Search results for: general hospital

Authors: Yeliz Yazıcı, Alev Erenler

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School is an institution designed to provide learning, teaching places and environments under guidance of selected teachers. School is not just a place or institution but it is a place where complex and living structures are alive and always changing. It is also an undeniable fact that schools have shaped the ideas, future, society as well as the students and their lives. While this is the situation, schools having academic excellence is considered as successful ones. Academic excellence is a composition of excellence in teachers, management and physical environment, also. This is the general perception of the authorities and parents when the excellence is the point but the school is a developing and supporting organism. In this concept, the main aim of this study is to compare student and teacher perceptions of school as a ‘positive support factor’. The study is designed as a quantitative and qualitative design and a questionnaire is applied to both teachers and students via online and face to face meetings. It is aimed to define the perceptions of the participants related to the school as a positive support factor. It means the role of school in establishing self-efficacy, shaping and acquiring the behavior etc. Gathered data is analyzed via SPSS program and the detailed discussion is carried in the frame of the related literature.

Keywords: positive support factor, education, school, student teacher perception

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Authors: Sophie Huck, Knut Linke

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This study will examine how IT practitioners can be motivated for IT studies and which kind of support they need during their occupational studies. Within this research project, the challenge of supporting students being engaged in business for several years arose. Here, it is especially important to successfully guide them through their studies. The problem of this group is that they finished their school education years ago. In order to gather first experiences, preliminary e-learning courses were introduced and tested with a group of users studying General Management. They had to work with these courses and have been questioned later on about their approach to the different methods. Moreover, a second group of potential students was interviewed with the help of online questionnaires to give information about their expectations regarding extra occupational studies. We also want to present best practices and cases in e-education in the subarea of mathematics and distance learning. Within these cases and practices, we use state of the art systems and technologies in e-education to find a way to increase teaching quality and the success of students. Our research indicated that the first group of enrolled students appreciated the new preliminary e-learning courses. The second group of potential students was convinced of this way of learning as a significant component of extra occupational studies. It can be concluded that this part of the project clarified the acceptance of the e-learning strategy by both groups and led to satisfactory results with the enrolled students.

Keywords: e-learning evaluation, self-learning, virtual classroom, virtual learning environments

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Authors: Lei Liu

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Since the famous opening up and reform strategy of China, lots of migrants have flowed from rural areas to urban areas. In this paper, the author investigates the rural elderly left behind, which are defined aged people left alone at home while their adult children have to migrant outside. This phenomenon is a quite general and serious social problem that cannot be ignored, accompanied by the process of urbanization and regional transferring of rural labor. The Chinese internal migration not only exerts great influence to China’s economy and urbanization but also obviously reduces the labor and care to rural aged people. Contrary to assumptions in some migration and aging studies, which show the inevitable negative effects of migration upon the old age care, the author highlights unique features in their daily strategies of house holding to integrate into society with the analysis of the conception of social inclusion. Through life history interviews with elderly left behind in one rural village, this article sheds light on three different factors of social inclusion, namely, economic inclusion, social identity and political inclusion and shows its necessaries to fully understand the status of the social wellbeing of rural elderly left behind.

Keywords: labor migration, elderly left behind, social inclusion, rural China

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Authors: Peter Shi

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Algorithmic trading is a rapidly expanding domain within quantitative finance, constituting a substantial portion of trading volumes in the US financial market. The demand for rigorous and robust mathematical theories underpinning these trading algorithms is ever-growing. In this study, the author establishes a new stock market model that integrates the Efficient Market Hypothesis and the statistical arbitrage. The model, for the first time, finds probabilistic relations between the rational price and the market price in terms of the conditional expectation. The theory consequently leads to a mathematical justification of the old market adage: buy-low and sell-high. The thresholds for “low” and “high” are precisely derived using a max-min operation on Bayes’s error. This explicit connection harmonizes the Efficient Market Hypothesis and Statistical Arbitrage, demonstrating their compatibility in explaining market dynamics. The amalgamation represents a pioneering contribution to quantitative finance. The study culminates in comprehensive numerical tests using historical market data, affirming that the “buy-low” and “sell-high” algorithm derived from this theory significantly outperforms the general market over the long term in four out of six distinct market environments.

Keywords: efficient market hypothesis, behavioral finance, Bayes' decision, algorithmic trading, risk control, stock market

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Authors: Eneken Titov, Ly Hobe

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The collaboration between the universities and companies has been a challenging topic for many years, and although we have many good experiences, those seem to be single examples between one university and company. In Ülemiste Smart City in Estonia, the new initiative was started in 2020 fall, when five Estonian universities cooperated, led by the Ülemiste City developing company Mainor, intending to provide charge-free university courses for the Ülemiste City companies and their employees to encourage university-company wider collaboration. Every Ülemiste City company gets a certain number of free educational credit hours per year to participate in university courses. A functional and simple web platform was developed to mediate university courses for the companies. From January 2021, the education credit platform is open for all Ülemiste City companies and their employees to join, and universities offer more than 9000 hours of courses (appr 150 ECTS). Just two months later, more than 20% of Ülemiste City companies (82 out of 400) have joined the project, and their employees have registered for more than in total 3000 hours courses. The first results already show that the project supports the university marketing and the continuous education mindset in general, whether 1/4 of the courses are paid courses (e.g., when the company is out of free credit).

Keywords: education, educational credit, smart city, university-industry collaboration

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Authors: Eliud Kiprop, Kenichi Matsui, Joseph Karanja, Hesborn Ondiba

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To double the share of renewable energy in the global energy mix by 2030 as part of actions for the Paris Agreement, policymakers in each ratifying country must accelerate their efforts within the next few years by implementing their own renewable energy strategies. Kenya has increased its funding for research and development in renewable energy sources largely because it intends to reduce greenhouse gas GHG emissions by 30% from business as usual (BAU) levels (143 MtCO₂eq) by 2030. In 2013, the Kenyan government launched an ambitious plan to increase the installed power generation capacity from 1,768MW to more than 5,000MW by the end of 2017. This paper examines the formulation and implementation process of this plan and shows how this plan will affect Kenya’s renewable energy industry and national policy implementation in general. Results demonstrate that, despite having a well- documented policy in place, the Kenyan government cannot meet its target of 5000MW by the end of 2017. Among other factors, we find that the main reason is attributable to the failure in adhering to the main principles of the policy plan. We also find that the government has failed to consider the future energy demand. Had the policy been implemented on time, we argue that there would have been excess power.

Keywords: policy implementation, policy plan, renewable energy, sustainable development

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Authors: Mohammed Russedul Islam, Shah M. Muniruzzaman, M. Kamrul-Al-Masud, Syed Sadat Morshed

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Bangladesh is one of the most climate vulnerable countries in the world. According to scientists it is predicted that temperature will raise 1-3% and precipitation 20% by 2050 in Bangladesh. Increased temperature and precipitation will deteriorate pavement structure in an accelerated rate. The study has found that pavement life will reduce significantly due to rise in temperature and precipitation in in a coastal road in Bangladesh. It will cause to increase the maintenance cost of the road. The study has found that reduction in pavement life will be caused due the decrease in stiffness and strength parameters of the pavement material due to high temperature and precipitation. It has found that use of new material costlier than the existing one will be necessary to prevent the reduction of pavement life. Eventually it will increase the re-construction cost of the road. The study has used mechanistic-empirical analysis method with a software GAMES (General analysis on multi-layered elastic systems) to find out the effect of temperature and precipitation rise on the pavement life. The study will help to guide road engineers of Bangladesh to prepare in advance to fight with the climate change effect.

Keywords: climate change, maintenance cost, mechanistic-empirical method, pavement life

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Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena

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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.

Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure

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Authors: Mohammad Hadi Mahmoodi, Mojtaba Farahani

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The present study aimed at investigating whether reflective thinking differentiates Iranian EFL learners regarding language learning strategy use, beliefs about language learning and teaching, and L2 proficiency. To this end, the researcher adopted a mixed method approach. First, 94 EFL learners were asked to complete Reflective Thinking Questionnaire (Kember et al., 2000), Beliefs about Language Learning and Teaching Inventory (Horwitz, 1985), Strategy Inventory for Language Learning (Oxford, 1990), and Oxford Quick Placement Test. The results of three separate one-way ANOVAs indicated that reflective thinking significantly differentiates Iranian EFL learners concerning: (a)language learning strategy use, (b) beliefs about language learning and teaching, and (c) general language proficiency. Furthermore, to see where the differences lay, three separate post-hoc Tukey tests were run the results of which showed that learners with different levels of reflectivity (high, mid, and low) were significantly different from each other in all three dependent variables. Finally, to increase the validity of the findings thirty of the participants were interviewed and the results were analyzed through template organizing style method (Crabtree & Miller, 1999). The results of the interview analysis supported the results of quantitative data analysis.

Keywords: reflective thinking, language learning strategy use, beliefs toward language learning and teaching

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Authors: Agbor Ekama Prisca Anne

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Current data on the prevalence and psychosocial correlates of sexual violence in the Cameroon is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of University students have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. A nationally representative sample of University students (N = 1,020) completed self-report measures of history of sexual violence and mental health. Approximately one-in-three (34.4%) students experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Female students were significantly more likely than men to have experienced all forms of sexual violence (ps < .001), with the exception of sexual assault by teachers or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a teacher associated with several other psychosocial outcomes in life, including education achievement, and behavior disorder. Sexual violence is a common experience in the general population and female students are disproportionately affected (1-in-2 girls versus 1-in-5 boys). Additional resources to increase mental health care among survivors of sexual violence is urgently needed.

Keywords: psychosocial, effects sexual, violence, females, students

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Minsun Kim, Ki-Sun Choi, Hyun-Jee Lee, Young-Chan You

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There is no reinforcement example for the renovation of the vertical and horizontal extension to existing building structures which is a shear wall type in apartment units in Korea. Among these existing structures, the structures which are shear wall type are rare overseas, while Korea has many shear wall apartment units. Recently, in Korea, a few researchers are trying to confirm the possibility of the vertical extension in existing building with shear walls. This study evaluates the possibility of the renovation by applying performance-based seismic design to existing buildings with shear walls in the analysis phase of the structure. In addition, force-based seismic design, used by general structural engineers in Korea, is carried out to compare the amount of reinforcement of walls, which is a main component of wall structure. As a result, we suggest that performance-based design obtains more economical advantages than force-based seismic design.

Keywords: design for extension, performance-based design, remodeling, shear wall frame, structural analysis

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Authors: Ahmed Elgadri

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In the last thirty years, studies on cross-cultural pragmatics in general and apology strategies in specific have focused on western and East-Asian societies. A small volume of research has been conducted in investigating speech acts production by Arabic dialect speakers. Therefore, this study investigated the apology strategies used by Libyan Arabic speakers using an online Discourse Completion Task (DCT) questionnaire. The DCT consisted of six situations covering different social contexts. The survey was written in Libyan Arabic dialect to help generate vernacular speech as much as possible. The participants were 25 Libyan nationals, 12 females, and 13 males. Also, to get a deeper understanding of the motivation behind the use of certain strategies, the researcher interviewed four participants using the Libyan Arabic dialect as well. The results revealed a high use of IFID, offer of repair, and explanation. Although this might support the universality claim of speech acts strategies, it was clear that cultural norms and religion determined the choice of apology strategies significantly. This led to the discovery of new culture-specific strategies, as outlined later in this paper. This study gives an insight into politeness strategies in Libyan society, and it is hoped to contribute to the field of cross-cultural pragmatics.

Keywords: apologies, cross-cultural pragmatics, language and culture, Libyan Arabic, politeness, pragmatics, socio-pragmatics, speech acts

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Authors: Nitu Marilena Cristina

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Decentralization of the education system is an educational policy option necessary from the perspective of democratizing internal life and streamlining service administration public. The experience of recent years has shown that decisions taken at central level do not to take into account all situations and especially all the specific needs and interests of the various institutions and individuals. A democratic society implies that the decision-making process is brought closer to the place of application, allowing citizens to take part in the decision-making that affects them directly or indirectly. Essentially decentralization of pre-university education is the transfer of authority, responsibility and resources in decision-making and general management, and financially to the educational units and the local community. This creates a frame of an effective collaboration between school and community. Modern theories on the leadership of education advocate the adoption of decentralization measures and participatory strategies. Numerous countries confronted with the educational impasse has appealed to these strategies. Reforming projects have begun application diversified and nuanced social decentralization models according to the specific social and educational situation. Analysis of legal provisions and measures adopted in the framework of the reform process indicates that, at least formally, decentralization is the solution chosen.

Keywords: decentralization, educational, management, reforming

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Authors: Arezoo Seifollahi

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One of the topics that is receiving a lot of attention in artistic circles and among Iran today and has been the subject of many conversations is the issue of Iranian graphics. In this research, the functional and practical aspects of Iranian painting as a visual-identity language in Iranian graphics have been investigated by relying on Iranian cultural and social posters in order to gain an understanding of the trend of contemporary graphic art in Iran and to help us reach the identity of graphics. In order to arrive at Iranian graphics, first, the issue of identity and what it is has been examined, and then this category has been addressed in Iran and throughout the history of this country in order to reveal the characteristics of the identity that has come to us today under the name of Iranian identity cognition. In the following, the search for Iranian identity in the art of this land, especially the art of painting, and then the art of contemporary painting and the search for identity in it have been discussed. After that, Iranian identity has been investigated in Iranian graphics. To understand Iranian graphics, after a brief description of its contemporary history, this art is examined at the considered time point. By using the inductive method of examining the posters of each course and taking into account the related cultural and social conditions, we tried to get a general and comprehensive understanding of the graphic features of each course.

Keywords: Iranian painting, graphic visual language, Iranian identity, social cultural poster

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Authors: A. Amar

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A new model, namely the crystal model, has been modified to calculate the radius and density distribution of light nuclei up to ⁸Be. The crystal model has been modified according to solid-state physics, which uses the analogy between nucleon distribution and atoms distribution in the crystal. The model has analytical analysis to calculate the radius where the density distribution of light nuclei has obtained from analogy of crystal lattice. The distribution of nucleons over crystal has been discussed in a general form. The equation that has been used to calculate binding energy was taken from the solid-state model of repulsive and attractive force. The numbers of the protons were taken to control repulsive force, where the atomic number was responsible for the attractive force. The parameter has been calculated from the crystal model was found to be proportional to the radius of the nucleus. The density distribution of light nuclei was taken as a summation of two clusters distribution as in ⁶Li=alpha+deuteron configuration. A test has been done on the data obtained for radius and density distribution using double folding for d+⁶,⁷Li with M3Y nucleon-nucleon interaction. Good agreement has been obtained for both the radius and density distribution of light nuclei. The model failed to calculate the radius of ⁹Be, so modifications should be done to overcome discrepancy.

Keywords: nuclear physics, nuclear lattice, study nucleus as crystal, light nuclei till to ⁸Be

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Authors: Fergal Fouhy, Alan O’Keeffe, Sean Costelloe, Michael Clarkson

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Background: Sarcoidosis is a systemic, non-infectious disease of unknown aetiology, characterized by non-caseating granulomatous inflammation. The lung is most often affected (90%); however, the condition can affect all organs, including the kidneys. There is limited evidence describing the incidence and characteristics of renal involvement in sarcoidosis. Serum angiotensin-converting enzyme (ACE) is a recognised biomarker used in the diagnosis and monitoring of sarcoidosis. Methods: A single-centre, retrospective cohort study of patients presenting to Cork University Hospital (CUH) in 2015 with first-time elevations of serum ACE was performed. This included an initial database review of ACE and other biochemistry results, followed by a medical chart review to confirm the presence or absence of sarcoidosis and management thereof. Acute kidney injury (AKI) was staged using the AKIN criteria, and chronic kidney disease (CKD) was staged using the KDIGO criteria. Follow-up was assessed over five years tracking serum creatinine, serum calcium, and estimated glomerular filtration rates (eGFR). Results: 119 patients were identified as having a first raised serum ACE in 2015. Seventy-nine male patients and forty female patients were identified. The mean age of patients identified was 47 years old. 11% had CKD at baseline. 18% developed an AKI at least once within the next five years. A further 6% developed CKD during this time period. 13% developed hypercalcemia. The patients within the lowest quartile of serums ACE had an incidence of sarcoidosis of 5%. None of this group developed hypercalcemia, 23% developed AKI, and 7% developed CKD. Of the patients with a serum ACE in the highest quartile, almost all had documented diagnoses of sarcoidosis with an incidence of 96%. 3% of this group developed hypercalcemia, 13% AKI and 3% developed CKD. Conclusions: There was an unexpectedly high incidence of AKI in patients who had a raised serum ACE. Not all patients with a raised serum ACE had a confirmed diagnosis of sarcoidosis. There does not appear to be a relationship between increased serum ACE levels and increased incidence of hypercalcaemia, AKI, and CKD. Ideally, all patients should have biopsy-proven sarcoidosis. This is an initial study that should be replicated with larger numbers and including multiple centres.

Keywords: sarcoidosis, acute kidney injury, chronic kidney disease, hypercalcemia

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Authors: Tomáš Ludík, Jiří Barta, Sabina Chytilová, Josef Navrátil

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Emergency management is a discipline of dealing with and avoiding risks. Appropriate emergency management software allows better management of these risks and has a direct influence on reducing potential negative impacts. Although there are several emergency management software products in the Czech Republic, they cover user requirements from the emergency management field only partially. Therefore, the paper focuses on the issues of requirement analysis within development of emergency management software. Analysis of the current state describes the basic features and properties of user requirements for software development as well as basic methods and approaches for gathering these requirements. Then, the paper presents more specific mechanisms for requirement analysis based on chosen software development approach: structured, object-oriented or agile. Based on these experiences it is designed new methodology for requirement analysis. Methodology describes how to map user requirements comprehensively in the field of emergency management and thus reduce misunderstanding between software analyst and emergency manager. Proposed methodology was consulted with department of fire brigade and also has been applied in the requirements analysis for their current emergency management software. The proposed methodology has general character and can be used also in other specific areas during requirement analysis.

Keywords: emergency software, methodology, requirement analysis, stakeholders, use case diagram, user stories

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

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Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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Authors: Cengiz Demir, Recep Keşli, Gülşah Aşık

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Objective: This study was carried out with the purpose of defining by using the E test method and determining the antibiotic resistance profiles of Gram-negative anaerobic bacilli isolated from various clinical specimens obtained from patients with suspected anaerobic infections and referred to Medical Microbiology Laboratory of Afyon Kocatepe University, ANS Application and Research Hospital. Methods: Two hundred and seventy eight clinical specimens were examined for isolation of the anaerobic bacteria in Medical Microbiology Laboratory between the 1st November 2014 and 30th October 2015. Specimens were cultivated by using Scheadler agar that 5% defibrinated sheep blood added, and Scheadler broth. The isolated anaerobic Gram-negative bacilli were identified conventional methods and Vitek 2 (ANC ID Card, bioMerieux, France) cards. Antibiotic resistance rates against to penicillin G, clindamycin, cefoxitin, metronidazole, moxifloxacin, imipenem, meropenem, ertapenem and doripenem were determined with E-test method for each isolate. Results: Of the isolated twenty-eight anaerobic gram negative bacilli fourteen were identified as the B. fragilis group, 9 were Prevotella group, and 5 were Fusobacterium group. The highest resistance rate was found against penicillin (78.5%) and resistance rates against clindamycin and cefoxitin were found as 17.8% and 21.4%, respectively. Against to the; metronidazole, moxifloxacin, imipenem, meropenem, ertapenem and doripenem, no resistance was found. Conclusion: Since high rate resistance has been detected against to penicillin in the study penicillin should not be preferred in empirical treatment. Cefoxitin can be preferred in empirical treatment; however, carrying out the antibiotic sensitivity testing will be more proper and beneficial. No resistance was observed against carbapenem group antibiotics and metronidazole; so that reason, these antibiotics should be reserved for treatment of infectious caused by resistant strains in the future.

Keywords: anaerobic gram-negative bacilli, anaerobe, antibiotics and resistance profiles, e-test method

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Authors: Faezeh Mohammadi, Ebrahim Ebrahimi, Neda Azimi

Abstract:

Use of ultrasound waves is one of the techniques for increasing the mixing and mass transfer in the microdevices. Ultrasound propagation into liquid medium leads to stimulation of the fluid, creates turbulence and so increases the mixing performance. In this study, CFD modeling of two-phase flow in a pitted micromixer equipped with a piezoelectric with frequency of 1.7 MHz has been studied. CFD modeling of micromixer at different velocity of fluid flow in the absence of ultrasound waves and with ultrasound application has been performed. The hydrodynamic of fluid flow and mixing efficiency for using ultrasound has been compared with the layout of no ultrasound application. The result of CFD modeling shows well agreements with the experimental results. The results showed that the flow pattern inside the micromixer in the absence of ultrasound waves is parallel, while when ultrasound has been applied, it is not parallel. In fact, propagation of ultrasound energy into the fluid flow in the studied micromixer changed the hydrodynamic and the forms of the flow pattern and caused to mixing enhancement. In general, from the CFD modeling results, it can be concluded that the applying ultrasound energy into the liquid medium causes an increase in the turbulences and mixing and consequently, improves the mass transfer rate within the micromixer.

Keywords: CFD modeling, ultrasound, mixing, mass transfer

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Authors: C. E. Ihejirika, M. I. Nwachukwu, R. F. Njoku-Tony, O. C. Ihejirika, U. O. Enwereuzoh, E. O. Imo, D. C. Ashiegbu

Abstract:

Disposal of industrial solid wastes in the environment is a major environmental challenge. This study investigated the effects of calcium carbide waste dumpsites on soil quality. Soil samples were collected with hand auger from three different dumpsites at varying depths and made into composite samples. Samples were subjected to standard analytical procedures. pH varied from 10.38 to 8.28, nitrate from 5.6mg/kg to 9.3mg/kg, phosphate from 8.8mg/kg to 12.3mg/kg, calcium carbide reduced from 10% to to 3%. Calcium carbide was absent in control soil samples. Bacterial counts from dumpsites ranged from 1.8 x 105cfu/g - 2.5 x 105cfu/g while fungal ranged from 0.8 x 103cfu/g - 1.4 x 103cfu/g. Bacterial isolates included Pseudomonas spp, Flavobacterium spp, and Achromobacter spp, while fungal isolates include Penicillium notatum, Aspergillus niger, and Rhizopus stolonifer. No organism was isolated from the dumpsites at soil depth of 0-15 cm, while there were isolates from other soil depths. Toxicity might be due to alkaline condition of the dumpsite. Calcium carbide might be bactericidal and fungicidal leading to cellular physiology, growth retardation, death, general loss of biodiversity and reduction of ecosystem processes. Detoxification of calcium carbide waste before disposal on soil might be the best option in management.

Keywords: biodiversity, calcium-carbide, denitrification, toxicity

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Authors: Vanessa R. Ralph, Leah J. Scharlott, Megan Y. Deshaye, Ryan L. Stowe

Abstract:

Given the traditions of chemistry teaching, one may not question whether chemical phenomena play a prominent role. Yet, the role of chemical phenomena in an introductory chemistry course may define the extent to which the course is introductory, chemistry, and equitable. Picture, for example, the classic Ideal Gas Law problem. If one envisions a prompt wherein students are tasked with calculating a missing variable, then one envisions a prompt that relies on chemical phenomena as a context rather than as a model to understand the natural world. Consider a prompt wherein students are tasked with applying molecular models of gases to explain why the vapor pressure of a gaseous solution of water differs from that of carbon dioxide. Here, the chemical phenomenon is not only the context but also the subject of the prompt. Deliveries of general and organic chemistry were identified as ranging wildly in the integration of chemical phenomena. The more incorporated the phenomena, the more equitable the assessment task was for students of varying access to pre-college math and science preparation. How chemical phenomena are integrated may very well define whether courses are chemistry, are introductory, and are equitable. Educators of chemistry are invited colleagues to discuss the role of chemical phenomena in their courses and consider the long-lasting impacts of replicating tradition for tradition’s sake.

Keywords: equitable educational practices, chemistry curriculum, content organization, assessment design

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Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

Abstract:

Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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Authors: Elizabeth A. Haruna, Bulus Kpame, Kankanala Venkateswarlu

Abstract:

The interaction of health and athletic performance with biologic aging has been an interesting and intriguing area for research. There has been a general acknowledgement of its importance to major public health and elite performance outcomes. There are many questions unanswered about the mechanisms of effects and dose-response changes. An attempt has been made in this paper to highlight potentially positive effects of regular training on the aging process and its effects on health. Age associated decline in health and performance results from the combination of the aging process itself, inactive lifestyle and primary diseases. An attempt is made in this paper to critically review what is known and what is unknown about evidence based changes, common to disuse and aging. Mechanisms responsible for the slowing decline in muscle mass and muscle force (sarcopenia) down of age – associated, weakness and fatigability due to year round athletic training have been discussed. It is in this regard we have attempted to share our views on advances made so far in understanding the impact of aging on health. We also attempted to explain how the biological effects of aging are minimized during appropriate year round athletic training. On the basis of available research evidence it was concluded that exercise training significantly slow down the deleterious effects of aging on health.

Keywords: aging, atrophy, sarcopenia, plyometric training

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Authors: Sarah M. Schoellhammer, Stephen Gibb

Abstract:

Bureaucracy, in particular, its core element, a formal and stable hierarchy of authority, is proving less and less appropriate under the conditions of today’s knowledge economy. Centralization and formalization were consistently found to hinder innovation, undermining cross-functional collaboration, personal responsibility, and flexibility. With its focus on systematical planning, controlling and monitoring the development of new or improved solutions for customers, even innovation management as a discipline is to a significant extent based on a mechanistic understanding of organizations. The most important drivers of innovation, human creativity, and initiative, however, can be more hindered than supported by central elements of classic innovation management, such as predefined innovation strategies, rigid stage gate processes, and decisions made in management gate meetings. Heterarchy, as an alternative network form of organization, is essentially characterized by its dynamic influence structures, whereby the biggest influence is allocated by the collective to the persons perceived the most competent in a certain issue. Theoretical arguments that the non-hierarchical concept better supports innovation than bureaucracy have been supported by empirical research. These prior studies either focus on the structure and general functioning of non-hierarchical organizations or on their innovativeness, that means innovation as an outcome. Complementing classic innovation management approaches, this work aims to shed light on how innovations are initiated and realized in heterarchies in order to identify alternative solutions practiced under conditions of the post-bureaucratic organization. Through an initial individual case study, which is part of a multiple-case project, the innovation practices of an innovative and highly heterarchical medium-sized company in the German fire engineering industry are investigated. In a pragmatic mixed methods approach media resonance, company documents, and workspace architecture are analyzed, in addition to qualitative interviews with the CEO and employees of the case company, as well as a quantitative survey aiming to characterize the company along five scaled dimensions of a heterarchy spectrum. The analysis reveals some similarities and striking differences to approaches suggested by classic innovation management. The studied heterarchy has no predefined innovation strategy guiding new product and service development. Instead, strategic direction is provided by the CEO, described as visionary and creative. Procedures for innovation are hardly formalized, with new product ideas being evaluated on the basis of gut feeling and flexible, rather general criteria. Employees still being hesitant to take responsibility and make decisions, hierarchical influence is still prominent. Described as open-minded and collaborative, culture and leadership were found largely congruent with definitions of innovation culture. Overall, innovation efforts at the case company tend to be coordinated more through cultural than through formal organizational mechanisms. To better enable innovation in mainstream organizations, responsible practitioners are recommended not to limit changes to reducing the central elements of the bureaucratic organization, formalization, and centralization. The freedoms this entails need to be sustained through cultural coordination mechanisms, with personal initiative and responsibility by employees as well as common innovation-supportive norms and values. These allow to integrate diverse competencies, opinions, and activities and, thus, to guide innovation efforts.

Keywords: bureaucracy, heterarchy, innovation management, values

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Authors: Kanokrat Kunasaraphan

Abstract:

The purpose of the study was to identify whether English language learning strategies commonly used by the first year students at International College, Suan Sunandha Rajabhat University include six direct and indirect strategies. The study served to explore whether there was a difference in these students’ use of six direct and indirect English learning strategies between the different levels of their English proficiency. The questionnaire used as a research instrument was comprised of two parts: General information of participants and the Strategy Inventory for Language Learning (SILL). The researcher employed descriptive statistics and one-way ANOVA (F-test) to analyze the data. The results of the analysis revealed that English learning strategies commonly used by the first year students include six direct and indirect strategies, including differences in strategy use of the students with different levels of English proficiency. Recommendations for future research include the study of language learning strategy use with other research methods focusing on other languages, specific language skills, and/or the relationship of language learning strategy use and other factors in other programs and/or institutions.

Keywords: English learning strategies, direct strategies, indirect strategies, proficiency level

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Authors: Amin Padash, Javad Kazem Zadeh Khoiy, Hossein Vahidi

Abstract:

Purpose: The mechanization system for the urban services was implemented in Tehran City in the year 2004 to promote the collection of domestic wastes; in 2010, in order to achieve the objectives of the project of urban services mechanization and qualitative promotion and improve the urban living environment, sustainable development and optimization of the recyclable solid wastes collection systems as well as other dry and non-organic wastes and conformity of the same to the modern urban management methods regarding integration of the mechanized urban services contractors and recycling contractors and in order to better and more correct fulfillment of the waste separation and considering the success of the mechanization plan of the dry wastes in most of the modern countries. The aim of this research is analyzing of Environmental Risk Assessment of the mechanization waste collection scheme in Tehran. Case Study: Tehran, the capital of Iran, with the population of 8.2 million people, occupies 730 km land expanse, which is 4% of total area of country. Tehran generated 2,788,912 ton (7,641 ton/day) of waste in year 2008. Hospital waste generation rate in Tehran reaches 83 ton/day. Almost 87% of total waste was disposed of by placing in a landfill located in Kahrizak region. This large amount of waste causes a significant challenge for the city. Methodology: To conduct the study, the methodology proposed in the standard Mil-St-88213 is used. This method is an efficient method to examine the position in opposition to the various processes and the action is effective. The method is based on the method of Military Standard and Specialized in the military to investigate and evaluate options to locate and identify the strengths and weaknesses of powers to decide on the best determining strategy has been used. Finding and Conclusion: In this study, the current status of mechanization systems to collect waste and identify its possible effects on the environment through a survey and assessment methodology Mil-St-88213, and then the best plan for action and mitigation of environmental risk has been proposed as Environmental Management Plan (EMP).

Keywords: environmental risk assessment, mechanization waste collection scheme, Mil-St-88213

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