Search results for: surgical safety checklist

Authors: Adnan Lanjawi

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This paper is carried out to investigate the management of hazardous waste in the chemistry section which belongs to Dubai Police forensic laboratory. The chemicals are the main contributor toward the accumulation of hazardous waste in the section. This is due to the requirement to use it in analysis, such as of explosives, drugs, inorganic and fire debris cases. This leads to negative effects on the environment and to the employees’ health and safety. The research investigates the quantity of chemicals there, the labels, the storage room and equipment used. The target is to reduce the need for disposal by looking at alternative options, such as elimination, substitution and recycling. The data was collected by interviewing the top managers there who have been working in the lab more than 20 years. Also, data was collected by observing employees and how they carry out experiments. Therefore, a survey was made to assess their knowledge about the hazardous waste. The management of hazardous chemicals in the chemistry section needs to be improved. The main findings illustrate that about 110 bottles of reference substances were going to be disposed of in 2014. These bottles were bought for about 100,000 UAE Dirhams (£17,600). This means that the management of substances purchase is not organised. There is no categorisation programme in place, which makes the waste control very difficult. In addition, the findings show that chemical are segregated according to alphabetical order, whereas the efficient way is to separate them according to their nature and property. In addition, the research suggested technology and experiments to follow to reduce the need for using solvents and chemicals in the sample preparation.

Keywords: control, hazard, laboratories, waste,

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Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

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Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

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Authors: Ahmad Akrad, Rabia Sehab, Fadi Alyoussef

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Nowadays, induction machines are widely used in industry thankful to their advantages comparing to other technologies. Indeed, there is a big demand because of their reliability, robustness and cost. The objective of this paper is to deal with diagnosis, detection and isolation of faults in a three-phase induction machine. Among the faults, Inter-turn short-circuit fault (ITSC), current sensors fault and single-phase open circuit fault are selected to deal with. However, a fault detection method is suggested using residual errors generated by the root mean square (RMS) of phase currents. The application of this method is based on an asymmetric nonlinear model of Induction Machine considering the winding fault of the three axes frame state space. In addition, current sensor redundancy and sensor fault detection and isolation (FDI) are adopted to ensure safety operation of induction machine drive. Finally, a validation is carried out by simulation in healthy and faulty operation modes to show the benefit of the proposed method to detect and to locate with, a high reliability, the three types of faults.

Keywords: induction machine, asymmetric nonlinear model, fault diagnosis, inter-turn short-circuit fault, root mean square, current sensor fault, fault detection and isolation

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Authors: Abrar Almutairi, Alyaa Farouk, Amal Gouda

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Background: Social capital is a factor that helps in bonding in a social network. The individual and the neighborhood social capital affect the health status of members of a particular society. In addition, to the influence of social health on the health of the population, social health has a significant effect on women, especially those with pregnancy. Study objective was to assess the impact of the social capital on the health status of pregnant women Design: A descriptive crosssectional correlational design was utilized in this study. Methods: A convenient sample of 210 pregnant women who attended the outpatient antenatal clinicsfor follow-up in King Fahad hospital (Ministry of National Guard Health Affairs/Riyadh) and King Abdullah bin Abdelaziz University Hospital (KAAUH, Ministry of Education /Riyadh) were included in the study. Data was collected using a self-administered questionnaire that was developed by the researchers based on the “World Bank Social Capital Assessment Tool” and SF-36 questionnaire (Short Form Health Survey). The questionnaire consists of 4 parts to collect information regarding socio-demographic data, obstetric and gynecological history, general scale of health status and social activity during pregnancy and the social capital of the study participants, with different types of questions such as multiple-choice questions, polar questions, and Likert scales. Data analysis was carried out by using Statistical Package for the Social Sciences version 23. Descriptive statistic as frequency, percentage, mean, and standard deviation was used to describe the sample characteristics, and the simple linear regression test was used to assess the relationship between the different variables, with level of significance P≤0.005. Result: This study revealed that only 31.1% of the study participants perceived that they have good general health status. About two thirds (62.8%) of the participants have moderate social capital, more than one ten (11.2٪) have high social capital and more than a quarter (26%) of them have low social capital. All dimensions of social capital except for empowerment and political action had positive significant correlations with the health status of pregnant women with P value ranging from 0.001 to 0.010in all dimensions. In general, the social capital showed high statistically significant association with the health status of the pregnant (P=0.002). Conclusion: Less than one third of the study participants had good perceived health status, and the majority of the study participants have moderate social capital, with only about one ten of them perceived that they have high social capital. Finally, neighborhood residency area, family size, sufficiency of income, past medical and surgical history and parity of the study participants were all significantly impacting the assessed health domains of the pregnant women.

Keywords: impact, social capital, health status, pregnant women

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Authors: Siamak Epackachi, Andrew S. Whittaker, Amit H. Varma

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An experimental program on steel-plate concrete (SC) composite shear walls was executed in the NEES laboratory at the University at Buffalo. Four large-size specimens were tested under displacement-controlled cyclic loading. The design variables considered in the testing program included wall thickness, reinforcement ratio, and faceplate slenderness ratio. The aspect ratio (height-to-length) of the four walls was 1.0. Each SC wall was installed on top of a re-usable foundation block. A bolted baseplate to RC foundation connection was used for all four walls. The walls were identified to be flexure-critical. This paper presents the damage to SC walls at different drift ratios, the cyclic force-displacement relationships, energy dissipation and equivalent viscous damping ratios, the strain and stress fields in the steel faceplates and the contribution of the steel faceplates to the total shear load, the variation of vertical strain in the steel faceplates along the length of the wall, near the base, at different drift ratios, the contributions of shear, flexure, and base rotation to the total lateral displacement, the displacement ductility of the SC walls, and the cyclic secant stiffness of the four SC walls.

Keywords: steel-plate composite shear wall, safety-related nuclear structure, flexure-critical wall, cyclic loading

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Authors: M. Mohsin Munir, Taimoor Ahmad, Javed Munir, Usman Rashid

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Determination of maximum elevation of a flowing fluid due to sudden rejection of load in a hydropower facility is of great interest to hydraulic engineers to ensure safety of the hydraulic structures. Several mathematical models exist that employ one-dimensional modeling for the determination of surge but none of these perfectly simulate real-time circumstances. The paper envisages investigation of surge inception and propagation for a Low Head Hydropower project using Computational Fluid Dynamics (CFD) analysis on FLOW-3D software package. The fluid dynamic model utilizes its analysis for surge by employing Reynolds’ Averaged Navier-Stokes Equations (RANSE). The CFD model is designed for a case study at Taunsa hydropower Project in Pakistan. Various scenarios have run through the model keeping in view upstream boundary conditions. The prototype results were then compared with the results of physical model testing for the same scenarios. The results of the numerical model proved quite accurate coherence with the physical model testing and offers insight into phenomenon which are not apparent in physical model and shall be adopted in future for the similar low head projects limiting delays and cost incurred in the physical model testing.

Keywords: surge, FLOW-3D, numerical model, Taunsa, RANSE

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Authors: P. Okoro Ugo Chigozie, P. A. Igbojekwe, E. N. Ukabuilu

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Tourism and terrorism experiences are best viewed as dynamic, complex systems with extreme diverse consequences on any nation’s economy. Tourism is one of the biggest industries in the world and one of the economical sectors which grows rapidly; tourism has positive impact on the nation’s economy. Terrorism is the method or the theory behind the method whereby an organized group or party seeks to achieve its avowed aims chiefly through the systematic use of violence; the consequences of terrorism on tourist destinations are inescapable and can be profound. Especially, it threatens the attractiveness of a tourist destination and strips the competitiveness of that destination. Destination’s vulnerability to politically motivated violence not only retracts tourists, but threatens sustainable tourism development. This paper examines the activities of the Jamaata Ahlis Sunna Liddaawati -an Islamic sect popularly known as Boko Haram – and its impact on sustainable tourism development in the Nigeria state. Possible triggers of this insurgency and potentially evolving measure against its influence on sustainable tourism including, strong image management of the tourism industry, feasible tourist safety policy, viable anti-terrorism measures, proactive respond to the challenge of terrorism, reinforcement of the legitimate frameworks and irrevocable penalty against menace of corruption; are discussed in this paper, as limiting the effects of insurgency on the attractiveness of Nigeria as safe tourists destination.

Keywords: Nigeria, terrorism, sustainable tourism development, corruption and competitiveness

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Authors: Sree Vennela P., V. Samyuktha Bhardwaj

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Hyponatremia is an electrolyte disturbance in which the sodium ion concentration in the serum is lower than normal. Sodium is the dominant extracellular cation (positive ion) and cannot freely cross from the interstitial space through the cell membrane, into the cell. Its homeostasis (stability of concentration) inside the cell is vital to the normal function of any cell. Normal serum sodium levels are between 135 and 145 mEq/L. Hyponatremia is defined as a serum level of less than 135 mEq/L and is considered severe when the serum level is below 125 mEq/L. In the vast majority of cases, Hyponatremia occurs as a result of excess body water diluting the serum sodium (salt level in the blood). Hyponatremia is often a complication of other medical illnesses in which excess water accumulates in the body at a higher rate than can be excreted (for example in congestive heart failure, syndrome of inappropriate antidiuretic hormone, SIADH, or polydipsia). Sometimes it may be a result of over-hydration (drinking too much water).Lack of sodium (salt) is very rarely the cause of Hyponatremia, although it can promote Hyponatremia indirectly. In particular, sodium loss can lead to a state of volume depletion (loss of blood volume in the body), with volume depletion serving as a signal for the release of ADH (anti-diuretic hormone). As a result of ADH-stimulated water retention (too much water in the body), blood sodium becomes diluted and Hyponatremia results.

Keywords: Tolvaptan, hyponatremia, syndrome of insufficient anti diuretic hormone (SIADH), euvolemic hyponatremia

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: Malik Takreem Ahmad, Pablo Lamata, Rasi Mizori

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Background: In recent years, mobile health apps have grown in popularity as a means for people to track and manage their health. While there is increasing worry that these applications may potentially contribute to the emergence of health anxiety, they can also help to encourage healthy behaviours and provide access to health information. Objective: The objective of this literature review is to look at available mhealth apps and critically evaluate the compromise between reassurance and anxiety. Methodology: A literature review was carried out to analyse the effects of mhealth apps on the creation of health anxiety within the general population. PubMed and SCOPUS were used to search for relevant articles, and abstracts were screened using inclusion criteria of the terms: mhealth apps; e-Health; healthcare apps; cyberchondria; Health anxiety; illness anxiety disorder. A total of 27 studies were included in the review. Results and discussion: The findings suggest a direct relationship between mobile health app use and health anxiety. The impact of mobile health apps on health anxiety may depend on how they are used - individuals receiving a constant stream of health-related information may trigger unnecessary concern about one's health. The need for more regulation and oversight is identified, which can lead to app quality and safety consistency. There are also concerns about data security and privacy and the resulting "digital gap" for individuals without mobiles or internet access. Conclusion: While health apps can be valuable tools for managing and tracking health, individuals need to use them in a balanced and informed way to avoid increased anxiety.

Keywords: mobile health, mhealth apps, cyberchondria, health anxiety

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Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

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Authors: V. Santamarina Campos, M. de Miguel Molina, S. Kröner, B. de Miguel Molina

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With this contribution, we want to show how the AiRT system could change the future way of working of a part of the creative industry and what new economic opportunities could arise for them. Remotely Piloted Aircraft Systems (RPAS), also more commonly known as drones, are now essential tools used by many different companies for their creative outdoor work. However, using this very flexible applicable tool indoor is almost impossible, since safe navigation cannot be guaranteed by the operator due to the lack of a reliable and affordable indoor positioning system which ensures a stable flight, among other issues. Here we present our first results of a European project, which consists of developing an indoor drone for professional footage especially designed for the creative industries. One of the main achievements of this project is the successful implication of the end-users in the overall design process from the very beginning. To ensure safe flight in confined spaces, our drone incorporates a positioning system based on ultra-wide band technology, an RGB-D (depth) camera for 3D environment reconstruction and the possibility to fully pre-program automatic flights. Since we also want to offer this tool for inexperienced pilots, we have always focused on user-friendly handling of the whole system throughout the entire process.

Keywords: virtual reality, 3D reconstruction, indoor positioning system, RPAS, remotely piloted aircraft systems, aerial film, intelligent navigation, advanced safety measures, creative industries

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Authors: Maryam Rasool, Farhan Munir, Fahad Nawaz, Saad Ahmad

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A patch antenna operating in the Ultra-Wide Band of frequency (3.1 GHz – 10.6 GHz) is designed with enhanced security from interference from other applications by incorporating the notching technique. Patch antennas in the Ultra-Wide Band are becoming widely famous due to their low power, light weight and high data rate capability. Micro strip patch antenna’s patch can be altered to increase its bandwidth and introduce UWB character in it. The designed antenna is a patch antenna consisting of a conductive sheet of metal mounted over a large sheet of metal called the ground plane with a substrate separating the two. Notched bands are public safety WLAN, WLAN and FSS. Different techniques used to implement the UWB antenna were individually implemented and there results were examined. V shaped patch was then chosen and modified to an arrow shaped patch to give the optimized results operating on the entire UWB region with considerable return loss. The frequency notch prevents the operation of the antenna at a particular range of frequency, hence minimizing interference from other systems. There are countless techniques for introducing the notch but we have used inverted C-shaped slots in the UWB patch to get the notch characteristics as output and also wavelength resonators to introduce notch in UWB band. The designed antenna is simulated in High Frequency Structural Simulator (HFSS) 13.0 by Ansoft.

Keywords: HFSS, Notch, UWB, WLAN

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Authors: MD. Kamruzzaman

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As a developing country, Bangladesh has seen an increase in total GDP in recent years. But it can be further improved by developing “Health-Care” (HC) services because it has enormous infrastructure problems all over the country. Bangladesh's HC system is now clearly poised to undergo reform at any process level, including prevention, diagnosis, and treatment. Although the Bangladeshi government is trying to develop the HC sector, due to health corruption in this sector, the improvement has not accelerated yet. For this reason, lots of Bangladeshi people are facing acute diseases. Regarding the prevention, diagnosis, and treatment of disease, this research will illustrate the law relating to health and HC to ensure excellent health and well-being. Firstly, this paper investigates health under Bangladeshi law from different perspectives related to the HC system. A massive gap has been investigated in this research after comparing Bangladeshi and international health law (HL). Secondly, a practical scenario is investigated and compared with international HC law. It is evident that the Bangladeshi HC system did not achieve a satisfactory standard level concerning international law. A staggering 70% of Bangladesh's population lives in rural areas, with no restrictions on access to hospitals and clinics. However, it is clear that proper HC infrastructure and some new medical practices are urgently needed to ensure HC quality. Finally, this research provides suggestions for developing a HC system to ensure the health of all Bangladeshi people that needs to be immediately implemented by the Bangladeshi government. This research has practical implications in the HC system for any developing country to maintain their citizen's safety.

Keywords: HC system, law relating, bangladeshi HL, international HL, human HC suggestions

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Authors: Boumaraf Malak

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The development of intelligent transportation systems (ITS) and artificial intelligence (AI) are spurring us to pave the way for the widespread adoption of autonomous vehicles (AVs). This is open again opportunities for smart roads, smart traffic safety, and mobility comfort. A highly intelligent decision-making system is essential for autonomous driving around dense, dynamic objects. It must be able to handle complex road geometry and topology, as well as complex multiagent interactions, and closely follow higher-level commands such as routing information. Autonomous vehicles have become a very hot research topic in recent years due to their significant ability to reduce traffic accidents and personal injuries. Using new artificial intelligence-based technologies handles important functions in scene understanding, motion planning, decision making, vehicle control, social behavior, and communication for AV. This paper focuses only on deep reinforcement learning-based methods; it does not include traditional (flat) planar techniques, which have been the subject of extensive research in the past because reinforcement learning (RL) has become a powerful learning framework now capable of learning complex policies in high dimensional environments. The DRL algorithm used so far found solutions to the four main problems of autonomous driving; in our paper, we highlight the challenges and point to possible future research directions.

Keywords: deep reinforcement learning, autonomous driving, deep deterministic policy gradient, deep Q-learning

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Authors: Mahmoud Hassanin, Amita Gupta

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Background: During current practice, Thiopentone is not cost-effectively added to resources wastage, risk of drug error with antibiotics, short shelf life, infection risk, and risk of delay while preparing during category one cesarean section. There is no significant difference or preference to the other alternative as per current use. Aims and Objectives: Patient safety, Cost-effective use of trust resources, problem awareness, Consider improvising on the current practice. Methods: In conjunction with the local department survey results, many studies support the change. Results: More than 50%(15 from 29) are already using Propofol, more than 75% of the participant are willing to shift to Propofol if it becomes standard, and the cost analysis also revealed that Thiopentone 10 X500=£60 Propofol 10X200= £5.20, Cost of Thiopentone/year =£2190. Approximately GA in a year =35-40 could cost approximately £20 Propofol, given it is a well-established practice. We could save not only money, but it will be environmentally friendly also to avoid adding any carbon footprints. Recommendation: Thiopentone is rarely used as an induction agent for the category one Caesarean section in our obstetric emergency theatres. Most obstetric anesthetists are using Propofol. Keep both Propofol and thiopentone(powder not withdrawn) in the cat one cesarean section emergency drugs tray ready until the department completely changes the practice protocol. A further retrospective study is required to compare the outcomes for these induction agents through the local database.

Keywords: thiopentone, propofol, category 1 caesarean, induction agents

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Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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Authors: Xinyi Zhao, Furong Tian

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Mycotoxins are secondary metabolic products of fungi. These are poisonous, carcinogens and mutagens in nature and pose a serious health threat to both humans and animals, causing severe illnesses and even deaths. The rapid, simple and cheap detection methods of mycotoxins are of immense importance and in great demand in the food and beverage industry as well as in agriculture and environmental monitoring. Lateral flow immunochromatographic strips (ICSTs) have been widely used in food safety, environment monitoring. Forty-six papers were identified and reviewed on Google Scholar and Scopus for their limit of detection and nanomaterial on Lateral flow immunochromatographic strips on different types of mycotoxins. The papers were dated 2001-2021. Twenty five papers were compared to identify the lowest limit of detection of among different mycotoxins (Aflatoxin B1: 10, Zearalenone:5, Fumonisin B1: 5, Trichothecene-A: 5). Most of these highly sensitive strips are competitive. Sandwich structure are usually used in large scale detection. In conclusion, the mycotoxin receives that most researches is aflatoxin B1 and its limit of detection is the lowest. Gold-nanopaticle based immunochromatographic test strips has the lowest limit of detection. Five papers involve smartphone detection and they all detect aflatoxin B1 with gold nanoparticles. In these papers, quantitative concentration results can be obtained when the user uploads the photograph of test lines using the smartphone application.

Keywords: aflatoxin B1, limit of detection, gold nanoparticle, lateral flow immunochromatographic strips, mycotoxins

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Authors: Lina Feng

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The study aimed at establishing quality evaluation indicators of an early education center for 0~3 years old, and defining the weight system of it. Expert questionnaire and Fuzzy Delphi method were applied. Firstly, in order to ensure the indicators in accordance with the practice of early education, 16 experts were invited as respondents to a preliminary Expert Questionnaire about Quality Evaluation Indicators of Early Education Center for 0~3 Years Old. The indicators were based on relevant studies on quality evaluation indicators of early education centers in China and abroad. Secondly, 20 scholars, kindergarten principals, and educational administrators were invited to form a fuzzy Delphi expert team. The experts’ opinions on the importance of indicators were calculated through triangle fuzzy numbers in order to select appropriate indicators and calculate indicator weights. This procedure resulted in the final Quality Evaluation Indicators of Early education Center for 0~3 Years Old. The Indicators contained three major levels, including 6 first-level indicators, 30 second-level indicators, and 147 third-level indicators. The 6 first-level indicators were health and safety; educational and cultivating activities; development of babies; conditions of the center; management of the center; and collaboration between family and the community. The indicators established by this study could provide suggestions for the high-quality environment for promoting the development of early year children.

Keywords: early education center for 0~3 years old, educational management, fuzzy delphi method, quality evaluation indicator

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Head and neck cancer (HNC) is a big global health problem in the world. Despite the development of diagnosis and treatment, the overall survival of HNC is still low. The well recognition of the interaction of the host immune system and cancer cells has led to realizing the processes of tumor initiation, progression and metastasis. Many systemic inflammatory responses have been shown to play a crucial role in cancer progression. The pre and post-treatment nutritional and immunological status of HNC patients is a reliable prognostic indicator of tumor outcomes and survivors. Methods: Between July 2020 to June 2022, We have enrolled 60 HNC patients, including 59 males and 1 female, in Chi Mei Medical Center, Liouying, Taiwan. The age distribution was from 37 to 81 years old (y/o), with a mean age of 57.6 y/o. We evaluated the pre-and post-treatment nutritional and immunological status of these HNC patients with body weight, body weight loss, body mass index (BMI), whole blood count including hemoglobin (Hb), lymphocyte, neutrophil and platelet counts, biochemistry including prealbumin, albumin, c-reactive protein (CRP), with the time period of before treatment, post-treatment 3 and 6 months. We calculated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to assess how these biomarkers influence the outcomes of HNC patients. Results: We have carcinoma of the hypopharynx in 21 cases with 35％, carcinoma of the larynx in 9 cases, carcinoma of the tonsil and tongue every 6 cases, carcinoma soft palate and tongue base every 5 cases, carcinoma of buccal mucosa, retromolar trigone and mouth floor every 2 cases, carcinoma of the hard palate and low lip each 1 case. There were stage I 15 cases, stage II 13 cases, stage III 6 cases, stage IVA 10 cases, and stage IVB 16 cases. All patients have received surgery, chemoradiation therapy or combined therapy. We have wound infection in 6 cases, 2 cases of pharyngocutaneous fistula, flap necrosis in 2 cases, and mortality in 6 cases. In the wound infection group, the average BMI is 20.4 kg/m2; the average Hb is 12.9 g/dL, the average albumin is 3.5 g/dL, the average NLR is 6.78, and the average PLR is 243.5. In the PC fistula and flap necrosis group, the average BMI is 21.65 kg/m2; the average Hb is 11.7 g/dL, the average albumin is 3.15 g/dL, average NLR is 13.28, average PLR is 418.84. In the mortality group, the average BMI is 22.3 kg/m2; the average Hb is 13.58 g/dL, the average albumin is 3.77 g/dL, the average NLR is 6.06, and the average PLR is 275.5. Conclusion: HNC is a big challenging public health problem worldwide, especially in the high prevalence of betel nut consumption area Taiwan. Besides the definite risk factors of smoking, drinking and betel nut related, the other biomarkers may play significant prognosticators in the HNC outcomes. We concluded that the average BMI is less than 22 kg/m2, the average Hb is low than 12.0 g/dL, the average albumin is low than 3.3 g/dL, the average NLR is low than 3, and the average PLR is more than 170, the surgical complications and mortality will be increased, and the prognosis is poor in HNC patients.

Keywords: nutritional, immunological, neutrophil-to-lymphocyte ratio, paltelet-to-lymphocyte ratio.

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Authors: Mohammad H. Yarmohamadian, Reza Safdari, Nahid Tavakoli

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In recent years, many countries have suffered various natural disasters. Disaster response continues to face the challenges in health care sector in all countries. Information and communication management is a significant challenge in disaster scene. During the last decades, rapid advances in information technology have led to manage information effectively and improve communication in health care setting. Information technology is a vital solution for effective response to disasters and emergencies so that if an efficient ICT-based health information system is available, it will be highly valuable in such situation. Of that, mobile technology represents a nearly computing technology infrastructure that is accessible, convenient, inexpensive and easy to use. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Since there is a high prevalence of cell phones among world population, it is expected the health care providers and managers to take measures for applying this technology for improvement patient safety and public health in disasters. At present there are challenges in the utilization of mhealth in disasters such as lack of structural and financial issues in our country. In this paper we will discuss about benefits and challenges of mhealth technology in disaster setting considering connectivity, usability, intelligibility, communication and teaching for implementing this technology for disaster response.

Keywords: information technology, mhealth, disaster, effective response

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Authors: Rui Chen, Shu-min Zhou, Xiong-jie Zhang, Ren-bo Wang, Fan Huang, Bin Tang

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During the temperature changes in reactor core, the nuclide cross section in reactor can vary with temperature, which eventually causes the changes of reactivity. To simulate the interaction between incident neutron and various materials at different temperatures on the nose, it is necessary to generate all the relevant reaction temperature-dependent cross section. Traditionally, the real time cross section generation method is used to avoid storing huge data but contains severe problems of low efficiency and adaptability for narrow energy region. Focused on the research on multi-temperature cross sections generation in real time during in neutron transport, this paper investigated the on-the-fly cross section generation method for resolved resonance region, thermal region and unresolved resonance region, and proposed the real time multi-temperature cross sections generation method based on double-exponential formula for resolved resonance region, as well as the Neville interpolation for thermal and unresolved resonance region. To prove the correctness and validity of multi-temperature cross sections generation based on wide energy region of incident neutron, the proposed method was applied in critical safety benchmark tests, which showed the capability for application in reactor multi-physical coupling simulation.

Keywords: cross section, neutron transport, numerical simulation, on-the-fly

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Authors: Xiaoping Zhang, Fengying Yan

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The implementation of the 'Urban Design Management Measures' requires that the master urban design should aim at creating a livable urban space. However, to our best knowledge, the existing researches and practices of master urban design not only focus less on the livable space but also face a number of problems such as paying more attention to the image of the city, ignoring the people-oriented and lacking dynamic continuity. In order to make the master urban design can better guide the construction of city. Firstly, the paper proposes the livable city hierarchy system to meet the needs of different groups of people and then constructs the framework of livable goal-oriented master urban design based on the theory of livable content and the ideological origin of people-oriented. Secondly, the paper takes the master urban design practice of Zibo as a sample and puts forward the design strategy of strengthening the pattern, improve the quality of space, shape the feature, and establish a series of action plans based on the strategy of urban space development. Finally, the paper explores the method system of livable goal-oriented master urban design from the aspects of safety pattern, morphology pattern, neighborhood scale, open space, street space, public interface, style feature, public participation and action plans.

Keywords: livable, master urban design, public participation, zibo city

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Authors: Vojko Kilar, Boris Azinović, David Koren

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Recently, an increasing trend of passive and low-energy buildings transferring form non earthquake-prone to earthquake-prone regions has thrown out the question about the seismic safety of such buildings. The paper describes the most commonly used thermal insulating materials and the special details, which could be critical from the point of view of earthquake resistance. The most critical appeared to be the cases of buildings founded on the RC foundation slab lying on a thermal insulation (TI) layer made of extruded polystyrene (XPS). It was pointed out that in such cases the seismic response of such buildings might differ to response of their fixed based counterparts. The main parameters that need special designers’ attention are: the building’s lateral top displacement, the ductility demand of the superstructure, the foundation friction coefficient demand, the maximum compressive stress in the TI layer and the percentage of the uplifted foundation. The analyses have shown that the potentially negative influences of inserting the TI under the foundation slab could be expected only for slender high-rise buildings subjected to severe earthquakes. Oppositely it was demonstrated for the foundation friction coefficient demand which could exceed the capacity value yet in the case of low-rise buildings subjected to moderate earthquakes. Some suggestions to prevent the horizontal shifts are also given.

Keywords: earthquake response, extruded polystyrene (XPS), low-energy buildings, foundations on thermal insulation layer

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Authors: Ross Lee, Pritpal Singh, Andrew Jester

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As the world transitions to a more sustainable energy economy, the deployment of energy storage technologies is expected to increase to develop a more resilient grid system. However, current technologies are associated with various environmental and safety issues throughout their entire lifecycle; therefore, new battery technology is necessary for grid applications to curtail these risks. Biological cells, such as human neurons and electrolytes in the electric eel, can serve as a more sustainable design template for a new bio-inspired (i.e., biomimetic) battery. Within biological cells, an electrochemical gradient across the cell membrane forms the membrane potential, which serves as the driving force for ion transport into/out of the cell, akin to the charging/discharging of a battery cell. This work serves as the first step to developing such a biomimetic battery cell, starting with the fabrication and characterization of ion-selective membranes to facilitate ion transport through the cell. Performance characteristics (e.g., cell voltage, power density, specific energy, roundtrip efficiency) for the cell under investigation are compared to incumbent battery technologies and biological cells to assess the readiness level for this emerging technology. Using a Na⁺-Form Nafion-117 membrane, the cell in this work successfully demonstrated behavior similar to human neurons; these findings will inform how cell components can be re-engineered to enhance device performance.

Keywords: battery, biomimetic, electrolytes, human neurons, ion-selective membranes, membrane potential

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Authors: Rajish Shil, Amal Alduhoori, Vipin Thomachan, Jamal Teir, Radhakrishnan Renganathan

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Background: Antiphospholipid antibody syndrome (APS) has a broad spectrum of thrombotic and non-thrombotic clinical manifestations. We present a case of APS presenting with seizure, stroke, and atrial mass. Case Description: A 38-year-old male presented with headache of 10 days duration and tonic-clonic seizure. The neurological examination was normal. Magnetic resonance imaging of brain showed small acute right cerebellar infarct. Magnetic resonance angiography of brain and neck showed a focal narrowing in the origin of the internal carotid artery bilaterally. Electroencephalogram was normal. He was started on aspirin, atorvastatin, and carbamazepine. Transthoracic and trans-esophageal echocardiography showed a pedunculated and lobular atrial mass, measuring 1 X 1.5 cm, which was freely mobile across mitral valve opening across the left ventricular inflow. Autoimmune screening showed positive Antiphospholipid antibodies in high titer (Cardiolipin IgG > 120 units/ml, B2 glycoprotein IgG 90 units/mL). Anti-nuclear antibody was negative. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Platelet count was low (111 x 109/L). The patient underwent successful surgical removal of the mass, which looked like a thrombotic clot, and Histopathological analysis confirmed it as a fibrinous clot, with no evidence of tumor cells. The patient was started on full anticoagulation treatment and was followed up regularly in the clinic, where our patient did not have any further complications from the disease. Discussion: Our patient was diagnosed to have APS based on the features of high positive anticardiolipin antibody IgG and B2 glycoprotein IgG levels, Stroke, thrombocytopenia, and abnormal echo findings. Thrombotic vegetation can mimic an atrial myxoma on echo. Conclusion: APS can present with neurological and cardiac manifestations, and therefore a high index of suspicion is necessary for a diagnosis of the disease as it can affect both short and long term treatment plans and prognosis. Therefore, in patients presenting with neurological symptoms like seizures, weakness and radiological diagnosis of stroke in a young patient, where atrial masses could be thought to be the cause of stroke, they should be screened for any concomitant findings of thrombocytopenia and/or activated partial thromboplastin time prolongation, which should raise the suspicion of vasculitis, specifically APS to be the primary cause of the clinical presentation.

Keywords: antiphospholipid syndrome, seizures, atrial mass, stroke

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Authors: Afroza Khatun, Masuma, Md. Younus Mia, Kamal Kanta Das

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Analysis of the microbial status and physicochemical parameters of some branded and street vended ice cream showed that total viable bacteria in branded ice cream ranged from 4.8×10³ to 1.10×10⁵ cfu/ml, and in street vended ice-cream ranged from 7.5×10⁴ to 1.6×10⁸ cfu/ml. Total coliform bacteria present up to 9.20×10³ cfu/ml in branded ice cream and 5.3×10³ to 9.6×10⁶ cfu/ml observed in street vended ice cream. Total E. coli were found to be present within a range from 0 to 4.5×10³ cfu/ml in branded and 4.1×10² to 7.5×10⁴ cfu/ml in street ice cream. The ranges of Staphylococcus aureus count were 1.8×10² to 2.9×10⁴ cfu/ml (branded) and 3.9×10⁴ to 7.9×10⁶ cfu/ml (street). The pH of both types of ice cream showed acidic to neutral conditions where the concentration of pH for branded ice cream was 5.5 to 6.9, as well as the value of pH in street ice cream, was 6.2 to 7.0. The range of Total soluble solids in several branded ice creams was 26 to 29%, and the value of TSS obtained in street-vended ice-creams ranged from 5 to 10%. The overall results of this research demonstrated that the microbial quality in all street ice creams exceeded the BSTI standard and exhibited lower quality than the industrially produced branded ice creams due to comparatively faulty manufacturing processes and poor hygiene practices. The presence of pathogenic microbes was also observed in branded ice creams which was quite alarming for public health. So it is suggested that the government authorized organization should conduct the proper monitoring system to ensure that both branded and street vended ice-creams are microbiologically safe to prevent public health hazards.

Keywords: food safety, microbiological analysis, physicochemical, ice-cream, E. coli, Staphylococcus aureus

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Authors: Wei Hu, Wenguang Chen, Chong Dong

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In order to improve the efficiency and safety of photovoltaic power generation devices, this photovoltaic power generation system combines Artificial Intelligence (AI) and the Internet of Things (IoT) to control the chasing photovoltaic power generation device to track the sun to improve power generation efficiency and then convert energy management. The system uses artificial intelligence as the control terminal, the power generation device executive end uses the Linux system, and Exynos4412 is the CPU. The power generating device collects the sun image information through Sony CCD. After several power generating devices feedback the data to the CPU for processing, several CPUs send the data to the artificial intelligence control terminal through the Internet. The control terminal integrates the executive terminal information, time information, and environmental information to decide whether to generate electricity normally and then whether to convert the converted electrical energy into the grid or store it in the battery pack. When the power generation environment is abnormal, the control terminal authorizes the protection strategy, the power generation device executive terminal stops power generation and enters a self-protection posture, and at the same time, the control terminal synchronizes the data with the cloud. At the same time, the system is more intelligent, more adaptive, and longer life.

Keywords: photo-voltaic power generation, the pursuit of light, artificial intelligence, internet of things, photovoltaic array, power management

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Authors: Afrin Jaman Bonny, Mehrin Jahan, Zannatul Ferdhoush, Mumenunnessa Keya, Md. Shihab Mahmud, Sharun Akter Khushbu, Sheak Rashed Haider Noori, Sheikh Abujar

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In 2020, the SARS-CoV-2 pandemic had led all the educational institutions to move to online learning platforms to ensure safety as well as the continuation of learning without any disruption to students’ academic life. But after the reopening of those educational institutions suddenly in Bangladesh, it became a vital demand to observe students take on this decision and how much they are comfortable with the new habits. When all educational institutions were ordered to re-open after more than a year, data was collected from students of all educational levels. A Google Form was used to conduct this online survey, and a total of 565 students participated without being pressured. The survey reveals the students' preferences for online and offline education systems, as well as their mental health at the time including their behavior to get back to offline classes depending on getting vaccinated or not. After evaluating the findings, it is clear that respondents' choices vary depending on gender and educational level, with female and male participants experiencing various mental health difficulties and attitudes toward returning to offline classes. As a result of this study, the student’s overall perspective on the sudden reopening of their educational institutions has been analyzed.

Keywords: covid-19 epidemic, educational proceeding, university students, school/college students, physical activity, online platforms, mental health, psychological distress

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Authors: Sakeena Naikwadi, K. Jagaluraiah Sannapapamma

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Vetiveria zizanioides is an aromatic grass and traditionally been used in aromatherapy and ayurvedic medicine. Vetiver root is multi-functional biopolymer and has highly aromatic, antimicrobial, UV blocking, antioxidant properties suitable for textile finishing. The vetiver root (Gulabi) powder of different concentration (2, 4, 6,8 percent) were extracted by aqueous and solvent methods subjected to bioassay for antimicrobial efficiency and GCMS spectral analysis. The organic cotton fabric was finished with vetiver root extract (8 percent) by exhaust and pad dry cure methods. The finished fabric was assessed for functional properties viz., UV protective factor, antimicrobial efficiency and aroma intensity. The results revealed that Ethanol extraction showed a greater zone of inhibition compared to aqueous extract in root powder. Among the concentrations, 8 percent root extract in ethanol showed a greater zone of inhibition against gram-positive organism S. aureus and gram-negative organism E. coli. The major compounds present in vetiver root extracts were diethyl pathalate with greater percentage (87.73 %) followed by 7- Isopropyl dimethyl carboxylic acid (4.05 %), 2-butanone 4-trimethyle cyclohexen (1.21 %), phenanthrene carboxylic acid (1.03 %), naphthalene pentanoic acid (0.99 %), 1-phenanthrene carboxylic acid and 1 cyclohexenone 2-methyl oxobuty (0.89 %). The sample finished by pad dry cure method exhibited better UV protection even after 10th wash as compared to exhaust method. Vetiver extract treated samples exhibited maximum zone of inhibition against S. aureus than the E. coli organism. The vetiver root extract treated organic cotton fabric through pad dry cure method possessed good antimicrobial activity against S. aureus and E. coli even after 20th washes compared to vetiver root extract treated by exhaust method. The olfactory analysis was carried out by 30 panels of members and opined that vetiver root extract treated fabric has very good and pleasant aroma with better tactile properties that provide cooling, soothing effect and enhances the mood of the wearer. Vetiver root extract finished organic cotton fabric possessed aroma, antimicrobial and UV properties which are aptly suitable for medical and healthcare textiles viz., wound dressing, bandage gauze, surgical cloths, baby diapers and sanitary napkins. It can be used as after finishing agent for variegated garments and made-ups and can be replaced with commercial after finishing agents.

Keywords: antimicrobial, olfactory analysis, UV protection factor, vetiver root extract

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