Search results for: post stroke survivors

Authors: Elizabeth M. Annoni, Elena G. Tolkacheva

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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that is a known prognostic marker for stroke, heart failure and death. Reentrant mechanisms of rotor formation, which are stable electrical sources of cardiac excitation, are believed to cause AF. No existing commercial mapping systems have been demonstrated to consistently and accurately predict rotor locations outside of the pulmonary veins in patients with persistent AF. There is a clear need for robust spatio-temporal techniques that can consistently identify rotors using unique characteristics of the electrical recordings at the pivot point that can be applied to clinical intracardiac mapping. Recently, we have developed four new signal analysis approaches – Shannon entropy (SE), Kurtosis (Kt), multi-scale frequency (MSF), and multi-scale entropy (MSE) – to identify the pivot points of rotors. These proposed techniques utilize different cardiac signal characteristics (other than local activation) to uncover the intrinsic complexity of the electrical activity in the rotors, which are not taken into account in current mapping methods. We validated these techniques using high-resolution optical mapping experiments in which direct visualization and identification of rotors in ex-vivo Langendorff-perfused hearts were possible. Episodes of ventricular tachycardia (VT) were induced using burst pacing, and two examples of rotors were used showing 3-sec episodes of a single stationary rotor and figure-8 reentry with one rotor being stationary and one meandering. Movies were captured at a rate of 600 frames per second for 3 sec. with 64x64 pixel resolution. These optical mapping movies were used to evaluate the performance and robustness of SE, Kt, MSF and MSE techniques with respect to the following clinical limitations: different time of recordings, different spatial resolution, and the presence of meandering rotors. To quantitatively compare the results, SE, Kt, MSF and MSE techniques were compared to the “true” rotor(s) identified using the phase map. Accuracy was calculated for each approach as the duration of the time series and spatial resolution were reduced. The time series duration was decreased from its original length of 3 sec, down to 2, 1, and 0.5 sec. The spatial resolution of the original VT episodes was decreased from 64x64 pixels to 32x32, 16x16, and 8x8 pixels by uniformly removing pixels from the optical mapping video.. Our results demonstrate that Kt, MSF and MSE were able to accurately identify the pivot point of the rotor under all three clinical limitations. The MSE approach demonstrated the best overall performance, but Kt was the best in identifying the pivot point of the meandering rotor. Artifacts mildly affect the performance of Kt, MSF and MSE techniques, but had a strong negative impact of the performance of SE. The results of our study motivate further validation of SE, Kt, MSF and MSE techniques using intra-atrial electrograms from paroxysmal and persistent AF patients to see if these approaches can identify pivot points in a clinical setting. More accurate rotor localization could significantly increase the efficacy of catheter ablation to treat AF, resulting in a higher success rate for single procedures.

Keywords: Atrial Fibrillation, Optical Mapping, Signal Processing, Rotors

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Authors: Philip Baillie, Stuart W. Campbell, Alexander M. Galloway, Stephen R. Cater, Norman A. McPherson

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This study compared the mechanical and microstructural properties produced during friction stir welding(FSW) of S275 structural steel in air and underwater. Post weld tests assessed the tensile strength, micro-hardness, distortion, Charpy impact toughness and fatigue performance in each case. The study showed that there was no significant difference in the strength, hardness or fatigue life of the air and underwater specimens. However, Charpy impact toughness was shown to decrease for the underwater specimens and was attributed to a lower degree of recrystallization caused by the higher rate of heat loss experienced when welding underwater. Reduced angular and longitudinal distortion was observed in the underwater welded plate compared to the plate welded in air.

Keywords: Charpy impact toughness, distortion, fatigue, friction stir welding(FSW), micro-hardness, underwater

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Authors: Saleh H. Abud, Z. Hassan, F. K. Yam

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Characteristics of MSM photodetector based on a porous In0.08Ga0.92N thin film were reported. Nanoporous structures of n-type In0.08Ga0.92N/AlN/Si thin films were synthesized by photoelectrochemical (PEC) etching at a ratio of 1:4 of HF:C2H5OH solution for 15 min. The structural and optical properties of pre- and post-etched thin films were investigated. Field emission scanning electron microscope and atomic force microscope images showed that the pre-etched thin film has a sufficiently smooth surface over a large region and the roughness increased for porous film. Blue shift has been observed in photoluminescence emission peak at 300 K for porous sample. The photoluminescence intensity of the porous film indicated that the optical properties have been enhanced. A high work function metals (Pt and Ni) were deposited as a metal contact on the porous films. The rise and recovery times of the devices were investigated at 390 nm chopped light. Finally, the sensitivity and quantum efficiency were also studied.

Keywords: porous InGaN, photoluminescence, SMS photodetector, atomic force microscopy

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Authors: Zohreh Afsharmand, Sokhanguei Yahya

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A growing body of literature suggests that that low-grade systemic inflammation associated to obesity plays a key role in the pathogenic mechanism of several disorders. In this study, the effect of 6 weeks aerobic training on IL-6 and IL-1B as inflammatory cytokine were investigated in adult obese women. For this purpose, 26 sedentary adult obese women were divided into exercise and control groups (n=12). Pre and post training of mentioned cytokines were measured in two groups. Student’s t-tests for paired samples were performed to determine whether there were significant within-group changes in the outcomes. A p value less than 0.05 was considered statistically significant. There were no statistically significant differences between the exercise and control groups with regard to anthropometrical markers or inflammatory cytokines. Despite the significant decrease in all anthropometrical markers, no significant differences were found in serum IL-6 and IL-1B by aerobic training with compared to baseline. Our findings indicate that aerobic training intervention for a short time is not associated with the anti-inflammatory property in obese women.

Keywords: aerobic training, cytokine, inflammation, obesity

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Authors: Dahna Alkahtani, Faryal Suraya, Fadah Alanazi

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Background: Buccal mucosal graft for urethral augmentation has surpassed other grafting options, and is now considered the standard of choice for substitution Urethroplasty. The graft has gained its popularity due to its excellent short and long-term results, easy harvesting as well as its ability in withstanding wet environments. However, although Buccal mucosal grafts are an excellent option, it is not free of complications, potential intraoral complications are bleeding, pain, swelling, injury to the nerve resulting in numbness, lip deviation or retraction. Objectives: The current study aims to evaluate the intraoral complications of buccal mucosa grafts harvested from one cheek, and used in Augmentation Urethroplasty. Methodology: The study was conducted retrospectively using the medical records of patients who underwent open augmentation urethroplasty with a buccal mucosa graft at King Khalid University Hospital, Saudi Arabia. Data collection of demographics included the type of graft used, presence or absence of strictures and its etiological factors. Pre-operative and post-operative evaluations were carried out on the subjects including the medical history, physical examination, uroflowmetry, retrograde urethrography, voiding cystourethrography and urine cultures were also noted. Further, the quality of life and complications of the procedure including the presence or occurrence of bleeding within 3-days post-procedure, the severity of pain, oral swelling after grafting, length of return to normal daily diet, painful surgical site, intake of painkillers, presence or absence of speech disturbance, numbness in the cheeks and lips were documented. Results: Thirty-two male subjects with ages ranging from 15 years to 72 years were included in the current study. Following the procedure, a hundred percent of the subjects returned to their normal daily diet by the sixth postoperative day. Further, the majority of the patients reported experiencing mild pain accounting for 61.3%, and 90.3% of the subjects reported using painkillers to control the pain. Surgical wound Pain was reportedly more common at the perineal site as 48.4% of the subjects experienced it; on the other hand, 41.9% of the patients experienced pain in the oral mucosa. The presence of speech disorders, as assessed through medical history, was found to be present in 3.2% of patients. The presence of numbness in the cheeks and lips was found in 3.2% of patients. Other complications such as parotid duct injury, delayed wound healing, non-healing wound and suture granuloma were rare as 90.3% of the subjects denied experiencing any of them, there were nonetheless reports of parotid duct injury by 6.5% of the patients, and non-healing wound by the 3.2% of patients. Conclusion: Buccal Mucosa Graft in Augmentation Urethroplasty is an ideal source of allograft, although not entirely painless; it is considerably safe with minimal intra-oral complication and undetectable strain on the patients’ quality of life.

Keywords: augmentation, buccal, graft, oral

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Authors: Fatiha Kaïd Berrahal, Nassima Kaïd, Djihad Affaf Selt

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The present paper is a comparative analysis of the Algerian writer Assia Djebar’s women of Algiers in Their Apartment (1982) and the Anglo-Egyptian Ahdaf Soueif’s The Map of Love (1999) foregrounded on the female protagonists’ painfully common colonial and patriarchal experiences, though in different geographical regions of North Africa. This study raises questions pertaining, first, to the emerging contemporary genre “Historiographic meta-fiction” in which the novels examined could be inscribed, then, the interplay of colonial history and personal memory that impinges on the development of the identity of the post-colonial female subject. As the novels alternate between the historical and the autobiographical, we currently seek to understand how it is pertinent and pressing for women to excavate the lost and occluded stories of the past for the adjustment of their present personal identities, which are undoubtedly an important part of the identity of a nation.

Keywords: postcolonial feminism, islamic feminism, memory, histoirographic metafiction

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Authors: Charmaine Lamiel, Van Hoa Nguyen, Jae-Jin Shim

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Supercapacitors are energy storage devices capable of storing more energy than conventional capacitors and have higher power density than batteries. The advantages of this method include the non-use of reducing agents and acidic medium, and no further use of a post-heat treatment unlike the conventional processes, in which calcination is generally employed after obtaining the initial product. Furthermore, it also offers a shorter reaction time at low temperatures and low power requirements, which allows low fabrication and energy cost. In this study, microwave irradiation was used for the facile and rapid synthesis of mesoporous RGO@(Co,Mn)3O4 nanosheets as an electrode material. The as-prepared electrode exhibited a high capacitance of 953 F•g^−1 at 1 A•g^−1 in a 6 M KOH electrolyte solution. Moreover, the electrode exhibited a high energy density of 76.2 Wh•kg^−1 at a power density of 720 W•kg^−1, and a high power density of 7200 W•kg^−1 at an energy density of 38 Wh•kg^−1. The successful methodology was considered to be efficient and cost-effective, thereby providing an active electrode material with very promising electrochemical performance.

Keywords: cobalt-manganese oxide, electrochemical, graphene, microwave synthesis, supercapacitor

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Authors: Ndivhuho Tshikovhi

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The debate about indigenous people throughout the world has been necessitated by different circumstances that indigenous communities continue to suffer. Indigenous people of the world suffer chronic diseases, poor education, high unemployment and slow economic developments. This paper contributes to the continuous debate by studying the common elements of indigenous entrepreneur of the world and that of the South African indigenous entrepreneur. The research objective of this paper is to understand what constitute an indigenous status in the South African context as opposed to the indigenous people of the world. Furthermore, the study will explore the indigenous status through their entrepreneurial engagements. The paper will adopt a secondary data research method, by utilising the literature on indigenous entrepreneurship practice and theory of indigenous entrepreneurship. The implications of this paper is to bring about an African indigenous entrepreneurship debate rooted from the correct circumstances rather than generalised definitions. Recommendations for future research will be outlined, together with further readings on circumstantial evidence that necessitate indigenous entrepreneurs status in South Africa.

Keywords: indigenous entrepreneur, indigenous, entrepreneurship, indigenous people, entrepreneurship development

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Authors: Leena Wanganoo

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In this digital age with the mushrooming of online companies across the globe has led to an unprecedented new business model. The frequency of online purchasing varies across the globe, but trend shows a steep upward movement. From Generation X to the Millennial the consumer not only wants to order the product with the click of mouse but also very demanding service quality during pre to post-transaction stage. The existing research examines the impact of website quality on the on behavioral intentions in e-services customers and has not adequately recognized the quality of e-commerce logistics perceived by the customer.In order to address this gap, this study examines the relationship among the logistics service quality, satisfaction, and loyalty. Drawing upon a sample of 350 millennial customers from various regions of UAE will work within the framework of structural equation modeling (SEM). Finally, the study would use Importance-Performance analysis (IPA) to discuss the relations of the level of customers’ expected logistics service quality and level of customers’ perceived logistics serviced quality.

Keywords: logistics service quality, customer satisfaction, loyalty, electronic commerce

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Authors: David Dolbow, Daniel Credeur, Mujtaba Rahimi, Dobrivoje Stokic, Jennifer Lemacks, Andrew Courtner

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Introduction: Obesity is at epidemic proportions in the spinal cord injury (SCI) population (66-75%), as individuals who suffer from paralysis undergo a dramatic decrease in muscle mass and a dramatic increase in adipose deposition. Obesity is a major public health concern which includes a doubling of the risk of heart disease, stroke and type II diabetes mellitus. It has been demonstrated that physical activity, and especially HIIT, can promote a healthy body composition and decrease the risk cardiometabolic disease in the able-bodied population. However, SCI typically limits voluntary exercise to the arms, but a high prevalence of shoulder pain in persons with chronic SCI (60-90%) can cause increased arm exercise to be problematic. Functional electrical stimulation (FES) cycling has proven to be a safe and effective way to exercise paralyzed leg muscles in clinical and home settings, saving the often overworked arms. Yet, HIIT-FES cycling had not been investigated prior to the current study. The purpose of this study was to investigate the body composition changes with combined HIIT-FES cycling and nutritional counseling on individuals with SCI. Design: A matched (level of injury, time since injury, body mass index) and controlled trail. Setting: University exercise performance laboratory. Subjects: Ten individuals with chronic SCI (C5-T9) ASIA impairment classification (A & B) were divided into the treatment group (n=5) for 30 minutes of HIIT-FES cycling 3 times per week for 8 weeks and nutritional counseling over the phone for 30 minutes once per week for 8 weeks and the control group (n=5) who received nutritional counseling only. Results: There was a statistically significant difference between the HIIT-FES group and the control group in mean body fat percentage change (-1.14 to +0.24) respectively, p = .030). There was also a statistically significant difference between the HIIT-FES and control groups in mean change in legs lean mass (+0.78 kg to -1.5 kg) respectively, p = 0.004. There was a nominal decrease in weight, BMI, total fat mass and a nominal increase in total lean mass for the HIIT-FES group over the control group. However, these changes were not found to be statistically significant. Additionally, there was a nominal decrease in the mean blood glucose levels for both groups 101.8 to 97.8 mg/dl for the HIIT-FES group and 94.6 to 93 mg/dl for the Nutrition only group, however, neither were found to be statistically significant. Conclusion: HIIT-FES cycling combined with nutritional counseling can provide healthful body composition changes including decreased body fat percentage in just 8 weeks. Future study recommendations include a greater number of participants, a primer electrical stimulation exercise program to better ready participants for HIIT-FES cycling and a greater volume of training above 30 minutes, 3 times per week for 8 weeks.

Keywords: body composition, functional electrical stimulation cycling, high-intensity interval training, spinal cord injury

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Authors: Saba Moghaddam

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There is an ongoing and dynamic interplay between cultural environment and individuals’ psych, an interaction that starts at birth and continues throughout life. Cultural Unconscious affects the way people choose their partners and how they shape their relationships. The aim of this study is to identify cultural unconscious beliefs that play a decisive role in the relationship between couples. The study used the method of thematic analysis, and through purposeful sampling and semi-interviews, the themes regarding cultural unconscious in 17 married people between the ages of 24 and 40 years were identified. These themes are (1) Feminization-masculinization of post-marriage roles; (2) Subordinate Women – an intergenerational belief; (3) cultural standards affecting the choice of spouse; (4) primary family beliefs about marriage. Based on these findings, traditional beliefs continue to play a decisive function and effect on people’s unconscious, and in order to achieve a couple's relationship satisfaction, identifying their roles and becoming conscious of these unconscious cultural beliefs is very important.

Keywords: couple relationship, partner choice, thematic analysis, unconscious cultural believes

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Authors: Sean Taylor, Sayantani Neogi, Julia Budka

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The important Egyptian New Kingdom settlement at Sai Island Sudan presents a complex stratigraphic archaeological record. This study takes the theoretic stance that it, not just the archaeological material being retrieved from the deposits but the sediments themselves that reflect human agency. These anthropogenic sediments reflect the use life of the buildings and spaces between and the post-depositional processes which operate to complicate the archaeological record. The application of soil micromorphology is a technique that takes intact block samples of sediment and analyses them in thin section under a petrological microscope. A detailed understanding of site formation processes and a contextualized knowledge of the material culture can be understood through careful and systematic observation of the changing facies. The major findings of the study are that soil and sedimentary information can provide valuable insights to the use of space during the New Kingdom and elucidate the complexities of site formation processes.

Keywords: anthropogenic sediment, New Kingdom, site formation processes, soil micromorphology

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Authors: Pedro Llanos, Diego García

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This paper is addressed to expanding our understanding of the effects of hypoxia training on our bodies to better model its dynamics and leverage some of its implications and effects on human health. Hypoxia training is a recommended practice for military and civilian pilots that allow them to recognize their early hypoxia signs and symptoms, and Scientist Astronaut Candidates (SACs) who underwent hypobaric hypoxia (HH) exposure as part of a training activity for prospective suborbital flight applications. This observational-analytical study describes physiologic responses and symptoms experienced by a SAC group before, during and after HH exposure and proposes a model for assessing predicted versus observed physiological responses. A group of individuals with diverse Science Technology Engineering Mathematics (STEM) backgrounds conducted a hypobaric training session to an altitude up to 22,000 ft (FL220) or 6,705 meters, where heart rate (HR), breathing rate (BR) and core temperature (Tc) were monitored with the use of a chest strap sensor pre and post HH exposure. A pulse oximeter registered levels of saturation of oxygen (SpO₂), number and duration of desaturations during the HH chamber flight. Hypoxia symptoms as described by the SACs during the HH training session were also registered. This data allowed to generate a preliminary predictive model of the oxygen desaturation and O₂ pressure curve for each subject, which consists of a sixth-order polynomial fit during exposure, and a fifth or fourth-order polynomial fit during recovery. Data analysis showed that HR and BR showed no significant differences between pre and post HH exposure in most of the SACs, while Tc measures showed slight but consistent decrement changes. All subjects registered SpO₂ greater than 94% for the majority of their individual HH exposures, but all of them presented at least one clinically significant desaturation (SpO₂ < 85% for more than 5 seconds) and half of the individuals showed SpO₂ below 87% for at least 30% of their HH exposure time. Finally, real time collection of HH symptoms presented temperature somatosensory perceptions (SP) for 65% of individuals, and task-focus issues for 52.5% of individuals as the most common HH indications. 95% of the subjects experienced HH onset symptoms below FL180; all participants achieved full recovery of HH symptoms within 1 minute of donning their O₂ mask. The current HH study performed on this group of individuals suggests a rapid and fully reversible physiologic response after HH exposure as expected and obtained in previous studies. Our data showed consistent results between predicted versus observed SpO₂ curves during HH suggesting a mathematical function that may be used to model HH performance deficiencies. During the HH study, real-time HH symptoms were registered providing evidenced SP and task focusing as the earliest and most common indicators. Finally, an assessment of HH signs of symptoms in a group of heterogeneous, non-pilot individuals showed similar results to previous studies in homogeneous populations of pilots.

Keywords: slow onset hypoxia, hypobaric chamber training, altitude sickness, symptoms and altitude, pressure cabin

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Authors: Amna B. Medani, M. A. Elbadwi Samia, Hassan A. Khalid

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In our study, nine Nubian goat kids were obtained, allotted into three groups, and healthily adapted in pens within the premises of the Veterinary Teaching Hospital, University of Khartoum to be given the oral doses of the dried herb shoots at daily doses of 1 and 5 gm/kg/day with drinking water, while the kids of the control group were left undosed. All goats were slaughtered,if not died, after 35 days. S. argel at the given doses caused signs of arched posture, ruffled hair, shivering and paralysis of limbs. On post mortem, lesions were seen to be hepatic fatty changes, renal necrosis, congested lungs and inflamed intestines. Serum chemistry investigations revealed significant increase (P< 0.05-0.01) in the activities of ALP(alkaline phosphates) and AST( aspartate-aminotransferase) in goats dosed with 5 gm /kg/ day. Also observed were significant increases in inorganic phosphorus and urea concentrations (P < 0.05-0.01) in both dosed goat groups. .Other investigations including the activity of GGT( gamma glutamyltransferase), creatinine, calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. On haematological evaluation , the goat kids dosed with 5 gm/kg/dayshowed a decrease in haemoglobin concentration and red blood cells count of (P < 0.05-0.01).Both groups of dosed goats showed a higher packed cell volume values of (P < 0.05) when compared to the control goats .Mean corpuscular haemoglobin values were not different from those of the control kids. S. argel at the given doses caused signs of arched posture, ruffled hair, shivering and paralysis of limbs. On post mortem, lesions were seen to be hepatic fatty changes, renal necrosis, congested lungs and inflamed intestines. Serum chemistry investigations revealed significant increase (P < 0.05-0.01) in the activities of ALP(alkaline phosphates) and AST( aspartate-aminotransferase) in goats dosed with 5 gm /kg/ day. Also observed were significant increases in inorganic phosphorus and urea concentrations (P < 0.05-0.01) in both dosed goat groups. .Other investigations including the activity of GGT( gamma-glutamyltransferase), creatinine, calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. On haematological evaluation , the goat kids dosed with 5 gm/kg/dayshowed a decrease in haemoglobin concentration and red blood cells count of (P < 0.05-0.01).Both groups of dosed goats showed a higher packed cell volume values of (P < 0.05) when compared to the control goats .Mean corpuscular haemoglobin values were not different from those of the control kids. Data obtained were then discussed to find S. argel irritable to intestines , toxic to the kidney and liver and a haematological mild toxin.Suggestions for future were forwarded.

Keywords: hargal, nubian goats, solenstemma argel, toxicity

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Authors: Anupam Deka

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Gender discrimination has been considered as a major obstacle in granting equal opportunity for woman in Higher education as education plays a pivotal role in a country’s socio-economic development. To examine the empowerment of women in the higher education field of Assam, a case study has been carried out. In the first stage, an overview of enrolment of students in different courses has been made by considering the whole state. In the second stage a study has been conducted regarding the enrolment of students in various degree and P-G courses for the period 2000-2007 under Gauhati University (which is one of the four universities of Assam) and the relevant data has been collected. It has been found that though the enrolment of students in the degree levels has been constantly increasing, but the enrolment of girls are not proportionately increasing, specially in commerce and law. On the other hand, in the post-graduate level, these proportions are higher in almost all the subjects (except some subjects like M. COM., L.L.M, M. C. A., Mathematics, etc.), indicating that more number of girls than boys are taking admission in the P-G courses.

Keywords: field study, enrolment of girls in degree and P G levels, regression lines, Chi Square test, diagrams and statistical tables

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Authors: Chariya Laohavich, Viboon Bunsrangsuk

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Objective: Bronchoscopy is a common outpatient procedure. The authors compared the patient anxiety level before and after received video-assisted procedural information. Method: One hundred and twenty patients who never received bronchoscopy and scheduled for elective bronchoscopy at outpatient Bronchosope unit at Ramathibodi Hospital, Mahidol University were randomized into control and intervention group. Video-assisted procedural information was given in intervention group. Pre and post procedural anxiety score were recorded and compared between two groups. Paired T-test was used for statistical analysis. Result: There was statistically significant decrease (p < 0.001) for anxiety score in patients who received video assisted procedural information compare with control group. Conclusion: Video-assisted procedural information should be given to patient who will have bronchoscopy to reduce anxiety.

Keywords: anxiety, bronchoscopy, video compact disc (VCD)

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Authors: Omair Anas

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The Persian Gulf has been in turmoil for a long time since the colonial administration has handed over the role to the small and weak kings and emirs who were assured of protection in return of many economic and security promises to them. The regional order, Saudi Arabia evolved was a rentier regional order secured by an expansion of rentier economy and taking responsibility for much of the expenses of the regional order on behalf of relatively poor countries. The two oil booms helped the Saudi state to expand the 'rentier order' driven stability and bring the countries like Egypt, Jordan, Syria, and Palestine under its tutelage. The disruptive misadventure, however, came with Iran's proclamation of the Islamic Revolution in 1979 which it wanted to be exported to its 'un-Islamic and American puppet' Arab neighbours. For Saudi Arabia, even the challenge presented by the socialist-nationalist Arab dictators like Gamal Abdul Nasser and Hafez Al-Assad was not that much threatening to the Saudi Arabia’s then-defensive realism. In the Arab uprisings, the Gulf monarchies saw a wave of insecurity and Iran found it an opportune time to complete the revolutionary process it could not complete after 1979. An alliance of convenience and ideology between Iran and Islamist groups had the real potential to challenge both Saudi Arabia’s own security and its leadership in the region. The disruptive threat appeared at a time when the Saudi state had already sensed an impending crisis originating from the shifts in the energy markets. Low energy prices, declining global demands, and huge investments in alternative energy resources required Saudi Arabia to rationalize its economy according to changing the global political economy. The domestic Saudi reforms remained gradual until the death of King Abdullah in 2015. What is happening now in the region, the Qatar crisis, the Lebanon crisis and the Saudi-Iranian proxy war in Iraq, Syria, and Yemen has combined three immediate objectives, rationalising Saudi economy and most importantly, the resetting the Saudi royal power for Saudi Arabia’s longest-serving future King Mohammad bin Salman. The Saudi King perhaps has no time to wait and watch the power vacuum appearing because of Iran’s expansionist foreign policy. The Saudis appear to be employing an offensive realism by advancing a pro-active regional policy to counter Iran’s threatening influence amid disappearing Western security from the region. As the Syrian civil war is coming to a compromised end with ceding much ground to Iran-controlled militias, Hezbollah and Al-Hashad, the Saudi state has lost much ground in these years and the threat from Iranian proxies is more than a reality, more clearly in Bahrain, Iraq, Syria, and Yemen. This paper attempts to analyse the changing Saudi behaviour in the region, which, the author understands, is shaped by an offensive-realist approach towards finding a favourable security environment for the Saudi-led regional order, a post-rentier order perhaps.

Keywords: terrorism, Saudi Arabia, Rentier State, gulf crisis

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Authors: Kamel Agroui, George Collins, Rydha Yaiche

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The objective of this study is to better understand the thermal characteristics and molecular behaviour of cured EVA before and after outdoor exposure. Thermal analysis methods as DSC, TSC and DMTA studies were conducted on EVA material. DSC experiments on EVA show a glass transition at about -33.1° C which is characteristic of crystalline phase and an endothermic peak at temperature of 55 °C characteristic of amorphous phase. The magnitude of the integrated temperature DSC peak for EVA is 14.4 J/g. The basic results by TSC technique is that there are two relaxations that are reproducibly observed in cured EVA encapsulant material. At temperature polarization 85°C, a low temperature relaxation occurs at –24.4°C and a high temperature relaxation occurs at +30.4ºC. DMTA results exhibit two tan peaks located at -14.9°C and +66.6°C. After outdoor exposure cured EVA by DSC analysis revealed two endothermic peaks due to post crystallization phenomenon and TSC suggests that prolonged exposure selectively effects the poly(vinyl acetate)-rich phase, with much less impact on the polyethylene-rich phase.

Keywords: EVA, encapsulation process, PV module, thermal analysis, quality control

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Authors: Eda Ozkara San

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Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

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Authors: Antonio Abatemarco, Francesca Stroffolini

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In the economic literature, Rawls’ Theory of Justice is usually interpreted in a two-stage setting, where a priority to the worst off individual is imposed as a distributive value judgment. In this paper, instead, we model Rawls’ Theory in a three-stage setting, that is, a separating line is drawn between the original position, the educational stage, and the working life. Hence, in this paper, we challenge the common interpretation of Rawls’ Theory of Justice as Fairness by showing that this Theory goes well beyond the definition of a distributive value judgment, in such a way as to embrace efficiency issues as well. In our model, inequalities are shown to be permitted as far as they stimulate a greater effort in education in the population, and so economic growth. To our knowledge, this is the only possibility for the inequality to be ‘bought’ by both the most-, and above all, the least-advantaged individual as suggested by the Difference Principle. Finally, by recalling the old tradition of ‘universal ex-post efficiency’, we show that a unique optimal social contract does not exist behind the veil of ignorance; more precisely, the sole set of potentially Rawls-optimal social contracts can be identified a priori, and partial justice orderings derived accordingly.

Keywords: justice, Rawls, inequality, social contract

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Authors: I. Pelizzoni, C. Cavallini, I. Salvaderi, F. Cavallini

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We present the improvement in writing skills obtained by 94 participants (aged between six and 10 years) with special educational needs through a writing enhancement program based on fluency principles. The study was planned and conducted with a single-subject experimental plan for each of the participants, in order to confirm the results in the literature. These results were obtained using precision teaching (PT) methodology to increase the number of written graphemes per minute in the pre- and post-test, by curriculum based measurement (CBM). Results indicated an increase in the number of written graphemes for all participants. The average overall duration of the intervention is 144 minutes in five months of treatment. These considerations have been analyzed taking account of the complexity of the implementation of measurement systems in real operational contexts (an Italian learning center) and important aspects of replicability and cost-effectiveness of such interventions.

Keywords: curriculum based measurement, precision teaching, writing skill, Italian learning center

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Authors: Kenneth A. Rostowsky, Alexander S. Maher, Nahian F. Chowdhury, Andrei Irimia

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The clinical significance of cerebral microbleeds (CMBs) due to mild traumatic brain injury (mTBI) remains unclear. Here we use magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and connectomic analysis to investigate the statistical association between mTBI-related CMBs, post-TBI changes to the human connectome and neurological/cognitive deficits. This study was undertaken in agreement with US federal law (45 CFR 46) and was approved by the Institutional Review Board (IRB) of the University of Southern California (USC). Two groups, one consisting of 26 (13 females) mTBI victims and another comprising 26 (13 females) healthy control (HC) volunteers were recruited through IRB-approved procedures. The acute Glasgow Coma Scale (GCS) score was available for each mTBI victim (mean µ = 13.2; standard deviation σ = 0.4). Each HC volunteer was assigned a GCS of 15 to indicate the absence of head trauma at the time of enrollment in our study. Volunteers in the HC and mTBI groups were matched according to their sex and age (HC: µ = 67.2 years, σ = 5.62 years; mTBI: µ = 66.8 years, σ = 5.93 years). MRI [including T1- and T2-weighted volumes, gradient recalled echo (GRE)/susceptibility weighted imaging (SWI)] and gradient echo (GE) DWI volumes were acquired using the same MRI scanner type (Trio TIM, Siemens Corp.). Skull-stripping and eddy current correction were implemented. DWI volumes were processed in TrackVis (http://trackvis.org) and 3D Slicer (http://www.slicer.org). Tensors were fit to DWI data to perform DTI, and tractography streamlines were then reconstructed using deterministic tractography. A voxel classifier was used to identify image features as CMB candidates using Microbleed Anatomic Rating Scale (MARS) guidelines. For each peri-lesional DTI streamline bundle, the null hypothesis was formulated as the statement that there was no neurological or cognitive deficit associated with between-scan differences in the mean FA of DTI streamlines within each bundle. The statistical significance of each hypothesis test was calculated at the α = 0.05 level, subject to the family-wise error rate (FWER) correction for multiple comparisons. Results: In HC volunteers, the along-track analysis failed to identify statistically significant differences in the mean FA of DTI streamline bundles. In the mTBI group, significant differences in the mean FA of peri-lesional streamline bundles were found in 21 out of 26 volunteers. In those volunteers where significant differences had been found, these differences were associated with an average of ~47% of all identified CMBs (σ = 21%). In 12 out of the 21 volunteers exhibiting significant FA changes, cognitive functions (memory acquisition and retrieval, top-down control of attention, planning, judgment, cognitive aspects of decision-making) were found to have deteriorated over the six months following injury (r = -0.32, p < 0.001). Our preliminary results suggest that acute post-TBI CMBs may be associated with cognitive decline in some mTBI patients. Future research should attempt to identify mTBI patients at high risk for cognitive sequelae.

Keywords: traumatic brain injury, magnetic resonance imaging, diffusion tensor imaging, connectomics

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Authors: Vaisnavy Govindasamy, Saba Ishrat

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Introduction: The Dexamethasone Intravitreal Implant 0.7 mg (OzurdexTM, Allergan®) is a biodegradable corticosteroid implant approved by the FDA for managing diabetic macular edema (DMO), macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), and posterior segment non-infectious uveitis. This implant can release dexamethasone over a six-month period, exhibiting peak effectiveness between 60 and 90 days post-administration. The intravitreal injection should be performed under sterile conditions. At James Cook University Hospital (JCUH), Ozurdex injections are currently administered in the Vitreo-Retinal (VR) theatre. This study aimed to evaluate the feasibility and potential advantages of establishing a dedicated clinic for Ozurdex administration separate from the VR theatre setting. Method: Retrospectively, data of all Ozurdex injections administered between October 2021 to October 2022 was collected from operating theatre registers at JCUH. Data pertaining to the indications for Ozurdex; waiting times from referral date to date of injection; duration of theatre time consumed; and post-injection complications were collected from electronic notes. The resources needed to establish a dedicated Ozurdex clinic were evaluated. Over a six-month period from October 2023 to March 2024, we gathered data on utilization of theatre 28. Results: A total of 135 Ozurdex injections were administered. Among the indications, uveitis represented 47.3% of cases, DMO with 23.6% and RVO with 22.9%. Remaining cases lacked sufficient data. Each Ozurdex injection procedure consumed 15 minutes in the VR theatre list. Complications arose in 5% of injections, totaling 7 cases. These included glaucoma, ocular hypertension, subconjunctival haemorrhage and implant migration. Waiting times averaged 6 weeks from date for referral to procedure date. We also found that, on an average theatre 28 was offered but remained unused for 4 days, totalling eight sessions in a month. Analysis: Establishing a sperate Ozurdex clinic would improve the quality of patient care in following ways: 1.Decrease injection waiting times (currently averaging 6 weeks), leading to better visual outcomes. 2.Free up approximately three hours of theatre time in Vitreo-Retina theatres each month, allowing for 3-4 additional surgeries. Reduce waiting times for critical retinal surgeries and enhance visual outcomes. 3.Provide additional training opportunities for trainees and retina fellows, improving their skills. 4.Optimize the use of empty theatre slots (theatre 28) currently experiencing underutilization of resources. Conclusion: These findings support the implementation of a separate clinic for administering Ozurdex injections at JCUH. It is evident that introducing a dedicated clinic will enhance operational efficiency, optimise resource utilsation, and improve overall quality of care for patients undergoing this treatment.

Keywords: opthalmology, ozurdex, efficiency, complication

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Authors: Jasna Milošević Đorđević, Jelisaveta Blagojević, Jovana Timotijević, Alison Mckinley

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Young people in Serbia, have grown up in turbulent times during the Balkan wars, in a cultural and economic isolation without adequate education on (ethnic, gender, social,..) equality. They often have very strong patriarchal gender stereotypes. The perception of gender in Serbia is still heavily influenced by traditional worldview and young people have little opportunity in traditional educational system to challenge it, receiving no formal sex education. Educational policies have addressed achieving gender equality as one of the goals, supporting all young people to gain better educational opportunities, but there are obvious shortcomings of the official education system in implementation of those goals. Therefore new approaches should be implemented. We evaluate the impact of non traditional approach, such as participatory theatre performance with strong transformative potential, especially in relation to gender issues. Theatre based intervention (TBI) was created to provoke the young people to become aware of their gender constructs. Engaging young people in modern form of education such as transformative gender intervention through participatory theatre could have positive impact on their sex knowledge and understanding gender roles. The transformative process in TBI happens on two levels – the affective and the cognitive. The founding agency of the project and evaluation is IPPF. The most important aim of this survey is evaluation of the transformative TBI, as a new educational approach related to better understanding gender as social construct. To reach this goal, we have measured attitude change in three indicators: a) gender identity/ perception of feminine identity, perception of masculine identity, importance of gender for personal identity, b) gender roles on the labor market, c) Gender equality in partnership & sexual behavior. Our main hypothesis is that participatory theatre-based intervention can have a transformational potential in challenging traditional gender knowledge and attitudes among youth in Serbia. To evaluate the impact of TB intervention, we implement: online baseline and end-line survey with nonparticipants of the TBI on the representative sample in targeted towns (control group). Additionally we conducted testing the experimental group twice: pretest at the beginning of each TBI and post testing of participants after the play. A sample of 500 respondents aged 18-30 years, from 9 towns in Serbia responded to online questionnaire in September 2017, in a baseline research. Pre and post measurement of all tested variables among participants in nine towns would be performed. End-line survey with 500 respondents would be conducted at the end of the project (early year 2018). After the first TBI (60 participants) no impact was detected on measured indicators: perception of desirable characteristics of man F(1,59)= 1.291, p=.260; perception of desirable characteristics of women F(1,55)=1.386, p= .244; gender identity importance F(1,63)= .050, p=.824; sex related behavior F(1,61)=1,145, p=.289; gender equality on labor market F(1,63)=.076, p=.783; gender equality in partnership F(1,61)=.201, p=.656; However, we hope that following intervention would bring more data showing that participatory theatre intervention explaining gender as a social construct could have additional positive impact in traditional educational system.

Keywords: educational impact, gender identity, gender role, participatory theatre based intervention

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Authors: Rohita Gupta, G. S. Brah, R. Verma, C. S. Mukhopadhayay

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Although chicken strains show differences in susceptibility to a number of diseases, the underlying immunological basis is yet to be elucidated. In the present study, heterophils were subjected to LPS stimulation and total RNA extraction, further differential gene expression was studied in broiler, layer and indigenous Aseel strain by Real Time RT-PCR at different time periods before and after induction. The expression of the 14 AvBDs and chTLR 1, 2, 3, 4, 5, 7, 15 and 21 was detectable in heterophils. The expression level of most of the AvBDs significantly increased (P<0.05) 3 hours post in vitro lipopolysaccharide challenge. Higher expression level and stronger activation of most AvBDs, NFkB-1 and IRF-3 in heterophils was observed, with the stimulation of LPS in layer compared to broiler, and in Aseel compared to both layer and broiler. This investigation will allow more refined interpretation of immuno-genetic basis of the variable disease resistance/susceptibility in divergent stock of chicken including indigenous breed. Moreover this study will be helpful in formulation of strategy for isolation of antimicrobial peptides from heterophils.

Keywords: differential expression, heterophils, cytokines, defensin, TLR

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Authors: Oladimeji Adetona Adeyeye, Emmanuel Rotimi Sadiku, Oluwaseun Olayinka Adeyeye

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In order to resuscitate soybean production and post-harvest processing especially, in term of threshing, there is need to develop an affordable threshing machine which will reduce drudgery associated with manual soybean threshing. Soybean thresher was fabricated and evaluated at Institute of Agricultural Research and Training IAR&T Apata Ibadan. The machine component includes; hopper, threshing unit, shaker, cleaning unit and the seed outlet, all working together to achieve the main objective of threshing and cleaning. TGX1835 - 10E variety was used for evaluation because of its high resistance to pests, rust and pustules. The final moisture content of the used sample was about 15%. The sample was weighed and introduced into the machine. The parameters evaluated includes moisture content, threshing efficiency, cleaning efficiency, machine capacity and speed. The threshing efficiency and capacity are 74% and 65.9kg/hr respectively. All materials used were sourced locally which makes the cost of production of the machine extremely cheaper than the imported soybean thresher.

Keywords: efficiency, machine capacity, speed, soybean, threshing

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Authors: Hanan Badr, Fahad Manee, Rao Shashidhar, Omar Bayoumy

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Introduction: Hypertension is the major risk factor for cardiovascular diseases and stroke and a universe leading cause of disability-adjusted life years and mortality. Adopting an unhealthy lifestyle is thought to be associated with developing hypertension regardless of predisposing genetic factors. This study aimed to examine the association between recreational physical activity (RPA), and sedentary behaviors with a risk of hypertension among ministry employees, where there is no role for occupational physical activity (PA), and to scrutinize participants’ time spent in RPA and sedentary behaviors on the working and weekend days. Methods: A cross-sectional study was conducted among randomly selected 2562 employees working at ten randomly selected ministries in Kuwait. To have a representative sample, the proportional allocation technique was used to define the number of participants in each ministry. A self-administered questionnaire was used to collect data about participants' socio-demographic characteristics, health status, and their 24 hours’ time use during a regular working day and a weekend day. The time use covered a list of 20 different activities practiced by a person daily. The New Zealand Physical Activity Questionnaire-Short Form (NZPAQ-SF) was used to assess the level of RPA. The scale generates three categories according to the number of hours spent in RPA/week: relatively inactive, relatively active, and highly active. Gender-matched trained nurses performed anthropometric measurements (weight and height) and measuring blood pressure (two readings) using an automatic blood pressure monitor (95% accuracy level compared to a calibrated mercury sphygmomanometer). Results: Participants’ mean age was 35.3±8.4 years, with almost equal gender distribution. About 13% of the participants were smokers, and 75% were overweight. Almost 10% reported doctor-diagnosed hypertension. Among those who did not, the mean systolic blood pressure was 119.9±14.2 and the mean diastolic blood pressure was 80.9±7.3. Moreover, 73.9% of participants were relatively physically inactive and 18% were highly active. Mean systolic and diastolic blood pressure showed a significant inverse association with the level of RPA (means of blood pressure measures were: 123.3/82.8 among relatively inactive, 119.7/80.4 among relatively active, and 116.6/79.6 among highly active). Furthermore, RPA occupied 1.6% and 1.8% of working and weekend days, respectively, while sedentary behaviors (watching TV, using electronics for social media or entertaining, etc.) occupied 11.2% and 13.1%, respectively. Sedentary behaviors were significantly associated with high levels of systolic and diastolic blood pressure. Binary logistic regression revealed that physical inactivity (OR=3.13, 95% CI: 2.25-4.35) and sedentary behaviors (OR=2.25, CI: 1.45-3.17) were independent risk factors for high systolic and diastolic blood pressure after adjustment for other covariates. Conclusions: Physical inactivity and sedentary lifestyle were associated with a high risk of hypertension. Further research to examine the independent role of RPA in improving blood pressure levels and cultural and occupational barriers for practicing RPA are recommended. Policies should be enacted in promoting PA in the workplace that might help in decreasing the risk of hypertension among sedentary occupation workers.

Keywords: physical activity, sedentary behaviors, hypertension, workplace

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Authors: James Moir

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This paper considers the political controversy in Britain, both pre- and post-EU referendum, concerning claims over welfare benefit tourism and immigration in the UK. These claims were seen to be a significant reason for the vote for Brexit despite evidence to the contrary that benefit tourism was not, and is not, implicated in the migration of East Europeans to the UK. Populist rhetoric is analysed alongside studies that contradict such views. These contentious issues are examined with respect to the agenda set by the United Kingdom Independence Party (UKIP) concerning anti-EU and anti-immigrant sentiment and the notion of cultural differences as the basis for supporting Brexit. The paper also examines the paradoxical claim that East European migrants are taking British jobs and driving down wages. Taken together, it is argued that these two kinds of claims effectively contribute to anti-immigration discourse based on the logic of economics, but also at the same time conceal more irrational fears of adapting to change through the inclusion of others. Such fears are considered as being founded upon a challenge to the stability of totems of national life and identity.

Keywords: benefits, Brexit, immigration, tourism, welfare

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Authors: Ana Paula Melchiors Stahlschmidt, Cristina Py de Pinto Gomes Mairesse

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This paper presents observations on the early supervised internships in Psychology, currently called basic internships in Brazil, and its importance in professional training. The work is an experience report and focuses on the Professional training, illustrated by the reality of a Brazilian institution, used as a case study. It was developed from the authors' experience as academic supervisors of this kind of practice throughout this undergraduate course, combined with aspects investigated in the post-doctoral research of one of them. Theoretical references on the subject and related national legislation are analyzed, as well as reports of students who experienced at least one semester of this type of practice, articulated to the observations of the authors. The results demonstrate the importance of the early supervised internships as a way of creating opportunities for the students of a first contact with the professional reality and the practice of psychologists in different fields of insertion, preparing them for further experiments that require more involvement in activities of training and practices in Psychology.

Keywords: training of psychologists, internships in psychology, supervised internships, combination of theory and practice

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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