Conventional and Rubberize Concrete Cylinders Filled with PVC Tube

The use of composite materials poly-vinyl chloride (PVC) in construction were studied. The use of PVC plastic pipe for concrete tubing is an alternative to use instead of concrete encased in steel tube and hence improve strength, ductility, durability, economical and environmental friendly. The key application of PVC tubing was its use in high aggressive environments and stop the penetration of chlorine and carbon dioxide directed towards core concrete and defect core concrete. Although the use of PVC as a composite materials in aggressive environments are efficient but PVC behave like brittle materials. The main parameters discussed are geometric and materials properties of thin PVC, stay-in-place formwork, PVC tubing from conventional concrete and rubberize concrete, confinement

Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future

Introduction: Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use. Methodology: Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known. Results: Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals. Conclusion: Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored

“Invaders”: U.S. Right wing media’s framing of muslim immigrants

This study identifies and examines the framing patterns in the U.S. right-wing media coverage of the President Donald Trump administration’s ban on immigrants from seven predominantly Muslim countries. The study is directed by one research question: How did the right-wing media frame the ban on Muslim immigrants? A total of 53 articles (news stories, features, and opinion pieces) from two right-wing U.S. media outlets, Daily Caller and Breitbart News, were identified and included in the analysis. Framing theory served as a framework for the analysis of the data. Findings of this study show that the right-wing media used negative frames for Muslim immigrants. The media organizations framed Muslims immigrants as a threat to the United States’ national security, a threat to the social well-being of the communities, and fundamentalists who do not want to integrate into the local culture. These media outlets also incorrectly framed European countries as anti-immigrant and portrayed Muslim immigrants as a source of turmoil in Europe

Khamosh Pani: Partition trauma, gender violence, and religious extremism in Pakistan

This paper looks at the question of partition of British India in 1947 and the rise of religious extremism in Pakistan through an analysis of internationally acclaimed and award-winning Pakistani film Khamosh Pani (silent waters). The paper uses Symbolic Interactionism and Feminist Theory with a critical perspective to establish how the present-day religious extremism in Pakistan has its roots in the colonial history of the country. However, it also highlights the diagnostic inability of Symbolic Interactionism as it smacks of the volunteerism and overlooks how statist and organized institutional power infringes upon socio-political meaning making processes. This paper argues that the film connects the communal nature of pre-partition violence to grassroots contemporary religious extremism in Pakistan to show how the rupture of a village life is the continuation of colonial heritage of communal violence. We argue based on the findings of this study that religious extremism that is manifest in today’s Pakistan is not a break from the past; instead, it is rooted in the colonial history connecting the national Pakistani elite with the regional neo-colonial interests

Trauma exposure and post-traumatic stress disorder among regional journalists in Pakistan

This study sought to examine work-related exposure to trauma and predictors of Post-Traumatic Stress Disorder (PTSD) symptoms among regional journalists in the Khyber Pakhtunkhwa (KP) province, a conflict-ridden area in northwest Pakistan. We recruited 216 KP journalists. Analysis of the surveys revealed a high prevalence of trauma exposure and PTSD symptoms. All of the participants had covered at least one trauma inducing event. Exposure to work-related trauma, active emotional coping and avoidant emotional coping were statistically significant factors associated with PTSD symptoms. This study is the first to highlight the severity of the impact of trauma on regional journalists in Pakistan

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk