Search results for: general hospital

Authors: Asif Khaliq, Sayeeda A. Sayed

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The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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Authors: Ringisai Abigail Mawondo-Dhliwayo, Kahilu Kajimo-Shakantu

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Due to financial challenges which governments in general face, it is becoming more difficult for many to continually use their limited resources to undertake infrastructural development. Governments increasingly now need other delivery approaches, in particular, the Public-Private Partnerships which make it possible for the public sector to achieve infrastructural development without incurring any/minimum cost. The literature reviewed outlined that benefits of PPPs include timely delivery of quality projects with cost limits. The methodology utilized for the empirical study comprised six interviews and sixty questionnaires which were undertaken and administered by construction consultants and government officials involved in PPPs projects. The results obtained showed that PPPs are not widely used in Zimbabwe although the need for their use exists. The study also found some challenges which prevent or derail the rate at which PPPs are utilized, of which the primary one was a political influence. It is concluded that despite limitations, PPPs remain the most effective and viable option for the delivery of government projects. The study recommends that policy and framework for the implementation of PPPs be developed. More useful information could have been obtained if final users of PPPs projects were included in the sample for data collection.

Keywords: construction projects, procurement, public private partnerships, public sector

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Authors: Hernán G. Cortés-Mora, José I. Péna-Reyes, Alfonso Herrera-Jiménez

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This article describes the implementation experience of Project-Based Learning (PBL) in an engineering course of the Universidad Nacional de Colombia, with the aim of strengthening student skills necessary for the exercise of their profession under a sustainability framework. Firstly, we present a literature review on the education for sustainability field, emphasizing the skills and knowledge areas required for its development, as well as the commitment of the Faculty of Engineering of the Universidad Nacional de Colombia, and other engineering faculties of the country, regarding education for sustainability. This article covers the general aspects of the course, describes how students team were formed, and how their experience was during the first semester of 2017. During this period two groups of students decided to develop their course project aiming to solve a problem regarding a Non-Governmental Organization (NGO) that works with head-of-household mothers in a low-income neighborhood in Bogota (Colombia). Subsequently, we show how sustainability is involved in the course, how tools are provided to students, and how activities are developed as to strengthen their abilities, which allows them to incorporate sustainability in their projects while also working on the methodology used to develop said projects. Finally, we introduce the results obtained by the students who sent the prototypes of their projects to the community they were working on and the conclusions reached by them regarding the course experience.

Keywords: sustainability, project-based learning, engineering education, higher education for sustainability

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Dan Wang

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Sandplay therapy is a Jungian psychological therapy developed by Dora Kalff in 1956. In sandplay therapy, the client first makes a sandtray with various miniatures and then has a communication with the therapist based on the sandtray. The special method makes sandplay therapy has great assessment potential. With regarding that the core treatment hypothesis of sandplay therapy - the self-healing power, is very similar to resilience. This study tries to use sandplay to evaluate psychological resilience. Participants are 107 undergraduates recruited from three public universities in China who were required to make an initial sandtray and to complete the Ego-Resiliency Scale (ER89) respectively. First, a 28- category General Sandtray Coding Manual (GSCM) was developed based on literature on sandplay therapy. Next, using GSCM to code the 107 initial sandtrays and conducted correlation analysis and regression analysis between all GSCM categories and ER89. Results show three categories (i.e., vitality, water types, and relationships) of sandplay account for 36.6% of the variance of ego-resilience and form the four-point Likert-type Sandtray Projective Test of Resilience (SPTR). Finally, it is found that SPTR dimensions and total score all have good inter-rater reliability, ranging from 0.89 to 0.93. This study provides an alternative approach to measure psychological resilience and can help to guide clinical social work.

Keywords: sandplay therapy, psychological resilience, measurement, college students

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Authors: Mohammed Bakhit Kashoob, Mohammed Salim Al-Maashani, Ahmed Abdullah Al-Marhoon

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Traffic calming measures are different design features or strategies used to reduce the speed of a traveling vehicle on a particular road. These calming measures are common on rural roads of Oman. Some of these measures are road speed limits, vertical deflections, horizontal deflections, and road signs. In general, vertical deflections such as rumble strips, road studs (cat’s eye), speed tables, and speed humps are widely used. In this paper, as vehicle speeding is a major cause of road traffic crashes and high fatalities in Oman, the effectiveness of existing traffic calming measures at current locations on rural roads is assessed. The study was conducted on the rural roads of Dhofar Governorate, which is located in the south of Oman. A special focus is given to the calming measures implemented on the mountain roads of Dhofar. It is shown that vertical deflection calming measures are effective in reducing vehicle speed to 20 to 40 kph, depending on the vertical deflection type and spacing. Calming measures are also proposed at locations with a high probability of traffic crashes based on the number of traffic crashes at these locations, road type, and road geometry.

Keywords: road safety, rural roads, speed, traffic calming measures, traffic crash

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Authors: A. Morina, S. Ö. Muti, M. Öztürk

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Celiac disease is a chronic intestinal disease observed in individuals with gluten intolerance. In this study, our aim was to create a protein matrix to mimic the functional properties of gluten. For this purpose, rennet casein and four emulsifying salts (disodium phosphate (DSP), tetrasodium pyrophosphate (TSPP), sodium acid pyrophosphate (SAPP), and sodium hexametaphosphate (SHMP)) were investigated in gluten-free bread manufacture. Compositional, textural, and visual properties of the gluten-free bread dough and gluten-free breads were investigated by a two–level factorial experimental design with two-star points (α = 1.414) and two replicates of the center point. Manufacturing gluten-free bread with rennet casein and SHMP significantly increased the bread volume (P < 0.0001, R² = 97.8). In general, utilization of rennet casein with DSP and SAPP increased bread hardness while no difference was observed in samples manufactured with TSPP and SHMP. Except for TSPP, bread color was improved by the utilization of rennet casein and DSP, SAPP, and SHMP combinations. In conclusion, it is possible to manufacture gluten-free bread with acceptable texture and color by rennet casein and SHMP.

Keywords: celiac disease, gluten-free bread, emulsified salts, rennet casein, rice flour

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Authors: Mahdeb Nadia, Ghadjati Nadhra, Bettihi Sara, Daamouche Z. El Youm, Bouzidi Abdelouahab

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The effects of subacute administration of total alkaloids of seeds Peganum harmala were studied in female Albino-Wistar rats. After intraperitoneal administration of dose 50 mg/kg for 10 days and 40 mg/kg for 7 days of total alkaloids to the seeds of Peganum harmala (animal treatment lasted 17 days), there were remarkable changes in general appearance and deaths occurred in experimental group. After 17 days a significant reduction was observed in the surviving animals treated with total alkaloid seeds.The Red Blood Cells (RBC), Hematocrit (HCT), Hemoglobin (HGB) and White blood cells (WBCs), show significant reduction in the treated groups. There were no statistical differences in Glutamic-Oxaloacetic Transaminase (GOT), Glutamic-pyruvic Transaminase (GPT) and Alkaline Phosphatase (ALP), total protein, glucose and creatinine observed between groups. However the urea was significantly higher in the treated female rats than the control group. Histological examination of liver showed no histopathological changes. Alkaloids of Peganum harmala showed significant toxicity in female rats.

Keywords: Peganum harmala, rat, liver, kidney, alkaloids, toxicity

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Authors: Emma M. Iglesias

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We have analyzed extreme movements of the main stocks traded in the Eurozone in the 2000-2012 period. Our results can help future very-risk-averse investors to choose their portfolios in the Eurozone for risk management purposes. We find two main results. First, we can clearly classify firms by economic sector according to their different estimated VaR values in five of the seven countries we analyze. In special, we find sectors in general where companies have very high (telecommunications and banking) and very low (petroleum, utilities, energy and consumption) estimated VaR values. Second, we only find differences according to the geographical situation of where the stocks are traded in two countries: (1) all firms in the Irish stock market (the only financially rescued country we analyze) have very high estimated VaR values in all sectors; while (2) in Spain all firms have very low estimated VaR values including in the banking and the telecommunications sectors. All our results are supported when we study also the expected shortfall of the firms.

Keywords: risk management, firms, pareto tail thickness parameter, GARCH-type models, value-at-risk, extreme value theory, heavy tails, stock indexes, eurozone

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Authors: Wen-Chen Hwang, Yu-Hsi Yuan

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According to the estimation made by researchers of safety and hygiene, 80% to 90% of workplace accidents in enterprises could be attributed to human factors. Nevertheless, human factors are not the only cause for accidents; instead, happening of accidents is also closely associated with the safety culture of the organization. Therefore, the most effective way of reducing accident rate would be to improve the social and the organizational factors that influence organization’s safety performance. Overview the present study is to understand the current level of safety culture in manufacturing enterprises. A tool for evaluating safety culture matching the needs and characteristics of manufacturing enterprises was developed by reviewing literature of safety culture, and taking the special backgrounds of the case enterprises into consideration. Expert validity was also implied for developing the questionnaire. Moreover, safety culture assessment was conducted through the practical investigation of the case enterprises. Total 505 samples were involved, 53 were executives and 452 were operators. The result of this study in comparison of the safety culture level between the executives and the operators was reached the significant level in 8 dimensions: Safety Commitment, Safety System, Safety Training, Safety Involvement, Reward and Motivation, Communication and Reporting, Leadership and Supervision, Learning and Changing. In general, the overall safety culture were executive level higher than operators level (M: 74.98 > 69.08; t=2.87; p < 0.01).

Keywords: questionnaire survey, safety culture, t-test, media studies

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Authors: Marzena Świgoń

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Nowadays, graduates should be prepared for serious challenges in the internal and external labor market. The notion that a degree is a “passport to employment” has been relegated to the past. In the last few years a phenomenon in the form of the increasing unemployment of highly educated young people in EU countries, including Poland has been observed. Empirical studies were conducted among Polish students in the scope of the so-called self-perceived employability review. In this study, a special scale was used which consisted of 19 statements regarding five components: student’s perception of university; field of study; self-belief; state of the external labor market; and, personal knowledge management. The respondent group consisted of final-year master’s students of International Relations at the University of Warmia and Mazury in Olsztyn, Poland. The findings of the empirical studies were compiled using statistical methods: descriptive statistics and inferential statistics. In general, in light of the conducted studies, the self-perceived employability of the Polish students was not high. Limitations of the studies were discussed, as well as the implications for future research in the scope of the students’ employability.

Keywords: self-perceived employability, students of international relations, university students, students employability

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Authors: Virpi Oksman

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Drones are new phenomenon in public spaces. Adoption of this kind of new technologies requires public acceptance. Drones and other unmanned aerial systems may have various impacts on people’s living environments, and the public is exposed to possible disadvantages of drones. Public acceptance may be expressed as positive or negative attitude by majority of the citizens towards the new technology or service or as rapid adoption of it in everyday life. In various parts of the globe, in cities and in rural areas, drones as emerging technologies are perceived quite differently. Public acceptance studies of drones have been conducted mostly in highly urbanized environments like in Singapore and in European cities. This paper presents results of a Nordic survey study (N=1000) conducted in Sweden and in Finland. The survey aims at understanding the level of acceptance of different uses of drones in public spaces and the main concerns and benefits related to emerging UAM technologies. The study shows that even though the general attitude towards drones is quite positive, privacy and safety, and noise levels are the main concerns by Nordic citizens. Also, for what purpose and by whom the drones are operated affects the acceptability significantly. The study concludes, that there is need for regulations that safeguard public interests. In addition, considering privacy in design, and quiet environmentally friendly drones support public acceptance of drones.

Keywords: public acceptance, privacy, safety, survey

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Authors: Martin Doran, Roy Sterritt, George Wilkie

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The majority of today’s mobile robots are very dependent on battery power. Mobile robots can operate untethered for a number of hours but eventually they will need to recharge their batteries in-order to continue to function. While computer processing and sensors have become cheaper and more powerful each year, battery development has progress very little. They are slow to re-charge, inefficient and lagging behind in the general progression of robotic development we see today. However, batteries are relatively cheap and when fully charged, can supply high power output necessary for operating heavy mobile robots. As there are no cheap alternatives to batteries, we need to find efficient ways to manage the power that batteries provide during their operational lifetime. This paper proposes the use of autonomic principles of self-adaption to address the behavioral changes a battery experiences as it gets older. In life, as we get older, we cannot perform tasks in the same way as we did in our youth; these tasks generally take longer to perform and require more of our energy to complete. Batteries also suffer from a form of degradation. As a battery gets older, it loses the ability to retain the same charge capacity it would have when brand new. This paper investigates how we can adapt the current state of a battery charge and cycle count, to the requirements of a mobile robot to perform its tasks.

Keywords: autonomic, self-adaptive, self-optimising, degradation

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Authors: Aliya Tokbergenova, Maida Tusupbekova, Daulet Dzhangaliyev, Alena Lavrinenko

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Background: Odontogenic phlegmons are ranked the first among pyoinflammatory processes in the frequency of hospitalization in maxillofacial surgery in the post-Soviet countries. The main role in etiology is played by obligate anaerobes and aerobes. According to numerous data, the structure of aerobic pathogens is dominated by staphylococci and gram-negative bacteria. Aim: The research aim is to study the microflora of the purulent discharge odontogenic inflammatory processes. Materials and methods: A total of 220 patients have been examined, of which 120 patients aged 25-59 years have been included in the research who did not have comorbidity hospitalized in the maxillofacial hospital in Karaganda (Kazakhstan) from January 2016 to July 2017. The bacteriological research has been carried out on the basis of the multiaccess laboratory of the KSMU, through the Matrix Assisted Laser Desorption/Ionization (MALDI) apparatus. The material sample was pus from the inflammation focus, taken during the operating period. Results: According to the research among 120 patients (100%), 15 patients (12.5%) have had microorganisms not grown. From 105 (87.5%) bacteriological results, it has been revealed the following 1) Streptococcus: 51 (42.5%): Streptococcus beta-haemolytic: 17 (14.2%), Streptococcus pneumoniae: 12 (10%), Streptococcus anginosus: 8 (6.6%), Streptococcus oralis: 8 (6.6%), Streptococcus constellatus: 6 (5.0%); 2) Staphylococci: 27 (22.5%): Staphylococci aureus: 14 (11.7%) and Staphylococci epidermidis: 13 (10.8%); 3) Pseudomonas aeruginosa: 12 (10%); 4) Neisseria: 11 (9.1%): Neisseria mucosa: 5 (4.1%) and Neisseria macacae: 6 (5.0%); 5) Klebsiella pneumoniae: 2 (1.7%); 6) Stenotrophomonas maltophilia: 2 (1.7%). 15 patients (12.5%) experienced complications in the form of 1) The dissemination of the process in 10 patients (8.4%). 2) Osteomyelitis in 3 (2.5%). 3) Mediastinitis in 1 (0.8%). 4) Sinusitis in 1 (0.8%). 15 patients (100%) were carried out repeated bacteriological examination, the following was revealed: 1) Streptococcus: 10 (66.7%): Streptococcus beta-haemolytic: 4 (26.7%), Streptococcus pneumoniae: 2 (13.3%), Streptococcus аnginosus: 2 (13.3%), Streptococcus oralis: 1 (6.7%), Streptococcus constellatus: 1 (6.7%); 2) Staphylococci: 4 (26.7%): Staphylococci aureus: 3 (20%) and Staphylococci epidermidis: 1 (6.7%); 3) Pseudomonas aeruginosa: 1 (6.7%). Conclusions: Thus, according to our research data, streptococci predominate in the odontogenic processes microflora in aerobic flora in the central Kazakhstan region, which refutes the leading role of staphylococci in the development of odontogenic inflammatory processes, thus creating prerequisites for studying new treatment approaches.

Keywords: maxillofacial surgery, microflora, odontogenic phlegmons, pyo-inflammatory

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Authors: Ava Zarif Sanayei, Sedigheh Sina

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Interventional radiology (IR) uses imaging guidance, including X-rays and CT scans, to deliver therapy precisely. Most IR procedures are performed under local anesthesia and start with a small needle being inserted through the skin, which may be called pinhole surgery or image-guided surgery. There is increasing concern about radiation exposure during interventional radiology procedures due to procedure complexity. The basic aim of optimizing radiation protection as outlined in ICRP 139, is to strike a balance between image quality and radiation dose while maximizing benefits, ensuring that diagnostic interpretation is satisfactory. This study aims to estimate the equivalent doses to the main trunk of the body for the Interventional radiologist and Superintendent using LiF: Mg, Ti (TLD-100) chips at the IR department of a hospital in Shiraz, Iran. In the initial stage, the dosimeters were calibrated with the use of various phantoms. Afterward, a group of dosimeters was prepared, following which they were used for three months. To measure the personal equivalent dose to the body, three TLD chips were put in a tissue-equivalent batch and used under a protective lead apron. After the completion of the duration, TLDs were read out by a TLD reader. The results revealed that these individuals received equivalent doses of 387.39 and 145.11 µSv, respectively. The findings of this investigation revealed that the total radiation exposure to the staff was less than the annual limit of occupational exposure. However, it's imperative to implement appropriate radiation protection measures. Although the dose received by the interventional radiologist is a bit noticeable, it may be due to the reason for using conventional equipment with over-couch x-ray tubes for interventional procedures. It is therefore important to use dedicated equipment and protective means such as glasses and screens whenever compatible with the intervention when they are available or have them fitted to equipment if they are not present. Based on the results, the placement of staff in an appropriate location led to increasing the dose to the radiologist. Manufacturing and installation of moveable lead curtains with a thickness of 0.25 millimeters can effectively minimize the radiation dose to the body. Providing adequate training on radiation safety principles, particularly for technologists, can be an optimal approach to further decreasing exposure.

Keywords: interventional radiology, personal monitoring, radiation protection, thermoluminescence dosimetry

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Authors: Seini G. Kaufusi

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Background. Physician-assisted death (PAD) has and continues to be a controversial issue in the U.S. Dying with dignity statutes exists in 9 U.S. jurisdictions that permit competent adults diagnosed with a terminal illness and given a prognosis of 6 month or less to live to request medication to hasten death. Robust advocacy for and against PAD influences policy, and opinions vary. Aim. This study aims to explore the association between race and the attitudes toward physician-assisted death in the U.S. Methods. Data for this study derives from the General Social Survey (GSS) dataset, a national survey conducted by the National Opinion Research Center (NORC) that focuses on the opinions and values of American’s. A cross-sectional design and probability sample from the 2018 data set was used to randomly select respondents. Results. The results indicated that race is significantly associated with attitudes towards physician-assisted death. The level of significance suggests a strong positive association, and the direction indicated that Black and Other racial groups have higher rates of positive decision about PAD. Conclusion. Although attitudes towards PAD varied, Black and other racial groups had favorable decisions for PAD. Further research is crucial in the continuous debate on PAD and understanding the influences of predictors for or against PAD.

Keywords: attitudes, euthanasia, physician-assisted death, race

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Authors: Saeed Ghali, Hoda El-Faramawy, Mamdouh Eissa, Michael Mishreky

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Scale-resistant austenitic stainless steel, X45CrNiW 18-9, has been developed, and modified steels produced through partial and total nickel replacement by nitrogen. These modified steels were produced in a 10 kg induction furnace under different nitrogen pressures and were cast into ingots. The produced modified stainless steels were forged, followed by air cooling. The phases of modified stainless steels have been investigated using the Schaeffler diagram, dilatometer, and microstructure observations. Both partial and total replacement of nickel using 0.33-0.50% nitrogen are effective in producing fully austenitic stainless steels. The nitrogen contents were determined and compared with those calculated using the Institute of Metal Science (IMS) equation. The results showed great deviations between the actual nitrogen contents and predicted values through IMS equation. So, an equation has been derived based on chemical composition, pressure, and temperature at 1600oC. [N%] = 0.0078 + 0.0406*X, where X is a function of chemical composition and nitrogen pressure. The derived equation has been used to calculate the nitrogen content of different steels using published data. The results reveal the difficulty of deriving a general equation for the prediction of nitrogen content covering different steel compositions. So, it is necessary to use a narrow composition range.

Keywords: solubility, nitrogen, stainless steel, Schaeffler

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Authors: Renjith George, Preethy Mary Donald

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Use of internet sources to retrieve health care related information among health care professionals has increased tremendously as the accessibility to internet is made easier through smart phones and tablets. Though there are huge data available at a finger touch, it is doubtful whether all the sources providing health care information adhere to evidence based practice. The objective of this survey was to study the prevalence of use of internet sources to get health care information, to assess the mind-set towards the authenticity of health care information available via internet sources and to study the awareness about evidence based practice in health care among medical and dental students in Melaka-Manipal Medical College. The survey was proposed as there is limited number of studies reported in the literature and this is the first of its kind in Malaysia. A cross sectional survey was conducted among the medical and dental students of Melaka-Manipal Medical College. A total of 521 students including medical and dental students in their clinical years of undergraduate study participated in the survey. A questionnaire consisting of 14 questions were constructed based on data available from the published literature and focused group discussion and was pre-tested for validation. Data analysis was done using SPSS. The statistical analysis of the results of the survey proved that the use of internet resources for health care information are equally preferred over the conventional resources among health care students. Though majority of the participants verify the authenticity of information from internet sources, there was considerable percentage of candidates who feels that all the information from the internet can be utilised for clinical decision making or were not aware about the need of verification of authenticity of such information. 63.7 % of the participants rely on evidence based practice in health care for clinical decision making while 34.2 % were not aware about it. A minority of 2.1% did not agree with the concept of evidence based practice. The observations of the survey reveals the increasing use of internet resources for health care information among health care students. The results warrants the need to move towards evidence based practice in health care as all health care information available online may not be reliable. The health care person should be judicious while utilising the information from such resources for clinical decision making.

Keywords: authenticity, evidence based practice, health care information, internet

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma

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Authors: Marina Arino Martin, John McEvoy, Eakalak Khan

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Endoxifen is an active metabolite responsible for the effectiveness of tamoxifen, a chemotherapeutic drug widely used for endocrine responsive breast cancer and chemo-preventive long-term treatment. Tamoxifen and endoxifen are not completely metabolized in human body and are actively excreted. As a result, they are released to the water environment via wastewater treatment plants (WWTPs). The presence of tamoxifen in the environment produces negative effects on aquatic lives due to its antiestrogenic activity. Because endoxifen is 30-100 times more potent than tamoxifen itself and also presents antiestrogenic activity, its presence in the water environment could result in even more toxic effects on aquatic lives compared to tamoxifen. Data on actual concentrations of endoxifen in the environment is limited due to recent discovery of endoxifen pharmaceutical activity. However, endoxifen has been detected in hospital and municipal wastewater effluents. The detection of endoxifen in wastewater effluents questions the treatment efficiency of WWTPs. Studies reporting information about endoxifen removal in WWTPs are also scarce. There was a study that used chlorination to eliminate endoxifen in wastewater. However, an inefficient degradation of endoxifen by chlorination and the production of hazardous disinfection by-products were observed. Therefore, there is a need to remove endoxifen from wastewater prior to chlorination in order to reduce the potential release of endoxifen into the environment and its possible effects. The aim of this research is to isolate and identify bacteria strain(s) capable of degrading endoxifen into less hazardous compound(s). For this purpose, bacteria strains from WWTPs were exposed to endoxifen as a sole carbon and nitrogen source for 40 days. Bacteria presenting positive growth were isolated and tested for endoxifen biodegradation. Endoxifen concentration and by-product formation were monitored. The Monod kinetic model was used to determine endoxifen biodegradation rate. Preliminary results of the study suggest that isolated bacteria from WWTPs are able to growth in presence of endoxifen as a sole carbon and nitrogen source. Ongoing work includes identification of these bacteria strains and by-product(s) of endoxifen biodegradation.

Keywords: biodegradation, bacterial degraders, endoxifen, wastewater

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Authors: Falek Kamel

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Various approaches are usually used in the dynamic analysis of beams vibrating transversally. For this, numerical methods allowing the solving of the general eigenvalue problem are utilized. The equilibrium equations describe the movement resulting from the solution of a fourth-order differential equation. Our investigation is based on the finite element method. The findings of these investigations are the vibration frequencies obtained by the Jacobi method. Two types of the elementary mass matrix are considered, representing a uniform distribution of the mass along with the element and concentrated ones located at fixed points whose number is increased progressively separated by equal distances at each evaluation stage. The studied beams have different boundary constraints representing several classical situations. Comparisons are made for beams where the distributed mass is replaced by n concentrated masses. As expected, the first calculus stage is to obtain the lowest number of beam parts that gives a frequency comparable to that issued from the Rayleigh formula. The obtained values are then compared to theoretical results based on the assumptions of the Bernoulli-Euler theory. These steps are used for the second type of mass representation in the same manner.

Keywords: structural elements, beams vibrating, dynamic analysis, finite element method, Jacobi method

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Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, R. Dhouieb, S. Saadi, M. A. Mesrati, A. Chadly

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Introduction: The hyoid bone is considered as one of many bones used to identify a missed person. There is a specificity of each population group in human identifications. Objective: To analyze the relationship between age, sex and metric parameters of hyoid bone in Tunisian population sample, using CT-scan. Materials and Methods: A prospective study was conducted in the Department of Forensic Medicine of FattoumaBourguiba Hospital of Monastir-Tunisia during 4 years. A total of 240 samples of hyoid bone were studied. The age of cases ranged from 18 days to 81 years. The specimens were collected only from the deceased of known age. Once dried, each hyoid bone was scanned using CT scan. For each specimen, 10 measurements were taken using a computer program. The measurements consisted of 6 lengths and 4 widths. A regression analysis was used to estimate the relationship between age, sex, and different measurements. For age estimation, a multiple logistic regression was carried out for samples ≤ 35 years. For sex determination, ROC curve was performed. Discriminant value finally retained was based on the best specificity with the best sensitivity. Results: The correlation between real age and estimated age was good (r²=0.72) for samples aged 35 years or less. The unstandardised canonical function equation was estimated using three variables: maximum length of the right greater cornua, length from the middle of the left joint space to the middle of the right joint space and perpendicular length from the centre point of a line between the distal ends of the right and left greater cornua to the centre point of the anterior view of the body of the hyoid bone. For sex determination, the ROC curve analysis reveals that the area under curve was at 81.8%. Discriminant value was 0.451 with a specificity of 73% and sensibility of 79%. The equation function was estimated based on two variables: maximum length of the greater cornua and maximum length of the hyoid bone. Conclusion: The findings of the current study suggest that metric analysis of the hyoid bone may predict the age ≤ 35 years. Sex estimation seems to be more reliable. Further studies dealing with the fusion of the hyoid bone and the current study could help to achieve more accurate age estimation rates.

Keywords: anthropology, age estimation, CT scan, sex determination, Tunisia

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Authors: Merouane Salhi, Toufik Zebbiche, Omar Abada

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When the stagnation pressure of perfect gas increases, the specific heat and their ratio do not remain constant anymore and start to vary with this pressure. The gas does not remain perfect. Its state equation change and it becomes a real gas. In this case, the effects of molecular size and inter molecular attraction forces intervene to correct the state equation. The aim of this work is to show and discuss the effect of stagnation pressure on supersonic thermo dynamical, physical and geometrical flow parameters, to find a general case for real gas. With the assumptions that Berthelot’s state equation accounts for molecular size and inter molecular force effects, expressions are developed for analyzing supersonic flow for thermally and calorically imperfect gas lower than the dissociation molecules threshold. The designs parameters for supersonic nozzle like thrust coefficient depend directly on stagnation parameters of the combustion chamber. The application is for air. A computation of error is made in this case to give a limit of perfect gas model compared to real gas model.

Keywords: supersonic flow, real gas model, Berthelot’s state equation, Simpson’s method, condensation function, stagnation pressure

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Authors: K. S. Ghosh, Sagnik Bose, Kapil Tripati

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Potentiodynamic polarization studies carried out on AA2024 and AA2014 Al-Cu-Mg alloys of various tempers in 3.5 wt. % NaCl and in 3.5 wt. % NaCl + 1.0 % H2O2 solution characteristic E-i curves. Corrosion potential (Ecorr) value has shifted towards more negative potential with the increase of artificial aging time. The Ecorr value for the alloy tempers has also shifted anodically in presence of H2O2 in 3.5 % NaCl solution. Further, passivity phenomenon has been observed in all the alloy tempers when tested in 3.5 wt. % NaCl solution at pH 12. Stress corrosion cracking (SCC) behaviour of friction stir weld (FSW) joint of AA2014 alloy has been studied bu slow strain rate test (SSRT) in 3.5 wt. % NaCl solution. Optical micrographs of the corroded surfaces of polarised samples showed general corrosion, extensive pitting and intergranular corrosion as well. Further, potentiodynamic cyclic polarization curves displayed wide hysteresis loop indicating that the alloy tempers are susceptible to pit growth damage. Attempts have been made to explain the variation of observed electrochemical and SCC behaviour of the alloy tempers and the electrolyte conditions with the help of microstructural features.

Keywords: AA 2014 and AA 2024 Al-C-Mg alloy, artificial ageing, potentiodynamic polarization, TEM micrographs, stress corrosion cracking (SCC)

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Authors: Hamna Hamid, Kashmala Zaman

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The aim of this study was to evaluate the relationship between self-efficacy, resilience, and social support among clinical psychologists, counselors, and teachers of special schools. The study also assesses the gender differences in self-efficacy, resilience, social support, and vicarious trauma and also vicarious trauma differences among three professions, i.e., clinical psychologists, counselors, and teachers of special schools. A sample of 150 women and 97 men were handed out a set questionnaire to complete: a General Self-Efficacy Scale, Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, and Vicarious Trauma Scale. Results showed that there is a significant negative correlation between self-efficacy, resilience, and vicarious trauma. Women experience higher levels of vicarious trauma as compared to men. At the same time, clinical psychologists and counselors experience higher levels of vicarious trauma as compared to teachers of special schools. The moderation effect of social support is not significant towards resilience and vicarious trauma.

Keywords: self-efficacy, resilience, vicarious-trauma social-support, social support

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Authors: Jason West

Abstract:

Low profitability in agriculture production along with increasing scrutiny over environmental effects is limiting food production at scale. In contrast, the mining sector offers access to resources including energy, water, transport and chemicals for food production at low marginal cost. Scalable agricultural production can benefit from the nexus of resources (water, energy, transport) offered by mining activity in remote locations. A decision support bioeconomic model for controlled environment vertical farms was used. Four submodels were used: crop structure, nutrient requirements, resource-crop integration, and economic. They escalate to a macro mathematical model. A demonstrable dynamic systems framework is needed to prove productive outcomes are feasible. We demonstrate a generalized bioeconomic macro model for controlled environment production systems in minesites using systems dynamics modeling methodology. Despite the complexity of bioeconomic modelling of resource-agricultural dynamic processes and interactions, the economic potential greater than general economic models would assume. Scalability of production as an input becomes a key success feature.

Keywords: crop production systems, mathematical model, mining, agriculture, dynamic systems

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Authors: Nesrine Frifita, Mohamed Gharbi, Kevin Mickus

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Physical methods based on gravity, seismic and seismological data were adopted to clarify the relationship between the distribution of seismicity and the crustal deformations under the chott belts and surrounding regions, in southern atlas of Tunisia. Gafsa and its surrounding were described as a moderate seismic zone, and the fault of Gafsa is one of most seismically active faults in Tunisia in general, and in the southern Atlas in particularly. The present work aims to prove a logical relationship between the distribution of seismicity and deformations which strongly related to thickness and density variations within the basement and sedimentary cover along the study area, through several physical methods; gravity, seismic and seismological data were interpreted to calculate physical propriety of the subsurface rocks, the depth and geometry of active faults and causatives bodies. Findings show that depths variation and mixed thin and thick skinned structural style characterizing the chott belts explain the moderate seismicity in the study area.

Keywords: potential fields, seismicity, Southern Atlas, Tunisia

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Authors: Saleh Alzahrani, Halim Boussabaine

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The Public Private Partnership (PPP) contracts are produced taking into account the reason that the configuration, development, operation, and financing of an open undertaking is to be recompensed to a private gathering inside a solitary contractual structure. PPP venture dangers are ordinarily connected with the improvement and development of another resource and in addition its operation for a considerable length of time. Without a doubt, the most genuine outcomes of dangers amid the development period are value and time overwhelms. These occasions are amongst the most extensively utilized situations as a part of worth for cash investigation dangers. The wellsprings of danger change over the life cycle of a PPP venture. In customary acquirement, the general population segment ordinarily needs to cover all value trouble from these dangers. At any rate there is bounty confirmation to recommend that cost pain is a standard in a percentage of the tasks that are conveyed under customary obtainment. This paper means to research the effect of endogenous dangers on expense overwhelm in KSA PPP ventures. The paper displays a brief writing survey on PPP danger evaluating systems, and after that presents an affiliation model between danger occasions and expense invade in KSA. The paper finishes up with considerations for future examination.

Keywords: PPP, risk pricing, impact of risk, Endogenous risks

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Authors: Ciza Didier

Abstract:

By definition, homosexuality designates the sexual or amorous attraction towards a person of the same sex or of the same gender as one's own. The Burundi country has superficially 27834km2 with 13 millions of population. There are groups of certain people assuming that they are homosexual and that they want to claim their rights. Burundian homosexuals often organise seminars in the premises of the National Health Security Agency (NHSA) located at Kigobe quarter, in Bujumbura, this is the place where they meet to try to exchange and create their association for claim their rights. There are 2 categories of homosexuals: - gays: homosexuality between men (male sex) - lesbians: homosexuality between women (female sex) In the gay couple, there is one who behaves like a woman and often wears feminine styles while the other always remains like a man and always wears masculine styles. In the lesbian couple, there is one who behaves like a man and wears men's styles while the other remains as she is like a woman. In general, Burundian society is against homosexuality. Our society sees them as pariahs carrying a curse. According to Burundian culture and customs, homosexuality is satanic, therefore it is a great sin. In April 2011, Burundian President Pierre Nkurunziza signed a law criminalizing homosexual acts and providing for a sentence of three months to two years in prison, as well as a fine of BIF 50,000 to BIF 100,000 for any homosexual behavior. The investigation recently done shows that out of 300 people questioned, 299 were against homosexuality saying that it is against Burundian culture and 1 was for homosexuality. All Burundians are not against homosexuality. Their country must therefore take into consideration the small party of people who are for homosexuality. Homosexuals, too, need to live like others.

Keywords: homosexuality, lesbian, gay, law

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Authors: Nashi Khan, Amina Khalid

Abstract:

Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.

Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome

Procedia PDF Downloads 456