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PurposeThe traditional failure mode and effect analysis (FMEA) has some limitations, such as the neglect of relevant historical data, subjective use of rating numbering and the less rationality and accuracy of the Risk Priority Number. The current study proposes a machine learning–enhanced FMEA (ML-FMEA) method based on a popular machine learning tool, Waikato environment for knowledge analysis (WEKA).Design/methodology/approachThis work uses the collected FMEA historical data to predict the probability of component/product failure risk by machine learning based on different commonly used classifiers. To compare the correct classification rate of ML-FMEA based on different classifiers, the 10-fold cross-validation is employed. Moreover, the prediction error is estimated by repeated experiments with different random seeds under varying initialization settings. Finally, the case of the submersible pump in Bhattacharjee et al. (2020) is utilized to test the performance of the proposed method.FindingsThe results show that ML-FMEA, based on most of the commonly used classifiers, outperforms the Bhattacharjee model. For example, the ML-FMEA based on Random Committee improves the correct classification rate from 77.47 to 90.09 per cent and area under the curve of receiver operating characteristic curve (ROC) from 80.9 to 91.8 per cent, respectively.Originality/valueThe proposed method not only enables the decision-maker to use the historical failure data and predict the probability of the risk of failure but also may pave a new way for the application of machine learning techniques in FMEA.

Antenatal (ANC) and postnatal care (PNC) are logical entry points for prevention and treatment of pregnancy-related illness and to reduce perinatal mortality. We developed signal functions and assessed availability of the essential components of care.Cross-sectional survey.Afghanistan, Chad, Ghana, Tanzania, Togo.Three hundred and twenty-one healthcare facilities.Fifteen essential components or signal functions of ANC and PNC were identified. Healthcare facility assessment for availability of each component, human resources, equipment, drugs and consumables required to provide each component.Availability of ANC PNC components.Across all countries, healthcare providers are available (median number per facility: 8; interquartile range [IQR] 3-17) with a ratio of 3:1 for secondary versus primary care. Significantly more women attend for ANC than PNC (1668 versus 300 per facility/year). None of the healthcare facilities was able to provide all 15 essential components of ANC and PNC. The majority (75%) could provide five components: diagnosis and management of syphilis, vaccination to prevent tetanus, BMI assessment, gestational diabetes screening, monitoring newborn growth. In Sub-Saharan countries, interventions for malaria and HIV (including prevention of mother to child transmission [PMTCT]) were available in 11.7-86.5% of facilities. Prevention and management of TB; assessment of pre- or post-term birth, fetal wellbeing, detection of multiple pregnancy, abnormal lie and presentation; screening and support for mental health and domestic abuse were provided in25% of facilities.Essential components of ANC and PNC are not in place. Focused attention on content is required if perinatal mortality and maternal morbidity during and after pregnancy are to be reduced.ANC and PNC are essential care bundles. We identified 15 core components. These are not in place in the majority of LMIC settings.

The increased greenhouse gas concentration in the atmosphere causes climate change. China and India are among the most significant contributors to global greenhouse gas emissions. The current study forecasts the greenhouse gas emissions from the countries' four sectors – Transportation, Building, Waste, and Manufacturing/Construction. By extending the classical grey forecasting model DGM (1,1), a new data-driven time-series forecasting technique, called DGM (1,1, α), is proposed and applied to forecast the greenhouse gas emissions in these sectors till 2028 with an accuracy of over 95%. The results show that the emissions are generally increasing. However, China continues to show a decline in greenhouse gas emissions from the manufacturing and construction industries. Also, the improved version of the Posterior-Variance Test is presented to test whether a given forecasting model is qualified or unqualified for a given problem. The comparative analyses with three forecasting models – DGM (1,1), Even GM (1,1), and Grey Verhulst models –revealed the proposed model's feasibility, flexibility, and accuracy. The study concludes with important implications and suggestions for the policy-makers to develop better emission mitigation policies.

Project stakeholders always investigate possible approaches to monitor project progress closely and further, taking necessary actions during the whole phases of the project in order to manage delays. Earned value management (EVM) is one of the methods, which can forecast the required costs for accomplishment of the project. The data collected from projects undertaken in order to update the master schedule often suffer from a level of uncertainty. Ignoring these uncertainties may even lead to project failure. Fuzzy theory has been previously used in the EVM for taking uncertainties into account. A major disadvantage of using fuzzy approaches is the need for incorporating expert judgments to construct a suitable membership function for all activities in the project undertaken. A potential approach for overcoming this issue lies in Grey theory. In this article, the current study deals with the EVM method in grey systems paradigm. Also, the performance of the proposed method, called grey earned value management (EVM-G), is evaluated through some numerical examples and a case study. The results demonstrate that the proposed approach has a unique performance in highly uncertain environments when experts have become unavailable. Comparisons between EVM-G and the fuzzy earned value management approaches reveal the superior performance of EVM-G.

OCTA is an imaging modality used in the assessment of the retinal vasculature. It operates on the principle of coherence tomography used in standard OCT with the addition of delineating the retinal vascular. This provides a modern non-invasive retinal vascular imaging method compared to conventional dye-based imaging. High quality depth resolution of the superficial and deep capillary networks is possible on OCTA whereas this was not possible prior. OCTA may be limited by image quality degradation from factors such as motion artefact or media opacities, and therefore may not be the investigation of choice for all patient groups. There are multiple potential clinical applications for OCTA in retinal and choroidal vascular disease. Ongoing research is necessary to substantiate the more widespread use of OCTA due to its significant cost burden compared to current modalities.

PurposeThe purpose of this paper is to develop a new approach for equipment states prediction and provide a method for early warning of possible trouble states.Design/methodology/approachA new two-stage multi-level equipment state classification system was proposed to forecast equipment operation status. The first stage involves predicting the equipment's normal state, and the second stage involves forecasting the equipment's abnormal status. Meanwhile, the equipment state classification is done according to the manufacturing company's internal specifications to define various equipment statuses. Then, the trouble state and waiting state were predicted by grey state prediction model.FindingsA new two-stage multi-level equipment status classification system and a new approach for equipment states prediction has been proposed in this paper.Practical implicationsThe application on a real-world case shown that the model is very effective for predicting equipment state. The equipment's major failure risk can be reduced significantly.Originality/valueThe proposed approach can help improve the effective prediction of the equipment's various operation states and reduce the equipment's major failure risk and thus maintenance costs.

The Inverse GMCR (Graph Model for Conflict Resolution) produces rankings of possible states (preference relation profiles) that will make the desired resolution of a conflict stable. However, there are usually numerous preference relation profiles making it difficult for a third party to choose an appropriate preference relation to design its mediation strategy. Moreover, the cost or effort of changing preference relations over states has rarely been studied in Inverse GMCR. The current study presents two inverse preference optimization models considering the cost and effort in changing preferences to address these issues. The first model aims to ascertain an optimal preference at minimum adjustment cost such that the desired equilibrium is reached. The other model is to find an optimal required preference under minimum adjustment amount, which is defined as the difference between the required preference matrix and the original preference matrix. Then, a Genetic Algorithm (GA)-based algorithm is proposed. Finally, the two proposed preference optimization methods are applied to two cases, demonstrating the effectiveness of the proposed methodology.

PurposeGlobal supply chains experienced unprecedented changes in 2020 and the relationship between domestic and global markets needed adjustments considering the long-term impacts of the changes that are unfolding around these markets. China has become the first country to announce a formal strategy – “Dual Circulation” Strategy (DCS) – to guide its self-reliant economic development in the post-COVID era. However, what exactly is the DCS and what drove China to publicize this strategy is not yet clear. This study aims to answer these questions.Design/methodology/approachBased on an extensive review of literature and media reports, a background has been constructed that justifies the DCS as a long-overdue historic necessity.FindingsA novel definition of “Dual Circulation” is introduced. A novel construct to visualize the domestic circulation in light of international and domestic markets and international circulation has been presented. The study argues that maintaining optimum levels of consumption and saving rates is crucial to the DCS’s success.Originality/valueThe study pioneers the first scientific definition of the “Dual Circulation” that will pave way for future debate on the topic. Also, it is the first time an academic study on the DCS has been executed.

This paper is aimed at scheduling optimal preventive replacement policies for a single unit system which is subject to stochastic deterioration and concurrently suffers from external shocks. Different from existing literature, two types of shocks are taken into account according to the effectiveness upon arrival of a random shock, in which Type Ⅰ shock is a non-fatal one increasing the damage magnitude on current degradation amount and Type Ⅱ shock is a fatal one resulting in system catastrophic failure immediately. System survival function is investigated numerically based on the degradation-threshold-shock (DTS) modelling framework, and subsequently, two categories of bivariate maintenance policies are scheduled from different perspectives. The optimal solutions for both policies are derived analytically, and the relative gain on the optimal average maintenance cost rate is incorporated to determine which policy is more profitable. An illustrative example is provided to validate the theoretical results.

Accurate evaluation of project performance is one of the biggest concerns of project-oriented organizations, and project managers are always looking for suitable tools and techniques to monitor and control the project activities. For a long time, the earned value management system is helping project managers in achieving this objective. However, its predominant focus on project cost and other limitations paved the way for the development of the earned duration management (EDM) system. The EDM system examines the performance of a project in term of time and can also measure the effectiveness of the project schedule at different stages. Since, in real-life, projects are frequently surrounded by uncertainties, the EDM system was extended to fuzzy EDM to make project performance evaluation more realistic but at the expense of increased computational costs and assumptions. Grey system theory is a promising soft computing approach for situations involving uncertainties and can be employed with the least possible information and assumptions. Unlike the fuzzy set theory, it does not require a membership function, thus facilitating data processing. By benefiting from these advantages, the current study aims to propose grey earned duration management (EDM-G) system and compares it with fuzzy EDM and the original EDM systems. The results suggest, the EDM-G system is a convenient and reliable system while it does not require sophisticated computations, large datasets, and membership functions. Finally, its execution on a real-life industrial case study confirmed its validity and reliability, even when multiple experts are involved in performance measurement.

Because of the COVID-19 outbreak, the supply of both essential and non-essential goods and services has been unprecedentedly disrupted. In the absence of any playbook, the need for innovative technologies to aid recovery from the Supply Chain (SC) disruptions quickly and effectively becomes persistent. The study aims to develop an innovative decision-making technology to handle the supplier selection problems arising from the frequent impreciseness and incompleteness in the nowadays' SC reports within the framework of the gresilient supply chain management. Through the integration of green and resilience aspects of the SCs, the supply chain 'gresilience' has been conceptualized. In light of this construct and based on the data collected from a manufacturing firm, the study deploys a two-fold decomposition of the core algorithm of the Ordinal Priority Approach (OPA), one for attributes and other for alternatives. It extends the OPA to the Fuzzy OPA (OPA-F) for solving the supplier selection problems. The study illustrates how green and resilience aspects of the SC can be integrated to better understand the gresilient suppliers in the wake of the SC disruptions. A novel construct of SC Gresilience is also furnished along with a novel definition of SC Gresilience. It also provides an innovative SC decision-making technology to help procurement managers to evaluate their suppliers. The resultant framework can help them better prepare for the COVID-19 like disruptions in the future.

Objectives: The aim of our study is to evaluate the possible association of serum magnesium in diabetic patients with and without retinopathy. Study Design: Cross-sectional observational. Setting: Bahawal Victoria Hospital, Bahawalpur. Period: September, 2018 to May, 2019. Material & Methods: A total of 258 subjects were enrolled in the study. They were divided in 3 groups, which comprised of 208 diabetic patients; 92 with retinopathy, 116 without retinopathy and the control group comprised of 50 healthy individuals. Both cases and controls were subjected to blood tests for the estimation of biochemical parameters. Results: A considerable decrease was observed in the serum magnesium level of diabetics in comparison with the healthy participants. The mean serum magnesium levels amongst the groups were 1.5 ± 0.2 mg/dl and 2.4 ± 0.3 mg/dl respectively (p

Nowadays, with the development of information management infrastructures in organizations and the improvement of the data storage process, managers are looking for appropriate decision-making methods based on large volumes of data. Therefore, it is crucial to choose the right approach to make the right decisions based on the volume of available data. The present study seeks to provide a comprehensive framework for the decision-making process using big data, even when it is incomplete. The framework of multiple criteria decision making (MCDM) consists of criteria and alternatives, whereas in real-world cases, decision-makers may face several criteria and alternatives. In this study, the Principal Component Analysis (PCA) approach was selected for the criteria clustering. Later, the K-means algorithm is used to cluster the alternatives, which estimates the optimal number of clusters using the Elbow method. The Fuzzy TOPSIS (TOPSIS-F) and Ordinal Priority Approach (OPA) have been used to rank clusters. Ultimately, the best alternative in the top cluster has been identified with the aid of the OPA, which has a unique function to solve MCDM problems with incomplete data. For evaluating the performance of the proposed approach, first, a pilot testing has been executed on a real-world case, and then a practical study was conducted at a refinery equipment manufacturing company with a project-oriented organizational structure. The approach is flexible, interactive, intelligent, and integrative, and significantly reduces the time and computation costs for the decision-makers. The results confirmed the soundness of the proposed approach, which can be used by managers of different companies with confidence.

PurposeIn the current study, two grey prediction models, Even GM (1, 1) and Non-homogeneous discrete grey model (NDGM), and ARIMA models are deployed to forecast cocoa bean production of the six major cocoa-producing countries. Furthermore, relying on Relative Growth Rate (RGR) and Doubling Time (Dt), production growth is analyzed.Design/methodology/approachThe secondary data were extracted from the United Nations Food and Agricultural Organization (FAO) database. Grey forecasting models are applied using the data covering 2008 to 2017 as their performance on the small sample size is well-recognized. The models' performance was estimated through MAPE, MAE and RMSE.FindingsResults show the two grey models fell below 10% of MAPE confirming their high accuracy and forecasting performance against that of the ARIMA. Therefore, the suitability of grey models for the cocoa production forecast is established. Findings also revealed that cocoa production in Côte d'Ivoire, Cameroon, Ghana and Brazil is likely to experience a rise with a growth rate of 2.52, 2.49, 2.45 and 2.72% by 2030, respectively. However, Nigeria and Indonesia are likely to experience a decrease with a growth rate of 2.25 and 2.21%, respectively.Practical implicationsFor a sustainable cocoa industry, stakeholders should investigate the decline in production despite the implementation of advanced agricultural mechanization in cocoa farming, which goes further to put food security at risk.Originality/valueThe study presents a pioneering attempt of using grey forecasting models to predict cocoa production.

We propose a low-cost, easy-to-fabricate, contactless microwave sensor for dielectric characterization of liquids. The design of the proposed sensor is based on a multiple complementary split-ring resonator (MCSRR) fabricated on a low-cost FR-4 substrate. A glass capillary tube having an inner diameter of $0.008\lambda _{{0}}$ is inserted in the high electric field region of the MCSRR to carry the liquid under test. The sensor is designed to operate at a resonant frequency of 2.45GHz for an empty tube and shifted resonant peaks are utilized for the dielectric characterization of different liquids. The maximum observed shifts in resonant frequency and Q factor are up to 400MHz and 31, respectively. The numerically established relations are experimentally verified through fabricated sensor for various binary mixtures of water and ethanol. The percentage errors between the calculated and reference permittivity of different samples are noticed to be less than 5%. The proposed device promises to be a cost-effective and convenient solution for accurate dielectric characterization of liquids and their binary aqueous solutions.

Due to mounting environmental and social challenges, supplier selection has become one of the most critical tasks of project‐oriented organizations. Because supplier selection can affect the long‐term success and profitability of the organizations and their projects, directly, embracing sustainability can add value in the equation. Considering sustainability measures can positively guide project managers in making better decisions for the projects in the long term. Therefore, the current study attempts to provide a conceptual model for selecting the best supplier based on a sustainability framework in megaprojects. Meanwhile, decision‐making methods can be employed as a proper tool to find the best supplier. Ordinal priority approach (OPA) is a recent development in multiple criteria decision making (MCDM), while it has many benefits compared with other methods like analytic hierarchy process (AHP) and technique for order of preference by similarity to ideal solution (TOPSIS). However, this method cannot consider multiple ranks during the decision‐making process, and using an uncertainty approach feels strongly. Grey systems theory (GST) can consider uncertainties with no need for large sample or proposing membership function. Hence, the current study employed the GST to consider multiple ranks for criteria and alternatives in the OPA method. This is the first time that a sustainable supplier selection framework has been presented for megaprojects with the aid of the Grey OPA (OPA‐G) method. Finally, a case study has been examined to evaluate the performance of the proposed approach. The results show that the proposed approach can be used in real‐world situations and it has acceptable performance under uncertainty conditions.

PurposeTourism industry is a highly complex system surrounded by many uncertainties because of its innumerable connections with other supporting systems. Considering tourism, a grey system, the current study proposes optimistic–pessimistic method (OPM). This technique can aid in improving forecast accuracy of four tourism-related indicators, inbound tourism to China, outbound tourism from China, revenues collected through inbound tourism and expenses incurred on outbound tourism.Design/methodology/approachThe study integrates OPM into EGM and then using the secondary data collected from the World Bank database, predicts the four tourism-related indicators. The mean absolute percentage error steered the performance of the models.FindingsOne of the main contributions of the study lies in its overall evaluation of one of the major travel and tourism countries of the world in light of four crucial indicators. The study highlights, four tourism-related indicators' recent information, contains more valuable information about the future.Originality/valueOPM represents a novel application of concept of whitenization of interval grey number in grey forecasting theory.

The study proposes a novel, convenient and dimensionless model of multi-criteria decision-making (MCDM), hereby referred to as Grey Absolute Decision Analysis (GADA) method. The foundation of the GADA method rests upon the Absolute Grey Relational Analysis (Absolute GRA) model and the system that the method follows to produce GADA Indexes and GADA Weights. The GADA Weights represent the relative weights of decision alternatives under given criteria. The method can handle both positive (“higher the better”) and negative (“lower the better”) criteria simultaneously in its algorithm. The method can deal with problems involving uncertainty and incomplete data. Two practical cases have been presented in the study to demonstrate the feasibility of the method. Furthermore, the GADA Weights obtained for the cases show that these values are comparable to the relative weights obtained through the traditional methods like AHP and SAW thus signifying the feasibility of the method. However, the conventional methods do not consider the mutual association between the judgments of the members of decision-making group (experts’ opinions), a weakness that the proposed method overwhelms. Therefore, the overall ranking obtained from the proposed method is acceptable, especially under the uncertain environment where the nature of mutual association between the judgments is not precise. The key benefit of the method lies in its adaptability to different scales of measurement. Also, it can provide relative weights and rankings of experts, criterion and alternatives. These benefits make the GADA method significant among the class of MCDM methods.

Purpose The purpose of this paper is to study the effect of nano alumina (Al2O3) on the properties of fresh concrete, hardened concrete and microstructure of concrete incorporated with high range water reducer (HRWR). This initiative was taken to improve characteristic properties of concrete using nano alumina because nano alumina can be easily be manufactured from a scrap of industrial aluminum products, so its incorporation in concrete will not only reduce industrial aluminum waste but will also change the morphology of concrete at the microstructural level. Design/methodology/approach To accomplish the objectives of the research, four different concrete mixes with the constant water–cement ratio (W/C) and superplasticizer (SP) content 0.4 and 0.6% by weight of cement, respectively, were prepared, whereas nano alumina content was altered by 0.3% and 0.4% by weight of cement. Fresh property of concrete was analyzed by using slump cone test, whereas hardened properties of concrete were analyzed through compression test and flexural strength test. The interaction of nano alumina with concrete composite was evaluated using an X-ray diffraction test. Findings It was observed that 0.6% superplasticizer by weight of cement increased workability by 22% but with the addition of 0.3%, nano alumina by weight of cement workability decreased by 31%. Compressive strength increased by 4.88% with the addition of 0.6% superplasticizer but with the addition of 0.3% nano alumina by weight of cement compressive strength increased by 18.60%. Also, flexural strength increased by 1.21% with the addition of 0.6% superplasticizer by weight of cement but with the addition of 0.3% nano alumina by weight of cement flexural strength increased by 8.76%. With the addition of superplasticizer, alite and belite phases remained un-hydrated but with the addition of nano alumina alite phase was hydrated while belite phase was un-hydrated. The size of belite crystals in mixes having nano alumina was less than that of mix having 0.6% superplasticizer. Also with the addition of nano alumina, a calcium aluminum silicate phase was formed which was responsible for the increment of strength in mixes having nano alumina. Originality/value Incorporation nano alumina (Al2O3) in concrete will not only reduce industrial aluminum waste but will also reduce CO2 emission. Nano alumina (Al2O3) also changes morphology of concrete at micro structural level.

Purpose The study aims to introduce two new models of project scheduling by incorporating potential quality loss cost (PQLC) in time–cost tradeoff problems by overcoming the drawbacks of the existing Kim, Khang and Hwang (KKH) model. The proposed methods are named the Revised KKH-I (RKKH-I) and Revised KKH-II (RKKH-II) models for project scheduling. Design/methodology/approach The performance of the existing KKH model has been tested using a numerical example followed by the identification of the main shortcomings of the KKH method. Later, a concrete effort has been made to address its shortcomings while improving its performance significantly. The comparative analysis of the Revised KKH models with the original model has also been presented along with sensitivity analyses. Findings The study recognizes that the construct on which the original KKH method was built is important; however, certain drawbacks make it unable to consider PQLC in projects, thus making its practical use questionable. The comparative analysis of the proposed methodology with the original method demonstrated that the new models (RKHH-I and II) are more comprehensive and intelligent than the existing KKH model. Originality/value The comparative analysis of the original KKH model and its improved version reveals that the revised model is far more suitable for project scheduling. The study is important for project managers who recognize project scheduling being one of the key parameters associated with project management process, crucial to control every day during the management of projects.

The construction industry has been recognized as one of the crucial industries of a country. In large-scale public projects, it is frequently observed that the client, who serves the public, seeks the services of several sub-contractors (project outsourcing firms) to execute projects. It also seeks the consulting firms' services to monitor the progress and performance of these sub-contractors. However, performance evaluation of a large number of sub-contractors is not only a challenging phase but also a source of conflict and mistrust between the evaluators and evaluatees because of the subjectivity in the evaluation process. The current study classifies perceived organizational performance into two streams, arguing that the one involving the opinions from the independent evaluators is more objective than the self-evaluation one. The study also makes a pioneering attempt in post-qualification performance evaluation of sub-contractors through the Ordinal Priority Approach (OPA), a promising multi-attribute decision-making methodology. The deployment of the OPA allows the decision-makers to estimate the weights of the evaluation criteria, the sub-contractors to be evaluated, and the experts who evaluated them simultaneously. Thus, the methodology can minimize the causes of mistrust by uncovering unreliable experts and inappropriate criteria. Also, a novel Relative Performance Index (RPI) has been proposed to standardize the performance evaluation system. The results show that evaluation of the firms does not end at their evaluation as without evaluating the evaluators, such an evaluation is only partially effective.

Aim: The investigation planned to decide pervasiveness, examples and danger variables of protective medication by obstetricians and gynecologists across Pakistan. Plan This is a poll study by composed and on the web meet for members. Methods: Among 1823 enrolled doctors in Obstetricians and Gynecologists Association in Lahore, Pakistan, from March 2019 To February 2020, 1488 members (84.6%) reacted the study. Our current research was conducted at Mayo Hospital, Lahore from March 2019 To February 2020. Fundamental result quantifies Participants' emphatically dissented/differ and firmly concurred/concurred alternatives were contrasted with decide explicit variables contributing to their inclinations towards protective medication. Results: Of the total 1486 members, 904/1488 (62.9%), 283/1489 (19.0%) and 170/283 (60.1%) members had encountered clinical debate, claim or loss of claim, separately; and 1284 (86.4%) members had had their associates presented with clinical debate, claim or loss of claim. Overall, 64.8 per cent of members unequivocally agreed or agreed with supervised medication. Sexual orientation, organizational obligation, business clinic, training status, subspecialty, introduction to any clinical issues, claims or loss of claim, and associate meetings were free risk factors applicable to members' inclinations toward protected medications in a multivariate model. Members were more likely to recognize or adopt a protected medication if they were female physicians, had no regulatory obligations, worked in non-tertiary emergency clinics, had a university degree, had been introduced to clinical issues, claims or loss of a claim, or had seen comparable associate encounters. Conclusion: About 67% of Chinese doctors rehearsing obstetrics and gynecology in our overview concurred with the act of protective medication, however they had assorted inclinations and comprehension of explicit practices, damages of cautious medication and doctor's jobs. Keywords: Associated Risk Factors, Defensive Medicine, Obstetricians, Gynecologists Throughout Pakistan.

Aim: To assess the possibility and viability of laparoscopic the board of confusions without transformation to laparotomy in gynecologic laparoscopic surgery. Methods: We examined significant intricacies during gynecologic laparoscopic medical procedure. In view of patients' clinical records, we detailed sorts of laparoscopic medical procedure, kinds of entanglement, early acknowledgment of inconveniences, furthermore, treatment strategy for complexities. Our current research was conducted at Mayo Hospital, Lahore from May 2019 to April 2020. Results: Overall, 34 (2.25%) mix-ups occurred in this survey. There were 18 (0.67%) bladder injuries, 6 (0.22%) significant vessel injuries, 4 (0.13%) interior injuries, 3 (0.11%) ureteral injuries, 2 (0.07%) diaphragmatic injuries, and 1 (0.06%) unfamiliar intravesical body. In total, 32 of the 6 injuries were effectively repaired by laparoscopy. In one case, the rectal hole occurred on the third day after the medical procedure; Hartmann's activity followed by colostomy inversion was performed. Conclusion: Laparoscopic the board of intricacies in gynecologic laparoscopic medical procedure is achievable and productive. Keywords: viability of laparoscopic, transformation to laparotomy, gynecologic laparoscopic surgery.

Ahmed, Javed, Chakraborti, Atanu, Hill, David E. (2020): First record of Thiania cf. subopressa Strand 1907 (Araneae: Salticidae: Euophryini) from India with some natural history notes on the species. Peckhamia 214 (1): 1-5, DOI: http://doi.org/10.5281/zenodo.7170965, {"references":["Ahmed, J., S. Laha and R. J. Pearce. 2019. First record of the genus Afraflacilla Berland & Millot, 1941 in India (Araneae: Salticidae: Chrysillini). Peckhamia 190.1: 1-3.","Ahmed, J., R. Khalap, D. E. Hill, Sumukha J. N. and K. Mohan. 2017. First record of Brettus cingulatus from India, with a review of Brettus in South and Southeast Asia (Araneae: Salticidae: Spartaeinae). Peckhamia 151.1: 1-13.","Ahmed, J., D. E. Hill, I. Banerjee, R. Khalap, R. J. Pearce and K. Mohan. 2018. First record of the genus Neobrettus Wanless 1984 from India, with some natural history notes (Araneae: Salticidae: Spartaeina). Peckhamia 166.1: 1-13.","Aronson, M. F. J., C. A. Lepczyk, K. L. Evans, M. A. Goddard, S. B. Lerman, J. S. MacIvor, C. H. Nilon and T. Vargo. 2017. Biodiversity in the city: key challenges for urban green space management. Frontiers in Ecology 15 (4):189-196.","Dan. 2010. Thiania subopressa - ♀. Online at https://bugguide.net/node/view/365401","HBS. 2000. Records of the Hawaii Biological Survey for 1999 - Part 2: Notes. Bishop Museum Occasional Papers 64: 1-63.","Lowe, E., C. G. Threlfall, S. M. Wilder and D. F. Hochuli. 2017. Environmental drivers of spider community composition at multiple scales along an urban gradient. Biodiversity and Conservation 27 (4): 829-852.","Li, D., S. H. Yik and W. K. Seah. 2002. Rivet-like nest-building and agonistic behaviour of Thiania bhamoensis, an iridescent jumping spider (Araneae: Salticidae) from Singapore. Raffles Bulletin of Zoology 50 (1): 143-151.","Murphy, F. and J. Murphy. 2000. An introduction to the spiders of South East Asia with notes on all the genera. Malaysian Nature Society, Kuala Lumpur. 1-388.","Suguro, T. 2012. Thiania suboppressa Strand 1907 (Araneae: Salticidae), new to Japanese fauna. Acta Arachnologica 61: 27-30.","WSC. 2020. World Spider Catalog. Version 21.0. Natural History Museum Bern, online at http://wsc.nmbe.ch, accessed on 26 JUN 2020, doi: 10.24436/2","Wesolowska, W. 1981. Salticidae (Aranei) from North Korea, China and Mongolia. Annales Zoologici, Warszawa 36: 45-83.","Zabka, M. 1985. Systematic and zoogeographic study on the family Salticidae (Araneae) from Viet-Nam. Annales Zoologici, Warszawa 39: 197-485."]}

Introduction Obesity can adversely impact efficacy and safety of AF ablation. NHS England have recently proposed restricting ablation in obese AF patients to those who demonstrate >10% reduction in body weight. The feasibility of this degree of weight reduction in a tertiary NHS AF clinic, and its impact on efficacy and safety of AF ablation has not been reported. Methods Consecutive AF patients with BMI>30 seen in an arrhythmia clinic were given advice to follow the 5:2 diet while on the waiting list for AF ablation. The diet involved calorie restriction to Results 58 patients (mean age was 65.2 [±9.7] years, 50% males, 64% persistent AF) with a mean baseline weight of 109.1 (±16.8) kgs, BMI of 36.7 (±4.1) were prescribed the 5:2 diet. Following a median of 5.3 (IQR 1.7-15.1) months, a mean weight loss of 8.1 (±7.5) kg was observed prior to AF ablation, p 10%, 3-10% and Conclusions Weight loss of >3% body weight can be achieved in the majority of patients seen in a tertiary AF clinic with a simple dietary advice, although weight reduction of greater than 10% is seen in only a minority. Modern AF ablation practice results in encouraging procedural safety as well as medium-term arrhythmia free survival rates in this traditionally difficult population, with no influence observed in our cohort of significant weight reduction. Whether this is because of advanced arrhythmia substrate by the time patients are referred for ablation is unclear. Conflict of Interest None

We propose a low-cost, easy-to-fabricate, contactless microwave sensor for dielectric characterization of liquids. The design of the proposed sensor is based on a multiple complementary split-ring resonator (MCSRR) fabricated on a low-cost FR-4 substrate. A glass capillary tube having an inner diameter of 0.008λ0 is inserted in the high electric field region of the MCSRR to carry the liquid under test. The sensor is designed to operate at a resonant frequency of 2.45GHz for an empty tube and shifted resonant peaks are utilized for the dielectric characterization of different liquids. The maximum observed shifts in resonant frequency and Q factor are up to 400MHz and 31, respectively. The numerically established relations are experimentally verified through fabricated sensor for various binary mixtures of water and ethanol. The percentage errors between the calculated and reference permittivity of different samples are noticed to be less than 5%. The proposed device promises to be a cost-effective and convenient solution for accurate dielectric characterization of liquids and their binary aqueous solutions.

Percutaneous coronary intervention (PCI) of severely calcified lesions is known to result in lower procedural success rates, higher complication rates, and worse long-term clinical outcomes compared to noncalcified lesions. Adequate lesion preparation through calcium modification is crucial in ensuring procedural success and reducing adverse cardiovascular outcomes. There are numerous calcium modification devices currently available whose usefulness depends on the nature of the calcific disease and its anatomical distribution. It can be challenging for the interventionists to decide which device is best suited for their patient. There is also emerging evidence for intravascular imaging in guiding selection of calcium modification devices using parameters such as calcium distribution and depth that directly impact on procedural success and clinical outcomes. In this review we aim to discuss the pathophysiology of coronary calcification, evaluate strategies and technologies of calcium modification and propose an A-M-A-S-A algorithm in managing calcified coronary lesions.

Neuropathic pain (NeP) is a global cause of suffering and debilitation leading to significant morbidity and reduced quality of life. New treatments are needed to address the growing prevalence of NeP and its impact on sleep, mood and functionality. Mirogabalin besylate (mirogabalin, Tarlige) is a gabapentinoid therapy developed by Daiichi Sankyo which is approved in Japan for the treatment of postherpetic neuralgia and painful diabetic peripheral neuropathy. Mirogabalin has a potent pain-modulating effect with a unique high affinity and prolonged dissociation rate for the a2delta-1 subunit of voltage-gated calcium (Ca2+) channels (VGCCs) on the dorsal root ganglion resulting in more sustained analgesia compared with traditional gabapentinoids. Additionally, mirogabalin has a superior adverse events (AEs) profile due to a rapid dissociation from the a2delta-2 subunit of VGCCs potentially implicated in central nervous system-specific AEs. The most common AEs for mirogabalin are dizziness (approximately 8-16%), somnolence (approximately 6-24%) and headache (approximately 6-14%), with a lower incidence of constipation, nausea, diarrhea, vomiting, edema, fatigue and weight gain. Postmarketing studies are required to evaluate its analgesic durability and efficacy when combined with other antineuropathic agents such as tricyclics, duloxetine and tramadol/tapentadol.

Shape optimization and heat analysis of heat exchangers are important areas of research that are seeking attention among scholars from thermal engineering and related fields since decades. In the 123rd volume of Applied Thermal Engineering a paper entitled “Shape optimization of welded plate heat exchangers based on grey correlation theory” was published. The current study exposed not only the inappropriate execution of Deng’s Grey Relational Analysis model, which is referred to as grey correlational theory in that publication, but also some miscalculations. Problem with the design of the experiment and other issues have also been reported. These mistakes, along with the fact that some crucial data was missing from that publication, make the reproducibility of the certain results in that publication problematic, and are highlighted in the current study. The study is particularly important for industrial heat analysts and the researchers interested in multi-objective optimization through grey methods.

PurposeMucopolysaccharidoses (MPSs) are a heterogeneous group of lysosomal storage disorders. Ocular complications (such as corneal clouding, retinopathy and optic neuropathy) are common. Notably, there is a paucity of data on the effect of genotype and systemic treatments (enzyme replacement therapy or haematopoietic stem cell transplantation) on the ocular phenotype in MPS. We prospectively studied the ocular features of patients with MPSI (Hurler/Hurler-Scheie/Scheie), MPSIV (Morquio) and MPSVI (Maroteaux-Lamy), to evaluate the effect of different therapeutic interventions and to correlate the findings with genetic and biomarker data.MethodsProspective observational cohort study. Study participants underwent detailed ocular examination including visual acuity; assessment of corneal clouding (Iris camera Corneal Opacification Measure score and Pentacam densitometry) and retinal and optic nerve imaging (optical coherence tomography and wide-field fundus imaging). Data on genotype, biomarkers and delivered therapies (type and length of treatment) were also collected for each patient where available.ResultsOverall, 21 patients with MPSI, 4 patients with MPSIV and 3 patients with MPSVI were recruited. Corneal clouding scores were higher in MPSI compared with MPSIV and MPSVI. Retinopathy was evident in patients with MPSI only. Association was observed between corneal clouding and biomarkers in MPSI, MPSIV and MPSVI. However, no clear association was seen between genotype or treatment type and ocular phenotype.ConclusionsThe ocular phenotype in MPS is variable, with corneal clouding occurring in MPSI, MPSIV and MPSVI, and retinopathy in MPSI only. There was an association between corneal clouding and efficacy of systemic treatment as measured by biomarkers.

Purpose The purpose of this paper is to analyse the relationship between outpatient satisfaction and the five constructs of healthcare projects’ service quality in Pakistan using Deng’s grey incidence analysis (GIA) model, absolute degree GIA model (ADGIA), a novel second synthetic degree GIA (SSDGIA) model and two approaches of decision-making under uncertainty. Design/methodology/approach The study proposes a new synthetic GIA model and demonstrates its feasibility on data (N=221) collected from both public and private sector healthcare projects of Punjab, the most populous province of Pakistan, using a self-administered questionnaire developed using the original SERVQUAL approach. Findings The results of decision analysis approach indicated that outpatients’ satisfaction from the private sector healthcare projects is higher as compared to the public healthcare projects’. The results from the proposed model revealed that tangibility and reliability play an important role in shaping the patient satisfaction in the public and private sectors, respectively. Originality/value The study is pioneer in evaluating a healthcare system’s service quality using grey system theory. The study proposes the SSDGIA model as a novel method to evaluate parameters comprehensively based on their mutual association (given by absolute degree of grey incidence) and inter-dependencies (given by Deng’s degree of grey incidence), and tests the new model in the given scenario. The study is novel in terms of its analysis of data and modelling. The study also proposes a comprehensive structure of the healthcare delivery system of Pakistan.

The purpose of this paper is to empirically analyze the effect of the relationship between trust in top management (TTM) and trust in immediate supervisor (TIS), who was organizational project manager in our case, on perceived organizational performance in Pakistani public and private project-based organizations (PBOs).,The survey (N=108) was done using a questionnaire that was sent to project managers in the selected PBOs in Pakistan with a request to forward it to their immediate subordinates. Later, established statistical techniques (correlation and regression analyses) and gray incidence analysis models were applied to test the hypotheses.,The results from both methods reveal that TTM was more strongly correlated to perceived organizational performance of PBOs and, in general, public sector employees are more trusted than private sector employees. The gray method revealed that in both private and public PBOs, trust in project manager is greater predictor of perceived organizational performance, while statistical analysis confirmed this only for private sector PBOs. According to statistical analysis, the public sector employees who trust their top management are more likely to have good perception of the organizational performance. Later, the study argues that because of the proven superiority of gray methods over statistics on small samples, the results obtained from gray method should be used for decision making and implications.,The study is pioneer in evaluating the association between TIS and TTM in PBOs using both statistical and gray systems methods.

Purpose This review provides an update on the investigations and treatment options for gastroparesis. Methods A comprehensive literature search of Medline, PubMed, Embase and OVID was conducted which included all systematic reviews and research articles that focused on the diagnosis, investigations and management diabetic gastroparesis. Findings Dietary modifications and pharmacologic treatment with prokinetics to increase gastric motility form the mainstay of treatment. However, the use of prokinetics is limited by adverse effects and serious adverse effects, leaving metoclopramide as the only drug approved by the US Food and Drug Administration for the treatment of gastroparesis. Newer therapies, including motilin receptor agonists, ghrelin receptor agonists, and neurokinin receptor antagonists, are currently being investigated. Transpyloric stenting, gastric electrical stimulation, and gastric per-oral endoscopic myotomy provide mechanical options for intervention, and surgical interventions in severe intractable gastroparesis include laparoscopic pyloroplasty or gastrectomy. Implications Advances to better understand the pathophysiology and management of diabetic gastroparesis have been limited, especially with discordance between symptoms and severity of delay in gastric emptying. Established treatment options are limited; however, recent pharmacologic and surgical interventions show promise.

With the COVID-19 pandemic spreading across the world, its disruptive effect on the provision and utilization of non- COVID related health services have become well-documented. As countries developed mitigation strategies to help continue the delivery of essential health services through the pandemic, they needed to carefully weigh the benefits and risks of pursuing these strategies. In an attempt to assist countries in their mitigation efforts, a Benefit-Risk model was designed to provide guidance on how to compare the health benefits of sustained essential reproductive, maternal, newborn and child (RMNCH) services against the risk of SARS-CoV-2 infections incurred by the countries’ populations when accessing these services. This article describes how two existing models were combined to create this model, the field-testing process carried out from November 2020 through March 2021 in six countries and the findings. The overall Benefit-Risk Ratio in the 6 countries analyzed was found to be between 13.7 and 79.2, which means that for every 13.7 to 79.2 lives gained due to increased RMNCH service coverage, there was one loss of a life related to COVID-19. In all cases and for all services, the benefit of maintaining essential health services far exceeded the risks associated with additional COVID-19 infections and deaths. This modelling process illustrated how essential health services can continue to operate during a pandemic and how mitigation measures can reduce COVID-19 infections and restore or increase coverage of essential health services. Overall, this Benefit-Risk analysis underscored the importance and value of maintaining coverage of essential health services even during public health emergencies, including the recent COVID-19 pandemic

PURPOSE: To determine whether the ocular phenotype in patients with mucopolysaccharidosis type I (MPSI) Hurler is affected by the efficacy of previous haemopoietic stem cell transplantation (HSCT).DESIGN: A retrospective cohort study of patients with MPSI who had undergone treatment with HSCT.METHODS: Ocular phenotype was documented for each patient and compared to levels of biomarkers representing efficacy of previous transplantation.MAIN OUTCOME MEASURES: Assessment of visual acuity (VA), severity of corneal clouding and the presence of optic neuropathy or retinopathy. Biomarker assessment included dermatan sulphate/chondroitin sulphate (DS/CS) ratio and iduronidase enzyme level.RESULTS: Severe corneal clouding was significantly greater in patients with lower iduronidase levels (p = 0.023) and raised DS/CS ratio (R2 = 0.28 p = 0.043). Better VA was related to a higher iduronidase levels (R2 = 0.15, p = 0.004) and lower DS/CS ratio (R2 = 0.38, p = 0.001).CONCLUSION: Improved ocular phenotypes in MPSI are associated with markers signifying efficacy of prior transplant. Early and effective HSCT may result in a better visual prognosis and reduction in ocular complications for patients with MPSI.

Malware development has seen diversity in terms of architecture and features. This advancement in the competencies of malware poses a severe threat and opens new research dimensions in malware detection. This study is focused on metamorphic malware, which is the most advanced member of the malware family. It is quite impossible for anti-virus applications using traditional signature-based methods to detect metamorphic malware, which makes it difficult to classify this type of malware accordingly. Recent research literature about malware detection and classification discusses this issue related to malware behavior. The main goal of this paper is to develop a classification method according to malware types by taking into consideration the behavior of malware. We started this research by developing a new dataset containing API calls made on the windows operating system, which represents the behavior of malicious software. The types of malicious malware included in the dataset are Adware, Backdoor, Downloader, Dropper, spyware, Trojan, Virus, and Worm. The classification method used in this study is LSTM (Long Short-Term Memory), which is a widely used classification method in sequential data. The results obtained by the classifier demonstrate accuracy up to 95% with 0.83 $F_1$-score, which is quite satisfactory. We also run our experiments with binary and multi-class malware datasets to show the classification performance of the LSTM model. Another significant contribution of this research paper is the development of a new dataset for Windows operating systems based on API calls. To the best of our knowledge, there is no such dataset available before our research. The availability of our dataset on GitHub facilitates the research community in the domain of malware detection to benefit and make a further contribution to this domain.

Diabetic peripheral neuropathy in people with type 2 diabetes is poorly managed because of its insidious onset, delayed diagnosis and more complex aetiology resulting from the contribution of not only hyperglycaemia, but also ageing, hyperlipidaemia, hypertension and obesity. Because there is no US Food and Drug Adminstration-approved disease-modifying therapy for diabetic peripheral neuropathy, the key to ameliorating it in type 2 diabetes has to be through earlier diagnosis and timely multi-factorial risk factor reduction. The management of painful diabetic peripheral neuropathy also requires a detailed appraisal of the choice of therapy, taking into account efficacy, patient wishes, comorbidities, side effect profile and potential for abuse.

The study makes pioneer attempt in proposing Grey Group QUALIFLEX method. With the aid of the concept of grey numbers, the current study extends the paradigm on which the original QUALIFLEX model was built. After presenting the preliminaries and algorithm, the study shows the feasibility of the proposed model by executing it on a project management case, where the proposed method has been used to rank different project managers based on the experts’ opinions. The study is a valuable addition in multi-criteria group decision making research and is particularly useful for the decisionmakers looking for flexible, convenient and inclusive method able to handle both linguistic and crisp input data under uncertainty.

Ahmed, Javed, Laha, Supratim, Pearce, Richard J. (2019): First record of the genus Afraflacilla Berland & Millot, 1941 in India (Araneae: Salticidae: Chrysillini). Peckhamia 190 (1): 1-3, DOI: http://doi.org/10.5281/zenodo.7170519, {"references":["Aronson, M. F. J., C. A. Lepczyk, K. L. Evans, M. A. Goddard, S. B. Lerman, J. S. MacIvor, C. H. Nilon and T. Vargo. 2017. Biodiversity in the city: key challenges for urban green space management. Frontiers in Ecology 15 (4):189-196.","Cao, Q., S. Li and M. Zabka. 2016. The jumping spiders from Xishuangbanna, Yunnan, China (Araneae, Salticidae). Zookeys. 630: 43-104.","Lowe, E., C. G. Threlfall, S. M. Wilder and D. F. Hochuli. 2017. Environmental drivers of spider community composition at multiple scales along an urban gradient. Biodiversity and Conservation 27 (4): 829-852.","Maddison, W. 2015. A phylogenetic classification of jumping spiders (Araneae: Salticidae). Journal of Arachnology 43 (3): 231-292.","WSC. 2019. World Spider Catalog. Version 20.5. Natural History Museum Bern, online at http://wsc.nmbe.ch, accessed on 1st. SEP. 2019. doi: 10.24436/2","Zabka, M. 1993. Salticidae (Arachnida: Araneae) of the Oriental, Australian and Pacific regions. IX. Genera Afraflacilla Berland & Millot 1941 and Evarcha Simon 1902. Invertebrate Taxonomy 7 (2): 279-295.","Zabka, M. and M. R. Gray. 2002. Salticidae (Arachnida: Araneae) from Oriental, Australian and Pacific Regions, XVI. New species of Grayenulla and Afraflacilla. Records of the Australian Museum. 54 (3): 269-274."]}

Ahmed, Javed, Khalap, Rajashree, Kumbhar, Somnath, Hill, David E., Pearce, Richard J., Mohan, Krishna (2019): Field notes on the jumping spider Telamonia dimidiata in Maharashtra (Araneae: Salticidae: Plexippina). Peckhamia 181 (1): 1-6, DOI: http://doi.org/10.5281/zenodo.7169300, {"references":["Ahmed, J., K. Mohan, R. Khalap and D. E. Hill. 2015. Araneophagic behavior in Plexippus petersi (Karsch 1878) (Araneae: Salticidae: Plexippoida: Plexippinae). Peckhamia 132.1: 1-4.","Ahmed, J. and Y. Satam. 2015. The structure and utilization of silk constructs by Hyllus semicupreus (Simon, 1885) (Araneae: Salticidae). Peckhamia 125.1: 1-3.","Hill, D. E. 2010. Sunda to Sahul: Trans-Wallacean distribution of recent salticid genera (Araneae: Salticidae). Peckhamia 80.1: 1-60.","Hill, D. E. 2018a. Notes on the jumping spiders Colonus puerperus (Hentz 1846) and Colonus sylvanus (Hentz 1846) in the southeastern United States (Araneae: Salticidae: Amycoida: Gophoini). Peckhamia 99.2: 1-63.","Hill, D. E. 2018b. Jumping spiders of the Phidippus princeps group in the southeastern United States (Araneae: Salticidae: Dendryphantina). Peckhamia 169.1: 1-72.","Hill, D. E., Abhijith A. P. C. and J. P. Burini. 2019. Do jumping spiders (Araneae: Salticidae) draw their own portraits? Peckhamia 179.1: 1-14.","iNaturalist. 2019. Two-striped Telamonia (Telamonia dimidiata), at https://www.inaturalist.org/taxa/148396-Telamoniadimidiata, accessed 16 MAR 2019.","Jackson, R. R. 2000. Prey preferences and visual discrimination ability of Brettus, Cocalus and Cyrba, araneophagic jumping spiders (Araneae: Salticidae) from Australia, Kenya and Sri Lanka. New Zealand Journal of Zoology 27 (1): 29-39.","Jackson, R. R. and S. E. A. Hallas. 1986. Comparative biology of Portia africana, P. albimana, P. fimbriata, P. labiata, and P. shultzi, araneophagic, web-building jumping spiders (Araneae: Salticidae): Utilisation of webs, predatory versatility, and intraspecific interactions. New Zealand Journal of Zoology 13: 423-489.","Kumbhar, S. 2019. Rehne [Rhene] sp. predation on Telamonia dimidiata (female), video at https://www.youtube.com/watch? v=FG8v3KKeG8Y&feature=share","Maddison, W. P. 2015. A phylogenetic classification of jumping spiders (Araneae: Salticidae). Journal of Arachnology 43: 231-292.","Nasir, M. D. M. 2016. Distribution of spiders In Malaysia with special emphasis of the systematics and ecology of the orb-web spider (Araneae: Tetragnathidae). PhD Thesis, University of Malaysia, Kuala Lumpur.","Preston-Mafham, K. G. and A. Cahill. 2000. Female-initiated copulations in two tetragnathid spiders from Indonesia: Leucauge nigrovittata and Tylorida ventralis. Journal of Zoology 252 (4): 415-420.","Raut, V. 2015. Two-striped Telamonia, Telamonia dimidiata, at http://www.inaturalist.org/photos/1683520","Roy, T. K., S. Saha, S. and D. Raychaudhuri. 2016. A treatise on the jumping spiders (Araneae: Salticidae) of tea ecosystem of Dooars, West Bengal, India. World Scientific News 53 (1): 1-66.","Sen, S., D. C. Dhali, S. Saha and D, Raychaudhur. 2015. Spiders (Araneae: Arachnida) of Reserve Forests of Dooars: Gorumara National Park, Chapramari Wildlife Sanctuary and Mahananda Wildlife Sanctuary. World Scientific News 20: 1-339.","Simon, E. 1899. Contribution a la faune de Sumatra. Arachnides recueillis par M. J. L. Weyers, a Sumatra. Deuxieme memoire. Annales de la Societe Entomologique de Belgique 43: 78-125.","Sudhikumar, A. V., M. J. Mathew, E. Sunish, S. Murugesan and P. A. Sebastian. 2005. Preliminary studies on the spider fauna in Mannavan shola forest, Kerala, India (Araneae). European Arachnology 2005, Acta Zoologica Bulgarica Supplement No. 1: 319-327.","Thorell, T. 1887. Viaggio di L. Fea in Birmania e regioni vicine. II. Primo saggio sui ragni birmani. Annali del Museo Civico di Storia Naturale di Genova 25: 5-417.","WSC. 2019. World Spider Catalog. Version 20.0. Natural History Museum Bern, at http://wsc.nmbe.ch, accessed 15 MAR 2019."]}

The prevalence of diabetic peripheral neuropathy and painful diabetic peripheral neuropathy in the Middle East shows huge variability. This reflects the differing diagnostic techniques employed to diagnose neuropathy, but also the heterogeneity of the populations studied and the selection of populations from primary and secondary care. The treatment of diabetic neuropathy per se is inadequate as reflected by the poor control of risk factors such as glucose control, blood pressure and lipids in this region, which translates into the high rates of foot ulceration and amputation. In relation to symptomatic treatment, recommendations based on trials conducted in the West are without question, endorsed for the treatment of populations in the Middle East. Surely the demographics and patient responses both in terms of efficacy and side effects differ and therefore warrant local clinical trials. There is an over reliance on the prescription of B vitamins with the claim that they induce nerve repair. Whilst there is evidence for the relief of neuropathic symptoms with both vitamin B and D, again clinical trials are required in this region to establish their role in the treatment of diabetic neuropathy and painful diabetic neuropathy.