Search results for: fire severity level

Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Calvin Pak-Wing Cheng, Julie Sittlington, Yu-Tao Xiang, Tim Man Ho Li

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Insomnia is one of the most common health problems in the general population. Insomnia can be acute, intermittent, and become chronic, often due to comorbidity with other physical and mental health conditions. Although there are conventional pharmaceutical and psychotherapeutic treatments to treat symptoms of insomnia, however; there is no robust and novel randomized controlled trial (RCT) using transdermal neurostimulation on individuals with insomnia symptoms. This gives us the impetus to execute the first nationwide RCT. Aim: To evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. Design: This study was a two-armed, double blinded, randomized, sham-controlled trial. Sampling: 60 community-dwelling adults aged 18 and 60 years with moderate insomnia symptoms or above (Insomnia Severity Index > 14) were recruited. All subjects were computerized randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. Intervention: All participants received a home-use VeNS device and used 30-min VeNS sessions during five consecutive days across a 4-week period (total treatment hours: 10). Baseline measurements and post-VeNS evaluation of the psychological outcomes, including 1) insomnia severity, 2) sleep quality, and 3) quality of life were investigated. The short-and long-term sustainability of the VeNS intervention was assessed immediately after poststim and at a 1-month and 3-month follow-up period. Data analysis: A mixed GEE model was used to analyze the repeated measures data. Missing data were managed by multiple imputations. The level of significance was set to p < 0.05. Significance of the study: This is the first trial to examine the efficacy and safety of VeNS among adults with insomnia symptoms in Hong Kong. Findings that emerged were used to determine whether this VeNS device can be considered a self-help technological device to reduce the severity of insomnia in the community setting and to reduce the global disease burden. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04452981.

Keywords: adults, insomnia, neuromodulation, rct, vestibular stimulation

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Authors: Khalid Kaddoura, Ahmed Assad, Tarek Zayed

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Sewer pipelines are prone to deterioration over-time. In fact, their deterioration does not follow a fixed downward pattern. This is in fact due to the defects that propagate through their service life. Sewer pipeline defects are categorized into distinct groups. However, the main two groups are the structural and operational defects. By definition, the structural defects influence the structural integrity of the sewer pipelines such as deformation, cracks, fractures, holes, etc. However, the operational defects are the ones that affect the flow of the sewer medium in the pipelines such as: roots, debris, attached deposits, infiltration, etc. Yet, the process for each defect to emerge follows a cause and effect relationship. Deformation, which is the change of the sewer pipeline geometry, is one type of an influencing defect that could be found in many sewer pipelines due to many surrounding factors. This defect could lead to collapse if the percentage exceeds 15%. Therefore, it is essential to predict the deformation percentage before confronting such a situation. Accordingly, this study will predict the percentage of the deformation defect in sewer pipelines adopting the multiple regression analysis. Several factors will be considered in establishing the model, which are expected to influence the defamation defect severity. Besides, this study will construct a time-based curve to understand how the defect would evolve overtime. Thus, this study is expected to be an asset for decision-makers as it will provide informative conclusions about the deformation defect severity. As a result, inspections will be minimized and so the budgets.

Keywords: deformation, prediction, regression analysis, sewer pipelines

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Authors: Rania A. R. Soudan, Easter Joury

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Introduction: Psoriasis is a common chronic dermatologic disease. It may affect the mucous membranes. The presence of oral mucosal lesions has been a subject of controversy. The aim: To determine possible association between oral mucosal lesions and psoriasis, and to correlate the same with different types of psoriasis and severity of the disease. Materials and Methods: The oral mucosa was clinically examined in 100 randomly selected Syrian psoriatic patients presented to the Dermatological Diseases Hospital in Damascus University, Syria (February 2009 - December 2010), and in 100 matched controls. PASI index was used to evaluate the disease severity. Chi-square and Student t-test were used to compare differences between groups. Results: Oral mucosal lesions were observed in 72% of the psoriasis cases, while 46% of the control group’s subjects had oral lesions. Fissured tongue, geographic tongue, and red lesions were detected in 36%, 25%, and 7% of the examined psoriatics, respectively. These lesions were significantly more frequent in the psoriatics than in the controls. A correlation was found between furred tongue and the age of the psoriasis patients. However, an association was observed for fissured tongue, furred tongue with the severity of the disease, and for fissured tongue, white lesions, cheilitis with nail involvement. However, no correlation with the psoriasis types was recorded. Conclusion: Some oral mucosal lesions were associated with psoriasis, so these lesions may be considered as oral manifestations of this disease, and should be taken into account in new studies as possible predictors or markers of this dermatitis. Further studies are recommended to confirm these oral manifestations.

Keywords: psoriasis, tongue, mucosa, lesions

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Authors: T. Mrna, R. Doubrava

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This paper describes airworthiness requirements with respect damage tolerance. Damage tolerance determines the amount and magnitude of damage on parts of the airplane. Airworthiness requirements determine the amount of damage that can still be in flight capable of the condition. Component damage can be defined as barely visible impact damage, visible impact damage or clear visible impact damage. Damage is also distributed it according to the velocity. It is divided into low or high velocity impact damage. The severity of damage to the part of airplane divides the airworthiness requirements into several categories according to severity. Airworthiness requirements are determined by type airplane. All types of airplane do not have the same conditions for airworthiness requirements. This knowledge is important for designing and operating an airplane.

Keywords: airworthiness requirements, composite, damage tolerance, low and high velocity impact

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Authors: Artur Krukowski, Emmanouela Vogiatzaki

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The article presents results from the AF3 project “Advanced Forest Fire Fighting” focused on Unmanned Aircraft Systems (UAS)-based 3D surveillance and 3D area mapping using high-resolution photogrammetric methods from multispectral imaging, also taking advantage of the 3D scanning techniques from the SCAN4RECO project. We also present a proprietary embedded sensor system used for the detection of fire ignitions in the forest using near-infrared based scanner with weight and form factors allowing it to be easily deployed on standard commercial micro-UAVs, such as DJI Inspire or Mavic. Results from real-life pilot trials in Greece, Spain, and Israel demonstrated added-value in the use of UAS for precise and reliable detection of forest fires, as well as high-resolution 3D aerial modeling for accurate quantification of human resources and equipment required for firefighting.

Keywords: forest wildfires, surveillance, fuel volume estimation, firefighting, ignition detectors, 3D modelling, UAV

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Authors: Sima Parvizi Omran, Rezvan Tavakoli, Mahnaz Safari, Mohammadreza Aghasadeghi, Abolfazl Fateh, Pooneh Rahimi

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Background: SARS-CoV-2, a single-stranded RNA betacoronavirus causes the global outbreak of coronavirus disease 2019 (COVID-19). Several clinical and scientific concerns are raised by this pandemic. Genetic factors can contribute to pathogenesis and disease susceptibility. There are single nucleotide polymorphisms (SNPs) in many of the genes in the immune system that affect the expression of specific genes or functions of some proteins related to immune responses against viral infections. In this study, we analyzed the impact of polymorphism in the interferon alpha and beta receptor subunit 2 (IFNAR2) and dipeptidyl peptidase 9 (Dpp9) genes and clinical parameters on the susceptibility and resistance to Coronavirus disease (COVID-19). Methods: A total of 330- SARS-CoV-2 positive patients (188 survivors and 142 nonsurvivors) were included in this study. All single-nucleotide polymorphisms (SNPs) on IFNAR2 (rs2236757) and Dpp9 (rs2109069) were genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: In survivor patients, the frequency of the favourable genotypes of IFNAR2 SNP (rs2236757 GC) was significantly higher than in nonsurvivor patients, and also Dpp9 (rs2109069 AT) genotypes were associated with the severity of COVID-19 infection. Conclusions: This study demonstrated that the severity of COVID- 19 patients was strongly associated with clinical parameters and unfavourable IFNAR2, Dpp9 SNP genotypes. In order to establish the relationship between host genetic factors and the severity of COVID-19 infection, further studies are needed in multiple parts of the world.

Keywords: SARS-CoV-2, COVID-19, interferon alpha and beta receptor subunit 2, dipeptidyl peptidase 9, single-nucleotide polymorphisms

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: R. H. Begaydarova, B. Zh. Kultanov, B. T. Esilbaeva, G. E. Nasakaeva, Y. Yukhnevich, G. K. Alshynbekova, A. E. Dyusembaeva

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Background: The level of middle molecules of peptides (MMP) allows to evaluate the severity and prognosis of the disease and is a criterion for the effectiveness of the treatment. The detection the products of lipidperoxidation cascade, such as conjugated dienes, malondialdehyde in biological material, has an important role in the development of pathogenesis, the diagnosis and prognosis in different parasitic diseases. Purpose of the study was to evaluate the state of endogenous intoxication and indicators of lipid peroxidation in patients with giardiasis before and after treatment. Materials and methods: Endogenous intoxication was evaluated in patients with giardiasis in the level of middle molecules of peptides (MMP) in the blood. The amount of MMP and products of lipid peroxidation were determined in the blood of 198 patients with giardiasis, 129 of them were women (65%), 69 were men (35%). The MMP level was detected for comparison in the blood of 84 healthy volunteers. The lipid peroxidation were determined in 40 healthy men and women without giardiasis and history of chronic diseases. Data were processed by conventional methods of variation statistics, we calculated the arithmetic mean (M) and standard dispersion (m). t-test (t) was used to assess differences. Results: The level of MMP in the blood was significantly higher in patients with giardiasis in comparison with group of healthy men and women. MMP concentration in the blood of women with Giardia was 2.5 times greater than that of the comparison groups of women. The level of MMP exceeds more than 6 times in men with giardiasis. The decrease in the intensity of endogenous intoxication was two weeks after antigiardia therapy, both men and women. According to the study, a statistically significant increase in the level of all the studied parameters lipid peroxidation cascade was observed in the blood of men with giardiasis, with the exception of the total primary production (NGN). The treatment of giardiasis helped to stabilize the level of almost all metabolites of lipid peroxidation cascade. The exception was level of malondialdehyde, it was significantly elevated to compare with the control group and after treatment. Conclusion: Thus, the MMP level was significantly higher in blood of patients with giardiasis than in comparison group. This is evidence of severe endogenous intoxication caused by giardia infection. The accumulation of primary and secondary products of lipid peroxidation was observed in the blood of men and women. These processes tend to be more active in men than in women. Antigiardiasis therapy contributed to the normalization of almost all the studied indicators of lipid peroxidation in the blood of participants, except the level malondialdehyde in the blood of men.

Keywords: enzymes of antioxidant protection, giardiasis, blood, treatment

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Authors: Agnieszka Nowogrodzka

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Objectives: ADHD is a neurodevelopmental disorder in which symptoms are most prominent throughout childhood. In the longer term, these symptoms, as well as the behaviour of the child, the experiences arising from the response of the community to the child's symptoms, as well as the functioning of the community itself, all contribute to the onset of secondary symptoms and subsequent outcomes of the disorder, such as crime or mental disorders. The purpose of this study is to estimate the prevalence of ADHD among Polish convicts serving a prison sentence. To that end, the study will focus on the relationship between the severity of ADHD and early childhood trauma, family relations, maladaptive cognitive schemas, as well as mental disorders. It is an attempt to assess the interdependence between ADHD, childhood experiences, and secondary outcomes. Methods: The study enrolled two groups of first-time convicts and repeat offenders aged between 21 and 65 –each of the study groups comprised 120 participants; 240 participants in total took part in the study. Participants were recruited in semi-open penal institutions in Poland (Poznań Custody Suite, Wronki Penal Institution, Iława Penal Institution). The control group comprised 110 men without criminal records aged 21 to 65. The DIVA 5.0 questionnaire was employed to identify the severity of ADHD symptoms. Other questionnaires employed in the course of the study included the Childhood Trauma Questionnaire (CTQ), The Family Adaptability and Cohesion Scale IV (FACES-IV), Young Schema Questionnaire (YSQ), and the General Health Questionnaire (GHQ-30). Results: The findings of the study in question are currently still being compiled and will be shared during the conference. The findings of a pilot study involving two cohorts of convicts (each numbering 20 men) and a control group (20 men with no criminal records) indicate a significant correlation between ADHD and the experience of early childhood trauma. The severity of ADHD also shows a correlation with the assessment of the functioning of the family, with the subjects assessing the relationships in their families more negatively than the control group. Furthermore, the severity of ADHD is also correlated with maladaptive emotional schemas manifesting in the participants. The findings also show a correlation between selected dimensions and the severity of offenses.

Keywords: ADHD, social impairments, mental disorders, early childhood traumas, criminality

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Authors: Haibo Sheng, Yuan Hu

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Spinel structure Zinc stannate (Zn2SnO4, ZS)/Graphene was successfully synthesized by a simple in situ hydrothermal route. Morphological study and structure analysis confirmed the homogenously loading of ZS on the graphene sheets. Then, the resulted ZS/graphene hybrids were incorporated into epoxy resin to form EP/ZS/graphene composites by a solvent dispersion method. Improved thermal stability was investigated by Thermogravimetric Analysis (TGA). Cone calorimeter result showed low peak heat release rate (PHRR). Toxical gases release during combustion was evaluated by a facile device organized in our lab. The results showed that the release of NOx, HCN decrease of about 55%. Also, TG-IR technology was used to investigate the gas release during the EP decomposition process. The CO release had decreased about 80%.The EP/G/ZS showed lowest hazards during combustion (including flame retardancy, thermal stability, lower toxical gases release and so on) than pure EP.

Keywords: fire hazards, zinc stannate, epoxy resin, toxical gas hazards

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Authors: J. R. Wang, Y. Chiang, W. S. Hsu, H. C. Chen, S. H. Chen, J. H. Yang, S. W. Chen, C. Shih

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In this study, the RASCAL and ALOHA codes are used to establish an analysis methodology for hydrogen fluoride (HF) evaluation. There are three main steps in this study. First, the UF₆ data were collected. Second, one postulated case was analyzed by using the RASCAL and UF₆ data. This postulated case assumes that fire occurring and UF₆ is releasing from a building. Third, the results of RASCAL for HF mass were as the input data of ALOHA. Two postulated cases of HF were analyzed by using ALOHA code and the results of RASCAL. These postulated cases assume fire occurring and HF is releasing with no raining (Case 1) or raining (Case 2) condition. According to the analysis results of ALOHA, the HF concentration of Case 2 is smaller than Case 1. The results can be a reference for the preparing of emergency plans for the release of HF.

Keywords: RASCAL, ALOHA, UF₆, hydrogen fluoride

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Authors: M. Marsadek, A. Mohamed

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Power system security analysis is the most time demanding process due to large number of possible contingencies that need to be analyzed.  In a power system, any contingency resulting in security violation such as line overload or low voltage may occur for a number of reasons at any time.  To efficiently rank a contingency, both probability and the extent of security violation must be considered so as not to underestimate the risk associated with the contingency. This paper proposed a contingency ranking method that take into account the probabilistic nature of power system and the severity of contingency by using a newly developed method based on risk factor.  The proposed technique is implemented on IEEE 24-bus system.

Keywords: line overload, low voltage, probability, risk factor, severity

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Authors: M. H. Saeed, M. Rasool, M. A. Jawed

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Arc Flash Analysis has been a subject of great interest since the electrical fire incidents have been reduced to a great extent after the implementation of arc flash study at different sites. An Arc flash in substations is caused by short circuits over the air or other melted conductors and small shrapnel. Arc flash incidents result in the majority of deaths in substations worldwide. Engro Fertilizers Limited (EFERT) site having a mix of vintage non-internal arc rated and modern arc rated switchgears, carried out an arc flash study of the whole site in accordance with NFPA70E standard. The results not only included optimizing site protection coordination settings but also included marking of Shock and Arc flash protection boundaries in all switchgear rooms. Work permit procedures upgradation is also done in accordance with this study to ensure proper arc rated PPEs and arc flash boundaries protocols are fully observed and followed. With the new safety, protocols working on electrical equipment will be much safer than ever before.

Keywords: Arc flash, non-internal arc rated, protection coordination, shock boundary

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Authors: Lidia Kowalska, Edward Arseniuk

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Glume and leaf blotch is a disease of wheat caused by necrotrophic fungus Parastagonospora nodorum. It is a serious pathogen in many wheat-growing areas throughout the world. Use of resistant cultivars is the most effective and economical means to control the above-mentioned disease. Plant breeders and pathologists have worked intensively to incorporate resistance to the pathogen in new cultivars. Conventional methods of breeding for resistance can be supported by using the biotechnological ones, i.e., somatic embryogenesis and androgenesis. Therefore, an effort was undertaken to compare genetic variation in P. nodorum resistance among winter wheat somaclones, dihaploids and conventional varieties. For the purpose, a population of 16 somaclonal and 4 dihaploid wheat lines from six crosses were used to assess their resistance to P. nodorum under field conditions. Lines were grown in disease-free (fungicide protected) and inoculated micro plots in 2 replications of a split-plot design in a single environment. The plant leaves were inoculated with a mixture of P. nodorum isolates three times. Spore concentrations were adjusted to 4 x 10⁶ of viable spores per one milliliter. The disease severity was rated on a scale, where > 90% – susceptible, < 10% - resistant. Disease ratings of plant leaves showed statistically significant differences among all lines tested. Higher resistance to P. nodorum was observed more often on leaves of somaclonal lines than on dihaploid ones. On average, disease, severity reached 15% on leaves of somaclones and 30% on leaves of dihaploids. Some of the genotypes were showing low leaf infection, e.g. dihaploid D-33 (disease severity 4%) and a somaclone S-1 (disease severity 2%). The results from this study prove that dihaploid and somaclonal variation might be successfully used as an additional source of wheat resistance to the pathogen and it could be recommended to use in commercial breeding programs. The reported results prove that biotechnological methods may effectively be used in breeding for disease resistance of wheat to fungal necrotrophic pathogens.

Keywords: glume and leaf blotch, somaclonal, androgenic variation, wheat, resistance breeding

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Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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Authors: Marzena Trojanczyk, Mariusz Jaworski, Ewa Dmoch Gajzlerska

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Purpose: The purpose of this paper is to assess the relationship between the level of quality of life and willingness to take treatment in patients with eating disorders as anorexia, bulimia and compulsive bingeing. Material and methods: The subjects consisted of 99 women with eating disorders: anorexia, n = 33; bulimia, n = 35; compulsive overeating, n = 31 and 35 women in the control group. The study used an original questionnaire to assess the overall quality of life, as well as selected areas of the physical, mental, social and spiritual satisfaction. The subjects were also asked about the level of motivation for treatment, and the importance of the disease in the lives of patients. Statistical analyses were performed using the statistical program SPSS 18.0. Results: Women with eating disorders in particular groups did not differ with respect to each other in the aspect of overall quality of life, satisfaction with the development of the spiritual, social functioning and mental health. The severity level of the disease in the lives of patients showed a negative correlation with social functioning in women with anorexia nervosa. In the case of patients with compulsive bingeing a positive relationship between the level of importance of the disease and the satisfaction of spiritual development is reported. Conclusions: Concerning the inferior quality of life, there is no relationship between a willingness to take treatment and the importance of the disease in the lives of patients with anorexia, bulimia and compulsive bingeing.

Keywords: anorexia, bulimia, compulsive overeating, quality of life

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Authors: Teklay Gebrecherkos, Mahmud Abdulkader, Tobias Rinke De Wit, Britta C. Urban, Feyissa Chala, Yazezew Kebede, Dawit Welday

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Background: C-reactive protein (CRP) levels are a reliable surrogate for interleukin-6 bioactivity that plays a pivotal role in the pathogenesis of cytokine storm associated with severe COVID-19. There is a lack of data on the role of CRP as a determinant of COVID-19 severity status in the African context. Methods: We determined the longitudinal kinetics of CRP levels on 78 RT-PCR-confirmed COVID-19 patients (49 non-severe and 29 severe cases) and 50 PCR-negative controls. Results: COVID-19 patients had overall significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0-127.8) mg/L vs. 0.9 (IQR: 0.5-1.9) mg/L; p=0.0004)]. Moreover, severe COVID-19 patients had significantly higher median CRP levels than non-severe cases [166.1 (IQR: 48.6-332.5) mg/L vs. 2.4 (IQR: 1.2-7.6) mg/L; p<0.00001)]. In addition, persistently elevated levels of CRP were exhibited among those with comorbidities and higher age groups. Area under receiver operating characteristic curve (AUC) analysis of CRP levels distinguished PCR-confirmed COVID-19 patients from the ones with PCR-negative non-COVID-19 individuals, with an AUC value of 0.77 (95% CI: 0.68-0.84; p=0.001). Moreover, it clearly distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73-0.91). After adjusting for age and the presence of comorbidities, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 (adjusted relative risk 3.99 (95%CI: 1.35-11.82; p=0.013). Conclusions: Determining CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes.

Keywords: CRP, COVID-19, SARS-CoV-2, biomarker

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Authors: Agoston Restas

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Introduction: In case of managing disasters decision makers can face many times such a special situation where any pre-sign of the drastically change is missing therefore the improvised decision making can be required. The complexity, ambiguity, uncertainty or the volatility of the situation can require many times the improvisation as decision making. It can be taken at any level of the management (strategic, operational and tactical) but at tactical level the main reason of the improvisation is surely time pressure. It is certainly the biggest problem during the management. Methods: The author used different tools and methods to achieve his goals; one of them was the study of the relevant literature, the other one was his own experience as a firefighting manager. Other results come from two surveys that are referred to; one of them was an essay analysis, the second one was a word association test, specially created for the research. Results and discussion: This article proves that, in certain situations, the multi-criteria, evaluating decision-making processes simply cannot be used or only in a limited manner. However, it can be seen that managers, directors or commanders are many times in situations that simply cannot be ignored when making decisions which should be made in a short time. The functional background of decisions made in a short time, their mechanism, which is different from the conventional, was studied lately and this special decision procedure was given the name recognition-primed decision. In the article, author illustrates the limits of the possibilities of analytical decision-making, presents the general operating mechanism of recognition-primed decision-making, elaborates on its special model relevant to managers at tactical level, as well as explore and systemize the factors that facilitate (catalyze) the processes with an example with fire managers.

Keywords: decision making, disaster managers, recognition primed decision, model for making decisions in emergencies

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Authors: hadi kargar, bahador shabani

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In this article, 16 cylinder motor combustion CFD modeling with a diameter of 165 mm and 195 mm along the way to help the FIRE software to optimize its function to work. A three-dimensional model of the processes that formed inside the cylinder made that involves mixing the fuel and air, ignition and spraying. In this three-dimensional model, all chemical species, density of air fuel spraying and spray with full profile intended to detailed results from mixing the fuel and air, igniting the ignition advance, spray, and mixed media in different times and get fit by moving the piston. Optimal selection of the model for the shape of the piston and spraying fuel specifications (including the management of spraying, the number of azhneh hole, start time of spraying and spraying angle) to achieve the best fuel consumption and minimal pollution. The spray hole 6 and 7 in three different configurations with five spraying and gives the best geometry and various performances in the simulation. 6 hole spray angle, finally spraying 72.5 degrees and two forms of spraying a better performance in comparison with other items of their own.

Keywords: spray, FIRE, CFD, optimize, diesel engine

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Authors: Akshita Swaminathan, Vinayak Malhotra

Abstract:

Smoldering is one of the most persistent types of combustion which can take place for very long periods (hours, days, months) if there is an abundance of fuel. It causes quite a notable number of accidents and is one of the prime suspects for fire and safety hazards. It can be ignited with weaker ignition and is more difficult to suppress than flaming combustion. Upward spread smoldering is the case in which the air flow is parallel to the direction of the smoldering front. This type of smoldering is quite uncontrollable, and hence, there is a need to study this phenomenon. As compared to flaming combustion, a smoldering phenomenon often goes unrecognised and hence is a cause for various fire accidents. A simplified experimental setup was raised to study the upward spread smoldering, its effects due to varying forced flow and its effects when it takes place in the presence of external heat sources and alternative energy sources such as acoustic energy. Linear configurations were studied depending on varying forced flow effects on upward spread smoldering. Effect of varying forced flow on upward spread smoldering was observed and studied: (i) in the presence of external heat source (ii) in the presence of external alternative energy sources (acoustic energy). The role of ash removal was observed and studied. Results indicate that upward spread forced smoldering was affected by various key controlling parameters such as the speed of the forced flow, surface orientation, interspace distance (distance between forced flow and the pilot fuel). When an external heat source was placed on either side of the pilot fuel, it was observed that the smoldering phenomenon was affected. The surface orientation and interspace distance between the external heat sources and the pilot fuel were found to play a huge role in altering the regression rate. Lastly, by impinging an alternative energy source in the form of acoustic energy on the smoldering front, it was observed that varying frequencies affected the smoldering phenomenon in different ways. The surface orientation also played an important role. This project highlights the importance of fire and safety hazard and means of better combustion for all kinds of scientific research and practical applications. The knowledge acquired from this work can be applied to various engineering systems ranging from aircrafts, spacecrafts and even to buildings fires, wildfires and help us in better understanding and hence avoiding such widespread fires. Various fire disasters have been recorded in aircrafts due to small electric short circuits which led to smoldering fires. These eventually caused the engine to catch fire that cost damage to life and property. Studying this phenomenon can help us to control, if not prevent, such disasters.

Keywords: alternative energy sources, flaming combustion, ignition, regression rate, smoldering

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Authors: Ionela-Daniela Carja, Diana Serbezeanu, Tachita Vlad-Bubulac, Corneliu Hamciuc

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Nowadays, epoxy materials are extensively used in ever more areas and under ever more demanding environmental conditions due to their remarkable combination of properties, light weight and ease of processing. However, these materials greatly increase the fire risk due to their flammability and possible release of toxic by-products as a result of their chemical composition which consists mainly from carbon and hydrogen atoms. Therefore, improving the fire retardant behaviour to prevent the loss of life and property is of particular concern among government regulatory bodies, consumers and manufacturers alike. Modification of epoxy resins with organophosphorus compounds, as reactive flame retardants or additives, is the key to achieving non-flammable advanced epoxy materials. Herein, a detailed characterization of fire behaviour for a series of phosphorus-containing epoxy thermosets is reported. A carefully designed phosphorus flame retardant additive was simply blended with a bifunctional bisphenol-A based epoxy resin. Further thermal cross-linking in the presence of various aminic hardeners led to eco-friendly flame retardant epoxy resins. The type of hardener, concentration of flame retardant additive, compatibility between the components of the mixture, char formation and morphology, thermal stability, flame retardant mechanisms were investigated. It was found that even a very low content of phosphorus introduced into the epoxy matrix increased the limiting oxygen index value to about 30%. In addition, the peak of the heat release rate value decreased up to 45% as compared to the one of the neat epoxy system. The main flame retardant mechanism was the condensed-phase one as revealed by SEM and XPS measurements.

Keywords: condensed-phase mechanism, eco-friendly phosphorus flame retardant, epoxy resin, thermal stability

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Authors: Yu-Chi Liao, Nai-Wen Guo, Chun‑Hung Lee, Yung-Chin Lu, Cheng-Hung Ko

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Objective: The incidence of behavioral addictions, especially substance use disorders (SUDs), is gradually be taken seriously with various physical health problems. Mindfulness-based relapse prevention (MBRP) is a treatment option for promoting long-term health behavior change in recent years. MBRP is a structured protocol that integrates formal meditation practices with the cognitive-behavioral approach of relapse prevention treatment by teaching participants not to engage in reappraisal or savoring techniques. However, considering SUDs as a complex brain disease, questionnaires and symptom evaluation are not sufficient to evaluate the effect of MBRP. Neurophysiological biomarkers such as quantitative electroencephalogram (QEEG) may improve accurately represent the curative effects. This study attempted to find out the neurophysiological indicator of MBRP in various severity SUD involuntary clients. Participants and Methods: Thirteen participants (all males) completed 8-week mindfulness-based treatment provided by trained, licensed clinical psychologists. The behavioral data were from the Severity of Dependence Scale (SDS) and Negative Mood Regulation Scale (NMR) before and afterMBRP treatment. The QEEG data were simultaneously recorded with executive attention tasks, called comprehensive nonverbal attention test(CNAT). The two-way repeated-measures (treatment * severity) ANOVA and independent t-test were used for statistical analysis. Results: Thirteen participants regrouped into high substance dependence (HS) and low substance dependence (LS) by SDS cut-off. The HS group showed more SDS total score and lower gamma wave in the Go/No Go task of CNAT at pretest. Both groups showed the main effect that they had a lower frontal theta/beta ratio (TBR) during the simple reaction time task of CNAT. The main effect showed that the delay errors of CNAT were lower after MBRP. There was no other difference in CNAT between groups. However, after MBRP, compared to LS, the HS group have resonant progress in improving SDS and NMR scores. The neurophysiological index, the frontal TBR of the HS during the Go/No Go task of CNATdecreased than that of the LS group. Otherwise, the LS group’s gamma wave was a significant reduction on the Go/No Go task of CNAT. Conclusion: The QEEG data supports the MBRP can restore the prefrontal function of involuntary addicts and lower their errors in executive attention tasks. However, the improvement of MBRPfor the addict with high addiction severity is significantly more than that with low severity, including QEEG’s indicators and negative emotion regulation. Future directions include investigating the reasons for differences in efficacy among different severity of the addiction.

Keywords: mindfulness, involuntary clients, QEEG, emotion regulation

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Authors: Farideh Aramideh

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The aim of this essay is to study the light in Zoroastrianism, and Masnavi by Rumi. The use of light goes back to thousand years B.C. the light in the legacy of ancient Iranian wisdom has been used in Mithraism, Zurvanism, Zoroastrianism and Manichaean religion and spirituality has been emanated in the world through the light. Ontology and angelology and the sacredness of fire in Zoroastrianism have been interpreted according to the concept of light. The ruling atmosphere on mazdaism world is the world which is full of light and angels, and light is one of the basis of worldview in ancient Iranian mysticism, especially Zoroastrianism and Manichaean, continued widely in Islamic mysticism, and also it always provokes discussions among scholars and mystics especially Iranian mystics. Light and fire are used as the signs and symbols of God's existence, The Shining lights emanated from the sacred essence of God, knowledge, and mysticism, love, discovering the wisdom and a way to God. Rumi speaks eloquently about light in Masnavi, and by using the light; he could render his readers the fundamental mystic subjects such as the true existence of God, the verity of prophets and saints, intuition of God, spiritual states of union with God and abiding in God, which are the most complicated mystic terms.

Keywords: zoroastrianism, myticims, Masnavi, light

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Authors: Nasrin Galehdar, Sedigheh Nadri, Elham Nazari, Isan Darvishi, Abouzar Mohammadi

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Background and aim:Nausea and vomiting are complications of cesarean section. The pharmacological and non-pharmacological approaches were applied to decrease postoperative nausea and vomiting. The aim of the present study was to compare the effects of Ondansetron and acupressure on postoperative nausea and vomiting in patients undergone an elective cesarean section. Materials and method: The study was designed as a randomized clinical trial. A total of 120 patients were allocated to two equal groups. Four mgs of Ondansetron was administered for the Ondansetron group after clamping the umbilical cord. The acupressure bracelets were fastened in the PC6 point for acupressure group for 15 minutes. The patients were monitored in terms of incidence, severity, and episodes of nausea and vomiting. The data obtained were analyzed by SPSS software version 18 with a significance level of 0.05. Results: There was no significant statistical difference in nausea severity among the groups intra-operatively, in the recovery and surgery wards. The incidence and episodes of vomiting were significantly higher in patients undergone acupressure intra-operatively, in the recovery and surgery wards (P< 0.05). No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Conclusion: No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Thus, it is suggested to perform the studies with larger size and comparing the effects of acupressure with other antiemetic medications.

Keywords: ondansetron, acupressure, nausea, vomiting

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Authors: Mohammed Abed, Rita Nemes, Salem Nehme

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The present study experimentally investigated the impact of incorporating unprocessed waste fly ash (UWFA) on the residual mechanical properties of self-compacting concrete (SCC) after exposure to elevated temperature. Three mixtures of SCC have been produced by replacing the cement mass by 0%, 15% and 30% of UWFA. Generally, the fire resistance of SCC has been enhanced by replacing the cement up to 15% of UWFA, especially in case of residual modulus of elasticity which considers more sensitive than other mechanical properties at elevated temperature. However, a strong linear relationship has been observed between the residual flexural strength and modulus of elasticity, where both of them affected significantly by the cracks appearance and propagation as a result of elevated temperature. Sustainable products could be produced by incorporating unprocessed waste powder materials in the production of concrete, where the waste materials, CO₂ emissions, and the energy needed for processing are reduced.

Keywords: self-compacting high-performance concrete, unprocessed waste fly ash, fire resistance, residual modulus of elasticity

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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Authors: Mohammed Moustafa, Khaled Ayad, Waleed Reda

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Shoulder impingement syndrome is the most common disorder of the shoulder, resulting in functional loss and disability. Objective: This study was designed to compare between the effects of scapular muscle training versus rhythmic stabilization exercises in treatment of shoulder impingement syndrome. Methods: Thirty patients participated in this study; they were assigned randomly into two experimental groups. The first experimental group (A) consisted of 15 patients with a mean age (21.87±2.72) years; they received graduated rhythmic stabilization exercises and stretching of the posterior capsule. The second experimental group (B) consisted of 15 patients with a mean age (22.27±2.94) years; they received scapular muscle training exercises in addition to stretching of the posterior capsule. Treatment was given three times per week, every other day, for four consecutive weeks. Patients have been evaluated pretreatment and post treatment for shoulder pain severity and functional disability. Results: Both groups showed highly statistical significant reduction in pain severity and functional disability measured post-treatment when compared with their corresponding values in pretreatment assessment. Conclusion: Both of rhythmic stabilization exercises and scapular muscle training are effective interventions to reduce shoulder pain severity and functional disability.

Keywords: impingement syndrome, scapular exercises, rhythmic stabilization exercises, posterior capsule stretch

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Authors: Ratna Siti Khodijah, Mirzam Abdurrachman

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Gold is recovered from gold ores. Within the ores, there are not only gold but also several types of precious metals. Copper, silver, and platinum group elements (ruthenium, rhodium, palladium, rhenium, osmium, and iridium) are metals commonly found in the ores. These metals combine to form an ore because they have the same properties. It is due to their position in periodic-system-of-elements are near to gold. However, the presence of mercury in every gold ore has not been mentioned, even though it is located right next to gold in the periodic-system-of-elements and they are located in the same block, d-block. Thus, it is possible that mercury is contained in the ores. Moreover, the elements of the same group with mercury—zinc and cadmium—sometimes can be found in the ores. It is suspected that mercury can not be detected because the processing of gold ores usually using fire assay method. Before the ores melting, mercury would evaporate because it has the lowest boiling point of all precious metal in the ores. Therefore, it suggested doing research on the presence of mercury in gold ores by CVAAS method. The results of this study would obtain the amount of mercury in gold ores that should be purified. So it can be produced economically if possible.

Keywords: boiling point, d-block, fire assay, precious metal

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Authors: Yu Guan, Song Lu, Wei Yuan, Heping Zhang

Abstract:

Gas fire extinguishing system is widely used due to its cleanliness and efficiency, and since its spray will be affected by many factors such as convection and obstacles in jetting region, so in order to evaluate its effectiveness, detecting concentration distribution in the jetting area is indispensable, which is commonly achieved by aspirating concentration detection technique. During the concentration measurement, the response time of detector is a very important parameter, especially for those fire-extinguishing systems with rapid gas dispersion. Long response time will not only underestimate its concentration but also prolong the change of concentration with time. Therefore it is necessary to analyze the factors influencing the response time. In the paper, an aspirating concentration detection method was introduced, which is achieved by using a small critical nozzle and a laminar flowmeter, and because of the response time is mainly related to the gas transport process from sampling site to the sensor, the effects of exhaust pipe size, gas flow rate, and gas concentration on its response time were analyzed. During the research, Bromotrifluoromethane (CBrF₃) was used. The effect of the sampling tube was investigated with different length of 1, 2, 3, 4 and 5 m (5mm in pipe diameter) and different pipe diameter of 3, 4, 5, 6 and 8 mm (3m in length). The effect of gas flow rate was analyzed by changing the throat diameter of the critical nozzle with 0.5, 0.682, 0.75, 0.8, 0.84 and 0.88 mm. The effect of gas concentration on response time was studied with the concentration range of 0-25%. The result showed that the response time increased with the increase of both the length and diameter of the sampling pipe, and the effect of length on response time was linear, but for the effect of diameter, it was exponential. It was also found that as the throat diameter of critical nozzle increased, the response time reduced a lot, in other words, gas flow rate has a great influence on response time. For the effect of gas concentration, the response time increased with the increase of the CBrF₃ concentration, and the slope of the curve was reduced.

Keywords: aspirating concentration detection, fire extinguishing, gaseous agent, response time

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