Search results for: structured radiology report

Authors: Hanifa Maryani Ahmad, Muslim Yusuf

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Background: Unilateral crossbite can be defined as an abnormal transverse relationship between the upper and lower teeth where the mandibular buccal cusp occluding to the maxillary buccal cusp and which involves only one side of the arch. This report describes the treatment of an adolescent female with Class III malocclussion unilateral crossbite resulting from a mildly constricted maxillary arch. The patient had a Class III skeletal relationship, Class III molar relationships, unilateral crossbite on the left side, and deviated midlines. Objectives: The treatment objectives were to correct the abnormal transverse relationship, achieve proper dental inclination, and correct the unilateral crossbites to improve the facial profile. Case management: The treatment protocol was using transpalatal arch with extension arm modification to expand the maxillary arch. Following the levelling and aligning stage of treatment, using a vertical loop while mandibular arch was expanded after getting an end to end relationship on the anterior side. Results: Corrections of the unilateral crossbite were achieved in 4 months. The treatment is still on process because the canines relationship were not corrected. Conclusions: This report highlights a treatment using transpalatal arch with extension arm modification that can be used to expand the transverse width of an arch to correct the discrepancy. Even though the treatment processes were still ongoing, the correction of the unilateral crossbite have been achieved in 4 months by only using the transpalatal arch.

Keywords: crossbite unilateral, late growing, non-extraction, transpalatal arch

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Authors: Barbosa M. L. S., von Ancken A. C. B., Coelho C. P.

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In order to improve the treatment of epileptic dogs, this case report aims toobjective todescribe the use of the homeopathic medicine Cicuta virosa for the treatmentof seizuresin dogs that already use allopathy to control them. Howeach patient presents symptoms individually, the choice of medicationhomeopathic treatment must also be individualized. He was treated in the municipality of RibeirãoPires, São Paulo - Brazil, an animal of the canine species, female, 7 years old, SRD, with a history of seizuregeneralized tonic-clonic for two years, with a variable frequency of 1-2 seizures perday. With no identifiable etiology, the patient used phenobarbital daily, and the dose ofmedication was increased according to the frequency of seizures. The serum concentration of phenobarbital within 12 hours of itsadministration via blood sample was within the range ofreference. The patient experienced weight gain and intermittent sedation. the choice ofhomeopathic medicine Cicuta virosa 6 cH, prepared according to the PharmacopoeiaBrazilian Homeopathic Medicine, occurred due to its characteristic action on the nervous system, especially in epileptic animals that present with seizures, spasmodic contractions of the muscles of the whole body starting from the head, mouth, extremely violent, with rigidity and opisthotonos, extreme agitation, contortionsmultiple. The animal was submitted to treatment with 2 globules orally twicea day for 30 days. The treatment resulted in a clinical cure as there was no moreseizures, being effective to control this symptom.

Keywords: homeopathy, cicuta virosa, epilepsy, veterinary medicine

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Authors: Chanho Park, Juneseok You, Kuewhan Jang, Sungsoo Na

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Detection technique of nanotoxic materials is strongly imperative, because nano-toxic materials can harmfully influence human health and environment as their engineering applications are growing rapidly in recent years. In present work, we report the DNA immobilized quartz crystal microbalance (QCM) based sensor for detection of nano-toxic materials such as silver ions, Hg2+ etc. by using functionalization of quartz crystal with a target-specific DNA. Since the mass of a target material is comparable to that of an atom, the mass change caused by target binding to DNA on the quartz crystal is so small that it is practically difficult to detect the ions at low concentrations. In our study, we have demonstrated fast and in situ detection of nanotoxic materials using quartz crystal microbalance. We report the label-free and highly sensitive detection of silver ion for present case, which is a typical nano-toxic material by using QCM and silver-specific DNA. The detection is based on the measurement of frequency shift of Quartz crystal from constitution of the cytosine-Ag+-cytosine binding. It is shown that the silver-specific DNA measured frequency shift by QCM enables the capturing of silver ions below 100pM. The results suggest that DNA-based detection opens a new avenue for the development of a practical water-testing sensor.

Keywords: nano-toxic ions, quartz crystal microbalance, frequency shift, target-specific DNA

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Authors: Gul Jan

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It is the first quantitative ethno-botanical analysis and conservation issues of medicinal flora of Alpine and Sub-alpine, Hindikush region of Pakistan. The objective of the study aims to report, compare the uses and highlight the ethno-Botanical significance of medicinal plants for treatment of various diseases. A total of 250 (242 males and 8 females) local informants including 10 Local Traditional Healers were interviewed. Information was collected through semi-structured interviews, analyzed and compared by quantitative ethno-botanical indices such as Jaccard index (JI), Informant Consensus Factor (ICF), use value (UV) and Relative frequency of citation (RFC).Thorough survey indicated that 57 medicinal plants belongs to 43 families were investigated to treat various illnesses. The highest ICF is recorded for digestive system (0.69%), Circolatory system (0.61%), urinary tract system, (0.53%) and respiratory system (0.52%). Used value indicated that, Achillea mellefolium (UV = 0.68), Aconitum violaceum (UV = 0.69), Valeriana jatamansi (UV = 0.63), Berberis lyceum (UV = 0.65) and are exceedingly medicinal plant species used in the region. In comparison, highest similarity index is recorded in these studies with JI 17.72 followed by 16.41. According to DMR output, Pinus williciana ranked first due to multipurpose uses among all species and was found most threatened with higher market value. Unwise used of natural assets pooled with unsuitable harvesting practices have exaggerated pressure on plant species of the research region. The main issues causative to natural variety loss found were over grazing of animals, forest violation, wild animal hunting, fodder, plant collection as medicine, fuel wood, forest fire, and invasive species negatively affect the natural resources. For viable utilization, in situ and ex situ conservation, skillful collecting, and reforestation project may be the resolution. Further wide field management research is required.

Keywords: quantitative analysis, conservations issues, medicinal flora, alpine and sub-alpine, Hindukush region

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Authors: Afnan Khoja, Ittisak Subrungruang, Kritchaya Ritruechai, Linda Jones, David Wall

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Background: Some characteristics might be stated as an objective of the curriculum and some might be hidden. The hidden curriculum is the unwritten and unintended lessons and perspectives that students absorb in school. Though, the hidden characteristics are expected that tutors hope students might have in order to become medical educators. We suspected our faculty hoped we would develop skills, know and develop beyond the written outcomes. Our research question aimed to explore the hidden curriculum; as part of our learning; we had to design and report findings. Summary of Work: We undertook semi-structured interviews with a sample of the centre for medical education faculty at Dundee. Participants answered the question , of what are the hidden characteristics that they hope Dundee MMed graduates might have after graduation. Thematic analysis was carried out on the interview scripts. Summary of Results: A thematic analysis was carried out on the interview transcripts. Three main themes were identified from all respondents' comments. These were lifelong learners, being flexible and problem solvers. In addition individual respondents also described sense of humour, collaboration, humility, role model, inquisitiveness, optimism, and ability to express oneself clearly. Discussion: Tutors put great value on three behaviours lifelong learner, flexible, and problem solver, which are part of professional characteristics in leadership. Therefore, leadership characteristics is incorporated as the outcomes of hidden characteristics that tutors would like to see. Conclusion: Tutors in the Master's program of medical education at the University of Dundee hope that medical education students should present the three main hidden characteristics, which are lifelong learner, flexible, and problem solver after graduation. Take-home Messages: These hidden characteristics are considered as informal unless a change has been made to the formal curriculum. Therefore, to reach the tutors’ expectations, further studies might be held to make this personal characteristics transformation more accessible.

Keywords: characteristics, hidden curriculum, transformation, informal

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Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

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Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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Authors: Robin Ratnasingham, Maher Elshakankiri

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This research report will look at how to make a smart washroom to increase public hygiene and cleanliness. The system would use IoT devices to pick up various activities in the washroom and notify the appropriate stakeholders or devices to regulate the condition of the washroom. As more people are required to physically go back to the office or school, ensuring a clean and sanitized washroom is even more important now than before. It would help prevent virus outbreaks and safeguard the organization from shutdowns or slowdowns in their business. A framework of the suggested smart washroom was introduced to help reduce the chances of a virus outbreak. Most organizations outsource renovation or implementation to an external party. Using the smart washroom framework, we looked at vendors that provide smart washroom solutions. There are IoT vendors that cannot match the framework, and there are vendors that can support the framework design. This segment is a niche market, and most of the devices are similar in their basic functions. However, all the vendors have unique characteristics to give them a competitive advantage over the rest of the IoT washroom companies. Ultimately, the organization would need to decide if they want to add IoT devices to enable smart capability or renovate the washroom to create a fluid IoT smart washroom design. The report would introduce an IoT smart washroom framework to help organizations design a cohesive preventive measure network for the daily maintenance routine. The framework is designed to help understand how to manage washroom cleanliness more efficiently and to provide guidance in achieving this goal. The leading result is eliminating potential viral outbreaks that could jeopardize the organization.

Keywords: IoT, smart washroom, public hygiene, cleanliness, virus outbreaks, safeguard

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Authors: Emil Danehorn, Ulla Peterson, Marie Oscarsson, Goldina Smirthwaite, Katarina Swahnberg

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Swedish students who choose to study abroad are common, but there has been limited research on exchange students. There are indications that some Swedish exchange students have been exposed to violence, but it is not known if they, already before their semester abroad, are more exposed to violence than students who remain on campus. Our aim was to investigate potential differences in exposure to physical, sexual, and emotional violence between prospective exchange students and campus students and between male and female students in general, as well as to determine any associations between mental health and exposure to violence among students in the total sample. Method: Comparative cross-sectional design using an online survey containing the NorVold Abuse Questionnaire and the General Health Questionnaire 12. A total of 565 participants took part in the study. Results: Prospective exchange students were less exposed to emotional violence compared to campus students. About one-half of all the participating female students had been exposed to sexual violence and about one-third of all the male students had been exposed to physical violence. The results also indicated that exposure to more than one form of violence was associated with poor mental health for students as a group. Conclusion: Prospective exchange students as a group do not report more exposure to physical and sexual violence than campus students but do report less exposure to emotional violence. However, the overall frequency of exposure to violence among the students was high. This highlights the need for proactive efforts for everyone, not least for exchange students who will be staying in a new environment unknown to them.

Keywords: sexual violence, physical violence, emotional violence, exchange students, mental health

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Authors: S. Hatamikia, A. Biguri, H. Furtado, G. Kronreif, J. Kettenbach, W. Birkfellner

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Nowadays, three dimensional Cone Beam CT (CBCT) has turned into a widespread clinical routine imaging modality for interventional radiology. In conventional CBCT, a circular sourcedetector trajectory is used to acquire a high number of 2D projections in order to reconstruct a 3D volume. However, the accumulated radiation dose due to the repetitive use of CBCT needed for the intraoperative procedure as well as daily pretreatment patient alignment for radiotherapy has become a concern. It is of great importance for both health care providers and patients to decrease the amount of radiation dose required for these interventional images. Thus, it is desirable to find some optimized source-detector trajectories with the reduced number of projections which could therefore lead to dose reduction. In this study we investigate some source-detector trajectories with the optimal arbitrary orientation in the way to maximize performance of the reconstructed image at particular regions of interest. To achieve this approach, we developed a box phantom consisting several small target polytetrafluoroethylene spheres at regular distances through the entire phantom. Each of these spheres serves as a target inside a particular region of interest. We use the 3D Point Spread Function (PSF) as a measure to evaluate the performance of the reconstructed image. We measured the spatial variance in terms of Full-Width-Half-Maximum (FWHM) of the local PSFs each related to a particular target. The lower value of FWHM shows the better spatial resolution of reconstruction results at the target area. One important feature of interventional radiology is that we have very well-known imaging targets as a prior knowledge of patient anatomy (e.g. preoperative CT) is usually available for interventional imaging. Therefore, we use a CT scan from the box phantom as the prior knowledge and consider that as the digital phantom in our simulations to find the optimal trajectory for a specific target. Based on the simulation phase we have the optimal trajectory which can be then applied on the device in real situation. We consider a Philips Allura FD20 Xper C-arm geometry to perform the simulations and real data acquisition. Our experimental results based on both simulation and real data show our proposed optimization scheme has the capacity to find optimized trajectories with minimal number of projections in order to localize the targets. Our results show the proposed optimized trajectories are able to localize the targets as good as a standard circular trajectory while using just 1/3 number of projections. Conclusion: We demonstrate that applying a minimal dedicated set of projections with optimized orientations is sufficient to localize targets, may minimize radiation.

Keywords: CBCT, C-arm, reconstruction, trajectory optimization

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Authors: Hatice Yildirim

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This study was an investigation into the role of teaching assistants (TAs) for deaf pupils in an English primary school. This study aimed to provide knowledge about how TAs support deaf pupils in mainstream schools in England. It is accepted that TAs have an important role in the inclusion of students with disabilities in mainstream schools. However, there has been a lack of attention paid to the role of TAs for deaf pupils in the literature. A qualitative case study approach was used to address the research questions. Twelve semi-structured classroom observations and six semi-structured interviews were carried out with four TAs and two teachers in one English mainstream primary school. The data analysis followed a thematic analysis framework. The results indicated that TAs are utilised based on a one-on-one support model and are deployed under the class teachers in the classroom. The classroom activities are carried out in small groups with the TAs and the class teacher’s agreement, as per the school’s policy. Findings show that TAs carried out seven different roles in the education of deaf pupils in an English mainstream primary school. Supporting the academic and social development of deaf pupils is TA`s main role. Also, they record pupils’ progress, communicate with pupils’ parents, take on a pastoral care role, tutor pupils in additional support lessons and raise awareness of deaf pupils’ issues.

Keywords: deaf, mainstream primary school, teaching assistant, teaching assistant`s roles

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Authors: Fatma Al Abdullah, Shahad Al Ameer, Ritaj Jaragh, Fatimah Khajah, Rawan Qambar, Amr Nounou

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Kuwait currently manufactures its tankers in foreign countries. Oil tankers play a role in the supply chain of the oil industry. Therefore, with Kuwait’s sufficient financial resources, the country should secure itself strategically in order to protect its oil industry to sustain economic development. The purpose of this report is designing an oil tankers’ shipyard facility. Basing the shipyard facility in Kuwait will have great economic rewards. The shipbuilding industry directly enhances the industrial chain in terms of new job and business opportunities as well as educational fields. Heavy Engineering Industries & Shipbuilding Co. K.S.C. (HEISCO) was chosen as a host due to benefits that will result from HEISCO’s existing infrastructure and expertise to reduce cost. The Facility Design methodology chosen has been used because it covers all aspects needed for the report. The oil tanker market is witnessing a shift from crude tankers to product tankers. Therefore the Panamax tanker (product tanker) was selected to be manufactured in the facility. The different departments needed in shipyards were identified based on studying different global shipyards. Technologies needed to build ships helped in the process design. It was noticed that ships are engineer to order. The new layout development of the proposed shipyard is currently in progress. A feasibility study will be conducted to ensure the success of the facility after developing the shipyard’s layout.

Keywords: oil tankers, shipbuilding, shipyard, facility design, Kuwait

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Authors: A. Alssbaiheen, S. Love

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Mobile government (m-government) is one of the promising technologies for developing the governance of developing countries. While developing countries often have less advanced internet infrastructure compared to the developed world, mobile phone penetration is very high in the Gulf Cooperation Council (GCC) countries and mobile internet use offers a means to transcend traditional logistical barriers to accessing government services. The study explores the challenges and opportunities of the mobile government in Saudi Arabia. Semi-structured interviews were conducted with a diverse cohort of Saudi mobile users. A total of 77 semi-structured interviews were collected and subsequently analysed using open, axial, and selective coding. The participants’ responses revealed that many opportunities exist for the development of m-government in Saudi Arabia, including high popular awareness of government initiatives in e-government, and willingness to use such services, largely due to the time-saving and convenience aspects it offers compared with traditional bureaucratic services. However, numerous barriers were identified, including the low quality and speed of the internet, service customization, and concerns about privacy data security. It was also felt that in addition to infrastructure challenges, the traditional bureaucratic attitude of government department would itself hinder the effective deployment and utilization of m-government services.

Keywords: awareness, barriers, challenges, government services, mobile government, m-government, opportunities

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Authors: Evans Iyamu

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Genes encoding hydrophobins play distinct roles at different stages of the life cycle of fungi, and they foster hyphal attachment to surfaces. The hydrophobin Sc4 is known to provide a hydrophobic membrane lining of the gas channels within Schizophyllum commune fruiting bodies. Here, we cultivated non-fruiting, monokaryotic S. commune 12-43 on glass surfaces that could be verified by micrography. Differential gene expression profiling of nine hydrophobin genes and the hydrophobin-like sc15 gene by quantitative PCR showed significant up-regulation of sc4 when S. commune was attached to glass surfaces, also confirmed with RNA-Seq data analysis. Another silicate, namely quartz sand, was investigated, and induction of sc4 was seen as well. The up-regulation of the hydrophobin gene sc4 may indicate involvement in S. commune hyphal attachment to glass as well as quartz surfaces. We propose that the covering of hyphae by Sc4 allows for direct interaction with the hydrophobic surfaces of silicates and that differential functions of specific hydrophobin genes depend on the surface interface involved. This study could help with the clarification of the biological functions of hydrophobins in natural surroundings, including hydrophobic surface attachment. Therefore, the analysis of growth on glass serves as a basis for understanding S. commune interaction with glass surfaces while providing the possibility to visualize the interaction microscopically.

Keywords: hydrophobin, structured glass surfaces, differential gene expression, quartz sand

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Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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Authors: Roni Rachel Mendelson, Caileigh Pudela

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Bacillus cereus is a toxin-producing, facultatively anaerobic gram-positive bacterium that is widely distributed environmentally. It can quickly multiply at room temperature with an abundantly present preformed toxin. When ingested, this toxin can cause gastrointestinal illness, which is the commonly known manifestation of the disease. Bacillus cereus sepsis is a disease that is mostly concerning in the population of the immunocompromised patients. One of them is acute lymphoblastic leukemia’s patients during induction. Pediatric acute lymphoblastic leukemia is a common pediatric hematologic malignancy. It is characterized by the rapid proliferation of poorly differentiated lymphoid progenitor cells inside the bone marrow. We present here a 21-month-old boy undergoing induction chemotherapy for acute lymphoblastic leukemia who developed bacillus sepsis bacteremia and, as a result, multi organ failure leading to seizures and multiple strokes. Our case report highlights the extensive overall and neurological damage that can be caused because of bacillus cereus bacteremia, which can lead to higher mortality rate and decreased in survivorship in a highly curable disease. It is very subtle and difficult to recognize and appears to be deteriorating extremely fast. There should be a low threshold for work up and empiric coverage for neutropenic patients during acute lymphoblastic leukemia induction therapy.

Keywords: acute lymphoblastic leukemia, bacillus cereus, immunocompromised, sepsis

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Authors: Sangmo Jon, Ganghyok Kim, Kwanghyok Jong, Ilnam Jo, Hyangsun Kim, Kukhyon Pae, GyeChol Sin

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The back contact dye solar cells (BCDSCs), in which the transparent conductive oxide (TCO) is omitted, have the potential to use intact low-cost general substrates such as glass, metal foil, and papers. Herein, we introduce a facile manufacturing method of a Ti back contact electrode for the BCDSCs. We found that the polylinkers such as poly(butyl titanate) have a strong binding property to make Ti particles connect with one another. A porous Ti film, which consists of Ti particles of ≤10㎛ size connected by a small amount of polylinkers, has an excellent low sheet resistance of 10 ohm sq⁻¹ for an efficient electron collection for DSCs. This Ti back contact electrode can be prepared by using a facile printing method under normal ambient conditions. Conjugating the new back contact electrode technology with the traditional monolithic structure using the carbon counter electrode, we fabricated all TCO-less DSCs. These four-layer structured DSCs consist of a dye-adsorbed nanocrystalline TiO₂ film on a glass substrate, a porous Ti back contact layer, a ZrO₂ spacer layer, and a carbon counter electrode in a layered structure. Under AM 1.5G and 100mWcm⁻² simulated sunlight illumination, the four-layer structured DSCs with N719 dyes and I⁻/I₃⁻ redox electrolytes achieved PCEs up to 5.21%.

Keywords: dye solar cells, TCO-less, back contact, printing, porous Ti film

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Authors: Yuri Seu, Hyun Jin Park, Jin Seo Park, Yong-Suk Moon, HongtaeKim, Mi-Sun Hur

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The present case report describes bifid ureters arising directly from the separate calyces and renal pelvis of the kidney. It was a single common ureter leading away from the bladder, which was separated into incompletely duplicated ureters near the level of the anterior superior iliac supine. These two branches then entered the left kidney through their own courses. Each ureter traveled anterior and posterior to the renal vein, respectively. These two ureters formed a Y-shaped pattern. One ureter coursed anterior to the renal vein with shorter length, and it terminated at the renal pelvis that was divided into major calices in approximately lower two thirds of the kidney. The other ureter coursed posterior to the renal vein with longer length, terminating at approximately the upper third of the kidney. The renal calices in the upper third of the kidney were directly connected to the posterior ureter, whereas the other major calices in the lower two thirds of the kidney formed the renal pelvis connecting to the anterior ureter. Thus, convergence of the major calices was separated according to the terminations of two ureters. These anomalous ureters were traced to the calices of the kidney, thereby providing a reference of a rare variation of the ureter. The bifid ureters arising from the separate calyces and renal pelvis should be considered by radiologists when evaluating images and diagnosing possible complications of these anomalies.

Keywords: bifid ureters, kidney, major calices, renal pelvis

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Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei

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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.

Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality

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Authors: Mustafa Cam, Nedim Ongun, Ufuk Kutluana

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Introduction: Restless LegsSyndrome (RLS) is a common, under-recognized disorder disrupts sleep and diminishes quality of life (1). The most common conditions highly associated with RLS include renalfailure, iron and folic acid deficiency, peripheral neuropathy, pregnancy, celiacdisease, Crohn’sdiseaseandrarelymalignancy (2).Despite a clear relation between low peripheral iron and increased prevalence and severity of RLS, the prevalence and clinical significance of RLS in iron-deficientanemic populations is unknown (2). We report here a case of RLS due to iron deficiency in the setting of neuroendocrinetumor. Report of Case: A 35 year-old man was referred to our clinic with general weakness, weight loss (10 kg in 2 months)and 2-month history of uncomfortable sensations in his legs with urge to move, partially relieved by movement. The symptoms were presented very day, worsening in the evening; the discomfort forced the patient to getup and walk around at night. RLS was severe, with a score of 22 at the International RLS ratingscale. The patient had no past medical history. The patient underwent a complete set of blood analyses and the following ab normal values were found (normal limitswithinbrackets): hemoglobin 9.9 g/dl (14-18), MCV 70 fL (80-94), ferritin 3,5 ng/mL (13-150). Brain and spinemagnetic resonance imaging was normal. The patient consultated with gastroenterology clinic and gastointestinal systemendoscopy was performed for theetiology of the iron deficiency anemia. After the gastricbiopsy, results allowed us to reach the diagnosis of neuroen docrine tumor and the patient referred to oncology clinic. Discussion: The first important consideration from this case report is that the patient was referred to our clinic because of his severe RLS symptoms dramatically reducing his quality of life. However, our clinical study clearly demonstrated that RLS was not the primary disease. Considering the information available for this patient, we believe that the most likely possibility is that RLS was secondary to iron deficiency, a very well-known and established cause of RLS in theliterature (3,4). Neuroendocrine tumors (NETs) are rare epithelial neoplasms with neuroendocrine differentiation that most commonly originate in the lungs and gastrointestinal tract (5). NETs vary widely in their clinical presentation; symptoms are often nonspecific and can be mistaken for those of other more common conditions (6). 50% of patients with reported disease stage have either regional or distant metastases at diagnosis (7). Accurate and earlier NET diagnosis is the first step in shortening the time to optimal care and improved outcomes for patients (8). The most important message from this case report is that RLS symptoms can sometimes be thesign of a life-threatening condition. Conclusion: Careful and complete collection of clinical and laboratory data should be carried out in RLS patients. Inparticular, if RLS onset coincides with weight loss and iron deficieny anemia, gastricendos copy should be performed. It is known about that malignancy is a rare etiology in RLS patients and to our knowledge; it is the first case with neuro endocrine tumor presenting with RLS.

Keywords: neurology, neuroendocrine tumor, restless legs syndrome, sleep

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Authors: Namrata D. Hiremath, Mahalaxmi Bhille, P. G. Sunitha Hiremath

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Computer systems play an integral role in all facets of the engineering profession. This calls for an understanding of the processor-level components of computer systems, their design and operation, and their impact on the overall performance of the systems. Systems users are always in need of faster, more powerful, yet cheaper computer systems. The focus of Computer Science engineering graduates is inclined towards software oriented base. To be an efficient programmer there is a need to understand the role of hardware architecture towards the same. It is essential for the students of Computer Science and Engineering to know the basic building blocks of any computing device and how the digital principles can be used to build them. Hence two courses Digital Electronics of 3 credits, which is associated with lab of 1.5 credits and Computer Organization of 5 credits, were introduced at the sophomore level. Activity was introduced with the objective to teach the hardware concepts to the students of Computer science engineering through structured lab. The students were asked to design and implement a component of a computing device using MultiSim simulation tool and build the same using hardware components. The experience of the activity helped the students to understand the real time applications of the SSI and MSI components. The impact of the activity was evaluated and the performance was measured. The paper explains the achievement of the ABET outcomes a, c and k.

Keywords: digital, computer organization, ABET, structured enquiry, course activity

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Authors: Antoinette Maarawi, Zoe Anxionnaz-Minvielle, Pierre Coste, Nathalie Di Miceli Raimondi, Michel Cabassud

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Milli-structured heat exchanger/reactors have been recently widely used, especially in the chemical industry, due to their enhanced performances in heat and mass transfer compared to conventional apparatuses. In our work, the ‘DeanHex’ heat exchanger/reactor with a 2D-meandering channel is investigated both experimentally and numerically. The square cross-sectioned channel has a hydraulic diameter of 2mm. The aim of our study is to model local physico-chemical phenomena (heat and mass transfer, axial dispersion, etc.) for a liquid-liquid two-phase flow in our lab-scale meandering channel, which represents the central part of the heat exchanger/reactor design. The numerical approach of the reactor is based on a 1D model for the flow channel encapsulated in a 3D model for the surrounding solid, using COMSOL Multiphysics V5.5. The use of the 1D approach to model the milli-channel reduces significantly the calculation time compared to 3D approaches, which are generally focused on local effects. Our 1D/3D approach intends to bridge the gap between the simulation at a small scale and the simulation at the reactor scale at a reasonable CPU cost. The heat transfer process between the 1D milli-channel and its 3D surrounding is modeled. The feasibility of this 1D/3D coupling was verified by comparing simulation results to experimental ones originated from two previous works. Temperature profiles along the channel axis obtained by simulation fit the experimental profiles for both cases. The next step is to integrate the liquid-liquid mass transfer model and to validate it with our experimental results. The hydrodynamics of the liquid-liquid two-phase system is modeled using the ‘mixture model approach’. The mass transfer behavior is represented by an overall volumetric mass transfer coefficient ‘kLa’ correlation obtained from our experimental results in the millimetric size meandering channel. The present work is a first step towards the scale-up of our ‘DeanHex’ expecting future industrialization of such equipment. Therefore, a generalized scaled-up model of the reactor comprising all the transfer processes will be built in order to predict the performance of the reactor in terms of conversion rate and energy efficiency at an industrial scale.

Keywords: liquid-liquid mass transfer, milli-structured reactor, 1D/3D model, process intensification

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Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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Authors: Vijay Khopkar, Balaram Sahoo

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Material with high value of dielectric constant has application in the electronics devices. Existing lead based materials have issues such as toxicity and problem with synthesis procedure. Double perovskite structured barium iron niobate (BaFe0.5Nb0.5O3, BFN) is the lead-free material, showing a high value of dielectric constant. Origin of high value of the dielectric constant in BFN is not clear. We studied the dielectric behavior of polycrystalline BFN sample over wide temperature and frequency range. A BFN sample synthesis by conventional solid states reaction method and phase pure dens pellet was used for dielectric study. The SEM and TEM study shows the presence of grain and grain boundary region. The dielectric measurement was done between frequency range of 40 Hz to 5 MHz and temperature between 20 K to 500 K. At 500 K temperature and lower frequency, there observed high value of dielectric constant which decreases with increase in frequency. The dipolar relaxation follows non-Debye type polarization with relaxation straight of 3560 at room temperature (300 K). Activation energy calculated from the dielectric and modulus formalism found to be 17.26 meV and 2.74 meV corresponds to the energy required for the motion of Fe3+ and Nb5+ ions within the oxygen octahedra. Our study shows that BFN is the order disorder type ferroelectric material.

Keywords: barium iron niobate, dielectric, ferroelectric, non-Debye

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Authors: Kulvinder Singh Mann

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The usability and simulation of information systems, known as Hospital Information System (HIS), Radiology Information System (RIS), and Picture Archiving, Communication System, for electronic medical records has shown a good impact for actors in the hospital. The objective is to help and make their work easier; such as for a nurse or administration staff to record the medical records of the patient, and for a patient to check their bill transparently. However, several limitations still exists on such area regarding the type of data being stored in the system, ability for data transfer, storage and protocols to support communication between medical devices and digital images. This paper reports the simulation result of integrating several systems to cope with those limitations by using the Modality Worklist and DICOM standard. It succeeds in documenting the reason of that failure so future research will gain better understanding and be able to integrate those systems.

Keywords: HIS, RIS, PACS, modality worklist, DICOM, digital images

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Authors: Pedram Saadati, Zahra Nazari

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In the last decade, the role and importance of knowledge-based technological businesses in the insurance industry has greatly increased, and due to the weakness of previous studies in Iran, the current research deals with the design of the InsurTech empowerment model. In order to obtain the conceptual model of the research, a hybrid framework has been used. The statistical population of the research in the qualitative part were experts, and in the quantitative part, the InsurTech activists. The tools of data collection in the qualitative part were in-depth and semi-structured interviews and structured self-interaction matrix, and in the quantitative part, a researcher-made questionnaire. In the qualitative part, 55 indicators, 20 components and 8 concepts (dimensions) were obtained by the content analysis method, then the relationships of the concepts with each other and the levels of the components were investigated. In the quantitative part, the information was analyzed using the descriptive analytical method in the way of path analysis and confirmatory factor analysis. The proposed model consists of eight dimensions of supporter capability, supervisor of insurance innovation ecosystem, managerial, financial, technological, marketing, opportunity identification, innovative InsurTech capabilities. The results of statistical tests in identifying the relationships of the concepts with each other have been examined in detail and suggestions have been presented in the conclusion section.

Keywords: insurTech, knowledge-base, empowerment model, factor analysis, insurance

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Authors: Nino Gogatishvili, Davit Kvernadze, Giorgi Japharidze

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Background and aims: Landau Kleffner syndrome (LKS) is a rare disorder with epileptic seizures and acquired aphasia. It usually starts in initially healthy children. The first symptoms are language regression and behavioral disturbances, and the sleep EEG reveals abnormal epileptiform activity. The aim was to discuss the efficacy of Clobazam for Landau Kleffner syndrome. Case report: We report a case of an 11-year-old boy with an uneventful pregnancy and delivery. He began to walk at 11 months and speak with simple phrases at the age of 2,5 years. At the age of 18 months, he had febrile convulsions; at the age of 5 years, the parents noticed language regression, stuttering, and serious behavioral dysfunction, including hyperactivity, temper outbursts. The epileptic seizure was not noticed. MRI was without any abnormality. Neuropsychological testing revealed verbal auditory agnosia. Sleep EEG showed abundant left fronto-temporal spikes, reaching over 85% during non-rapid eye movement sleep (non-REM sleep). Treatment was started with Clobazam. After ten weeks, EEG was improved. Stuttering and behavior also improved. Results: Since the start of Clobazam treatment, stuttering and behavior improved. Now, he is 11 years old, without antiseizure medication. Sleep EEG shows fronto-temporal spikes on the left side, over 10-49 % of non-REM sleep, bioccipital spikes, and slow-wave discharges and spike-waves. Conclusions: This case provides further support for the efficacy of Clobazam in patients with LKS.

Keywords: Landau-Kleffner syndrome, antiseizure medication, stuttering, aphasia

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Authors: Buket Canbaz Öztürk, N. Füsun Çam, Günseli Yaprak, Osman Candan

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The external terrestrial radiation exposure is related to the types of rock from which the soils originate. Higher radiation levels are associated with igneous rocks, such as granite, and lower levels with sedimentary rocks. Therefore, this study aims to assess the gamma radiation exposure of soils associated with granitic rocks in Kapıdağ Peninsula, Turkey. In the ongoing study, a comprehensive survey carried out systematically as a part of the environmental monitoring program on radiologic impact of the granitoid areas in Western Anatolia. The activity measurements of the gamma emitters (238U, 232Th and 40K) in the surface soil samples and the granitic rocks carried out by means of NaI(Tl) gamma-ray spectrometry system. To evaluate the radiological hazard of the natural radioactivity, the absorbed dose rate (D), the annual effective dose rate (AED), the radium equivalent activity (Raeq) and the external (Hex) hazard index were calculated according to the UNSCEAR 2000 report. The corresponding absorbed dose rates in air from all natural radionuclides were always much lower than 200 nGy h-1 and did not exceed the typical range of worldwide average values noticed in the UNSCEAR (2000) report. Furthermore, the correlation between soil and granitic rock samples were utilized, and external gamma radiation exposure distribution was mapped in Kapıdağ Peninsula.

Keywords: external absorbed dose, granitic rocks, Kapıdağ Peninsula, soil

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Authors: Blanca Fatela Cantillo, Silvia Iglesias Cerrato, Guadalupe Garrido Ceca

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Purpose: Bleb dysfunction is a late complication following glaucoma filtration surgery. We describe our surgical technique for excision and reconstruction of a hypertrophic bleb complication using bovine pericardium patch graft (Tutopatch®) and amniotic membrane. Material and methods: The case report presents a hypertrophic bleb over the cornea with good intraocular pressure control. The hanging bleb without leak caused dysesthesia and high irregular astigmatism. Bleb reconstruction involved the excision of corneal fibrous material and avascular conjunctiva, preserving the original scleral and tennon. Bovine pericardium patch graft (Tutopatch®) was sited over these with fixed sutures, reinforcing the underlying scleral, and the conjunctiva advanced. The superior epithelium corneal defect was covered using an amniotic membrane. Conclusion: Repair of bleb dysfunction with varied techniques has been reported, including conjunctival advancement, use of scleral patch graft, dural patch graft, or pericardium. Additional use of amniotic membrane promotes epithelialization and exhibits anti-fibrotic and anti-inflammatory features. Reconstruction with bovine pericardium patch graft and amniotic membrane resulted in pain relief, visual rehabilitation, and good aesthetic results, with preservation of bleb function.

Keywords: reconstruction, hypertrophic bleb, bovine pericardium, amniotic membrane, dysesthesia of the bleb

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Authors: Rashi Mahato

Abstract:

Talent management represents an organization’s effort to attract, develop and retain highly skilled and valuable employees. The goal is to have people with capabilities and commitment needed for current and future organizational success. The organizational talent pool is its managerial talent referred to as leadership pipeline. It is managed through various systems and processes to help the organization source, reward, evaluate, develop and move employees into various functions and roles. The pipeline bends, turns, and sometimes breaks as organizations identify who is 'ready now' and who is 'on track' for larger leadership roles. From this perspective, talent management designs structured approach and a robust mechanism for high potential employees to meet organization’s needs. The paper attempts to provide a roadmap and a structured approach towards building a high performing organization through well-defined career path. Managers want career paths to be defined, so that an adequate number of individuals may be identified and prepared to fill future vacancies. Once career progression patterns are identified, more systematic forecasting of talent requirements is possible. For the development of senior management talent or leadership team, career paths are needed as guidelines for talent management across functional and organizational lines. Career path is one of the important tools for talent management and aligning talent with business strategy. This paper briefly describes the approach for career path and the concept of

Keywords: career path, career path framework, lateral movement, talent management

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Authors: Waqas Ahmad, Eisha Tahir, Shahper Aqeel, Imran Khalid Niazi, Amjad Iqbal

Abstract:

Background: Breast conservation surgery applies a number of techniques for accurate localization of lesions. Wire localization remains the method of choice in non-palpable breast cancers post-neoadjuvant chemotherapy. Objective: The aim of our study was to determine the accuracy of wire localization procedures in our department and compare it with internationally set protocols as per the Royal College of Radiologists. Post wire mammography, as well as the margin status of the postoperative specimen, assessed the accuracy of the procedure. Methods: We retrospectively reviewed the data of 225 patients who presented to our department from May 2014 to June 2015 post neoadjuvant chemotherapy with non-palpable cancers. These patients are candidates for wire localized lumpectomies either under ultrasound or stereotactic guidance. Metallic marker was placed in all the patients at the time of biopsy. Post wire mammogram was performed in all the patients and the distance of the wire tip from the marker was calculated. The presence or absence of the metallic clip in the postoperative specimen, as well as the marginal status of the postoperative specimen, was noted. Results: 157 sonographic and 68 stereotactic wire localization procedures were performed. 95% of the wire tips were within 1 cm of the metallic marker. Marginal status was negative in 94% of the patients in histopathological specimen. Conclusion: Our audit report declares more than 95% accuracy of image guided wire localization in successful excision of non-palpable breast lesions.

Keywords: breast, cancer, non-palpable, wire localization

Procedia PDF Downloads 310