Search results for: hospital building

Authors: Yu-Tzu Hsu, Alice Wu, Hsiang-Kuang Tseng

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Introduction: Hepatitis A virus causes acute hepatitis and is usually transmitted by a fecal-oral route of food contamination, which is more prevalent in areas with poor hygienic practices. However, we described a hepatitis A outbreak associated with a fecal-oral route of sexual behavior in men who has sex with men (MSM) in Northern Taiwan. Methods: We retrospectively collected patients with acute HAV infection in MacKay Memorial Hospital, Taipei, Taiwan between July 2015 and November 2016. Demographic data (age, gender, onset time and infection risk), laboratory data (GOT, GPT, bilirubin, HIV status, HBsAg, HCV antibody and syphilis), clinical symptoms and travel history with a foreign tour were analyzed. We compared variables between HIV and non-HIV group. Unless otherwise stated, continuous variables were expressed as mean ± SD, and categorical variables were expressed as number (percentage) for each item. The t test for continuous variables was applied for the comparison between two groups and chi-square for categorical variables were applied for measures of association. Results: We collected 80 cases during the study period. Among them, 54 (67.5%) cases were MSM and 43 (53.8%) cases were HIV positive. The average age was 32.6±7.59 years-old. The average value of initial liver function was 1324 IU/L for AST (GOT), 2100 IU/L for ALT (GPT), and 5.82 mg/dL for bilirubin. We found seven (8.6%) cases were in the status of HBV carrier, five (6.3%) cases were positive for HCV antibody, and 15 (18.6%) cases were co-infected with syphilis. With regards to associated symptoms, 32 (40%) had fever, 46 (57.5%) had nausea, 34 (42.5%) had abdominal discomfort and 46 (57.5%) had general malaise. To compare the non-HIV patients with HIV patients, HIV patients were more likely to be male (p=0.008), MSM (p=0.000), co-infected syphilis (p=0.000) and slowly improving liver function of transaminases (p=0.033, 0.027). Conclusion: The HAV outbreak in Northern Taiwan was mainly occurred in MSM population. Hereafter, our cohort data support a policy in Taiwan to provide one dose of free HAV vaccine shot in this population. Hopefully, the outbreak could be stop by the free vaccine policy and public education.

Keywords: acute hepatitis A, men who has sex with men, human immunodeficiency virus, vaccine

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Authors: Mahrooz Abed, Amir R. Masoodi

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Many structural lateral systems are used in tall buildings such as rigid frames, braced frames, shear walls, tubular structures and core structures. Some efficient structures for drift control and base moment reduction in tall buildings is outrigger and belt truss systems. When adopting outrigger beams in building design, their location should be in an optimum position for an economical design. A range of different strategies has been employed to identify the optimum locations of these outrigger beams under wind load. However, there is an absence of scientific research or case studies dealing with optimum outrigger location using buckling analysis. In this paper, one outrigger system is considered at the middle of height of structure. The optimum location of outrigger will be found based on the buckling load limitation. The core of structure is modeled by a clamped tapered beam. The exact stiffness matrix of tapered beam is formulated based on the Euler-Bernoulli theory. Finally, based on the buckling load of structure, the optimal location of outrigger will be found.

Keywords: tall buildings, outrigger system, buckling load, second-order effects, Euler-Bernoulli beam theory

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Authors: Styliani Kotrotsiou, Evagelia Kotrotsiou, Fani Mokia, Theodosis Paralikas, Konstantinos Tsaras

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Objective: The objective of this study was the investigation of the mental health of patients undergoing chronic or transient hemodialysis at Artificial Kidney Unit, as well as its relationship to the demographic characteristic of patients. Material and Method: The study took place in Larisa during the month of December in 2016 and the sample was composed of 60 patients undergoing in chronic or transient hemodialysis at Artificial Kidney Unit of the University General Hospital of Larisa. For the investigation of the physical and mental health of patients who participated in the study, the tool measurement << General Health Questionnaire- 28 >> (GHQ-28) was used. The questionnaires were administered with the interview method during the hemodialysis. This survey is designed for the existence or not of a mental disorder. It examines four factors (physical symptoms, anxiety, social dysfunction and depression). Results: The hemodialysis patients gave the following scores: -to the physical symptoms, women showed a higher average value than men (1,16 ± 1,26 against 0,49 ± 0,93), -at the anxiety scale, it seems that women are superior to men (1,68 ± 1,20 against 0,90 ± 1,22), -at the social dysfunction scale, the elderly patients ( > 65 years old) were presented a with higher average (2,59), and -at the depression scale, patients with a higher average value were those who lived in non-urban areas. The appearance of mental disorder, in relation to patient characteristics, did not show significant statistical correlation. The sex, the age and the place of residence affect more the assessment of mental health, while education did not seem to have any significant effect on the other. Conclusions: The hemodialysis process can significantly affect the patient’s Quality of Life and it can bring adverse changes in lifestyle, affecting the physical, social and psychological state of the individual. For that reason, hemodialysis should be aimed not only at extending life but in upgrading the Quality of Life.

Keywords: hemodialysis, chronic kidney disease, depression, social dysfunction, physical condition

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Authors: I. Djefour, M. Saidi, I. Tlemsani, S. Toubal

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Lignin is a molecule derived from wood and also generated as waste from the paper industry. With a view to its valorization and protection of the environment, we are interested in its use as a superplasticizer-type adjuvant in mortars and concretes to improve their mechanical strengths. The additives of the concrete have a very strong influence on the properties of the fresh and / or hardened concrete. This study examines the development and use of industrial waste and lignin extracted from a renewable natural source (wood) in cementitious materials. The use of these resources is known at present as a definite resurgence of interest in the development of building materials. Physicomechanical characteristics of mortars are determined by optimization quantity of the natural superplasticizer. The results show that the mechanical strengths of mortars based on natural adjuvant have improved by 20% (64 MPa) for a W/C ratio = 0.4, and the amount of natural adjuvant of dry extract needed is 40 times smaller than commercial adjuvant. This study has a scientific impact (improving the performance of the mortar with an increase in compactness and reduction of the quantity of water), ecological use of the lignin waste generated by the paper industry) and economic reduction of the cost price necessary to elaboration of self-compacting mortars and concretes).

Keywords: biopolymer (lignin), industrial waste, mechanical resistances, self compacting mortars (SCM)

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Authors: Nizar Abu-Jaber

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Late Pleistocene and Holocene carbonate crusts in the south of Jordan were studied using a combination of field documentation, petrography, geochemical and isotopic techniques. These surficial crusts and vein deposits appear to have formed as a result of interaction between near-surface groundwater, surficial soil and sediments and rising carbon dioxide. Rising mantle CO2 dissolves in the water to create carbonic acid, which in turn dissolves the calcite in the soil in the sediments. When the pH rises later due to degassing, the carbonate crusts are left in the places where the water was flowing in veins, channels and interfaces between high and low permeability materials. The crusts have the potential for being important records of natural and human agencies on the landscape of the area. They reflect the isotopic composition of the waters in which they precipitated in, and also contain isotopic information about the aeolian calcium fluxes affecting the area (using strontium isotopes). Moreover, changing stream valley base levels can be identified and measured, which can help quantify the rates of tectonic movement. Finally, human activities such and channel construction and terrace building can be identified and traced temporally and spatially using these deposits.

Keywords: anthropogenic change, carbonate crusts, environmental change, Jordan

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Authors: Laura Niño Cáceres, Daisy Yoo, Caroline Hummels

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COVID-19 accelerated digital healthcare technology usage in many countries, such as Colombia, whose digital healthcare vision and projects are proof of this. However, with a significant cultural indigenous and Afro-Colombian heritage, only some parts of the country are willing to follow the proposed digital Western approach to health. Our paper presents the national healthcare system’s digital narrative, which we contrast with the micro-narrative of an Afro-Colombian ethnomedicine unit in Bogota called Kilombo Yumma. This ethnomedical unit is building its mobile app to safeguard and represent its ancestral medicine practices in local and national healthcare information systems. Kilombo Yumma is keen on promoting their beliefs and practices, which have been passed on through oral traditions and currently exist in the hands of a few older women. We unraveled their ambition, core beliefs, and practices through asset-based design. These assets outlined pluriversal and decolonizing forms of digital healthcare to increase social justice and connect Western and ancestral medicine digital opportunities through HCI.

Keywords: asset-based design, mobile app, decolonizing HCI, Afro-Colombian ancestral medicine

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Authors: Albert Maake, Ifunanya Isama

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International remittances to developing countries reached US$ 485 billion in 2018. By 2015, the East African region had surpassed US$3.5 mark. Considering this, there is no argument as to the contribution of Diaspora remittances as an alternative source of funds in the development process of the developing countries. Nevertheless, this paper seeks to argue that good governance in areas such as policy design, implementation and monitoring play a critical role in the sustainable development process of a nation as opposed to Diaspora remittances in general. Therefore this study intends at analyzing the contribution of Governance as opposed to that of Diaspora remittances for nation development. Employing documentary analysis technique, the secondary data with respect to the countries under study on Diaspora remittances will be collected. Selected indicators for Governance-HDI, Debt-to-GDP Ratio and Corruption Index, will be sourced from the World Bank Data for the purpose of consistency and where applicable the Central Statistical Agencies of the Nations under study. By means of descriptive statistics and content analysis the data will be comparatively analyzed to highlight the unique experiences in Rwanda and Kenya. The findings and interpretations from the study will affirm and promote capacity building for best practices in good governance for the countries under study.

Keywords: diaspora remittance, governance, Kenya, Rwanda, sustainable development

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Authors: Darius Singh

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This study adopts a research, develop, and deploy methodology to create a state-of-the-art forest preschool environment using technology and the Gaia (Earth) Education Philosophy as design support. The new philosophy adopts an ancient Greek terminology, “Gaia,” meaning “Mother Earth”, and it take its principle to model everything with the oldest living and breathing entity that it know – Earth. This includes using nature and biomimicry-based principles in building design, environments, curricula, teaching, learning, values and outcomes for children. The study highlights the potential effectiveness of the Gaia (Earth) Education Philosophy as a means of designing Earth-inspired environments for children’s learning. The discuss the strengths of biomimicry-based design principles and propose a curriculum that emphasizes natural outcomes for early childhood learning. Theoretical implications of the study are that the Gaia (Earth) Education Philosophy could serve as a strong foundation for educating young learners.it present a unique approach that promotes connections with Earth-principles and lessons that can contribute to the development of social and environmental consciousness among children and help educate generations to come into a stable and balanced future.

Keywords: earth science, nature education, sustainability, gaia, forest school, nature, inspirational teaching and learning

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Authors: Ermias A. Tegegn, Million Meshesha

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Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) is a major cause of death for most African countries. Ethiopia is one of the seriously affected countries in sub Saharan Africa. Previously in Ethiopia, having HIV/AIDS was almost equivalent to a death sentence. With the introduction of Antiretroviral Therapy (ART), HIV/AIDS has become chronic, but manageable disease. The study focused on a data mining technique to predict future living status of HIV/AIDS patients at the time of drug regimen change when the patients become toxic to the currently taking ART drug combination. The data is taken from University of Gondar Hospital ART program database. Hybrid methodology is followed to explore the application of data mining on ART program dataset. Data cleaning, handling missing values and data transformation were used for preprocessing the data. WEKA 3.7.9 data mining tools, classification algorithms, and expertise are utilized as means to address the research problem. By using four different classification algorithms, (i.e., J48 Classifier, PART rule induction, Naïve Bayes and Neural network) and by adjusting their parameters thirty-two models were built on the pre-processed University of Gondar ART program dataset. The performances of the models were evaluated using the standard metrics of accuracy, precision, recall, and F-measure. The most effective model to predict the status of HIV patients with drug regimen substitution is pruned J48 decision tree with a classification accuracy of 98.01%. This study extracts interesting attributes such as Ever taking Cotrim, Ever taking TbRx, CD4 count, Age, Weight, and Gender so as to predict the status of drug regimen substitution. The outcome of this study can be used as an assistant tool for the clinician to help them make more appropriate drug regimen substitution. Future research directions are forwarded to come up with an applicable system in the area of the study.

Keywords: HIV drug regimen, data mining, hybrid methodology, predictive model

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Authors: Yan Yu, Wang Yu, Chen Xintong, Liu Yi, Zhang Yanzhong, Wang Yanji, Chen Xingyu, Zhang Miaocheng, Tong Yi

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Neuromorphic computing based on spiking neural networks (SNNs) has emerged as a promising avenue for building the next generation of intelligent computing systems. Owing to its high-density integration, low power, and outstanding nonlinearity, memristors have attracted emerging attention on achieving SNNs. However, fabricating a low-power and robust memristor-based spiking neuron without extra electrical components is still a challenge for brain-inspired systems. In this work, we demonstrate a TiO₂-based threshold switching (TS) memristor to emulate a leaky integrate-and-fire (LIF) neuron without auxiliary circuits, used to realize single layer fully connected (FC) SNNs. Moreover, our TiO₂-based resistive switching (RS) memristors realize spiking-time-dependent-plasticity (STDP), originating from the Ag diffusion-based filamentary mechanism. This work demonstrates that TiO2-based memristors may provide an efficient method to construct hardware neuromorphic computing systems.

Keywords: leaky integrate-and-fire, memristor, spiking neural networks, spiking-time-dependent-plasticity

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Authors: Hessah Alsulami, Majedah Aldosari

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Introduction: Platelet threshold of 10x109 /L is recommended for clinically stable thrombocytopenic pediatric patients. Transfusions at a higher level (given the absence of research evidence, as determined by clinical circumstances, generally at threshold of 40x109 /L) may be required for patients with signs of bleeding, high fever, hyper-leukocytosis, rapid fall in platelet count, concomitant coagulation abnormality, critically ill patients, and those with impaired platelet function (including drug induced). Transfusions at a higher level may be also required for patients undergoing invasive procedures. Method: This study is a retrospective observational analysis of platelet transfusion thresholds in a single secondary pediatric hospital in Riyadh. From the blood bank database, the list of the patients who received platelet transfusions in the second half of 2018 was retrieved. Patients were divided into two groups; group A, those belong to the category of high platelet level for transfusion (such as those with bleeding, high fever, rapid fall in platelet count, impaired platelet function or undergoing invasive procedures) and group B, those who were not. Then we looked at the pre and post transfusion platelet levels for each group. The data was analyzed using GraphPad software and the data expressed as Mean ± SD. Result: A total of 112 of transfusion episodes in 61 patients (38% female) were analyzed. The age ranged from 24 days to 8 years. The distribution of platelet transfusion episodes was 64% (n=72) for group A and 36% (n= 40) for group B. The mean pre-transfusion platelet count was 46x103 ± (11x 103) for group A and 28x103 ± (6x103) for group B. the post-transfusion mean platelet count was 61 x 103 ± (14 x 103) and 60 x103 ± (24 x 103) for group A and B respectively. Among the groups the rise in the mean platelet count after transfusion was significant among stable patients (group B) compared to unstable patients (group A) (P < 0.001). Conclusion: The platelet count threshold for transfusion varied with the clinical condition and is higher among unstable patients’ group which is expected. For stable patients the threshold was higher than what it should be which means that the clinicians don’t follow the guidelines in this regard. The rise of platelet count after transfusion was higher among stable patients.

Keywords: platelet, transfusion, threshold, pediatric

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Authors: Sherif Sabri, Suzy Fawzi, Sanaa Abdelshafy, Ayman Nagah

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Introduction: Static derangements in lactate homeostasis during ICU stay have become established as a clinically useful marker of increased risk of hospital and ICU mortality. Lactate indices or kinetic alteration of the anaerobic metabolism make it a potential parameter to evaluate disease severity and intervention adequacy. This is an inexpensive and simple clinical parameter that can be obtained by a minimally invasive means. Aim of work: Comparing the predictive value of dynamic indices of hyperlactatemia in the first twenty four hours of intensive care unit (ICU) admission with other static values are more commonly used. Patients and Methods: This study included 40 critically ill patients above 18 years old of both sexes with Hyperlactamia (≥ 2 m mol/L). Patients were divided into septic group (n=20) and low oxygen transport group (n=20), which include all causes of low-O2. Six lactate indices specifically relating to the first 24 hours of ICU admission were considered, three static indices and three dynamic indices. Results: There were no statistically significant differences among the two groups regarding age, most of the laboratory results including ABG and the need for mechanical ventilation. Admission lactate was significantly higher in low-oxygen transport group than the septic group [37.5±11.4 versus 30.6±7.8 P-value 0.034]. Maximum lactate was significantly higher in low-oxygen transport group than the septic group P-value (0.044). On the other hand absolute lactate (mg) was higher in septic group P-value (< 0.001). Percentage change of lactate was higher in the septic group (47.8±11.3) than the low-oxygen transport group (26.1±12.6) with highly significant P-value (< 0.001). Lastly, time weighted lactate was higher in the low-oxygen transport group (1.72±0.81) than the septic group (1.05±0.8) with significant P-value (0.012). There were statistically significant differences regarding lactate indices in survivors and non survivors, whether in septic or low-oxygen transport group. Conclusion: In critically ill patients, time weighted lactate and percent in lactate change in the first 24 hours can be an independent predictive factor in ICU mortality. Also, a rising compared to a falling blood lactate concentration over the first 24 hours can be associated with significant increase in the risk of mortality.

Keywords: critically ill patients, lactate indices, mortality in intensive care, anaerobic metabolism

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Authors: Reira Kinoshita, Shin'ichi Ishimaru

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Vapochromism is a type of chromism in which the color of a substance changes when it is exposed to the vapor of volatile materials, and has been investigated for the application of chemical sensors for volatile organic compounds causing sick building syndrome and health hazards in workspaces. We synthesized intercalation compounds of 3,3',5,5'-tetramethylbenzidine (TMB), and tetrasilisicfluormica (TSFM) by the commonly used cation-exchange method with the cation ratio TMB²⁺/CEC of TSFM = 1.0, 2.0, 2.7 and 5.4 to investigate the vapochromism of these materials. The obtained samples were characterized by powder XRD, XRF, TG-DTA, N₂ adsorption, and SEM. Vapochromism was measured for each sample under a controlled atmosphere by a handy reflectance spectrometer directly from the outside of the glass sample tubes. The color was yellow for all specimens vacuum-dried at 50 °C, but it turned green under H₂O vapor exposure for the samples with TMB²⁺/CEC = 2.0, 2.7, and 5.4 and blue under acetonitrile vapor for all cation ratios. Especially the sample TMB²⁺/CEC = 2.0 showed clear chromism both for water and acetonitrile. On the other hand, no clear color change was observed for vapors of alcohols, acetone, and non-polar solvents. From these results, this material can be expected to apply for easy detection of humidity and acetonitrile vapor in the environment.

Keywords: chemical sensor, intercalation compound, tetramethylbenzidine, tetrasilisicfluormica, vapochromism, volatile organic compounds

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Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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Authors: Preethy Mary Donald, Renjith George

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Oral tori are localized non-neoplastic protuberances of maxilla and mandible. Torus palatinus (TP) is found on the midline of the roof of mouth existing as single growth or in clusters. Torus mandibularis(TM) is located on the lingual aspect of the mandible commonly between canine and premolar region. Etiology of their presence was not clear and was found to be multifactorial. Their variations in relation to age, gender, ethnicity and also the characteristics of TP and TM have become the interest of multiple studies. The objectives of this study were to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) among patients who have visited outpatient department, Faculty of Dentistry, Melaka Manipal Medical College. 108 patients were examined for the presence of oral tori at the outpatient department, Faculty of Dentistry, Melaka-Manipal Medical College. Factors such as age, gender, ethnicity of the patients and size, shape, location of the oral tori were studied. For TP, Malays (62.96%) have been found to have the highest prevalence than Chinese (43.3%) and Indians (35.71%). For TM, Chinese (7.46%) had predominated compared to Malays (7.41%) and Indians (0%). There is no significant association between occurrence of TP and TM with age, gender and ethnicity. For Torus palatinus, the most common size was Grade 1(1-3mm), most common location was molar region, and the most common shape was spindle. For Torus mandibularis, the most frequent location was canine premolar region and exists in unilateral single or bilateral single fashion. The overall prevalence rates were 47.2% for TP and 6.48% for TM. However, there is no significant association between occurrence of TP and TM with age, gender and ethnicity. The results showed variations in clinical characteristics and support the findings that occurrence of tori is a dynamic phenomenon which is multifactorial owing to the environmental factors such as stress from occlusion and dietary habits. It could be due to the genetic make-up of the individual.

Keywords: torus palatinus, torus mandibularis, age, gender

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Authors: Arthur D. Wiedemann, Christopher Fuller, Kyle A. Pascioni

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With the introduction of electric motors, small unmanned aerial vehicle designers have to consider trade-offs between acoustic noise and thrust generated. Currently, there are few low-computational tools available for predicting acoustic noise emitted by a propeller into the far-field. Artificial neural networks offer a highly non-linear and adaptive model for predicting isolated and interactive tonal noise. But neural networks require large data sets, exceeding practical considerations in modeling experimental results. A methodology known as physics guided machine learning has been applied in this study to reduce the required data set to train the network. After building and evaluating several neural networks, the best model is investigated to determine how the network successfully predicts the acoustic waveform. Lastly, a post-network transfer function is developed to remove discontinuity from the predicted waveform. Overall, methodologies from physics guided machine learning show a notable improvement in prediction performance, but additional loss functions are necessary for constructing predictive networks on small datasets.

Keywords: aeroacoustics, machine learning, propeller, rotor, neural network, physics guided machine learning

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Authors: Sandile Daniel Ngidi

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A brickforce is a product consisting of two main parallel wires joined by in-line welded cross wires. Embedded in the normal thickness of the brickwork joint, the wires are manufactured to a flattened profile to simplify location into the mortar joint without steel build-up problems at lap positions corners/junctions or when used in conjunction with wall ties. A brickforce has been in continuous use since 1918. It is placed in the cement between courses of bricks. Brickforce is used in every course of the foundations and every course above lintel height. Otherwise, brickforce is used every fourth course in between the foundations and lintel height or a concrete slab and lintel height. The brickforce strengthens and stabilizes the wall, especially if you are building on unstable ground. It provides brickwork increased resistance to tensional stresses. Brickforce uses high tensile steel wires, which can withstand high forces but with a very little stretch. This helps to keep crack widths to a minimum. Recently a debate has opened about the purpose of using brickforce in single-story buildings. The debate has been compounded by the fact that there is no consensus about the spacing of brickforce in brickwork or masonry. In addition, very little information had been published on the relative merits of using the same size of brickforce for the different atmospheric conditions in South Africa. This paper aims to compare different types of brickforce systems used in different countries. Conclusions are made to identify the point and location of brickforce that optimize the system.

Keywords: brickforce, masonry concrete, reinforcement, strengthening, wall panels

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Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

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Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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Authors: Abdulrahman S. Alqahtani

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The revolution of computing and networks could revolutionise terrorism in the same way that it has brought about changes in other aspects of life. The modern technological era has faced countries with a new set of security challenges. There are many states and potential adversaries who have the potential and capacity in cyberspace, which makes them able to carry out cyber-attacks in the future. Some of them are currently conducting surveillance, gathering and analysis of technical information, and mapping of networks and nodes and infrastructure of opponents, which may be exploited in future conflicts. This poster presents the results of the quantitative study (survey) to test the validity of the proposed theoretical framework for the cyber terrorist threats. This theoretical framework will help to in-depth understand these new digital terrorist threats. It may also be a practical guide for managers and technicians in critical infrastructure, to understand and assess the threats they face. It might also be the foundation for building a national strategy to counter cyberterrorism. In the beginning, it provides basic information about the data. To purify the data, reliability and exploratory factor analysis, as well as confirmatory factor analysis (CFA) were performed. Then, Structural Equation Modelling (SEM) was utilised to test the final model of the theory and to assess the overall goodness-of-fit between the proposed model and the collected data set.

Keywords: cyberterrorism, critical infrastructure, , national security, theoretical framework, terrorism

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Authors: Abdolamir Allameh, Seyyed Mortaza Haghgoo, Adnan Khosravi, Esmaeil Mortaz, Mihan Pourabdollah-Toutkaboni, Sharareh Seifi

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Non-Small Cell Lung Carcinoma (NSCLC) is associated with a number of gene mutations in epidermal growth factor receptor (EGFR). The prognostic significance of mutations in exons 19 and 21, together with serum levels of EGFR, amphiregulin (AR), and Transforming Growth Factor-alpha (TGF-α) are implicated in diagnosis and treatment. The aim of this study was to examine the relationship of EGFR mutations in selected exons with the expression of relevant ligands in sera samples of NSCLC patients. For this, a group of NSCLC patients (n=98) referred to the hospital for lung surgery with a mean age of 59±10.5 were enrolled (M/F: 75/23). Blood specimen was collected from each patient. Besides, formalin fixed paraffin embedded tissues were processed for DNA extraction. Gene mutations in exons 19 and 21 were detected by direct sequencing, following DNA amplification which was done by PCR (Polymerase Chain Reaction). Also, serum levels of EGFR, AR, and TGF-α were measured by ELISA. The results of our study show that EGFR mutations were present in 37% of Iranian NSCLC patients. The most frequently identified mutations were deletions in exon 19 (72.2%) and substitutions in exon 21 (27.8%). The most frequently identified alteration, which is considered as a rare mutation, was the E872K mutation in exon 21, which was found in 90% (9 out of 10) cases. EGFR mutation detected in exon 21 was significantly (P<0.05) correlated with the levels of its ligands, EGFR and TGF-α in serum samples. Furthermore, it was found that increased serum AR (>3pg/ml) and TGF-α (>10.5 pg/ml) were associated with shorter overall survival (P<0.05). The results clearly showed a close relationship between EGFR mutations and serum EGFR and serum TGF-α. Increased serum EGFR was associated with TGF-α and AR and linked to poor prognosis of NSCLC. These findings are implicated in clinical decision-making related to EGFR-Tyrosine kinase inhibitors (TKIs).

Keywords: lung cancer, Iranian patients, epidermal growth factor, mutation, prognosis

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Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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Authors: Marthella Rivera Roidatua

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Since the release of Convention on the Rights of Persons with Disabilities in 2006, disability became a mainstreamed global issue. Many developed countries have shown the continuous effort to improve their disability employment policy, for example, the US and the UK with their integrated support system through disability benefits. Relative little recent research on developing country is available. Surprisingly, Indonesia, just enacted the Law No.8/2016 on Disability that bravely highlighted on integrating disabled people into the workforce. It shows a positive progress shifting traditional perspective to what Tom Shakespeare’s concept of a social model of disability. But, the main question is how can this law support the disabled people to access and maintain paid work. Thus, besides the earlier literature reviews, interviews with leading sectors, Ministry of Social Affairs and Ministry of Manpower, was conducted to examine government’s attitude towards the disabled worker. Insights from two local social enterprises on disability were also engaged in building better perspective. The various source of data was triangulated then analysed with a thematic approach. Results were encouraging the Indonesian government to have a better collaboration with other impactful local organisations in promoting the disability employment. In the end, this paper also recommends the government to make a reasonable adjustment and practical guideline for companies in hiring disabled.

Keywords: disability, employment, policy, Indonesia, collaboration, guidelines

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Authors: Siamak Eskandari, Neda Ebadi

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After discovering and using Freon as refrigerant in refrigerators and air conditioners, researchers have been working hard to minimize massive environmental damage caused by this type of systems, including ozone depletion, heat production, and urban warming. However, there is a growing concern for global warming and climate change and its impacts on climates. Although gas air conditioners can provide comfort in short term, there are long-term consequences and effects, including global warming, polar ice melting, sea level rising, rising sea surface temperatures, reduction in seasonal precipitation, tropical storms, and drought. In this theoretical and practical study, Peltier electronic chip was used with no gas in the structure and operation. In fact, cooling and heating are based on bipolar electronics. With an innovative method, Peltier air conditioners provide cooling in warm seasons and heating in cold seasons in buildings. Such a system prevents ambient warming. The problem of air circulation between high buildings in large cities and draught will be considerably resolved through the use of the silent fan in the system. In addition, the system is designed and developed in accordance with international standards such as LEED and Energy Star.

Keywords: energy, Building cooling and heating, peltier, leed, energy star

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Authors: Dipti Chand, Riya Saboo

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OBJECTIVES: Early and correct diagnosis may present a significant clinical challenge in diagnosis of patients presenting to Emergency Department with Acute Dyspnoea. The common cause of acute dyspnoea and respiratory distress in Emergency Department are Decompensated Heart Failure (HF), Chronic Obstructive Pulmonary Disease (COPD), Asthma, Pneumonia, Acute Respiratory Distress Syndrome (ARDS), Pulmonary Embolism (PE), and other causes like anaemia. The aim of the study was to measure NT-pro Brain Natriuretic Peptide (BNP) and exhaled End-Tidal Carbon dioxide (ETCO2) in patients presenting with dyspnoea. MATERIAL AND METHODS: This prospective, cross-sectional and observational study was performed at the Government Medical College and Hospital, Nagpur, between October 2019 and October 2021 in patients admitted to the Medicine Intensive Care Unit. Three groups of patients were compared: (1) HFrelated acute dyspnoea group (n = 52), (2) pulmonary (COPD/PE)-related acute dyspnoea group (n = 31) and (3) sepsis with ARDS-related dyspnoea group (n = 13). All patients underwent initial clinical examination with a recording of initial vital parameters along with on-admission ETCO2 measurement, NT-proBNP testing, arterial blood gas analysis, lung ultrasound examination, 2D echocardiography, chest X-rays, and other relevant diagnostic laboratory testing. RESULTS: 96 patients were included in the study. Median NT-proBNP was found to be high for the Heart Failure group (11,480 pg/ml), followed by the sepsis group (780 pg/ml), and pulmonary group had an Nt ProBNP of 231 pg/ml. The mean ETCO2 value was maximum in the pulmonary group (48.610 mmHg) followed by Heart Failure (31.51 mmHg) and the sepsis group (19.46 mmHg). The results were found to be statistically significant (P < 0.05). CONCLUSION: NT-proBNP has high diagnostic accuracy in differentiating acute HF-related dyspnoea from pulmonary (COPD and ARDS)-related acute dyspnoea. The higher levels of ETCO2 help in diagnosing patients with COPD.

Keywords: NT PRO BNP, ETCO2, dyspnoea, lung USG

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Authors: John McDowall, Crysta Derham

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Broaden and build theory of emotion describes how experiencing positive emotions, such as happiness, broadens our ‘thought-action repertoire’ leading us to be more likely to go out and act on our positive emotions. This results in the building of new relationships, resources and skills, which we can draw on in times of need throughout life. In contrast, the experience of negative emotion is thought to narrow our ‘thought-action repertoire’, leading to specific actions to aid in survival. Three experiments aimed to explore the effect of briefly presented schematic faces (happy, sad, and neutral) on attentional scope using the flanker task. Based on the broaden and build theory it was hypothesised that there would be an increase in reaction time in trials primed with a happy face due to a broadening of attention, leading to increased flanker interference. A decrease in reaction time was predicted for trials primed with a sad face, due to a narrowing of attention leading to less flanker interference. Results lended partial support to the broaden and build hypothesis, with reaction times being slower following happy primes in incongruent flanker trials. Recent research is discussed in regards to potential mediators of the relationship between emotion and attention.

Keywords: emotion, attention, broaden and build, flanker task

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Authors: Kyle Yatich Terik, Collins Oduor

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The current healthcare system has made healthcare more accessible and efficient by the use of information technology through the implementation of computer algorithms that generate menus based on the diagnosis. While many systems just like these have been created over the years, their main objective is to help healthy individuals calculate their calorie intake and assist them by providing food selections based on a pre-specified calorie. That application has been proven to be useful in some ways, and they are not suitable for monitoring, planning, and managing hospital patients, especially that critical condition their dietary needs. The system also addresses a number of objectives, such as; the main objective is to be able to design, develop and implement an efficient, user-friendly as well as and interactive dietary management system. The specific design development objectives include developing a system that will facilitate a monitoring feature for users using graphs, developing a system that will provide system-generated reports to the users, dietitians, and system admins, design a system that allows users to measure their BMI (Body Mass Index), the system will also provide food template feature that will guide the user on a balanced diet plan. In order to develop the system, further research was carried out in Kenya, Nairobi County, using online questionnaires being the preferred research design approach. From the 44 respondents, one could create discussions such as the major challenges encountered from the manual dietary system, which include no easily accessible information of the calorie intake for food products, expensive to physically visit a dietitian to create a tailored diet plan. Conclusively, the system has the potential of improving the quality of life of people as a whole by providing a standard for healthy living and allowing individuals to have readily available knowledge through food templates that will guide people and allow users to create their own diet plans that consist of a balanced diet.

Keywords: DMS, dietitian, patient, administrator

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Authors: Subodh Kumar, Amit Varde

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Typical on-premises high-performance computing (HPC) environments consist of a fixed number and a fixed set of computing hardware. During the design of the HPC environment, the hardware components, including but not limited to CPU, Memory, GPU, and networking, are carefully chosen from select vendors for optimal performance. High capital cost for building the environment is a prime factor influencing the design environment. A class of software called “Job Schedulers” are critical to maximizing these resources and running multiple workloads to extract the maximum value for the high capital cost. In principle, schedulers work by preventing workloads and users from monopolizing the finite hardware resources by queuing jobs in a workload. A cloud-based HPC environment does not have the limitations of fixed (type of and quantity of) hardware resources. In theory, users and workloads could spin up any number and type of hardware resource. This paper discusses the limitations of using traditional scheduling algorithms for cloud-based HPC workloads. It proposes a new set of features, called “HPC optimizers,” for maximizing the benefits of the elasticity and scalability of the cloud with the goal of cost-performance optimization of the workload.

Keywords: high performance computing, HPC, cloud computing, optimization, schedulers

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Authors: J. J. Mathew

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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

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Authors: Azadeh Bashiri

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Introduction: In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. Background: This study, provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. Methods: This is a cross-sectional study that was conducted in 2013. The student community was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also, Visual Paradigm software was used to design a conceptual model. Result: Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. Conclusion: According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, provide the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Keywords: structured radiology report, information needs, minimum data set, electronic health record system in Iran

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Authors: Kanzumba Kusakana

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The Democratic Republic of Congo (DRC) is currently experiencing a general energy crisis due to lack of proper investment and management in the energy sector. 93, 6% of the country is highly dependent on wood fuels as main source of energy having severe impacts such as deforestation and general degradation of the environment. On the other hand, the major share of the electricity produced mainly from ill-conditioned hydro and thermal power stations is principally used to supply the industrial sector as well as very few urban areas. Nevertheless, DRC possesses huge potential in renewable resources such as hydropower, biomass, methane gas, solar geothermal and moderate wind potential that can be used for energy generation. Recently the country has initiated projects to build decentralized micro hydropower station to supply remotes and isolated areas; to rehabilitate its existent main hydropower plants and transmission lines as well as to extend its current generation capacity by building new hydropower stations able to respond to a major part of the African continent energy needs. This paper presents a comprehensive review of current energy resources as well as of the electricity situation in DRC. Recent energy projects, the energy policy as well as the energy challenges in the DRC are also presented.

Keywords: energy, biomass, hydro power, renewable energy, energy policy, Democratic Republic of Congo

Procedia PDF Downloads 330