Search results for: college entrance examination

Authors: S. J. Yune, S. Y. Lee, S. J. Im, B. S. Kam, S. Y. Baek

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This study aimed to determine the reliability of clinical performance assessments, having been emphasized by ability-based education, and professors overall assessment methods. We addressed the following problems: First, we try to find out whether there is a difference in what we consider to be the main variables affecting the clinical performance test according to the evaluator’s working period and the number of evaluation experience. Second, we examined the relationship among the global rating score (G), analytic global rating score (Gc), and the sum of the analytical checklists (C). What are the main factors affecting clinical performance assessments in relation to the numbers of times the evaluator had administered evaluations and the length of their working period service? What is the relationship between overall assessment score and analytic checklist score? How does analytic global rating with 6 components in OSCE and 4 components in sub-domains (Gc) CPX: aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude overall assessment score and task-specific analytic checklist score sum (C) affect the professor’s overall global rating assessment score (G)? We studied 75 professors who attended a 2016 Bugyeoung Consortium clinical skills performances test evaluating third and fourth year medical students at the Pusan National University Medical school in South Korea (39 prof. in OSCE, 36 prof. in CPX; all consented to participate in our study). Each evaluator used 3 forms; a task-specific analytic checklist, subsequent analytic global rating scale with sub-6 domains, and overall global scale. After the evaluation, the professors responded to the questionnaire on the important factors of clinical performance assessment. The data were analyzed by frequency analysis, correlation analysis, and hierarchical regression analysis using SPSS 21.0. Their understanding of overall assessment was analyzed by dividing the subjects into groups based on experiences. As a result, they considered ‘precision’ most important in overall OSCE assessment, and ‘precise accuracy physical examination’, ‘systemic approaches to taking patient history’, and ‘diagnostic skill capability’ in overall CPX assessment. For OSCE, there was no clear difference of opinion about the main factors, but there was for CPX. Analytic global rating scale score, overall rating scale score, and analytic checklist score had meaningful mutual correlations. According to the regression analysis results, task-specific checklist score sum had the greatest effect on overall global rating. professors regarded task-specific analytic checklist total score sum as best reflecting overall OSCE test score, followed by aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude on a subsequent analytic global rating scale. For CPX, subsequent analytic global rating scale score, overall global rating scale score, and task-specific checklist score had meaningful mutual correlations. These findings support explanations for validity of professors’ global rating in clinical performance assessment.

Keywords: global rating, clinical performance assessment, medical education, analytic checklist

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Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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Authors: Éva Pintér, Péter Bagó, Nikolett Deutsch, Miklós Hetényi

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The process of digital transformation has a profound influence on all sectors of the worldwide economy and the business environment. The influence of blockchain technology can be observed in the digital economy and e-government, rendering it an essential element of a nation's growth strategy. The banking industry is experiencing significant expansion and development of financial technology firms. Utilizing developing technologies such as artificial intelligence (AI), machine learning (ML), and big data (BD), these entrants are offering more streamlined financial solutions, promptly addressing client demands, and presenting a challenge to incumbent institutions. The advantages of digital transformation are evident in the corporate realm, and firms that resist its adoption put their survival at risk. The advent of digital technologies has revolutionized the business environment, streamlining processes and creating opportunities for enhanced communication and collaboration. Thanks to the aid of digital technologies, businesses can now swiftly and effortlessly retrieve vast quantities of information, all the while accelerating the process of creating new and improved products and services. Big data analytics is generally recognized as a transformative force in business, considered the fourth paradigm of science, and seen as the next frontier for innovation, competition, and productivity. Big data, an emerging technology that is shaping the future of the banking sector, offers numerous advantages to banks. It enables them to effectively track consumer behavior and make informed decisions, thereby enhancing their operational efficiency. Banks may embrace big data technologies to promptly and efficiently identify fraud, as well as gain insights into client preferences, which can then be leveraged to create better-tailored products and services. Moreover, the utilization of big data technology empowers banks to develop more intelligent and streamlined models for accurately recognizing and focusing on the suitable clientele with pertinent offers. There is a scarcity of research on big data analytics in the banking industry, with the majority of existing studies only examining the advantages and prospects associated with big data. Although big data technologies are crucial, there is a dearth of empirical evidence about the role of big data analytics (BDA) capabilities in bank performance. This research addresses a gap in the existing literature by introducing a model that combines the resource-based view (RBV), the technical organization environment framework (TOE), and dynamic capability theory (DC). This study investigates the influence of Big Data Analytics (BDA) utilization on the performance of market and risk management. This is supported by a comparative examination of Hungarian mobile banking services.

Keywords: big data, digital transformation, dynamic capabilities, mobile banking

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Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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Authors: Taghrid Asfar, Olusanya J. Oluwole, Michael Schmidt, Alejandra Casas, Zoran Bursac, Wasim Maziak.

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Waterpipe (WP) smoking (a.k.a. hookah) has increased dramatically in the US mainly due to the misperception that it is safer than cigarette smoking. Mounting evidence show that WP smoking is addictive and harmful. Health warning labels (HWLs) are effective in communicating smoking-related risks. Currently, the FDA requires that WP tobacco packages have a textual HWL about nicotine. While this represents a good step, it is inadequate given the established harm of WP smoking beyond addiction and the superior performance of pictorial HWLs over text-only ones. We developed 24 WP pictorial HWLs in a Delphi study among international expert panel. HWLs were grouped into 6 themes: addiction, harm compared to cigarettes, harm to others, health effects, quitting, and specific harms. This study aims to compare the effect of the pictorial HWLs compared to the FDA HWL, and 2) the effect of pictorial HWLs between the 6 themes. A 2x7 between/within subject online factorial experimental study was conducted among a national convenience sample of 300 (50% current WP smokers; 50% nonsmokers) US adults (females 71.1%; mean age of 31.1±3.41 years) in March 2022. The first factor varied WP smoking status (smokers, nonsmokers). The second factor varied the HWL theme and type (text, pictorial). Participants were randomized to view and rate 7 HWLs: 1 FDA text HWL (control) and 6 HWLs, one from each of the 6 themes, all presented in random order. HWLs were rated based on the message impact framework into five categories: attention, reaction (believability, relevance, fear), perceived effectiveness, intentions to quit WP among current smokers, and intention to not initiate WP among nonsmokers. measures were assessed on a 5-point Likert scale (1=not at all to 5=very much) for attention and reaction and on a 7-point Likert scale (1=not at all to 7=very much) for the perceived effectiveness and intentions to quit or not initiate WP smoking. Means and SDs of outcome measures for each HWL type and theme were calculated. Planned comparisons using Friedman test followed by pairwise Wilcoxon signed-rank test for multiple comparisons were used to examine distributional differences of outcomes between the HWL type and themes. Approximately 74.4 % of participants were non-Hispanic Whites, 68.4% had college degrees, and 41.5% were under the poverty level. Participants reported starting WTS on average at 20.3±8.19 years. Compared with the FDA text HWL, pictorial HWLs elicited higher attention (p<0.0001), fear (p<0.0001), harm perception (p<0.0003), perceived effectiveness (p<0.0001), and intentions to quit (p=0.0014) and not initiate WP smoking (p<0.0003). HWLs in theme 3 (harm to others) achieved the highest rating in attention (4.14±1), believability (4.15±0.95), overall perceived effectiveness (7.60±2.35), harm perception (7.53±2.43), and intentions to quit (7.35±2.57). HWLs in theme 2 (WP harm compared to cigarettes) achieved the highest rating in discouraging WP smoking initiation (7.32±2.54). Pictorial HWLs were superior to the FDA text-only for several communication outcomes. Pictorial HWLs related to WP harm to others and WP harm compared to cigarette are promising. These findings provide strong evidence for the potential implementation of WP-specific pictorial HWLs.

Keywords: health communication, waterpipe smoking, factorial experiment, reaction, harm perception, tobacco regulations

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Authors: Sinem Tas

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This research paper attempts to study the perspective of personal experience in relation to spatial dynamics and artistic outcomes within the realm of cultural identity. This article serves as a partial analysis within a broader PhD investigation that focuses on the cultural dynamics and political structures behind cultural identity through an autoethnography of narrative while presenting its correlation with artistic creation in the context of space and people. Focusing on the artistic/creative practice project AUTRUI, the primary goal is to analyse and understand the influence of personal experiences and culturally constructed identity as an artist in resulting in the compositional modality of the last image considering self-reflective experience. Referencing the works of Joyce Davidson and Christine Milligan - the scholars who emphasise the importance of emotion and spatial experience in geographical studies contribute to this work as they highlight the significance of emotion across various spatial scales in their work Embodying Emotion Sensing Space: Introducing Emotional Geographies (2004). Their perspective suggests that understanding emotions within different spatial contexts is crucial for comprehending human experiences and interactions with space. Incorporating the insights of scholars like Yi-Fu Tuan, particularly his seminal work Space and Place: The Perspective of Experience (1979), is important for creating an in-depth frame of geographical experience. Tuan's humanistic perspective on space and place provides a valuable theoretical framework for understanding the interplay between personal experiences and spatial contexts. A substantial contextualisation of the geopolitics of Turkey - the implications for national identity and cohesion - will be addressed by drawing an outline of the political and geographical frame as a methodological strategy to understand the dynamics behind this research. Besides the bibliographical reading, the methods used to study this relation are participatory observation, memory work along with memoir analysis, personal interviews, and discussion of photographs and news. The utilisation of the self as data requires the analysis of the written sources with personal engagement. By delving into written sources such as written communications or diaries as well as memoirs, the research gains a firsthand perspective, enriching the analytical depth of the study. Furthermore, the examination of photography and news articles serves as a valuable means of contextualising experiences from a journalist's background within specific geographical settings. The inclusion of interviews with close family members access provides firsthand perspectives and intimate insights rooted in shared experiences within similar geographical contexts, offering complementary insights and diversified viewpoints, enhancing the comprehensiveness of the investigation.

Keywords: art, autoethnography, place and space, Turkey

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Authors: G. Yanay-Ventura, H. Desivilya Syna, K. Michael

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Social businesses are based on the idea that an enterprise can be established for the sake of profit and, at the same time, with the aim of fulfilling social goals. Yet, the question of how these goals can be integrated in practice to derive parallel benefit in both realms still needs to be examined. Particularly notable in this context is the ‘governance challenge’ of social businesses, meaning the danger of the mission drifts from the social goal in the pursuit of good business. This study is based on an evaluation study of a social business that operates as a restaurant providing professional training to at-risk youth. The evaluation was based on the collection of a variety of data through interviews with stakeholders in the enterprise (directors and managers, business partners, social partners, and position holders in the restaurant and the social enterprise), a focus group consisting of the youth receiving the professional training, observations of the restaurant’s operation, and analysis of the social enterprise’s primary documents. The evaluation highlighted significant strengths of the social enterprise, including reaching relatively fast business sustainability, effective management of the restaurant, stable employment of the restaurant staff, and effective management of the social project. The social enterprise and business management have both enjoyed positive evaluations from a variety of stakeholders. Clearly, the restaurant was deemed by all a promising young business. However, the social project suffered from a 90% dropout rate among the youth entering its ranks, extreme monthly fluctuation in the number of youths participating, and a distinct minority of the youth who have succeeded in completing their training period. Possible explanations of the high dropout rate included the small number of cooks, which impeded the effectiveness of the training process and the provision of advanced cooking skills; lack of clarity regarding the essence and the elements of training; and lack of a meaningful peer group for the youth engaged in the program. Paradoxically, despite the stakeholders’ great appreciation for the social enterprise, the challenge of governability was also formidable, revealing a tangible risk of mission drift in the reduction of the social enterprise’s target population and a breach of the commitment made to the youth with regard to practical training. The risk of mission drifts emerged as a hidden and evasive issue for the stakeholders, who revealed a deep appreciation for the management and the outcomes of the social enterprise. The challenge of integration, therefore, requires an in-depth examination of how to maintain a successful business without hindering the achievement of the social goal. The study concludes that clear conceptualization of the training process and its aims, increased cooks’ participation in the social project, and novel conceptions with regard to the evaluation of success could serve to benefit the youth and impede mission drift.

Keywords: evaluation study, management, mission drift, social business

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Authors: Angelis P. Barlampas

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Introduction: The term phantom lung mass describes the ovoid collection of fluid within the interlobular fissure, which initially creates the impression of a mass. The problem of correct differential diagnosis is great, especially in plain radiography. A case is presented with three nodular pulmonary foci, the shape, location, and density of which, as well as the presence of chronic loculated pleural effusions, suggest the presence of multiple phantom tumors of the lung. Purpose: The aim of this paper is to draw the attention of non-experienced and non-specialized physicians to the existence of benign findings that mimic pathological conditions and vice versa. The careful study of a radiological examination and the comparison with previous exams or further control protect against quick wrong conclusions. Methods: A hospitalized patient underwent a non-contrast CT scan of the chest as part of the general control of her situation. Results: Computed tomography revealed pleural effusions, some of them loculated, increased cardiothoracic index, as well as the presence of three nodular foci, one in the left lung and two in the right with a maximum density of up to 18 Hounsfield units and a mean diameter of approximately five centimeters. Two of them are located in the characteristical anatomical position of the major interlobular fissure. The third one is located in the area of the right lower lobe’s posterior basal part, and it presents the same characteristics as the previous ones and is likely to be a loculated fluid collection, within an auxiliary interlobular fissure or a cyst, in the context of the patient's more general pleural entrapments and loculations. The differential diagnosis of nodular foci based on their imaging characteristics includes the following: a) rare metastatic foci with low density (liposarcoma, mucous tumors of the digestive or genital system, necrotic metastatic foci, metastatic renal cancer, etc.), b) necrotic multiple primary lung tumor locations (squamous epithelial cancer, etc. ), c) hamartomas of the lung, d) fibrotic tumors of the interlobular fissures, e) lipoid pneumonia, f) fluid concentrations within the interlobular fissures, g) lipoma of the lung, h) myelolipomas of the lung. Conclusions: The collection of fluid within the interlobular fissure of the lung can give the false impression of a lung mass, particularly on plain chest radiography. In the case of computed tomography, the ability to measure the density of a lesion, combined with the provided high anatomical details of the location and characteristics of the lesion, can lead relatively easily to the correct diagnosis. In cases of doubt or image artifacts, comparison with previous or subsequent examinations can resolve any disagreements, while in rare cases, intravenous contrast may be necessary.

Keywords: phantom mass, chest CT, pleural effusion, cancer

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Authors: K. H. Reeta, Bhavana Prasher, Mitali Mukerji, Dhwani Dholakia, Sangeeta Khanna, Archana Vats, Shivam Pandey, Sandeep Seth, Subir Kumar Maulik

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Introduction Research has demonstrated a connection between coronary artery disease (CAD) and genetics. We did a deep literature mining using both bioinformatics and manual efforts to identify the susceptible polymorphisms in coronary artery disease. Further, the study sought to validate these findings in an Asian population. Methodology In first phase, we used an automated pipeline which organizes and presents structured information on SNPs, Population and Diseases. The information was obtained by applying Natural Language Processing (NLP) techniques to approximately 28 million PubMed abstracts. To accomplish this, we utilized Python scripts to extract and curate disease-related data, filter out false positives, and categorize them into 24 hierarchical groups using named Entity Recognition (NER) algorithms. From the extensive research conducted, a total of 466 unique PubMed Identifiers (PMIDs) and 694 Single Nucleotide Polymorphisms (SNPs) related to coronary artery disease (CAD) were identified. To refine the selection process, a thorough manual examination of all the studies was carried out. Specifically, SNPs that demonstrated susceptibility to CAD and exhibited a positive Odds Ratio (OR) were selected, and a final pool of 324 SNPs was compiled. The next phase involved validating the identified SNPs in DNA samples of 96 CAD patients and 37 healthy controls from Indian population using Global Screening Array. ResultsThe results exhibited out of 324, only 108 SNPs were expressed, further 4 SNPs showed significant difference of minor allele frequency in cases and controls. These were rs187238 of IL-18 gene, rs731236 of VDR gene, rs11556218 of IL16 gene and rs5882 of CETP gene. Prior researches have reported association of these SNPs with various pathways like endothelial damage, susceptibility of vitamin D receptor (VDR) polymorphisms, and reduction of HDL-cholesterol levels, ultimately leading to the development of CAD. Among these, only rs731236 had been studied in Indian population and that too in diabetes and vitamin D deficiency. For the first time, these SNPs were reported to be associated with CAD in Indian population. Conclusion: This pool of 324 SNP s is a unique kind of resource that can help to uncover risk associations in CAD. Here, we validated in Indian population. Further, validation in different populations may offer valuable insights and contribute to the development of a screening tool and may help in enabling the implementation of primary prevention strategies targeted at the vulnerable population.

Keywords: coronary artery disease, single nucleotide polymorphism, susceptible SNP, bioinformatics

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Authors: Samanta Kietytė

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The object of this study is the verbal derivatives stemming from the Lithuanian prefix per-. The prefix under examination can be classified as prepositional, having descended from the preposition per, thereby sharing the same prototypical meaning – denoting movement OVER. These frequently co-occur within sentences (1). The aim of this paper is to conduct a semantic analysis of the prefix per- and to propose a possible radial network of its meanings. In essence, the aim is to identify the interrelationships existing between its meanings. 1) Jis peršoko per tvorą/ 3SG.NOM.M jump.PST.3 over fence.ACC.SG. /ʻHe jumped over the fenceʼ. The foundation of this work lies in the methodological and theoretical framework of cognitive linguistics. The prototypical meaning of prefixes consistently embodies spatial dimensions that can be described through image schemas. This entails the identification of the trajectory, the landmark, and the relation between them in the situation described by the prefixed verb. The meanings of linguistic units are not perceived as arbitrary, but rather, they are interconnected through semantic motivation. According to this perspective, a singular meaning within linguistic units is considered as prototypical, while additional meanings are descended (not necessarily directly) from it. For example, one of the per- meanings TRANSFER (2) is derived from the prototypical meaning OVER. 2) Prašau persiųsti vadovo laišką man./ Ask.PRS.1 forward.INF manager.GEN.SG email.ACC.SG 1.SG.DAT/ ʻPlease forward the manager‘s email to meʼ. Certain semantic relations are explained by the conceptual metaphor and metonymy theory. For instances, when prefixed verb has a meaning WIN (3) it is related to the prototypical meaning. In this case, the prefixed verb describes situations of winning in various ways. In the prototypical meaning, the trajector moves higher than the landmark, and winning is metaphorically perceived as being higher. 3) Sūnus peraugo tėvą./ Son.NOM.SG outgrow.PST.3 father.ACC.SG/ ʻThe son has outgrown the fatherʼ. The data utilized for this study was collected from the 2014 grammatically annotated text "Lithuanian Web (LithuanianWaC v2)", consisting of 63,645,700 words. Given that the corpus is grammatically lemmatized, the list of the 793 items was obtained using the wordlist function and specifying that verbs starting with per were searched. The list included not only prefixed verbs but also other verbs whose roots have the same letter sequences as prefixes. Also, words with misspellings, without diacritical marks, and words listed for lemmatization errors were rejected, and a total of 475 derivatives were left for further analysis. The semantic analysis revealed that there are 12 distinct meanings of the prefix per-. The spatial meanings were extracted by determining what a trajector is, what a landmark is, and what the relation between them is. The connection between non-spatial meanings and spatial ones occurs through semantic motivation established by identifying elements that correspond to the trajector and landmark. The analysis reveals that there are no strict boundaries among these meanings, instead showing a continuum that encompasses a central core and a peripheral association with their internal structure, i.e., some derivatives are more prototypical of a particular meaning than others.

Keywords: word-formation, cognitive semantics, metaphor, radial networks, prototype theory, prefix

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Authors: Agâh Tuğrul Korucu, Ismail Fatih Yavuzaslan, Lale Toraman

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Nowadays, thanks to development of technology, integration of technology into teaching and learning activities is spreading. Increasing technological literacy which is one of the expected competencies for individuals of 21st century is associated with the effective use of technology in education. The most important factor in effective use of technology in education institutions is ICT teachers. The concept of computer assisted instruction (CAI) refers to the utilization of information and communication technology as a tool aided teachers in order to make education more efficient and improve its quality in the process of educational. Teachers can use computers in different places and times according to owned hardware and software facilities and characteristics of the subject and student in CAI. Analyzing teachers’ use of computers in education is significant because teachers are the ones who manage the course and they are the most important element in comprehending the topic by students. To accomplish computer-assisted instruction efficiently is possible through having positive attitude of teachers. Determination the level of knowledge, attitude and behavior of teachers who get the professional knowledge from educational faculties and elimination of deficiencies if any are crucial when teachers are at the faculty. Therefore, the aim of this paper is to identify ICT teachers' attitudes toward computer-assisted instruction in terms of different variables. Research group consists of 200 prospective ICT teachers studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education CEIT department. As data collection tool of the study; “personal information form” developed by the researchers and used to collect demographic data and "the attitude scale related to computer-assisted instruction" are used. The scale consists of 20 items. 10 of these items show positive feature, while 10 of them show negative feature. The Kaiser-Meyer-Olkin (KMO) coefficient of the scale is found 0.88 and Barlett test significance value is found 0.000. The Cronbach’s alpha reliability coefficient of the scale is found 0.93. In order to analyze the data collected by data collection tools computer-based statistical software package used; statistical techniques such as descriptive statistics, t-test, and analysis of variance are utilized. It is determined that the attitudes of prospective instructors towards computers do not differ according to their educational branches. On the other hand, the attitudes of prospective instructors who own computers towards computer-supported education are determined higher than those of the prospective instructors who do not own computers. It is established that the departments of students who previously received computer lessons do not affect this situation so much. The result is that; the computer experience affects the attitude point regarding the computer-supported education positively.

Keywords: computer based instruction, teacher candidate, attitude, technology based instruction, information and communication technologies

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Authors: F. Uriel, M. M. Fernandez Liporace

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In the last decade, academic achievement in higher education has become a topic of agenda in Argentina, regarding the high figures of adjustment problems, academic failure and dropout, and the low graduation rates in the context of massive classes and traditional teaching methods. Psychological variables, such as perceived social support, academic motivation and learning styles and strategies have much to offer since their measurement by tests allows a proper diagnose of their influence on academic achievement. Framed in a major research, several studies analysed multiple samples, totalizing 5135 students attending Argentinean public universities. The first goal was aimed at the identification of statistically significant differences in psychological variables -perceived social support, learning styles, learning strategies, and academic motivation- by age, gender, and degree of academic advance (freshmen versus sophomores). Thus, an inferential group differences study for each psychological dependent variable was developed by means of student’s T tests, given the features of data distribution. The second goal, aimed at examining associations between the four psychological variables on the one hand, and academic achievement on the other, was responded by correlational studies, calculating Pearson’s coefficients, employing grades as the quantitative indicator of academic achievement. The positive and significant results that were obtained led to the formulation of different predictive models of academic achievement which had to be tested in terms of adjustment and predictive power. These models took the four psychological variables above mentioned as predictors, using regression equations, examining predictors individually, in groups of two, and together, analysing indirect effects as well, and adding the degree of academic advance and gender, which had shown their importance within the first goal’s findings. The most relevant results were: first, gender showed no influence on any dependent variable. Second, only good achievers perceived high social support from teachers, and male students were prone to perceive less social support. Third, freshmen exhibited a pragmatic learning style, preferring unstructured environments, the use of examples and simultaneous-visual processing in learning, whereas sophomores manifest an assimilative learning style, choosing sequential and analytic processing modes. Despite these features, freshmen have to deal with abstract contents and sophomores, with practical learning situations due to study programs in force. Fifth, no differences in academic motivation were found between freshmen and sophomores. However, the latter employ a higher number of more efficient learning strategies. Sixth, freshmen low achievers lack intrinsic motivation. Seventh, models testing showed that social support, learning styles and academic motivation influence learning strategies, which affect academic achievement in freshmen, particularly males; only learning styles influence achievement in sophomores of both genders with direct effects. These findings led to conclude that educational psychologists, education specialists, teachers, and universities must plan urgent and major changes. These must be applied in renewed and better study programs, syllabi and classes, as well as tutoring and training systems. Such developments should be targeted to the support and empowerment of students in their academic pathways, and therefore to the upgrade of learning quality, especially in the case of freshmen, male freshmen, and low achievers.

Keywords: academic achievement, academic motivation, coping, learning strategies, learning styles, perceived social support

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Authors: Cheh-Shyh Ting, Jiin-Liang Lin

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This study was conducted at the Wanglung Farm in Pingtung County to test the groundwater seepage influences on the implemented project for artificial groundwater recharge. The study was divided into three phases. The first phase, conducted on natural groundwater that was recharged through the local climate and growing conditions, observed the natural form of vegetation species. The original plants were flooded, and after 60 days it was observed that of the original plants only Goosegrass (Eleusine indica) and Black heart (Polygonum lapathifolium Linn.) remained. Direct infiltration tests were carried out, and calculations for the effect of vegetation on infiltration velocity of the recharge pool were noted. The second phase was an indoor test. Bahia grass and wild amaranth were selected as vegetation roots. After growth, the distribution of different grassroots was observed in order to facilitate a comparison permeability coefficient calculated by the amount of penetration and to explore the relationship between density and the efficiency to groundwater recharge. The third phase was the root tomography analysis, further observation of the development of plant roots using computed tomography technology. Computed Tomography, also known as (CT), is a diagnostic imaging examination, normally used in the medical field. In the first phase of the feasibility study, most non-aquatic plants wilted and died within seven days. In seven days, the remaining plants were used for experimental infiltration analysis. Results showed that in eight hours of infiltration test, Eleusine indica stems averaged 0.466 m/day and wild amaranth averaged 0.014 m/day. The second phase of the experiment was conducted on the remains of the plant a week in it had died and rotted, and the infiltration experiment was performed under these conditions. The results showed eight hours in end of the infiltration test, Eleusine indica stems averaged 0.033 m/day, and wild amaranth averaged 0.098 m/day. Non-aquatic plants died within two weeks, and their rotted remains clogged the pores of bottom soil particles, causing obstruction of recharge pool infiltration. Experiment results showed that eight hours in the test the average infiltration velocity for Eleusine indica stems was 0.0229 m/day and wild amaranth averaged 0.0117 m/day. Since the rotted roots of the plants blocked the pores of the soil in the recharge pool, which resulted in the obstruction of the artificial infiltration pond and showed an immediate impact on recharge efficiency. In order to observe the development of plant roots, the third phase used computed tomography imaging. Iodine developer was injected into the Black heart, allowing its cross-sectional images to be shown on CT and to be used to observe root development.

Keywords: artificial recharge of groundwater, computed tomography, infiltration velocity, vegetation root system

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Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

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AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

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Authors: Aabha Chaubey, Bani Bhattacharya

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Evaluation of the quality of teaching in engineering education in India needs to be conducted on a continuous basis to achieve the best teaching quality in technical education. Quality teaching is an influential factor in technical education which impacts largely on learning outcomes of the students. Present study is not exclusively theory-driven, but it draws on various specific concepts and constructs in the domain of technical education. These include teaching and learning in higher education, teacher effectiveness, and teacher evaluation and performance management in higher education. Student Evaluation of Education Quality (SEEQ) was proposed as one of the evaluation instruments of the quality teaching in engineering education. SEEQ is one of the popular and standard instrument widely utilized all over the world and bears the validity and reliability in educational world. The present study was designed to evaluate the teaching quality through SEEQ in the context of technical education in India, including its validity and reliability based on the collected data. The multiple dimensionality of SEEQ that is present in every teaching and learning process made it quite suitable to collect the feedback of students regarding the quality of instructions and instructor. The SEEQ comprises of 9 original constructs i.e.; learning value, teacher enthusiasm, organization, group interaction, and individual rapport, breadth of coverage, assessment, assignments and overall rating of particular course and instructor with total of 33 items. In the present study, a total of 350 samples comprising first year undergraduate students from Indian Institute of Technology, Kharagpur (IIT, Kharagpur, India) were included for the evaluation of the importance of SEEQ. They belonged to four different courses of different streams of engineering studies. The above studies depicted the validity and reliability of SEEQ was based upon the collected data. This further needs Confirmatory Factor Analysis (CFA) and Analysis of Moment structure (AMOS) for various scaled instrument like SEEQ Cronbach’s alpha which are associated with SPSS for the examination of the internal consistency. The evaluation of the effectiveness of SEEQ in CFA is implemented on the basis of fit indices such as CMIN/df, CFI, GFI, AGFI and RMSEA readings. The major findings of this study showed the fitness indices such as ChiSq = 993.664,df = 390,ChiSq/df = 2.548,GFI = 0.782,AGFI = 0.736,CFI = 0.848,RMSEA = 0.062,TLI = 0.945,RMR = 0.029,PCLOSE = 0.006. The final analysis of the fit indices presented positive construct validity and stability, on the other hand a higher reliability was also depicted which indicated towards internal consistency. Thus, the study suggests the effectivity of SEEQ as the indicator of the quality evaluation instrument in teaching-learning process in engineering education in India. Therefore, it is expected that with the continuation of this research in engineering education there remains a possibility towards the betterment of the quality of the technical education in India. It is also expected that this study will provide an empirical and theoretical logic towards locating a construct or factor related to teaching, which has the greatest impact on teaching and learning process in a particular course or stream in engineering education.

Keywords: confirmatory factor analysis, engineering education, SEEQ, teaching and learning process

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Authors: Sif J. Friis, Mette Poulsen, Torben Strom Hansen, Peter Herskind, Jens V. Nygaard

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Gastric biomechanics governs a large range of scientific and engineering fields, from gastric health issues to interaction mechanisms between external devices and the tissue. Determination of mechanical properties of the stomach is, thus, crucial, both for understanding gastric pathologies as well as for the development of medical concepts and device designs. Although the field of gastric biomechanics is emerging, advances within medical devices interacting with the gastric tissue could greatly benefit from an increased understanding of tissue anisotropy and heterogeneity. Thus, in this study, uniaxial tensile tests of gastric tissue were executed in order to study biomechanical properties within the same individual as well as across individuals. With biomechanical tests in the strain domain, tissue from the antrum region of six porcine stomachs was tested using eight samples from each stomach (n = 48). The samples were cut so that they followed dominant fiber orientations. Accordingly, from each stomach, four samples were longitudinally oriented, and four samples were circumferentially oriented. A step-wise stress relaxation test with five incremental steps up to 25 % strain with 200 s rest periods for each step was performed, followed by a 25 % strain ramp test with three different strain rates. Theoretical analysis of the data provided stress-strain/time curves as well as 20 material parameters (e.g., stiffness coefficients, dissipative energy densities, and relaxation time coefficients) used for statistical comparisons between samples from the same stomach as well as in between stomachs. Results showed that, for the 20 material parameters, heterogeneity across individuals, when extracting samples from the same area, was in the same order of variation as the samples within the same stomach. For samples from the same stomach, the mean deviation percentage for all 20 parameters was 21 % and 18 % for longitudinal and circumferential orientations, compared to 25 % and 19 %, respectively, for samples across individuals. This observation was also supported by a nonparametric one-way ANOVA analysis, where results showed that the 20 material parameters from each of the six stomachs came from the same distribution with a level of statistical significance of P > 0.05. Direction-dependency was also examined, and it was found that the maximum stress for longitudinal samples was significantly higher than for circumferential samples. However, there were no significant differences in the 20 material parameters, with the exception of the equilibrium stiffness coefficient (P = 0.0039) and two other stiffness coefficients found from the relaxation tests (P = 0.0065, 0.0374). Nor did the stomach tissue show any significant differences between the three strain-rates used in the ramp test. Heterogeneity within the same region has not been examined earlier, yet, the importance of the sampling area has been demonstrated in this study. All material parameters found are essential to understand the passive mechanics of the stomach and may be used for mathematical and computational modeling. Additionally, an extension of the protocol used may be relevant for compiling a comparative study between the human stomach and the pig stomach.

Keywords: antrum region, gastric biomechanics, loading-unloading, stress relaxation, uniaxial tensile testing

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Authors: Tomasz Lewinski

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The right to know becomes gradually recognised as an increasing number of states adopts national legislations regarding access to state-held information. Laws differ from each other in the scope of the right to information (hereinafter: RTI). In all regimes of RTI, there are exceptions from the general notion of the right. States’ authorities too often use exceptions to justify refusals to requests for state-held information. This paper sets out how states hamper RTI basing on the notion of exception and by not providing an effective procedure that could redress unlawful denials. This paper bases on two selected examples of RTI incorporation into the national legal regime, United Kingdom, and South Africa. It succinctly outlines the international standard given in Article 19 of the International Covenant on Civil and Political Rights (hereinafter: ICCPR) and its influence on the RTI in selected countries. It shortly demonstrates as a background to further analysis the Human Rights Committee’s jurisprudence and standards articulated by successive Special Rapporteurs on freedom of opinion and expression. Subsequently, it presents a brief comparison of these standards with the regional standards, namely the African Charter on Human and Peoples' Rights and the European Convention on Human Rights. It critically discusses the regimes of exceptions in RTI legislations in respective national laws. It shows how excessive these regimes are, what implications they have for the transparency in general. Also, the objective is to divide exceptions enumerated in legislations of selected states in relation to exceptions provided in Article 19 of the ICCPR. Basing on the established division of exceptions by its natures, it compares both regimes of exceptions related to the principle of national security. That is to compare jurisprudence of domestic courts, and overview practices of states’ authorities applied to RTI requests. The paper evaluates remedies available in legislations, including contexts of the length and costs of the subsequent proceedings. This provides a general assessment of the given mechanisms and present potential risks of its ineffectiveness. The paper relies on examination of the national legislations, comments of the credible non-governmental organisations (e.g. The Public's Right to Know Principles on Freedom of Information Legislation by the Article 19, The Tshwane Principles on National Security and the Right to Information), academics and also the research of the relevant judgements delivered by domestic and international courts. Conclusion assesses whether selected countries’ legislations go in line with international law and trends, whether the jurisprudence of the regional courts provide appropriate benchmarks for national courts to address RTI issues effectively. Furthermore, it identifies the largest disadvantages of current legislations and to what outcomes it leads in domestic courts jurisprudences. In the end, it provides recommendations and policy arguments for states to improve transparency and support local organisations in their endeavours to establish more transparent states and societies.

Keywords: access to information, freedom of information, national security, right to know, transparency

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Authors: David Philpott, Karen Kennedy

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In recognition of an increasingly diverse student population, a Teaching and Learning Framework was developed at Memorial University of Newfoundland. This framework emphasizes work that is engaging, supportive, inclusive, responsive, committed to discovery, and is outcomes-oriented for both educators and learners. The goal of the Teaching and Learning framework was to develop a number of initiatives that builds on existing knowledge, proven programs, and existing supports in order to respond to the specific needs of identified groups of diverse learners: 1) academically vulnerable first year students; 2) students with individual learning needs associated with disorders and/or mental health issues; 3) international students and those from non-western cultures. This session provides an overview of this process. The strategies employed to develop these initiatives were drawn primarily from research on student success and retention (literature review), information on pre-existing programs (environmental scan), an analysis of in-house data on students at our institution; consultations with key informants at all of Memorial’s campuses. The first initiative that emerged from this research was a pilot project proposal for a first-year success program in support of the first-year experience of academically vulnerable students. This program offers a university experience that is enhanced by smaller classes, supplemental instruction, learning communities, and advising sessions. The second initiative that arose under the mandate of the Teaching and Learning Framework was a collaborative effort between two institutions (Memorial University and the College of the North Atlantic). Both institutions participated in a shared conversation to examine programs and services that support an accessible and inclusive environment for students with disorders and/or mental health issues. A report was prepared based on these conversations and an extensive review of research and programs across the country. Efforts are now being made to explore possible initiatives that address culturally diverse and non-traditional learners. While an expanding literature has emerged on diversity in higher education, the process of developing institutional initiatives is usually excluded from such discussions, while the focus remains on effective practice. The proposals that were developed constitute a co-ordination and strengthening of existing services and programs; a weaving of supports to engage a diverse body of students in a sense of community. This presentation will act as a guide through the process of developing projects addressing learner diversity and engage attendees in a discussion of institutional practices that have been implemented in support of overcoming challenges, as well as provide feedback on institutional and student outcomes. The focus of this session will be on effective practice, and will be of particular interest to university administrators, educational developers, and educators wishing to implement similar initiatives on their campuses; possible adaptations for practice will be addressed. A presentation of findings from this research will be followed by an open discussion where the sharing of research, initiatives, and best practices for the enhancement of teaching and learning is welcomed. There is much insight and understanding to be gained through the sharing of ideas and collaborative practice as we move forward to further develop the program and prepare other initiatives in support of diversity and inclusion.

Keywords: eco-scale, green analysis, environmentally-friendly, pharmaceuticals analysis

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Authors: Stuart Noel

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In a streetcar Named Desire, Tennessee Williams presents Blanche DuBois, a most complex and intriguing character who often uses prestige language to project the image of an upper-class speaker and to disguise her darker and complicated self. She embodies various fascinating and contrasting characteristics. Like New Orleans (the locale of the play), Blanche represents two opposing images. One image projects that of genteel, Southern charm and beauty, speaking formally and using prestige language and what some linguists refer to as “hypercorrection,” and the other image reveals that of a soiled, deteriorating façade, full of decadence and illusion. Williams said on more than one occasion that Blanche’s use of such language was a direct reflection of her personality and character (as a high school English teacher). Prestige language is an exaggeratedly elevated, pretentious, and oftentimes melodramatic form of one’s language incorporating superstandard or more standard speech than usual in order to project a highly authoritative individual identity. Speech styles carry personal identification meaning not only because they are closely associated with certain social classes but because they tend to be associated with certain conversational contexts. Features which may be considered to be “elaborated” in form (for example, full forms vs. contractions) tend to cluster together in speech registers/styles which are typically considered to be more formal and/or of higher social prestige, such as academic lectures and news broadcasts. Members of higher social classes have access to the elaborated registers which characterize formal writings and pre-planned speech events, such as lectures, while members of lower classes are relegated to using the more economical registers associated with casual, face-to-face conversational interaction, since they do not participate in as many planned speech events as upper-class speakers. Tennessee Williams’s work is characteristically concerned with the conflict between the illusions of an individual and the reality of his/her situation equated with a conflict between truth and beauty. An examination of Blanche DuBois reveals a recurring theme of art and decay and the use of prestige language to reveal artistry in language and to hide a deteriorating self. His graceful and poetic writing personifies her downfall and deterioration. Her loneliness and disappointment are the things so often strongly feared by the sensitive artists and heroes in the world. Hers is also a special and delicate human spirit that is often misunderstood and repressed by society. Blanche is afflicted with a psychic illness growing out of her inability to face the harshness of human existence. She is a sensitive, artistic, and beauty-haunted creature who is avoiding her own humanity while hiding behind her use of prestige language. And she embodies a partial projection of Williams himself.

Keywords: American drama, prestige language, Southern American literature, Tennessee Williams

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Authors: Ali Kassem, Yhea Kishik, Ali Hassan, Mohamed Abdelwahab

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Introduction: Accelerated coronary and peripheral vascular atherosclerosis is one of the most common and chronic complications of diabetes mellitus. A recent aspect of coronary artery disease in this condition is its silent nature. The aim of the work: Detection of the prevalence of silent myocardial ischemia (SMI) in Upper Egypt type 2 diabetic males and to select male diabetic population who should be screened for SMI. Patients and methods: 100 type 2 diabetic male patients with a negative history of angina or anginal equivalent symptoms and 30 healthy control were included. Full medical history and thorough clinical examination were done for all participants. Fasting and post prandial blood glucose level, lipid profile, (HbA1c), microalbuminuria, and C-reactive protein were done for all participants Resting ECG, trans-thoracic echocardiography, treadmill exercise ECG, myocardial perfusion imaging were done for all participants and patients positive for one or more NITs were subjected for coronary angiography. Results Twenty nine patients (29%) were positive for one or more NITs in the patients group compared to only one case (3.3%) in the controls. After coronary angiography, 20 patients were positive for significant coronary artery stenosis in the patients group, while it was refused to be done by the patient in the controls. There were statistical significant difference between the two groups regarding, hypertension, dyslipidemia and obesity, family history of DM and IHD with higher levels of microalbuminuria, C-reactive protein, total lipids in patient group versus controls According to coronary angiography, patients were subdivided into two subgroups, 20 positive for SMI (positive for coronary angiography) and 80 negative for SMI (negative for coronary angiography). No statistical difference regarding family history of DM and type of diabetic therapy was found between the two subgroups. Yet, smoking, hypertension, obesity, dyslipidemia and family history of IHD were significantly higher in diabetics positive versus those negative for SMI. 90% of patients in subgroup positive for SMI had two or more cardiac risk factors while only two patients had one cardiac risk factor (10%). Uncontrolled DM was detected more in patients positive for SMI. Diabetic complications were more prevalent in patients positive for SMI versus those negative for SMI. Most of the patients positive for SMI have DM more than 5 years duration. Resting ECG and resting Echo detected only 6 and 11 cases, respectively, of the 20 positive cases in group positive for SMI compared to treadmill exercise ECG and myocardial perfusion imaging that detected 16 and 18 cases respectively, Conclusion: Type 2 diabetic male patients should be screened for detection of SMI when aged above 50 years old, diabetes duration is more than 5 years, presence of two or more cardiac risk factors and/or patients suffering from one or more of the chronic diabetic complications. CRP, is an important parameter for selection of type 2 diabetic male patients who should be screened for SMI. Non invasive cardiac tests are reliable for screening of SMI in these patients in our locality.

Keywords: C-reactive protein, Silent myocardial ischemia, Stress tests, type 2 DM

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Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar

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The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.

Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin

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Authors: Hasmithaa Neha, Atul Kumar Patidar, Girish Ch Kothyari

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The northward convergence of the Indian plate has a dominating influence over the structural and geomorphic development of the Himalayan region. The highly deformed and complex stratigraphy in the area arises from a confluence of exogenic and endogenetic geological processes. This region frequently experiences natural hazards such as debris flows, flash floods, avalanches, landslides, and earthquakes due to its harsh and steep topography and fragile rock formations. Therefore, remote sensing technique-based examination and real-time monitoring of tectonically sensitive regions may provide crucial early warnings and invaluable data for effective hazard mitigation strategies. In order to identify unusual changes in the river gradients, the current study demonstrates a spatial quantitative geomorphic analysis of the upper Alaknanda River basin, Uttarakhand Himalaya, India, using gradient length anomaly analysis (GLAA). This basin is highly vulnerable to ground creeping and landslides due to the presence of active faults/thrusts, toe-cutting of slopes for road widening, development of heavy engineering projects on the highly sheared bedrock, and periodic earthquakes. The intersecting joint sets developed in the bedrocks have formed wedges that have facilitated the recurrence of several landslides. The main objective of current research is to identify abnormal gradient lengths, indicating potential landslide-prone zones. High-resolution digital elevation data and geospatial techniques are used to perform this analysis. The results of GLAA are corroborated with the historical landslide events and ultimately used for the generation of landslide susceptibility maps of the current study area. The preliminary results indicate that approximately 3.97% of the basin is stable, while about 8.54% is classified as moderately stable and suitable for human habitation. However, roughly 19.89% fall within the zone of moderate vulnerability, 38.06% are classified as vulnerable, and 29% fall within the highly vulnerable zones, posing risks for geohazards, including landslides, glacial avalanches, and earthquakes. This research provides valuable insights into the spatial distribution of landslide-prone areas. It offers a basis for implementing proactive measures for landslide risk reduction, including land-use planning, early warning systems, and infrastructure development techniques.

Keywords: landslide vulnerability, geohazard, GLA, upper Alaknanda Basin, Uttarakhand Himalaya

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Authors: Nina Sankat, Gerd Wilsch, Cassian Gottlieb, Steven Millar, Tobias Guenther

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Laser-Induced Breakdown Spectroscopy (LIBS) is a combination of laser ablation and optical emission spectroscopy, which in principle can simultaneously analyze all elements on the periodic table. Materials can be analyzed in terms of chemical composition in a two-dimensional, time efficient and minor destructive manner. These advantages predestine LIBS as a monitoring technique in the field of civil engineering. The decreasing service life of concrete infrastructures is a continuously growing problematic. A variety of intruding, harmful substances can damage the reinforcement or the concrete itself. To insure a sufficient service life a regular monitoring of the structure is necessary. LIBS offers many applications to accomplish a successful examination of the conditions of concrete structures. A selection of those applications are the 2D-evaluation of chlorine-, sodium- and sulfur-concentration, the identification of carbonation depths and the representation of the heterogeneity of concrete. LIBS obtains this information by using a pulsed laser with a short pulse length (some mJ), which is focused on the surfaces of the analyzed specimen, for this only an optical access is needed. Because of the high power density (some GW/cm²) a minimal amount of material is vaporized and transformed into a plasma. This plasma emits light depending on the chemical composition of the vaporized material. By analyzing the emitted light, information for every measurement point is gained. The chemical composition of the scanned area is visualized in a 2D-map with spatial resolutions up to 0.1 mm x 0.1 mm. Those 2D-maps can be converted into classic depth profiles, as typically seen for the results of chloride concentration provided by chemical analysis like potentiometric titration. However, the 2D-visualization offers many advantages like illustrating chlorine carrying cracks, direct imaging of the carbonation depth and in general allowing the separation of the aggregates from the cement paste. By calibrating the LIBS-System, not only qualitative but quantitative results can be obtained. Those quantitative results can also be based on the cement paste, while excluding the aggregates. An additional advantage of LIBS is its mobility. By using the mobile system, located at BAM, onsite measurements are feasible. The mobile LIBS-system was already used to obtain chloride, sodium and sulfur concentrations onsite of parking decks, bridges and sewage treatment plants even under hard conditions like ongoing construction work or rough weather. All those prospects make LIBS a promising method to secure the integrity of infrastructures in a sustainable manner.

Keywords: concrete, damage assessment, harmful substances, LIBS

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Authors: Mohammed AL-Hasani

Abstract:

The Pandemic COVID-19 altered the daily habits and affected the functional performance of the cities after this crisis leaving remarkable impacts on many metropolises worldwide. It is so obvious that having more densification in the city leads to more threats altering this main approach that was called for achieving sustainable development. The main goal to achieve resiliency in the cities, especially in forcing risks, is to deal with a planning system that is able to resist, absorb, accommodate and recover from the impacts that had been affected. Many Cities in London, Wuhan, New York, and others worldwide carried different planning approaches and varied in reaction to safeguard the impacts of the pandemic. The cities globally varied from the radiant pattern predicted by Le Corbusier, or having multi urban centers more like the approach of Frank Lloyd Wright’s Broadacre City, or having linear growth or gridiron expansion that was common by Doxiadis, compact pattern, and many other hygiene patterns. These urban patterns shape the spatial distribution and Identify both open and natural spaces with gentrified and gentrifying areas. This crisis paid attention to reassess many planning approaches and examine the existing urban patterns focusing more on the aim of continuity and resiliency in managing the crises within the rapid transformation and the power of market forces. According to that, this paper hypothesized that those urban planning patterns determine the method of reaction in assuring quarantine for the inhabitance and the performance of public services and need to be updated through carrying out an innovative urban management system and adopt further resilience patterns in prospective urban planning approaches. This paper investigates the adaptivity and resiliency of variant urban planning patterns regarding selected cities worldwide that affected by COVID-19 and their role in applying certain management strategies in controlling the pandemic spread, finding out the main potentials that should be included in prospective planning approaches. The examination encompasses the spatial arrangement, blocks definition, plots arrangement, and urban space typologies. This paper aims to investigate the urban patterns to deliberate also the debate between densification as one of the more sustainable planning approaches and disaggregation tendency that was followed after the pandemic by restructuring and managing its application according to the assessment of the spatial distribution and urban patterns. The biggest long-term threat to dense cities proves the need to shift to online working and telecommuting, creating a mixture between using cyber and urban spaces to remobilize the city. Reassessing spatial design and growth, open spaces, urban population density, and public awareness are the main solutions that should be carried out to face the outbreak in our current cities that should be managed from global to tertiary levels and could develop criteria for designing the prospective cities

Keywords: COVID-19, densification, resiliency, urban patterns

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Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

Abstract:

We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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Authors: Geum Yeon Sim, Jasal Patel, Anand Kumthekar, Stanley Wainapel

Abstract:

A 65-year-old right-hand dominant African-American man, formerly employed as a security guard, was referred to Rehabilitation Medicine with bilateral hand stiffness and weakness. His past medical history was only significant for myelofibrosis, diagnosed 4 years earlier, for which he was receiving scheduled blood transfusions. Approximately 2 years ago, he began to notice stiffness and swelling in his non-dominant hand that progressed to pain and decreased strength, limiting his hand function. Similar but milder symptoms developed in his right hand several months later. There was no history of prior injury or exposure to cold. Physical examination showed enlargement of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints with finger flexion contractures, Swan-neck and Boutonniere deformities, and associated joint tenderness. Changes were more prominent in the left hand. X-rays showed mild osteoarthritis of several bilateral PIP joints. Anti-nuclear antibodies, rheumatoid factor, and cyclic citrullinated peptide antibodies were negative. MRI of the hand showed no erosions or synovitis. A rheumatology consultation was obtained, and the cause of his symptoms was attributed to myelofibrosis-related arthropathy with secondary osteoarthritis. The patient was tried on diclofenac cream and received a few courses of Occupational Therapy with limited functional improvement. Primary myelofibrosis (PMF) is a rare myeloproliferative neoplasm characterized by clonal proliferation of myeloid cells with variable morphologic maturity and hematopoietic efficiency. Rheumatic manifestations of malignancies include direct invasion, paraneoplastic presentations, secondary gout, or hypertrophic osteoarthropathy. PMF causes gradual bone marrow fibrosis with extramedullary metaplastic hematopoiesis in the liver, spleen, or lymph nodes. Musculoskeletal symptoms are not common and are not well described in the literature. The first reported case of myelofibrosis related arthritis was seronegative arthritis due to synovial invasion of myeloproliferative elements. Myelofibrosis has been associated with autoimmune diseases such as systemic lupus erythematosus, progressive systemic sclerosis, and rheumatoid arthritis. Gout has been reported in patients with myelofibrosis, and the underlying mechanism is thought to be related to the high turnover of nucleic acids that is greatly augmented in this disease. X-ray findings in these patients usually include erosive arthritis with synovitis. Treatment of underlying PMF is the treatment of choice, along with anti-inflammatory medications. Physicians should be cognizant of recognizing this rare entity in patients with PMF while maintaining clinical suspicion for more common causes of joint deformities, such as rheumatic diseases.

Keywords: myelofibrosis, arthritis, arthralgia, malignancy

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Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam

Abstract:

Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.

Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis

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Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

Abstract:

Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

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Authors: K. Sahithya, I. Balasundar, Pritapant, T. Raghua

Abstract:

Ni-based superalloy with a nominal composition Ni-14% Cr-11% Co-5.8% Mo-2.4% Ti-2.4% Nb-2.8% Al-0.26 % Fe-0.032% Si-0.069% C (all in wt %) is used as turbine discs in a variety of aero engines. Like any other superalloy, the primary processing of the as-cast superalloy poses a major challenge due to its complex alloy chemistry. The challenge was circumvented by characterizing the different phases present in the material, optimizing the homogenization treatment, identifying a suitable thermomechanical processing window using dynamic materials modeling. The as-cast material was subjected to homogenization at 1200°C for a soaking period of 8 hours and quenched using different media. Water quenching (WQ) after homogenization resulted in very fine spherical γꞌ precipitates of sizes 30-50 nm, whereas furnace cooling (FC) after homogenization resulted in bimodal distribution of precipitates (primary gamma prime of size 300nm and secondary gamma prime of size 5-10 nm). MC type primary carbides that are stable till the melting point of the material were found in both WQ and FC samples. Deformation behaviour of both the materials below (1000-1100°C) and above gamma prime solvus (1100-1175°C) was evaluated by subjecting the material to series of compression tests at different constant true strain rates (0.0001/sec-1/sec). An in-detail examination of the precipitate dislocation interaction mechanisms carried out using TEM revealed precipitate shearing and Orowan looping as the mechanisms governing deformation in WQ and FC, respectively. Incoherent/semi coherent gamma prime precipitates in the case of FC material facilitates better workability of the material, whereas the coherent precipitates in WQ material contributed to higher resistance to deformation of the material. Both the materials exhibited discontinuous dynamic recrystallization (DDRX) above gamma prime solvus temperature. The recrystallization kinetics was slower in the case of WQ material. Very fine grain boundary carbides ( ≤ 300 nm) retarded the recrystallisation kinetics in WQ. Coarse carbides (1-5 µm) facilitate particle stimulated nucleation in FC material. The FC material was cogged (primary hot working) 1120˚C, 0.03/sec resulting in significant grain refinement, i.e., from 3000 μm to 100 μm. The primary processed material was subjected to intensive thermomechanical deformation subsequently by reducing the temperature by 50˚C in each processing step with intermittent heterogenization treatment at selected temperatures aimed at simultaneous coarsening of the gamma prime precipitates and refinement of the gamma matrix grains. The heterogeneous annealing treatment carried out, resulted in gamma grains of 10 μm and gamma prime precipitates of 1-2 μm. Further thermo mechanical processing of the material was carried out at 1025˚C to increase the homogeneity of the obtained micro-duplex structure.

Keywords: superalloys, dynamic material modeling, nickel alloys, dynamic recrystallization, superplasticity

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