Dengue outbreak 2013: Clinical profile of patients presenting at DHQ Burner and THQ Shangla, Khyber Pakhtunkhwa, Pakistan

We evaluated the clinical features, disease severity, laboratory findings and outcome of serologically confirmed cases of Dengue fever in Patients during the recent outbreak in two districts (Buner & Shangla) in 2013, Khyber Pkhtunkhwa, Pakistan. We encountered 320 cases of Dengue fever during 5 months period (July to November, 2013). The dengue infection rate in females (180: 56%.2) was higher as compared to males (140: 43.8%). The dengue infections were more frequently seen in the post-monsoon season than in the monsoon period. The death ratio in the overall weighted prevalence was 0%. All the patients suffered from fever but no specific pattern could be identified, degree was variable ranging from low to high grade. Abdominal pain was the next most common symptom followed by vomiting and diarrhea. Only (45%) patients complained of body aches and pains, (30%) patients had hemorrhagic manifestations in the form of gum bleed, and (05%) patients had melena while (15%) patient’s complained of skin rashes. The most common clinical sign was the Enlarged liver that was present in (75%) patients. There is critical need for molecular and entomological surveillance of dengue among the dengue epidemics-prone areas to eliminate the disease

Assessment of Salt Tolerance Ability among Different Accessions of Sunflower (Helianthus annuus L.)

Twenty sunflower (Helianthus annuus L.) accessions were evaluated against three different salinity levels. Triplicate factorial completely randomized design was followed. Salinity was developed with NaCl to achieve the final salinity levels of 3dSm-1, 6dSm-1 and 9dSm-1, whereas control contained tap water. Data of 60 days old ten seedlings from each entry was recorded and analyzed. Accessions G-36, G-61, A-23, A-6, and A-185 performed better in both controlled and saline conditions. These accessions showed better biomass production and high shoot and root growth by least concentration of Na+ and higher concentration of K+ and Cl- in leaf sap resulting in better K+ and Na+. Keywords: Halianthus annus, salinity, biomass, leaf sa

A Study of Pakistan-China Defense Relations (2000-2012)

Pakistan and China have cordial bilateral relations right from the very beginning. Pakistan being the most significant Muslim country located at a geo-strategically important geological juncture and equipped with nuclear deterrent while China being the most emergent economic and technological giant have remained the focus of attention for regional and international political actors. Owing to the strategically complex regional location and the obvious involvement of major political actors of international community herein, both countries have to strengthen the mutual defense ties. Both countries are currently working jointly in all fields related to defense including nuclear cooperation and development of conventional and non-conventional weaponries.Gawadar Port is a geo-strategically important project which is being developed jointly by both countries. The said port and the respective region are constantly under attack by the countries which do not want Pak-China collaboration to flourish. In the context of War Against Terrorism, it is quite significant to examine the quantum of defense collaboration between both countries to conclude that whether Pakistan-China defense relations have been affected by the said war positively or negatively. The present study finds that in spite of various hurdles being present between both countries to improve their geostrategic relationship; both are still managing to strengthen their bilateral defense collaboration. Keywords: Pakistan, China, defense, geostrategic, relationship, War Against Terrorism

Knowledge Management as a Strategy & Competitive Advantage: A Strong Influence to Success (A Survey of Knowledge Management Case Studies of Different Organizations)

There has been a great deal of recognition in the business world that information and knowledge management can be vital tools in organizations. Knowledge management can be proven a competitive advantage of any organization. The rationale of this exploratory study is to investigate the link among knowledge management system & techniques and organizational success by using knowledge as completive advantage. It is a qualitative research study of different case studies of the use of knowledge management as competitive advantage in different organization that leads to success. A total of 8 different organizations are studied and results propose that by using knowledge management as strategy and competitive advantage, these organizations earn high profit. And it has a great influence to success. Implication and Directions are also discussed together with limitation and suggestions for future research. Keywords: Knowledge Management, Organization, Tacit Knowledge, Explicit Knowledge, KMS, KM Strategies, KM Technologies, Productivity, Competitive Advantage

Inductively Powered Implantable System with Far-field Data Transmitter for an Intracranial Pressure Monitoring Application: Design and Performance Validation

Monitoring of the intracranial pressure (ICP) is an essential activity for many brain diseases and injuries. For an adult, ICP value is between 7 mmHg to 15 mmHg . However, for a critically ill patient, the ICP should be maintained below 20 mmHg. Therefore, continuous monitoring of ICP is a life-saving activity. Several invasive and non-invasive methods have been proposed for monitoring of the ICP. However, invasive methods cannot be used for continuous monitoring of the ICP due to the risk of infection. Moreover, non-invasive methods lack in accuracy.Therefore, many researchers reported battery-powered or fully passive implantable systems. However, a battery-powered implant has limited life and large size. On the other hand, in a fully passive implant the readout distance is relatively small in comparison with a battery-powered implant due to its zero-power operation.In contrast, this work presents the development of an inductively powered implantable system equipped with a data transmission unit for an ICP monitoring application. The developed system has three main parts: an implant or in-body unit, an on-body unit and an off-body unit. The on-body unit powers the implant through inductive near-field link. After the activation, the implant, consists of a piezoresistive pressure sensor and a data transmission unit, transmits the pressure signal at the industrial, scientific, and medical radio (ISM) band of 2.45 GHz. The off-body unit receives the transmitted signal from the implant and estimates the pressure value.The simulation and the measurement results of both near-filed and far-field links are presented. After the development of the system, the pressue readout measurement results have been presented in the air, water and in a setting mimicking the human head dielectric properties. For biocompatibility, the implant is coated with biocompatible adhesive silicone. The effect of coating on both wireless links has also been studied.Finally, this work also presents the effect of misalignment between the inductively coupled antennas on the pressure readout accuracy of the developed ICP monitoring system and discusses the solution to overcome this impact. The thesis also presents the response of the developed ICP monitoring system with the change in the temperature

Statistical Sensor Fusion of Ultra Wide Band Ranging and Real Time Kinematic Satellite Navigation

Position, velocity and time (PVT) can be calculated from Global Positioning System (GPS). Two types of GPS measurement models are present, code phase measurement model and carrier phase measurement model. Range measurement in GPS is affected by different types of errors including atmospheric, multipath, satellite and receiver clock and ephemeris errors. Atmospheric errors are the biggest source of error amongst these. Receivers within close proximity to each other face mostly same atmospheric errors from GPS signal. Several differential techniques have been developed during the last few years to mitigate these common errors. It means that the accuracy can be improved by using multiple receivers which mitigate the majority of errors. Real Time Kinematic (RTK) concept uses carrier phase measurements, which have high accuracy. RTK concept was originally developed for application such as surveying. The unknown ambiguity in the number of cycle between each satellite and receiver node is the main issue in RTK technique, moreover these ambiguities are integer numbers. Once the ambiguity is solved, it remains constant as long as the receiver maintains a phase lock on satellites signals. However, the loss of phase lock results in cycle slips and the ambiguity needs to solve again. In this work, RTKLIB, an open source software, is used for the RTK GPS positioning. Ultra-Wide Band (UWB) is known since early 1900s with synonymous terms such as impulse, time domain, nonsinusoidal, baseband, carrier free, orthogonal function and large relative bandwidth radio signals. The huge frequency bandwidth of UWB makes it suitable for positioning and navigation applications. Multipath resistance, high accuracy, low cost and low power implementation are other features of UWB. The huge bandwidth in frequency domain corresponds to short pulse in time domain, usually of nanosecond (ns) order. The Time of arrival (TOA), the time difference of arrival (TDOA) and the received signal strength (RSS) are known methods to calculate the range between the source and the target through UWB. TOA and TDOA are highly accurate but have clock synchronization problem. To overcome this problem, a modified method known as two-way time-of-flight can be used. BeSpoon phone equipped with UWB is used here for UWB ranging. To summarize the previous discussion, RTK GPS positioning has a high accuracy but has integer ambiguity resolution problem which causes cycle slips and requires good satellite visibility as well. Moreover RTK GPS positioning solution is for outdoor applications only and has high dynamic outdoor range. UWB, on the other hand, can give highly accurate positioning solution but has low dynamic range. UWB can be used for both indoor and outdoor applications. Moreover, high bandwidth of UWB makes it multipath resistant and as result can be used in shadow areas. Thus, the fusion of RTK GPS and UWB positioning may compensates the limitations of both and result in better performance system. In this thesis a Kalman filter is used for fusion of UWB and RTK GPS positioning solutions. UWB gives range from tags which are in meter and relative to BeSpoon phone while RTK GPS positioning solution is in geodetic coordinates form (latitude and longitude). Three steps are involved in fusion; first, convert UWB ranges to position in local coordinate by using trilateration, second, convert geodetic coordinates of RTK GPS to local coordinates through rotation matrix and third, use Kalman filter for fusion of both positioning data. The main goal of the thesis is the fusion of both RTK GPS and UWB positioning solutions with the help of Kalman filter in order to obtain better performance compare to stand-alone RTK GPS. Tampere University of Technology (TUT) parking area is used for testing. One corner of TUT parking area has the known coordinate point which is used for the base station of RTK GPS. Reference track and tags positions are drawn through Laser instrument Leica TPS1200 which has millimeter level of accuracy. Measurement results show that the fusion of UWB and RTK GPS positioning solutions have better performance compared to stand-alone RTK GPS solution. Whenever measurement from RTK GPS gives erroneous/missing result, the measurement from UWB sensor corrects it and the resulting solution from filter has better performance

Myasthenia Gravis Mimicking Third Cranial Nerve Palsy: a Case Report

Background: The most common pituitary adenoma presentation is a visual field defect and inappropriate pituitary hormone secretion. The compression of the optic chiasma causes visual impairment. Large pituitary adenomas can rarely cause diplopia and ptosis secondary to adenoma's lateral extension into the cavernous sinus. Myasthenia gravis (MG) is an autoimmune disorder involving neuromuscular junctions. It is characterized by skeletal muscle fatigability, commonly involving extraocular muscles, face, and limbs. It is estimated that 75% of MG patients present with ptosis and diplopia. The association of MG with pituitary adenoma is very rare. Case Description: A 30-year-old lady presented with headache, diplopia, and ptosis of the left eye for two months. She was diagnosed with acromegaly secondary to pituitary adenoma. Ptosis is a rare presenting feature in pituitary adenoma. Her case was discussed in a multidisciplinary meeting, and the consensus was that her ptosis is likely secondary to pituitary adenoma, which was involving the left cavernous sinus. She underwent transsphenoidal resection of pituitary macro adenoma. Three weeks post-surgery, she developed bilateral ptosis, dysarthria, dysphonia, which was diagnosed as myasthenia gravis. Clinical implications: Ptosis is a rare manifestation of pituitary adenoma. Nonetheless, pituitary tumor patients presenting with ptosis should be evaluated for the neuromuscular disorder. A high index of suspicion is required for early diagnosis and prompt treatment of myasthenia gravis

Organizational Resilience: A Dynamic Capability of Complex Systems

In recent years, the concept of organizational resilience has largely attracted the interest of academicians and practitioners alike. A fair number of researches have been conducted on developing the concept of organizational resilience. However, there seems to be a lack of consensus over its conceptualization mainly because the concept itself is prodigious and is used in a variety of disciplines. Furthermore, research within the domain of organizational resilience has been outcome oriented; however, questions addressing the drivers of resilience are yet to be answered. On the other hand, research within the domain of dynamic capabilities view have long been criticized as tautological, resistant to operationalization, and lacking the unification of thought. However, there exists a sufficient degree of conceptual similitude between the two concepts, mainly due to their epistemological similarities grounded within the theoretical assumptions of chaotic systems, environmental dynamism, and systems thinking. Incorporating both perspectives in parallel for understanding the theoretical connections can lead to clarifications at an ontological level. Therefore, this paper attempts to propose a holistic model of organizational resilience by incorporating a lens metaphor of dynamic capabilities view. This paper is divided into four sections. The first section of this paper lays down the multidisciplinary discourses within the realm of organizational resilience. The second section highlights the management discourse about the conceptualization of organizational resilience. The third section of this paper uses a lens metaphor of dynamic capabilities view in an attempt to add depth to the concept of organizational resilience. The fourth and the final section attempts to propose the drivers of organizational resilience from a strategic viewpoint

Comparative Analysis of Flexural Capacity of Bamboo Reinforced and Conventional Steel Reinforced Concrete Beams Through Numerical Evaluation

Steel reinforcement bars are commonly used in the building industry, but their production contributes to toxic waste and emissions. Bamboo is being marketed as a sustainable alternative due to its low cost and tensile strength. It is a readily available natural material that can potentially replace steel as a conventional reinforcement. The idea of hybrid beams (50% bamboo and 50% steel) was developed to get equal outcomes in terms of the structural reaction, and ABAQUS was used to develop a set of beams. By using conventional dimensions and material qualities, a total of five beams were modeled. According to the analysis, the maximum displacements for each beam would be different. The load-displacement curve of five beams was obtained and it was determined that when combined with steel, bamboo may partially replace it

Optimal Glomerular Filtration Rate Equations for Various Age Groups, Disease Conditions and Ethnicities in Asia: A Systematic Review

(1) Background: The performance of estimated glomerular filtration rate (eGFR) equations in the Asian population has been widely questioned. The primary objective of this study was to gather evidence regarding optimal GFR equations in Asia for various age groups, disease conditions, and ethnicities. The secondary objective was to see whether the equations based on the combination of creatinine and cystatin C biomarkers if employed are satisfactory across different age groups and disease conditions in various ethnicities in Asia compared to those based on either of the single biomarkers. (2) Methods: Validation studies that had both creatinine and cystatin C-based equations either alone or in combination, validated in specific disease conditions, and those which compared the performance of these equations with exogenous markers were eligible only. The bias, precision, and 30% accuracy (P30) of each equation were recorded accordingly. (3) Results: Twenty-one studies consisting of 11,371 participants were included and 54 equations were extracted. The bias, precision, and P30 accuracies of the equations ranged from −14.54 to 9.96 mL/min/1.73 m2, 1.61 to 59.85 mL/min/1.73 m2, and 4.7% to 96.10%. The highest values of P30 accuracies were found for the JSN-CKDI equation (96.10%) in Chinese adult renal transplant recipients, for the BIS-2 equation (94.5%) in Chinese elderly CKD patients, and Filler equation (93.70%) also in Chinese adult renal transplant recipients. (4) Conclusions: Optimal equations were identified accordingly and it was proven that combination biomarker equations are more precise and accurate in most of the age groups and disease conditions. These can be considered equations of choice for the specific age groups, disease conditions, and ethnicities within Asia