System, control and sustainability: a concept of control in the local environment system

The formal characteristics of built environments are generated and governed by a range of forces. Most significant among these are political and economic forces typically extended on any settlement from outside. Various authors (Mumford, Lozano, Lange) have recognised this in the context of large cities but such forces are also imposed upon smaller settlements. This is in effect a disempowerment of people in local environments and settlements in requiring that they realise their ways, norms and customs towards centrally derived criteria. The author strongly believes that external forces risk swamping and even obliterating the development of diverse local knowledge and their consequent transformation into local ideologies, technology and built form. This research is an attempt to form a theoretical understanding of a concept of control as seen in the local environment system. It defines forces and powers that shape local built environment. In so doing it tries to identify aspects and facets of this concept and attempts to establish a model that would explain it. This concept will help in gaining an understanding of the real forces shaping existing built form. While recognising the existence of such powers, it is vital that the built environment is seen as a process and not an end product. To do so is to understand it as a system of transformation, and to recognise the different configurations of systems and how they transform the built environment accordingly. Only within the context of systems thinking can power be understood to operate as an inherent characteristic of any system, where the internal order of control differs. While the research recognises the existence of different configurations of local control seen in settlement form, it defines two that exist today varyingly. Those governed and controlled centrally by the state exemplified by modern state developments; and those that are organic have a local hierarchical system of decision making and an internal system of norms, exemplified by vernacular organic built environments. It is also important to identify what define local control. The study proposes three functions of local control: local order system; economic activity; and knowledge and technology. These determine local parties and the powers they have to define the built environment. Observing these furthers an understanding of the concept and its internal mechanisms. To observe the theoretical framework of the thesis, a comparative study in two settlements is conducted: one where the state defines form; the other where built form is locally defined. The three functions of control are observed in terms of parties and powers, and through indicators derived during the theoretical discussions. In order to assess the effects of local control it is applied against sustainability, used as a measurement of quality in the environment, because of its ability to provide a wide array of parameters and because of its international acceptance. A list of indicators relating to sustainability are compiled and set against those of control observing the practical implications. Sustainability becomes a method to evaluate the effects of local internal control as opposed to central state control. In formulating and then observing this concept it will be possible to develop better practical applications and solve recurrent problems. It may also enable decision -makers to readdress development be altering local control patterns

The Effect of Peri-Radial Injection of Papaverine Versus Nitroglycerine on Radial Artery Diameter Prior to Cannulation

Objective:The present study aimed to compare the effect of periradial injection of Papaverine versus Nitroglycerine on radial artery diameter prior to cannulation in cardiac surgery patients. We hoped that periradial injection will facilitate the radial artery cannulation and decrease its spasm. Design:This is a prospective randomized controlled trial that included ninety patients scheduled for elective cardiac surgery. Interventions:Patients were randomly assigned into one of three groups: One group received a peri-radial subcutaneous injection of Papaverine and Lignocaine 2% (30 participants); the second group received a peri-radial subcutaneous injection of Nitroglycerine and Lignocaine 2% (30 participants) and a control group that received a peri-radial subcutaneous injection of Lignocaine 2% (30 participants). Measurements and Main Results:The radial artery diameter was measured by ultrasound before the injection and 20 minutes following injection, and the radial pulse palpability score was measured on a score of 1 (being weak) to 3 (being strongly palpable) before the injection and 20 minutes after.We observed a significant increase in radial artery diameter after injection of Papaverine (p< 0.001) and Nitroglycerine (p< 0.001), compared to baseline values, while there was no significant change in the control group. The changes in the Papaverine group were significantly higher (p= 0.003) than that observed in the Nitroglycerine group.The palpatory score of the radial artery was significantly higher in the Papaverine group than the Nitroglycerine group and both are significantly higher than the control group. Conclusions: Papaverine achieved significant increases in radial artery diameter and palpability score

Postoperative Outcomes after Laparoscopic Cholecystectomy in Elderly Patients

Background: Age is a critical factor influencing the death and morbidities afterward cholecystectomy. It was revealed that laparoscopic cholecystectomy (LC) in the elderly has similar security and effectiveness to those in young people. The gold-standard in the management of cholelithiasis is LC. Objectives: This work was aimed to assess post-operative outcomes of LC between elderly cases and for comparing the post-operative outcome of LC among ages groups >60yrs and <60yrs. Patients and Methods: This prospective study conducted among 68 cases who experienced LC at Damanhur Medical National Institute Hospital. Cases were allocated into 2 groups according to ages: elderly (≥60yrs, n= 38) and young (<60 yrs, n= 35). Results: 68 cases divided into two groups. The mean age is 68.4± 5.7 and 49.1± 10.5 among elderly and younger groups. There is significant difference between groups regarding age and comorbidities. The mean operative time was 62.8± 21.2 and 59.5± 18.7 among elderly and young groups. There is no statistically significant difference between two groups regarding intraoperative data. There is nonsignificant change regarding postoperative outcomes after LC. Conclusion: It could be concluded that laparoscopic cholecystectomy in elderly cases is similar with young cases. Consequently, LC is secure even in the elderly

Surgical Management and Outcome of Patients with Thyroid Diseases during the COVID-19 Pandemic

Background: Globally, healthcare authorities have reacted by restricting medical care to emergency cases and postponing elective surgical procedures of all types. Elective surgeries have been almost totally postponed keeping to a minimum the risk of transmission of SARS-CoV-2 and to allow a better allocation of resources. Since thyroid surgery usually does not cover immediate surgical interventions, during this pandemic nearly all the patients who require thyroid surgery care are experiencing delays in the operation planning procedure. Objective: The aim of the work was to investigate the impact of COVID-19 pandemic on thyroid surgery.Subjects and methods: We conducted prospective study from August 2020 to February 2021 among all patients who attended to Damanhur Medical National Institute Hospital. Total sample size was 60 patients and patients with positive COVID-19 were enrolled in group 1 (cases) and those who were negative COVID-19 were enrolled in group 2 (controls). Results: A total of 60 patients were seen during the study period. Males were 35 (58.3%) while females were 25 (41.7%). The mean age 39.5± 9.5 years. There is no statistically significant difference between patients with COVID-19 and patients without COVID-19 regarding developing complications from thyroid surgeries.Conclusion: The COVID-19 pandemic has created a complicated set of issues for patients with endocrine-related cancers. Most thyroid cancers are indolent and so postponement of surgery in the era of COVID-19. There is no significant association between COVID-19 and complications of surgery

Students' motivation in reading test responses washback effect on learning in higher education

This article reported the result of investigation washback on students learning and motivation along Reading subject as a test for EFL learners. Two main aspects were studied: students’ perception of the exam (attitude, content, methodology, course, and preparation) and student perceived to their motivation. A mixed-methods approach utilized to address the issue. Descriptive and frequency scale used to analyze quantitative data obtained from surveying 120 students. For qualitative, the data analysis elicited from observations of two classes and interviews with 12 students as representatives of four levels. The study found that students expressed positive rather than negative washback to both variables (i.e., learning and motivation) toward the exam. Findings indicated that the subject meets their needs and the test appropriate to measure their achievement goals. However, high-stakes testing still has leftover doubt feeling in preparation. Otherwise, the motivation, which covered content, methodology, and attitude, indicated, there is a positive attitude that affects students’ development, and it brings students to get an optimal point on the test. Keywords: Students learning; motivation; students’ perceptio

Three regimens for re-treatment failure of Sofosbuvir-based therapy for chronic hepatitis-C genotype-4: a cohort study

Despite the high sustained virologic response (SVR) rates of direct-acting antiviral (DAAs) therapy, a small number of patients does not eradicate the virus, and these patients represent a challenge. This study aims to compare the outcomes of three second-line regimens for DAAs-experienced patients with chronic hepatitis C (CHC). This prospective observational study was conducted at the Damanhur Viral Hepatitis Center from January 2017 to February 2020. We included patients with CHC who did not achieve SVR after the complete course of Sofosbuvir/Daclatasvir±Ribavirin (SOF/DAC±RBV). The primary endpoint was SVR-12 after re-treatment. This study included 360 patients (with a mean age of 51.53±11.38 years). Approximately 51.1% of the patients were males, and 65.5% had liver cirrhosis. All patients of group 1 (45 patients) received SOF/VEL/VOX over 12-weeks; SVR-12 was achieved in 44 patients (97.8%). Group 2 (28 patients) received SOF/DAC/RBV over 24-weeks; (one patient was lost during follow-ups and one patient discontinued treatment due to hepatic decompensation). SVR-12 was achieved in 25 patients (96.2%). Group 3 (287 patients) received SOF/Ombitasvir/Paritaprevir/Ritonavir/RBV) over 12-weeks. Eight patients were lost during follow-ups, and one patient discontinued treatment due to grade 4 adverse events. SVR-12 was achieved in 276 patients (99.3%). There was no difference between the groups regarding their age, gender distribution, baseline viral load or comorbidities. Adverse events (thrombocytopenia, anemia, hyperbilirubinaemia and prolonged INR) were significantly higher in group 3, while group 1 did not experience any. The three studied retreatment regimens can be used for DAAs treatment-experienced patients considering availability. The SOF/VEL/VOX combination had the least adverse events

An Update on Larynx Cancer

Abstract: The exact causes of larynx cancer are not fully understood, but certain risk factors have been identified. • Tobacco use: Smoking, as well as smokeless tobacco use, increases the risk of developing larynx cancer. • Alcohol consumption: Excessive and long-term alcohol consumption is associated with an increased risk of larynx cancer. The risk is even higher for individuals who both smoke and drink alcohol. Human papillomavirus (HPV) infection: Certain strains of HPV, primarily HPV type 16, have been linked to an increased risk of larynx cancer. Common signs and symptoms of larynx cancer may include: • Hoarseness or voice changes that persist for more than two weeks. • Persistent sore throat or pain in the throat. • Ear pain. The diagnosis of larynx cancer involves a thorough examination by a healthcare professional, including a physical examination of the throat and neck. Additional tests such as imaging studies (e.g., CT scan, MRI) and a biopsy may be performed to confirm the diagnosis and determine the stage of cancer. Treatment options for larynx cancer depend on various factors including the stage and location of the cancer, as well as the overall health of the patient. Treatment modalities may include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these approaches. It's important for individuals experiencing any persistent symptoms related to the larynx or voice changes to consult with a healthcare professional for a proper evaluation and diagnosis. Keywords: larynx cancer, smokeless tobacco, HPV) infection. Title: An Update on Larynx Cancer Author: Wael Mohammed Alkhaldi, Salman Fahad Aldawsari, Zakaria Said Bohassan, Meshari Dhahawi Alanazi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 11, Issue 1, April 2023 - September 2023 Page No: 276-289 Research Publish Journals Website: www.researchpublish.com Published Date: 22-September-2023 DOI: https://doi.org/10.5281/zenodo.8369372 Paper Download Link (Source) https://www.researchpublish.com/papers/an-update-on-larynx-cancerInternational Journal of Healthcare Sciences, ISSN 2348-5728 (Online), Research Publish Journals, Website: www.researchpublish.co

Effect of ABCB1 (3435C>T) and CYP3A5 (6986A>G) genes polymorphism on tacrolimus concentrations and dosage requirements in liver transplant patients

AbstractBackgroundTacrolimus (TAC) is an immunosuppressant used in organtransplant recipients. It is a substrate of drug transporter ABCB1 as well as of cytochrome P4503A (CYP3A).AimTo assess the influence of ABCB1 (3435 C>T) and CYP3A5 (6986 A>G) genes polymorphism of liver transplant donors and recipients on blood level and dose requirements of oral tacrolimus, to help in designing an individualized tacrolimus regimen for liver transplant recipients.Subjects and methodsForty-eight adult liver transplant recipients and their matching living donors were prospectively enrolled in this study. TAC doses and blood concentration were recorded on 1st, 2nd and 3rd days, after 1 and 2weeks, and at 1, 3 and 6months postoperatively using ultra performance liquid chromatography Tandem mass spectrometry. Genotyping of ABCB1 (3435C>T) and CYP450 3A5 (6986A>G) genes were determined by Polymerase chain reaction followed by restriction fragment length polymorphism and by TaqMan allelic discrimination assay techniques, respectively.ResultsOf the enrolled 48 recipients, CYP3A5∗3/∗3 and CYP3A5∗1/∗3 genotypes were detected in 18 (37.5%) and in 20 (41.7%) recipients respectively, while ABCB1 CT and TT genotypes were detected in16 (33.3%) and 10 (20.8%) recipients respectively. TAC daily dose was significantly increased among recipients carrying ABCB1 CC genotype compared to recipients carrying CT and TT genotypes during and after the first month postoperatively. During 1st, 2nd days and 2weeks post-transplant, a significant increase of TAC concentration / dose ratio was observed among recipients carrying CYP3A5∗3∗3 genotype than recipients carrying 1∗1∗ and 1∗3∗ genotypes, and among recipients carrying ABCB1 CT and TT genotypes compared to those carrying CC genotype on 1st, 3rd days and at 3months postoperatively.ConclusionsABCB1 and CYP3A5 genetic polymorphism is one of the factors influencing TAC pharmacokinetics, screening for these SNPs prior to liver transplantation might be helpful for individualization of tacrolimus treatment

Different chemical behaviors and antioxidant activity of three novel schiff bases containing hydroxyl groups. X-ray structure of CH2{cyclo-C6H10-NH=CH-(2-O-naphth)}2.H2O

The antioxidant activities of three new Schiff base compounds, 1–3, were studied through their direct scavenging ability to eliminate free radicals using DPPH and ABTS methods and also through their indirect antioxidant activity as measured using the ferric thiocyanate (FTC) method. The number of OH groups in the compounds and their positions play a role in the activity. The crystal structure of CH2{cycloC6H10NHCH-(2-O-naphth)}2.H2O (1), has been determined and proves the existence of intramolecular hydrogen-bonds and hydrogen-bonded water molecules and reveals the keto-amine (NH⋯O) tautomer of this compound. One cyclo-hexyl ring was found to be disordered, and was resolved in two orientations. Hydrogen atoms of the NHCH groups were located in difference maps and were refined freely. Compounds 2 and 3 exhibit the enol-imine form. The UV–vis spectra of the three compounds have been studied in organic solvents of different polarity, and in basic and acidic media, and were found helpful in understanding the tautomeric forms in these compounds; the polarity was modified by adding (CF3COOH) or [(C2H5)3N] to the solvent. All three compounds have been characterized by elemental analysis, UV–vis, FTIR, NMR and MS

Rock slope stability analysis using shear strength reduction technique (SSRT) – case histories

Purpose. This study aims to evaluate the slope stability of open pit comprising massive and jointed rock mass. Methods. Mohr-Coulomb yield function (MC) with shear strength reduction technique (SSRT) are incorporated in finite element analysis (FEA) and four different slopes with varying geometry and geological structural features with an ultimate slope angle of 34° are analyzed using the two-dimensional FEA Program RS2D. The first slope comprises blocky rock mass; the second slope has a network of joints parallel to slope face; the third slope has a parallel joint networks dip out the slope face, and the last slope has a cross-joints network. Findings. The critical strength reduction factor (CSRF) indicates whether the slope face is stable (if CSRF ≥ 1) or not. The minimum CSRF of 0.53 (e.g. compared to 0.55 for parallel joints dip out to the slope face, 0.58 for joints parallel to slope face and 0.65 with no joint existed) is obtained with cross-joints network existed. The CSRF (e.g., CSRF = 0.49) reduces when the MC slip criterion is adopted with the jointed rock mass. Originality. This study attempts new stability indicator namely critical strength reduction factor (CSRF) embedded in shear strength reduction technique (SSRT), based on finite element (FEM) to assess the slope of open pit with respect to presence of geological discontinuities. Practical implications. The slope stability of rock mass is significant to design parameters in open pit mines. Unexpected instability is eventually costly, hazardous to personnel/machinery, disrupted to the mining operation and time-consuming. Therefore, this study Provides a methodology for the application of shear strength reduction technique (SSRT) when evaluating the slope stability of open pit mines with respect to existence of geological features. As a result, the mine planners and engineers will be able to know a head of time when and where necessary support is needed.Мета. Дослідження стійкості укосу при відкритій розробці вугільного пласта в умовах твердих і тріщинуватих порід на основі чисельного моделювання. Методика. Функція плинності Мора-Кулона і метод зменшення опору зсуву використані разом з аналізом кінцевих елементів, причому 4 укоси з відмінностями в геометрії та геологічних структурних характеристиках (з оптимальним кутом схилу 34°) проаналізовані за допомогою двомірної програми FEA Program RS2D. Перший укіс представлений бриластою гірської породою, другий укіс покритий сіткою тріщин, паралельних поверхні укосу, третій укіс має паралельні тріщини, перпендикулярні до поверхні укосу, і останній укіс покритий сіткою пересічних тріщин. Результати. Показано, що ступінь стійкості укосу характеризується індексом зменшення критичного опору (ІЗКО) і при ІЗКО ≥ 1 укіс вважається стійким. Встановлено, що мінімальне значення ІЗКО дорівнює 0.53 (0.55 – для паралельних тріщин, перпендикулярних до поверхні укосу; 0.58 – для тріщин паралельних поверхні укосу; 0.65 – при відсутності тріщин) і відповідає укосу, який покритий сіткою пересічних тріщин. ІЗКО зменшується (наприклад, до 0.49), коли зсувне зміщення функції плинності Мора-Кулона застосовується для аналізу тріщинуватих порід. Наукова новизна. Запропоновано індекс зменшення критичного опору в якості нового індикатора стійкості, який є ключовим фактором методу зменшення опору зсуву, заснованого на методі скінченних елементів, і застосовується для виявлення геологічних несуцільностей укосу кар’єру. Практична значимість. Запропоновано метод зменшення опору зсуву при оцінці стійкості схилу в кар’єрах з урахуванням існуючих геологічних особливостей. Стійкість породного масиву є важливим фактором при проектуванні параметрів кар’єрів, а при проектуванні шахт – для вибору місць та способів кріплення.Цель. Исследование устойчивости откоса при открытой разработке угольного пласта в условиях твердых и трещиноватых пород на основе численного моделирования. Методика. Функция текучести Мора-Кулона и метод уменьшения сопротивления сдвигу использованы вместе с анализом конечных элементов, причем 4 откоса с различиями в геометрии и геологических структурных характеристиках (с оптимальным углом склона 34°) проанализированы с помощью двухмерной программы FEA Program RS2D. Первый откос представлен глыбистой горной породой, второй откос покрыт сеткой трещин, параллельных поверхности откоса, третий откос имеет параллельные трещины, перпендикулярные к поверхности откоса, и последний откос покрыт сеткой пересекающихся трещин. Результаты. Показано, что степень устойчивости откоса характеризуется индексом уменьшения критичного сопротивления (ИУКС) и при ИУКС ≥ 1 откос считается устойчивым. Установлено, что минимальное значение ИУКС равно 0.53 (0.55 – для параллельных трещин, перпендикулярных к поверхности откоса; 0.58 – для трещин, параллельных поверхности откоса; и 0.65 – при отсутствии трещин) и соответствует откосу, который покрыт сеткой пересекающихся трещин. ИУКС уменьшается (например, до 0.49), когда сдвиговое смещение функции текучести Мора-Кулона применяется для анализа трещиноватых пород. Научная новизна. Предложен индекс уменьшения критичного сопротивления в качестве нового индикатора устойчивости, который является ключевым фактором метода уменьшения сопротивления сдвигу, основанного на методе конечных элементов, и применяется для выявления геологических несплошностей откоса карьера. Практическая значимость. Предложен метод уменьшения сопротивления сдвигу при оценке устойчивости склона в карьерах с учетом существующих геологических особенностей. Устойчивость породного массива является важным фактором при проектировании параметров карьеров, а при проектировании шахт – для выбора места и способов крепления.The authors acknowledge the support of Rocscience Inc. for getting a free full educational version of RS2D (Rock-Soil two-dimensional finite-element analysis program). The authors are grateful for their support