Search results for: Mark Kevin Torres

Authors: S. M. Rifat, André L. Marchildon, Mark F. Tachie

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Experiments were performed to investigate the effects of roughness on the reattachment and redevelopment regions over a 12 mm forward facing step (FFS) in an open channel flow. The experiments were performed over an upstream smooth wall and a smooth FFS, an upstream wall coated with sandpaper 36 grit and a smooth FFS and an upstream rough wall produced from sandpaper 36 grit and a FFS coated with sandpaper 36 grit. To investigate only the wall roughness effects, Reynolds number, Froude number, aspect ratio and blockage ratio were kept constant. Upstream profiles showed reduced streamwise mean velocities close to the rough wall compared to the smooth wall, but the turbulence level was increased by upstream wall roughness. The reattachment length for the smooth-smooth wall experiment was 1.78h; however, when it is replaced with rough-smooth wall the reattachment length decreased to 1.53h. It was observed that the upstream roughness increased the physical size of contours of maximum turbulence level; however, the downstream roughness decreased both the size and magnitude of contours in the vicinity of the leading edge of the step. Quadrant analysis was performed to investigate the dominant Reynolds shear stress contribution in the recirculation region. The Reynolds shear stress and turbulent kinetic energy profiles after the reattachment showed slower recovery compared to the streamwise mean velocity, however all the profiles fairly collapse on their corresponding upstream profiles at x/h = 60. It was concluded that to obtain a complete collapse several more streamwise distances would be required.

Keywords: forward facing step, open channel, separated and reattached turbulent flows, wall roughness

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Authors: Katrina Angeline Santos, Francis Mark Fernandez, Francheska Esmao

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Intervention is defined as a forcible interference by a state or states with power in the affairs of another state using force or the threat of force. On the other hand, a military intervention is an intervention, specifically used to define an intervention which uses force. With these, the authors realized a lack in the concept of intervention wherein it is an invited one.The authors wrote this paper to introduce a concept of intervention wherein the intervening state is offering assistance to the state in crisis which asked for one. The authors decided to make a contextual description of this phenomenon because of the lack of concepts regarding intervention between the idea of a single state performing a ‘heroic’ role of intervening in the crisis of another state. The problem that the authors would like to address is regarding the lack of availability in the concept of intervention wherein the state in crisis is seeking the assistance of another state. The authors utilized a contextual description approach to the study through the descriptive presentation of the series of events, by utilizing the news articles and news reports published, which happened in Ukraine and Crimea. This concept is further demonstrated through the utilization of a conceptual framework which shows the mutual relationship between the states. From the analysis of the behavior of Russia and its role in the Crimean Crisis 2014, the authors are able to coin the term, 'Caped Intervention' to describe an intervention of a state as a response to the invitation of assistance of a state in crisis in order for them to achieve their goals. This concept entails a mutual relationship between an intervening state and a sate in crisis. The concept of Caped Intervention describes the role of Russia as a Caped State or an intervening state observed through its action towards Crimea. This concept will help in the observation of the behavior of actors or states in events such as this. It will further help in analyzing the actors’ role in intervention by making it possible to classify the intervening acts into another concept.

Keywords: assistance, caped intervention, crisis, heroic

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Authors: Sugandhi, Parteek Kumar, Sanmeet Kaur

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Sign Language (SL) is used by deaf and other people who cannot speak but can hear or have a problem with spoken languages due to some disability. It is a visual gesture language that makes use of either one hand or both hands, arms, face, body to convey meanings and thoughts. SL automation system is an effective way which provides an interface to communicate with normal people using a computer. In this paper, an avatar based dictionary has been proposed for text to Indian Sign Language (ISL) generation system. This research work will also depict a literature review on SL corpus available for various SL s over the years. For ISL generation system, a written form of SL is required and there are certain techniques available for writing the SL. The system uses Hamburg sign language Notation System (HamNoSys) and Signing Gesture Mark-up Language (SiGML) for ISL generation. It is developed in PHP using Web Graphics Library (WebGL) technology for 3D avatar animation. A multilingual ISL dictionary is developed using HamNoSys for both English and Hindi Language. This dictionary will be used as a database to associate signs with words or phrases of a spoken language. It provides an interface for admin panel to manage the dictionary, i.e., modification, addition, or deletion of a word. Through this interface, HamNoSys can be developed and stored in a database and these notations can be converted into its corresponding SiGML file manually. The system takes natural language input sentence in English and Hindi language and generate 3D sign animation using an avatar. SL generation systems have potential applications in many domains such as healthcare sector, media, educational institutes, commercial sectors, transportation services etc. This research work will help the researchers to understand various techniques used for writing SL and generation of Sign Language systems.

Keywords: avatar, dictionary, HamNoSys, hearing impaired, Indian sign language (ISL), sign language

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Thelma Palaoag, Melanie Basa, Jezreel Mark Panilo

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Checking short-answer questions and essays, whether it may be paper or electronic in form, is a tiring and tedious task for teachers. Evaluating a student’s output require wide array of domains. Scoring the work is often a critical task. Several attempts in the past few years to create an automated writing assessment software but only have received negative results from teachers and students alike due to unreliability in scoring, does not provide feedback and others. The study aims to create an application that will be able to check short-answer questions which incorporate information extraction. Information extraction is a subfield of Natural Language Processing (NLP) where a chunk of text (technically known as unstructured text) is being broken down to gather necessary bits of data and/or keywords (structured text) to be further analyzed or rather be utilized by query tools. The proposed system shall be able to extract keywords or phrases from the individual’s answers to match it into a corpora of words (as defined by the instructor), which shall be the basis of evaluation of the individual’s answer. The proposed system shall also enable the teacher to provide feedback and re-evaluate the output of the student for some writing elements in which the computer cannot fully evaluate such as creativity and logic. Teachers can formulate, design, and check short answer questions efficiently by defining keywords or phrases as parameters by assigning weights for checking answers. With the proposed system, teacher’s time in checking and evaluating students output shall be lessened, thus, making the teacher more productive and easier.

Keywords: information extraction, short-answer question, natural language processing, application

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Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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Authors: Ana-María Gómez-Carvajal, Hernando Santamaría-García, Mateo Bernal, Mario Valderrama, Daniela Lizarazo, Juliana Restrepo, María Fernanda Barreto, Angélica Parra, Paula Torres, Diana Matallana, Jaime Silva, José Santamaría-García, Sandra Baez

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Higher levels of oxytocin are associated with better performance on social cognition tasks. However, higher levels of oxytocin have also been associated with increased levels of envy and schadenfreude. Considering these antecedents, this study aims to explore social emotions (i.e., envy and schadenfreude) and other components of social cognition (i.e. ToM and empathy), in women in the puerperal period and their respective partners, compared to a control group of men and women without children or partners. Control women should be in the luteal phase of the menstrual cycle or taking oral contraceptives as they allow oxytocin levels to remain stable. We selected this population since increased levels of oxytocin are present in both mothers and fathers of newborn babies. Both groups were matched by age, sex, and education level. Twenty-two parents of newborns (11 women, 11 men) and 15 controls (8 women, 7 men) performed an experimental task designed to trigger schadenfreude and envy. In this task, each participant was shown a real-life photograph and a description of two target characters matched in age and gender with the participant. The task comprised two experimental blocks. In the first block, participants read 15 sentences describing fortunate events involving either character. After reading each sentence, participants rated the event in terms of how much envy they felt for the character (1=no envy, 9=extreme envy). In the second block, participants read and reported the intensity of their pleasure (schadenfreude, 1=no pleasure, 9=extreme pleasure) in response to 15 unfortunate events happening to the characters. Five neutral events were included in each block. Moreover, participants were assessed with ToM and empathy tests. Potential confounding variables such as general cognitive functioning, stress levels, hours of sleep and depression symptoms were also measured. Results showed that parents of newborns showed increased levels of envy and schadenfreude. These effects are not explained by any confounding factor. Moreover, no significant differences were found in ToM or empathy tests. Our results offer unprecedented evidence of specific differences in envy and schadenfreude levels in parents of newborns. Our findings support previous studies showing a negative relationship between oxytocin levels and negative social emotions. Further studies should assess the direct relationship between oxytocin levels in parents of newborns and the performance in social emotions tasks.

Keywords: envy, empathy, oxytocin, schadenfreude, social emotions, theory of mind

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Authors: Samuel Munaf, Kevin Swingler, Franz Brülisauer, Anthony O’Hare, George Gunn, Aaron Reeves

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Background: Avian influenza, more commonly known as Bird flu, is a viral zoonotic respiratory disease stemming from various species of poultry, including pets and migratory birds. Researchers have purported that the accessibility of health information online, in addition to the low-cost data collection methods the internet provides, has revolutionized the methods in which epidemiological and disease surveillance data is utilized. This paper examines the feasibility of using internet data sources, such as Twitter and livestock forums, for the early detection of the avian flu outbreak, through the use of text mining algorithms and social network analysis. Methods: Social media mining was conducted on Twitter between the period of 01/01/2021 to 31/12/2021 via the Twitter API in Python. The results were filtered firstly by hashtags (#avianflu, #birdflu), word occurrences (avian flu, bird flu, H5N1), and then refined further by location to include only those results from within the UK. Analysis was conducted on this text in a time-series manner to determine keyword frequencies and topic modeling to uncover insights in the text prior to a confirmed outbreak. Further analysis was performed by examining clinical signs (e.g., swollen head, blue comb, dullness) within the time series prior to the confirmed avian flu outbreak by the Animal and Plant Health Agency (APHA). Results: The increased search results in Google and avian flu-related tweets showed a correlation in time with the confirmed cases. Topic modeling uncovered clusters of word occurrences relating to livestock biosecurity, disposal of dead birds, and prevention measures. Conclusions: Text mining social media data can prove to be useful in relation to analysing discussed topics for epidemiological surveillance purposes, especially given the lack of applied research in the veterinary domain. The small sample size of tweets for certain weekly time periods makes it difficult to provide statistically plausible results, in addition to a great amount of textual noise in the data.

Keywords: veterinary epidemiology, disease surveillance, infodemiology, infoveillance, avian influenza, social media

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: M. S. Sulaiman, N. Hassan, M. A. Aziz, M. S. A. Haron, J. H. A. Halim

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The classic profile of heritage clay roof tiles gives unique characteristics and timeless style to the almost historical building. It is not only designed to meet basic construction needs, offering great performance and durability but also highlights unnoticed stamp impressions, known as ‘insignia imprinted.’ It seems that the insignia imprinted is not significant to all stakeholders, especially in preserving heritage clay roof tiles in Malaysia. They are not even realized the existence and importance of that element, where it represents the cognitive and social character of that particular era. It creates a sense of belongings for the manufacturers regarding their most elementary features, such as a fortress, crown, fauna and etc. This research aims to identify and analyze the late stamp marks on heritage interlocking clay roof tiles in a government heritage building in Malaysia. The methodology used is literature reviews (desktop study), observation on sites, and interviews. Initial findings from the preliminary observation on-site in Peninsular Malaysia show some evidence that the stamp marks appear on the front and back sides of the tile that indicates the year, manufacturer, code numbers, and logos. Almost more than 30 samples of different types of stamp marks were found and collected. Some of which had been described Guichard & Carvin Cie Marsielle St Andre France, Pierre Sacoman St Henry Marsielle, Tuileries Aixoises Les Milles B.D.R France, The Calicut Tile Co Feroke, And B. Pinto & Co Mangalore dated 1865, 1919 and 1936. In view of this abundance of materials, it will lead to the establishment of a comprehensive database consisting of detailed specifications and material performance for future conservation works and maintenance purposes that will sustain for future references.

Keywords: clay roof tiles, insignia imprinted, interlocking, stamp mark

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Authors: Ruiyuan Wang, Jing Han, Bruno Di Biase, Mark Antoniou

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The purpose of this study is to explore the relationship between working memory (WM) capacity and Chinese-English consecutive interpreting (CI) performance in interpreting learners with different study abroad experience (SAE). Such relationship is not well understood. This study also examines whether Chinese interpreting learners with SAE in English-speaking countries, demonstrate a better performance in inflectional morphology and agreement, notoriously unstable in Chinese speakers of English L2, in their interpreting output than learners without SAE. Fifty Chinese university students, majoring in Chinese-English Interpreting, were recruited in Australia (n=25) and China (n=25). The two groups matched in age, language proficiency, and interpreting training period. Study abroad (SA) group has been studying in an English-speaking country (Australia) for over 12 months, and none of the students recruited in China (the no study abroad = NSA group) had ever studied or lived in an English-speaking country. Data on language proficiency and training background were collected via a questionnaire. Lexical retrieval performance and working memory (WM) capacity data were collected experimentally, and finally, interpreting data was elicited via a direct CI task. Main results of the study show that WM significantly correlated with participants' CI performance independently of learning context. Moreover, SA outperformed NSA learners in terms of subject-verb number agreement. Apart from that, WM capacity was also found to correlate significantly with their morphosyntactic accuracy. This paper sheds some light on the relationship between study abroad, WM capacity, and CI performance. Exploring the effect of study abroad on interpreting trainees and how various important factors correlate may help interpreting educators bring forward more targeted teaching paradigms for participants with different learning experiences.

Keywords: study abroad experience, consecutive interpreting, working memory, inflectional agreement

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Authors: Syed Muhammad Basit Ali, Usama Saleem, Irtiza Ali

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Internal combustion engines have been pioneers in the aviation industry, use of piston engines for aircraft propulsion, from propeller-driven bi-planes to turbo-prop, commercial, and cargo airliners. To provide an adequate amount of thrust piston engine rotates the propeller at a specific rpm, allowing enough mass airflow. Thrust is the only forward-acting force of an aircraft that helps heavier than air bodies to fly, depending on the mathematical model and variables included in that with the correct measurement. Test-benches have been a bench-mark in the aerospace industry to analyse the results before a flight, having paramount significance in reliability and safety engineering, depending on the mathematical model and variables included in that with the correct measurement. Calculation of thrust from a piston engine also depends on environmental changes, the diameter of the propeller, and the density of air. The project would be centered on piston engines used in the aviation industry for light aircraft and UAVs. A static thrust test bench involves various units, each performing a designed purpose to monitor and display. Static thrust tests are performed on the ground, and safety concerns hold paramount importance. The execution of this study involves research, design, manufacturing, and results based on reverse engineering initiating from virtual design, analytical analysis, and simulations. The final evaluation of results gathered from various methods such as co-relation between conventional mass-spring and digital loadcell. On average, we received 17.5kg of thrust (25+ engine run-ups – around 40 hours of engine run), only 10% deviation from analytically calculated thrust –providing 90% accuracy.

Keywords: aviation, aeronautics, static thrust, test bench, aircraft maintenance

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Authors: Alejandra Torres-Landa López

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Introduction: Can architecture students be creative in spaces conformed by an educational infrastructure build with paradigms of the past?, this question and others related are answered in this paper as it presents the PhD research: An anthropic conflict in Mexican Higher Education Institutes, problems and challenges of the educational infrastructure in teaching and learning History of Architecture. This research was finished in 2013 and is one of the first studies conducted nationwide in Mexico that analysis the educational infrastructure impact in learning architecture; its objective was to identify which elements of the educational infrastructure of Mexican Higher Education Institutes where architects are formed, hinder or contribute to the teaching and learning of History of Architecture; how and why it happens. The methodology: A mixed methodology was used combining quantitative and qualitative analysis. Different resources and strategies for data collection were used, such as questionnaires for students and teachers, interviews to architecture research experts, direct observations in Architecture classes, among others; the data collected was analyses using SPSS and MAXQDA. The veracity of the quantitative data was supported by the Cronbach’s Alpha Coefficient, obtaining a 0.86, figure that gives the data enough support. All the above enabled to certify the anthropic conflict in which Mexican Universities are. Major findings of the study: Although some of findings were probably not unknown, they haven’t been systematized and analyzed with the depth to which it’s done in this research. So, it can be said, that the educational infrastructure of most of the Higher Education Institutes studied, is a barrier to the educational process, some of the reasons are: the little morphological variation of space, the inadequate control of lighting, noise, temperature, equipment and furniture, the poor or none accessibility for disable people; as well as the absence, obsolescence and / or insufficiency of information technologies are some of the issues that generate an anthropic conflict understanding it as the trouble that teachers and students have to relate between them, in order to achieve significant learning). It is clear that most of the educational infrastructure of Mexican Higher Education Institutes is anchored to paradigms of the past; it seems that they respond to the previous era of industrialization. The results confirm that the educational infrastructure of Mexican Higher Education Institutes where architects are formed, is perceived as a "closed container" of people and data; infrastructure that becomes a barrier to teaching and learning process. Conclusion: The research results show it's time to change the paradigm in which we conceive the educational infrastructure, it’s time to stop seen it just only as classrooms, workshops, laboratories and libraries, as it must be seen from a constructive, urban, architectural and human point of view, taking into account their different dimensions: physical, technological, documental, social, among others; so the educational infrastructure can become a set of elements that organize and create spaces where ideas and thoughts can be shared; to be a social catalyst where people can interact between each other and with the space itself.

Keywords: educational infrastructure, impact of space in learning architecture outcomes, learning environments, teaching architecture, learning architecture

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Authors: M. Shukry

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According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.

Keywords: aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, Indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma

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Authors: Maritza Estela Garay-Rodriguez, Mirella Gutierrez-Arzaluz, Miguel Torres-Rodriguez, Violeta Mugica-Alvarez

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Arsenic is an element present in the earth's crust and is dispersed in the environment through natural processes and some anthropogenic activities. Naturally released into the environment through the weathering and erosion of sulphides mineral, some activities such as mining, the use of pesticides or wood preservatives potentially increase the concentration of arsenic in air, water, and soil. The natural arsenic release of a geological material is a threat to the world's drinking water sources. In aqueous phase is found in inorganic form, as arsenate and arsenite mainly, the contamination of groundwater by salts of this element originates what is known as endemic regional hydroarsenicism. The International Agency for Research on Cancer (IARC) categorizes the inorganic As within group I, as a substance with proven carcinogenic action for humans. It has been found the presence of As in groundwater in several countries such as Argentina, Mexico, Bangladesh, Canada and the United States. Regarding the concentration of arsenic in drinking water according to the World Health Organization (WHO) and the Environmental Protection Agency (EPA) establish maximum concentrations of 10 μg L⁻¹. In Mexico, in some states as Hidalgo, Morelos and Michoacán concentrations of arsenic have been found in bodies of water around 1000 μg L⁻¹, a concentration that is well above what is allowed by Mexican regulations with the NOM-127- SSA1-1994 that establishes a limit of 25 μg L⁻¹. Given this problem in Mexico, this research proposes the use of a natural Mexican zeolite (clinoptilolite type) native to the district of Etla in the central valley region of Oaxaca, as an adsorbent for the removal of arsenic. The zeolite was subjected to a conditioning with iron oxide by the precipitation-impregnation method with 0.5 M iron nitrate solution, in order to increase the natural adsorption capacity of this material. The removal of arsenic was carried out in a column with a fixed bed of conditioned zeolite, since it combines the advantages of a conventional filter with those of a natural adsorbent medium, providing a continuous treatment, of low cost and relatively easy to operate, for its implementation in marginalized areas. The zeolite was characterized by XRD, SEM/EDS, and FTIR before and after the arsenic adsorption tests, the results showed that the modification methods used are adequate to prepare adsorbent materials since it does not modify its structure, the results showed that with a particle size of 1.18 mm, an initial concentration of As (V) ions of 1 ppm, a pH of 7 and at room temperature, a removal of 98.7% was obtained with an adsorption capacity of 260 μg As g⁻¹ zeolite. The results obtained indicated that the conditioned zeolite is favorable for the elimination of arsenate in water containing up to 1000 μg As L⁻¹ and could be suitable for removing arsenate from pits of water.

Keywords: adsorption, arsenic, iron conditioning, natural zeolite

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Authors: Maria Albuquerque, Miguel Matias, Ângelo Sá, Juliana Sousa, Maria Manuel Mouzinho

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Obesity is a frequent disease in Portugal. The surgical treatment is very effective and has an indication when there is a failure of the medical treatment. Although massive weight loss is associated with considerable health gains, these patients are characterized by a variable degree of dermolipodistrophy. In some cases, there is even the development of physical symptoms such as intertriginous, and some degree of psychological distress is present. In almost all cases, a desire for a better body contour, which inhibits some aspects of social life, is a fact. A prospective study was made to access the impact of body contouring surgery in the quality of life of patients who underwent a massive weight lost correction surgical procedure at Centro Hospitalar de Lisboa Central between January 2020 and December 2021. The patients were submitted to the Body Q subjective questionnaire adapted for the Portuguese language and accessed for the following categories: Anguish with Appearance, Contempt with Body Image, Satisfaction with the Abdomen, and Overall Satisfaction with the Body. The questionnaire was repeated at the 6 months mark. A total of 80 patients were sampled. The sex distribution was 79 female and 1 male. The median BMI index before surgery was inferior to 28%. The pre operatory questionnaire showed high scores for Anguish with Appearance and low scores for the body image self-evaluation. Overall, there was an improvement of at least 50% in all the evaluated scores. Additionally, a correlation was found between abdominoplasty and the contempt with body image and satisfaction with the abdomen (p-value <0.05). Massive weight loss is associated with important body deformities that have a significant impact on the patient’s personal and social life. Body contouring surgery is then vital for these patients as it implicates major aesthetic and functional benefits.

Keywords: abdominoplasty, cruroplasty, obesity, massive weight loss

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Authors: Mark Herman Sumagang Potoy

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State of the City Address (SOCA) is a speech, modelled after the State of the Nation Address, given not as mandated by law but usually a matter of practice or tradition delivered before the chief executive’s constituents. Through this, the general public is made to know the performance of the local government unit and its agenda for the coming year. Therefore, it is imperative for SOCAs to clearly convey its message and carry out the myriad function of enlightening its readers which could be achieved through the proper use of reference. Anaphora and cataphora are the two major types of reference; the former refer back to something that has already been mentioned while the latter points forward to something which is yet to be said. This paper seeks to identify the types of reference employed on the SOCAs from 2014 to 2016 of Hon. Rosalina Garcia Jalosjos, Mayor of Dapitan City and look into how the references contribute to the clarity of the message of the text. The qualitative method of research is used in this study through an in-depth analysis of the corpus. As soon as the copies of the SOCAs are secured from the Office of the City Mayor, they are then analyzed using documentary technique categorizing the types of reference as to anaphora and cataphora, counting each of these types and describing the implications of the dominant types used in the addresses. After a thorough analysis, it is found out that the two reference types namely, anaphora and cataphora are both employed on the three SOCAs, the former being used more frequently than the latter accounting to 80% and 20% of actual usage, respectively. Moreover, the use of anaphors and cataphora on the three addresses helps in conveying the message clearly because they primarily become aids to avoid the repetition of the same element in the text especially when there wasn’t a need to emphasize a point. Finally, it is recommended that writers of State of the City Addresses should have a vast knowledge on how reference should be used and the functions they take in the text since this is a vital tool to clearly transmit a message. Moreover, English teachers should explicitly teach the proper usage of anaphora and cataphora, as instruments to develop cohesion in written discourse, to enable students to write not only with sense but also with fluidity in tying utterances together.

Keywords: anaphora, cataphora, reference, State of the City Address

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Authors: Armenio Lopes, Carlos Ferreira

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In the specific context of the Iberian Union between 1580 and 1640, characteristics emerged in Portuguese architecture that stood out from the main architectural production of the period. Recognised and identified aspects that had begun making their appearance decades before (1521) became significantly more marked during the Hapsburg-Spanish occupation. Distinctive even from the imperialist language of Spain, this trend would endure even after the restoration of independence (1706), continuing through to the start of the age of absolutism. Or perhaps not. This trend, recognised as Plain Style (Kubler), associated with a certain scarcity of resources, involved a certain formal and decorative simplification, as well as a particular set of conventions that would subsequently mark the landscape. This expression could also be seen as a means of asserting a certain spirit of independence as the Iberian Union breathed its last. The image of a simple, bare-bones architecture with purer design lines is associated by various authors –most notably Kubler– with the narratives of modernism, to whose principles it is similar, in a context-specific to the period. There is a contrast with some of the exuberance of the baroque or its expression in the Manueline period, in a similar fashion to modernism's responses to nineteenth-century eclecticism. This assertion and practice of simple architecture, drafted from the interpretation of the treaties, and highlighting a certain classical inspiration, was to become a benchmark in the theory of architecture, spanning the Baroque and Mannerism, until achieving contemporary recognition within certain originality and modernity. At a time when the baroque and its scenography became generally very widespread, it is important also to recognise the role played by plain style architecture in the construction of a rather complex and contradictory waterfront landscape, featuring promises of exuberance and more discrete practices.

Keywords: Carlos Mardel, Lisbon's waterfront, plain style, urban image on the waterfront

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Authors: Navid Nasrolah Mazandarani, Faezeh Mohammadi Tahrodi, Jr., Norshida Ujang, Richard Jan Pech

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Human evolution has designed us to be dependent on social and natural settings, but designed of our modern cities often ignore this fact. It is evident that high-rise buildings dominate most metropolitan city centers. As a result urban parks are very limited and in many cases are not socially responsive to our social needs in these urban ‘jungles’. This paper emphasizes the functions of urban morphology in supporting socialization in Lake Garden, one of the main urban parks in Kuala Lumpur, Malaysia. It discusses two relevant theories; first the concept of users’ experience coined by Kevin Lynch (1960) which states that way-finding is related to the process of forming mental maps of environmental surroundings. Second, the concept of social activity coined by Jan Gehl (1987) which holds that urban public spaces can be more attractive when they provide welcoming places in which people can walk around and spend time. Until recently, research on socio-spatial behavior mainly focused on social ties, place attachment and human well-being; with less focus on the spatial dimension of social behavior. This paper examines the socio-spatial behavior within the spatial structure of the urban park by exploring the relationship between way-finding and social activity. The urban structures defined by the paths and nodes were analyzed as the fundamental topological structure of space to understand their effects on the social engagement pattern. The study uses a photo questionnaire survey to inspect the spatial dimension in relation to the social activities within paths and nodes. To understand the legibility of the park, spatial cognition was evaluated using sketch maps produced by 30 participants who visited the park. The results of the sketch mapping indicated that a spatial image has a strong interrelation with socio-spatial behavior. Moreover, an integrated spatial structure of the park generated integrated use and social activity. It was found that people recognized and remembered the spaces where they engaged in social activities. They could experience the park more thoroughly, when they found their way continuously through an integrated park structure. Therefore, the benefits of both perceptual and social dimensions of planning and design happened simultaneously. The findings can assist urban planners and designers to redevelop urban parks by considering the social quality design that contributes to clear mental images of these places.

Keywords: spatial structure, social activities, sketch map, urban park, way-finding

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Authors: Luisito L. Lacatan, Gian Carlo J. Bergonia, Felipe C. Buado III, Gerald L. Gono, Ron Mark V. Ortil, Calvin A. Yap

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This paper features the development of a Mobile Self-sustaining Electricity Generator for water distillation process with MCU- based wireless controller & indicator designed to solve the problem of scarcity of clean water. It is a fact that pure water is precious nowadays and its value is more precious to those who do not have or enjoy it. There are many water filtration products in existence today. However, none of these products fully satisfies the needs of families needing clean drinking water. All of the following products require either large sums of money or extensive maintenance, and some products do not even come with a guarantee of potable water. The proposed project was designed to alleviate the problem of scarcity of potable water in the country and part of the purpose was also to identify the problem or loopholes of the project such as the distance and speed required to produce electricity using a wheel and alternator, the required time for the heating element to heat up, the capacity of the battery to maintain the heat of the heating element and the time required for the boiler to produce a clean and potable water. The project has three parts. The first part included the researchers’ effort to plan every part of the project from the conversion of mechanical energy to electrical energy, from purifying water to potable drinking water to the controller and indicator of the project using microcontroller unit (MCU). This included identifying the problem encountered and any possible solution to prevent and avoid errors. Gathering and reviewing related studies about the project helped the researcher reduce and prevent any problems before they could be encountered. It also included the price and quantity of materials used to control the budget.

Keywords: mobile, self – sustaining, electricity generator, water distillation, wireless battery indicator, wireless water level indicator

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Authors: Karl Gerrard Tiu See

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Military bases are an indelible mark of prolonged US defense relationships in the Pacific. Bases like the Subic Naval Base in Olongapo City have irreversible consequences for their host communities, not all of which are positive. One consequence the Subic Naval Base had for Olongapo City was the rise of vibrant sex industry. While the Philippine Senate voted to remove US bases like Subic in 1991, the question remains as to why did prostitution not end after the bases pull-out? To answer this question, the study used an institutionalist lens coupled with focus group discussions from the sex industry. It found that prostitution persisted due to two main reasons. The first was that like Olongapo City; the sex industry successfully shifted its reliance from the military to foreign tourism. The second was that agreements such as the 1996 Visiting Forces Agreement (VFA) ensured that the sex industry continued to receive US military clientele. With the contextual factors as the backdrop, this study used the Theory of Institutional Change to study institutions pivotal in altering Olongapo City and its sex industry after Subic Naval Base. These include local government, civil society actors such as NGOs, and the city’s economic base. The study found that policy such as the VFA allowed the bases period status quo to revive (Symbionts). This led to renewed exploitation from the military presence coupled with foreign tourism (Opportunists). The local government, however, shifted focus away from base reliance which allowed a reinvigorated civil society to effect a gradual change (Subversives). Furthermore, uncertainties like rising HIV incidence, abandoned children born from US soldiers, and the Enhanced Defence Cooperation Agreement (EDCA) remain to change the sex industry’s future, for better or worse.

Keywords: Philippine-USA defence relations, overseas USA basing, 1991 Philippine-USA bases pull-out, Olongapo city, Subic naval base, institutional change

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Authors: Nataliya Apanovich, Mark Wright

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Uganda is among the poorest but fastest growing populations in the world. Its annual population growth of 3% puts additional stress through land fragmentation, agricultural intensification, and deforestation on already highly weathered tropical (Ferralsol) soils. All of these factors lead to decreased agricultural yields and consequently diminished food security. The central region of Uganda, Buganda Kingdom, is especially vulnerable in terms of food security as its high population density coupled with mismanagement of natural resources led to gradual loss of its soil and even changes in microclimate. These changes are negatively affecting livelihoods of smallholder farmers who comprise 80% of all population in Uganda. This research focuses on biochar for soil remediation in Masaka District, Uganda. If produced on a small scale from locally sourced materials, biochar can increase the quality of soil in a cost and time effective manner. To assess biochar potential, 151 smallholder farmers were interviewed on the types of crops grown, agricultural residues produced and their use, as well as on attitudes towards biochar use and its production on a small scale. The interviews were conducted in 7 sub-counties, 32 parishes, and 92 villages. The total farmland covered by the study was 606.2 kilometers. Additional information on the state of agricultural development and environmental degradation in the district was solicited from four local government officials via informal interviews. This project has been conducted in collaboration with the international agricultural research institution, Makerere University in Kampala, Uganda. The results of this research can have implications on the way farmers perceive the value of their agricultural residues and what they decide to do with them. The underlying objective is to help smallholders in degraded soils increase their agricultural yields through the use of biochar without diverting the already established uses of agricultural residues to a new soil management practice.

Keywords: agricultural residues, biochar, central Uganda, food security, soil erosion, soil remediation

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Authors: Mark Salisbury

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The arrival of artificially intelligent avatars and the automation they bring is worrying many of us, not only for our livelihood but for the jobs that may be lost to our kids. We worry about what our place will be as human beings in this new economy where much of it will be conducted online in the metaverse – in a network of 3D virtual worlds – working with intelligent machines. The Future of Leadership was written to address these fears and show what our place will be – the right place – in this new economy of AI avatars, automation, and 3D virtual worlds. But to be successful in this new economy, our job will be to bring wisdom to our workplace and the marketplace. And we will use AI avatars and 3D virtual worlds to do it. However, this book is about more than AI and the avatars that we will work with in the metaverse. It’s about building Organizational intelligence (OI) -- the capability of an organization to comprehend and create knowledge relevant to its purpose; in other words, it is the intellectual capacity of the entire organization. To increase organizational intelligence requires a new kind of knowledge worker, a wisdom worker, that requires a new kind of leadership. This book begins your story for how to become a leader of wisdom workers and be successful in the emerging wisdom economy. After this presentation, conference participants will be able to do the following: Recognize the characteristics of the new generation of wisdom workers and how they differ from their predecessors. Recognize that new leadership methods and techniques are needed to lead this new generation of wisdom workers. Apply personal and professional values – personal integrity, belief in something larger than yourself, and keeping the best interest of others in mind – to improve your work performance and lead others. Exhibit an attitude of confidence, courage, and reciprocity of sharing knowledge to increase your productivity and influence others. Leverage artificial intelligence to accelerate your ability to learn, augment your decision-making, and influence others.Utilize new technologies to communicate with human colleagues and intelligent machines to develop better solutions more quickly.

Keywords: metaverse, generative artificial intelligence, automation, leadership, organizational intelligence, wisdom worker

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Authors: Jason Hoellwarth, Atiya Oomatia, Anuj Chavan, Kevin Tetsworth, Munjed Al Muderis

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Introduction: Percutaneous EndoProsthetic Osseointegration for Limbs (PEPOL) facilitates improved quality of life (QOL) and objective mobility for most amputees discontent with their traditional socket prosthesis (TSP) experience. Some amputees desiring PEPOL have residual bone much shorter than the currently marketed press-fit implant lengths of 14-16 cm, potentially a risk for failure to integrate. We report on the techniques used, complications experienced, the management of those complications, and the overall mobility outcomes of seven patients who had femur distraction osteogenesis (DO) with a Freedom nail followed by PEPOL. Method: Retrospective evaluation of a prospectively maintained database identified nine patients (5 females) who had transfemoral DO in preparation for PEPOL with two years of follow-up after PEPOL. Six patients had traumatic causes of amputation, one had perinatal complications, one was performed to manage necrotizing fasciitis and one was performed as a result of osteosarcoma. Result: The average age at which DO commenced was 39.4±15.9 years, and seven patients had their amputation more than ten years prior (average 25.5±18.8 years). The residual femurs, on average, started at 102.2±39.7 mm and were lengthened 58.1±20.7 mm, 98±45% of the goal (99±161% of the original bone length). Five patients (56%) had a complication requiring additional surgery: four events of inadequate regeneration were managed with continued lengthening to the desired goal followed by autograft placement harvested from contralateral femur reaming; one patient had the cerclage wires break, which required operative replacement. All patients had osseointegration performed at 355±123 days after the initial lengthening nail surgery. One patient had K-level >2 before DO, at a mean of 3.4±0.6 (2.6-4.4) years following osseointegration. Six patients had K-level >2. The 6-Minute Walk Test remained unchanged (267±56 vs. 308 ± 117 meters). Patient self-rating of prosthesis function, problems, and amputee situation did not significantly change from before DO to after osseointegration. Six patients required additional surgery following osseointegration: six to remove fixation plates placed to maintain distraction osteogenesis length at osseointegration; two required irritation and debridement for infection. Conclusion: Extremely short residual femurs, which make TSP use troublesome, can be lengthened with externally controlled telescoping nails and successfully achieve osseointegration. However, it is imperative to counsel patients that additional surgery to address inadequate regeneration or to remove painful hardware used to maintain fixation may be necessary. This may improve the amputee’s expectations before beginning a potentially arduous process.

Keywords: osseointegration, limb lengthening, quality of life, amputation

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

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Aihong Zhao, Priya Sastry, Mark L Field, Mohamad Bashir, Arvind Singh, David Richens

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Objectives: Intramural haematoma (IMH) is one of the pathologies, along with acute aortic dissection, that present as Acute Aortic Syndrome (AAS). Evidence suggests that unlike aortic dissection, some intramural haematomas may regress with medical management. However, intramural haematomas have been traditionally managed like acute aortic dissections. Given that some of these pathologies may regress with conservative management, it would be useful to be able to identify which of these may not need high risk emergency intervention. A computational aortic model was used in this study to try and identify intramural haematomas with risk of progression to aortic dissection. Methods: We created a computational model of the aorta with luminal blood flow. Reports in the literature have identified 11 mm as the radial clot thickness that is associated with heightened risk of progression of intramural haematoma. Accordingly, haematomas of varying sizes were implanted in the modeled aortic wall to test this hypothesis. The model was exposed to physiological blood flows and the stresses and strains in each layer of the aortic wall were recorded. Results: Size and shape of clot were seen to affect the magnitude of aortic stresses. The greatest stresses and strains were recorded in the intima of the model. When the haematoma exceeded 10 mm in all dimensions, the stress on the intima reached breaking point. Conclusion: Intramural clot size appears to be a contributory factor affecting aortic wall stress. Our computer simulation corroborates clinical evidence in the literature proposing that IMH diameter greater than 11 mm may be predictive of progression. This preliminary report suggests finite element modelling of the aortic wall may be a useful process by which to examine putative variables important in predicting progression or regression of intramural haematoma.

Keywords: intramural haematoma, acute aortic syndrome, finite element analysis,

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Authors: Abdallah Al-ZoubI, Mamoun Dmour

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The spectrum of IoT devices is becoming widely diversified, entering almost all possible fields and finding applications in industry, health, finance, logistics, education, to name a few. The IoT active endpoint sensors and devices exceeded the 12 billion mark in 2021 and are expected to reach 27 billion in 2025, with over $34 billion in total market value. This sheer rise in numbers and use of IoT devices bring with it considerable concerns regarding data storage, analysis, manipulation and protection. IoT Blockchain-based systems have recently been proposed as a decentralized solution for large-scale data storage and protection. COVID-19 has actually accelerated the desire to utilize IoT devices as it impacted both demand and supply and significantly affected several regions due to logistic reasons such as supply chain interruptions, shortage of shipping containers and port congestion. An IoT-blockchain system is proposed to handle big data generated by a distributed network of sensors and controllers in an interactive manner. The system is designed using the Ethereum platform, which utilizes smart contracts, programmed in solidity to execute and manage data generated by IoT sensors and devices. such as Raspberry Pi 4, Rasbpian, and add-on hardware security modules. The proposed system will run a number of applications hosted by a local machine used to validate transactions. It then sends data to the rest of the network through InterPlanetary File System (IPFS) and Ethereum Swarm, forming a closed IoT ecosystem run by blockchain where a number of distributed IoT devices can communicate and interact, thus forming a closed, controlled environment. A prototype has been deployed with three IoT handling units distributed over a wide geographical space in order to examine its feasibility, performance and costs. Initial results indicated that big IoT data retrieval and storage is feasible and interactivity is possible, provided that certain conditions of cost, speed and thorough put are met.

Keywords: IoT devices, blockchain, Ethereum, big data

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Authors: Hannah K. M. Tang, Muhammad Ateeq, Mark J. Lake, Badr Abdullah, Frederic A. Bezombes

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There is little research applying virtual reality (VR) to the treatment of musculoskeletal injury in athletes. This is despite their prevalence, and the implications for physical and psychological health. Nevertheless, developments of wireless VR headsets better facilitate dynamic movement in VR environments (VREs), and more research is expected in this emerging field. This systematic review identified publications that used VR interventions for the analysis or treatment of lower-limb musculoskeletal injury of athletes. It established a search protocol, and through narrative discussion, identified existing trends. Database searches encompassed four term sets: 1) VR systems; 2) musculoskeletal injuries; 3) sporting population; 4) movement outcome analysis. Overall, a total of 126 publications were identified through database searching, and twelve were included in the final analysis and discussion. Many of the studies were pilot and proof of concept work. Seven of the twelve publications were observational studies. However, this may provide preliminary data from which clinical trials will branch. If specified, the focus of the literature was very narrow, with very similar population demographics and injuries. The trends in the literature findings emphasised the role of VR and attentional focus, the strategic manipulation of movement outcomes, and the transfer of skill to the real-world. Causal inferences may have been undermined by flaws, as most studies were limited by the practicality of conducting a two-factor clinical-VR-based study. In conclusion, by assessing the exploratory studies, and combining this with the use of numerous developments, techniques, and tools, a novel application could be established to utilise VR with dynamic movement, for the effective treatment of specific musculoskeletal injuries of athletes.

Keywords: athletes, lower-limb musculoskeletal injury, rehabilitation, return-to-sport, virtual reality

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Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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Authors: Nadeesha Sewwandi, Dilini Shashikala, Rajarathnam Kanapathy, Shivakumaran Viyasan, Saman Kumara, Duminda Guruge

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Introduction: Nutrition is fundamental for good health and development during the early years of life. This study describes how rural community does interventions for improving the nutrition and health of children less than 5 year ages using health promotion approach and this study was conducted with children society and mothers groups in a rural village called Welankulama in Sri Lanka. Methodology: The details got from Public Health Midwife in this village showed there were malnourished children under 5 years age. So, we discussed this problem with the children society, mothers groups and identified the determinants with them. Then they wanted to address some of the determinants that they prioritized from their discussions. ‘Evening school’ was a new place to this village to do collective feeding for small children. ‘Mobile library’ was another new concept in this village and nutrition books, evidence collection were there to read for villagers. Mothers marked the foods given to their kids in a book called ‘Nutrition book’. And also mothers tend to mark the level of eating foods to motivate their children in a ‘Hapana calendar’. Results: In terms of results, malnourished children under 5 years age got reduced and the number of children having illnesses got reduced. Marking nutrition book and ‘Hapana calendar’ were become as trend among mothers. Apart from the above, there was good improvement of physical, social and emotional wellbeing of children. Children who received early stimulation with nutrition supplements had better outcomes than children who only received nutrition supplements, thereby amplifying the impact of nutrition. Conclusion: Health promotion interventions are helped to change nutritional behaviors of early childhood in rural community and it makes children healthier and better able to learn.

Keywords: early childhood, nutrition, determinants, health promotion process

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