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Objective: To determine the association of socio-demographic and clinic-pathological risk factors with oral cancer in Kelantan, Malaysia. Material and Methods: A 19-year cross-sectional survey was performed in Hospital Universiti Sains Malaysia (HUSM), Malaysia. Medical record of 301 oral cancer patients was retrieved from the Medical Records office. Results: The majority of the oral cancer cases were male (62.8%), non-smokers (57.5%), non-alcohol consumers (83.4%), non-betel quid chewers (96.7%), and belonged to Malay ethnicity (68.8%). At the time of diagnosis, most of the patients were at stage II (38.9%). Approximately one-third (30.6%) of the total OC patients experienced loco-regional/distant metastasis, whereas no metastasis was detected in around two-thirds of cases (69.4%). A combination of surgery and radiotherapy was the most commonly employed treatment modality (27.2%). At the time of this study, the survival status of most of the patients was alive (69.1%). The most frequently encountered oral cancer in the Kelantanese population was oral squamous cell carcinoma (70.1%), with the tongue being the most frequently involved oral cavity site (35.5%). Conclusion: More than three-fourths of the cases were alive at follow-up, which included the cases that did not undergo any form of treatment.

Electrical resistivity tomography (ERT) has turned out to be one of the most applied and user-friendly geophysical methods in geotechnical and geoenvironmental research. ERT is an emerging technology that is becoming popular nowadays for investigating subsurface conditions. Multiple attributes of the technology using various electrode configurations significantly reduce measurement time and are suitable for applications even in hardly accessible mountain areas. It is a noninvasive test for subsurface characterization and a very sensitive method used to determine geophysical properties, i.e., structural integrity, water content, fluid composition, etc. This paper aimed to elucidate the ERT technique's main features and applications in geotechnical and geoenvironmental engineering through four case studies. The first case study investigated the possible flow paths and areas of moisture accumulation after leachate recirculation in a bioreactor landfill. The second case study attempted to determine the moisture variation along highway pavement. The third case study explored the slope failure investigation by ERT. The fourth case study demonstrated the efficiency of the ERT method in the landfill evapotranspiration (ET) cover to investigate moisture variation on a broader scale and performance monitoring. In all of the four cases, ERT exhibited promising performance. [ABSTRACT FROM AUTHOR]

Background: Severe sepsis and septic shock are two major causes of death in children with sepsis. The Pediatric risk of mortality (PRISM) score allows for mortality risk assessment in the pediatric ICU. It is institution-independent and can be used within limits to compare different intensive care units. Materials and Methods: It was a prospective observational hospital based study. All patients admitted in the Paediatric Intensive Care Unit between the age group of one month to 14 years who fulfilled the inclusion criteria were prospectively observed and details were recorded in a predesigned proforma. Critical illness severity was estimated with the Paediatric Risk of Mortality (PRISM III-24) score. Results: 30 patients (14 males & 16 females) were included in the study&mortality rate of 40.0% was witnessed.29(96.7%) patients were given pressor support. In terms of outcome, 17(94.4%) of the 18 discharged patients received pressor support and 01(5.6%) of them did not receive any pressor support. On the other hand, all 12 expired patients received pressor support (P=0.406). 25(83.3%) patients required mechanical ventilation. In terms of outcome, 14(77.8%) of the discharged patients required mechanical ventilation while 04(22.2%) of them did not require it. On the other hand, out of 16 patients who expired, 11(91.7%) required mechanical ventilation while 01(8.3%) did not require it (P=0.317). None of the patients, either from the discharged ones or from the expired ones, had a low-risk HsCRP level(<3). The mean PRISM III Score at admission in discharged patients was 20.5±3.65 and the mean PRISM III Score at admission in expired patients was 23.25±1.76 (P=0.01). The mean PRISM III score at 24 hours in discharged patients was 17.33±4.46 and the mean PRISM III score in expired patients was 22.50±1.50 (P=0.001). When analyzed in specificity versus threshold (ROC) curve, PRISM III Score was significant at both time intervals i.e., at admission (P=0.019) and at 24 hours (P=0.003). Conclusion:. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Different types of diseases have been treated by restricted caloric intake or fasting. Although during this long time, fasting protective measures, for example, supplements, are given to the patients to protect vital organs such as the liver and kidney, little attention is given to the brain. The current research aims to investigate hypoglycemia due to prolonged fasting disrupts blood-brain barrier (BBB) in mice. MATERIALS AND METHODS: Immunohistochemistry (IHC) and in situ hybridization (ISH) techniques were used to examine the expression of different genes. Evans blue extravasation and wet-dry technique were performed to evaluate the integrity of BBB and the formation of brain edema, respectively. RESULTS: We confirmed that hypoglycemia affected mice fasting brain by examining the increased expression of glucose transporter protein 1 and hyperphosphorylation of tau protein. We subsequently found downregulated expression of some genes, which are involved in maintaining BBB such as vascular endothelial growth factor (VEGF) in astrocytes and claudin-5 (a vital component of BBB) and VEGF receptor (VEGFR1) in endothelial cells by ISH. We also found that prolonged fasting caused the brain endothelial cells to express lipocalin-2, an inflammatory marker of brain endothelial cells. We performed Evans blue extravasation to show more dye was retained in the brain of fasted mice than in control mice as a result of BBB disruption. Finally, wet-dry method showed that the brain of prolonged fasted mice contained significantly higher amount of water confirming the formation of brain edema. Therefore, special attention should be given to the brain during treatment with prolonged fasting for various diseases. CONCLUSIONS: Our results demonstrated that hypoglycemia due to prolonged fasting disrupts BBB and produces brain edema in wild-type mice, highlighting the importance of brain health during treatment with prolonged fasting. [ABSTRACT FROM AUTHOR]

Abstract Background Neurological disorders are the most common cause of morbidity and mortality in developing countries. Available evidence on urban–rural differences on neurological diseases is scare in such countries. Our study objective was to determine the prevalence of neurological diseases in urban and rural tertiary care hospitals of Sindh, Pakistan. Methods This was a cross sectional study conducted in selected urban and rural region of tertiary care hospitals of Sindh, Pakistan. The outpatients medical records of adults (18 years and above) was obtained from January 1st, 2014 to December 31st, 2014. Results A total of 10,786 outpatients visit were recorded in this period. Mean age of the participants was 40.6 ± 15 years; majority was females 6104 (56.6%). About three-fourth of the patients were from rural hospital 7828 (72.6%). Common neurological diseases were headache disorders 3613 (33.4%), nerve and root lesion 2928 (27.1%), vascular diseases 1440 (13.3%), epilepsies 566 (5.2%), muscle disorders 424 (3.9%), psychiatric disorders 340 (3.1%) and CNS infection 303 (2.8%). Comparison between the urban and rural samples showed that ischaemic stroke (72.7% vs. 82%) and psychiatric disorders (2.1% vs. 3.5%) were more prevalent in rural area as compared to urban setting. Conclusion Stroke, headache and nerve and root lesion are major causes of neurological disorders in urban and rural settings of Sindh, Pakistan. The policy and planning must be focus on primary care, preventive measures and the promotion of health.

In his commentary, Boike Rehbein questions the hegemony that the Global North maintains over the theory and philosophy of science and calls for an epistemological and disciplinary reinvention. The scientific discourse needs to move away from binaries such as global–national and universalism–relativism, as they are misleading in their exclusivity. Rather, Rehbein calls for a multicentric epistemology informed by local sources, perspectives and theories. Area Studies is identified as a key arena of such an epistemological shift, reinventing itself by becoming increasingly comparative and translocal in scope, as well as inter-/trans- or multidisciplinary. In this context, the values and challenges of cooperation in Area Studies are highlighted. Ahsan Kamal praises Rehbein’s approach as a concrete contribution to decolonising Area Studies and knowledge production, but urges a constant questioning of the location of the North and South, the authenticity of what is deemed the “local”, and the beneficiaries of this new form of knowledge production. Manan Ahmed Asif considers that despite progress being made and Rehbein’s approach having important ethical value, colonialism is still deeply inscribed in Area Studies, as the Global North continues to control the material, financial and organisational resources.

Objective. The aim of this systematic review was to evaluate the effectiveness of laser application in temporomandibular joint disorder. Methods. PubMed, SCOPUS, Science Direct, Web of Science, and Google Scholar electronic databases were searched systematically with restricting the languages to only English and year (January 2001 to March 2020), and studies were selected based on the inclusion criteria. Study quality and publication bias were assessed by using the Robvis, a software package of R statistical software. Results. This systematic review included 32 studies (1172 patients) based on the inclusion and exclusion criteria. Most of the studies reported significant reduction of pain by the use of the laser during TMD treatment. Two-thirds of the study (78.13%) found a better outcome comparing with conventional one. According to Robvis, 84.4% of the studies were high methodological studies with low risk of bias. Conclusion. TMD patients suffer with continuous pain for long time even after conventional treatment. Laser therapy shows a promising outcome of pain reduction for TMD patients. Therefore, laser therapy can be recommended for the TMD patients’ better outcome. This trial is registered with PROSPERO (CRD42020177562).

Moisture and suction variation beneath pavement contribute significantly to the volumetric deformation of expansive subgrade in response to climatic loading. In order to quantify the damage due to climatic loading, estimation of moisture, and suction variation in pavement subgrade is of paramount importance. The objective of the current study is to investigate the moisture and suction variation in response to precipitation events with the aid of numerical modeling in the unsaturated pavement subgrade. In unsaturated soils where the voids are filled with both water and air, the SWCC describes the volume of the voids that remain filled with water as the soil drains pore water. The SWCC has been identified as the vital soil information required to analyze seepage, stability, and volume change problems involved in unsaturated soils. However, the selection of unsaturated flow parameters is typically laboratory-based which represents specific conditions rather than a dynamic scenario of the field. In this study, an attempt was undertaken to conduct numerical modeling using field generated unsaturated flow parameters along with five other predictive models. Results indicated the distinct variation of moisture and suction distribution in subgrade from the same rainfall event while using laboratory versus field generated SWCC unsaturated flow parameters. In addition, predicted model yielded output was also varying with the field generated parameters’ output. Instead of using laboratory-generated static parameters, it was found that field generated dynamic unsaturated flow parameters were able to capture better suction variation at the pavement subgrade.

Water balance covers for landfill closure are used as a barrier which act with the natural processes to reduce percolation. The ideal performance of water balance cover is characterized by the minimal quantity of percolation. The rate of percolation of water balance cover largely depends on unsaturated soil behavior. In this study, percolation was evaluated through unsaturated soil parameters of six instrumented lysimeters. The field instrumentation included moisture sensors, tensiometers, rain gauge, dosing siphon, and pressure transducer. Soil water storage (SWS) capacity (SA) was quantified from the soil water characteristic curves (SWCC) which were developed based on laboratory experiments and field instrumentation data. Required SWS (SR) was also measured from the field monitoring results. Based on analysis, the relative storage ratio (SR/SA) was observed to be greater than unity (1) in most of the cases, indicating potential percolation. The SR/SA was also found competent to identify the lysimeter with higher quantity of percolations. The estimated percolation from the laboratory experimented and field generated SWCCs fairly resembled with the actual field measured percolation. The analyzed results also developed a framework to estimate the thickness of the cover storage layer required to manage percolation for the specific region of the study area.

Abstract: The negative pore water pressure or soil suction has significant effect on the performance of geotechnical infrastructures (e.g., slope, pavement, embankment etc.). The unsaturated behavior of soil is not static, rather offers variation in response to climatic loading. The objective of the study was to evaluate field-based techniques of SWCC construction in terms of capturing these variation as compared to laboratory methods and predictive models. The field assessment could allow the quantification of hysteresis effect on the SWCC. Instrumentation data from one Texas, USA highway was used in this study. Soil Water Characteristic Curves (SWCCs) were regenerated utilizing co-located moisture and suction data from the field. Laboratory and field measured SWCCs from the instrumented site were fitted by van Genuchten model. Previously developed predicted models were also utilized to evaluate the SWCC parameters. Based on the evapotranspiration and rainfall amounts, distinct drying and wetting cycles were recorded. Though hourly data was collected in this study, average daily values were used for the analysis. Unsaturated flow parameters (α, n, m) were determined from both laboratory testing and field moisture-suction data along with the predictive models. Clear differences were observed between the values obtained from predictive models and field generated SWCC. The outcome from this study revealed that field reconstructed SWCCs can be used to simulate higher precision in numerical modeling in numerous geotechnical applications.

The use of the evapotranspiration cover for landfill is increasing because of its long-term enhanced performance. However, the performance of evapotranspiration cover primarily depends on the onsite geo-climatic conditions. Therefore, field verification of cover performance through constructed test plots is required before actual implementation. Additionally, numerical modeling and comparison with field results are necessary for future performance prediction. The objective of this study was to simulate the water balance hydrology of evapotranspiration cover using the code SEEP/W. Drainage lysimeter was constructed with fine-grained soil and native vegetation. Field water balance data from the lysimeter were obtained through instrumentation. Onsite climatological data, laboratory and field investigated soil parameters and actual field studied plant parameters were used as model input. Based on one year’s simulation, it was observed that the code nearly captured the seasonal variations in the water balance quantities measured in the field. Surface runoff was reasonably predicted in the model where precipitation intensity appeared to be responsible to some extent. Evapotranspiration was slightly overpredicted and the fluctuation in soil water storage was similar to the field results. The model predicted annual percolation was approximately 45 mm, which is under-predicted than the actual field measured annual percolation of 62 mm.