Search results for: secondary metabolite

Authors: Janneth Gonzalez, Andres Pinzon Velasco, Maria Angarita, Nicolas Mendoza

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Astrocytes play an important role in various processes in the brain, including pathological conditions such as neurodegenerative diseases. Recent studies have shown that the increase in saturated fatty acids such as palmitic acid (PA) triggers pro-inflammatory pathways in the brain. The use of synthetic neurosteroids such as tibolone has demonstrated neuro-protective mechanisms. However, there are few studies on the neuro-protective mechanisms of tibolone, especially at the systemic (omic) level. In this study, we performed the integration of multi-omic data (transcriptome and proteome) into a human astrocyte genomic scale metabolic model to study the astrocytic response during palmitate treatment. We evaluated metabolic fluxes in three scenarios (healthy, induced inflammation by PA, and tibolone treatment under PA inflammation). We also use control theory to identify those reactions that control the astrocytic system. Our results suggest that PA generates a modulation of central and secondary metabolism, showing a change in energy source use through inhibition of folate cycle and fatty acid β-oxidation and upregulation of ketone bodies formation.We found 25 metabolic switches under PA-mediated cellular regulation, 9 of which were critical only in the inflammatory scenario but not in the protective tibolone one. Within these reactions, inhibitory, total, and directional coupling profiles were key findings, playing a fundamental role in the (de)regulation in metabolic pathways that increase neurotoxicity and represent potential treatment targets. Finally, this study framework facilitates the understanding of metabolic regulation strategies, andit can be used for in silico exploring the mechanisms of astrocytic cell regulation, directing a more complex future experimental work in neurodegenerative diseases.

Keywords: astrocytes, data integration, palmitic acid, computational model, multi-omics, control theory

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Authors: Kougioumtzis Konstantin, Rylander Pär, Karlsteen Magnus

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Ball skills as a subset of fundamental motor skills are predictors for performance in sports. Currently, most tools evaluate ball skills utilizing subjective ratings. The aim of this study was to examine the psychometric properties of a newly developed instrument to objectively measure ball handling skills (BHS-test) utilizing digital instrument. Participants were a convenience sample of 213 adolescents (age M = 17.1 years, SD =3.6; 55% females, 45% males) recruited from upper secondary schools and invited to a sports hall for the assessment. The 8-item instrument incorporated both accuracy-based ball skill tests and repetitive-performance tests with a ball. Testers counted performance manually in the four tests (one throwing and three juggling tasks). Furthermore, assessment was technologically enhanced in the other four tests utilizing a ball machine, a Kinect camera and balls with motion sensors (one balancing and three rolling tasks). 3D printing technology was used to construct equipment, while all results were administered digitally with smart phones/tablets, computers and a specially constructed application to send data to a server. The instrument was deemed reliable (α = .77) and principal component analysis was used in a random subset (53 of the participants). Furthermore, latent variable modeling was employed to confirm the structure with the remaining subset (160 of the participants). The analysis showed good factorial-related validity with one factor explaining 57.90 % of the total variance. Four loadings were larger than .80, two more exceeded .76 and the other two were .65 and .49. The one factor solution was confirmed by a first order model with one general factor and an excellent fit between model and data (χ² = 16.12, DF = 20; RMSEA = .00, CI90 .00–.05; CFI = 1.00; SRMR = .02). The loadings on the general factor ranged between .65 and .83. Our findings indicate good reliability and construct validity for the BHS-test. To develop the instrument further, more studies are needed with various age-groups, e.g. children. We suggest using the BHS-test for diagnostic or assessment purpose for talent development and sports participation interventions that focus on ball games.

Keywords: ball-handling skills, ball-handling ability, technologically-enhanced measurements, assessment

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Authors: Rafikoddin Kazi

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Almost all the major religions of the world condemn the transactions based on interest which promotes self-centered and materialistic thinking. Still, it is amazing to note that it has become the tradition of transaction at world level hence it is called traditional financial system. The main feature of this system is that it considers economic aspects of the transaction only. This system supports the economic development and not the welfare of humankind. However, it is worth mentioning the fact that, except Islamic financial system no other financial system stood in front of it as a viable alternative system. Although many countries have tried to create financial infrastructure and system, still the Malaysian Islamic financial system has got its own peculiarity. It has made tremendous progress in creating sound Islamic Financial system. However, the historical aspect of this country which has passed through Islamic and traditional financial system has got its own advantages and disadvantages. The advantageous factor is that, despite having mix and heterogeneous culture, it has succeeded in creating Islamic Financial System based on the dual legal system to satisfy the needs of multi-cultural factors. This fact has proved that Islamic Financial System does not need purely Muslim population. However, due to adoption of the dual legal system, several legal issues have been taken place. According to this system, the application of Islamic Law has been limited only up to some family and religious matters. The rest of the matters are being dealt with under the traditional laws, the principles and practices of which are different from that of the Islamic Legal System. The matter becomes all the more complicated when the cases are partially or simultaneously concerned with traditional vis-à-vis Islamic Laws as it requires expertise in both the legal systems. However, the educational principles and systems are different in respect of both the systems. To face this problem, Shariah Advisory Council has been established. But the Multiplicity of Shariah authorities without judicial power has created confusion at various levels. Therefore, some experts have stressed the need for improving, empowering the Islamic financial, legal system to make it more integrated and holistic. In view of the above, an endeavor has been made in this paper to throw some light on the matters related to the adoption of the dual legal system. The paper is conceptual in nature and the method adopted is the intensive survey of literature thereby all the information has been gathered from the secondary sources.

Keywords: Islamic financial system, Islamic legal system, Islamic capital market (ICM) , traditional financial system

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Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

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Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

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Authors: Haruna Karamba, Nafisa Muhammad Danyaro

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The study describe the action of natural latex (extract) of two sub-aquatic macrophytes plants i.e., Cassia occidentalis and Physalis angulata which were tested against two water snail species; Bulinus globusus and Lymnaea natalensis, the intermediate host of Bilharziasis (chistosomiasis) in the tropical countries. Bilherziasis is a disease prevalent and endermic to tropical Africa, seriously undermining health status of Nigerian youth. The easiest way to eradicate the disease is to eliminate the secondary host of the pathogen, chistosoma species. Therefore we carried out a research to investigate the molluscicidal effect of the leaf extract of C. occidentalis and P. angulata on mortality rate of B. globusus and L. natalensis water snails using pond water in the laboratory of science laboratory department of Kano State Polytechnic, Nigeria. One hundred and fifty juveniles’ snails were collected from Jakara Dam in the Northeastern part of Kano, Nigeria. The snails were put inside a plastic container and transported immediately to the laboratory where they were transferred into reservoir tank containing pond water and kept for 48 hours to get acclimatized with laboratory environment. Twelve water bathes 2/3 filled with pond water were prepared and kept in the laboratory. Leaf extract of the plants were obtained by blending and homogenizing the leaf tissue from which the extract were obtained and prepared in 10, 20, 30, 40 and 50 ppm, in addition to 0 ppm, which served as control. Ten snails were placed in each of the twelve water bathes. Six water bathes for the species of C. accidentalis extract and other six for P. angulata. The treatment combinations were maintained for 2 days after which the number of living snails present in each water bathes were counted and subsequently at 2 days intervals. The result indicated that extracts from both plants were lethal to the snails as concentration of the extract increases particularly mortality rate was highest at 40 and 50 ppm. Conclusively the toxicity of the extracts from these plants proven lethal to snails and hence can be used as molluscicides for cheap and easy method of eliminating water snails and therefore reducing the incidence of Bilharziasis.

Keywords: schistosomiasis, bilharziasis, Bulinus globusus, Lymnea natalensis, Physalis angulata, Cassia occidentalis, Kano

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Authors: Freddy Munzhelele

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Setting: the empirical research has shown that the life cycle theory has an impact on the firms’ financing decisions, particularly the dividend pay-outs. Accordingly, the life cycle theory posits that as a firm matures, it gets to a level and capacity where it distributes more cash as dividends. On the other hand, the young firms prioritise investment opportunities sets and their financing; thus, they pay little or no dividends. The research on firms’ financing decisions also demonstrated, among others, the adoption of trade-off and pecking order theories on the dynamics of firms capital structure. The trade-off theory talks to firms holding a favourable position regarding debt structures particularly as to the cost and benefits thereof; and pecking order is concerned with firms preferring a hierarchical order as to choosing financing sources. The case of life cycle hypothesis explaining the financial managers’ decisions as regards the firms’ capital structure dynamics appears to be an interesting link, yet this link has been neglected in corporate finance research. If this link is to be explored as an empirical research, the financial decision-making alternatives will be enhanced immensely, since no conclusive evidence has been found yet as to the dynamics of capital structure. Aim: the aim of this study is to examine the impact of life cycle theory on the capital structure dynamics trade-off and pecking order theories of firms listed in retail, industrial and mining sectors of the JSE. These sectors are among the key contributors to the GDP in the South African economy. Design and methodology: following the postpositivist research paradigm, the study is quantitative in nature and utilises secondary data obtainable from the financial statements of sampled firm for the period 2010 – 2022. The firms’ financial statements will be extracted from the IRESS database. Since the data will be in panel form, a combination of the static and dynamic panel data estimators will used to analyse data. The overall data analyses will be done using STATA program. Value add: this study directly investigates the link between the life cycle theory and the dynamics of capital structure decisions, particularly the trade-off and pecking order theories.

Keywords: life cycle theory, trade-off theory, pecking order theory, capital structure, JSE listed firms

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Authors: Barbora Valockova

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Scholars recommend the establishment of a multilateral coordination mechanism by ASEAN, such as an infrastructure forum, to contain the China-Japan infrastructure financing competition in the region. However, they do not systematically investigate the reasons for its absence. This paper aims to fill the gap by addressing the following question: Why has ASEAN been unable to set up any multilateral coordination mechanism to soften the China-Japan infrastructure financing competition? This paper argues that ASEAN has not been able to set up such a mechanism due to its limited centrality in connectivity. This limited centrality decreases ASEAN’s ability to manage the China-Japan competition in a more comprehensive and coordinated way. Rather, ASEAN acts as a scope setter in connectivity, although this is not completely ineffective. This paper is divided into four sections. The first section explores the key tenets of the concept of ASEAN centrality in connectivity, which is under-examined in the current literature. The second section examines the extent to which ASEAN limited centrality in connectivity is being respected by China and Japan. The third section analyses how various stakeholders, such as ASEAN member states, their leaders and bureaucracy, and foreign private companies prevent ASEAN from attaining stronger centrality. The last section concludes and offers recommendations. Data is gathered using primary sources (official ASEAN, Chinese, and Japanese documents, interviews, etc.) and secondary material. By providing a nuanced analysis of ASEAN centrality in connectivity and developing a new operationalization of the concept, this paper aims to contribute to the international relations literature on ASEAN centrality. Initial findings suggest that while ASEAN limited centrality in connectivity has some effectiveness, it is not sufficient for setting up a multilateral coordination mechanism. While it represents a solid departure point, any potential possessed by ASEAN to evolve beyond a scope setter in connectivity is hampered by stakeholders involved in infrastructure development. While these players and their interactions can have both positive and negative effects on the scope set by ASEAN, it is unlikely that they would allow ASEAN to become the real central player. There can be no stronger ASEAN centrality in connectivity without ASEAN unity and neutrality. However, the last two factors are difficult to attain in the context of infrastructure development since ASEAN member states and stakeholders all have their styles and preferences. All other things being equal, these circumstances favor a loose, vague, and quasi-prescriptive arrangement among the relevant stakeholders.

Keywords: ASEAN centrality, China-Japan infrastructure competition, connectivity, scope setter

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Dejen Alemu, Murray E. Jennex, Temtim Assefa

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Agriculture is the mainstay of the Ethiopian economy; however, the sector is dominated by smallholder farmers resulting in land fragmentation and suffering from low productivity. Due to these issues, much effort has been put into the transformation of the sector to bring about more sustainable rural economic development. Technological advancements have been applied for the betterment of farmers resulting in the design of tools that are potentially capable of supporting the agricultural sector; however, their use and relevance are still alien to the local rural communities. The notion of the creating, capturing and sharing of knowledge has also been repetitively raised by many international donor agencies to transform the sector, yet the most current approaches to knowledge dissemination focus on knowledge that originates from the western view of scientific rationality while overlooking the role of indigenous knowledge (IK). Therefore, in agricultural knowledge management system (KMS) development, the integration of IKS with scientific knowledge is a critical success factor. The present study aims to contribute in the discourse on how to best integrate scientific and IK in agricultural KMS development. The conceptual framework of the research is anchored in concepts drawn from the theory of situated learning in communities of practice (CoPs): knowledge brokering. Using the KMS development practices of Ethiopian agricultural transformation agency as a case area, this research employed an interpretive analysis using primary and secondary qualitative data acquired through in-depth semi-structured interviews and participatory observations. As a result, concepts are identified for understanding the integration of the two major knowledge systems (i.e., indigenous and scientific knowledge) and participation of relevant stakeholders in particular the local farmers in agricultural KMS development through the roles of extension agent as a knowledge broker including crossing boundaries, in-between position, translation and interpretation, negotiation, and networking. The research shall have a theoretical contribution in addressing the incorporation of a variety of knowledge systems in agriculture and practically to provide insight for policy makers in agriculture regarding the importance of IK integration in agricultural KMS development and support marginalized small-scale farmers.

Keywords: communities of practice, indigenous knowledge, knowledge management system development, knowledge brokering

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Authors: O. R. Adeniyi, A. Ayandiji

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Losses are common in most vegetables because the fruit ripens rapidly and most plantain products can only be stored for a few days thereby limiting their utilization. Plantain (and banana) is highly perishable at the ambient temperature prevalent in the tropics. The specific objective of this study is to identify the socioeconomic characteristics of banana/plantain dealers and determine the perceived effect of the losses incurred in the process of marketing banana/plantain. The study was carried out in Ondo and Lagos states of south-western Nigeria. Purposive sampling technique was used to collect information from “Kolawole plantain depot”, the point of purchase in Ondo State and “Alamutu plantain market” in Mushin the point of sales in Lagos state. Preliminary study was conducted with the use of primary data collected through well-structured questionnaires administered on 60 respondents and 55 fully completed ones analysed. Budgeting, gross margin and multiple linear regression were used for analyses. Most merchants were found to be in the middle age class (30-50 years), majority of whom were female and completed their secondary school education, with eighty percent having more than 5 years’ experience of in banana/plantain marketing. The highest losses were incurred during transportation and these losses constitute about 5.62 percent of the potential total revenue. On the average, loss in gross margin is about ₦6,000.00 per merchant. The impacts of these losses are reflected in the continuously reducing level of their income. Age of the respondents played a major role in determining the level of care in the handling of the fruits. The middle age class tends to be more favoured. In conclusion, the merchants need adequate and sustainable transportation and storage facilities as a matter of utmost urgency. There is the need for government to encourage producers of the product (farmers) by giving them motivating incentives and ensuring that the environment is made conducive also for dealers by providing adequate storage facilities and ready markets locally and possibly for export.

Keywords: post-harvest, losses, plantain, banana, simple regression

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Authors: Moksha Singh

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The proponents of deinstitutionalization, including Goffman and others, in their works, have regarded institutions (orphanages to be specific) as regulated social arrangements that negatively impinge upon a resident’s development. They, therefore, propose alternative forms of care. However, even after five decades of this critique institutionalization remains the only hope for children with social, physical and mental disabilities in larger parts of the developing world such as the conflict affected state of Jammu and Kashmir in India. This paper is based on the experiences of children who lost their parents to insurgency and counter-insurgency operations and the rehabilitation process. This study is qualitative in nature and adopts descriptive-cum-exploratory research design. Using theoretical sampling, six orphanages and thirty one child residents who lost their parent(s) in the course of the armed conflict in the state of Jammu and Kashmir in India were studied in the year 2009-2010. It included interviews, observation, life histories and introspective accounts of the orphans and the management. The results were drawn through the qualitative examination, understanding, and interpretation of the primary and secondary data. The findings suggested that rehabilitation of these conflict-affected children is taking place mainly through residential child care facilities run by non-governmental bodies. Alternative forms of rehabilitation are not functional in the state because of various geopolitical and socio-cultural complexities. Even after five years of arriving at these conclusions and more, the state of Jammu and Kashmir still lacks a comprehensive rehabilitation plan for these children. This has further encouraged a mushroomed growth of legal and illegal institutions. Some of these institutions compromise the standard norms of functioning and yet remain the only hope for thousands rendered orphan. These institutions, therefore, are there to stay as other alternative forms of care are not available in the state. A comprehensive intervention policy is needed based on the cultural specifics of the state and incorporation of views of institutions offering aid, the state and the children. The paper introduces Small Group Residential Care Model through which it is expected that the restoration process can be made smooth and effective.

Keywords: armed conflict, children's rights, institutionalization, orphanages, rehabilitation

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Authors: Ismail S. Bostanci, Ebru Akkaya

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Microalgae-derived biodiesel, fertilizer or industrial chemicals' production with wastewater has great potential. Especially water from a municipal wastewater treatment plant is a very important nutrient source for biofuel production. Microalgae biomass production in open ponds system is lower cost culture systems. There are many hurdles for commercial algal biomass production in large scale. One of the important technical bottlenecks for microalgae production in open system is culture contamination. The algae culture contaminants can generally be described as invading organisms which could cause pond crash. These invading organisms can be competitors, parasites, and predators. Contamination is unavoidable in open systems. Potential contaminant organisms are already inoculated if wastewater is utilized for algal biomass cultivation. Especially, it is important to control contaminants to retain in acceptable level in order to reach true potential of algal biofuel production. There are several contamination management methods in algae industry, ranging from mechanical, chemical, biological and growth condition change applications. However, none of them are accepted as a suitable contamination control method. This experiment describes an innovative contamination control method, 'Recirculated Sedimentation Method', to manage contamination to avoid pond cash. The method can be used for the production of algal biofuel, fertilizer etc. and algal wastewater treatment. To evaluate the performance of the method on algal culture, an experiment was conducted for 90 days at a lab-scale raceway (60 L) reactor with the use of non-sterilized and non-filtered wastewater (secondary effluent and centrate of anaerobic digestion). The application of the method provided the following; removing contaminants (predators and diatoms) and other debris from reactor without discharging the culture (with microscopic evidence), increasing raceway tank’s suspended solids holding capacity (770 mg L-1), increasing ammonium removal rate (29.83 mg L-1 d-1), decreasing algal and microbial biofilm formation on inner walls of reactor, washing out generated nitrifier from reactor to prevent ammonium consumption.

Keywords: contamination control, microalgae culture contamination, pond crash, predator control

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Authors: Amulya P. Rao, Prathima S., Sreedevi N.

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Speech sound disorders (SSD) encompass the major concern in younger population of India with highest prevalence rate among the speech disorders. Children with SSD if not identified and rehabilitated at the earliest, are at risk for academic difficulties. This necessitates early identification using screening tools assessing the frequently misarticulated speech sounds. The literature on frequently misarticulated speech sounds is ample in English and other western languages targeting individuals with various communication disorders. Articulation is language specific, and there are limited studies reporting the same in Kannada, a Dravidian Language. Hence, the present study aimed to identify the frequently misarticulated consonants in Kannada and also to examine the error type. A retrospective, descriptive study was carried out using secondary data analysis of 41 participants (34-phonetic type and 7-phonemic type) with SSD in the age range 3-to 12-years. All the consonants of Kannada were analyzed by considering three words for each speech sound from the Kannada Diagnostic Photo Articulation test (KDPAT). Picture naming task was carried out, and responses were audio recorded. The recorded data were transcribed using IPA 2018 broad transcription. A criterion of 2/3 or 3/3 error productions was set to consider the speech sound to be an error. Number of error productions was calculated for each consonant in each participant. Then, the percentage of participants meeting the criteria were documented for each consonant to identify the frequently misarticulated speech sound. Overall results indicated that velar /k/ (48.78%) and /g/ (43.90%) were frequently misarticulated followed by voiced retroflex /ɖ/ (36.58%) and trill /r/ (36.58%). The lateral retroflex /ɭ/ was misarticulated by 31.70% of the children with SSD. Dentals (/t/, /n/), bilabials (/p/, /b/, /m/) and labiodental /v/ were produced correctly by all the participants. The highly misarticulated velars /k/ and /g/ were frequently substituted by dentals /t/ and /d/ respectively or omitted. Participants with SSD-phonemic type had multiple substitutions for one speech sound whereas, SSD-phonetic type had consistent single sound substitutions. Intra- and inter-judge reliability for 10% of the data using Cronbach’s Alpha revealed good reliability (0.8 ≤ α < 0.9). Analyzing a larger sample by replicating such studies will validate the present study results.

Keywords: consonant, frequently misarticulated, Kannada, SSD

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Authors: Obadiah Nwabueze

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Bodija market is classified as Central Business District (CBD) of Ibadan North Local Government Area of Oyo State (Nigeria) because of socio economic activities, so Crime is a peculiar social issue that causes insecurity. The law enforcement agencies tasked with crime prevention and control such as the Nigerian Police have insufficient manpower, and a resultant effect is the emergence of Vigilante groups as citizen’s response to crime control and prevention (self-help). The research design adopted for this study is a case study design exploring Vigilante activities in Bodija Market. The study utilizes both quantitative and qualitative approach, sources of data includes primary and secondary sources. A sample of 127 respondents randomly picked from the 4 sections of Bodija Market through questionnaire, comprising of 50 male and 77 females which alienates issues of gender bias in addition to the 4 in-depth interview, making a total of 131 respondents. Statistical package for Social Sciences (SPSS) was used. The descriptive statistics of simple frequency, percentage, charts and graphs were computed for the analysis. Finding in the study shows that the market vigilante is able to deter and disrupt criminal activities through strategic spiritual intelligence (SSI), use of charm and juju, physical presence in strategic locations vulnerable to crime occurrence. Findings in the study also show that vigilantes collaborate with the police by assisting them in surveillance, tracking down criminals, identifying black spots, acting as informants to the police, arrest and handover criminal to police. Their challenges include poor equipment, motivation, unhealthy rivalry between the vigilante and the police. The study recommends that the government should support vigilantes with logistics and training, including patrol vehicle and radio communication. The study also recommends the integration of the informal mechanism (juju and charm) of crime detection and prevention into the formal policing strategy, an office should be created in the force commands for use of SSI.

Keywords: central business district, CBD, charm, Juju, strategic spiritual intelligence, SSI

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Authors: Soumya Mishra, Elena Neiterman

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Aligned with the growing interest in the impact of the pandemic on academic experiences of university students, this study aimed to examine the challenges Canadian undergraduate students experienced during the university closures due to COVID-19. Using qualitative methodological approach, the study utilized semi-structured interviews conducted with 20 undergraduate students enrolled in an Ontario university to explore their thoughts and experience regarding online learning during the peak of the COVID-19 pandemic, from January 2021 to March 2021. The interviews yielded four major themes with the following associated subthemes: Personal Challenges Associated with Adapting to the Pandemic (Change in the Type of Stress Experienced, Unique Impact on Certain Groups of Students, Decreased Motivation, Crucial Role of Resilience), Social Challenges Associated with Adapting to the Pandemic (Increased Loneliness, Challenges Faced while Communicating, Perception of Group work, Role of Living Conditions), Challenges associated with Accessing University Resources (Crucial Role of Professors, Perception of Virtual Events, Importance of Physical Spaces). Overall, the analysis showed that the COVID-19 pandemic fostered resilience and psychological flexibility amongst all students. However, the mental health and social wellbeing of students deteriorated during the COVID-19 pandemic and they reported experiencing chronic stress, anxiety and loneliness. International students, first year and final year students experienced a unique set of challenges. It was hard for participants in our study to make strong new connections with their classmates and maintain existing friendships with their peers. The importance of professors in facilitating learning was amplified in the online environment due to the lack of in-person interaction with other students. Despite these challenges, most participants reported that they received high grades during online learning. The findings from this study could be helpful for organizations and individuals working towards fostering the wellbeing of undergraduate students. They can also help in making post-secondary institutions more resilient to future emergencies by creating contingency plans regarding online instructions and risk management techniques.

Keywords: Canadian, COVID-19, university students, wellbeing

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Authors: Norazilawati Binti Md Dahlal, Nabiila Binti Mat Yusoff, Anis Najiha Binti Ahmad

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With the increasing demand for halal products, there is a growing emphasis on ensuring their quality and adherence to halal standards. However, the vulnerability of halal goods to fraud and adulteration poses a significant challenge to the integrity of the halal industry. Whistleblowers play a pivotal role in safeguarding the safety and integrity of halal food by exposing wrongdoings, misconduct, and fraudulent practices. This study explores the implementation of whistleblowing practices aligned with halal and toyyib principles to effectively address halal food fraud issues. Whistleblowing is defined as the act of disclosing information about misconduct, immorality, or unlawful activities to relevant authorities or the public. Although whistleblowing is universally recognized as beneficial, it exposes whistleblowers to substantial risks, including career setbacks, reputation damage, and personal safety threats. Despite legal protections, whistleblowers often face retaliation and hesitancy to come forward. By integrating the principles of halal and toyyib, which encompass the physical and spiritual as well as material and supernatural elements, effective whistleblowing practices can be developed. These principles include the physical characteristic of the product in accordance with Shari’ah law (P1); products that are sourced ethically and responsibly (P2); Products that meet high standard of quality and safety (P3); functioning as servant and caliph of Allah in managing according to Allah's commands and prohibitions (P4); not excessively wasteful or extravagant (P5); positive moral and spiritual implications associated with the product (P6); and aimed at achieving prosperity in both this life and the Hereafter (P7). Employing a quantitative research approach, this study examines Islamic primary data sources and secondary data sources to investigate the prevalence and impact of whistleblowing in the halal industry. By analyzing the principles of halal and toyyib and exploring the importance of whistleblowing effective whistleblowing practices, this research aims to enhance our understanding of promoting accountability and justice within the halal industry from an Islamic perspective.

Keywords: whistleblowing, halal and toyyib, food fraud, halal integrity, Islamic practices

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Authors: Siobhan Hegarty, Michael Bloomfield, Kim Entholt, Dorothy Williams, Helen Kennerley

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Complex Post-Traumatic Stress Disorder (CPTSD) confers greater risk of poor outcomes than does Post-Traumatic Stress Disorder (PTSD). Despite this, the current treatment guidelines for CPTSD aim to reduce only the ‘core’ symptoms of re-experiencing, hyper-vigilance and avoidance, while not addressing the Disturbances of Self Organisation (DSO) symptoms that distinguish this novel diagnosis from PTSD. The Recovering from Child Abuse Programme (RCAP) is a group protocol, based on the principles of cognitive behavioural therapy (CBT). Preliminary evidence suggests the program is effective at reducing DSO symptoms. This pilot study is the first to investigate the potential effectiveness of the RCAP for the specific treatment of CPTSD. This study was conducted as a service evaluation in a secondary care, traumatic stress service. Treatment was delivered once a week, in two-hour sessions, to ten existing female CPTSD patients of the service, who had experienced sexual abuse in childhood. The programme was administered by two therapists and two additional facilitators, following the RCAP protocol manual. Symptom severity was measured before the administration of therapy and was tracked across a range of measures (International Trauma Questionnaire; Patient Health Questionnaire; Community Assessment of Psychic Experience; Work and Social Adjustment Scale) at five time points, over the course of treatment. Qualitative appraisal of the programme was gathered via weekly feedback forms and from audio-taped recordings of verbal feedback given during group sessions. Preliminary results suggest the programme causes a slight reduction in CPTSD and depressive symptom severity and preliminary qualitative analysis suggests that the RCAP is both helpful and acceptable to group members. Final results and conclusions will follow completed thematic analysis of results.

Keywords: Child sexual abuse, Cognitive behavioural therapy, Complex post-traumatic stress disorder, Recovering from child abuse programme

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Authors: Narmina Ismayilova, Shamil Zabitov, Fuad Askerzadeh, Raqif Seyfullayev

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Tulallar volcano-tectonic structure is located in the conjugation zone of the Gekgel horst-uplift, Dashkesan, and Agzhakend synclinorium. Regionally, these geological structures are an integral part of the Lok-Karabakh island arc system. Tulallar field is represented by three areas (Central, East, West). The area of the ore field is located within a partially eroded oblong volcano-tectonic depression. In the central part, the core is divided by the deep Tulallar-Chiragdara-Toganalinsky fault with arcuate fragments of the ring structure into three blocks -East, Central, and West, within which the same areas of the Tulallar field are located. In general, for the deposit, the position of both ore-bearing vein zones and ore-bearing blocks is controlled by fractures of two systems - sub-latitudinal and near-meridional orientations. Mineralization of gold-sulfide ores is confined to these zones of disturbances. The zones have a northwestern and northeastern (near-meridian) strike with a steep dip (70-85◦) to the southwest and southeast. The average thickness of the zones is 35 m; they are traced for 2.5 km along the strike and 500 m along with the dip. In general, for the indicated thickness, the zones contain an average of 1.56 ppm Au; however, areas enriched in noble metal are distinguished within them. The zones are complicated by postore fault tectonics. Gold mineralization is localized in the Kimmeridgian volcanics of andesi-basalt-porphyritic composition and their vitrolithoclastic, agglomerate tuffs, and tuff breccias. For the central part of the Tulallar ore field, a map of geochemical anomalies was built on the basis of analysis data carried out in an international laboratory. The total gold content ranges from 0.1-5 g/t, and in some places, even more than 5 g/t. The highest gold content is observed in the monoquartz facies among the secondary quartzites with quartz veins. The smallest amount of gold content appeared in the quartz-kaolin facies. And also, anomalous values of gold content are located in the upper part of the quartz vein. As a result, an en-echelon arrangement of anomalous values of gold along the strike and dip was revealed.

Keywords: geochemical anomaly, gold deposit, mineralization, Tulallar

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Authors: Christophe Spaas, Lies Pottel, Joke De Ceulaer, Johan Abeloos, Philippe Lamoral, Tom De Backer, Calix De Clercq

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We aimed to evaluate the accuracy of an in-house developed low-cost computer-assisted surgery (CAS) protocol for osseous free flap mandibular reconstruction. All patients who underwent primary or secondary mandibular reconstruction with a free (solely or composite) osseous flap, either a fibula free flap or iliac crest free flap, between January 2014 and December 2017 were evaluated. The low-cost protocol consisted out of a virtual surgical planning, a prebend custom reconstruction plate and an individualized free flap positioning guide. The accuracy of the protocol was evaluated through comparison of the postoperative outcome with the 3D virtual planning, based on measurement of the following parameters: intercondylar distance, mandibular angle (axial and sagittal), inner angular distance, anterior-posterior distance, length of the fibular/iliac crest segments and osteotomy angles. A statistical analysis of the obtained values was done. Virtual 3D surgical planning and cutting guide design were performed with Proplan CMF® software (Materialise, Leuven, Belgium) and IPS Gate (KLS Martin, Tuttlingen, Germany). Segmentation of the DICOM data as well as outcome analysis were done with BrainLab iPlan® Software (Brainlab AG, Feldkirchen, Germany). A cost analysis of the protocol was done. Twenty-two patients (11 fibula /11 iliac crest) were included and analyzed. Based on voxel-based registration on the cranial base, 3D virtual planning landmark parameters did not significantly differ from those measured on the actual treatment outcome (p-values >0.05). A cost evaluation of the in-house developed CAS protocol revealed a 1750 euro cost reduction in comparison with a standard CAS protocol with a patient-specific reconstruction plate. Our results indicate that an accurate transfer of the planning with our in-house developed low-cost CAS protocol is feasible at a significant lower cost.

Keywords: CAD/CAM, computer-assisted surgery, low-cost, mandibular reconstruction

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

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Authors: Todd Jackson

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In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

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Authors: Fatma Mohamed Magdy Badr El Dine, Amr Mohamed Abd Allah

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Introduction: Age estimation of individuals is one of the crucial steps in forensic practice. Different traditional methods rely on the length of the diaphysis of long bones of limbs, epiphyseal-diaphyseal union, fusion of the primary ossification centers as well as dental eruption. However, there is a growing need for the development of precise and reliable methods to estimate age, especially in cases where dismembered corpses, burnt bodies, purified or fragmented parts are recovered. Teeth are the hardest and indestructible structure in the human body. In recent years, assessment of pulp/tooth area ratio, as an indirect quantification of secondary dentine deposition has received a considerable attention. However, scanty work has been done in Egypt in terms of applicability of pulp/tooth ratio for age estimation. Aim of the Work: The present work was designed to assess the Cameriere’s method for age estimation from pulp/tooth ratio of maxillary canines, central and lateral incisors among a sample from Egyptian population. In addition, to formulate regression equations to be used as population-based standards for age determination. Material and Methods: The present study was conducted on 270 peri-apical X-rays of maxillary canines, central and lateral incisors (collected from 131 males and 139 females aged between 19 and 52 years). The pulp and tooth areas were measured using the Adobe Photoshop software program and the pulp/tooth area ratio was computed. Linear regression equations were determined separately for canines, central and lateral incisors. Results: A significant correlation was recorded between the pulp/tooth area ratio and the chronological age. The linear regression analysis revealed a coefficient of determination (R² = 0.824 for canine, 0.588 for central incisor and 0.737 for lateral incisor teeth). Three regression equations were derived. Conclusion: As a conclusion, the pulp/tooth ratio is a useful technique for estimating age among Egyptians. Additionally, the regression equation derived from canines gave better result than the incisors.

Keywords: age determination, canines, central incisors, Egypt, lateral incisors, pulp/tooth ratio

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Authors: Kamila Irena Szpunar

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The central idea of the study is considered from two perspectives. The first perspective includes the interpersonal relationships formed by coach and athlete. Another perspective is connected with motivational environment which is created by the coach in team. This study will show the interplay between the perceived motivational climate created by the coach and the interpersonal dynamics between coaches and athletes. It is important because it will supply knowledge of the interpersonal conditions that can foster adaptive or maladaptive behavior in sport conditions. It also ensures implications for understanding how the perceived motivational atmosphere in a team is manifested at the level of coach – athlete relationship and interactions. The primary purpose of the study was to identify the association between coach-athlete relationship and athletes' perception of the motivational climate in team sports. The secondary purposes examined the differences between female and male athletes in perceiving of the motivational climate and the coach athlete-relationship. To check coach-athlete relationship Polish translation of The Coach-Athlete Relationship Questionnaire will be used. It measures athletes' perceptions of coach- athlete relationship defined by 3+1 Cs conceptual model of the coach-athlete relationship. From this model were used three constructs such as closeness (feelings of trust, respect etc.), commitment (thoughts about the future of the relationship), and complementarity (co-operative interactions during practice sessions). To check perceived motivational climate will be used Polish translation of The Perceived Motivational Climate in Sport Questionnaire-2 (PMCSQ-2). PMCSQ-2 was created to assess athletes' perceptions of the motivational climates in their teams. The questionnaire includes two general dimensions, the perceived task-involving climate and the perceived ego-involving climate; each contains three subscales. To check the associations between elements the motivational climate and coach-athlete relationship was used canonical correlation analysis. Student's t-test was used to check gender differences in athletes' perceptions of the motivational climate and the coach-athlete relationship. The findings suggest that in Polish athletes' perceptions of the coach-athlete relationship have motivational significance and that there are gender differences between female and male athletes in both variables – coach-athlete relationship and kind of motivational climate. According to the author's knowledge, such kind of study has not been conducted in Polish conditions before and is the first study on the subject of the motivational climate and the coach-athlete relationship in Poland. Information from this study can be useful for the development of interventions for enhancing the quality of coach- athlete relationship and its associated outcomes connected with motivational climate.

Keywords: coach-athlete relationship, ego-involving climate, motivational climate, task-involving climate

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Authors: Abdul Kader

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This paper attempts to investigate several contributory factors to recent volatility in the Islamic Banking sector of Bangladesh. In particular, the study explores corporate governance, credit management, credit regulations, inept board of directors, using religious sentiment as a means to deceive general people, and the degree of political interference as potential contributory factors. To find the correlation among different variables, semi-structured questionnaires were distributed among the clients, bank managers, some Banking scholars and ex-members of the board of directors of three Islamic Banks in Bangladesh. Later, ten interviews were collected from key informants to gain in-depth information about the present mismanagement of Islamic Banks in Bangladesh. After then, data were analyzed using statistical software and substantiated by secondary sources like newspapers, reports and investigative reports aired in screen media. The paper found a correlation between almost all contributory factors and recent unstable conditions in the Islamic banking sector. After performing regression analysis, this paper found a more significant relationship between some of the contributory factors with Banking volatility than others. For instance, credit management, inept board of directors, depriving customers of proving no profit in the name of business—no interest-- and political interference have a strong significant positive correlation with the present poor condition of Islamic Banking. This paper concludes that while internal management is important in recovering the losses, the government needs to ensure framing better policy for the Islamic Banking system, Central Bank needs to supervise and monitor all Islamic banks meticulously and loan receivers must go through the impartial evaluation and approved by the representatives of the Central Shariah Board. This paper also recommends that there is a need to strengthen the auditing system and improve regulatory oversight of the Islamic Banks in Bangladesh. Policy recommendations that this paper put forward could provide an outline for dealing with the existing challenging condition of Islamic Banks and these could be applied to similar problems in other countries where the Islamic Banking model exists.

Keywords: Islamic bank, volatility in banking sector, shariah law, credit management, political interference

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Authors: Rachel Koshy, Nazrila Hairizan Bt. Nasir, Samsiah Bt. Awang, Kamaliah Bt. Mohamad Noh

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Malaysia collaborated as a ‘trailblazer’ country with PHCPI (Primary Health Care Performance Initiative) to populate the Primary Health Care (PHC) Vital Signs Profile (VSP) for the country. The PHC VSP provides an innovative snapshot of the primary health care system's performance. Four domains were assessed: system financing, system capacity, system performance, and system equity, and completed in 2019. There were two phases using a mixed method study design. The first phase involved a quantitative study, utilising existing secondary data from national and international sources. In the case of unavailability of data for any indicators, comparable alternative indicators were used. The second phase was a mixed quantitative-qualitative approach to measure the functional capacity based on governance and leadership, population health needs, inputs, population health management, and facility organisation and management. PHC spending constituted 35% of overall health spending in Malaysia, with a per capita PHC spending of $152. The capacity domain was strong in the three subdomains of governance and leadership, information system, and funds management. The two subdomains of drugs & supplies and facility organisation & management had low scores, but the lowest score was in empanelment of the population under the population health management. The PHC system performed with an access index of 98%, quality index of 84%, and service coverage of 62%. In the equity domain, there was little fluctuation in the coverage of reproductive, maternal, newborn, and child health services by mother’s level of education and under-five child mortality between urban and rural areas. The public sector was stronger in the capacity domain as compared to the private sector. This is due to the different financing, organisational structures, and service delivery mechanism. The VSP has identified areas for improvement in the effort to provide high-quality PHC for the population. The gaps in PHC can be addressed through the system approach and the positioning of public and private primary health care delivery systems.

Keywords: primary health care, health system, system domains, vital signs profile

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Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

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Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset (Sindh province) on a total of 3133 Married Women of Reproductive Age (MWRA) aged 15-49 years. Source of family planning (public/private sector) was the main exposure variable. Outcome variable was client satisfaction judged by ten different dimensions of client satisfaction. Means and standard deviations were calculated for continuous variable while for categorical variable frequencies and percentages were computed. For univariate analysis, Chi-square/Fisher Exact test was used to find an association between clients’ satisfaction in public and private sectors. Ten different multivariate models were made. Variables were checked for multi-collinearity, confounding, and interaction, and then advanced logistic regression was used to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92,95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care (follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29).

Keywords: client satisfaction, family planning, public private partnership, quality of care

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Authors: K. Tesfamariam, S. Gebreyesus, C. Lachat, P. Kolsteren, S. De Saeger, M. De Boevre, A. Argaw

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Aflatoxins are toxic secondary metabolites produced by Aspergillus fungi, which are ubiquitously present in the food supplies of low- and middle-income countries. Studies of maternal aflatoxin exposure and fetal outcomes are mainly focused on size at birth and the effect on intrauterine fetal growth has not been assessed using repeated longitudinal fetal biometry across gestation. Therefore, this study intends to assess the association between chronic aflatoxin exposure during pregnancy and fetal growth trajectories in a rural Ethiopian setting. In a prospective cohort study, we enrolled 492 pregnant women. A phlebotomist collected 5 mL of a venous blood sample from eligible women before 28 completed weeks of gestation and aflatoxin B1-lysine concentration was determined using liquid chromatography-tandem mass spectrometry. The mean (±SD) gestational age was 19.1 (3.71) weeks at enrollment, and 28.5 (3.51) and 34.5 (2.44) weeks of gestation at the second and third rounds of ultrasound measurements, respectively. Estimated fetal weight was expressed in centiles using the INTERGROWTH-21st reference. We fitted a multivariable linear mixed-effects model to estimate the rate of fetal growth between aflatoxin-exposed (i.e., aflatoxin B1-lysine concentration above or equal to the limit of detection) and non-exposed mothers in the study. Mothers had a mean (±SD) age of 26.0 (4.58) years. The median (P25, P75) serum AFB1-lysine concentration was 12.6 (0.93, 96.9) pg/mg albumin, and aflatoxin exposure was observed in 86.6% of maternal blood samples. Eighty-five percent of the women enrolled provided at least two ultrasound measurements for analysis. On average, the aflatoxin-exposed group had a significantly lower change over time in fetal weight-for-gestational age centile than the unexposed group (ß = -1.01 centiles/week, 95% CI: -1.87, -0.15, p = 0.02). Chronic maternal AF exposure is associated with lower fetal weight gain over time. Our findings emphasize the importance of nutrition-sensitive strategies to mitigate dietary aflatoxin exposure as well as adopting food safety measures in low-income settings, particularly during the fetal period of development.

Keywords: aflatoxin, fetal growth, low-income setting, mycotoxins

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Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

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Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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Authors: Ghodratollah Rostami Paydar

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The Baba-Ali and Galali iron deposits are located in northwest Hamedan and the Iranian Sanandaj-Sirjan geological structural zone. The host rocks of these deposits are metavolcanosedimentary successions of Songhor stratigraphic series with permo-trriassic age. Field investigation, ore geometry, textures and structures and paragenetic sequence of minerals, all indicate that the ore minerals are crystallized in four stages: primary volcanosedimentary stage, secondary regional metamorphism with formation of ductile shear zones, contact metamorphism and metasomatism stage and the finally late hydrothermal mineralization within uplift and exposure. Totally 29 samples of sulfide, oxide-silicate and carbonate minerals of iron orees and gangue has been purified for stable isotope analysis. The isotope ratio data assure that occurrence of dynamothermal metamorphism in these areas typically involves a lengthy period of time, which results in a tendency toward isotopic homogenization specifically in O and H stable isotopes and showing the role of metamorphic waters in mineralization process. Measurement of δ34S (CDT) in first generation of pyrite is higher than another ones, so it confirms the volcanogenic origin of primary iron mineralization. δ13C data measurements in Galali carbonate country rocks show a marine origin. δ18O in magnetite and skarn forming silicates, δ18O and δ13C in limestone and skarn calcite and δ34S in sulphides are all consistent with the interaction of a magmatic-equilibrated fluid with Galali limestone, and a dominantly magmatic source for S. All these data imply skarn formation and mineralisation in a magmatic-hydrothermal system that maintained high salinity to relatively late stages resulting in the formation of the regional Na metasomatic alteration halo. Late stage hydrothermal quartz-calcite veinlets are important for gold mineralization, but the economic evaluation is required to detailed geochemical studies.

Keywords: iron, polygenetic, stable isotope, BabaAli, Galali

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