The Epiphanic Consciousness in Joyce’s “The Dead”

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mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Joyce’s story “The Dead” reflects the significance of epiphanic consciousness that underlies the epiphanic mode of education. It is argued that the story challenges the ethos of the institutional mode of education and exposes the gap between ‘substantial knowledge’ and ‘abstract knowledge.’ Despite being well-educated, Gabriel, the central character, undergoes a process of transformation when the epiphanic moment reveals the futility of his actions. This research paper investigates how far and above his education is with regard to the actual experience of life. The new knowledge unlocks a new level of growth in him. He achieves a new vision of reality and a sense of transcendental unity with existence whether dead (past) or alive (present).</p

FEMALE AS OWNER AND MANAGER, EXPORT ORIENTATION, AND VALUE RELEVANCE OF INNOVATION EVIDENCE FROM EMERGIN G COUNTRIES

The study investigates the impact of the females at the top, females with majority and minority ownership, and females as workers on the export orientation. Moreover, the study also examines the value relevance of the product, process, market, and organizational innovation in the relationship between the females at four different levels in hierarchy and export orientations in the case of emerging markets. The study use data of Enterprise survey conducted by the World Bank from 2002 to 2019 for 40 emerging countries. The sample included 20,019 export- oriented firms. We use hierarchical regression models for estimation. The results of various models show that females at the top position and females with majority ownership have a positive and significant effect on the export orientation. However, female minority ownership and female workers have no significant influence on export orientation. Moreover, product, market, and process innovations have a positive and significant incremental effect in the relationship between females at the top and females holding majority ownership and export orientation. The theory of internationalization is found valid as females in the two significant positions (majority shareholdings and manager at top) are found relevant to the export orientation of the firms. The findings of the study that females as controlling shareholder behave differently than men in emerging markets challenge the principal-principal agency conflicts. Organizations chasing the goal to improve their revenues and grow through exports shall try to attract female investors and hire or promote female to the rank of top-level managerial positions.Moreover, the results of the study encourage small firms to employ and utilize the potentials of females as managers and focus on innovations to exploit export opportunities.Whereas, to boost exports of the local industries, governments are required to provide structural and legal support

Out Come of Surgical Management of Tethered Cord Syndrome

Objective: To determine neurological outcome after surgical management of tethered cord syndrome. Material and Methods: This descriptive study was conducted in the department of Neurosurgery, Lahore General Hospital Lahore. Over a period of Three Years From 2012 to 2014. Study Comprised of Fifty Patients after fulfilling the inclusion and exclusion criteria. Results: The mean age of the patients was 36 ± 10 Years There were 30 (60.0%) male and 20 (40.0%) female patients. There was improvement in neurological status. The distribution of improvement in neurological status, revealed 35 (70.0%) patients had improvement in back pain, 18 (36.0%) improved motor function and 17 (34.0%) improved urinary incontinence. Conclusion: It is concluded from this study that back pain, motor function and urinary incontinence improve postoperatively in the majority of patients. The rate of symptomatic improvement was greatest for back pain, followed by motor, and then urinary improvement. Abbreviations: TCS: Tethered Cord Syndrome. ATCS: Adult Tethered Cord Syndrome

Role of Emergency Decompressive Craniectomy in Patients of Traumatic Brain Injury

Objective: To study the role of emergency decompressive craniectomy in patients of traumatic brain injury. Methodology: This observational study was performed in the department of Neurosurgery, MTI, LRH, Peshawar, from 1st February, 2016 to 31st January, 2017. A total of 28 patients of traumatic brain injury, who underwent emergency decompressive craniectomy within 24 hours of their admission were included in the study after applying the inclusion and exclusion criteria. A questionnaire was used to document the data. Data analysis was performed with the help of SPSS version 20. Results: The total no. of patients were 28, out of which 21 (75%) were male and 7 (25%) were female. The mean age of all the patients was 31 ± 19.84, with a range of 10 – 80 years. The preoperative diagnosis was acute subdural hematoma (ASDH) in 15 (53.6%), large contusion in 6 (21.4%), post-traumatic intracerebral bleed in 3 (10.7%), and ASDH plus small multiple contusions in 4 (14.3%) patients. Dura was left open in all the cases. The preoperative mean GCS was 8.39 ± 3.01. A total of 8 (28.6%) patients expired during the first postoperative week. The mean GCS of the remaining 20 patients at discharge was 10.55 ± 4.05. At 3 months follow-up, 7 (25%) patients were in vegetative state (GOS2), 3 (10.7%) were having major disability (GOS3) and 10 (35.7%) had good (GOS 4 and 5) clinical outcome. Conclusion: The decompressive craniectomy can be very helpful in patients of traumatic brain injury because it can lower the ICP and improve the survival rate in TBI patients. Abbreviations: GCS (Glasgow Coma Scale), GOS (Glasgow Outcome Scale), ICP (Intracranial Pressure)

Brain Death Islamic Perspective

Western world has well defined criteria for declaring the patient brain dead and discontinuation of life support treatment. However in the Muslim world these methods and practices are seen with skepticism as to their acceptance from Islamic and Sharia point op view, which in fact is incorrect and is due to lack of knowledge and absence of Institutional guidelines on this matter. Islamic law permits the withdrawal of futile treatment, including life support, from brain dead patients allowing death to take its natural course. “Do not resuscitate” is permitted in Islamic law in brain dead patients. Euthenesia is however unacceptable in Islam. Although debate continues about the details of brain death criteria within Islamic scholars, brain death is accepted as true death by the majority of Mulim scholars and there is concensus on discontinuation of life support treatment in brain dead patients

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

DECLARATION

We hereby declare that the thesis titled “Design and Development of Unmanned Aerial Vehicle (Drone) for Civil Applications ” is submitted to the Department of Electrical and Electronics Engineering of BRAC University in partial fulfillment of the Bachelor of Science in Electrical and Electronics Engineering. This is work was not submitted elsewhere for the award of any other degree or any other publication

EFFECT OF ATROPINE AND GLYCOPYRROLATE IN PATIENTS WITH ORGANOPHOSPHATE POISONING

Objective: To determine the drug therapy effects of atropine alone and the combined therapy of atropine and glycopyrrolate in patients with organophosphate poisoning. Patients and methods: Total one hundred patients with history of organophosphorus poisoning were included in the study. These patients were divided in to two groups with 50 patients each. One group was treated with atropine alone while the other group was treated with atropine in combination with glycopyrrolate. The results of treatment of both groups were compared after 48 hours of the treatment and data was analyzed on SPSS version 18.0 and statically evaluated by using paired student T-test. Results: During one year study period total one hundred patients with OP poisoning were evaluate as far as management is concerned. The mean ± for age (years) for overall population was 23.74±4.72. The group-A consisted of 50 patients out of which 28 were males and 22 were females. All belonged to the mean age of 22.82 ± 1.166% mostly from rural areas (62%). The group–B also consisted of 50 patients with 29 males and 21 females having mean age of 22.88 ± 1.1. Majority of patients in this group i-e 88% belonged to rural areas with 56% of them were from low economic status. The mortality rate among patients treated with atropine alone was 20% (10 patients), whereas the mortality rate recorded with a combined therapy of on atropine and glycopyrrolate therapy was only 8% (P> 0.05). Conclusion: Since, glycopyrrolate doesn’t cross the blood brain barrier thus; it has no effects on Central Nervous System. Therefore, the combined therapy of atropine with glycopyrrolate showed more positive results as compared to therapy with atropine alone, in the management of mild to moderate cases of organophosphate poisoning. Key words: Organophosphorus poisoning, atropine, glycopyrrolate, blood brain barrier