Search results for: advance care planning

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

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Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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Authors: M. Shemis, O. Maher, G. Casterou, F. Gauffre

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Hepatitis C virus (HCV) is a major cause of chronic liver disease with a global 170 million chronic carriers at risk of developing liver cirrhosis and/or liver cancer. Egypt reports the highest prevalence of HCV worldwide. Currently, two classes of assays are used in the diagnosis and management of HCV infection. Despite the high sensitivity and specificity of the available diagnostic assays, they are time-consuming, labor-intensive, expensive, and require specialized equipment and highly qualified personal. It is therefore important for clinical and economic terms to develop a low-tech assay for the direct detection of HCV RNA with acceptable sensitivity and specificity, short turnaround time, and cost-effectiveness. Such an assay would be critical to control HCV in developing countries with limited resources and high infection rates, such as Egypt. The unique optical and physical properties of gold nanoparticles (AuNPs) have allowed the use of these nanoparticles in developing simple and rapid colorimetric assays for clinical diagnosis offering higher sensitivity and specificity than current detection techniques. The current research aims to develop a detection assay for HCV RNA using gold nanoparticles (AuNPs). Methods: 200 anti-HCV positive samples and 50 anti-HCV negative plasma samples were collected from Egyptian patients. HCV viral load was quantified using m2000rt (Abbott Molecular Inc., Des Plaines, IL). HCV genotypes were determined using multiplex nested RT- PCR. The assay is based on the aggregation of AuNPs in presence of the target RNA. Aggregation of AuNPs causes a color shift from red to blue. AuNPs were synthesized using citrate reduction method. Different sets of probes within the 5’ UTR conserved region of the HCV genome were designed, grafted on AuNPs and optimized for the efficient detection of HCV RNA. Results: The nano-gold assay could colorimetrically detect HCV RNA down to 125 IU/ml with sensitivity and specificity of 91.1% and 93.8% respectively. The turnaround time of the assay is < 30 min. Conclusions: The assay allows sensitive and rapid detection of HCV RNA and represents an inexpensive and simple point-of-care assay for resource-limited settings.

Keywords: HCV, gold nanoparticles, point of care, viral load

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Authors: Driss Kettani

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ICT4D actors are naturally attempted to include AI in the range of enabling technologies and tools that could support and boost the Development process, and to refer to these as AI4D. But, doing so, assumes that AI complies with the very specific features of ICT4D context, including, among others, affordability, relevance, openness, and ownership. Clearly, none of these is fulfilled, and the enthusiastic posture that AI4D is a natural part of ICT4D is not grounded and, to certain extent, does not serve the purpose of Technology for Development at all. In the context of Development, it is important to emphasize and prioritize ICT4D, in the national digital transformation strategies, instead of borrowing "trendy" waves of the IT Industry that are motivated by business considerations, with no specific care/consideration to Development.

Keywords: AI, ICT4D, technology for development, position paper

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Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: Elachouri Mostafa, Fakchich Jamila, Lazaar Jamila, Elmadmad Mohammed, Marhom Mostafa

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Of course, there has been a great growth in scientific information about medicinal plants in recent decades, but in many ways this has proved poor compensation, because such information is accessible, in practice, only to a very few people and anyway, rather little of it is relevant to problems of management and utilization, as encountered in the field. Active compounds are used in most traditional medicines and play an important role in advancing sustainable rural livelihoods through their conservation, cultivation, propagation, marketing and commercialization. Medicinal herbs are great resources for various pharmaceutical compounds and urgent measures are required to protect these plant species from their natural destruction and disappearance. Indeed, there is a real danger of indigenous Arab medicinal practices and knowledge disappearing altogether, further weakening traditional Arab culture and creating more insecurity, as well as forsaking a resource of inestimable economic and health care importance. As scientific approach, the ethnopharmacological investigation remains the principal way to improve, evaluate, and increase the odds of finding of biologically active compounds derived from medicinal plants. As developing country, belonging to the Mediterranean basin, Morocco country is endowed with resources of medicinal and aromatic plants. These plants have been used over the millennia for human welfare, even today. Besides, Morocco has a large plant biodiversity, in fact, its medicinal flora account more than 4200 species growing on various bioclimatic zones from subhumide to arid and Saharan. Nevertheless, the human and animal pressure resulting from the increase of rural population needs has led to degradation of this patrimony. In this paper, we focus our attention on ethnopharmacological studies carried out in Morocco. The goal of this work is to clarify the importance of herbs as platform for drugs discovery and further development, to highlight the importance of ethnopharmacological study as approach on discovery of natural products in the health care field, and to discuss the limit of ethnopharmacological investigation of drug discovery in Morocco.

Keywords: Morocco, medicinal plants, ethnopharmacology, natural products, drug-discovery

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Authors: Susan Cardillo

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This research will consider ways to bridge the gap between Computer Science and Media Communications and while doing so create Social Entrepreneurship for student success. New Media, as it has been referred to, is considered content available on-demand through Internet, a digital device, usually containing some kind of interactivity and creative participation. It is the interplay between technology, images, media and communications. The next generation of the newspaper, radio, television, and film students need to have a working knowledge of the technologies that are available for the creation of their work and taught to use this knowledge to create a voice. The work is interdisciplinary; in communications, we understand the necessity of reporting and disseminating information. In documentary film we understand the instructional and historic aspects of media and technology and in the non-profit sector, we see the need for expanding outlets for good. So, the true necessity is to utilize ‘new media’ technologies to advance social causes while reporting information, teaching and creating art. Goals: The goal of this research is to give communications students a better understanding of the technology that is both, currently at their disposal, and on the horizon, so that they can use it in their media, communications and art endeavors to be a voice for their generation. There is no longer a need to be a computer scientist to have a working knowledge of communication technologies and how they will benefit our work. There are many free and easy to use applications available for the creation of interactive communications. Methodology: This is Qualitative-Case Study that puts these ideas into action. There is a survey at the end of the experiment that is qualitative in nature and allows for the participants to share ideas and feelings about the technology and approach.

Keywords: interactive storytelling, web documentary, mass communications, teaching

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Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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Authors: Syed Faizan Hassan Shah

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Introduction: Burn injuries are among the most devastating of all injuries. Burns is the fourth most common type of trauma worldwide. Ap?proximately 90 percent of burns occur in low to middle-income countries. Nearly half a million Americans each year, with approximately 40,000 hospitalizations and 3,400 deaths annually, suffer burns. The survival rate for admitted burn patients has improved consistently over the past four decades, largely attributed to national decreases in burn size, improvements in burn critical care, and advancements in burn wound care. Objectives: The present study was conducted to compare the efficacy of Honey dressing versus Silver Sulfadiazine dressing for complete wound healing in the 2nd-degree thermal burn. Study Design: A Randomized controlled trial was carried out in the Department of General Surgery/burn unit of Ayub Teaching Hospital Abbottabad from July to December 2018. The study population included thermal burn patients presenting with ASA-I, ASA-II, and body surface area less than 50% of the age group above 12 to 60 years of either gender. All the patients were randomly divided into two equal groups of patients by blocked randomization using permuted block g 6. In group ‘A,’ patients underwent dressing by honey method, and patients in group ‘B’ had silver sulfadiazine dressing. The dressing was changed every 48 hours by a senior sur?geon, and the condition of the wound was observed. Time duration till complete wound healing was noted in the Proforma. Results: A total of 100 patients were selected and divided into two groups of 50 patients in each two groups. The mean age of the patients was 27.66±13.388 ran?ging from 12 to 60 years of age, and the mean duration of complete healing of wound in days was 20.20±6.251, ranging from 2 to 30 days. Mean comparison of age with both groups, age of the patients was 21.24±3.761 (n=50) in group ‘A,’ i.e., honey dressing, and 19.16±7.911 (n=50) was in group ‘B,’ i.e., silver sulfadiazine dressing. Efficacy in the honey dressing group was found effective in 48(75.0%) and ineffect? ive in 2(5.6%) out of 50 patients. Efficacy in silver sulfadiazine dressing group 16(25.0%) was three found effective and in 34(94.4%) was inef?fective out of 50 patients. There was a statistically significant difference between both groups. (P=0.000) . Conclusion: honey dressing is more effective as compared to silver sulfadiazine dressing in terms of complete wound healing in second-degree thermal burn patients; our study also concluded the same.

Keywords: efficacy, honey dressing, silver sulfadiazine dressing, wound healing

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Authors: M. Petunia Tsweleng

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Statement of the Problem: Research and aid organisations report that children and adolescents orphaned due to HIV and AIDS are particularly vulnerable as they are often exposed to negative effects of both HIV and AIDS and orphanhood. Without much-needed parental love, care, and support, these children and adolescents are at risk of poor developmental outcomes. A cursory look at the available literature on AIDS-orphaned adolescents, and the quality of caregiving relationships with caregivers, shows that this is a relatively under-researched terrain. This article is a review of the literature on caregiving relationships of adolescents orphaned due to AIDS and their current primary caregivers. It aims to inform community programmes and policymakers by providing insight into the qualities of these relationships. Methodology: A comprehensive search of both peer-reviewed and non-peer-reviewed literature was conducted through EBSCOhost, SpringLINK, PsycINFO, SAGE, PubMed, Elsevier ScienceDirect, JSTOR, Wiley Online Library databases, and Google Scholar. The combination of keywords used for the search were: (caregiving relationships); (orphans OR AIDS orphaned children OR AIDS orphaned adolescents); (primary caregivers); and (quality caregiving); (orphans); (HIV and AIDS). The search took place between 24 January and 28 February 2022. Both qualitative and quantitative research studies published between 2010 and 2020 were reviewed. However, only qualitative studies were selected in the end -as they presented more profound findings concerning orphan-caregiver relationships. The following three stages of meta-synthesis analysis were used to analyse data: refutational syntheses, reciprocal syntheses, and line of argument. Results: The search resulted in a total of 2090 titles, of which 750 were duplicates and therefore subtracted. The researcher reviewed all the titles and abstracts of the remaining 1340 articles. 329 articles were identified as relevant, and full texts were reviewed. Following the review of the full texts, 313 studies were excluded for relevance and 4 for methodology. Twelve articles representing 11 studies fulfilled the inclusion criteria and were selected. These studies, representing different countries across the globe, reported similar forms of hardships experienced by caregivers economically, psychosocially, and healthwise. However, the studies also show that the majority of caregivers found contentment in caring for orphans, particularly grandmother carers, and were thus enabled to provide love, care, and support despite hardships. This resulted in positive caregiving relationships -as orphans fared well emotionally and psychosocially. Some relationships, however, were found negative due to unhealed emotional wounds suffered by both caregivers and orphans and others due to the caregiver’s lack of interest in providing care. These findings were based on self-report data from both orphans and caregivers. Conclusion: Findings suggest that intervention efforts need to be intensified to: alleviate poverty in households that are affected by HIV and AIDS pandemic, strengthen the community psychosocial support programmes for orphans and their caregivers; and integrate clinical services with community programmes for the healing of emotional and psychological wounds. Contributions: Findings inform community programmes and policymakers by providing insight into the qualities of the mentioned relationships as well as identifying factors commonly associated with high-quality caregiving and poor-quality caregiving.

Keywords: systematic review, caregiving relationships, orphans and primary caregivers, AIDS

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Authors: M. S. Maglasang, S. O. Palacio, L. P. Ogdoc

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Business Process Outsourcing has been one of the fastest growing and emerging industry in the Philippines today. Unlike most of the contact service centers, more popularly known as "call centers", The BPO Industry’s primary outsourced service is performing audits of the global clients' logistics. As a service industry, manpower is considered as the most important yet the most expensive resource in the company. Because of this, there is a need to maximize the human resources so people are effectively and efficiently utilized. The main purpose of the study is to optimize the current manpower resources through effective distribution and assignment of different types of bills to the different skill-level of data entry operators. The assignment model parameters include the average observed time matrix gathered from through time study, which incorporates the learning curve concept. Subsequently, a simulation model was made to duplicate the arrival rate of demand which includes the different batches and types of bill per day. Next, a mathematical linear programming model was formulated. Its objective is to minimize direct labor cost per bill by allocating the different types of bills to the different skill-levels of operators. Finally, a hypothesis test was done to validate the model, comparing the actual and simulated results. The analysis of results revealed that the there’s low utilization of effective capacity because of its failure to determine the product-mix, skill-mix, and simulated demand as model parameters. Moreover, failure to consider the effects of learning curve leads to overestimation of labor needs. From 107 current number of operators, the proposed model gives a result of 79 operators. This results to an increase of utilization of effective capacity to 14.94%. It is recommended that the excess 28 operators would be reallocated to the other areas of the department. Finally, a manpower capacity planning model is also recommended in support to management’s decisions on what to do when the current capacity would reach its limit with the expected increasing demand.

Keywords: optimization modelling, linear programming, simulation, time and motion study, capacity planning

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Authors: Sanghoon Shim, Jaehwan Jung, Sung-Ah Kim

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As the digital technology develops, studies on the TUI (Tangible User Interface) that links the physical environment utilizing the human senses with the virtual environment through the computer are actively being conducted. In addition, there has been a tremendous advance in computer design making through the use of computer-aided design techniques, which enable optimized decision-making through comparison with machine learning and parallel comparison of alternatives. However, a complex design that can respond to user requirements or performance can emerge through the intuition of the designer, but it is difficult to actualize the emerged design by the designer's ability alone. Ancillary tools such as Gaudí's Sandbag can be an instrument to reinforce and evolve emerged ideas from designers. With the advent of many commercial tools that support 3D objects, designers' intentions are easily reflected in their designs, but the degree of their reflection reflects their intentions according to the proficiency of design tools. This study embodies the environment in which the form can be implemented by the fingers of the most basic designer in the initial design phase of the complex type building design. Leapmotion is used as a sensor to recognize the hand motions of the designer, and it is converted into digital information to realize an environment that can be linked in real time in virtual reality (VR). In addition, the implemented design can be linked with Rhino™, a 3D authoring tool, and its plug-in Grasshopper™ in real time. As a result, it is possible to design sensibly using TUI, and it can serve as a tool for assisting designer intuition.

Keywords: design environment, digital modeling, hand gesture, TUI, virtual reality

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Authors: Yu-Ju Hsieh, Lin-Hung Lin, Wen-Hui Chang

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This study was designed as an interventional research and intended to validate whether the introduction of drinking vinegar every day can reduce and even prevent urinary tract infection in Taiwan home stayed disabilities who using indwelling catheter. The data was collected from the subjects who have received home care case at northern Taiwan, according to the questionnaire and a medical records retroactive methodology, the subjects were informed and consent to drink 15ml of table vinegar in a daily diet, and through routine urine testing and culture study. Home care nurses would assist collecting urine at the point of before and after a meal from total 35 studied subjects per month, and total collected 4 times for testing. The results showed that when the average age of study subjects was 65.46 years and catheter indwelling time was 15 years, drinking table vinegar could inhibit the activity of E. coli O157: H7 and reduce its breeding. Before drinking table vinegar daily, the subjects’ urine pH value was 7.0-8.0, and the average was 7.5, and the urine PH value dropped to 6.5 after drinking table vinegar for a month. There were two purple urine cases whose urine were changed from purple to normal color after two weeks of drinking, and the protein and bacteria values of urine gradually improved. Urine smell unpleasant before attending to this study, and the symptom improved significantly only after 1 week, and the urine smell returned to normal ammonia and became clean after 1 month later. None of these subjects received treatment in a hospital due to urinary tract infection, and there were no signs of bleeding in all cases during this study. The subjects of this study are chronic patients with a long-term bedridden catheterization; drinking cranberry juice is an economic burden for them, and also highly prohibited for diabetes patients. By adapting to use cheaper table vinegar to acidified urine and improve its smell and ease Purple Urine Syndrome, to furthermore, proven urinary tract infection, it can also to reduce the financial burden on families, the cost of social resources and the rate of re-admission.

Keywords: table vinegar, urinary tract infection, disability patients, long-term indwelling catheter

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Authors: Md. Ashikur Rahman

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Optimal breastfeeding practice is essential to reducing childhood morbidity and mortality and helps to achieve Millennium Development Goal (MDG). A cross-sectional study was conducted in a rural area in Dhaka district to explore the barrier to optimal breastfeeding practices. The population of this study constitutes all nursing mothers having children aged 0-6 months, and they were selected purposively. The study adopted a structured and in-depth interview procedure consisting of open and closed-ended questions. Four hundred rural nursing mothers constituted the sample of the structured interview, while 15 were involved in the in-depth interview. Among the respondent's majority (67%) were in the age group 17-25 years, with a mean age of 24.44 years. Most (39.5%) of the mothers were housewives with a secondary level of education (46.5%). About 32% of mothers started breastfeeding within one hour after birth. But delayed initiation was reported in 31.5% of mothers, whereas 36.8% of mothers forgot the exact time of initiation of breastfeeding. The main reason not to practice colostrum was mothers tried to breastfeed, but there was no milk, stated 13.8% of mothers. In addition, about one-third (34.3%) of the respondents practiced pre-lacteal feeding, and among them, 12.8% introduced sugar with water. Reasons given by the mothers for bottle-feeding was that baby was not satisfied with breast milk only; 22.0% of mothers indicated this cause. The main influence to take formula milk by their mother and mothers-in-law was stated by 18.8% of mothers. Some mothers stated that major constraints to EBF were the perception of not having enough milk (25.5 %) and babies crying seems to be hungry (8.8%). One-third of the mothers (31.5%) felt uncomfortable during breastfeeding. Access to antenatal and postnatal counseling in the study area also was a key obstacle to optimal breastfeeding practices. In a qualitative survey, some mothers believed that there was no difference between breast milk and formula milk. Colostrum feeding, pre-lacteal feeding, early initiation of breastfeeding, and exclusive breastfeeding were strongly associated with family type, family member, birth order, religion, husbands' occupation, delivery attendants and delivery type, postnatal care, and health care facilities. To reduce the barriers to the successful practice of exclusive breastfeeding, there is a need for a grass-roots approach to educating and counseling nursing mothers with identifying factors influencing or discouraging the optimal practice.

Keywords: exclusive, breast feeding, practices, Bangladesh

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Authors: Katalin Szöllősi, László Szabó

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Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

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Authors: Nick Farid, Roghoyeh Salmeh

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The planning and operation of the power grid is becoming much more complex because of the introduction of renewable energy resources, the digitalization of the electricity industry, as well as the coupling of efficiency and greener energy trends. These changes, along with new trends, make interactions between grid users and the other stakeholders more complex. This paper focuses on the main “physical” and “logical” interactions between grid users and the grid stakeholders, both from power system equipment and information management standpoints, and proposes a new interoperability model for Smart Grids.

Keywords: user interface, interoperability layers, grid architecture framework, smart grid

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Authors: Chinfen Chen

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This paper aims to focus on the challenges and doubts encountered in the implementation of ‘bilingual teaching in some fields of courses’, and propose implementation principles and strategies from the four areas of curriculum design, teaching strategies, teaching language application, and bilingual teaching implementation and operation, as a school The administrative team considers when planning bilingual teaching and also clarifies teachers' doubts about the implementation of bilingual teaching to enhance their willingness and confidence to participate in bilingual teaching.

Keywords: bilingual education policy, language immersion, partial bilingual education, content knowledge and target language acquisition, inquiry-based teaching.

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Authors: Ana Gabriela Diaz, Luis Fermín Córdova, Jr., Roberto Lamazares

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The island of Cuba, the largest of the Greater Antilles, is located in the tropical North Atlantic. It is annually affected by numerous weather events, which have caused severe damage to our coastal areas. In the same way that many other coastlines around the world, the beautiful beaches of the Hicacos Peninsula also suffer from erosion. This leads to a structural regression of the coastline. If measures are not taken, the hotels will be exposed to the advance of the sea, and it will be a serious problem for the economy. With the aim of studying the intensity of this type of activity, specialists of group of coastal and marine engineering from CIH, in the framework of the research conducted within the project MEGACOSTAS 2, provide their research to simulate extreme events and assess their impact in coastal areas, mainly regarding the definition of flood volumes and morphodynamic changes in sandy beaches. The main objective of this work is the evaluation of the process of Varadero beach erosion (the coastal sector has an important impact in the country's economy) on the Hicacos Peninsula for different paths of hurricanes. The mathematical model XBeach, which was integrated into the Coastal engineering system introduced by the project of MEGACOSTA 2 to determine the area and the more critical profiles for the path of hurricanes under study, was applied. The results of this project have shown that Center area is the greatest dynamic area in the simulation of the three paths of hurricanes under study, showing high erosion volumes and the greatest average length of regression of the coastline, from 15- 22 m.

Keywords: beach, erosion, mathematical model, coastal areas

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Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education

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Authors: Kwak, Hyo-Gyung, Gang, Han Gul

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In the context of an increasing need for reliability and safety in concrete structures under blast and impact loading condition, the behavior of concrete under high strain rate condition has been an important issue. Since concrete subjected to impact loading associated with high strain rate shows quite different material behavior from that in the static state, several material models are proposed and used to describe the high strain rate behavior under blast and impact loading. In the process of modelling, in advance, mesh dependency in the used finite element (FE) is the key problem because simulation results under high strain-rate condition are quite sensitive to applied FE mesh size. It means that the accuracy of simulation results may deeply be dependent on FE mesh size in simulations. This paper introduces an improved criterion which can minimize the mesh-dependency of simulation results on the basis of the fracture energy concept, and HJC (Holmquist Johnson Cook), CSC (Continuous Surface Cap) and K&C (Karagozian & Case) models are examined to trace their relative sensitivity to the used FE mesh size. To coincide with the purpose of the penetration test with a concrete plate under a projectile (bullet), the residual velocities of projectile after penetration are compared. The correlation studies between analytical results and the parametric studies associated with them show that the variation of residual velocity with the used FE mesh size is quite reduced by applying a unique failure strain value determined according to the proposed criterion.

Keywords: high strain rate concrete, penetration simulation, failure strain, mesh-dependency, fracture energy

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Authors: Batuhan Kocaoglu

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Nowadays digital transformation is a hot topic both in service and production business. For the companies who want to stay alive in the following years, they should change how they do their business. Industry leaders started to improve their ERP (Enterprise Resource Planning) like backbone technologies to digital advances such as analytics, mobility, sensor-embedded smart devices, AI (Artificial Intelligence) and more. Selecting the appropriate technology for the related business problem also is a hot topic. Besides this, to operate in the modern environment and fulfill rapidly changing customer expectations, a digital transformation of the business is required and change the way the business runs, affect how they do their business. Even the digital transformation term is trendy the literature is limited and covers just the philosophy instead of a solid implementation plan. Current studies urge firms to start their digital transformation, but few tell us how to do. The huge investments scare companies with blur definitions and concepts. The aim of this paper to solidify the steps of the digital transformation and offer a roadmap for the companies and academicians. The proposed roadmap is developed based upon insights from the literature review, semi-structured interviews, and expert views to explore and identify crucial steps. We introduced our roadmap in the form of 8 main steps: Awareness; Planning; Operations; Implementation; Go-live; Optimization; Autonomation; Business Transformation; including a total of 11 sub-steps with examples. This study also emphasizes four dimensions of the digital transformation mainly: Readiness assessment; Building organizational infrastructure; Building technical infrastructure; Maturity assessment. Finally, roadmap corresponds the steps with three main terms used in digital transformation literacy as Digitization; Digitalization; and Digital Transformation. The resulted model shows that 'business process' and 'organizational issues' should be resolved before technology decisions and 'digitization'. Companies can start their journey with the solid steps, using the proposed roadmap to increase the success of their project implementation. Our roadmap is also adaptable for relevant Industry 4.0 and enterprise application projects. This roadmap will be useful for companies to persuade their top management for investments. Our results can be used as a baseline for further researches related to readiness assessment and maturity assessment studies.

Keywords: digital transformation, digital business, ERP, roadmap

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Authors: K. C. Tanuja, Mamatha P. Raj

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Urbanisation is happening rapidly all over the world. As population increasing in the urban settlements, its required to provide quality of life to all the inhabitants who live in. Urban design is a place making strategic planning. Urban design principles promote visualising any place environmentally, socially and economically viable. Urban design strategies include building mass, transit development, economic viability and sustenance and social aspects.

Keywords: livable streets, social interaction, pedestrian use, urban design

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Authors: Tarek S. Duzan, Fisal Ben Ammer, Mohamed Sula

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In some places within Sirt Basin-Libya, it has been noticed that seismic data below pre-upper cretaceous unconformity (PUK) is hopeless to resolve the large-scale structural features and is unable to fully determine reservoir delineation. Seismic artifacts (multiples) are observed in the reservoir zone (Nubian Formation) below PUK, which complicate the process of seismic interpretation. The nature of the unconformity and the structures below are still ambiguous and not fully understood which generates a significant gap in characterizing the geometry of the reservoir, the uncertainty accompanied with lack of reliable seismic data creates difficulties in building a robust geological model. High resolution dipmeter is highly useful in steeply dipping zones. This paper uses FMl and OBMl borehole images (dipmeter) to analyze the structures below the PUK unconformity from two wells drilled recently in the North Gialo field (a mature reservoir). In addition, borehole images introduce new evidences that the PUK unconformity is angular and the bedding planes within the Nubian formation (below PUK) are significantly titled. Structural dips extracted from high resolution borehole images are used to construct a new geological model by the utilization of latest software technology. Therefore, it is important to use the advance well logs technology such as FMI-HD for any future drilling and up-date the existing model in order to minimize the structural uncertainty.

Keywords: FMI (formation micro imager), OBMI (oil base mud imager), UBI (ultra sonic borehole imager), nub sandstone reservoir in North gialo

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Authors: Abimbola Olaotan Akinsete

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Government all over the world has intensified efforts in making internet and resource centres readily available in public institutions and centres for the advancement of humanity and working processes. Information and communication resource centre will not only help in the reduction of task that are presumed to be herculean. This centres influenced the working rate and productivity of both staffs and students and its benefit. The utilization of the internet and information resource centre will not only speed up service delivery, working time and efficiency of the system. Information and Communication Technology plays significant roles in presenting equalization strategy for developing university community and improving educational service delivery. This equalization will not only advance, accelerate and ensure results are accessed electronically, ensuring the transfer and confirmation of students’ academic records and their results in the world without physically available to request for these services. This study seeks to make Critical Appraisal of Adekunle Ajasin University Policy on Internet Resource Centre in Service Delivery Adekunle Ajasin University, Akungba-Akoko, Ondo State. The study employ descriptive survey design method in identifying hindrances of the non-utilization of technology in the service delivery in the university. Findings revealed that the adoption of internet and resource centre in the Exams and Records unit of the University shall help in delivering more in students’ records/results processing.

Keywords: internet, resource, centre, policy and service delivery

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Authors: Mahla Azimi

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Introduction: Post-bladder catheter infection is a common and significant healthcare-associated infection that affects individuals with indwelling urinary catheters. These infections can lead to various complications, including urinary tract infections (UTIs), bacteremia, sepsis, and increased morbidity and mortality rates. This article aims to provide a comprehensive review of post-bladder catheter infections, including their causes, risk factors, clinical presentation, diagnosis, treatment options, and preventive measures. Causes and Risk Factors: Post-bladder catheter infections primarily occur due to the colonization of microorganisms on the surface of the urinary catheter. The most common pathogens involved are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species. Several risk factors contribute to the development of these infections, such as prolonged catheterization duration, improper insertion technique, poor hygiene practices during catheter care, compromised immune system function in patients with underlying conditions or immunosuppressive therapy. Clinical Presentation: Patients with post-bladder catheter infections may present with symptoms such as fever, chills, malaise, suprapubic pain or tenderness, and cloudy or foul-smelling urine. In severe cases or when left untreated for an extended period of time, patients may develop more severe symptoms like hematuria or signs of systemic infection. Diagnosis: The diagnosis of post-bladder catheter infection involves a combination of clinical evaluation and laboratory investigations. Urinalysis is crucial in identifying pyuria (presence of white blood cells) and bacteriuria (presence of bacteria). A urine culture is performed to identify the causative organism(s) and determine its antibiotic susceptibility profile. Treatment Options: Prompt initiation of appropriate antibiotic therapy is essential in managing post-bladder catheter infections. Empirical treatment should cover common pathogens until culture results are available. The choice of antibiotics should be guided by local antibiogram data to ensure optimal therapy. In some cases, catheter removal may be necessary, especially if the infection is recurrent or associated with severe complications. Preventive Measures: Prevention plays a vital role in reducing the incidence of post-bladder catheter infections. Strategies include proper hand hygiene, aseptic technique during catheter insertion and care, regular catheter maintenance, and timely removal of unnecessary catheters. Healthcare professionals should also promote patient education regarding self-care practices and signs of infection. Conclusion: Post-bladder catheter infections are a significant healthcare concern that can lead to severe complications and increased healthcare costs. Early recognition, appropriate diagnosis, and prompt treatment are crucial in managing these infections effectively. Implementing preventive measures can significantly reduce the incidence of post-bladder catheter infections and improve patient outcomes. Further research is needed to explore novel strategies for prevention and management in this field.

Keywords: post-bladder catheter infection, urinary tract infection, bacteriuria, indwelling urinary catheters, prevention

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Authors: Kevin F. Hsu, Alvin Chua, Sarah X. Lin

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As a multilingual society, Singaporean names for different parts of the city have changed over time. Residents included Indigenous Malays, dialect-speakers from China, European settler-colonists, and Tamil-speakers from South India. Each group would name locations in their own languages. Today, as ancestral tongues are increasingly supplanted by English, contemporary Singaporeans’ understanding of once-common place names is disappearing. After demolition or redevelopment, some urban places will only exist in archival records or in human memory. United Nations conferences on the standardization of geographic names have called attention to how place names relate to identity, well-being, and a sense of belonging. The Singapore Place-Naming Project responds to these imperatives by capturing past and present place names through digitizing historical maps, mining archival records, and applying selective crowd-sourcing to trace the evolution of place names throughout the city. The project ensures that both formal and vernacular geographical names remain accessible to historians, city planners, and the public. The project is compiling a gazetteer, a geospatial archive of placenames, with streets, buildings, landmarks, and other points of interest (POI) appearing in the historic maps and planning documents of Singapore, currently held by the National Archives of Singapore, the National Library Board, university departments, and the Urban Redevelopment Authority. To create a spatial layer of information, the project links each place name to either a geo-referenced point, line segment, or polygon, along with the original source material in which the name appears. This record is supplemented by crowd-sourced contributions from civil service officers and heritage specialists, drawing from their collective memory to (1) define geospatial boundaries of historic places that appear in past documents, but maybe unfamiliar to users today, and (2) identify and record vernacular place names not captured in formal planning documents. An intuitive interface allows participants to demarcate feature classes, vernacular phrasings, time periods, and other knowledge related to historical or forgotten spaces. Participants are stratified into age bands and ethnicity to improve representativeness. Future iterations could allow additional public contributions. Names reveal meanings that communities assign to each place. While existing historical maps of Singapore allow users to toggle between present-day and historical raster files, this project goes a step further by adding layers of social understanding and planning documents. Tracking place names illuminates linguistic, cultural, commercial, and demographic shifts in Singapore, in the context of transformations of the urban environment. The project also demonstrates how a moderated, selectively crowd-sourced effort can solicit useful geospatial data at scale, sourced from different generations, and at higher granularity than traditional surveys, while mitigating negative impacts of unmoderated crowd-sourcing. Stakeholder agencies believe the project will achieve several objectives, including Supporting heritage conservation and public education; Safeguarding intangible cultural heritage; Providing historical context for street, place or development-renaming requests; Enhancing place-making with deeper historical knowledge; Facilitating emergency and social services by tagging legal addresses to vernacular place names; Encouraging public engagement with heritage by eliciting multi-stakeholder input.

Keywords: collective memory, crowd-sourced, digital heritage, geospatial, geographical names, linguistic heritage, place-naming, Singapore, Southeast Asia

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Authors: Kalina Alina Aidarovna, Khayrullina Yulia Sergeevna

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The question of forming quality housing and living environment remains a vexed problem in the current situation of high-rise apartment building in big cities of Russia. At this start up stage of the modern so-called "mass housing" market it needs to identify key quality characteristics on a different scale from apartments to the district. This paper describes the methodology of qualitative assessment of modern mass housing construction, made on the basis of the ITMO university in cooperation with the institute of spatial planning "Urbanika," based on the case study of St. Petersburg’s residential mass housing built in 2011-2014. The methodology of the study of housing and living environment goes back to the native and foreign urbanists of 60s - 80s, such Jane Jacobs, Jan Gehl, Oscar Newman, Krasheninnikov, as well as Sommer, Stools, Kohnen and Sherrod, Krasilnikova, Sychev, Zhdanov, Tinyaeva considering spatial features of living environment in a wide range of its characteristics (environmental control, territorial and personalization, privacy, etc.). Assessment is carrying out on the proposed system of criteria developed for each residential environment scale-district, quarter, courtyard, building surrounding grounds, houses, and flats. Thus the objects of study are planning unit of residential development areas (residential area, neighborhood, quarter) residential units areas (living artist, a house), and households (apartments) consisting of residential units. As a product of identified methodology, after the results of case studies of more than 700 residential complexes in St. Petersburg, we intend the creation of affordable online resource that would allow conducting a detailed qualitative evaluation or comparative characteristics of residential complexes for all participants of the construction market-developers, designers, realtors and buyers. Thereby the main objective of the rating may be achieved to improve knowledge, requirements, and demand for quality housing and living environment among the major stakeholders of the construction market.

Keywords: methodology of living environment, qualitative assessment of mass housing, scale-district, vexed problem

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Authors: Monika Nuffer, Wesley Nuffer

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The problem of obesity is one that continues to be faced in the United States health care system and across the developing world. Prescription medications are available, but are often very expensive with minimal insurance coverage. The over-the-counter diet aid industry is a robust one, selling billions of dollars in products every year. It is important for clinicians to understand the myriad of different nutritional supplements marketed for obesity, and to weigh the evidence behind these products. This manuscript outlines the most commonly used nutritional supplements currently marketed for weight loss, reviewing the evidence with a focus on the efficacy and safety of these products.

Keywords: obesity, weight loss, herbal products, nutritional supplements

Procedia PDF Downloads 220

Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

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Authors: Abdullah Karaman, Kursad Sayin

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In this research, which information technologies are used in small hotel businesses, and the information technologies-performance perception of the managers are pointed out. During the research, the questionnaire was prepared and the small scale hotel managers were interviewed face to face and they filled out the questionnaire and the answers acquired were evaluated. As the result of the research, it was obtained that the managers do not care much about the information technologies usage in practice even though they accepted that the information technologies are important in terms of performance.

Keywords: information technologies, managers, performance, small hotels

Procedia PDF Downloads 467

Authors: Gule Teri

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The effective validation of analytical methods forms a crucial component of pharmaceutical manufacturing. However, traditional validation techniques can occasionally fail to fully account for inherent variations within datasets, which may result in inconsistent outcomes. This deficiency in validation accuracy is particularly noticeable when quantifying low concentrations of active pharmaceutical ingredients (APIs), excipients, or impurities, introducing a risk to the reliability of the results and, subsequently, the safety and effectiveness of the pharmaceutical products. In response to this challenge, we introduce an enhanced, tolerance-based Design of Experiments (DoE) approach for the validation of analytical methods. This approach distinctly measures variability with reference to tolerance or design margins, enhancing the precision and trustworthiness of the results. This method provides a systematic, statistically grounded validation technique that improves the truthfulness of results. It offers an essential tool for industry professionals aiming to guarantee the accuracy of their measurements, particularly for low-concentration components. By incorporating this innovative method, pharmaceutical manufacturers can substantially advance their validation processes, subsequently improving the overall quality and safety of their products. This paper delves deeper into the development, application, and advantages of this tolerance-based DoE approach and demonstrates its effectiveness using High-Performance Liquid Chromatography (HPLC) data for verification. This paper also discusses the potential implications and future applications of this method in enhancing pharmaceutical manufacturing practices and outcomes.

Keywords: tolerance-based design, design of experiments, analytical method validation, quality control, biopharmaceutical manufacturing

Procedia PDF Downloads 54