Search results for: accounting history

Authors: Nasrin Akter, Bilkis Banu, Farhana Faruque, Fatema Afrin, Sujana Haque Chowdhury, Sarder Mahmud Hossain

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Objectives: To combat the growing prevalence of hypertension in Bangladesh, it is pivotal to have an in-depth understanding of quality of life (QOL) among hypertensive people. The aim of this study was to measure QOL of hypertensive people and its determinants in a selected tertiary hospital in Dhaka city. Design & Methods: This analytical cross-sectional study was conducted among randomly selected 300 hypertensive patients from two cardiac departments of Square Hospitals Limited. Data were collected through the face-to-face interview method. WHOQOL-BREF questionnaire was used to assess the QOL. Mean scores of quality of life were analyzed through descriptive statistics. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analyses were used to measure the association between QOL domains and independent variables. Results: Both overall QOL and domains had a good internal consistency, (r = 0.13–0.77, p< 0.01). The QOL among hypertensive patients was found to be poor in the psychological (71%) and social (74.7%) domains and good in the environmental (63%) and physical (65%) domains. Backward binary regressions revealed that being older (p=0.01), diabetic (p=0.02), having history of COVID-19 (p=0.01), and poor monthly income (USD ≤853.14) (p=0.01) were significantly associated with poor QOL in all domain. Moreover, older age (p=0.01) and poor lifestyle (p=0.02) were significantly associated with poor overall quality of life and poor general health perception. Conclusion: The results revealed low QOL in the psychological and social domain including significant factors associated with the poor QOL in all domains. To enhance the quality of life for hypertensive patients—especially those who are older, diabetic, have lower incomes, experienced COVID-19, and maintain poor lifestyles—effective interventions and health system strengthening are crucial.

Keywords: quality of life, hypertension, WHOQOL-BREF, analytical cross-sectional study

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Authors: Liz van Acker, Linda Colley

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Political processes are shaped by the gendered culture of parliaments. This paper examines how the institution of parliament has been affected by the changing number of women in politics. In order to understand how and why gender change occurs, the paper employs a feminist historical institutionalism approach. It argues that while it is difficult to change the gendered nature of political institutions, it is possible, from a gender perspective, to understand the processes of change both formally and informally. Increasing women’s representation has been a slow process which has not occurred without political struggles. A broadly defined ‘feminist historical institutionalism’ has critiqued existing approaches to institutions and combined historical institutional analysis with tools of gender to enhance our understanding of institutional processes and change. The paper examines the gendered rules, norms, and practices that influence institutional design choices and processes. Institutions such as Parliament often are able to adjust to women’s entry and absorb them without too much interruption. Exploring the hidden aspects to informal institutions involves identifying unspoken and accepted norms that may guide decision-making – exposing and questioning the gender status quo. This paper examines the representation of women in the Queensland Parliament, Australia. It places the Queensland experience in historical context, as well as in the national and international context. The study is interesting, given that its gender representation has rocketed from one of the worst performing states in 2012 to one of the best performing in 2015 with further improvements in 2017. The state currently has a re-elected female Premier, a female Deputy Premier and a female-dominated cabinet – in fact, Queensland was the first ministry in Australia to have a majority of women in its Cabinet. However, it is unnecessary to dig far below these headlines to see that this is uncharacteristic of its history: progress towards this current position has been slow and patchy. The paper finds that matters such as the glass ceiling and the use of quotas explain women’s recent success in Queensland politics.

Keywords: feminist historical institutional approach, glass ceiling, quotas, women’s participation in politics

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Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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Authors: Mohammad Mokhtari, Mehdi Masoodi, Parvaneh Faridi

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history of tsunami generating earthquakes along the Makran Subduction Zone provides evidence of the potential tsunami hazard for the whole coastal area. In comparison with other subduction zone in the world, the Makran region of southern Pakistan and southeastern Iran remains low seismicity. Also, it is one of the least studied area in the northwest of the Indian Ocean regarding tsunami studies. We present a review of studies dealing with the historical /and ongoing palaeotsunamis supported by IGCP of UNESCO in the Makran Subduction Zone. The historical tsunami presented here includes about nine tsunamis in the Makran Subduction Zone, of which over 7 tsunamis occur in the eastern Makran. Tsunami is not as common in the western Makran as in the eastern Makran, where a database of historical events exists. The historically well-documented event is related to the 1945 earthquake with a magnitude of 8.1moment magnitude and tsunami in the western and eastern Makran. There are no details as to whether a tsunami was generated by a seismic event before 1945 off western Makran. But several potentially large tsunamigenic events in the MSZ before 1945 occurred in 325 B.C., 1008, 1483, 1524, 1765, 1851, 1864, and 1897. Here we will present new findings from a historical point of view, immediately, we would like to emphasize that the area needs to be considered with higher research investigation. As mentioned above, a palaeotsunami (geological evidence) is now being planned, and here we will present the first phase result. From a risk point of view, the study shows as preliminary achievement within 20 minutes the wave reaches to Iranian as well Pakistan and Oman coastal zone with very much destructive tsunami waves capable of inundating destructive effect. It is important to note that all the coastal areas of all states surrounding the MSZ are being developed very rapidly, so any event would have a devastating effect on this region. Although several papers published about modelling, seismology, tsunami deposits in the last decades; as Makran is a forgotten subduction zone, more data such as the main crustal structure, fault location, and its related parameter are required.

Keywords: historical tsunami, Indian ocean, makran subduction zone, palaeotsunami

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Authors: S. M. C. Kelly, M. Goulden

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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

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Authors: Reena Aggarwal

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Wall art is a manifestation of the human mind and an absorbing form of cultural expression. Solapur wall hanging making art reflects cultural values, regional sensibilities, beliefs, and identity and helps to preserve the many different communities. The tango of warp and weft in many ways than one tells the story of civilization itself. Solapur wall hanging is a poem in multicolor, written with the warp and weft having long, rich, and complex history with indigenous design vocabularies made by the Padmasali communities. The wall-hanging weaving of Solapur has remained unaltered for years, from being very basic and monochrome having landscapes and portraits catering only to the local market, thereby becoming a potential family income generation tool. The study focuses on the need for contemporization of the Solapur wall hanging and also deliberates on the fact that wherever the culture of native people has been aided by intervention, in nearly every case, the quality of their craft has began to be enhanced. The study also found the underlying reason for diminishing sales to a declining market, low sales, lack of innovation in design, and product development. Keeping in mind that the artisans of Solapur have heroically always hold on to their ancient beliefs and practices, which give them strength and identity, and a sense of pride, an intervention program was developed with an objective of widening the market and help artisans have a sustaining income which include urban consumers and create designs suitable for the urban market. The process of defining and measuring the advantages of design intervention was achieved by using qualitative research methods. An ethnographic research methodology was adopted, which includes six months of close interface with artisans from ten families engaged in making of wall hanging in Solapur. Design solutions were proposed in terms of product diversification and design extensions of the existing product line for increased variety. A collection of contemporary wall arts (wall decor) and room dividers were designed and developed.

Keywords: wall hanging, Solapur, contemporization, traditional, sustainable

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Authors: Aoife Prendergast

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The synergy between theory and practice can be considered elusive, the touchstone for the development of successful undergraduate programmes particularly in allied health professions such as social care. A 'pracademic' is a person who spans both the somewhat ethereal world of academia as a scholar and the pragmatic world of practice. This paper examines the concept of 'pracademia' in relation to the role of the social care practitioner and continuing professional development. It also assists in the understanding of the synergy between social care professionals and higher education. A consideration of the identity and position in terms of approach to regulation is explored as well as an acknowledgement of the strengths and opportunities for sharing power in hierarchical positions. The world of practice serves as the centre point of the academic compass for most professional programs. Just as schools of engineering and law are disciplined by the marketplace, which seeks well-trained students, so our social care programmes must perennially find ways to address the fast changing needs of practitioners, whether they be government, not-for-profit organizations, consulting firms or contractors. We may not expect such traditional academic disciplines as history, sociology, or political science to cater to the needs of external audiences or practitioners— indeed, these disciplines' insulation from public concerns and issues is considered a strength by some. This paper aims to explore the integration of academic teaching and research with the communities of practice in social care. This appears to be a fundamental aspiration of the social care profession. While building and integrating an important body of academic theory and concepts from a variety of disciplines, social care as a field has embraced a professional orientation by seeking to be relevant to practitioners at various levels. While teaching theory, social care programmes, and faculty are often acutely aware that their academic content and credibility, in part, rest on a deep connection with practitioners. While theory can be self-contained, the impact of our research and teaching arguably finds its most compelling and highest audience when it addresses the agenda items and concerns of practitioners.

Keywords: social care, pracademia, supervision, practice education

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Authors: Lucia Liu, Matthew Koziol

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Obsessive-compulsive disorder (OCD), a long-lasting anxiety disorder involving recurrent, intrusive thoughts, affects over 2 million adults in the United States. Transcranial magnetic stimulation (TMS) stands out as a noninvasive, cutting-edge therapy that has been shown to reduce symptoms in patients with treatment-resistant OCD. The Food and Drug Administration (FDA) approved protocol pairs TMS sessions with individualized symptom provocation, aiming to improve the susceptibility of brain circuits to stimulation. However, limited standardization or guidance exists on how to conduct symptom provocation and which methods are most effective. This study aims to compare the effect of internal versus external techniques to induce obsessional stress in a clinical setting during TMS therapy. Two symptom provocation methods, (i) Asking patients thought-provoking questions about their obsessions (internal) and (ii) Requesting patients to perform obsession-related tasks (external), were employed in a crossover design with repeated measurement. Thirty-six treatments of NeuroStar TMS were administered to each of two patients over 8 weeks in an outpatient clinic. Patient One received 18 sessions of internal provocation followed by 18 sessions of external provocation, while Patient Two received 18 sessions of external provocation followed by 18 sessions of internal provocation. The primary outcome was the level of self-reported obsessional stress on a visual analog scale from 1 to 10. The secondary outcome was self-reported OCD severity, collected biweekly in a four-level Likert-scale (1 to 4) of bad, fair, good and excellent. Outcomes were compared and tested between provocation arms through repeated measures ANOVA, accounting for intra-patient correlations. Ages were 42 for Patient One (male, White) and 57 for Patient Two (male, White). Both patients had similar moderate symptoms at baseline, as determined through the Yale-Brown Obsessive Compulsive Scale (YBOCS). When comparing obsessional stress induced across the two arms of internal and external provocation methods, the mean (SD) was 6.03 (1.18) for internal and 4.01 (1.28) for external strategies (P=0.0019); ranges were 3 to 8 for internal and 2 to 8 for external strategies. Internal provocation yielded 5 (31.25%) bad, 6 (33.33%) fair, 3 (18.75%) good, and 2 (12.5%) excellent responses for OCD status, while external provocation yielded 5 (31.25%) bad, 9 (56.25%) fair, 1 (6.25%) good, and 1 (6.25%) excellent responses (P=0.58). Internal symptom provocation tactics had a significantly stronger impact on inducing obsessional stress and led to better OCD status (non-significant). This could be attributed to the fact that answering questions may prompt patients to reflect more on their lived experiences and struggles with OCD. In the future, clinical trials with larger sample sizes are warranted to validate this finding. Results support the increased integration of internal methods into structured provocation protocols, potentially reducing the time required for provocation and achieving greater treatment response to TMS.

Keywords: obsessive-compulsive disorder, transcranial magnetic stimulation, mental health, symptom provocation

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Authors: Christen Kutz

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Objective: The aim of this study is to review a case series of 4 high-level Olympic and Division 1 wrestlers who experienced debilitating posterior circulation ischemic strokes during or after a competitive wrestling event and to identify risk factors, etiology and outcomes of stroke in young, healthy elite wrestlers. Background: Stroke occurs in one in 10,000 people under age 64. In young adults, the most common causes of stroke are cardiac embolism, hypercoagulable state, and vasculopathy. One-third of these strokes occur in young, fit individuals. There is little published literature about ischemic strokes that occur in wrestlers. Based on the nature of wrestling, the risk of injury or dissection to neurovascular structures may be a possible theory, but very few case reports exist. Methodology: 4 wrestlers under the age of 44 with a known history of ischemic stroke participated in individual interviews either in person or virtually. Each of the wrestlers provided their demographic information, wrestling background, clinical presentation at the time of stroke, imaging results, identification of potential risk factors, acute treatment and recovery. Results: 3 white male Division 1 wrestlers (2 Lehigh University, 1 Lock Haven University) and 1 black male 2008 Olympian experienced posterior circulation strokes. Case #1 felt a “pop” while wrestling (lateral medullary infarct, possible vertebral artery dissection); Case #2 awoke with severe vertigo, sweating, and vomiting after wrestling the previous day (left cerebellar infarct, (+) protein S deficiency); Case #3 severe vertigo, ataxia, and sensation of impending doom after wrestling earlier that week (left cerebellar infarct, hypoplastic left vertebral artery (+) anti-cardiolipin antibodies). Case #4 severe dizziness, confusion (left cerebellar stroke, vertebral artery dissection, small PFO). Conclusion: 3 wrestlers were started on anti-platelet therapy, risk factors were modified, and returned to their sport. 1 wrestler was placed on anti-coagulation and retired from competition.

Keywords: stroke, wrestling, Olympic, posterior circulation

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Authors: Niamh Higgins, Dawn Howard

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The Irish agri-food sector is of major importance to Ireland’s manufacturing sector and to the Irish economy through employment and the exporting of animal products worldwide. Infectious diseases and parasites have an impact on farm animal health causing profitability and productivity to be affected. For the sustainability of Irish dairy farming, there must be the highest standard of animal health. There can be a lack of information in accounting for > 1% of complete microbial diversity in an environment. There is the tendency of culture-based methods of microbial identification to overestimate the prevalence of species which grow easily on an agar surface. There is a need for new technologies to address these issues to assist with animal health. Metagenomic approaches provide information on both the whole genome and transcriptome present through DNA sequencing of total DNA from environmental samples producing high determination of functional and taxonomic information. Nanopore Next Generation Technologies have the ability to be powerful sequencing technologies. They provide high throughput, low material requirements and produce ultra-long reads, simplifying the experimental process. The aim of this study is to use a metagenomics approach to analyze dairy cattle faecal samples using the Oxford Nanopore MinION Next Generation Sequencer and to establish an in-house pipeline for metagenomic characterization of complex samples. Faecal samples will be obtained from Irish dairy farms, DNA extracted and the MinION will be used for sequencing, followed by bioinformatics analysis. Of particular interest, will be the parasite Buxtonella sulcata, which there has been little research on and which there is no research on its presence on Irish dairy farms. Preliminary results have shown the ability of the MinION to produce hundreds of reads in a relatively short time frame of eight hours. The faecal samples were obtained from 90 dairy cows on a Galway farm. The results from Oxford Nanopore ‘What’s in my pot’ (WIMP) using the Epi2me workflow, show that from a total of 926 classified reads, 87% were from the Kingdom Bacteria, 10% were from the Kingdom Eukaryota, 3% were from the Kingdom Archaea and < 1% were from the Kingdom Viruses. The most prevalent bacteria were those from the Genus Acholeplasma (71 reads), Bacteroides (35 reads), Clostridium (33 reads), Acinetobacter (20 reads). The most prevalent species present were those from the Genus Acholeplasma and included Acholeplasma laidlawii (39 reads) and Acholeplasma brassicae (26 reads). The preliminary results show the ability of the MinION for the identification of microorganisms to species level coming from a complex sample. With ongoing optimization of the pipe-line, the number of classified reads are likely to increase. Metagenomics has the potential in animal health for diagnostics of microorganisms present on farms. This would support wprevention rather than a cure approach as is outlined in the DAFMs National Farmed Animal Health Strategy 2017-2022.

Keywords: animal health, buxtonella sulcata, infectious disease, irish dairy cattle, metagenomics, minION, next generation sequencing

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Authors: Temesgen Oljira, Olugbenga Akindeji Okunlola, Akinade Shadrach Olatunji, Dereje Ayalew, Bekele A. Bedada, Tasin Godlove Bafon

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The Megele area gold-bearing Neoproterozoic rocks in the Western Ethiopian Shield has been under exploration for the last few decades. The geochemical and ore petrological characterization of the gold-bearing granite gneiss and associated quartz vein is crucial in understanding the gold's genesis. The present study concerns the ore petrological, geochemical, and stable O2 and S characterization of the gold-bearing granite gneiss and associated quartz vein. This area is known for its long history of placer gold mining. The presence of quartz veins of different generations and orientations, visible sulfide mineralization, and oxidation suggests that the Megele area is geologically fertile for mineralization. The Au and base metals analysis also indicate that Megele area rocks are characterized by Cu (2-22 ppm av. 7.83 ppm), Zn (2-53 ppm av. 29.33 ppm), Co (1-27 ppm av. 13.33 ppm), Ni (2-16 ppm av. 10 ppm), Pb (5-10 ppm av. 8.33 ppm), Au (1-5 ppb av. 2.11 ppb), Ag (0.5 ppm), As (5-12 ppm av. 7.83 ppm), Cd (0.5ppm), Li (0.5 ppm), Mo (1-4 ppm av. 1.6 ppm), Sc (5-13 ppm av. 9.3 ppm), and Tl (10 ppm). The oxygen isotope (δ18O) values of gold-bearing granite gneiss and associated quartz veins range from +8.6 to +11.5 ‰, suggesting the mixing of metamorphic water with magmatic water within the ore-forming fluid. The Sulfur isotope (δ34S) values of gold-bearing granite gneiss range from -1.92 to -0.45 ‰ (mean value of -1.13 ‰) indicating the narrow range of value. This suggests that the sulfides have been precipitated from the fluid system originating from a single source of the magmatic component under sulfur isotopic fractionation equilibrium condition. The tectonic setting of the host rocks, the occurrence of ore bodies, mineral assemblages of the host rocks and proposed ore-forming fluids of the Megele area gold prospects have similarities with features of orogenic gold deposit. The δ18O and δ34S isotopic values also suggested a metamorphic origin with the magmatic components. Thus, the Megele gold prospect could be related to an orogenic gold deposit related to metamorphism and associated intrusions.

Keywords: fluid source, gold mineralization, oxygen isotope, stable isotope, sulfur isotope

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Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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Authors: Shih-Tsung Chen, Yenchin Hsiao

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Evergreen Lily is a newly-built school after Morakot Typhoon took place. The school is located on Majia farm, which is surrounded by mountains. The fund in the construction of the school is solely sponsored by Chang Yung-Fa Foundation. There are 483 permanent houses near the school belonging to three tribes, Dashe, Majia, and Haocha. Due to the most ancient heritages of Paiwan and Rukai in these three tribes, the school is full of cultural atmosphere. From modern and traditional perspectives, Evergreen Lily strives to establish and develop a long-lasting educational model to meet the expectation of the tribes, parents, and the public. This study is a case study of how to develop indigenous education in newly established schools after the Morakot Hurricane disaster to meet the concept of environmental education. The systematic curriculum construction of education and cultural integration and the systematic practice of curriculum practice will be discussed, and the concept and practice of tribal education curriculum and sustainable environmental education will be understood. This study found that this school integrates the spirit of natural philosophy, democratic education, ethnic and experimental education, and constructs a knowledge system that includes three levels of spiritual culture, institutional culture, and material culture, as well as six dimensions of life philosophy, natural ecology, organizational system, tribal literature and history, song and dance, and technical and artistic methods. Adhering to the concept of harmonious education and the sustainable common good, the development of school-based tribal academic courses accounts for about one-third of the total number of teaching sessions, and there are different cultural themes in grades one to six, and there are clear teaching modules to effectively enhance students' potential inspiration. The complete curriculum implementation model can be described as a model for the development of indigenous schools to sustainable environmental education.

Keywords: environmental education, indigenous education, sustainable development, school-based curriculum

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Authors: Nabil A. A. Mohamed, Alaa A. A. Balbaa, Khaled E. Ayad

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Osteoarthritis (OA) of the knee is the most common form of arthritis and leads to more activity limitations (e.g., disability in walking and stair climbing) than any other disease, especially in the elderly. Recently, impaired proprioceptive accuracy of the knee has been proposed as a local factor in the onset and progression of radiographic knee OA (ROA). Purpose: To compare the clinical and radiological findings in healthy with that of knee OA. Also, to determine if there is a correlation between the clinical and radiological findings in patients with knee OA. Subjects: Fifty one patients diagnosed as unilateral or bilateral knee OA with age ranged between 35-70 years, from both gender without any previous history of knee trauma or surgery, and twenty one normal subjects with age ranged from 35 - 68 years. METHODS: peak torque/body weight (PT/BW) was recorded from knee extensors at isokinetic isometric mode at angle of 45 degree. Also, the Absolute Angular Error was recorded at 45O and 30O to measure joint position sense (JPS). They made anteroposterior (AP) plain X-rays from standing semiflexed knee position and their average score of Timed Up and Go test(TUG) and WOMAC were recorded as a measure of knee pain, stiffness and function. Comparison between the mean values of different variables in the two groups was performed using unpaired student t test. The P value less or equal to 0.05 was considered significant. Results: There were significant differences between the studied variables between the experimental and control groups except the values of AAE at 30O. Also, there were no significant correlation between the clinical findings (pain, function, muscle strength and proprioception) and the severity of arthritic changes in X-rays. CONCLUSION: From the finding of the current study we can conclude that there were a significant difference between the both groups in all studied parameters (the WOMAC, functional level, quadriceps muscle strength and the joint proprioception). Also this study did not support the dependency on radiological findings in management of knee OA as the radiological features did not necessarily indicate the level of structural damage of patients with knee OA and we should consider the clinical features in our treatment plan.

Keywords: joint position sense, peak torque, proprioception, radiological knee osteoarthritis

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Authors: Souhila Belabbas

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This paper focuses on the Kabyles’ multilingual practices in the UK, within the Kabyle/Amazigh Cultural Organisation in London, on online platforms and at home. The Kabyles have roots in northern Algeria and associate their language, Kabyle, with a pre-Arabized history of northern Africa. Drawing on ethnographic research with this community, this study brings together their post-migration language preservation activisms as well as their dynamic multilingual practices and situational language choice into a dialogue. This shows the enduring significance of the heritage language for social, cultural and historical identity. It also demonstrates that the current survival of the “mother tongue” hinges on multilingual and multi-sited language activisms, which bear the hallmarks of both new creativities and diminishing fluencies in multilingual spaces. These multilingual repertoires also included a range of ideological stances, expressed as cultural, moral, and political attitudes to the “mother tongue” and to other, potentially more dominant, languages in their lives, involving both inclusive and exclusive instances. The Kabyles in the UK practice everyday forms of multilingualism in the dynamic terms whilst making strong identity claims to an endangered heritage language. Crucially, their language contact experiences were not a post-migration novelty but part of their pre-migration lifeworlds. The participants involved in this study shared a commitment to Kabyle identity activism. They expressed this differently, varyingly foregrounding cultural, social or political issues. These differences were related to their North-African cultural background, live, gender, religious and/or political affiliation, as well as to their different migratory trajectories. Among these ethno-conscious individuals, the use of Kabyle was often particularly vibrant in informal domains of casual conversations and mixed in with French, English and often Arabic. During community events and festivals, though, many made special efforts to converse in Kabyle as if to make a point about their commitment to a shared identity.

Keywords: ethnography, language ideology, language choice, heritage language, migration trajectories, multilingual repertoires

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Authors: Souhila Belabbas

Abstract:

This paper focuses on the Kabyles’ multilingual practices in the UK, within the Kabyle/Amazigh Cultural Organisation in London, on online platforms and at home. The Kabyles have roots in northern Algeria and associate their language, Kabyle, with a pre-Arabized history of northern Africa. Drawing on ethnographic research with this community, this study brings together their post-migration language preservation activisms as well as their dynamic multilingual practices and situational language choice into a dialogue. This shows the enduring significance of the heritage language for social, cultural and historical identity. It also demonstrates that the current survival of the “mother tongue” hinges on multilingual and multi-sited language activisms, which bear the hallmarks of both new creativities and diminishing fluencies in multilingual spaces. These multilingual repertoires also included a range of ideological stances, expressed as cultural, moral, and political attitudes to the “mother tongue” and to other, potentially more dominant, languages in their lives, involving both inclusive and exclusive instances. The Kabyles in the UK practice everyday forms of multilingualism in the dynamic terms whilst making strong identity claims to an endangered heritage language. Crucially, their language contact experiences were not a post-migration novelty but part of their pre-migration lifeworlds. The participants involved in this study shared a commitment to Kabyle identity activism. They expressed this differently, varyingly foregrounding cultural, social or political issues. These differences were related to their North-African cultural background, live, gender, religious and/or political affiliation, as well as to their different migratory trajectories. Among these ethno-conscious individuals, the use of Kabyle was often particularly vibrant in informal domains of casual conversations and mixed in with French, English and often Arabic. During community events and festivals, though, many made special efforts to converse in Kabyle as if to make a point about their commitment to a shared identity.

Keywords: ethnography, language ideology, language choice, heritage language, migration trajectories, multilingual repertoires

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Authors: Noel Mariam George

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This paper explores the history of Tibetan citizenship, one of the primary non-partition refugee communities, and their negotiation of 'in-betweenness' as a mode of political and legal belonging in India. While South Asian citizenship histories have primarily centered around the 1947 and 1971 Partitions, this paper uncovers an often-overlooked period, spanning the 1950s, 60s, and 70s, when Tibetans began to assert their claims within the Indian state. This paper challenges the conventional teleological narrative of partition by highlighting a distinct period when the Indian state negotiated boundaries of belonging for non-partition refugees differently. It explores how Tibetans occupied an 'in-between' status, existing as both foreigners and potential citizens, thereby complicating the traditional citizen-refugee binary. Moreover, it underscores that citizenship during this era was not solely determined by legal frameworks. Instead, it was a dynamic process shaped by historical contexts, practices, and relationships. Tibetans pursued citizen-like claims through legal battles, lobbying, protests, volunteering, and collective solidarity, revealing citizenship as an 'act' embedded in their daily lives. Tibetan liminality is characterized by their simultaneous maintenance of exile identity and pursuit of citizen-like claims in India. The cautious Indian state, reluctant to label Tibetans as either 'refugees' or 'citizens,' has contributed to this liminal status. This duality has intensified Tibetans' precarity but has also led to creative and transformative practices that have expanded the boundaries of democracy and citizenship in India. Beyond traditional narratives of Indian benevolence, this paper scrutinizes the geopolitical factors driving Indian support for Tibetans. Additionally, it challenges 'common-sensical' narratives by demonstrating how Tibetans strategically navigated Indian citizenship. Using archival sources from the British Library and the National Archives in London and Delhi along with digitized materials, the paper reveals citizenship as a multi-faceted historical process. It examines how Tibetans exercised agency within the Indian state despite their liminal status.

Keywords: citizenship, borderlands, forced displacement, refugees in India

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Authors: Hee-Young Song

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Background and objectives: In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations proposed a multidimensional assessment of patients’ conditions that included both functional parameters and patient-reported outcomes, with the aim to provide a comprehensive assessment of the disease, thus meeting both the needs of the patient and the role of the physician. However, few studies have evaluated patient-reported outcomes as well as objective functional assessments among individuals with chronic obstructive pulmonary disease (COPD) in clinical practice in Korea. This study was undertaken to explore the relationship between functional status assessed by the 6-minute walking distance (MWD) test and subjective health status reported by stable patients with COPD residing in community. Methods: A cross-sectional descriptive study was conducted with 118 stable COPD patients aged 69.4 years old and selected by a convenient sampling from an outpatient department of pulmonology in a tertiaryhospitals. The 6-MWD test was conducted according to standardized instructions. Participants also completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI). Medical records were reviewed to obtain disease-related characteristics including duration of the disease and forced expiratory volume in 1 second (FEV1). Data were analyzed using PASW statistics 20.0. Results: Mean FEV1% of participants was 63.51% and mean 6-MWD and CAT scores were 297.54m and 17.7, respectively. The 6-MWD and CAT showed significant negative correlations (r= -.280, p=.002); FEV1 and CAT did as well correlations (r= -.347, p < .001). Conclusions: Findings suggest that the better functional status an individual with COPD has, the better subjective health status is, and provide the support for using patient-reported outcomes along with functional parameters to facilitate comprehensive assessment of COPD patients in real clinical practices.

Keywords: chronic obstructive pulmonary disease, COPD assessment test, functional status, patient-reported outcomes

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Authors: Emily S. M. Chow

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The word ‘utopia’ was coined by Thomas More in Utopia (1516). Its Greek roots ‘ou’ means ‘not’ and ‘topos’ means ‘place.’ In other words, it literally refers to ‘no-place.’ However, the possibility of having an alternative and better future society has always been appealing. In fact, at the core of every utopianism is the search for a future alternative state with the anticipation of a better life. Nonetheless, the practicalities of such ideas have never ceased to be questioned. At times, building a utopia presents itself as a divisive act. In addition to the violence that must be employed to sweep away the old regime in order to make space for the new, all utopias carry within them the potential for bringing catastrophic consequences to human life. After all, every utopia seeks to remodel the individual in a very particular way for the benefit of the masses. In this sense, utopian thinking has the potential both to create and destroy the future. While writing during a traumatic transitional period in Zimbabwe’s history, Dambudzo Marechera witnessed an age of upheavals in which different parties battled for power over Zimbabwe. Being aware of the fact that all institutionalized narratives, be they originated from the governance of the UK, Ian Smith’s white minority regime or Zimbabwe’s revolutionary parties, revealed themselves to be nothing more than fiction, Marechera realized the impossibility of determining reality absolutely. As such, this thesis concerns the writing of the Zimbabwean maverick, Dambudzo Marechera. It argues that Marechera writes a unique vision of utopia. In short, for Marechera utopia is not a static entity but a moment of perpetual change. He rethinks utopia in the sense that he phrases it as an event that ceaselessly contests institutionalized and naturalized narratives of a post-colonial self and its relationship to society. Marechera writes towards a vision of an alternative future of the country. Yet, it is a vision that does not constitute a fully rounded sense of utopia. Being cautious about the world and the operation of power upon the people, rather than imposing his own utopian ideals, Marechera chooses to instead peeling away the narrative constitution of the self in relation to society in order to turn towards a truly radical utopian thinking that empowers the individual.

Keywords: African literature, Marechera, post-colonial literature, utopian studies

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Authors: Paula Costa, Ana Picado, Filomena Pinto, Justina Catarino

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Environmental impact associated with large scale shale gas development is of major concern to the public, policy makers and other stakeholders. To assess this impact on the atmosphere, it is important to monitoring ambient air quality prior to and during all shale gas operation stages. Baseline observations can provide a standard of the pre-shale gas development state of the environment. The lack of baseline concentrations was identified as an important knowledge gap to assess the impact of emissions to the air due to shale gas operations. In fact baseline monitoring of air quality are missing in several regions, where there is a strong possibility of future shale gas exploration. This makes it difficult to properly identify, quantify and characterize environmental impacts that may be associated with shale gas development. The implementation of a baseline air monitoring program is imperative to be able to assess the total emissions related with shale gas operations. In fact, any monitoring programme should be designed to provide indicative information on background levels. A baseline air monitoring program should identify and characterize targeted air pollutants, most frequently described from monitoring and emission measurements, as well as those expected from hydraulic fracturing activities, and establish ambient air conditions prior to start-up of potential emission sources from shale gas operations. This program has to be planned for at least one year accounting for ambient variations. In the literature, in addition to GHG emissions of CH4, CO2 and nitrogen oxides (NOx), fugitive emissions from shale gas production can release volatile organic compounds (VOCs), aldehydes (formaldehyde, acetaldehyde) and hazardous air pollutants (HAPs). The VOCs include a.o., benzene, toluene, ethyl benzene, xylenes, hexanes, 2,2,4-trimethylpentane, styrene. The concentrations of six air pollutants (ozone, particulate matter (PM), carbon monoxide (CO), nitrogen oxides (NOx), sulphur oxides (SOx), and lead) whose regional ambient air levels are regulated by the Environmental Protection Agency (EPA), are often discussed. However, the main concern in the emissions to air associated to shale gas operations, seems to be the leakage of methane. Methane is identified as a compound of major concern due to its strong global warming potential. The identification of methane leakage from shale gas activities is complex due to the existence of several other CH4 sources (e.g. landfill, agricultural activity or gas pipeline/compressor station). An integrated monitoring study of methane emissions may be a suitable mean of distinguishing the contribution of different sources of methane to ambient levels. All data analysis needs to be carefully interpreted taking, also, into account the meteorological conditions of the site. This may require the implementation of a more intensive monitoring programme. So, it is essential the development of a low-cost sampling strategy, suitable for establishing pre-operations baseline data as well as an integrated monitoring program to assess the emissions from shale gas operation sites. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 640715.

Keywords: air emissions, baseline, green house gases, shale gas

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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Authors: Anum Javed

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This study identifies the dynamical image of human body that continues its metamorphosis in the virtual field of reality. It calls attention to the ways where humans start co-evolving with other life forms; technology in particular and are striving to establish a realm outside the physical framework of matter. The problem exceeds the area of technological ethics by explicably and explanatorily entering the space of literary texts and criticism. Textual analysis of Geek Love (1989) by Katherine Dunn is adjoined with posthumanist perspectives of Pramod K. Nayar to beget psycho-somatic changes in man’s nature of being. It uncovers the meaning people give to their experiences in this budding social and cultural phenomena of material representation tied up with personal practices and technological innovations. It also observes an ethical, physical and psychological reassessment of man within the context of technological evolutions. The study indicates the elements that have rendered morphological freedom and new materialism in man’s consciousness. Moreover this work is inquisitive of what it means to be a human in this time of accelerating change where surgeries, implants, extensions, cloning and robotics have shaped a new sense of being. It attempts to go beyond individual’s body image and explores how objectifying media and culture have influenced people’s judgement of others on new material grounds. It further argues a decentring of the glorified image of man as an independent entity because of his energetic partnership with intelligent machines and external agents. The history of the future progress of technology is also mentioned. The methodology adopted is posthumanist techno-ethical textual analysis. This work necessitates a negotiating relationship between man and technology in order to achieve harmonic and balanced interconnected existence. The study concludes by recommending a call for an ethical set of codes to be cultivated for the techno-human habituation. Posthumanism ushers a strong need of adopting new ethics within the terminology of neo-materialist humanism.

Keywords: corporeality, dematerialism, human ethos, posthumanism

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Authors: Galit Truman Zinman

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The 'Islamic State' (IS) is one of the most successful jihadist groups in the modern history. The 'Islamic State' strives to realize the idea of erasing the borders between Muslim countries and establishing a wide Islamic caliphate. The 'Islamic State' is based on religious unity and opposition to existing political order. In this paper, the main argument is that the 'Islamic State' is characterized by two significant tendencies of state-building: preservation and change. The methodology of this study is based on the process tracing method and the analysis of primary sources: decisions, announcements and speeches of religious leaders of the Islamic State, slogans, rituals and symbols, audio and video clips produced by the Al-Hayat Media Center, films distributed on YouTube, as well as the content analysis of Dabiq`s articles (IS official Journal) and nasheeds (jihadi songs). The major findings of this study indicate that in practice the 'Islamic State' uses the same socio-political functions typical to the modern state (preservation), but introduces a different religious-ideological content (change). On the one hand, there is a preservation of the principles of existing modern state. Even with the rejection of secularization, globalization, and nationalism, there is an establishment of typical modern nation-state patterns. It is still a state entity, which has an ideological infrastructure, territory, population, governance and a monopoly on the use of violence, security services, justice system, tax collection, etc. All these functions characterize the modern state, and despite the desire of the 'Islamic State' to create a new kind of state, it reminds patterns of the typical modern nation-state. As for the religious-ideological content of the new state, here we can see a tendency of great change. The 'Islamic State' aims to create an Islamic caliphate which would allow the establishment of religious law and order, under a big commitment to return civilization to a seventh-century environment. The 'Islamic State' favors the fight against Western culture and its liberal ideology. It supports the struggle for global jihad against the unbelievers. Today, despite the territorial 'contraction' and the undermining of the organization's governance in Iraq and Syria, the 'Islamic State' continues to maintain its brand among jihadist activists around the world.

Keywords: Islamic State, Islamic caliphate, modern nation-state, religious law and order

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Authors: Md. Rifad Chowdhury

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This research study investigates employees' conception of work motivation to perform at the municipal corporation in Bangladesh. The municipal corporation is one of the key administrative bodies of Bangladesh’s local government. Municipal corporation employees provide essential public services in the country’s semi-urban areas. Work motivation has been defined as a result of interaction between the individual and the environment. Local government studies indicate the work environment of the municipal corporation is unique because of its key colonial and political history, several reform attempts, non-western social perspectives, job functions, and traditional governance. The explorative purpose of this study is to find and analyse the conceptions of employees’ work motivation within this environment to expand a better understanding of work motivation. According to the purpose of this study, a qualitative method has been adopted, which has remained a very unpopular method among work motivational researchers in Bangladesh. Twenty-two semi-structured online interviews were conducted in this study. Phenomenographic research methodology has been adopted to describe the limited number of qualitatively different ways of experiencing work motivation. During the analysis of the semi-structured interview transcripts, the focus was on the employees' perspectives as employees experience work motivation or the second-order perspective to explore and analyse the conceptions. Based on the participants' collective experiences and dimensions of variation across the different ways of experiencing, six conceptions of employee work motivation to perform at the municipal corporation were identified in this study. The relationships between conceptions were further elaborated in terms of critical variations across the conceptions. Six dimensions of critical variations have emerged within and between the conceptions. In the outcome space, the relationships between conceptions and dimensions of critical variations are presented in a logical structure. The findings of this research study show significance to expand the understanding of work motivation and the research context of phenomenography. The findings of this research will contribute to the ongoing attention of contextual work motivational understanding from a Bangladeshi perspective and phenomenographic research conceptions in organisational behaviour studies.

Keywords: work motivation, qualitative, phenomenography, local government

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Authors: Mahdi Sepehrmanesh

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This essay explores Gerald Vizenor's innovative concepts of the tragedy of absence and the comedy of presence as frameworks for understanding and challenging dominant narratives about Native American identity and history. Vizenor's work critiques the notion of irrevocable cultural loss and rigid definitions of Indigenous identity based on blood quantum and stereotypical practices. Through subversive humor, trickster figures, and storytelling, Vizenor asserts the active presence and continuance of Native peoples, advocating for a dynamic, self-determined understanding of Native identity. The essay examines Vizenor's use of postmodern techniques, including his engagement with simulation and hyperreality, to disrupt colonial discourses and create new spaces for Indigenous expression. It explores the concept of "crossblood" identities as a means of resisting essentialist notions of Native authenticity and embracing the complexities of contemporary Indigenous experiences. Vizenor's ideas of survivance and transmotion are analyzed as strategies for cultural resilience and adaptation in the face of ongoing colonial pressures. The interplay between absence and presence in Vizenor's work is discussed, particularly through the lens of shadow survivance and the power of storytelling. The essay also delves into Vizenor's critique of terminal creed and his promotion of natural reason as an alternative epistemology to Western rationalism. While acknowledging the significant influence of Vizenor's work on Native American literature and theory, the essay also addresses critiques of his approach, including concerns about the accessibility of his writing and its political effectiveness. Despite these debates, the essay argues that Vizenor's concepts offer a powerful vision of Indigenous futurity that is rooted in tradition yet open to change, inspiring hope and agency in the face of oppression. By examining Vizenor's multifaceted approach to Native American identity and presence, this essay contributes to ongoing discussions about Indigenous representation, cultural continuity, and resistance to colonial narratives in literature and beyond.

Keywords: gerald vizenor, identity native american literature, survivance, trickster discourse, identity

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Authors: Mohamed El Horri, Amine Mouden, Reda Messaoudi, Mohamed Chekkal, Driss Benlaldj, Malika Baghdadi, Lahcene Benmahdi, Fatima Seghier

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Background/aim: Recently, the Von Willebrand factor antigen (vWF-Ag)has been identified as a new marker of portal hypertension (PH) and its complications. Few studies talked about its role in the prediction of esophageal varices. VWF-Ag is considered a non-invasive approach, In order to avoid the endoscopic burden, cost, drawbacks, unpleasant and repeated examinations to the patients. In our study, we aimed to evaluate the ability of this marker in the prediction of another complication of portal hypertension, which is portal hypertensive gastropathy (PHG), the one that is diagnosed also by endoscopic tools. Patients and methods: It is about a prospective study, which include 124 cirrhotic patients with no history of bleeding who underwent screening endoscopy for PH-related complications like esophageal varices (EVs) and PHG. Routine biological tests were performed as well as the VWF-Ag testing by both ELFA and Immunoturbidimetric techniques. The diagnostic performance of our marker was assessed using sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and receiver operating characteristic curves. Results: 124 patients were enrolled in this study, with a mean age of 58 years [CI: 55 – 60 years] and a sex ratio of 1.17. Viral etiologies were found in 50% of patients. Screening endoscopy revealed the presence of PHG in 20.2% of cases, while for EVsthey were found in 83.1% of cases. VWF-Ag levels, were significantly increased in patients with PHG compared to those who have not: 441% [CI: 375 – 506], versus 279% [CI: 253 – 304], respectively (p <0.0001). Using the area under the receiver operating characteristic curve (AUC), vWF-Ag was a good predictor for the presence of PHG. With a value higher than 320% and an AUC of 0.824, VWF-Ag had an 84% sensitivity, 74% specificity, 44.7% positive predictive value, 94.8% negative predictive value, and 75.8% diagnostic accuracy. Conclusion: VWF-Ag is a good non-invasive low coast marker for excluding the presence of PHG in patients with liver cirrhosis. Using this marker as part of a selective screening strategy might reduce the need for endoscopic screening and the coast of the management of these kinds of patients.

Keywords: von willebrand factor, portal hypertensive gastropathy, prediction, liver cirrhosis

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Authors: Betty Kibirige

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Students entering the University of Zululand (UNIZULU) Science Faculty mostly come with skills that allow them to prepare for exams and pass them in order to satisfy requirements for entry into a tertiary Institution. Some students hail from deep rural schools with limited facilities, while others come from well-resourced schools. Personal experience has shown that it may take a student the whole time at a tertiary institution following the same skills as those acquired in high school as a sure means of entering the next level in their development, namely a postgraduate program. While it is apparent that at this point in human history, it is totally impossible to teach all the possible content in any one subject, many academics approach teaching and learning from the traditional point of view. It therefore became apparent to explore ways of developing a graduate that will be able to approach life with skills that allows them to navigate knowledge by applying conceptual and critical thinking skills. Recently, the Science Faculty at the University of Zululand introduced two Engineering programs. In an endeavour to approach the development of the Engineering graduate in this institution to be able to tackle problem-solving in the present-day excessive information availability, it became necessary to study and review approaches used by various academics in order to settle for a possible best approach to the challenge at hand. This paper focuses on the development of a deep rural child in a graduate with conceptual and critical thinking skills as major attributes possessed upon graduation. For this purpose, various approaches were studied. A combination of these approaches was repackaged to form an approach that may appear novel to UNIZULU and the rural child, especially for the Engineering discipline. The approach was checked by offering quiz questions to students participating in an engineering module, observing test scores in the targeted module and make comparative studies. Test results are discussed in the article. It was concluded that students’ graduate attributes could be tailored subconsciously to indeed include conceptual and critical thinking skills, but through more than one approach depending mainly on the student's high school background.

Keywords: graduate attributes, conceptual skills, critical thinking skills, traditional approach

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Authors: Anamika Choudhary, Neha Qurrat Ain

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Background: Congenital agenesis of uterine cervix is a rare anomaly often associated with partial or complete agenesis of vagina. Here is a case report of a 14 year old girl who presented with primary amenorrhea and cyclical abdominal pain since last one year with suprapubic mass palpable. On examination complete absence of a vagina was found, and ultrasound along with magnetic resonance imaging (MRI) suggested cervicovaginal agenesis associated with cryptomenorrhea, which resulted in hematometra and b/l hematosalpinx with pelvic endometriosis. After proper counseling regarding anastomosis failure and the need for future laprotomy or hysterectomy, the patient planned for laparoscopic uterovaginal anastomosis with modified McIndoe vaginoplasty with split skin graft. Case Summary: Chief complaint: The 14 year old girl presented with primary amenorrhea and cyclical abdominal pain. Diagnosis:On history, examination and investigations we made differential diagnoses of cervicovaginal agenesis, cervicovaginal atresia. Post operatively, we concluded it’s a cervicovaginal agenesis. Intervention: Laparoscopic uterovaginal anastomosis was done, and neovagina was created using split skin graft from the thigh and silicone stent. The graft was kept patent, and restenosis was prevented using a dental mould as vaginal dilator. Outcome: Postoperatively 1 year follow-up has been done. We have observed successful uterovaginal anastomosis and good uptake of graft. We also observed the resumption of normal menstrual bleeding. Currently, there has been no restenosis, abnormal vaginal discharge and decreased dysmenorrhea. Conclusion: Laparoscopic-assisted uterovaginal anastomosis can be the treatment of choice in patients with cervical agenesis and atresia instead of hysterectomy, thereby preserving the reproductive function. This conservative approach has better outcomes, as stated in the procedure below. The procedure is successful insofar as the resumption of menstrual function. However, long-term reproductive outcomes, progression of endometriosis, functioning of fallopian tubes, and sexual life in these girls will require further follow-up.

Keywords: cervicovaginal agenesis, uterovaginal anastomosis, dental mould, silicon stent

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Authors: Islam Abouelhamd

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Rives have long been recognized as one of the most important natural resources, They are important to ensure human health, civilization, and sustainable development, and the importance of rivers as the focal point of cities was established from the early times of civilization and will remain so. Urban design of Riverfront has been an issue of wide concern and extensive discussion since the 1970s, however, Cities seek a riverfront that is a place of public enjoyment, They want a Riverfront where there is ample visual and physical public access to both the water and the land, they want a place that contributes to the quality of life in all of its aspects; economic, social, and cultural, on another hand, Successful urban design of Riverfront requires an understanding of development processes, dimensions of urban design and an appreciation of the distinctiveness of Riverfront locations. A close association between cities and river is inherently over the history of civilization, and in fact, many urban cities in Egypt are located close to Nile River areas. Always trying to use the land closer to the river to take advantage of the benefits it provides, And in spite of the significant role played by the littoral fronts in the life of the city, the riverfronts have remained generally in Egypt and especially in Asyut city neglected. According to the knowledge gained from the literature review, review of case studies and the historical researches of Asyut Riverfront, this research aims to identify the urban transformations of Asyut riverfront and expect the Opportunities and Challenges which will play an important part of the future urban design issues and researches will prepare, especially in the case study area (northern areas of Asyut riverfront). After that, the case study data, historical framework and International experiences were collected and analyzed to Produce Primary indicators of the expectations of the riverfront urban design process inside the case study area, In addition to preparing the conclusions of the theoretical framework and recommendations for the paper.

Keywords: civilization, sustainable development, riverfront, urban transformations

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Authors: Yexin Qu

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Izafe is a construction typically found in Iranian languages, which is attested already in Old Avestan and Old Persian. The narrow sense of izafe can be described as the linear structure of [NP pt Modifier] with pt as an uninflectable particle or clitic. The history of the Iranian izafe has the following stages: Stage I: Verbless nominal relative clauses, Stage II: Verbless nominal relative clauses with Case Attraction; and Stage III: Narrow sense izafe. Previous works suggest that embedded relative clauses and correlatives in other Indo-European languages might be relevant for the source of the izafe-construction. Stage I, as the precursor of narrow sense izafe, or so-called “prezafe” is not found in branches other than Iranian. Comparable cases have been demonstrated in Vedic, Greek, and some rare cases in Latin. This suggests “prezafe” may date back very early in Indo-European. Izafe-like structures are not attested in branches such as Balto-Slavic and Germanic, but Balto-Slavic definite adjectives and Germanic weak adjectives can be compared to the verbless nominal relative clauses and analyzed as developments of verbless relative clauses parallel to izafe in Indo-Iranian, as are called “parizafe” in this paper. In this paper, the verbless RC is compared with Germanic weak adjectives. The Germanic languages used n-stem derivation to form determined derivatives, which are semantically equivalent to the appositive RC and eventually became weak adjectives. To be more precise, starting from an adjective “X”, the Germanic weak adjective structure is formed as [det X-n], literally “the X”, with the meaning “the X one”, which can be shown to be semantically equivalent to “the one which is X”. In this paper, Stage I suggest that, syntactically, the Germanic verbless relative clauses went through CP to DP relabeling like Iranian, based on the following observations: (1) Germanic relative pronouns (e.g., Gothic saei, Old English se) and determiners (e.g., Gothic sa, Old English se) are both from the *so/to pronominal roots; (2) the semantic equivalence of Germanic weak adjectives and the izafe structure. This may suggest that Germanic may also have had “Prezafe” Stages I and II. In conclusion: “Prezafe” in Stage I may have been a phenomenon of the proto-language, Stage II was the result of independent parallel developments and then each branch had its own strategy.

Keywords: izafe, relative clause, Germanic, Indo-European

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