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Aim COVID-19 has led to unprecedented waiting times for elective surgery. Optimising patient pathways is paramount in tackling the backlog. Length of hospital stay (LOS) is an accepted surrogate for successful elective surgery. The aims of our study were: 1) report on changes in LOS after restarting our elective THA service; 2) identify barriers to early discharge, 3) investigate effectiveness of implemented changes. Method A retrospective review of consecutive patients undergoing elective THA, comparing three groups: 1) enhanced care pathway (n=96; 09/2019–12/2019); 2) COVID group (n=56; 03/2021–04/2021); 3) intervention group (n=96; 05/2021–08/2021). Results LOS in the enhanced care pathway group was 2.6 ±2.1 days. During initial resumption of elective operating (COVID group) the LOS was 4.8 ±4.5 days (statistically significant increase; p=0.011). Factors affecting LOS included reduced physiotherapy provision; lack of pre-operative occupational therapy review; loss of educational classes and worse pre-operative functional status. To address these our department employed three new physiotherapists, introduced training for nursing staff and created a post-operative proforma. The LOS subsequently reduced to 3.7 ±4.6days (p=0.166). Subgroup analysis of the intervention group showed age Conclusions COVID-19 has had a significant effect on LOS, which is still not reversed. For effective resumption of THA services, pre-pandemic enhanced care pathways should be reinstated. With current restrictions preventing face-to-face classes, online educational sessions could be offered. Those younger than 75 years and ASA1–2 are most likely to be discharged without delay.

These article intents to analyze the behavior of second-grade dusty fluid flowing through a flexible tube whose walls are induced by the peristaltic movement. Coupled equations for the fluid and solid particles have been modelled by considering streamline conversions. Regular perturbation technique has been implemented to get the solutions and the outcomes are demonstrated through graphs. The impact of diverse parameters on the contour presentations and on the velocity of the solid grains and fluid has been illustrated. The velocity for both fluid and solid grains is increased with the enhancement in wave number and Reynolds number. In retrograde region, pumping rate increases with the increase in α and it decreases for increased values of δ. Key words: Peristaltic flow, second-grade dusty fluid, tube, axisymmetric flow.

EBV-related lymphoproliferations in post-transplant settings range from non-destructive hyperplasia to polymorphic post-transplant lymphoproliferative disorder (PTLD) to overt lymphoma. Here we present two unusual cases of pediatric non-mass-forming gastrointestinal (GI) PTLDs with mixed pathologic features of non-destructive and polymorphic categories. Both patients were EBV naive and presented within 1 year of transplant with non-specific gastrointestinal symptoms (diarrhea, abdominal pain, and food intolerance) with hypoalbuminemia, cytopenia, and EBV viremia. No mass lesions were found on imaging and endoscopy. Random GI biopsies showed a non-mass-forming, but polymorphic-appearing lymphoid infiltrate with EBV positivity, monotypic plasma cells, and clonal B cells. Cyclophosphamide, steroids, and rituximab treatment had good clinical response in all cases, including one case which had poor response initially with rituximab alone. Based on these cases, we conclude that GI PTLD in children can present with vague abdominal symptoms, cytopenia, and hypoalbuminemia, and can be non-mass-forming and non-destructive. A high level of suspicion with random GI biopsies and clinicopathologic and laboratory correlation are required. Since these patients have no mass lesions, evaluating symptomatic relief, EBV viral load, improvement in cytopenia(s), serum albumin levels, and/or resolution of other systemic symptoms may be needed to monitor response to therapy.

Variation in the density of the solid particles suspended in the fluid must have an impact on its flow and behavior. This study deals with the inhomogeneous behavior of the solid grains suspended in the fluid. The number density of the dust grains is taken as a variable. The coupled equations for solid granules and the fluid under long wavelength have been modeled. Streamline transformations have been invoked and results are discussed through graphs. Results show decay in the velocity of dust and fluid is observed as the slip parameter enhances. The trapped bolus enlarges in the lower part of the passage, with the increase in number density of dust particles.

This study includes the dynamics of Walter’s B fluid conveying dust granules through an inclined asymmetric passage. An inclined magnetic field is imposed on the flowing fluid in order to investigate its consequences on the temperature, pressure rise and velocity. Stream functions transformation is applied to the derived equations of the dust granules and the fluid. Regular perturbation method has been carried out to interpret the nonlinear equations. Graphical demonstration of various parameters is included to analyze the results. It is detected that the velocity attenuates as the magnetic field and the viscoelastic parameter increase for both dust particles fluid. The pressure rise throughout the region increases as Reynolds number is increased. The temperature decreases as Prandtl number is increased. This research can aid investigators to understand the elastic properties of paints, in plastic engineering and extensional polymers.

This study presents the impact of MHD on peristaltic flow of a dusty fluid in an endoscope. The concentric tube is filled in with an incompressible fluid which is flowing through a porous medium. The outer tube wall is flexible while the inner tube is rigid. Coupled equations for both the solid granules and the fluid have been modelled by supposing long wavelength and low Reynolds number assumptions. Analytically results attained are presented through graphs. The impact of different parameters on velocity, pressure rise and streamlines have been included. It has been concluded that the trapped bolus reduces in the case of α and increases in the case of M.

The purpose of this study was to examine the influences of religiousness on the prevalence of Narcissistic Personality Disorder (NPD) among young adults. Prevalence of three forms of Allportian religious orientation, three forms of quest religious orientation and seven symptoms of NPD were examined through self-reported measures. 618 randomly selected Muslim students from the four public sector Pakistani universities participated in the study. Three research instruments comprising Religious Orientation Scale developed by Gorsuch and McPherson, Quest Scale developed by Batson and Schoenrade and Narcissistic Personality Inventory developed by Raskin and Terry were used to collect the data. All subscales demonstrated more than .70 Cronbach Alpha Coefficients. The findings demonstrate comparatively higher presence of intrinsic, extrinsic personal and extrinsic social religious orientations among the Pakistani Muslim young adults. The presence of NPD symptoms remains higher among the participants too. The study concludes that the religious orientations significantly explain the variances in the prevalence of NPD symptoms among the Muslim university students with the direct effects of intrinsic and extrinsic personal religious orientations and indirect effects of quest religious orientations.

The current research examines the potential of Pakistani universities to challenge terrorism on intellectual grounds. In this regard, the qualitative research approach was followed to achieve the research objectives. The researcher interviewed 100 faculty members and heads of teaching departments to collect the data. The thematic analysis approach was followed to reach conclusions. The study reveals that universities in Pakistan face various internal and external challenges, which reduce their capacity to protect students from religious radicalisation. At the end of the article, the consequences of these challenges for students in Pakistan and strategies to strengthen the contribution of Pakistani universities in war against terrorism are deliberated.

Structural, mechanical, thermal and magnetic properties of Quaternary Heusler alloys (QHA) CrFeTiZ (Z = Al, Si, Ge, Ga) are determined by employing full potential - linearized augmented plane wave (FP-LAPW) method using density functional theory (DFT). Geometry optimization of all these QHAs is accomplished and Type 2 is found the most stable. Elastic parameters reveal the mechanical stability and ductile behavior of all considered alloys. The calculated Debye Temperature (θ D) assured that these alloys can be appropriate for high temperature devices due to high thermal conductivity ( κ ) and melting temperature (Tmelt). All these compounds are half metallic (HM) in nature as the band gap (Eg) is present in one spin orientation. The values of Eg for CrFeTiAl and CrFeTiGa are 0.68 eV and 0.86 eV respectively which are obtained by employing generalized gradient approximation (GGA) while Hubbard parameter (U) with GGA is used to calculate Eg of CrFeTiGe and CrFeTiSi and the Eg are 0.93 eV and 0.9 eV. The calculated magnetic moment (MM) of CrFeTiZ (Z = Al, Si, Ge, Ga) alloys agrees with Slater-Pauling rule (SPR). From the obtained results it is envisaged that these materials are suitable candidates for spintronic and high temperature devices.

International Transaction Journal of Engineering, Management, & Applied Sciences & Technologies, 10, 17, 10A17C: 1-17

This paper explores the impact of wall properties on the Walter’s B fluid with fine solid particles in a uniform channel. Traveling sinusoidal wave is imposed on the channel walls which induces peristaltic motion in the fluid. A regular series is employed to obtain analytic solution by taking small wave number. The phenomenon is modeled in the form of stream function for both fluid and solid particles. Impact of pertinent parameters such as viscoelastic parameter $$\kappa$$ , wave number $$\delta$$ , the elastic tension, i.e., rigidity of the wall (E1), the mass characterizing parameter, i.e., stiffness of the wall (E2) and the damping nature of the wall (E3) are discussed through graphs for both fluid and dust particles. It is observed that the size of the trapped bolus increases on the right-hand side of the channel for both fluid and solid particles by increasing viscoelastic parameter. The flow rate of fluid particles increases by increasing viscoelastic parameter, while it decreases for solid particles.

The policies directed towards increasing access to education, often ignore how the political economy of local social structures can configure educational opportunity for the marginalized. This paper reports key findings of a qualitative, multiple-case study that explored caste-based social exclusion and educational opportunity in rural Punjab, Pakistan. Social exclusion was conceptualized within Sen’s capability approach and analysed under multiple dimensions of social exclusion suggested by Whitley (2005), and Bourdieu’s social critical theory. The data from seventy-two low and high caste parents, school heads and focus group interviews, reveal evidence of caste based social exclusion. This refracted into ‘active’ and ‘passive’ forms of institutional exclusion ( Sen, 2000 ), across temporal and spatial planes. It also resulted in micro-level exclusionary processes within schools and the self deselection of the most stigmatized from education.

Considering a general spherically symmetric, static, anisotropic space–time with perfect fluid, solutions of the Einstein field equations with polytropic equation of state are obtained. A physical ...

Cognitive experiential self-theory (CEST) postulates that past experiences develop implicit beliefs in human cognitive system. These beliefs modify and generate schemas attaching meanings to self, others and relations between self and others. Allport's religious orientations are explanations of people religious beliefs focusing the reasons of their religiousness. We, in the current study investigated the contribution of secondary school students’ religious affiliations (fellowship with Hinduism, Christianity or Islam) as well as religious orientations (intrinsic, extrinsic personal and extrinsic social) in developing their cognitive experiential thinking systems. The Hindu (N = 1050), Christian (N = 1073), and Muslim (N = 1394) secondary school students participated in the study. Age universal I–E (intrinsic–extrinsic religiosity) scale and rational experiential inventory for adolescents (REI-A) were adapted to collect the required information. We conclude that the students’ religious affiliations and orientations have significant impacts on their cognitive systems, specifically on rational thinking rather than on experiential thinking. The religious orientations moderately explain the variances in rational thinking of Hindu and Muslim students, while their impact on the rational choices of the Christian students is very small. In general, both an intrinsic orientation to religion and an external personal orientation are positively associated with rational thinking, while an external social orientation is negatively associated. Religious affiliations and orientations have very little effect on experiential thinking.

The UCT Student Surgical Society is an undergraduate surgical society based at the University of Cape Town (UCT) which aims to promote surgical education amongst medical students early in their medical careers. Founded in 2006, this was Africa's first student surgical society and has been joined by other medical schools in Africa also establishing their own undergraduate student surgical societies. In this review of the first 10 years of the society, we describe its objectives, its evolution and its international role.

Objective In this study, we report acute blood transfusion reactions at our hospital, compare our analysis with the reported data and identify areas for improvement. Background Haemovigilance programmes have been implemented in many countries, and adverse events associated with blood transfusion are published in their annual reports. Pakistan has no current established programme. Material and methods A cross-sectional study was conducted, and all adverse reactions reported to the blood bank from January 2014 to March 2016 were included. An adverse response in the patient, related to administration of blood (within 24 h), was considered an immediate transfusion reaction. Results During the study period, 20 956 blood components were issued. A total of 32 (0·15%) adverse reactions were documented. Allergic reactions were the most common adverse event observed in 15 (46·8%) of the cases. Febrile non-haemolytic transfusion reaction (FNHTR) was the second most common reaction seen in nine (28%) followed by bacterial contamination in four (12·5%) and acute haemolytic reaction in two (6·2%) of the cases. Conclusion The low incidence indicates underreporting and the need for a formal haemovigilance system. International benchmarking between different medical systems is helpful to identify areas in the transfusion process that have to be changed to improve transfusion safety.

The article explores perspectives on academic activities in public sector universities in Pakistan. Seven Pakistani universities yielded 290 teachers and 568 students in the sample. Factor analysis indicated five main factors in both teacher and student data sets. Both teachers and students were dissatisfied with the performance of the universities on quality of curriculum, teaching and leadership development opportunities for students. However, research, staff development and assessment were felt to be satisfactory at most of the universities. The former is a matter of great concern for all stakeholders, including the Higher Education Commission, the management of the universities, and teachers and students.

Students’ performance and behavior in online learning environment is associated with their readiness to opt digital learning approach. We in this research investigated distance learners’ emotional intelligence as a determinant of their readiness for online learning. 432 learners enrolled in correspondence based distance learning programs participated in the study. Wong and Law emotional intelligence scale (WLEIS) and online learning readiness scale (OLRS) were adapted with some modifications to collected the required data. Pearson correlation and multiple regression analysis were done to achieve the research objectives. The findings illustrate that emotional intelligence has a large size effect on sampled students’ readiness for online learning.

Purpose: To review magnetic resonance imaging (MRI) and secretin stimulated magnetic resonance cholangiopancreatography (S-MRCP) findings of patients with suspected chronic pancreatitis and compare them with endoscopic pancreatic function testing (ePFT). Materials and Methods: MRI and S-MRCP findings of 36 patients with clinically suspected chronic pancreatitis were reviewed. Baseline ductal changes, duodenal filling grades, and pancreatic duct caliber change (PDC) on S-MRCP, mean values of pancreatic anteroposterior (AP) diameter, signal intensity ratio (SIR) between pancreas and the spleen on T1-weighted fat saturated images, and arterial to venous (A/V) enhancement ratios were compared between groups of normal and abnormal pancreatic exocrine function determined by ePFT. Results: All patients (n = 24) with normal ePFT (HCO3 >80 mEq/L) had grade 3 normal duodenal filling. Patients with abnormal ePFT (HCO3

In this paper, cold spray was used as an additive manufacturing method to fabricate 5 mm thick SiC/Al metal matrix composites with various SiC contents. The effects of SiC contents and heat treatment on the microstructure, thermophysical and flexural properties were investigated. Additionally, the composites were characterized for retention of SiC particulates, splat size, surface roughness and the progressive understanding of strengthening, toughening and cracking mechanisms. Mechanical properties were investigated via three-point bending test, thermophysical analysis, and hardness test. In the as-sprayed state, flexural strength increased from 95.3 MPa to 133.5 MPa, an appreciation of 40% as the SiC contents increased, and the main toughening and strengthening mechanisms were zigzag crack propagation and high retention of SiC particulates respectively. In the heat treatment conditions, flexural strength appreciated significantly compared to the as-sprayed condition and this was as a result of coarsening of pure Al splat. Crack branching, crack deflection and interface delamination were considered as the main toughening mechanisms at the heat treatment conditions. Experimental results were consistent with the measured CTE, hardness, porosity and flexural modulus.

The purpose of the paper is to explore Students' perception of university teaching behaviours in Pakistan. Three hundred and fifty students from the six public sector Pakistani universities returned questionnaires. Assessment framework, learning activities and instructional strategies emerged from factor analysis as common factors. Students' views on five conceptual variables were also analysed: instructional design, active teaching, learning activities, questioning styles; and assessment framework. University teaching in Pakistan was found to be driven by assessment. This is a matter of concern for all stake holders, including the administration of the universities, teachers, students and the Higher Education Commission. A teaching behaviour paradigm shift is required, switching from knowledge-oriented teaching behaviour focused on successful passage through assessment, to teaching behaviour focused upon the development of transferable skills demanded by external markets.

We have developed advanced seismic attenuation systems for Gravitational Wave (GW) detectors. The design consists of an Inverted Pendulum (IP) holding stages of Geometrical Anti-Spring Filters (GASF) and pendula, which isolate the test mass suspension from ground noise. The ultra-low-frequency IP suppresses the horizontal seismic noise, while the GASF suppresses the vertical ground vibrations. The three legs of the IP are supported by cylindrical maraging steel flexural joints. The IP can be tuned to very low frequencies by carefully adjusting its load. As a best result, we have achieved an ultra low, ∼12 mHz pendulum frequency for the system prototype made for Advanced LIGO (Laser Interferometer Gravitational Wave Observatory). The measured quality factor, Q , of this IP, ranging from Q ∼2500 (at 0.45 Hz) to Q ∼2 (at 12 mHz), is compatible with structural damping, and is proportional to the square of the pendulum frequency. Tunable counterweights allow for precise center-of-percussion tuning to achieve the required attenuation up to the first leg internal resonance (∼60 Hz for advanced LIGO prototype). All measurements are in good agreement with our analytical models. We therefore expect good attenuation in the low-frequency region, from ∼0.1to ∼50 Hz, covering the micro-seismic peak. The extremely soft IP requires minimal control force, which simplifies any needed actuation.