Search results for: late presentation

Authors: Lynette Nickleberry Stewart

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The present presentation seeks to explore distinction across disciplines in the appropriateness of accelerated courses and suggestions for implementing accelerated courses in various disciplines. Grounded in a review of research on accelerated learning (AL), this presentation will discuss the intradisciplinary appropriateness of accelerated courses for various topics and student types, and make suggestions for implementing augmented courses. Meant to inform an emerging ‘handbook’ of accelerated course development, facilitators will lead participants in a discussion of personal challenges and triumphs in their attempts at accelerated course design.

Keywords: adult learning, abbreviated courses, accelerated learning, course design

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Authors: Ece Sarigul

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It is an undeniable fact that, teachers need new strategies to communicate with students of the next generation and to shape enticing educational experiences for them. Many schools have launched iPad/ Tablets initiatives in an effort to enhance student learning. Despite their rapid adoption, the extent to which iPads / Tablets increase student engagement and learning is not well understood. This presentation aims to examine the use of iPads and Tablets in primary and high schools in Turkey as well as in the world to increase academic achievement through promotion of higher order thinking skills. In addition to explaining the ideas of school teachers and students who use the specific iPads or Tablets , various applications in schools and their use will be discussed and demonstrated in this study. The specific” iPads or Tablets” applications discussed in this presentation can be incorporated into the curriculum to assist in developing transformative practices and programs to meet the needs of a diverse student population. In the conclusion section of the presentation, there will be some suggestions for teachers about the effective use of technological devices in the classroom. This study can help educators understand better how students are currently using iPads and Tablets and shape future use.

Keywords: ipads, language teaching, tablets, technology

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Authors: Sara Fioretti

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During the Middle Bronze Age, southern Italy underwent a reorganisation of social structures where local cultures, such as the sub-Apennine and Nuragic, flourished and participated in maritime trade. This paper explores the socio-economic relationships, in both cross-cultural and potentially inter-regional settings, present within the archaeological repertoire of the southern Italian Late Bronze Age (LBA 1600 -1050 BCE). The emergence of economic relations within the connectivity of the regional settlements is explored through ceramic contexts found in the case studies Punta di Zambrone, Broglio di Trebisacce, and Nuraghe Antigori. This paper discusses the findings of a statistical and theoretical approach from an ongoing study in relation to the Mediterranean’s characterisation as a period dominated by Mycenaean influence. This study engages with a theoretical bricolage of Social Networks Entanglement, and Assertive Objects Theory to address the selective and assertive dynamics evident in the cross-cultural trade exchanges as well as consider inter-regional dynamics. Through this intersection of theory and statistical analysis, the case studies establish a small percentage of pottery as imported, whilst assertive productions have a relatively higher quantity. Overall, the majority still adheres to regional Italian traditions. Therefore, we can dissect the rhizomatic relationships cultivated by the Italian coasts and Mycenaeans and their roles within their networks through the intersection of theoretical and statistical analysis. This research offers a new perspective on the complex nature of the Late Bronze Age relational structures.

Keywords: late bronze age, mediterranean archaeology, exchanges and trade, frequency distribution of ceramic assemblages, social network theory, rhizomatic exchanges

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Authors: Gizelle K. Vianna, Gabriel V. Cunha, Gustavo S. Oliveira

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Foliage diseases in plants can cause a reduction in both quality and quantity of agricultural production. Intelligent detection of plant diseases is an essential research topic as it may help monitoring large fields of crops by automatically detecting the symptoms of foliage diseases. This work investigates ways to recognize the late blight disease from the analysis of tomato digital images, collected directly from the field. A pair of multilayer perceptron neural network analyzes the digital images, using data from both RGB and HSL color models, and classifies each image pixel. One neural network is responsible for the identification of healthy regions of the tomato leaf, while the other identifies the injured regions. The outputs of both networks are combined to generate the final classification of each pixel from the image and the pixel classes are used to repaint the original tomato images by using a color representation that highlights the injuries on the plant. The new images will have only green, red or black pixels, if they came from healthy or injured portions of the leaf, or from the background of the image, respectively. The system presented an accuracy of 97% in detection and estimation of the level of damage on the tomato leaves caused by late blight.

Keywords: artificial neural networks, digital image processing, pattern recognition, phytosanitary

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Authors: Vivian Franco

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There has been a great deal of research about vowel production of second language learners of Spanish, vowel variation across Spanish dialects, and more recently, research related to Spanish heritage speakers’ vowel production based on speech style. However, there is little investigation reported on Spanish heritage speakers’ vowel production in regard to task modality by incorporating own comparison groups of monolinguals and late bilinguals. Thus, the present study investigates the influence of speech style on Spanish heritage speakers’ vowel production by comparing Spanish-English early and late bilinguals and Spanish monolinguals. The study was guided by the following research question: How do early bilinguals (heritage speakers) differ/relate to advanced L2 speakers of Spanish (late bilinguals) and Spanish monolinguals in their vowel quality (acoustic distribution) and quantity (duration) based on speech style? The participants were a total of 11 speakers of Spanish: 7 early Spanish-English bilinguals with a similar linguistic background (simultaneous bilinguals of the second generation); 2 advanced L2 speakers of Spanish; and 2 Spanish monolinguals from Mexico. The study consisted of two tasks. The first one adopted a semi-spontaneous style by a solicited narration of life experiences and a description of a favorite movie with the purpose to collect spontaneous speech. The second task was a reading activity in which the participants read two paragraphs of a Mexican literary essay 'La nuez.' This task aimed to obtain a more controlled speech style. From this study, it can be concluded that early bilinguals and monolinguals show a smaller formant vowel space overall compared to the late bilinguals in both speech styles. In terms of formant values by stress, the early bilinguals and the late bilinguals resembled in the semi-spontaneous speech style as their unstressed vowel space overlapped with that of the unstressed vowels different from the monolinguals who displayed a slightly reduced unstressed vowel space. For the controlled data, the early bilinguals were similar to the monolinguals as their stressed and unstressed vowel spaces overlapped in comparison to the late bilinguals who showed a more clear reduction of unstressed vowel space. In regard to stress, the monolinguals revealed longer vowel duration overall. However, findings of duration by stress showed that the early bilinguals and the monolinguals remained stable with shorter values of unstressed vowels in the semi-spontaneous data and longer duration in the controlled data when compared to the late bilinguals who displayed opposite results. These findings suggest an implication for Spanish heritage speakers and L2 Spanish vowels research as it has been frequently argued that Spanish bilinguals differ from the Spanish monolinguals by their vowel reduction and centralized vowel space influenced by English. However, some Spanish varieties are characterized by vowel reduction especially in certain phonetic contexts so that some vowels present more weakening than others. Consequently, it would not be conclusive to affirm an English influence on the Spanish of these bilinguals.

Keywords: Spanish-English bilinguals, Spanish monolinguals, spontaneous and controlled speech, vowel production.

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Authors: Ammar Manaa

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The late Pleistocene raised coral reef terraces, 1 to 5 m above present sea level, are distinguished in Rabigh area into two marine terraces at elevations 0.5 m and 3.20 m, in addition to back-reef facies. The lower and upper terraces consist mainly of corals that increased in abundance and distribution in the upper terrace, with a minor occurrence of detrital quartz and feldspar. The back-reef facies consist mainly of coralline algae with a minor occurrence of corals. The upper terrace was interpreted as a reef crest or algal ridge due to the dominance of bindstone facies. The lower terrace indicates an outer reef flat with the occurrence of grainstone and rudstone facies. The coral framework in the upper terrace indicates a low energy environment. Within the back-reef terrace, calcareous mud was dominant, which indicates low energy, lagoon environment. The XRD results for the studied terraces revealed a variable abundance of aragonite, high-Mg calcite, and low-Mg calcite, with a slight increase in calcite and high-Mg calcite in the upper terrace. The dominant diagenetic processes in the terraces are cementation by fibrous and blocky calcite and dissolution that varied slightly between the lower and upper terraces. This study provides a coral reef model relevant to a low energy system in a dry and hot environment.

Keywords: late Pleistocene, Rabigh, reef terraces, Red Sea, Saudi Arabia.

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Authors: Jakub Młoźniak, Adam Szymański, Gabriela Stondzik, Dagny Krankowska, Tomasz Mikuła

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Nontuberculous mycobacteria (NTM) are bacterial species that cause diversely manifesting diseases mainly in immunocompromised patients. In people with HIV, NTM infection is an AIDS-defining disease and usually appears when the lymphocyte T CD4 count is below 50 cells/μl. The usage of antiretroviral therapy has decreased the prevalence of NTM among people with HIV, but the disease can still be observed especially among patients with late HIV diagnosis. Common presence in environment, human colonization, clinical similarity with tuberculosis and slow growth on culture makes NTM especially hard to diagnose. The study aimed to analyze the epidemiology and clinical course of NTM among patients with HIV. This study included patients with NTM and HIV admitted to our department between 2017 and 2023. Medical records of patients were analyzed and data on age, sex, median time from HIV diagnosis to identification of NTM infection, median CD4 count at NTM diagnosis, methods of determining NTM infection, type of species of mycobacteria identified, clinical symptoms and treatment course were gathered. Twenty-four patients (20 men, 4 women) with identified NTM were included in this study. Among them, 20 were HIV late presenters. The patients' median age was 40. The main symptoms which patients presented were fever, weight loss and cough. Pulmonary disease confirmed with positive cultures from sputum/bronchoalveolar lavage was present in 18 patients. M. avium was the most common species identified. M. marinum caused disseminated skin lesions in 1 patient. Out of all, 5 people were not treated for NTM caused by lack of symptoms and suspicion of colonization with mycobacterium. Concomitant tuberculosis was present in 6 patients. The median diagnostic time from HIV to NTM infections was 3.5 months. The median CD4 count at NTM identification was 69.5 cells/μl. Median NTM treatment time was 16 months but 7 patients haven’t finished their treatment yet. The most commonly used medications were ethambutol and clarithromycin. Among analyzed patients, 4 of them have died. NTM infections are still an important disease among patients who are HIV late presenters. This disease should be taken into consideration during the differential diagnosis of fever, weight loss and cough in people with HIV with lymphocyte T CD4 count <100 cells/μl. Presence of tuberculosis does not exclude nontuberculous mycobacterium coinfection.

Keywords: mycobacteriosis, HIV, late presenter, epidemiology

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Authors: Kamelia Hamza

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Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.

Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders

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Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing

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Background: Reversal of vision metamorphopsia is a transient form of metamorphopsia described as an upside-down alteration of the visual field in the coronal plane. Patients would describe objects, such as cups, upside down, but the tea would not spill, and people would walk on their heads. It is extremely rare as a stable finding, lasting days or weeks. We report a case wherein this type of metamorphopsia occurred only in written words and lasted for six months. Objective: To the best of our knowledge, we report the first rare occurrence of reversal of vision metamorphopsia described as inverted words as the sole initial presentation of an underlying stroke. Case Presentation: We report a 59-year-old male with poorly controlled hypertension and diabetes mellitus who presented with a 3-day history of difficulty reading, described as the words were turned upside down as if the words were inverted horizontally then with the progression of deficits such as right homonymous hemianopia and achromatopsia, prosopagnosia. Cranial magnetic resonance imaging (MRI) revealed an acute infarct on the left posterior cerebral artery territory. Follow-up after six months revealed improvement of the visual field cut but with the persistence of the higher cortical function deficits. Conclusion: We report the first rare occurrence of metamorphopsia described as purely inverted words as the sole initial presentation of an underlying stroke. The differential diagnoses of a patient presenting with text reversal metamorphopsia should include stroke in the occipitotemporal areas. It further expands the landscape of metamorphopsias due to its exclusivity to written words and prolonged duration. Knowing these clinical features will help identify the lesion locus and improve subsequent stroke care, especially in time-bound management like intravenous thrombolysis.

Keywords: rare presentation, text reversal metamorphopsia, ischemic stroke, stroke

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Authors: Hanna Salminen

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Due to the large societal changes in working life, such as retirement reforms, globalization and technological changes, careers are becoming longer, more varied and unpredictable than before. Similar to other new career concepts, such as protean and boundaryless career, a sustainable career concept emphasizes an individual’s active role and agency in managing his/her own career in changing working life. However, the sustainable career concept also underlines the importance of safeguarding and developing human capital over time and thereby fostering continuity. Especially, the theoretical discussion around sustainable careers stresses flexible career choices that meet an individual’s own personal needs, allow work-family balance and promotes continuous learning. Although sustainable careers concern employees at all ages, this study focuses on older employees (aged 50+). So far, the changing nature of careers has been mainly investigated among younger generations, and the changing and prolonging late career phase has received less attention among career scholars. In other words, there is lack of knowledge regarding what constitutes a sustainable career in the late career phase and how the individual, organizational, and societal levels of sustainable career ecosystem are interconnected. The theoretical discussion around sustainable careers is closely linked to the sustainable management of human resources in organizations. In the field of human resource management (HRM), sustainable HRM has received more attention in recent years and it has been seen as a step forward from strategic HRM approach. As a concept, sustainable HRM stresses the long-term focus on organizations’ social, economic, and ecological resources, and the benefits of HRM practices for employees, organizations, and the society at large. However, some HRM scholars argue that the ecological and financial matters have overshadowed the social aspect of sustainability. In this study, the sustainable career and sustainable HRM literature are combined. As a result of an integrative literature review, this study provides new insight, how sustainable late career phase has been understood and conceptualized in sustainable career and sustainable HRM literature.

Keywords: sustainability, career, human resource management, ageing

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Authors: Ahmad Rasyadan Arshad, A. Rahman A. Jamal, N. Mohamed Ibrahim, Nor Azian Abdul Murad

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Introduction: Parkinson’s disease (PD) is a complex and asymptomatic disease where patients are usually diagnosed at late stage where about 70% of the dopaminergic neurons are lost. Therefore, identification of molecular biomarkers is crucial for early diagnosis of PD. MicroRNA (miRNA) is a short nucleotide non-coding small RNA which regulates the gene expression in post-translational process. The involvement of these miRNAs in neurodegenerative diseases includes maintenance of neuronal development, necrosis, mitochondrial dysfunction and oxidative stress. Thus, miRNA could be a potential biomarkers for diagnosis of PD. Objective: This study aim to identify the miRNA involved in Late Onset PD (LOPD) and Early Onset PD (EOPD) compared to the controls. Methods: This is a case-control study involved PD patients in the Chancellor Tunku Muhriz Hospital at the UKM Medical Centre. miRNA samples were extracted using miRNeasy serum/plasma kit from Qiagen. The quality of miRNA extracted was determined using Agilent RNA 6000 Nano kit in the Bioanalyzer. miRNA expression was performed using GeneChip miRNA 4.0 chip from Affymetrix. Microarray was performed in EOPD (n= 7), LOPD (n=9) and healthy control (n=11). Expression Console and Transcriptomic Analyses Console were used to analyze the microarray data. Result: miR-129-5p was significantly downregulated in EOPD compared to LOPD with -4.2 fold change (p = <0.050. miR-301a-3p was upregulated in EOPD compared to healthy control (fold = 10.3, p = <0.05). In LOPD versus healthy control, miR-486-3p (fold = 15.28, p = <0.05), miR-29c-3p (fold = 12.21, p = <0.05) and miR-301a-3p (fold = 10.01, p =< 0.05) were upregulated. Conclusion: Several miRNA have been identified to be differentially expressed in EOPD compared to LOPD and PD versus control. These miRNAs could serve as the potential biomarkers for early diagnosis of PD. However, these miRNAs need to be validated in a larger sample size.

Keywords: early onset PD, late onset PD, microRNA (miRNA), microarray

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Authors: Laurence Craven

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Academic writing is one of the most important class a freshman will take, as it provides the skill needed to formulate an academic essay in any discipline. Written assignments are the most common form of assessment in higher education and thus it is of paramount importance for students to master the skill of academic writing. This presentation aims to give practitioners multiple ways to enhance their academic writing classes using the Blackboard environment, with a view to improving student performance. The presentation will include ways to improve assessment and give corrective feedback. It will also provide ideas on how to increase variety in teaching lessons, assigning homework and on organizing materials.

Keywords: academic writing, assessment, e-learning, technology

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Authors: Lien Gysens, Bert Vanmechelen, Maarten Haspeslagh, Piet Maes, Ann Martens

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Bovine papillomavirus (BPV) types 1 and 2 play a central role in the etiology of the most common neoplasm in horses, the equine sarcoid. The unknown mechanism behind the unique variety in a clinical presentation on the one hand and the host-dependent clinical outcome of BPV-1 infection, on the other hand, indicate the involvement of additional factors. Earlier studies have reported the potential functional significance of intratypic sequence variants, along with the existence of sarcoid-sourced BPV variants. Therefore, intratypic sequence variation seems to be an important emerging viral factor. This study aimed to give a broad insight in sarcoid-sourced BPV variation and explore its potential association with disease presentation. In order to do this, a nanopore sequencing approach was successfully optimized for screening a wide spectrum of clinical samples. Specimens of each tumour were initially screened for BPV-1/-2 by quantitative real-time PCR. A custom-designed primer set was used on BPV-positive samples to amplify the complete viral genome in two multiplex PCR reactions, resulting in a set of overlapping amplicons. For phylogenetic analysis, separate alignments were made of all available complete genome sequences for BPV-1/-2. The resulting alignments were used to infer Bayesian phylogenetic trees. We found substantial genetic variation among sarcoid-derived BPV-1, although this variation could not be linked to disease severity. Several of the BPV-1 genomes had multiple major deletions. Remarkably, the majority of the cluster within the region coding for late viral genes. Together with the extensiveness (up to 603 nucleotides) of the described deletions, this suggests an altered function of L1/L2 in disease pathogenesis. By generating a significant amount of complete-length BPV genomes, we succeeded in introducing next-generation sequencing into veterinary research focusing on the equine sarcoid, thus facilitating the first report of both nanopore-based sequencing of complete sarcoid-sourced BPV-1/-2 and the simultaneous nanopore sequencing of multiple complete genomes originating from a single clinical sample.

Keywords: Bovine papillomavirus, equine sarcoid, horse, nanopore sequencing, phylogenetic analysis

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Authors: Bezuglov Eduard, Achkasov Evgeniy, Emanov Anton, Shagiakhmetova Larisa, Pirmakhanov Bekzhan, Morgans Ryland

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Background: Previous studies have found that there is a wide range of the relative age effect (RAE) in young athletes, which is dependent on age and gender. However, there is currently scant data comparing the prevalence of the RAE in successful athletes across different age groups from the same sport during the same time period. We aimed to compare the prevalence of the RAE in different age groups of successful athletes. Materials and methods: The date of birth of all youth (under 18 years old) and senior (20 years and above) male and female track and field athletes were analyzed. All athletes had entered the World Top 20 rankings in disciplines where performance rules were the same at youth and adult levels. Data were collected from the website www. tilostopaja.eu between 1999 and 2006. Results: A significant prevalence of RAE in successful youth track and field athletes were reported. Early-born (61,1%) and late-born (38,9%) athletes were represented respectively (χ2 = 131,1, p < 0,001, ϖ = 0,24). The RAE is not significant in successful senior track and field athletes. Athletes born in the first half of the year are only 0.4% more prevalent than athletes born in the second half of the year (50,2% and 49,8%, respectively). Olympic Games and World Championship medalists are more often late-born athletes (44,1% and 55,9%, respectively) (p = 0,014, χ2 = 6,1, ϖ = 0,20). Conclusion: The RAE is only prevalent in successful young track and field athletes. The RAE was not observed in successful senior track and field athletes, regardless of gender, in any of the analyzed discipline groups. The RAE reverse was observed in successful senior track and field athletes.

Keywords: relative age effect, track, and field, talent identification, underdog effect

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Authors: Eisa Y. Adam, Anas A. Fadlelmula, Ali E. Ali

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Sorghum head bug is a key insect pest of sorghum, and it is important to pay attention to the peak time of the pest abundance. The objective of this study was to study the effect of planting date on head bugs population. Field experiment was conducted during 2007/08 – 2008/09 and 2013/14 - 2014/15 cropping seasons at the Damazine Research Station Farm, Blue Nile State to determine sorghum head bugs incidence and abundance through the sowing date. Different sowing dates (early, mid and late sowing) and a susceptible sorghum variety known as Wad Ahmed variety were used the experiment. The experimental design used was randomized complete block design (RCBD). Data were collected on the number of head bug adults and nymphs/panicle, damage percent, coloration and a puncture due to bug feeding and oviposition, 1000 seeds weight and yield. The results showed that significantly (P<0.05) higher number of bugs and damage percent were recorded on the late sowing date for the four seasons followed by the mid sowing, while the early sowing gave low number of bugs, damage percent and high1000 weight. There were significant differences between protected and unprotected heads. The late sowing (August) is a critical sorghum planting time because it coincided with highest numbers of the head bugs.

Keywords: abundance, damage, headbugs, panicle

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Authors: AliAkbar Hafezi, Jalal Taherian, Jamshid Abedi, Mahsa Elahi, Behnam Kadkhodaei

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Background: Soft tissue sarcomas (STS) are generally treated with a combination of limb preservation surgery and radiation therapy. Today, preoperative radiation therapy is considered for accurate treatment volume and smaller field size. Therefore, this study was performed to compare preoperative with postoperative radiation therapy in patients with extremity STS. Methods: In this non-randomized clinical trial, patients with localized extremity STS referred to the orthopedic clinics in Iran from 2021 to 2023 were studied. Patients were randomly divided into two groups: preoperative and postoperative radiation therapy. The two groups of patients were compared in terms of acute (wound dehiscence and infection) and late (limb edema, subcutaneous fibrosis, and joint stiffness) complications and their severity, as well as local recurrence and other one-year outcomes. Results: A total of 80 patients with localized extremity STS were evaluated in two treatment groups. The groups were matched in terms of age, sex, history of diabetes mellitus, hypertension, smoking, involved side, involved extremity, lesion location, and tumor histopathology. The acute complications of treatment in the two groups of patients did not differ significantly (P > 0.05). Of the late complications, only joint stiffness between the two groups had significant statistical differences (P < 0.001). The severity of all three late complications in the postoperative radiation therapy group was significantly higher (P < 0.05). There was no significant difference between the two groups in terms of the rate of local recurrence of other one-year outcomes (P > 0.05). Conclusion: This study showed that in patients with localized extremity STS, the two therapeutic approaches of adjuvant and neoadjuvant radiation therapy did not differ significantly in terms of local recurrence and distant metastasis during the one-year follow-up period and due to fewer late complications in preoperative radiotherapy group, this treatment approach can be a better choice than postoperative radiation therapy.

Keywords: soft tissue sarcoma, extremity, preoperative radiation therapy, postoperative radiation therapy

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Authors: Harim Mohsin, Afshan Channa, Beena Saad

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The Kocher Debre Semelaigne Syndrome (KDSS) is known as cretinism muscular hypertrophy. It is an unusual presentation in intellectually deficit children, commonly associated with congenital or iatrogenic hypothyroidism. The creatinine phosphokinase (CPK) is usually elevated and it’s commonly found in males, consanguineous marriage and ages 18 months to 10 years. It might be misdiagnosed without the classical features of hypothyroidism at first presentation. We present a case of 15 year old intellectually deficit female with epilepsy managed on phenytoin. She had rigidity, myxedema, calf muscle hypertrophy and agitation. The patient was managed as Neuroleptic Malignant Syndrome due to raised CPK of 40,680 IU/L and mixed presentation. Nevertheless, no improvement was noticed and thyroid profile was done to exclude alternative resources. Thyroid stimulating hormone (TSH) was 74.5 IU, Free T3 1.22 ng/dl, and Free T4 0.43 ng/dl. Thyroxine was started along with change in antiepileptic leading to recovery. This case report highlights the inconsistent finding of KDSS. The female gender, non-consanguineous marriage, delayed onset with primarily neuromuscular symptoms, and raised CPK is a rare demonstration in KDSS. Additionally, thyroid profile is not routinely done, which can lead to misdiagnosis and mismanagement.

Keywords: cretinism, hypothyroidism, intellectual deficit, KDSS

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Authors: Siti Navila

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Hedging as a kind of pragmatic competence is an essential part in achieving the goal in communication, especially in academic discourse where the process of sharing knowledge among academic community takes place. Academic discourse demands an appropriateness and modesty of an author or speaker in stating arguments, to name but few, by considering the politeness, being cautious and tentative, and differentiating personal opinions and facts in which these aspects can be achieved through hedging. This study was conducted to find the hedging devices used by students as well as to analyze how they use them in their oral presentation. Some oral presentations from English Department students of the State University of Jakarta on their Academic Presentation course final test were recorded and explored formally and functionally. It was found that the most frequent hedging devices used by students were shields from all hedging devices that students commonly used when they showed suggestion, stated claims, showed opinion to provide possible but still valid answer, and offered the appropriate solution. The researcher suggests that hedging can be familiarized in learning, since potential conflicts that is likely to occur while delivering ideas in academic contexts such as disagreement, criticism, and personal judgment can be reduced with the use of hedging. It will also benefit students in achieving the academic competence with an ability to demonstrate their ideas appropriately and more acceptable in academic discourse.

Keywords: academic discourse, hedging, hedging devices, lexical hedges, Meyer classification

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Authors: Paul M. H. J. Roekaerts

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In recent years, it became clear that much intensive care (ICU) survivors develop a post-intensive care syndrome (PICS) consisting of psychiatric, cognitive and physical problems for a prolonged period after their ICU stay. Physical inactivity and delirium during the ICU stay are the main determinants of the post-ICU PICS. This presentation will focus on delirium, its epidemiology, prevalence, effect on outcome, risk factors and the current standard of care for managing delirium. Because ICU delirium is a predictor of prolonged length-of-stay in the ICU and of death, the use of a delirium prevention bundle (DPB) becomes mandatory in every ICU. In this presentation, a DPB bundle will be discussed consisting of six components: pain, sedation, sleep, sensory and intellectual stimulation, early mobilization, and hydration. For every of the six components, what to do and what not to do will be discussed. The author will present his own institutional policy on pharmacological and non-pharmacological interventions in the management of delirium. The component ‘early mobilization’ will be discussed more in detail, as this component is extremely important in the prevention of delirium as well as in the prevention of the PICS. The author will conclude his presentation with the remaining areas of uncertainties/work and research to be done.

Keywords: delirium, delirium prevention bundle, early mobilisation in intensive care (ICU), post-intensive care syndrome (PICS)

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Authors: Abdelrahman A. Ramzy, Bassel S. Abdallah, Mohamed E. Bahgat, Sarah M. Abdelkader, Sherif H. ElGohary

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Attention-Deficit/Hyperactivity Disorder (ADHD), epilepsy, and autism affect millions of children worldwide, many of which are undiagnosed despite the fact that all of these disorders are detectable in early childhood. Late diagnosis can cause severe problems due to the late treatment and to the misconceptions and lack of awareness as a whole towards these disorders. Moreover, electroencephalography (EEG) has played a vital role in the assessment of neural function in children. Therefore, quantitative EEG measurement will be utilized as a tool for use in the evaluation of patients who may have ADHD, epilepsy, and autism. We propose a screening tool that uses EEG signals and machine learning algorithms to detect these disorders at an early age in an automated manner. The proposed classifiers used with epilepsy as a step taken for the work done so far, provided an accuracy of approximately 97% using SVM, Naïve Bayes and Decision tree, while 98% using KNN, which gives hope for the work yet to be conducted.

Keywords: ADHD, autism, epilepsy, EEG, SVM

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Authors: Hui-Hsin Huang, Sheng-Tung Huang, Chi-Ming Lee, Chiao-Han Yen, Chun-Mao Lin

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At initiation stage, there are no symptoms at initiation stage; however, at late stage, patients suffer symptoms as soon as ovarian cancer metastasis. Moreover, ovarian cancer cells are resistant to some anti-ovarian cancer drugs in clinical. Thus, it is very important to find an effective treatment for resistant ovarian cancer. Anthraquinone derivatives are able to induce DNA damage and lead to cell apoptosis, so several derivatives have been used for clinical application. Therefore, to explore more effective anti-ovarian cancer drugs, this study investigates the mechanism of three new anthraquinone compounds bearing different functional groups to camptothecin-resistance ovarian cell line A2780R2000. Cell viability was determined by MTT assay after treating A2780R2000 with the three new anthraquinone compounds. The results indicated that IC50 values are 33.44μM (Compound I), 25.77μM (Compound II) and 24.59μM (Compound III). Next, through cell cycle analysis, the results demonstrated that three new anthraquinone compounds not only induced A2780R2000 cell cycle arrest at early stage but also apoptosis at late stage. Besides, through apoptosis assay, the results indicated new anthraquinone compound induced apoptosis at late stage. Furthermore, the results of western blot show that the three new anthraquinone compounds lead to A2780R2000 apoptosis through intrinsic pathway. Theses results suggested that three new anthraquinone compounds may be potential new drugs for clinical cancer treatment in the future.

Keywords: anthraquinone, camptothecin, resistance, ovarian cancer

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Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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Authors: Hongxin Zhao, Shibing Yang, Bingming Yi, Yi Ning

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Background: A few studies have found evidence that exposure to endogenous or postmenopausal exogenous estrogens may be associated with a lower prevalence of age-related macular degeneration (AMD), but dispute over this association is ongoing due to inconsistent results reported by different studies. Objectives: To conduct a systematic review and meta-analysis to investigate the association between hormone replacement therapy (HRT) use and AMD. Methods: Relevant studies that assessed the association between HRT and AMD were searched through four databases (PubMed, Web of Science, Cochrane Library, EMBASE) and reference lists of retrieved studies. Study selection, data extraction and quality assessment were conducted by three independent reviewers. The fixed-effect meta-analyses were performed to estimate the association between HRT ever-use and AMD by pooling risk ratio (RR) or odds ratio (OR) across studies. Results: The review identified 2 prospective and 7 cross-sectional studies with 93992 female participants that reported an estimate of the association between HRT ever-use and presence of early AMD or late AMD. Meta-analyses showed that there were no statistically significant associations between HRT ever-use and early AMD (pooled RR for cohort studies was 1.04, 95% CI 0.86 - 1.24; pooled OR for cross-sectional studies was 0.91, 95% CI 0.82 - 1.01). The pooled results from cross-sectional studies also showed no statistically significant association between HRT ever-use and late AMD (OR 1.01; 95% CI 0.89 - 1.15). Conclusions: The pooled effects from observational studies published to date indicate that HRT use is associated with neither early nor late AMD. Exposure to HRT may not protect women from developing AMD.

Keywords: hormone replacement therapy, age-related macular degeneration, meta-analysis, systematic review

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Authors: Fatma Abdel Moneim Al Tawil

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This study was undertaken to evaluate an educational program regarding scientific writing and presentation skills among university students. This interventional study used a one-group, pretest/posttest design and was conducted in Al Jouf University among four colleges in Saudi Arabia. Baseline students’ assessment was conducted for developing educational program. Interventional, one group, pretest/posttest study was designed to evaluate the effectiveness of the educational program. Three parts evaluation sheet with total scores of 30 was used for 113 students for the development of the program and 52 students for test pretest phase. Wilcoxon signed ranks showed statistically significant improvement in the combined overall program skills score from a median of 56.7 pre to a median of 86.7 post, (z = 6.231, p < 0.001). When compared to preprogram intervention, post interventions 51.9 % of students achieve excellent performance. While pre intervention no students (0.0 %) achieve this score. Regarding to scientific writing skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 60 pre to a median of 90 post, (z = 6.122, p < 0.001). None of students had excellent performance changed to 73.1%. Regarding to oral presentation skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 50 pre to a median of 80 post, (z = 6.153, p < 0.001). None of students had excellent performance changed to 48.1%. Such educational program needs to be incorporated into classroom delivery of the students’ curriculum. Scientific writing skills book needed to be developed to be recommended as a basic educational strategy for all university faculties.

Keywords: scientific writing, presentation skills, university students, educational program

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Authors: Hussein El-Zohary

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This research aims at studying the late Alexandrian school of philosophy in the 6th century AD, the adaptation of its methodologies by the Islamic world, and its impact on Muslim philosophical thought. The Alexandrian school has been underestimated by many scholars who regard its production at the end of the classical age as mere interpretations of previous writings and delimit its achievement to the preservation of ancient philosophical heritage. The research reviews the leading figures of the Alexandrian school and its production of philosophical commentaries studying ancient Greek philosophy in its entirety. It also traces the transmission of its heritage to the Islamic world through direct translations into Syriac first and then into Arabic. The research highlights the impact of the Alexandrian commentaries on Muslim recognition of Plato and Aristotle as well as its philosophical teaching methodology starting with the study of Aristotle’s Categories as introductory to understand Plato’s philosophy.

Keywords: Alexandrian school of philosophy, categories, commentaries, Syriac

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Authors: Eman G. Alayad, Mazen G. Aleyad, Mohammed Alshahrani, Ibrahim Alnaami

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Introduction: Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease that can occur at any age. Patients with CVT commonly present with headache, focal neurological deficit, decreased level of consciousness and seizures. Many etiologic risk factors have been reported for CVT, high altitude and oral contraceptive pill some of them. Case Presentation: A 37-year-old woman living in Abha city in the southeastern area of Saudi Arabia. (about 10,000 feet-3000 m) over the sea. complaining acute onset of severe diffuse headache and generalized tonic clonic convulsions. Followed by loss of consciousness. She was on contraceptive pills for the last 3 years. No significant Medical or surgical history. Brain CT revealed subarachnoid hemorrhage, with MRI findings showing thrombosis in transvers sinus. There was no vascular malformations such as aneurysm, arteriovenous malformation (AVM), or dural arteriovenous fistula. A CVT with subarachnoid hemorrhage was our final diagnosis based on clinical presentation and radiographic findings. Discussion: Patients with CVT had evidence of cortical SAH by 10 of 233, others found 3% of SAH was caused by CVT, indicating that the presence of cortical SAH without involvement of the basal cisterns may provide an early sign of underlying CVT. However, what is more interesting in this case, is the relationship of high altitude with CVT and SAH, which previously undescribed. Conclusion: High-altitude climbing per se was described as a risk factor for the development of CVT, though its occurrence was probably rare. Whether it is primary in etiology due to high altitude induced hypercoagulable state of unknown origin or due to cerebrovascular disturbances there is a need for further investigation especially at this unusual presentation of subarachnoid hemorrhage.

Keywords: cerebral venous thrombosis, high-altitude, subarachnoid hemorrhage, stroke

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Authors: Abdul M. Khan, Ayesha Iqbal

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In this paper, new dental remains of Merycopotamus (Anthracotheriidae) are described. The specimens were collected during field work by the authors from the well dated fossiliferous locality 'Hasnot' belonging to the Dhok Pathan Formation, and from 'Tatrot' village belonging to Tatrot Formation of the Potwar Plateau, Pakistan. The stratigraphic age of the Neogene deposits around Hasnot is 7 - 5 Ma; whereas the age of the Tatrot Formation is from 3.4 - 2.6 Ma. The newly discovered material when compared with the previous records of the genus Merycopotamus from the Siwaliks led us to identify all the three reported species of this genus from the Siwaliks of Pakistan. As the sample comprises only the dental remains so the identification of the specimens is solely based upon the morpho-metric analysis. The occlusal pattern of the upper molar in Merycopotamus dissimilis is different from Merycopotamus medioximus and Merycopotamus nanus in having a mesostyle fully divided, forming two prominent cusps, while mesostyle in M. medioximus is partly divided and small lateral crests are present on the mesostyle. A continuous loop like mesostyle is present in Merycopotamus nanus. The entoconid fold is present in Merycopotamus dissimilis on the lower molars whereas it is absent in Merycopotamus medioximus and Merycopotamus nanus. The hypoconulid in M. dissimilis is relatively simple but a loop like hypoconulid is present in M. medioximus and M. nanus. The results of the present findings are in line with the previous records of the genus Merycopotamus, with M. nanus, M. medioximus and M. dissimilis in the Late Miocene – Early Pliocene Dhok Pathan Formation, and M. dissimilis in the Late Pliocene Tatrot sediments of Pakistan.

Keywords: Dhok Pathan, late miocene, merycopotamus, pliocene, Tatrot

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Authors: Eugene Stepanov, Arkadi Ponossov

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Ordinary differential equations with switching nonlinearities constitute a very useful tool in many applications. The solutions of such equations can usually be calculated analytically if they cross the discontinuities transversally. Otherwise, one has trajectories that slides along the discontinuity, and the calculations become less straightforward in this case. For instance, one of the problems one faces is non-uniqueness of the sliding modes. In the presentation, it is proposed to apply the theory of hybrid dynamical systems to calculate the solutions that are ‘hidden’ in the discontinuities. Roughly, one equips the underlying switched system with an explicitly designed discrete dynamical system (‘automaton’), which governs the dynamics of the switched system. This construction ‘splits’ the dynamics, which, as it is shown in the presentation, gives uniqueness of the resulting hybrid trajectories and at the same time provides explicit formulae for them. Projecting the hybrid trajectories back onto the original continuous system explains non-uniqueness of its trajectories. The automaton is designed with the help of the attractors of the specially constructed adjoint dynamical system. Several examples are provided in the presentation, which supports the efficiency of the suggested scheme. The method can be of interest in control theory, gene regulatory networks, neural field models and other fields, where switched dynamics is a part of the analysis.

Keywords: hybrid dynamical systems, singular perturbation analysis, sliding modes, switched dynamics

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Authors: Khizar Samiullah Samiullah, Riffat Yasin, Khurrum Feroz, Omer Draz, Memmona Nazish

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New fossil remains of artiodactyl have been recovered from three Late Miocene localities, Lava, Dhok Bun Ameer Khatoon and Hasnoot. These localities belong to lower and middle Siwalik Hills of Pakistan, the Chinji and Dhok Pathan Formation respectively and are remarkably rich in fossils of artiodactyl. The fauna mainly comprises various families of order Artiodactyla; Cervidae, Equidea, Proboscidea, Giraffidea, Rhinocerotidae, Tragulidea, Suidae and Primates. In Chinji Formation Lava and Dhok Bun Ameer Khatoon are located in district Chakwal while in Upper Dhok Pathan Formation the best fossils exposure site is Hasnoot which is located in District Jhelum, Punjab, Pakistan. Specimens described and discussed here include right and left maxilla, isolated upper premolars and molars which have been collected during extensive fieldwork. After morphological and comparative analysis the collection is attributed to Giraffokeryx, Giraffa, Listriodon, Dorcatherium, Selenoportax and Pachyportax. In this study evolutionary status, taxonomy and biogeographical distribution as well as the relationship of different Artiodactyls have been discussed comprehensively. The Palaeoenvironmental studies reveal the persistence of mosaics of diverse habitats ranging from tropical evergreen forest to subtropical ones, closed seasonal woodlands to wooded savannas during the deposition of these outcrops.

Keywords: Artiodactyla, fossil dentition, late Miocene, lower and middle Siwaliks

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Authors: Vaibhav Baliyan, S. S. Parihar

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With the rise in temperature during reproductive phase and moisture stress, winter wheat yields are likely to decrease because of limited plant growth, higher rate of night respiration, higher spikelet sterility or number of grains per spike and restricted embryo development thereby reducing grain number. Crop management practices play a pivotal role in minimizing adverse effects of terminal heat stress on wheat production. Amongst various agronomic management practices, adjusting sowing date, crop cultivars and irrigation scheduling have been realized to be simple yet powerful, implementable and eco-friendly mitigation strategies to sustain yields under elevated temperature conditions. Taking into account, large variability in wheat production in space and time, a study was conducted to identify the suitable wheat varieties under both early and late planting with suitable irrigation schedule for minimizing terminal heat stress effect and thereby improving wheat production. Experiments were conducted at research farms of Indian Agricultural Research Institute, New Delhi, India, separately for timely and late sown conditions with suitable varieties with staggering dates of sowing from 1st November to 30th November in case of timely sown and from 1st December to 31st December for late sown condition. The irrigation schedule followed for both the experiments were 100% of ETc (evapotranspiration of crop), 80% of ETc and 60% of ETc. Results of the timely sown experiment indicated that 1st November sowing resulted in higher grain yield followed by 10th November. However, delay in sowing thereafter resulted in gradual decrease in yield and the maximum reduction was noticed under 30th November sowing. Amongst the varieties, HD3086 produced higher grain yield compared to other varieties. Irrigation applied based on 100% of ETc gave higher yield comparable to 80% of ETc but both were significantly higher than 60% of ETc. It was further observed that even liberal irrigation under 100% of ETc could not compensate the yield under delayed sowing suggesting that rise in temperature beyond January adversely affected the growth and development of crop as well as forced maturity resulting in significant reduction of yield attributing characters due to terminal heat stress. Similar observations were recorded under late sown experiment too. Planting on 1st December along with 100% ETc of irrigation schedule resulted in significantly higher grain yield as compared to other dates and irrigation regimes. Further, it was observed that reduction in yield under late sown conditions was significantly large than the timely sown conditions irrespective of the variety grown and irrigation schedule followed. Delayed sowing resulted in reducing crop growth period and forced maturity in turn led to significant deterioration in all the yield attributing characters and there by reduction in yield suggesting that terminal heat stress had greater impact on yield under late sown crop than timely sown due to temperature rise coinciding with reproductive phase of the crop.

Keywords: climate, irrigation, mitigation, wheat

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