US-China global competition and dilemma for Vietnam's strategic choices in the South China Sea conflict

The South China Sea (SCS) conflict has become a critical factor for regional peace and development with growing geopolitical competition between China and the USA. To face the rising threat of China, the study argues that the balance of power theory is relevant to explain why Vietnam attempts to strengthen strategic alliances with the USA, Russia, EU, and India to balance against the rising threat of China in SCS. However, this theory is not able to explain why Vietnam has a bandwagoning policy toward China at the same time. To fill the gap of the previous studies, this study endeavors to put forward the point that as geopolitical rivalry between the two superpowers, the United States and China, intensifies, Vietnam is put in a predicament of balancing the economic and the political choices against the choices of taking a neutral stand against the assertiveness of China in the SCS. Further, the alternative traditional balance options with ASEAN, and Russia are not sufficiently effective for Vietnam to balance against China since the position of both ASEAN and Russia is much weaker than China. This study also suggests that the support of the USA, EU, and its alliance for Vietnam’s position creates unbearable costs for China’s aggressive behaviors in SCS. By using the mathematical and logical framework, the study suggests that Vietnam tends to adopt a mixed strategy (balancing, bandwagoning, neutrality) in dealing with China’s threats

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effect of La3+ ions substituted M-type barium hexa-ferrite on magnetic, optical, and dielectric properties

Effect of La3+ ions substituted M-type barium hexa-ferrite on magnetic, optical, and dielectric propertie

Enhancement of structural and magnetic properties of M-type hexaferrite permanent magnet based on synthesis temperature

The main purpose of this research work is to develop the single domain magnetic particles of M-type barium hexaferrite (BaFe12O19) using oxide precursors employing conventional powder metallurgy technique. The phase formation and magnetic performance of the powders and magnets will be optimized by adjusting calcination and sintering temperatures. The synthesis of M-type barium hexaferrite was carried out in two sections. A series of four samples have been prepared by initial wet mixed powders calcined at different temperatures, i.e., 750, 850, 950 and 1050 degrees C. On the basis of structural analysis, the sample calcined at 950 degrees C has been selected and further divided into four parts to sintered them at 1100,1150,1200 and 1250 degrees C. The structural measurements depict the confirmation of M-type barium hexaferrite structure. SEM micrographs show the hexagonal-shaped grains. The abrupt decrease in coercivity for the sample sintered at 1250 degrees C has been seen which may be due to high sintering temperature, at which the particles have multi-domain properties

VENOUS THROMBOEMBOLISM AND ITS OUTCOME IN PEDIATRIC PATIENTS AT A TER-TIARY CARE HOSPITAL OF KARACHI

Venous thromboembolism (VTE) was once considered a rare finding in pediatric population but it has been increasing with recent advances in medical care and technology to diagnose it. This study was conducted to determine the clinical presentation, associated factors and outcome of VTE in hospitalized children in a tertiary care children hospital of Karachi. This descriptive cross sectional study was conducted at National Institute of Child Health, Karachi from December 2020 to January 2022. All patients hospitalized with VTE or who were diagnosed to have DVT while at hospital were included in study. Demographic characteristics, clinical presentation, medical history and laboratory workup was recorded in a semi-structured proforma. Patients were managed by treating physicians as per hospital protocol. Treatment details were recorded along with outcome. A Total of 36 children were diagnosed with VTE. Nine (25%) patients were admitted with clinical features suggestive of DVT while remaining 27 (75%) developed DVT during hospital stay. Median hospital stay of those who developed DVT at hospital was 15 days (IQR 10-30days). Infectious etiology (n=21, 58.3%) was the most common admitting diagnosis followed by central nervous system disorders (n=4, 11.1%). Common clinical features among VTE children were fever, seizures and edema of limbs. Prolonged hospital stay with immobilization and central venous catheterization particularly due to infectious etiology are common factors among children who develop VTE and such patients need to be considered for VTE prophylaxis and treatment

The LUMBER PUNCTURE AND ASSOCIATED FACTORS AMONG PARENTS OF CHILDREN HOSPITALIZED WITH SUSPECTED CENTRAL NERVOUS SYSTEM INFECTONS

  Lumber Puncture (LP) can be performed for both diagnostic and therapeutic purposes. Failure to perform LP is associated with greater morbidity and mortality due to delayed diagnosis and improper management. This study was conducted to evaluate frequency of LP refusal and its associated factors among parents of children hospitalized with suspected Central Nervous System (CNS) infections. This cross-sectional study was conducted from October 2021 to April 2022 at National Institute of Child Health (NICH), Karachi, Pakistani. Parents/attendants of all pediatric patients hospitalized with suspected CNS infections and advised LP by the treating physicians were included in the study. A semi-structured questionnaire was used to assess the perception and attitude of patients’ towards the procedure and if they agreed for their child to undergo LP. Parents of 338 children were enrolled, out of which 203(60.1%) consented for LP. Majority refused because of fear of complications followed by those who believed LP was not required (29%). Common misconceptions regarding LP complications were risk of death (13%), epilepsy (11%) and paralysis (7%). Significantly lower refusals were observed when no other course was offered as alternate to LP (p-value <0.001). There was high frequency of LP refusal among parents of pediatric patients presenting with suspected CNS infections, most important cause of refusal was fear of complications

Utilization of Aspergillus oryzae to produce pectin lyase from various agro-industrial residues

The present study was aimed to investigate the culture influence on pectin lyase production potential of fungal strain Aspergillus oryzae. The enzyme profile of A. oryzae showed highest activity of pectin lyase after 3rd day of incubation on lemon peel waste under solid state fermentation conditions. To induce the pectin lyase synthesis capability of A. oryzae at optimal level various culture variables including physical and nutritional parameters were optimized by adopting classical optimization technique. Therefore, through fermentation process optimization the production of pectin lyase was substantially induced up to the level of 875 U/mL, when fermentation medium of lemon peel waste inoculated with 5 mL spore suspension of A. oryzae. The optimal fermentation conditions for maximum pectin lyase yield were as: optimum pH 5, 70% moisture level and incubated at 40 °C in addition with 1% sterile glucose solution as readily available carbon source and 0.2% yeast extract as an inexpensive nitrogen supplement (1%). The results obtained in current investigation so far demonstrated that culture conditions have great influence on the pectin lyase production potential of A. oryzae

Bioactivity analysis of the Ta (V) doped SiO2–CaO–Na2O–P2O5 ceramics prepared by solid state sintering method

The main objective of the study was to control the degradation rate of material at a higher degradation rate improving the chemical stability of the material. Ta is known to have good chemical resistance, biocompatibility and show no adverse biological response. In the present study, SiO2–Na2O–CaO–P2O5 bioceramics with different Ta2O5 contents was prepared by solid state sintering method at 1000 °C. The as-sintered ceramics were subjected to immersion studies in stimulated body fluid (SBF) for 21 days under static condition and characterized by XRD, FTIR, SEM, and AAS. The findings of the research indicate that the addition of Ta2O5 controlled degradability, and all samples showed sufficient bioactivity