The significance of variceal haemorrhage in Ghana: A retrospective review

Background: This study describes the burden of bleeding oesophageal varices at the main tertiary referral centre in Accra.Design: Retrospective design to describe the endoscopic spectrum and review mortality data following acute upper gastro-intestinal bleeding at the Korle-Bu Teaching Hospital. Endoscopic data was reviewed in the Endoscopy Unit between 2007 and 2010. Mortality data was collated from the Department of Medicine between 2010 and 2013.Interventions: The study questionnaire compiled clinical and demographic characteristics, endoscopic diagnoses, length of hospital admission and treatment regimens. Main outcome measures: Aetiology and time-trend analysis of mortality rates following acute upper gastro- intestinal bleeding; variceal bleeding treatment modalities.Results: On review of the endoscopic diagnoses, gastro- oesophageal varices were identified in 21.9% of cases followed by gastritis 21.7%, duodenal ulcer, 17.0%, and gastric ulcer, 13.2%. Gastro-oesophageal varices were the predominant cause of death from acute upper gastro-intestinal haemorrhage from 46% in 2010 to 76% in 2013. Outcomes following acute upper gastro-intestinal bleeding were dismal with some 38% of fatalities occurring within the first 24 hours. Injection sclerotherapy was the dominant endoscopic modality for secondary prevention of variceal bleeding in comparison with band ligation, mainly as a result of cost and availability.Conclusions: At the tertiary centre in Accra, variceal bleeding is an increasingly common cause of acute upper gastro-intestinal haemorrhage in comparison with previous reviews in Ghana. Its significantly high in-hospital mortality reflects inadequate facilities to deal with this medical emergency. A strategic approach to care with endoscopic services equipped with all the necessary therapeutic interventions will be vital in improving the outcomes of variceal bleeding in Ghana.Keywords: gastro-oesophageal; varices; bleeding; gastro- intestinal, Ghana

From cosy games to metaverse: deriving positive interaction qualities through netnography

The Metaverse has great potential to provide novel experiences that are not possible in the physical world, but there are still barriers for entry that make it less accessible for some users. To gain design guidelines for a more welcoming Metaverse experience, we examined cosy games, which offer a non-violent and relaxing experience. Using netnography we first observed 6 videos on how players express themselves in 5 different cosy games. We then applied thematic analysis to identify two main aspects of the positive user experience: positive emotional experiences and anticipation experiences. The findings will serve as the foundation for exploring the future potential and create design frameworks for creating more inclusive Metaverse applications

STUDI PERENCANAAN PORTAL BETON BERTULANG PADA GEDUNG FAKULTAS TEKNOLOGI PERTANIAN UNIVERSITAS BRAWIJAYA MALANG DENGAN SISTEM RANGKA PEMIKUL MOMEN KHUSUS (SRPMK)

Seiring dengan perkembangan jaman dan infrastruktur yang kini semakin meningkat, ditambah dengan pertumbuhan penduduk, maka semakin besar pula pembangunan sarana dan prasarana untuk menunjang kehidupan. Dalam pembangunan sarana dan prasarana tersebut seringkali terjadi kendala di karenakan minimnya lahan yang tersedia. sehingga untuk mengatasi kendala tersebut, maka gedung bertingkat menjadi salah satu cara yang di pilih. Dari kondisi tersebut diperlukan perencanaan struktur pada Gedung Fakultas Pertanian Universitas Brawijaya yaitu dengan struktur beton bertulang yang mampu menahan beban terutama beban gempa. Salah satunya dengan menggunakan Sistem Rangka Pemikul Momen Khusus (SRPMK) dikarekanan analisa pada struktur akan menghasilkan gaya-gaya seperti momen lentur, gaya geser, gaya aksial yang nantiya akan menjadi patokan dalam mendesain elemen-elemen struktur. Dari hasil perhitungan penulangan pada Balok B2 400/700 mm(B56 lantai 1 ) bentang 6,3 meter didapat tulangan longitudinal tumpuan Kiri dan kanan 6D25 untuk tulangan atas dan 4D25 tulangan bawah , tulangan longitudinal lapangan 4D25 untuk bagian atas dan 4D25 untuk bagian bawah. Untuk Kolom K2 lantai 3 (C11) dengan dimensi 1000 x 1400 mm, tinggi 4 meter didapat tulangan longitudinal 28D25, tulangan transversal 7 D 13-100 untuk daerah sendi plastis, 2 D13-150 (dengan 3 ikat silang) daerah luar sendi plastis dan daerah sambungan lewatan7 D13-100. Pada sambungan HBK ( joint )diperoleh Pengekang vertical cukup menggunakan tulangan longitudinal kolom K2 ( 1000 mm x 1400 mm ), pengekang horinzontal 7 kaki D13 ( 7 Lapis ). Kata Kunci : Bangunan bertingkat, Beton bertulang, SRPMK, HB

Epidemiology of Helicobacter pylori infection in dyspeptic Ghanaian patients

Introduction: Helicobacter pylori is a gram-negative urease-producing bacterium causally linked with gastritis, peptic ulcer disease and gastricadenocarcinoma. Infection is more frequent and acquired at an earlier age in developing countries compared to European populations. The incidence of Helicobacter pylori infection in dyspeptic Ghanaian patients was 75.4 %. However, epidemiological factors associated with infection vary across populations. Methods: This study used a cross-sectional design to  consecutively sample dyspeptic patients at the Endoscopy Unit of the Korle-Bu Teaching Hospital, Accra between 2010 and 2012. The study questionnaire elicited their epidemiological clinical characteristics.  Helicobacter pylori infection was confirmed by rapid-urease examination of antral biopsies at upper Gastro-intestinal endoscopy.Results: The sample population of dyspeptic patients attending the Endoscopy Unit for upper GI endoscopy yielded 242 patients of which 47.5 % were females. The age distribution of H. pylori-infection was even across most age – groups, ranging from 69.2% (61 – 70) years to 80% (21 –30) years. Helicobacter pylori prevalence decreased across areas mapping to the three residential classes in accordance with increasing affluence with rural areas having the highest prevalence. The unemployed and patients in farming had relatively high Helicobacter pylori infection rates of 92.3 % and 91.7 % respectively.Conclusion: Helicobacter pylori is endemic in Ghana but the persistently high prevalence across age groups despite significant community anti-microbial use suggests likely re-crudescence or re-infection from multiple sources in a developing country. Socio-cultural factors such as residential class and farming may be facilitating factors for its continued prevalence

T h e E f f e c tof Usi n g Cr o ssw or d P u z z le on Voc ab u lary Ac h ieve m e n t of the E igh th Ye ar S tud e n ts of S M P N e ge r i 5 Je m b e r in the 2012/2013 Ac ad e m ic Ye ar s

S UM M AR Y T h e E f f e c tof Usi n g Cr o ssw or d P u z z le on Voc ab u lary Ac h ieve m e n t of the E igh th Ye ar S tud e n ts of S M P N e ge r i 5 Je m b e r in the 2012/2013 Ac ad e m ic Ye ar s ; Ne ne n g R a tna wa ti , 080 210491015; 2012:40 pa g e s; En g li sh Edu c a ti on P rog r a m, L a n g u a g e a nd Ar ts De p a rtmen t, F a c ult y o f Te a c h e r Tr a ini n g a nd Educ a ti o n, J e mber Unive rsit y . This re se a rc h wa s P re e x pe rimen tal re se a rc h. Th e pupose o f this r e se a rc h wa s to know whe ther or not ther e w a s a si g nific a nt e ff e c t o f usin g C rossw or d P uz z le on voc a bular y a c hiveme nt of the e ig hth y e a r stude nts of S MP Ne g e ri 5 J e mber in the 2012/2013 ac a de mi c y e a r. The population of thi s r e se a rc h wa s the e i g hth y e a r students o f S MP Ne ge ri 5 J e mber in the 2012/201 3 a c a de mi c y e a r. Homo g e nit y t e st wa s done to know the homog e n e it y of the pop ulation a nd to de ter mi ne the re se a rc h sa mpl e s. T he re sult of the homogene it y test w a s a na l y z e d usin g AN O VA a nd the re sult sho we d that F Obse rva ti on (F ) v a lue w a s 0.102 . Th e va lu e of F table in t he 5% o f si g nifi c a nc e lev e l wa s 2.26 . Ha vin g be e n c ompar e d, the re sult of „ F 0 ‟ wa s lowe r than that of the F table (0.10 2< 2.26 ). Th e re sul t im pli e d that ther e w a s not diff e re n c e s on th e students‟ Eng li sh Voc a b ula r y a bil it y a mon g those c lasse s. I n othe r wo rds, the population wa s homog e n e ous. Thus, tw o c lasse s w e re take n a s the e x pe rimen tal c lass a nd c ontrol xiii 0 c lass ra ndoml y b y usin g lot ter y . The c l a sses w e r e V II I C (e x pe rimen tal g roup ) a nd V II I F (c ontrol g roup) . The tot a l number of the re sponde nts we r e 77 students that c onsi sted of 38 students of V II I C a s the e x pe rimen tal gr oup that wa s tau g ht voc a bular y b y usin g C r osswor d P uz z le, while the c ontrol g roup c onsi sted of 39 students of V II I F that w a s taug ht vo c a bula r y b y using lec turin g te c hnique . The pr im a r y da ta of thi s re se a r c h we re c oll e c ted fr om the students‟ sc or e s of voc a bular y a c hieve ment test. The supporting da ta we re g a ined f rom int e rvie w a nd doc umenta ti on. The students‟ voc a bular y a c hive ment wa s c oll e c ted fr om the post test to make the c ompar ison be twe e n th e two gr oups a fte r th e tre a tm e nt done . The re sult s of the re se a rc h w e re a n a l y z e d b y using t test f or mul a . The re sult of the a na l y sis indi c a ted that the stat ist ica l va lue of t test w a s 2.54 , while t he t ta ble with the sig nific a nt a lev e l of 5% a nd the de gr e e of f re e do m (D f) of 72 wa s 1.67. The va lue of t test wa s 2.54 a nd it wa s hig he r than 1.67 (2.54 > 1 .67). The re for e , the null h y pothe sis (H o) whic h w a s for mul a t e d : “ ther e is no sig nifi c a nt ef f e c t o f usin g C rossw or d P uz z le on Voc a bular y A c hivem e nt of the e ig hth y e a r students of S MP N 5 J e mber in the 2012/2013 Ac a de mi c y e a r ” wa s r e jec t e d. On the other ha nd, the for mul a ted a lt e rna ti ve h y pothesis (H a ): “ ther e is a sig nific a nt e ff e c t of using C ross wor d P uz z le on Voc a bular y A c hivem e nt of the e ig hth y e a r students of S MP N 5 J e mber in the 2012/2013 Ac a de mi c y e a r ” wa s a c c e pted. B a se d on the r e sult of thi s re se a r c h, the En g li sh tea c he r is a dvised to a ppl y the C rossw or d P uz z le, e sp e c iall y in tea c hin g Vo c a bular y to im p rove the students‟ voc a bular y a c hieve m e nt. F ur ther , the students a r e sugg e st e d to pr a c ti c e voc a bular y using C rossw or d P uz z le i n ord e r to inc r e a se th e ir Eng li sh voc a bul a r y

Cryogenic Thermal Shock Effects on Optical Properties of Quantum Emitters in Hexagonal Boron Nitride.

Solid-state quantum emitters are vital building blocks for quantum information science and quantum technology. Among various types of solid-state emitters discovered to date, color centers in hexagonal boron nitride have garnered tremendous traction in recent years, thanks to their environmental robustness, high brightness, and room-temperature operation. Most recently, these quantum emitters have been employed for satellite-based quantum key distribution. One of the most important requirements to qualify these emitters for space-based applications is their optical stability against cryogenic thermal shock. Such an understanding has, however, remained elusive to date. Here, we report on the effects caused by such thermal shock that induces random, irreversible changes in the spectral characteristics of the quantum emitters. By employing a combination of structural characterizations and density functional calculations, we attribute the observed changes to lattice strain caused by cryogenic temperature shock. Our study sheds light on the stability of the quantum emitters under extreme conditions─similar to those countered in outer space

Planning the world’s new towns: A tale of two countries, 1975-2013

Reflecting their extensive domestic programmes, the UK and France became major exporters of New Town planning expertise during the later twentieth century. Yet each country delivered its expertise in markedly different ways. Drawing on the UK’s own New Towns programme begun in 1946, a public sector international New Town planning agency, the British Urban Development Services Unit was created in 1975. However it quickly proved unsuccessful and was abandoned in 1978. Instead national expertise was exported by UK private planning consultants, with strong government encouragement. By contrast France, whose own Villes Nouvelles programme started in 1960, created a single public sector international planning agency Groupement d’intéret économique Villes Nouvelles de France in 1984 that operated successfully (latterly under a different name) until 2013. The chapter briefly considers the international efforts of the two countries, largely but not exclusively in oil-exporting countries and their respective own former colonial Empires. It also interprets their different approaches in light of their different political histories. Thus the UK was much earlier affected by neo-liberal, pro-market political ideologies that instinctively favoured private rather than public sector approaches. This was especially so given the already established position of its private planning consultancies both in international work and in preparing the original master plans of many UK New Towns. In France, by contrast, neo-liberal sentiments were only slowly accepted and private planning consultancies were much less important. The chapter ends by briefly considering the wider impacts of the two countries’ different approaches

Aligning to disadvantage: how corporate political activity and strategic homophily create path dependence in the firm

To what extent should firms get close to government for competitive advantage? What happens if they get too close? In this article we explore how corporate political activity inculcated strategic homophily in leading UK aluminium producer, the British Aluminium Company Ltd, resulting in its path dependence and eventual lock-in. The article makes three main contributions: a longitudinal study of corporate political activity and strategic homophily revealing their organizational manifestations and detailed understanding of certain mechanisms of path dependence; articulating the value of historical methods and perspectives to exploring organizational path dependence; and exploring the impact that prolonged business-government relations can have on the organizational behaviour and strategic outlook of the firm with implications for TMT selection and environmental scanning. In so doing it responds to calls for firms to align market positions with political activity, as well as those for the recognition of the value of business history in better understanding the links between corporate political activity and firm performance. It further elucidates the longer-term consequences of strategic homophily, which has to date focused on the early stages of venture formation