Remifentanil vs dexmedetomidine for severely preeclamptic parturients scheduled for cesarean section under general anesthesia: A randomized controlled trial

AbstractObjectivesTo compare the effect of remifentanil vs dexmedetomidine on hemodynamic response of noxious stimuli and neonatal outcome in preeclamptic parturient underwent C.S. under G.A.MethodsThis blinded, prospective, randomized trial included 50 preeclamptic parturients underwent C.S under G.A., randomized into two equal groups [25 patients each]: group R [remifentanil]: received 1μg/kg loading and 0.05μg/kg/min infusion doses and group D [dexmedetomidine] received 1/kg loading and 0.2μg/kg/h infusion doses. Maternal MAP and HR were assessed before medication (T0), just after induction of GA (TI), just after intubation (TT), two minutes after intubation (TT2), just after skin incision (TS), two minutes after skin incision (TS2), just after delivery of the baby (TD), and at the end of operation (TE). Time between induction and fetal delivery (I-D interval), time between incision of the uterus and delivery (U-D interval), and time between stop of the infusion of the tested drugs and delivery (D-D interval) were recorded. Neonatal Apgar score was recorded at 1 and 5min and the need for resuscitative measures.ResultsMaternal MAP and HR in group R were statistically lower at (TI), (TT), (TT2), (TS) and (TS2). Neonatal Apgar score was statistically lower in group R with higher incidence for tactile stimulation.ConclusionBoth remifentanil and dexmedetomidine were effective on blunting the pressor response to noxious stimuli in severely preeclamptic parturients. While remifentanil was marginally more effective in suppressing the pressor response, dexmedetomidine was safer for the neonates

Examining the Effect of Joint and Dual Audits on Earnings Management Practices

The purpose of the paper is to determine the impact of the voluntary adoption of the joint external audit approach in reducing earnings management practices through accruals and real operations compared with the adoption of the dual external audit approach. The research follows a quantitative approach to collect and analyze data from companies listed on the Egyptian Stock Exchange during the period 2010-2014. 104 firm-year observations are tested in the sample. The findings of the empirical study shows evidence that there are consistent earnings management practices in the studied sample regardless of the type of audit (joint or dual). There is a negative association between joint audit and discretionary accruals compared to dual audit. This means that firms with joint audit are less engaged in accrual earnings management practices. In addition, large firms that adopt joint audit are less engaged in accrual earnings management. However, there is no effect of joint audit on real earnings management practices compared to dual audit. Our results are consistent for firm size, profitability and leverage. Both firm profitability and leverage show positive association with earnings management practices while size did not have a significant effect on either type of practice. Finally, we find that firms with high (low) profitability that adopt joint audits are less (more) likely to engage in real earnings management practices. Our results are of use to regulators, external auditors and investors.</jats:p

Pengaruh Liquid Hold-Up terhadap Transisi Pola Aliran 2 Fasa Air-Udara dari Stratified Ke Slug pada Pipa 50 mm

The slug flow pattern is one of the most avoiding factors in piping systems due to its destructive characteristics. Research on the criteria of the slug formation is still the concern. The present study focused on finding out the influence of liquid hold-up toward the transition of the flow pattern from stratified to slug pattern. It was conducted on a 50 mm-diameter horizontal acrylic pipe. The visual data was obtained from a fully developed area (180-210 D) by variations of liquid superficial rate (JL) of 0,03-0,3 m/s and gas superficial rate (JG) from 0,7 to 3,77 m/s. The high-speed camera with 2000 fps recording speed was the instrument to obtain the visual data. The measurement of the liquid hold-up is made by Constant Electric Current Method (CECM). The drastic decrement of liquid hold-up value on the wave growth mechanism (JG ≤ 1,88 m/s) indicated the changes in flow patterns from the stratified to the slug pattern, while on the wave coalescence mechanism (JG &gt; 1,88 m/s) the liquid hold-up remains increases. The pattern change from pseudo slug to the slug pattern was not decreasing on its film thickness, yet, it tends to increase the frequency and the liquid slug length

Phylogenomic Review of Root Nitrogen-Fixing Symbiont Population Nodulating Northwestern African Wild Legumes

The present review discusses the phylogenomic diversity of root nitrogen-fixing bacteria associated to wild legumes under North African soils. The genus Ensifer is a dominant rhizobium lineage nodulating the majority of the wild legumes, followed by the genus Rhizobium and Mesorhizobium. In addition, to the known rhizobial genera, two new Microvirga and Phyllobacterium genera were described as real nodulating and nitrogen-fixing microsymbiotes from Lupinus spp. The promising rhizobia related to nitrogen fixation efficiency in association with some legumes are shared. Phylogenetic studies are contributing greatly to our knowledge of relationships on both sides of the plant-bacteria nodulation symbiosis. Multiple origins of nodulation (perhaps even within the legume family) appear likely. However, all nodulating flowering plants are more closely related than previously suspected, suggesting that the predisposition to nodulate might have arisen only once. The origins of nodulation, and the extent to which developmental programs are conserved in nodules, remain unclear, but an improved understanding of the relationships between nodulin genes is providing some clues

The factors influencing students' performance at Universiti Teknologi MARA Kedah, Malaysia

Many studies are carried out to explore factors affecting students’ performance (academic achievement). The purpose of this research is to identify and examine factors that affect students’ performance at UiTM Kedah. A set of questionnaires was distributed to the respective respondents. Several factors that being discussed in this research are demographic, active learning, students’ attendance, involvement in extracurricular activities, peer influence and course assessment. The data is analyzed using descriptive analysis, factor analysis, reliability testing and Pearson correlation of Statistical Package for Social Sciences (SPSS). After conducting factor analysis, all variables are grouped into five factors which exclude peer influence. The researchers found that four factors are positively related to students’ performance that are demographic, active learning, students’ attendance and involvement in extracurricular activities. However, course assessment was found to be negatively related to students’ performance. Further research on students’ performance can be conducted on a larger scale including all UiTM to obtain better result

Social Impact of Videos at New Media Platforms on the eLearning Acceptance during the Covid-19

In a country like Jordan, where technology acceptance and implementation are booming, eLearning acceptance has helped to cope with the current global healthcare crisis (Covid-19). This research examines the primary factors behind eLearning acceptance among Jordanian students. Employing an experimental approach and selecting a sample of n=332 respondents, using Structural Equation Modelling to assess the proposed conceptual framework, our findings indicated that perceived ease-of-use and usefulness were the primary determinants of shaping positive behavioral intentions towards eLearning acceptance. We found a strong significant mediating role of online videos to accept eLearning during the Covid- 19 outbreak and concluded that along with the primary factors of technology and behavioral intention, online videos play a strong role in accelerating eLearning acceptance

The performance of Keretapi Tanah Melayu Berhad (KTMB): analysis based on profitability / Firdaus Ali Mokhtar

This study reveals on the important of towards having a good performance based on profitability. From that, the analysis on the profitability performance will be carried out. The reason is because the stability of one company is depending on their profitability performance and how they utilize it for the company benefits. They can operate effectively and efficiently by having good profitability performance. From the financial statement (balance sheet and income statement), the evaluation of the company performance can be done. To analyze the company that involve in this study, the basic tool of financial analysis will be used. The profitability ratios will be calculated based on the information disclosed on the financial statement of the companies. The study identifies the financial strength on certain criteria. There are five types of common profitability ratios will apply to calculate the financial statement such as gross profit margin, net profit margin, operating profit margin, return on asset and return on equity. The determination whether the company doing well in managing their financial activities in the last 5 years can be made by analysis of profitability ratio. An analysis has been given on each of the selected ratios after been calculated. From the ratio, we will know the performance of the company is decrease in year 2008. This is because the cost of good sales of the company is high and affects the company performance. For better performance in the future, the company needs to take some action in order to increase the effectiveness and efficiency of the company