, is a substitute for execution and it should be provided with the basis of the present criminal punishment structure and with the premise of abolishing capital punishment or limiting its use. The aim of this paper, therefore, is to explore a substitute for capital punishment in China. For the criminal sanction system in China, the death penalty with suspension, naturally, is an execution, so it wouldn’t be the substitute; life sentences without parole is out of the tune with punishment policy that promoting correction and rehabilitation; life-imprisonment, which is one of the most severe punishment measure in the sanction system, should be a suitable substitute for executing but it needs to be improved, including the term of imprisonment, the commutation and parole conditions.

Keywords: alternative sanctions, capital punishment, life imprisonment, life imprisonment without parole, China

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Authors: Sami Ayad, Mengshan Lee

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The Sustainable Development Goals (SDGs) were designed to be the best possible blueprint to achieve peace, prosperity, and overall, a better and more sustainable future for the Earth and all its people, and such a blueprint is needed more than ever. The SDGs face many hurdles that will prevent them from becoming a reality, one of such hurdles, arguably, is the chemical pollution and unintended chemical impacts generated through the production of various goods and resources that we consume. Chemical Alternatives Assessment has proven to be a viable solution for chemical pollution management in terms of filtering out hazardous chemicals for a greener alternative. However, the current substitution practice lacks crucial quantitative datasets (exposures and life cycle impacts) to ensure no unintended trade-offs occur in the substitution process. A Chemical Life Cycle Alternative Assessment (CLiCAA) framework is proposed as a reliable and replicable alternative to Life Cycle Based Alternative Assessment (LCAA) as it integrates chemical molecular structure analysis and Chemical Life Cycle Collaborative (CLiCC) web-based tool to fill in data gaps that the former frameworks suffer from. The CLiCAA framework consists of a four filtering layers, the first two being mandatory, with the final two being optional assessment and data extrapolation steps. Each layer includes relevant impact categories of each chemical, ranging from human to environmental impacts, that will be assessed and aggregated into unique scores for overall comparable results, with little to no data. A feasibility study will demonstrate the efficiency and accuracy of CLiCAA whilst bridging both cancer potency and exposure limit data, hoping to provide the necessary categorical impact information for every firm possible, especially those disadvantaged in terms of research and resource management.

Keywords: chemical alternative assessment, LCA, LCAA, CLiCC, CLiCAA, chemical substitution framework, cancer potency data, chemical molecular structure analysis

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Authors: Olufunke Olufunmilayo Ilemobayo, Barakat. O Abdulazeez

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Profit making among poultry egg farmers has been a challenge to efficient distribution of scarce farm resources over the years, due majorly to low capital base, inefficient management, technical inefficiency, economic inefficiency, thus poultry egg production has moved into an underperformed situation, characterised by low profit margin. Though previous studies focus mainly on broiler production and efficiency of its production, however, paucity of information exist in the areas of profit efficiency in the study area. Hence, determinants of profit efficiency among poultry egg farmers in Ondo State, Nigeria were investigated. A purposive sampling technique was used to obtain primary data from poultry egg farmers in Owo and Akure local government area of Ondo State, through a well-structured questionnaire. socio-economic characteristics such as age, gender, educational level, marital status, household size, access to credit, extension contact, other variables were input and output data like flock size, cost of feeder and drinker, cost of feed, cost of labour, cost of drugs and medications, cost of energy, price of crate of table egg, price of spent layers were variables used in the study. Data were analysed using descriptive statistics, budgeting analysis, and stochastic profit function/inefficiency model. Result of the descriptive statistics shows that 52 per cent of the poultry farmers were between 31-40 years, 62 per cent were male, 90 per cent had tertiary education, 66 per cent were primarily poultry farmers, 78 per cent were original poultry farm owners and 55 per cent had more than 5 years’ work experience. Descriptive statistics on cost and returns indicated that 64 per cent of the return were from sales of egg, while the remaining 36 per cent was from sales of spent layers. The cost of feeding take the highest proportion of 69 per cent of cost of production and cost of medication the lowest (7 per cent). A positive gross margin of N5, 518,869.76, net farm income of ₦ 5, 500.446.82 and net return on investment of 0.28 indicated poultry egg production is profitable. Equipment’s cost (22.757), feeding cost (18.3437), labour cost (136.698), flock size (16.209), drug and medication cost (4.509) were factors that affecting profit efficiency, while education (-2.3143), household size (-18.4291), access to credit (-16.027), and experience (-7.277) were determinant of profit efficiency. Education, household size, access to credit and experience in poultry production were the main determinants of profit efficiency of poultry egg production in Ondo State. Other factors that affect profit efficiency were cost of feeding, cost of labour, flock size, cost of drug and medication, they positively and significantly influenced profit efficiency in Ondo State, Nigeria.

Keywords: cost and returns, economic inefficiency, profit margin, technical inefficiency

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Authors: Ragy Raafat Gaber Attaalla

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For cardiovascular illness, oral P2Y12 inhibitors including clopidogrel, prasugrel, and ticagrelor are frequently recommended. Each of these medications has advantages and disadvantages. In the absence of genotyping, it has been demonstrated that the stronger platelet aggregation inhibitors prasugrel and ticagrelor are superior than clopidogrel at preventing significant adverse cardiovascular events following an acute coronary syndrome and percutaneous coronary intervention (PCI). Both, nevertheless, come with a higher risk of bleeding unrelated to a coronary artery bypass. As a prodrug, clopidogrel needs to be bioactivated, principally by the CYP2C19 enzyme. A CYP2C19 no function allele and diminished or absent CYP2C19 enzyme activity are present in about 30% of people. The reduced exposure to the active metabolite of clopidogrel and reduced inhibition of platelet aggregation among clopidogrel-treated carriers of a CYP2C19 no function allele likely contributed to the reduced efficacy of clopidogrel in clinical trials. Clopidogrel's pharmacogenetic results are strongest when used in conjunction with PCI, but evidence for other indications is growing. One of the most typical examples of clinical pharmacogenetic application is CYP2C19 genotype-guided antiplatelet medication following PCI. Guidance is available from expert consensus groups and regulatory bodies to assist with incorporating genetic information into P2Y12 inhibitor prescribing decisions. Here, we examine the data supporting genotype-guided P2Y12 inhibitor selection's effects on clopidogrel response and outcomes and discuss tips for pharmacogenetic implementation. We also discuss procedures for using genotype data to choose P2Y12 inhibitor therapies as well as any unmet research needs. Finally, choosing a P2Y12 inhibitor medication that optimally balances the atherothrombotic and bleeding risks may be influenced by both clinical and genetic factors.

Keywords: inhibitors, cardiovascular events, coronary intervention, pharmacogenetic implementation

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Authors: Sahar Iqrar, Malik Adeel Anwar, Zain Akram, Maria Noor

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Introduction: Oral lichen planus is a chronic inflammatory condition of unknown etiology. Oral lichen planus may be related with several other diseases. Grinspan's Syndrome is characterized by a triad of oral lichen planus, hypertension, and diabetes mellitus. Other associations reported in the literature are with chronic liver disease and, with dyslipidemia. The nature of these associations is still not fully understood. Material and methods: Study was conducted in Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A total of n=89 clinically diagnosed patients of oral lichen planus of both gender and all age groups were recruited and detailed history were recorded in the designed performs. Results: A total of n=89 patients were taken with male to female ratio of 3:8 in which 24 were male and 65 females. Mean age was 48.8 ± 13.8 years. Age range of 10-74 years was seen. Among these patients suffering from oral lichen planus, 41.6% (n=37) had a positive history for hypertension with 59.5% (n=22) of these patients were taking different medication for their condition. Whereas Diabetes Mellitus was found in 24.7% (n=22) patients with 72.7% (n=16) of these patients using the hypoglycemic drug (oral or injectable) to control their blood glucose levels. Out of these n=89 lichen planus patients 21.3% had both hypertension and diabetes mellitus (fulfilling the criteria for Grinspan's Syndrome). Out of this Grinspan's Syndrome pool 94.7% (n=19) were taking drug atleast for one of the two conditions. Conclusion: As noticed form the medical history of the patients, most of them were using hypoglycemic drugs for diabetes mellitus and beta blockers, diuretics and calcium channel blockers for hypertension. These drugs are known for lichenoid reaction. Therefore, it should be ruled out at histopathological/ immunological and molecular level whether these patients are suffering from lichen planus or lichenoid drug reaction to truly declare them as patients with Grinspan’s Syndrome.

Keywords: diabetes mellitus, grinspan's syndrome, lichenoid drug reaction, oral lichen planus

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Authors: Lavan Vickneson

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In today’s modern economy, the conventional banking model is the primary banking system used around the world. A significant problem faced by the conventional banking model is the recurring nature of banking crises. History’s record of the various banking crises, ranging from the Great Depression to the 2008 subprime mortgage crisis, is testament to the fact that banking crises continue to strike despite the preventive measures in place, such as bank’s minimum capital requirements and deposit guarantee schemes. If banking crises continue to occur despite these preventive measures, it necessarily follows that there are inherent flaws with the conventional banking model itself. In light of this, a possible alternative banking model to the conventional banking model is Islamic banking. To date, Islamic banking has been a niche market, predominantly serving Muslim investors. This paper seeks to explore the possibility of Islamic banking being more than just a niche market and playing a greater role in banking sectors around the world, by being a viable alternative to the conventional banking model.

Keywords: bank crises, conventional banking model, Islamic banking, niche market

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Authors: R. Velvarska, A. Vrablik, M. Fiedlerova, R. Cerny

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Near-infrared spectrometry (NIR) was tested as a rapid and alternative tool for determination of biodiesel oxidation stability. A PetroOxy method is standardly used for the determination, but this method is hazardous due to the possibility of explosion and ignition of flammable fuels. The second disadvantage is time consuming. The near-infrared spectrometry served for the development of the calibration model which was composed of 133 real samples (calibration standards). The reference values of these standards were obtained by PetroOxy method. Many chemometric diagnostics were used for the development of the final NIR model with the aim to have accurate prediction of the oxidation stability. The final NIR model was validated by 30 validation standards. The repeatability was determined as well with the acceptable residual standard deviation (8.59 %). The NIR spectrometry has proved to be an accurate alternative method for the determination of biodiesel oxidation stability with advantages as the time and cost saving, non-destructive character of analyzing and the possibility of online monitoring in safe mode.

Keywords: biodiesel, fatty acid methyl ester, NIR, oxidation stability

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Authors: Odoh Ben Uruchi

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Access to Justice implies access to social and distributive Justice. Access to social justice in Nigeria remains an illusion where cases last in courts for unduly long period of time, as is currently the situation in the country. As the popular saying goes– justice delayed is justice denied. It is, however, important to underscore the point that these perspectives are not necessarily disconnected since the extent to which one can have distributive justice in any system is largely determined by the level and effectiveness of social justice in the country. Generally, Alternative Dispute Resolution (ADR) Processes are increasingly being accepted in Nigeria as appropriate mechanisms for resolving disputes. While some jurisdictions have institutionalized ADR through the concept of a Multidoor Courthouse, many other are at different stages of doing same. With these developments, it is obvious that stakeholders in the administration of justice in Nigeria, can no longer be indifferent about understanding and fully mainstreaming ADR into their various activities and professional practice. Any framework for promoting social justice in Nigeria should therefore of necessity include provision of avenues for use of ADR in the protection and enforcement of citizen’s rights. The constitutional and other legal provisions that guarantee various rights of citizens cannot of itself ensure the enjoyment of the rights in the absence of an effective framework for dispute resolution. Excessive reliance on litigation and other adversarial approaches will also fail to ensure a sound regime of social justice. There should be structured mainstreaming of alternative dispute resolution mechanisms in justice delivery if the society must provide and guarantee social justice to the citizens. This paper seeks to address some of the fundamental issues affecting the perception, knowledge and skills of ADR in the provision of social justice. In doing this, the paper proposes to unlock the full enormous potentials of Alternative Dispute Resolution (ADR) in promoting access to justice in Nigeria.

Keywords: aspects, dimensions, alternative dispute resolution, social justice

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Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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The history of gaseous fuel use in the motive power of vehicles dates back to the second half of the nineteenth century, and thus the beginnings of the automotive industry. The engines were powered by coal gas and became the prototype for internal combustion engines built so far. It can thus be considered that this construction gave rise to the automotive industry. As the socio-economic development advances, so does the number of motor vehicles. Although, due to technological progress in recent decades, the emissions generated by internal combustion engines of cars have been reduced, a sharp increase in the number of cars and the rapidly growing traffic are an important source of air pollution and a major cause of acoustic threat, in particular in large urban agglomerations. One of the solutions, in terms of reducing exhaust emissions and improving air quality, is a more extensive use of alternative fuels: CNG, LNG, electricity and hydrogen. In the case of electricity use for transport, it should be noted that the environmental outcome depends on the structure of electricity generation. The paper shows selected regulations affecting the use of alternative fuels for transport (including Directive 2014/94/EU) and its dynamics between 2000 and 2015 in Poland and selected EU countries. The paper also gives a focus on the impact of alternative fuels on the environment by comparing the volume of individual emissions (compared to the emissions from conventional fuels: petrol and diesel oil). Bearing in mind that the extent of various alternative fuel use is determined in first place by economic conditions, the article describes the price relationships between alternative and conventional fuels in Poland and selected EU countries. It is pointed out that although Poland has a wealth of experience in using methane alternative fuels for transport, one of the main barriers to their development in Poland is the extensive use of LPG. In addition, a poorly developed network of CNG stations in Poland, which does not allow easy transport, especially in the northern part of the country, is a serious problem to a further development of CNG use as fuel for transport. An interesting solution to this problem seems to be the use of home CNG filling stations: Home Refuelling Appliance (HRA, refuelling time 8-10 hours) and Home Refuelling Station (HRS, refuelling time 8-10 minutes). The team is working on HRA and HRS technologies. The article also highlights the impact of alternative fuel use on energy security by reducing reliance on imports of crude oil and petroleum products.

Keywords: alternative fuels, CNG (Compressed Natural Gas), CNG stations, LNG (Liquefied Natural Gas), NGVs (Natural Gas Vehicles), pollutant emissions

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Authors: Scott Snyder

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Grading approaches in higher education have not changed meaningfully in over 100 years. While there is variation in the types of grades assigned across countries, most use approaches based on simple ordinal scales (e.g, letter grades). While grades are generally viewed as an indication of a student's performance, challenges arise regarding the clarity, validity, and reliability of letter grades. Research about grading in higher education has primarily focused on grade inflation, student attitudes toward grading, impacts of grades, and benefits of plus-minus letter grade systems. Little research is available about alternative approaches to grading, varying approaches used by faculty within and across colleges, and faculty attitudes toward grades and alternative approaches to grading. To begin to address these gaps, a survey was conducted of faculty in a sample of departments at three diverse colleges in a southeastern state in the US. The survey focused on faculty experiences with and attitudes toward grading, the degree to which faculty innovate in teaching and grading practices, and faculty interest in alternatives to the point system approach to grading. Responses were received from 104 instructors (21% response rate). The majority reported that teaching accounted for 50% or more of their academic duties. Almost all (92%) of respondents reported using point and percentage systems for their grading. While all respondents agreed that grades should reflect the degree to which objectives were mastered, half indicated that grades should also reflect effort or improvement. Over 60% felt that grades should be predictive of success in subsequent courses or real life applications. Most respondents disagreed that grades should compare students to other students. About 42% worried about their own grade inflation and grade inflation in their college. Only 17% disagreed that grades mean different things based on the instructor while 75% thought it would be good if there was agreement. Less than 50% of respondents felt that grades were directly useful for identifying students who should/should not continue, identify strengths/weaknesses, predict which students will be most successful, or contribute to program monitoring of student progress. Instructors were less willing to modify assessment than they were to modify instruction and curriculum. Most respondents (76%) were interested in learning about alternative approaches to grading (e.g., specifications grading). The factors that were most associated with willingness to adopt a new grading approach were clarity to students and simplicity of adoption of the approach. Follow-up studies are underway to investigate implementations of alternative grading approaches, expand the study to universities and departments not involved in the initial study, examine student attitudes about alternative approaches, and refine the measure of attitude toward adoption of alternative grading practices within the survey. Workshops about challenges of using percentage and point systems for determining grades and workshops regarding alternative approaches to grading are being offered.

Keywords: alternative approaches to grading, grades, higher education, letter grades

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Authors: H. Sakamoto, Y. Nakagawara, S. Oguri

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Drought stress is a critical environmental factor that adversely affects crop productivity and quality. Because of their immobile nature, plants have evolved mechanisms to sense and respond to drought stress. We identified a novel locus of Arabidopsis, designated DRA1 (drought responsive ankyrin 1), whose disruption leads to increased drought stress tolerance. DRA1 encodes a transmembrane protein with an ankyrin repeat motif that has been implicated in diverse cellular processes such as signal transduction. RT-PCR analysis revealed that there were at least two splicing variants of DRA1 transcripts in wild type plants. In response to drought stress, the levels of DRA1 transcripts retaining second and third introns were increased, whereas these introns were removed under unstressed conditions. These results suggest that DRA1 protein may negatively regulate plant drought tolerance and that the expression of DRA1 is regulated in response to drought stress by alternative splicing.

Keywords: alternative splicing, ankyrin repeat, Arabidopsis, drought tolerance

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Authors: Naci Büyükkaracığan, Murat Ahmet Ökmen

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In parallel with the population growth rate, the need of human being for energy sources in the world is gradually increasing incessant. The addition of this situation that demand for energy will be busier in the future, industrialization, the rise in living standards and technological developments, especially in developing countries. Alternative energy sources have aroused interest due to reasons such as serious environmental issues that were caused by fossil energy sources, potentially decreasing reserves, different social, political and economic problems caused by dependency on source providing countries and price instability. Especially in developed countries as European countries and also U.S.A particularly, alternative energy sources such as wind, geothermal, solar and biomass energy, hydrolic and hydrogen have been utilized in different forms, especially in electricity production. It includes a review of technical and environmental factors for energy sources that are potential replacements for fossil fuels and examines their fitness to supply the energy for a high standard of living on a worldwide basis. Despite all developments, fossil energy sources have been overwhelmingly used all around the world in primary energy sources consumption and they will outnumber other energy sources in the short term. Today, parallel to population growth and economy in Turkey, energy sources consumption is increasingly continuing. On one side, Turkey, currently 80% dependent on energy providing countries, has been heavily conducting fossil energy sources raw material quest within its own borders in order to lower the percentage, and the other side, there have been many researches for exploring potential of alternative energy sources and utilization. This case will lead to both a decrease in foreign energy dependency and a variety of energy sources. This study showed the current energy potential of Turkey and presents historical development of these energy sources and their share in electricity production. The research also seeked for answers to arguments that if the potential can be sufficient in the future. As a result of this study, it was concluded that observed geothermal energy, particularly active tectonic regions of Turkey, to have an alternative energy potential could be considered to be valuable on bass wind and solar energy.

Keywords: alternative energy sources, energy productions, hydroenergy, solar energy, wind energy

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Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

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Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: family carers, independent living, mental health crisis, persons with mental illness

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Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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Authors: Shailendra Kumar Singh

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In the 21st century, we are living through extraordinary times as we are linguistically blessed to live through an era in which the each sociolinguistic example of living appears to be refreshingly new without any precedence of the past. The word `New Linguistic World Order’ is no longer just the intangible fascination but an indication of the emerging reality that we are living through a time in which the word ‘linguistic purism’ no longer invokes the sense of self categorization and self identification. The contemporary world of today is linguistically rewarding. This is a time in which the very existence of global, powerful and local needs to be revisited in the context of power shift, demographic shift, social psychological shift and technological shift. Hence, the old linguistic world view has to be challenged in the midst of 21st century. The first years of the 21st century have thus far been marked by the rise global economy, technological revolution and demographic shift, now we are witnessing linguistic shift which is leading towards forming a new linguistic world order. On the other hand, with rising powers of China and India in Asia in tandem the notion of alternative west is set to become a lot more interesting linguistically. It comes at a point when the world is moving towards inclusive globalization due to vanishing power corridor of the west and ascending geopolitical impact of emerging superpower and superpower in waiting. Now it is a reality that the western world no longer continues to rise – in fact, it will have more pressure to act in situation when the alternative west is looking for balanced globalization. It is more than likely that demographically strong languages of alternative west will be in advantageous position. The paper challenges our preconceptions about the nature of sociolinguistic nature of world in the 21st century. It investigates what a linguistic world is likely to be in the future in contrast to what was a linguistic world before 21st century. In particular, the paper tries to answer the following questions: (a) What will be the common linguistic thread across world? (b) How unprecedented transformations can be mapped linguistically? (c) Do we need alternative linguistics to define inclusive globalization as the linguistic reality of the contemporary world has already been reshaped by increasingly integrated world economy, linguistic revolution and alternative west? (d) In which ways these issues can be addressed holistically? (e) Why linguistic world order is changing dramatically? (f) Is it true that the linguistic world around is changing faster than we can even really cope? (g) Is it true that what is coming next is linguistically greater than ever? (h) Do we need to prepare ourselves with new theoretical strategies to address emerging sociolinguistic reality?

Keywords: alternative linguistics, new linguistic world order, power shift, demographic shift, social psychological shift, technological shift

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Authors: Nabil Omar, Farah Jibril, Oraib Amjad

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Purpose: Trabecatine is a is a potent marine-derived antineoplastic drug which binds to the minor groove of the DNA, bending DNA towards the major groove resulting in a changed conformation that interferes with several DNA transcription factors, repair pathways and cell proliferation. Trabectedin was approved by the European Medicines Agency (EMA; London, UK) for the treatment of adult patients with advanced stage soft tissue sarcomas in whom treatment with anthracyclines and ifosfamide has failed, or for those who are not candidates for these therapies. The recommended dosing regimen is 1.5 mg/m2 IV over 24 hours every 3 weeks. The purpose of this study was to comprehensively review available data on the safety and efficacy of trabectedin used as indicated for patients at a Tertiary Cancer Center at Qatar. Methods: A medication administration report generated in the electronic health record identified all patients who received trabectedin between November 1, 2015 and November 1, 2017. This retrospective chart review evaluated the indication of trabectedin use, compliance to administration protocol and the recommended monitoring parameters, number of patients improved on the drug and continued treatment, number of patients discontinued treatment due to side-effects and the reported side effects. Progress and discharged notes were utilized to report experienced side effects during trabectedin therapy. A total of 3 patients were reviewed. Results: Total of 2 out of 3 patients who received trabectedin were receiving it for non-FDA and non-EMA, approved indications; metastatic rhabdomyosarcoma and ovarian cancer stage IV with poor prognosis. And only one patient received it as indicated for leiomyosarcoma of left ureter with metastases to liver, lungs and bone. None of the patients has continued the therapy due to development of serious side effects. One patient had stopped the medication after one cycle due to disease progression and transient hepatic toxicity, the other one had disease progression and developed 12 % reduction in LVEF after 12 cycles of trabectedin, and the third patient deceased, had disease progression on trabectedin after the 10th cycle that was received through peripheral line which resulted in developing extravasation and left arm cellulitis requiring debridement. Regarding monitoring parameters, at baseline the three patients had ECHO, and Creatine Phosphokinase (CPK) but it was not monitored during treatment as recommended. Conclusion: Utilizing this medication as indicated with performing the appropriate monitoring parameters as recommended can benefit patients who are receiving it. It is important to reinforce the intravenous administration via central intravenous line, the re-assessment of left ventricular ejection fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan at 2- to 3-month intervals thereafter until therapy is discontinued, and CPK and LFTs levels prior to each administration of trabectedin.

Keywords: trabectedin, drug-use evaluation, safety, effectiveness, adverse drug reaction, monitoring

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Authors: Johnas Buhori, Meinrad Haule Lembuka

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Introduction: Social work expands its boundary to accommodate indigenous knowledge and practice for better competence and services. In Tanzania, Mama Mkubwa Mkubwa (MMM) (Mother’s elder sister) is an indigenous practice of alternative child care that represents other traditional practices across African societies known as Ubuntu practice. Ubuntu is African Humanism with values and approaches that are connected to the social work. MMM focuses on using the elder sister of a deceased mother or father, a trusted elder woman from the extended family or indigenous community to provide alternative care to an orphan or vulnerable child. In Ubuntu's perspective, it takes a whole village or community to raise a child, meaning that every person in the community is responsible for child care. Methodology: A desk review method guided by Ubuntu theory was applied to enrich the study. Findings: MMM resembles the Ubuntu ideal of traditional child protection of those in need as part of alternative child care throughout Tanzanian history. Social work practice, along with other formal alternative child care, was introduced in Tanzania during the colonial era in 1940s and socio-economic problems of 1980s affected the country’s formal social welfare system, and suddenly HIV/AIDS pandemic triggered the vulnerability of children and hampered the capacity of the formal sector to provide social welfare services, including alternative child care. For decades, AIDS has contributed to an influx of orphans and vulnerable children that facilitated the re-emerging of traditional alternative child care at the community level, including MMM. MMM strongly practiced in regions where the AIDS pandemic affected the community, like Njombe, Coastal region, Kagera, etc. Despite of existing challenges, MMM remained to be the remarkably alternative child care practiced in both rural and urban communities integrated with social welfare services. Tanzania envisions a traditional mechanism of family or community environment for alternative child care with the notion that sometimes institutionalization care fails to offer children all they need to become productive members of society, and later, it becomes difficult to reconnect in the society. Implications to Social Work: MMM is compatible with social work by using strengths perspectives; MMM reflects Ubuntu's perspective on the ground of humane social work, using humane methods to achieve human goals. MMM further demonstrates the connectedness of those who care and those cared for and the inextricable link between them as Ubuntu-inspired models of social work that view children from family, community, environmental, and spiritual perspectives. Conclusion: Social work and MMM are compatible at the micro and mezzo levels; thus, application of MMM can be applied in social work practice beyond Tanzania when properly designed and integrated into other systems. When MMM is applied in social work, alternative care has the potential to support not only children but also empower families and communities. Since MMM is a community-owned and voluntary base, it can relieve the government, social workers, and other formal sectors from the annual burden of cost in the provision of institutionalized alternative child care.

Keywords: ubuntu, indigenous social work, african social work, ubuntu social work, child protection, child alternative care

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