Search results for: acquired brain injury

Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

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Authors: H. R. Vosoughifar, Seyedeh Zeinab. Hosseininejad, Nahid Shabazi, Seyed Mohialdin Hosseininejad

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In recent years, structure designers advocate further application of energy absorption devices for lateral loads damping. The Un-bonded Braced Frame (UBF) system is one of the efficient damping systems, which is made of a smart combination of steel and concrete or mortar. In this system, steel bears the earthquake-induced axial force as compressive or tension forces without loss of strength. Concrete or mortar around the steel core acts as a constraint for brace and prevents brace buckling during seismic axial load. In this study, the optimal bracing system in the high-rise structures has been evaluated considering the seismic stress distribution in the connections. An actual 18-story structure was modeled using the proper Finite Element (FE) software where braced with UBF, Eccentrically Braced Frames (EBF) and Concentrically Braced Frame (CBF) systems. Nonlinear static pushover and time-history analyses are then performed so that the acquired results demonstrate that the UBF system reduces drift values in the high-rise buildings. Further statistical analyses show that there is a significant difference between the drift values of UBF system compared with those resulted from the EBF and CBF systems. Hence, the seismic stress distribution in the connections of the proposed structure which braced with UBF system was investigated.

Keywords: optimal bracing system, high-rise structure, finite element analysis (FEA), seismic stress

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Authors: D. M. El-Tanbouly, R. M. Abdelsalam, A. S. Attia, M. T. Abdel-Aziz

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Lipopolysaccharide (LPS) endotoxin, a component of the outer membrane of Gram-negative bacteria, is involved in the pathogenesis of sepsis. LPS administration induces systemic inflammation that mimics many of the initial clinical features of sepsis and has deleterious effects on several organs including the liver and eventually leading to septic shock and death. The present study aimed to investigate the protective effect of magnesium, a well-known cofactor in many enzymatic reactions and a critical component of the antioxidant system, on hepatic damage associated with LPS induced- endotoxima in mice. Mg (20 and 40 mg/kg, po) was administered for 7 consecutive days. Systemic inflammation was induced one hour after the last dose of Mg by a single dose of LPS (2 mg/kg, ip) and three hours thereafter plasma was separated, animals were sacrificed and their livers were isolated. LPS-treated mice suffered from hepatic dysfunction revealed by histological observation, elevation in plasma transaminases activities, C-reactive protein content and caspase-3, a critical marker of apoptosis. Liver inflammation was evident by elevation in liver cytokines contents (TNF-α and IL-10) and myeloperoxidase (MPO) activity. Additionally, oxidative stress was manifested by increased liver lipoperoxidation, glutathione depletion, elevated total nitrate/nitrite (NOx) content and glutathione peroxidase (GPx) activity. Pretreatment with Mg largely mitigated these alternations through its anti-inflammatory and antioxidant potentials. Mg, therefore, could be regarded as an effective strategy for prevention of liver damage associated with septicemia.

Keywords: LPS, liver damage, magnesium, septicemia

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Authors: Chris Schoborg, Morgan C. Wang

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In the realm of the National Football League (NFL), substantial dedication of time and effort is invested by both players and coaches in meticulously analyzing the game footage of their opponents. The primary aim is to anticipate the actions of the opposing team. Defensive players and coaches are especially focused on deciphering their adversaries' intentions to effectively counter their strategies. Acquiring insights into the specific play type and its intended direction on the field would confer a significant competitive advantage. This study establishes pre-snap information as the cornerstone for predicting both the play type (e.g., deep pass, short pass, or run) and its spatial trajectory (right, left, or center). The dataset for this research spans the regular NFL season data for all 32 teams from 2013 to 2022. This dataset is acquired using the nflreadr package, which conveniently extracts play-by-play data from NFL games and imports it into the R environment as structured datasets. In this study, we employ a recently developed machine learning algorithm, XGBoost. The final predictive model achieves an impressive lift of 2.61. This signifies that the presented model is 2.61 times more effective than random guessing—a significant improvement. Such a model has the potential to markedly enhance defensive coaches' ability to formulate game plans and adequately prepare their players, thus mitigating the opposing offense's yardage and point gains.

Keywords: lift, NFL, sports analytics, XGBoost

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Authors: Uvais Qidwai, Mohamed Shakir

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This paper presents an initial study related to the use of robotic toys as teaching and therapeutic aid tools for teachers and care-givers as well as parents of children with various levels of autism spectrum disorder (ASD). Some of the most common features related to the behavior of a child with ASD are his/her social isolation, living in their own world, not being physically active, and not willing to learn new things. While the teachers, parents, and all other related care-givers do their best to improve the condition of these kids, it is usually quite an uphill task. However, one remarkable observation that has been reported by several teachers dealing with ASD children is the fact that the same children do get attracted to toys with lights and sounds. Hence, this project targets the development/modifications of such existing toys into appropriate behavior training tools which the care-givers can use as they would desire. Initially, the remote control is in hand of the trainer, but after some time, the child is entrusted with the control of the robotic toy to test for the level of interest. It has been found during the course of this study that children with quite low learning activity got extremely interested in the robot and even advanced to controlling the robot with the Electromyography (EMG). It has been observed that the children did show some hesitation in the beginning 5 minutes of the very first sessions of such interaction but were very comfortable afterwards which has been considered as a very strong indicator of the potential of this technique in teaching and rehabilitation of children with ASD or similar brain disorders.

Keywords: Autism Spectrum Disorder (ASD), robotic toys, IR control, electromyography, LabVIEW based remote control

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Authors: Farina Maqbool

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Background: It is well said that children are considered the future masons of the country and a healthy brain is found in a healthy body. Therefore, a healthy generation can be produced by giving knowledge of immunization to mothers. Immunization is the most lucrative public health intrusion that has placed the greatest effect on the health of the people. The main objective of the present study was to find out the mother’s knowledge, attitude, and practices towards childhood immunization. Methods: Multistage sampling technique was used. One hundred and sixty mothers were selected conveniently who have at least one child up to two years. Data were collected through the face to face interview. The chi-square test was used to test the significance of the association between independent and dependent variables. Data were analyzed using the Statistical Package for Social Science. Results: A higher percentage of mothers (85.0%) knew vaccine-preventable diseases. Major proportion (82.5%) of the mothers had thought that immunization is important for their child’s health. A majority (66.3%) of the respondents’ children were fully immunized, whereas 26.3 percent of them were replied negatively. Remaining 7.5 percent of the respondents’ child un-immunized Chi-square value (39.14) shows a highly significant association between the education of the respondents and receiving of all recommended vaccines for children. Gamma value shows a strong positive relationship between the variables.

Keywords: attitude, childhood, immunization, knowledge, practices

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Authors: Sina Mahdavi

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Background and Objective: Multiple sclerosis (MS) is an inflammatory autoimmune disease of the CNS that affects the myelination process in the central nervous system (CNS). Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially Human Herpesvirus 6 (HHV-6), and MS is one potential cause that is not well understood. In this study, we aim to summarize the available data on HHV-6 infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis", " Human Herpesvirus 6 ", and "central nervous system" in the databases PubMed and Google Scholar between 2017 and 2022 were searched, and 12 articles were chosen, studied, and analyzed. Results: HHV 6 tends towards TCD 4+ lymphocytes and enters the CNS due to the weakening of the blood-brain barrier due to inflammatory damage. Following the observation that the HHV-6 U24 protein has a seven amino acid sequence with myelin basic protein, which is one of the main components of the myelin sheath, it could cause a molecular mimicry mechanism followed by cross-reactivity. Reactivation of HHV-6 in the CNS can cause the release of proinflammatory cytokines, including TNF-α, leading to immune-mediated demyelination in patients with MS. Conclusion: There is a high expression of endogenous retroviruses during the course of MS, which indicates the relationship between HHV-6 and MS, and that this virus can play a role in the development of MS by creating an inflammatory state. Therefore, measures to modulate the expression of HHV-6 may be effective in reducing inflammatory processes in demyelinated areas of MS patients.

Keywords: multiple sclerosis, human herpesvirus 6, central nervous system, autoimmunity

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Authors: Omotayo Abidemi Funmilayo

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Skill acquisition in professional fields has been prioritized and considered important to demonstrate the mastery of subject matter and present oneself as an expert in such profession. The ability to acquire skills in different fields, however calls for different method from the instructor or teacher during training. Music is not an exception of such profession, where there exist different area of skills acquisition require practical performance. This paper, however, focused on the impact and effects of different methods on acquisition of practical knowledge in the handling of some musical instruments among the students of Emmanuel Alayande College of Education, Oyo. In this study, 30 students were selected and divided into two groups based on the selected area of learning, further division were made on each of the two major groups to consist of five students each, to be trained using different methodology for two months and three hours per week. Comparison of skill acquired were made using standard research instrument at reliable level of significance, test were carried out on the thirty students considered for the study based on area of skill acquisition. The students that were trained on the keyboard and saxophone using play way method, followed by the students that were trained using demonstration method while the set of students that received teaching instruction through lecture method performed below average. In conclusion, the study reveals that ability to acquire professional skill on handling musical instruments are better enhanced using play way method.

Keywords: music education, skill acquisition, keyboard, saxophone

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Authors: Hector Liu, Chih-Ming Tsai

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Consumer behaviors in the subscription of over-the-top (OTT) media services have substantially changed because of the COVID-19 pandemic; hence, this study aims to determine the factors affecting subscription intentions. The increased usage of OTT media, particularly in the lockdowns during the COVID-19 pandemic, has intensified the competition between both global and local streaming providers. While studies have discussed antecedents accounting for this change, they have paid limited attention to the psychological factors that shape consumer behavior in using OTT services. Given the changes in consumers’ psychological states during the pandemic, this study seeks to fill the research gap by integrating the expectancy-value model to provide insights into the key gratifications that consumers seek and obtain and that have affected their subscription to OTT services. This study proposes a theoretical model and assesses this framework on data collected from 1,068 OTT service users in Taiwan. The results strengthen the literature by indicating a clear growth in the popularity and subscription of OTT services because of the COVID-19 lockdowns as well as factors such as perceived quality and satisfaction, which influence behavioral intentions for OTT services. Most crucially, however, OTT viewers who acquired a sense of belonging, a sense of being accompanied, and a sense of reduction in anxiety due to being quarantined and in lockdown show a higher tendency to continue their subscriptions to their OTT services of choice during the pandemic. With consumer behavior trends forever changed by the COVID-19 pandemic, the implications from this study provide OTT service platforms with an opportunity to capitalize on their current and potential customers’ changing desires, demands, and factors for a continued subscription.

Keywords: consumer behavior, COVID-19, expectancy-value model, OTT media services

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Authors: Kemka C. Ihemelandu, Chukwuemeka U. Ihemelandu

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The incidence of melanoma has been increasing rapidly over the past two decades, making melanoma a current public health crisis. Unfortunately, even as screening efforts continue to expand in an effort to ameliorate the death rate from melanoma, there is a need to improve diagnostic accuracy to decrease misdiagnosis. Artificial intelligence (AI) a new frontier in patient care has the ability to improve the accuracy of melanoma diagnosis. Convolutional neural network (CNN) a form of deep neural network, most commonly applied to analyze visual imagery, has been shown to outperform the human brain in pattern recognition. However, there are noted limitations with the accuracy of the CNN models. Our aim in this study was the optimization of convolutional neural network algorithms for the automated diagnosis of melanoma. We hypothesized that Optimal selection of the momentum and batch hyperparameter increases model accuracy. Our most successful model developed during this study, showed that optimal selection of momentum of 0.25, batch size of 2, led to a superior performance and a faster model training time, with an accuracy of ~ 83% after nine hours of training. We did notice a lack of diversity in the dataset used, with a noted class imbalance favoring lighter vs. darker skin tone. Training set image transformations did not result in a superior model performance in our study.

Keywords: melanoma, convolutional neural network, momentum, batch hyperparameter

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Authors: F. C. Amadi, G. C. Enyi, G. Nasr

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Relative permeabilities are practical factors that are used to correct the single phase Darcy’s law for application to multiphase flow. For effective characterisation of large-scale multiphase flow in hydrocarbon recovery, relative permeability and capillary pressures are used. These parameters are acquired via special core flooding experiments. Special core analysis (SCAL) module of reservoir simulation is applied by engineers for the evaluation of these parameters. But, core flooding experiments in shale core sample are expensive and time consuming before various flow assumptions are achieved for instance Darcy’s law. This makes it imperative for the application of coreflooding simulations in which various analysis of relative permeabilities and capillary pressures of multiphase flow can be carried out efficiently and effectively at a relative pace. This paper presents a Sendra software simulation of core flooding to achieve to relative permeabilities and capillary pressures using different correlations. The approach used in this study was three steps. The first step, the basic petrophysical parameters of Marcellus shale sample such as porosity was determined using laboratory techniques. Secondly, core flooding was simulated for particular scenario of injection using different correlations. And thirdly the best fit correlations for the estimation of relative permeability and capillary pressure was obtained. This research approach saves cost and time and very reliable in the computation of relative permeability and capillary pressures at steady or unsteady state, drainage or imbibition processes in oil and gas industry when compared to other methods.

Keywords: relative permeabilty, porosity, 1-D black oil simulator, capillary pressures

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Authors: Aloysius Colman Chukwuemeka Ezeabasili, Chibuike Patrick Ezeabasili

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Medium Sized Construction Companies in Nigeria are those employing 50-250 workers that are mostly involved in roads, Commercial and domestic building Construction, among others. These companies are in the majority and contribute immensely to infrastructural development in Nigeria. Despite the last eight years of economic downturn and the past years of COVID-19 pandemic, signs of these Companies recovering from the economic recession and pandemic seem bright. Nigeria has recorded 213,000 confirmed cases 3968 deaths from COVID-19 as at now. These medium sized companies are currently trying to explore various opportunities to grow their businesses to achieve competitive advantages over others by studying and improving on their bidding efficiency, Strategies for selecting businesses, bidding markup Strategies, and cash flow. These strategies were studied through the recruitment of construction experts and professionals. Many of them have acquired new technologies that have impacted positively on their strategies. The impact of these technologies like the BIM, e-tendering, conditions of contract, and claim management strategies are advantages to them and has given them good advantages over their peers. Monte Carlo solution, Swot analysis, and average bid methods have also clearly added advantages to bidding practices. New and existing strategies are Scrutinized, and training of young Nigerians in advanced countries to acquire knowledge in best practices have elevated some of these companies. The Covid-19 has not been very harsh to Nigeria, and the country is surely not as devastated as the advanced countries. Nigeria has therefore been able to cope with the combination of the downturn and the pandemic.

Keywords: medium sized construction companies, competitive advantage, new bidding technologies, Nigeria

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Authors: Omar Sorour, Michael Leahy, Thomas Irvine, Vladimir Koren

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Introduction: Covid encephalitis is a rare yet dangerous complication, particularly affecting the older and immunocompromised. Symptoms range from confusion to delirium, coma, and seizures. Although neurological manifestations have become more well-characterized in COVID patients, little is known about whether priorneurological abnormalities may predispose patients to COVID encephalopathy. Case Description: A 73 y.o. male with a CT and MRI-confirmed stable, prior 9 mm cavernoma in the right frontal lobe and no past history of seizures was hospitalized with generalized weakness, abdominal pain, nausea, and shortness of breath with subsequent COVID pneumonia. Three days after the initial presentation, the patient developed a spontaneous generalized tonic-clonic seizure consistent with presumed COVID encephalitis, along with somnolence and confusion. A day later, the patient had two other seizure episodes. Follow-up EEG suggested an inter-ictal epileptic focus with sharp waves corresponding to roughly the same location as the patient’s pre-existing cavernoma. The patient’s seizures stopped shortly thereafter, while his encephalopathy continued for days. Conclusion: We illustrate that a pre-existing anatomic cortical abnormality may act as a potential nidus for new-onset seizure activity in the context of suggested COVID encephalopathy. Future studies may further demonstrate that manifestations of COVIDencephalopathy in certain patients may be more predictable than initially assumed.

Keywords: cavernoma, covid, encephalopathy, seizures

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Authors: Fateme Nokhodchi Bonab

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Studies related to magnetic resonance imaging (MRI) and drug delivery are reviewed in this study to demonstrate the role of transport theory in porous media in facilitating advances in biomedical applications. Diffusion processes are believed to be important in many therapeutic modalities such as: B. Delivery of drugs to the brain. We analyse the progress in the development of diffusion equations using the local volume average method and the evaluation of applications related to diffusion equations. Torsion and porosity have significant effects on diffusive transport. In this study, various relevant models of torsion are presented and mathematical modeling of drug release from biodegradable delivery systems is analysed. In this study, a new model of drug release kinetics from porous biodegradable polymeric microspheres under bulk and surface erosion of the polymer matrix is presented. Solute drug diffusion, drug dissolution from the solid phase, and polymer matrix erosion have been found to play a central role in controlling the overall drug release process. This work paves the way for MRI and drug delivery researchers to develop comprehensive models based on porous media theory that use fewer assumptions compared to other approaches.

Keywords: MRI, porous media, drug delivery, biomedical applications

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Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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Authors: B. W. Kenny, D.Mansour, K. G. Mansour, J. Attia, B. Meads

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There is currently insufficient evidence to make a conclusive statement about safety while immobilized in a short arm cast. There is a paucity of published literature on this topic. The purpose of this study is to specifically evaluate short arm casts and their effect on driving abilities, particularly steering and avoidance of obstacles. The ability to drive safely is extrapolated from this data. In this study, a randomised, controlled, crossover design was used to assess 30 subjects randomised into 2 groups. A Logitech force feedback steering column and simulated driving program with a standardised road course was used. Objective outcome measures were the number of times subjects drove off the track, the number of crashes, time to lap completion and subjective assessment on whether wearing a short arm plaster cast impeded their steering. Recruited subjects had no upper limb pathology. The side of the applied plaster cast was randomised. The mean lap completion time reduced with repetition, the difference being statistically significant. There was no significant difference in mean number of times subjects in casts drove off the track (3 with vs. 3.07 without casts), average number of crashes (1.27 vs 0.97). Steering ability was not reduced whilst a subject was immobilised in a short arm Plaster of Paris cast, despite subject’s own impressions that their steering was impeded. This may help guide doctors in their advice to patients regarding driving in these casts.

Keywords: upper limb, arm injury, plaster cast, splint, driving, automobile, bone fracture

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Authors: Afolabi O.J, Simon-Oke I.A., Oniya M.O., Okaka C.E.

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River blindness is a skin, and an eye disease caused by Onchocerca volvulus and vectored by a female hematophagous blackfly. The study aims to evaluate the distribution of the clinical signs of river blindness and the efficacy of ivermectin in the treatment of river blindness in Idogun. Observational studies in epidemiology that involve the use of a structured questionnaire to obtain useful epidemiological information from the respondents, physical assessment via palpation from head to ankle was used to assess clinical signs from the respondents and skin snip test was used to evaluate the prevalence of the disease. The efficacy of the drug was evaluated and expressed in percentages. One hundred and ninety-two (192) out of the 384 respondents examined, showed various signs of river blindness. However, it was only 108 (28.1%) respondents with the clinical signs that demonstrated Onchocerca volvulus microfilariae in their skin snips. The clinical signs observed among the respondents include skin depigmentation such as dermatitis, leopard skin, papules, pruritus and self-inflicted injury, while ocular symptoms include cataract, ocular lesion and partial blindness. Among these clinical signs, papules, and pruritus were the most dominant in the community. The prevalence of the clinical signs was observed to vary significantly among the age groups and gender (P<0.05). The efficacy of the drug after 6 and 12 months of treatments shows that the drug is more effective at age groups 10-50 years than the age groups 51-90 years. Ivermectin is observed to be efficacious in the treatment of the disease. However, to achieve eradication of the disease, the drug may be administered at 0.15mg/kg twice a year.

Keywords: riverblindness, clinical signs, ivermectin, Idogun

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Authors: Nafisa Komilova, Plamena Angelova, Andrey Abramov, Ulugbek Mirkhodjaev

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder which is induced by the loss of dopaminergic neurons in the midbrain. The mechanism of neurodegeneration is associated with the aggregation of misfolded proteins, oxidative stress, and mitochondrial disfunction. Considering this, the process of removal of unwanted organelles or proteins by autophagy is vitally important in neurons, and activation of these processes could be protective in PD. Short-time acidification of cytosol can activate mitophagy and autophagy, and here we used sodium pyruvate and sodium lactate in human fibroblasts with PD mutations (Pink1, Pink1/Park2, α-syn triplication, A53T) to induce changes in intracellular pH. We have found that both lactate and pyruvate in millimolar concentrations can induce short-time acidification of cytosol in these cells. It induced activation of mitophagy and autophagy in control and PD fibroblasts and protected against cell death. Importantly, the application of lactate to acute brain slices of control and Pink1 knockout mice also induced a reduction of pH in neurons and astrocytes that increase the level of mitophagy. Thus, acidification of cytosol by compounds which play important role in cell metabolism also can activate mitophagy and autophagy and protect cells in the familial form of PD.

Keywords: Parkinson's disease, mutations, mitophagy, autophagy

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Authors: Muhammad Saleem

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Tourism stands as one of the swiftly expanding sectors globally, contributing to 10% of the overall worldwide GDP. It holds a vital role in generating income, fostering employment opportunities, alleviating poverty, facilitating foreign exchange earnings, and advancing intercultural understanding. This industry encompasses a spectrum of activities, encompassing transportation, communication, hospitality, catering, entertainment, and advertising. The objective of this study is to assess the evolution and obstacles encountered by sports tourism in Pakistan. In pursuit of this objective, relevant literature has been scrutinized, while data has been acquired from 60 respondents, employing a simple random sampling approach for analysis. The survey comprised close-ended inquiries directed towards all participants. Analytical tools such as mean, mode, median, graphs, and percentages have been employed for data analysis. The findings revealed through robust analysis, indicate that the mean, mode, and median tools consistently yield results surpassing the 70% mark, underscoring that heightened development within sports tourism significantly augments its progress. Effective governance demonstrates a favorable influence on sports tourism, with increased government-provided safety and security potentially amplifying its expansion, thus attracting a higher number of tourists and consequently propelling the growth of the sports tourism sector. This study holds substantial significance for both academic scholars and industry practitioners within Pakistan's tourism landscape, as previous explorations in this realm have been relatively limited.

Keywords: obstacles-spots, evolution-tourism, sports-pakistan, sports-obstacles-pakistan

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Authors: Radwa El Shorbagy, Alaa El Din Balbaa, Khaled Ayad, Waleed Reda

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Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated.Objective: to determine the contribution of proximal hip strategy to dynamic posture control in patients with recurrent ankle sprain. Methods:Fifteen subjects with recurrent ankle sprain (Group A) and fifteen healthy control subjects (Group B) participated in this study. Abductor-adductor as well as flexor-extensor hip musculature control was abolished by fatigue using the Biodex Isokinatic System. Dynamic posture control was measured before and after fatigue by the Biodex Balance System. Results: Repeated measures MANOVA was used to compare within group differences. In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) lowered overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p=0.00) whereas; in group B fatiguing of hip flexors-extensors lowered significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Conclusion: fatiguing of hip muscles has a significant deleterious effect on dynamic posture control in patient with recurrent ankle sprain indicating their increased dependence on hip strategy.

Keywords: ankle sprain, fatigue hip muscles, dynamic balance, ankle sprain

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Authors: Sebai Amal, Massuel Sylvain

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Groundwater is the key element of the development of most of the semi-arid areas where water resources are increasingly scarce due to an irregularity of precipitation, on the one hand, and an increasing demand on the other hand. This is the case of the watershed of the Central Tunisia Merguellil, object of the present study, which focuses on an implementation of an underground flows hydrodynamic model to understand the recharge processes of the Kairouan’s plain groundwater by aquifers boundary through the hydraulic threshold of El Haouareb. The construction of a conceptual geological 3D model by the Hydro GeoBuilder software has led to a definition of the aquifers geometry in the studied area thanks to the data acquired by the analysis of geologic sections of drilling and piezometers crossed shells partially or in full. Overall analyses of the piezometric Chronicles of different piezometers located at the level of the dam indicate that the influence of the dam is felt especially in the aquifer carbonate which confirms that the dynamics of this aquifer are highly correlated to the dam’s dynamic. Groundwater maps, high and low-water dam, show a flow that moves towards the threshold of El Haouareb to the discharge of the waters of Ain El Beidha discharge towards the plain of Kairouan. Software FEFLOW 5.2 steady hydrodynamic modeling to simulate the hydraulic threshold at the level of the dam El Haouareb in a satisfactory manner. However, the sensitivity study to the different parameters shows equivalence problems and a fix to calibrate the limestones’ permeability. This work could be improved by refining the timing steady and amending the representation of limestones in the model.

Keywords: Hydrodynamic modeling, lithological modeling, hydraulic, semi-arid, merguellil, central Tunisia

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Authors: T. J. Ellapen, N. Acampora, S. Dawson, J. Arling, C. Van Niekerk, H. J. Van Heerden

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Objectives: To determine the comparative proprioceptive performance of injured versus non-injured adolescent female hockey players when wearing an ankle brace. Methods: Data were collected from 100 high school players who belonged to the Highway Secondary School KZN Hockey league via voluntary parental informed consent and player assent. Players completed an injury questionnaire probing the prevalence and nature of hockey injuries (March-August 2013). Subsequently players completed a Biodex proprioceptive test with and without an ankle brace. Probability was set at p≤ 0.05. Results: Twenty-two players sustained ankle injuries within the six months (p<0.001). Injured players performed similarly without bracing Right Anterior Posterior Index (RAPI): 2.8±0.9; Right Medial Lateral Index (RMLI): 1.9±0.7; Left Anterior Posterior Index (LAPI) LAPI: 2.7; Left Medial Lateral Index (LMLI): 1.7±0.6) as compared to bracing (RAPI: 2.7±1.4; RMLI: 1.8±0.6; LAPI: 2.6±1.0; LMLI: 1.5±0.6) (p>0.05). However, bracing (RAPI: 2.2±0.8; RMLI: 1.5±0.5; LAPI: 2.4±0.9; MLI: 1.5±0.5) improved the ankle stability of the non-injured group as compared to their unbraced performance (RAPI: 2.5±1.0; RMLI: 1.8±0.8; LAPI: 2.8±1.1; LMLI: 1.8±0.6) (p<0.05). Conclusion: Ankle bracing did not enhance the stability of injured ankles. However ankle bracing has an ergogenic effect enhancing the stability of healthy ankles.

Keywords: hockey, proprioception, ankle, bracing

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Authors: Fatemeh Noughani, Seyd Mehdi Sadat

Abstract:

Medical tourism or travel therapy is travelling from one country to another to be under medical treatment, utilizing the health factors of natural sector like mineral water springs and so on. From 1990s medical tourism around the world developed and grew because of different factors like globalization and free trade in the fields of health services, changes in exchange rates in the world economy (which caused the desirability of Asian countries as a medical tourist attraction) in a way that currently there is a close competition in this field among famous countries in medical services to make them find a desirable place in medical tourism market of the world as a complicated and growing industry in a short time. Perhaps tourism is an attractive industry and a good support for the economy of Iran, if we try to merge oil earnings and tourism industry it would be better and more constructive than putting them in front of each other. Moving from oil toward tourism economy especially medical tourism, must be one of the prospects of Iran's government for the oil industry to provide a few percent of the yearly earnings of the country. Among the achievements in medical tourism we can name the prevention of brain drain to other countries and an increase in employment rate for healthcare staff, increase in foreign exchange earnings of the country because of the tourists' staying and followed by increasing the quality of life and cultural transmission as well as empowering the medical human resources.

Keywords: developing countries, health tourism, quality of life, cultural transmission

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Authors: Renato André S. Silva, Nana L. F. Sampaio, Carlos J. G. Cruz, Bruno Vianna, Flávio O. Pires

Abstract:

multiple stage bicycle races require high physiological loads from professional cyclists. Such demands can lead to immunosuppression and health problems. However, in this type of competition, little is known about its physiological effects on amateur athletes, who generally receive less medical support. Thus, this study analyzes the hematological effects of a multiple stage bicycle race on amateur cyclists. Seven Brazilian national amateur cyclists (34 ± 4.21 years) underwent a laboratory test to evaluate VO2Max (69.89 ± 7.43 ml⋅kg-1⋅min-1). Six days later, these volunteers raced in the Tour of Goiás, participating in five races in four days (435 km) of competition. Arterial blood samples were collected one day before and one day after the competition. The Kolmogorov-Smirnov tests were used to evaluate the data distribution and Wilcoxon to compare the two moments (p <0.05) of data collection. The results show: Red cells ↓ 7.8% (5.1 ± 0.28 vs 4.7 ± 0.37 106 / mm 3, p = 0.01); Hemoglobin ↓ 7.9% (15.1 ± 0.31 vs 13.9 ± 0.27 g / dL, p = 0.01); Leukocytes ↑ 9.5% (4946 ± 553 versus 5416 ± 1075 / mm 3, p = 0.17); Platelets ↓ 7.0% (200.2 ± 51.5 vs 186.1 ± 39.5 / mm 3, p = 0.01); LDH ↑ 11% (164.4 ± 28.5 vs 182.5 ± 20.5 U / L, p = 0.17); CK ↑ 13.5% (290.7 ± 206.1 vs 330.1 ± 90.5 U / L, p = 0.39); CK-MB ↑ 2% (15.7 ± 3.9 vs. 20.1 ± 2.9 U / L, p = 0.06); Cortizol ↓ 13.5% (12.1 ± 2.4 vs 9.9 ± 1.9 μg / dL, p = 0.01); Total testosterone ↓ 7% (453.6 ± 120.1 vs 421.7 ± 74.3 ng / dL, p = 0.12); IGF-1 ↓ 15.1% (213.8 ± 18.8 vs 181.5 ± 34.7 ng / mL, p = 0.04). This means that there was significant reductions in O2 allocation / transport capacities, vascular injury disruption, and a fortuitous reduction of muscle skeletal anabolism along with maintenance and / or slight elevation of immune function, glucose and lipid energy and myocardial damage. Therefore, the results suggest that no abnormal health effect was identified among the athletes after participating in the Tour de Goiás.

Keywords: cycling, health effects, cycling stages races, haematology

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Authors: Muhammad Tayyab Afzal, Muhammad Arslan, Mirza Muhammad Waqar

Abstract:

Snow constitutes an important component of the cryosphere, characterized by high temporal and spatial variability. Because of the contribution of snow melt to water availability, snow is an important focus for research on climate change and adaptation. MODIS satellite data have been used to identify spatial-temporal trends in snow cover in the upper Indus basin. For this research MODIS satellite 8 day composite data of medium resolution (250m) have been analysed from 2001-2005.Pixel based supervised classification have been performed and extent of snow have been calculated of all the images. Results show large variation in snow cover between years while an increasing trend from west to east is observed. Temperature data for the Upper Indus Basin (UIB) have been analysed for seasonal and annual trends over the period 2001-2005 and calibrated with the results acquired by the research. From the analysis it is concluded that there are indications that regional warming is one of the factor that is affecting the hydrology of the upper Indus basin due to accelerated glacial melting during the simulation period, stream flow in the upper Indus basin can be predicted with a high degree of accuracy. This conclusion is also supported by the research of ICIMOD in which there is an observation that the average annual precipitation over a five year period is less than the observed stream flow and supported by positive temperature trends in all seasons.

Keywords: indus basin, MODIS, remote sensing, snow cover

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Authors: R. R. Ramsheeja, R. Sreeraj

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For view the internal structures of the human body such as liver, brain, kidney etc have a wide range of different modalities for medical images are provided nowadays. Computer Tomography is one of the most significant medical image modalities. In this paper use CT liver images for study the use of automatic computer aided techniques to calculate the volume of the liver tumor. Segmentation method is used for the detection of tumor from the CT scan is proposed. Gaussian filter is used for denoising the liver image and Adaptive Thresholding algorithm is used for segmentation. Multiple Region Of Interest(ROI) based method that may help to characteristic the feature different. It provides a significant impact on classification performance. Due to the characteristic of liver tumor lesion, inherent difficulties appear selective. For a better performance, a novel proposed system is introduced. Multiple ROI based feature selection and classification are performed. In order to obtain of relevant features for Support Vector Machine(SVM) classifier is important for better generalization performance. The proposed system helps to improve the better classification performance, reason in which we can see a significant reduction of features is used. The diagnosis of liver cancer from the computer tomography images is very difficult in nature. Early detection of liver tumor is very helpful to save the human life.

Keywords: computed tomography (CT), multiple region of interest(ROI), feature values, segmentation, SVM classification

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Authors: Seema Garcha, Sheetal Chopra, Navraj Sarao

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Plant hormones play a role in internal colonization by beneficial microbes and also systemic acquired resistance. They define qualitative and quantitative nature of root microbiome and also influence dynamics of root rhizospheric soil. The present study is an attempt to relate salicylic acid (signal molecule) content and qualitative nature of root endophytes at various stages in the growth of rice varieties of commercial value- Parmal 121 and Basmati 1121. Root seedlings of these varieties were raised using tissue culture techniques and then they were transplanted in the fields. Cultivation was done using conventional methods in agriculture. Field soil contained 0.39% N, 75.12 Kg/hectare of phosphorus and 163.0 Kg/hectare of potassium. Microfloral profiling of the root tissue was done using the selective microbiological medium. The salicylic acid content was estimated using HPLC-Agilent 1100 HPLC Series. Salicylic acid level of Basmati 1121 remained relatively low at the time of transplant and 90 days after transplant. It increased marginally at 60 days. A similar trend was observed with Parmal 121 as well. However, Parmal variety recorded 0.935 ug/g of salicylic acid at 60 days after transplant. Salicylic acid content decreased after 90 days as both the rice varieties remained disease free. The endophytic root microflora was established by 60 days after transplant in both the varieties after which their population became constant. Rhizobium spp dominated over Azotobacter spp. Genetic profiling of endophytes for nitrogen-fixing ability is underway.

Keywords: plant-microbe interaction, rice, root microbiome, salicylic acid

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Authors: Manjunath Attibele, Alsawafi Manal, Al Dughaishi Tamima

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Introduction: The purpose of this study was to describe the clinical characteristics and types of mechanisms of injuries caused by Motor vehicle accidents (MVA) during pregnancy. To analyze the patterns of accidents during pregnancy and its adverse consequences on both maternal and fetal outcome. Methods: This was a retrospective cohort study on pregnant patients who met with MVAs The study period was from January 1, 2010, to December 31, 2019. All relevant data were retrieved from electronic patients’ records from the hospital information system and from the antenatal ward admission register Results: Out of 168 women who had motor vehicle accidents during the study period, of which, 39 (23.2%) women during pregnancy. Twenty-one (53.8%) women were over 30 years old. Thirty-five (89.7%) women were Omanis, and 27 (69.2%) were in their third trimester. Twenty-three (59%) of accidents happened at night, and 31 (79.5%) of them happened on a weekday. Twenty-two (56.4%) of women were driving themselves, and 24 (61.5%) of them were not using any seatbelt. Accident related abdominal & back pain was seen in 23(59%) women. Regarding the outcome of pregnancy, 23 (74.2%) had a normal vaginal delivery. The mean accident to delivery interval was 7 weeks. Thirty (96.7%) of involved newborns were relatively healthy. One woman (3.2%) had a ruptured uterusleading to fetal death (3.2%). Conclusion: This study showed that the incidence of motor vehicle accidents during pregnancy is around 23.2% . Majority had trauma-associated pain. One serious injury to a woman causing a ruptured uterus which lead to fetal death. Majority of involved newborns were relatively healthy. No reported maternal death.

Keywords: motor vehicle accidents, pregnancy, maternal outcome, fetal outcome

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Authors: Jake Tempo, Jack Crozier, Huay Ann Chia, Philip Tan

Abstract:

Purpose: A prospective study was performed to determine whether temporary ureteric catheterization should be eliminated as a prophylactic method for preventing ureteric obstruction after uncomplicated ureteropyeloscopic lithotripsy. Material and Methods: From 2010 to 2014, 227 patients underwent uncomplicated ureteroscopic and/or pyeloscopic lithotripsy. Three patient-groups based on postoperative drainage method were analysed: temporary uretericcatheter (TUC), -ureteric JJ stent, and no-stent groups. Exclusion criteria included urosepsis, ureteric injury, and non-surgical complications delaying hospital-discharge. Outcome measures included parenteral analgesic requirements, prolonged hospitalization ≥2 days due to postoperative-pain, and readmissions rate. Results: Delayed discharge was reported in 14.5%(9 of 62) patients in the TUC group compared to 3.4%(4 of 119) in theureteric JJ stent group and 8.7%(4 of 46) in the no-drainage-group (p=0.02). Odds ratio for delayed-discharge between catheter- versus-ureteric JJ stent is 4.9 (95% CI = 1.6-15.0; p < 0.01). Parenteral analgesic requirements in the TUC group (12.9%) was also significantly higher than theureteric JJ stent group (1.7%; p=0.003). Readmissions were negligible between groups. Conclusions: Patients with ureteric catheters after uncomplicated ureteroscopy have a prolonged hospital stay with increased pain and parenteral analgesic requirements. There is a 7.6-fold increased requirement for parenteral analgesia and a 4.2-fold increased risk of delayed-discharge compared to a patient with a ureteric JJ stent.

Keywords: ureteric catheter, ureteric stent, ureteroscopy, pyeloscopy

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Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

Abstract:

Background: NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studiesare shortcoming on individual patient experience. The aim of this study was to assess the patient’ssatisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. Methods: For all patients managed with woodcast in our unit, we undertook a structured questionnairethat included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score, and the pain numerical score at the time of injury and six weeks after. Results: 30 patients were initially managed with woodcast.80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. Conclusion: For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Pariscasting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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