Search results for: heart failure patient

Authors: L. F. Tamele Jr., G. Buonocore, H. F. Muiambo

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Asphalt binders play an essential role in the performance and properties of asphalt mixtures. The increase in heavy loads, greater traffic volume, and high tire pressure, combined with a substantial variation in daily and seasonal pavement temperatures, are the main responsible for the failure of asphalt pavements. To avoid or mitigate these failures, the present research proposes the use of thermoplastic polymers, HDPE and LLDPE, and nanoclay Dellite 43B for modification of asphalt in order to improve its thermomechanical and rheological properties. The nanocomposites were prepared by the solution intercalation method in a high shear mixer for a mixing time of 2 h, at 180℃ and 5000 rpm. The addition of Dellite 43B improved the physical, rheological, and thermal properties of asphalt, either separated or in the form of polymer/bitumen blends. The results of the physical characterization showed a decrease in penetration and an increase in softening point, thermal susceptibility, viscosity, and stiffness. On the other hand, thermal characterization showed that the nanocomposites have greater stability at higher temperatures by exhibiting greater amounts of residues and improved initial and final decomposition temperatures. Thus, the modification of asphalt by polymers and nanoclays seems to be a suitable solution for road pavement in countries which experiment with high temperatures combined with long heavy rain seasons.

Keywords: asphalt, nanoclay dellite 43B, polymer modified asphalt, thermal and rheological properties

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Authors: Young Ae Song, So Yun Kim, Nan Ji Kim, So Young Jang, Yun Mee Park, Mi Jin Lee, Ji Yeon Lee

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Background & Purpose: Many patients have psychological problems such as depression and anxiety during the rehabilitation period. Such psychological instability affects the prognosis of the patient in the long term. We develop a nursing intervention program for rehabilitation inpatients using a rehabilitation self –management note and evaluate the effects of the program on depression, motivation, and self-efficacy. Methods: The study was conducted using a nonequivalent control group non-synchronized design. Participants were rehabilitation inpatients, 27 patients in the control group and 20 in the experimental group. Questionnaires were completed three times (pretest, 5 days, 10 days) Final data for 40 patients were analyzed, 23 patients in the control group and 17 in the experimental group. Data were analyzed using x2-test, t-test, and repeated measure ANOVA. Results: Depression in the experimental group decreased compared to the control group, but it was not significant. The motivation for the experimental group changed significantly (F=3.90, p=.029) and self-efficacy increased, but not significantly (F=0.59, p=.559) Conclusion: Results of this study indicate that nursing intervention programs for rehabilitation inpatients could be useful to decrease depression and to improve motivation and self-efficacy.

Keywords: depression, motivation, self-efficacy, rehabilitation inpatient, self-management workbook

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Authors: Mbuzeni Mathenjwa

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Upon their independence, most African countries adopted constitutions that proclaim respect for the rule of law. The decision to constitutionalise the rule of law is basically informed by the countries’ experience during the colonial era which was characterised by discrimination on various grounds including race, gender and religion. Despite the promise to be bound by and adhere to the rule of law, disrespect for the rule of law has become a norm in the African continent. This is evident from the reported incidence of abuse of power, failure to perform obligations imposed by law and flagrant disregard of the law by the Executive including the heads of states in the continent. In some African countries including South Africa, the courts of law have been approached to rule on the legality of the decisions of the executives, taken contrary to the prescripts of the law. South African Courts have laid down a number of decisions wherein they found that the conduct of the executive contravenes the rule of law. Consequently decisions of the executive have been declared invalid by courts. In this regard courts have become a safety net in preserving the rule of law in. Accordingly, this paper discusses the role of the courts in preserving the rule of law in Africa. This it does by explaining the notion of judicial independence and the doctrine of the rule of law. The explanation on the notion of judicial independence is relevant because only an independent judiciary can effectively review and set aside the decision of the executive including the president of a country. Furthermore, a comparative overview of the enforcement of the rule of law in African countries is done. The methods used for this research is literature review, and study of legislation and case law in selected African countries relating to the independence of the judiciary and the rule of law. Finally, a conclusion is drawn on the role of the independent judiciary to preserve the rule of law in Africa.

Keywords: Africa, constitutions, independence, judiciary

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Authors: Reza Akbari, Jalal MontazeriFashtali, PeymanMomeni Taromsari

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Pipeline systems, play an important role as a vital element in reducing or increasing the risk of earthquake damage and vulnerability. Pipelines are suitable, cheap, fast, and safe routes for transporting oil, gas, water, sewage, etc. The sepipelines must pass from a wide geographical area; hence they will structurally face different environmental and underground factors of earthquake forces’ effect. Therefore, structural engineering analysis and design for this type of lines requires the understanding of relevant parameters behavior and lack of familiarity with them can cause irreparable damages and risks to design and execution, especially in the face of earthquakes. Today, buried pipelines play an important role in human life cycle, thus, studying the vulnerability of pipeline systems is of particular importance. This study examines the behavior of buried pipelines affected by strike-slip fault. Studied fault is perpendicular to the tube axis and causes stress and deformation in the tube by sliding horizontally. In this study, the pipe-soil interaction is accurately simulated, so that one can examine the large displacements and strains, nonlinear material behavior and contact and friction conditions of soil and pipe. The results can be used for designing buried pipes and determining the amount of fault displacement that causes the failure of the buried pipes.

Keywords: pipe lines , earthquake , fault , soil-fault interaction

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Authors: Sarah Hamdan Al-Jahdali, Khaled Alsaad, Abdullah Al-Sayyari

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Objectives: To study the prevalence, clinicopathological features, risk factors and outcome of biopsy proven polyoma (BK) virus infection among Saudi kidney transplant recipients and compare them to negative BK virus group. Methods: We retrospectively reviewed the charts of all the patients with biopsy-proven polyoma (BK) virus infection in King Abdulaziz Medical City in Riyadh between 2005 and 2011. The details of clinical presentation, the indication for kidney biopsy, the laboratory findings at presentation, the natural history of the disease, thepathological findings, the prognosis as well as the response to therapy were all recorded. Results: Kidney biopsy was performed in 37 cases of unexplained graft dysfunction. BK virus was found in 10 (27%). Out of those 10, 3 (30%) ended with graft failure. BK virus occurred in all patients who received ATG induction therapy 100% versus 59.3% in the non BK virus patients (p=0.06). Furthermore, the risk of BK virus was much less in those who received acyclovir as an anti-viral prophylaxis as compared to those who did not receive it (p=0.01). Also, patients with BK virus weighed much less (mean 46.7±20.6 Kgs) than those without BK virus at time of transplantation (mean 64.3±12.1). Graft survival was better among deceased donor kidneys compared to living ones (P=0.016) and with older age (P=0.005). Conclusion: Our findings suggest the involvement of ATG induction therapy, the lack of antiviral prophylaxis therapy and lower weight at transplant as significant risk factors for the development of BK virus infection.

Keywords: BKVAN, BKV, kidney transpant, Saudi Arabia

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Authors: Amy Halseth, Kevin Shan, Kye Gilder, John Buse

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The study assessed the effect of prolonged-release naltrexone 32 mg/bupropion 360 mg (NB) on cardiovascular (CV) events in overweight/obese participants at elevated CV risk. Participants must lose ≥ 2% body weight at 16 wks, without a sustained increase in blood pressure, to continue drug. The study was terminated early after second interim analysis with 50% of all CV events. Data on CV endpoints has been published. Current analyses focus on weight change. Intent-to-treat (ITT) population (placebo [PBO] N=4450, NB N=4455) was 54.5% female, 83.5% white, mean age 61 yrs, mean BMI 37.3 kg/m2; 85.2% had type 2 diabetes, 32.1% had CV disease, 17.4% had both. At 52 wks, ITT-LOCF analysis showed greater least squares mean percent change in weight (LSM%ΔBW) with NB (-3.1%; 95% CI -4.8, -1.4) vs PBO (-0.3%; 95% CI -1.9, 1.4). Both groups demonstrated greater weight loss while on-treatment (NB [-7.3%], PBO [-3.9%]). Odds ratios of 5% and 10% weight loss were 3.3 and 4.1 (ITT-LOCF), respectively, in NB over PBO. At 104 wks, on-treatment LSM%ΔBW was -6.3% with NB (n=1137) vs -3.5% with PBO (n=741). Major reasons for NB withdrawal were adverse events (AE, 29%) and patient decision (21%), with GI disorders being the most common. Weight loss with NB in this study, in an older population predominantly with diabetes and elevated CV risk, was somewhat lower than that observed in overweight/obese participants without diabetes and similar to participants with diabetes in Phase 3 studies.

Keywords: contrave, mysimba, obesity, pharmacotherapy, weight loss

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Authors: Majeed Mohammed Midhin, Clare Finburgh

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To maintain a healthy balanced loyalty between art and politics posits a debatable issue. The artist is always on the look out for the potential tension between those two realms. Therefore, one of the most painful dilemmas the artist finds is how to function in a society without sacrificing the aesthetic values of his/her work. In other words, the life-long awareness of failure which derives from the concept of the artist as caught between unflattering social realities and the need to invent genuine art forms becomes a fertilizing soil for the artists to dig deep into its origin. Thus, within the framework of this dilemma, the question of the responsibility of the artist and the relationship of the art to politics will be illuminating. The present paper tackles the idea of the amorality of the artist in selected plays by Tom Stoppard. However, Stoppard’s awareness of his situation as a refugee has led him to keep at a distance from politics. He tried hard to avoid any intervention into the realms of political debate, especially in his earliest work. On the one hand, it is not meant that he did not interest in politics as such, but rather he preferred to question it than to create a fixed ideological position. On the other hand, Stoppard’s refusal to intervene in politics is ascribed to his feeling of gratitude to Britain where he settled. As a result, Stoppard has frequently been criticized for a lack of political engagement and also for not leaning too much for the left when he does engage. His reaction to these public criticisms finds expression in his self-conscious statements which defensively stressed the artifice of his work. He, like Oscar Wilde thinks that the responsibility of the artist is devoted to the realm of his/her art. Consequently, his consciousness for the role of the artist is truly reflected in his two plays, Artist Descending a Staircase(1972) and Travesties(1974).

Keywords: amorality, dilemma, aesthetic, responsibility of the artist, political theatre

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Authors: Asaad Alhabsi, Alyaqdan Algafri

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Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.

Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty

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Authors: Yongyu Duo, Xiaogang Liu, Qingrui Yue

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The anchor plays a critical role in the utilization of the tensile strength of carbon fiber-reinforced polymer (CFRP) plate when it is applied for the prestressed retrofitted and cable structures. In this paper, the anchor behavior of planar clamping anchor (PCA) under different interface treatment forms and normal pressures was investigated by the uniaxial static tensile test. Two interface treatment forms were adopted, including pure friction and the coupling action of friction and bonding. The results indicated that the load-bearing capacity of PCA could be obviously improved by the coupling action of friction and bonding compared with the action of pure friction. Under the normal pressure of 11 MPa, 22 MPa, and 33 MPa, the load-bearing capacity of PCA was enhanced by 164.61%, 68.40%, and 52.78%, respectively, and the tensile strength of the CFRP plate was fully exploited when the normal pressure reached 44 MPa. In addition, the experimental coefficient of static friction between the galling CFRP plate and a sandblasted steel plate was in the range of 0.28-0.30, corresponding to various normal pressure. Moreover, the failure mode was determined by the interface treatment form and normal pressure. The research in this paper has important guiding significance to optimize the design of the mechanical clamping anchor, contributing to promoting the application of CFRP plate in reinforcement and cable structure.

Keywords: PCA, CFRP plate, interface treatment form, normal pressure, friction, coupling action

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Authors: Muhammad Fiaz, Muhammad Saqlain, Abid Mahmood, S. M. Saqlan Naqvi, Rizwan Aziz Qazi, Ghazala Kaukab Raja

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Background: Metabolic Syndrome is a clustering of multiple risk factors including central obesity, hypertension, dyslipidemia and hyperglycemia. These risk phenotypes of metabolic syndrome (MetS) prevalent world-wide, Therefore we aimed to identify the frequency of risk phenotypes among metabolic syndrome subjects in local adult Pakistani population. Methods: Screening of subjects visiting out-patient department of medicine, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad was performed to assess the occurrence of risk phenotypes among MetS subjects in Pakistani population. The Metabolic Syndrome was defined based on International Diabetes Federation (IDF) criteria. Anthropometric and biochemical assay results were recorded. Data was analyzed using SPSS software (16.0). Results: Our results showed that dyslipidemia (31.50%) and hyperglycemia (30.50%) was most population specific risk phenotypes of MetS. The results showed the order of association of metabolic risk phenotypes to MetS as follows hyperglycemia>dyslipidemia>obesity >hypertension. Conclusion: The hyperglycemia and dyslipidemia were found be the major risk phenotypes among the MetS subjects and have greater chances of deceloping MetS among Pakistani Population.

Keywords: dyslipidemia, hypertention, metabolic syndrome, obesity

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Authors: Simon Guerin-Marthe, Marie Violay

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Thermal Pressurization (TP) has been proposed as a key mechanism involved in the weakening of faults during dynamic ruptures. Theoretical and numerical studies clearly show how frictional heating can lead to an increase in pore fluid pressure due to the rapid slip along faults occurring during earthquakes. In addition, recent laboratory studies have evidenced local pore pressure or local temperature variation during rotary shear tests, which are consistent with TP theoretical and numerical models. The aim of this study is to complement previous ones by measuring both local pore pressure and local temperature variations in the vicinity of a water-saturated calcite gouge layer subjected to a controlled slip velocity in direct double shear configuration. Laboratory investigation of TP process is crucial in order to understand the conditions at which it is likely to become a dominant mechanism controlling dynamic friction. It is also important in order to understand the timing and magnitude of temperature and pore pressure variations, to help understanding when it is negligible, and how it competes with other rather strengthening-mechanisms such as dilatancy, which can occur during rock failure. Here we present unique direct measurements of temperature and pressure variations during high-speed friction experiments under various load point velocities and show the timing of these variations relatively to the slip event.

Keywords: thermal pressurization, double-shear test, high-speed friction, dilatancy

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Authors: Safoin Aktaou, Aya Al Masri, Kamel Guerchouche, Malorie Martin, Fouad Maaloul

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Introduction: In the ‘Magnetic Resonance Imaging (MRI)’ department, all workers involved in preparing the patient, setting it up, tunnel cleaning, etc. are likely to be exposed to ‘ElectroMagnetic fields (EMF)’ emitted by the MRI device. Exposure to EMF can cause adverse radio-biological effects to workers. The purpose of this study is to propose an organizational process to manage and control EMF risks. Materials and methods: The study was conducted at seven MRI departments using machines with 1.5 and 3 Tesla magnetic fields. We assessed the exposure of each one by measuring the two electromagnetic fields (static and dynamic) at different distances from the MRI machine both inside and around the examination room. Measurement values were compared with British and American references (those of the UK's ‘Medicines and Healthcare Regulatory Agency (MHRA)’ and the ‘American Radiology Society (ACR)’). Results: Following the results of EMF measurements and their comparison with the recommendations of learned societies, a zoning system that adapts to needs of different MRI services across the country has been proposed. In effect, three risk areas have been identified within the MRI services. This has led to the development of a good practice guide related to the magnetic protection of MRI workers. Conclusion: The guide established by our study is a standard that allows MRI workers to protect themselves against the risk of electromagnetic fields.

Keywords: comparison with international references, measurement of electromagnetic fields, magnetic protection of workers, magnetic resonance imaging

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Authors: Genevieve Zingg

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Modern technology and social media platforms have fundamentally altered the nature of war crimes investigations by providing new forms of data, evidence, and documentation, and pose a unique opportunity to expand the efficacy of international law. However, much of the open source information available is deemed inadmissible in subsequent legal proceedings and fails to function as evidence largely due to issues of reliability and verifiability. Focusing on current judicial investigations related to ongoing conflicts in Syria and Iraq, this paper will examine key challenges and opportunities for the effective use of open source information in securing justice. This paper will consider strategies and approaches that can be used to ensure that information collected by affected populations meets basic admissibility standards. This paper argues that the critical failure to equip civilian populations in conflict zones with knowledge and information regarding established admissibility standards and guidelines both jeopardizes the potential of open source information and compromises the ability of victims to participate effectively in justice and accountability processes. The ultimate purpose of this paper is, therefore, to examine how to maximize the value of open source information based on the rules of evidence in international, regional, and national courts, and how to maximize the participation of affected populations in holding their abusers to account.

Keywords: human rights, international criminal law, international justice, international law, Iraq, open source information, social media, Syria, transitional justice, war crimes

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Authors: Mairo Musa Galadima

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This paper examines the impact of Mother tongue interference on students’ performance in English Language in Bauchi State. It is observed that the students of Bauchi district share the same problem with Hausa native speakers of Kano dialect which is the standard form. It is observed that there are some phonemes which are present in English but absent in Hausa so the Hausa speakers of Bauchi district also replace these sounds with similar ones present in Hausa. Students in Bauchi district fail English language because they transfer features of their mother tongue (MT) into English. The data is obtained through unobtrusive observation of the English speech of about fifty Hausa native speakers of Bauchi district which is similar to Kano dialect from Abubakar Tatari Ali Polytechnic, Bauchi since only those who have had some good background of secondary education are used because uneducated Nigeria English of whatever geographical location is more likely to be unintelligible as cockney or uneducated African-American English. For instance /Ə:/ is absent in Hausa so the speakers find it difficult to distinguish between such pairs of words as /bƏ:d / and /bΛst/, /fa:st/ and /fƏ:st / hence /a:/ is generally used wherever /Ə:/ is present regardless of the spelling, that is why words like ‘work’, ‘first’ and ‘person’ all have / a:/. In Hausa most speakers use /P/ in place of, or in alternation with /f/, e.g. ‘few’ is pronounced as ‘pew’, or ‘pen’, as ‘fen’, /b/ for /v/, /s/ for /z/ and /z/ for /ᵹ/. Also the word vision/visn/ is pronounced as /vidzn/. Therefore, there is confusion in spellings and pronunciation of words. One solution out of the problem is having constant practice with a qualified consistent staff and making use of standard textbooks in the learning process.

Keywords: English, failure, mother tongue, interference, students

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Authors: Nika Botchorishvili, Olgha Giorgishvili

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Many-year investigations of the nature of damping creep of rigid bodies and materials led to the discovery of the fundamental character of this phenomenon. It occurs only when a rigid body comes in contact with a surface-active medium (liquid or gaseous), which brings about a decrease of the free surface energy of a rigid body as a result of adsorption, chemo-sorption or wetting. The reversibility of the process consists of a gradual disappearance of creep deformation when the action of a surface-active medium stops. To clarify the essence of processes, a physical model is constructed by using Griffith’s scheme and the well-known representation formulas of deformation origination and failure processes. The total creep deformation is caused by the formation and opening of microcracks throughout the material volume under the action of load. This supposedly happens in macroscopically homogeneous silicate and organic glasses, while in polycrystals (tuff, gypsum, steel) contacting with a surface-active medium micro crack are formed mainly on the grain boundaries. The creep of rubber is due to its swelling activated by stress. Acknowledgment: All experiments are financially supported by Shota Rustaveli National Science Foundation of Georgia. Study of Properties of Concretes (Both Ordinary and Compacted) Made of Local Building Materials and Containing Admixtures, and Their Further Introduction in Construction Operations and Road Building. DP2016_26. 22.12.2016.

Keywords: process reversibility, surface-active medium, Rebinder’s effect, micro crack, creep

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Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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Objective: To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. Methods: This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute,Dhaka,Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Results: Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87 ± 7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032)difference in the two groups(sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statically significant (p<0.004) and diabetic, dyslipidaemic patients having true positive which were statically significant (p < 0.032 & 0.030).True positive patients had family history were 68 (83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant(p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138)and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90%), followed by LCX 42 (51.85%), RCA 36 (44.44%) and the LMCA was 9 (11.11%), .40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. Conclusion: It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients,resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetis, dyslipidaemic, family history and smoking are likely to have a true positive treadmill test result.

Keywords: exercise tolerance test, coronary artery disease, coronary angiography, true positive, false positive

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Authors: Ephrem Getahun, Shengwen Qi, Songfeng Guo, Yu Zou, Melesse Alemayehu

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Residual shear characteristics of slide soil profile sections (SSPS) were examined using ring shear tests to know the relative residual shear behaviors among the sections of slide soil. The multistage-multiphase shearing techniques were employed to perform the experiment for each soil specimen continuously towards large displacements. The grain distribution analysis of SSPS samples was characterized by coarsening upward from bottom slip to the top sections; however, the slip surface was considered as a sheared zone that endorses their low shear resistance for failure. There is an average range of 1-2.5 mm axial displacement on each stage of loadings and phases of shearing that depicts the significant effect of dilation and compression of soil specimen. The middle section has the largest consolidation percentage (10-29%), and vertical displacement compared to other sections and showed high shear strengthening behavior having maximum shear stress of 189kPa at 240kPa loading compared to basal and top sections. It is found that the middle section of SSPS has relatively high shear resistance behavior for large displacement shearing. The residual shear assessment indicates that there is a significant influence of large displacement and rate on the friction coefficient behaviors; it resulted in shear weakening effect to attain their residual condition.

Keywords: comparison, displacements, residual shear stress, shear behavior, slide soils

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Authors: Xia Huo

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Children are more vulnerable to environmental toxicants compared to adults, and their developing immune system is among the most sensitive targets regarding toxicity of environmental toxicants. Studies have found that exposure to environmental toxicants is associated with impaired immune function in children, but only a few studies have focused on the relationship between environmental toxicant exposure and vaccine antibody potency and immunoglobulin (Ig) levels in children. These studies investigated the associations of exposure to polychlorinated biphenyls (PCBs), perfluorinated compounds (PFCs), heavy metals (Pb, Cd, As, Hg) and PM2.5 with the serum-specific antibody concentrations and Ig levels against different vaccines, such as anti-Hib, tetanus, diphtheria toxoid, and analyze the possible mechanisms underlying exposure-related alterations of antibody titers and Ig levels against different vaccines. Results suggest that exposure to these toxicants is generally associated with decreased potency of antibodies produced from childhood immunizations and an overall deficiency in the protection the vaccines provide. Toxicant exposure is associated with vaccination failure and decreased antibody titers, and increased risk of immune-related diseases in children by altering specific immunoglobulin levels. Age, sex, nutritional status, and co-exposure may influence the effects of toxicants on the immune function in children. Epidemiological evidence suggests that exposure-induced changes to humoral immunerelated tissue/cells/molecules response to vaccines may have predominant roles in the inverse associations between antibody responsiveness to vaccines and environmental toxicants. These results help us to conduct better immunization policies for children under environmental toxicant burden.

Keywords: environmental toxicants, immunotoxicity, vaccination, antibodies, children's health

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Authors: Divya Pathak, James Sloane

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Surgical treatment of midface fractures should ideally occur within two weeks of injury, after which bony healing and consolidation make the repair more difficult for the operating surgeon. The oral and maxillofacial unit at the Royal Surrey Hospital is the tertiary referral center for maxillofacial trauma from five regional hospitals. This is a complete audit cycle of midface trauma referrals managed over a one year period. The standard set was that clinical assessment of the midface fracture would take place in a consultant led outpatient clinic within 7 days, and when indicated, surgical fixation would occur within 10 days of referral. Retrospective data was collected over one year (01/11/2018 - 31/12/2019). Three key changes were implemented: an IT referral mailbox, standardization of an on-call trauma table, and creation of a trauma theatre list. Re-audit was carried out over six months completing the cycle. 283 midface fracture referrals were received, of which 22 patients needed surgical fixation. The average time from referral to outpatient follow-up improved from 14.5 days to 8.3 days, and time from referral to surgery improved from 21.5 days to 11.6 days. Changes implemented in this audit significantly improved patient prioritization to appropriate outpatient clinics and shortened time to surgical intervention.

Keywords: maxillofacial trauma, midface trauma, oral and maxillofacial surgery, surgery fixation

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Authors: Maide Yesilyurt, Saide Faydalı

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Patients experience pain at different intensities in postoperative. The diagnosis of the pain, the assessment and the success of the treatment and care make the measurement of this finding compulsory. The aim of the study is to determine the evaluation differences numeric pain scales. The descriptive study was conducted with 360 patients with in postoperative. The data were obtained from questionnaires related to six numeric pain scales most preferred in clinical use, and a face-to-face interview technique was used by the researcher. Regarding to numeric pain scale, questions include forth positive and one negative statement. In evaluating the data; chi-square and Pearson correlation tests were used. For the study, the patients’ informed consents, the institution and the ethics committee received permission. In this study, patients' ages are between 18-80, 95.8% of the patients were not informed about pain assessment. Patients evaluated the 5-item numeric scale as the easy, can be answered quickly, accurate, and appropriate for clinical use and the 101 items numeric scale as complex than other scales. Regarding to numeric pain scales with positive statements between age, marital status, educational status, previous surgery, having chronic disease and getting information about pain assessment significant difference has been detected. All numeric pain scales are correlated to each other. As a result, it was determined that as the items in the numerical scales decreased, the patients were able to perceive the scales better, and the items in the scales increased, the patients were in trouble to understand.

Keywords: numeric pain scales, nurse, pain assessment, patient

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Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

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This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

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Authors: Dawid Jakimiuk, Krzysztof Mitura, Leszek Szpakowski, Sławomir Pilip, Daniel Celiński

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The Emergency Medical Teams (EMS) of the Ambulance Service in Siedlce serve the population living in the Mazowieckie Voivodeship (the area of eastern Poland with approximately 550,000 inhabitants). They provide health services at the pre-hospital stage to all life-threatening patients. The analysis covered the interventions of emergency medical teams in cases of suicide attempts that occurred in the years 2015-2018. The study was retrospective. The data was obtained on the basis of digital medical records of completed call-outs. When defining the disease entity, the International Statistical Classification of Diseases and Health Problems ICD-10 prepared by WHO was used. The relationship between selected disease entities and the area of EMT intervention, the patient's sex and age, and the time of occurrence of the event were investigated. Non-urban area was defined as the area inhabited by a population below 10,000 residents. Statistical analysis was performed using Pearson's Chi ^ 2 test and presenting the percentage of cases in the study group. Of all the suicide attempts, drug abuse cases were the most frequent, including: X60 (Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics); X61 (Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonian and psychotropic drugs, not elsewhere classified); X62 (Intentional self-poisoning by and exposure to narcotics and psycholeptics [hallucinogens], not elsewhere classified); X63 (Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system); X64 (Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substance) oraz X70 (Intentional self-harm by hanging, strangulation and suffocation). In total, they accounted for 69.4% of all interventions to suicide attempts in the studied period. Statistical analysis shows significant differences (χ2 = 39.30239, p <0.0001, n = 561) between the area of EMT intervention and the type of suicide attempt. In non-urban areas, a higher percentage of X70 diagnoses was recorded (55.67%), while in urban areas, X60-X64 (72.53%). In non-urban areas, a higher proportion of patients attempting suicide was observed compared to patients living in urban areas. For X70 and X60 - X64 in total, the incidence rates in non-urban areas were 80.8% and 56%, respectively. Significant differences were found (χ2 = 119.3304, p <0.0001, n = 561) depending on the method of attempting suicide in relation to the patient's sex. The percentage of women diagnosed with X60-X64 versus X70 was 87.50%, which was the largest number of patients (n = 154) as compared to men. In the case of X70 in relation to X60-X64, the percentage of men was 62.08%, which was the largest number of patients (n = 239) as compared to women (n = 22). In the case of X70, the percentage of men compared to women was as high as 92%. Significant differences were observed (χ2 = 14.94848, p <0.01058) between the hour of EMT intervention and the type of suicide attempt. The highest percentage of X70 occurred between 04:01 - 08:00 (64.44%), while X60-X64 between 00:01 - 04:00 (70.45%). The largest number of cases of all tested suicide attempts was recorded between 16:01 - 20:00 for X70 (n = 62), X60 - X64 (n = 82), respectively. The highest percentage of patients undertaking all suicide attempts studied at work was observed in the age range of 18-30 (31.5%), while the lowest was in the age group over 60 years of age. (11%). There was no significant correlation between the day of the week or individual months of the year and the type of suicide attempt - respectively (χ2 = 6.281729, p <0.39238, n = 561) and (χ2 = 3.348913, p <0.9857, n = 561). There were also no significant differences in the incidence of suicide attempts for each year in the study period (χ2 = 3.348913, p <0.9857 n = 561). The obtained results suggest the necessity to undertake preventive measures in order to minimize the number of suicide attempts. Such activities should be directed especially at young patients living in non-urban areas.

Keywords: emergency med, emergency medical team, attempted suicide, pre-hospital

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Authors: A. A. Balkhi, G. M. Mir, Javid A. Sheikh

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To cater the demands of increasing traffic with new applications the cellular mobile networks face new changes in deployment in infrastructure for making cellular networks heterogeneous. To reduce overhead processing the densely deployed cells require smart behavior with self-organizing capabilities with high adaptation to the neighborhood. We propose self-organization of unused resources usually excessive unused channels of neighbouring cells with densely populated cells to reduce handover failure rates. The neighboring cells share unused channels after fulfilling some conditional candidature criterion using threshold values so that they are not suffered themselves for starvation of channels in case of any abrupt change in traffic pattern. The cells are classified as ‘red’, ‘yellow’, or ‘green’, as per the available channels in cell which is governed by traffic pattern and thresholds. To combat the deficiency of channels in red cell, migration of unused channels from under-loaded cells, hierarchically from the qualified candidate neighboring cells is explored. The resources are returned back when the congested cell is capable of self-contained traffic management. In either of the cases conditional sharing of resources is executed for enhanced traffic management so that User Equipment (UE) is provided uninterrupted services with high Quality of Service (QoS). The fuzzy logic-based simulation results show that the proposed algorithm is efficiently in coincidence with improved successful handoffs.

Keywords: candidate cell, channel sharing, fuzzy logic, handover, small cells

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Authors: Adrian Sebastian, Chris Gillespie

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We describe a case of diffuse rectal involvement with cap polyposis, manifesting with a protein-losing colopathy and occurring in the setting of advanced mechanical pelvic floor dysfunction. A 59-year-old male with a 5-year history of persistent excessive flatulence, defecatory difficulties, and diarrhea. He had extensive cap polyposis of the entire rectum endoscopically. His symptoms progressed to severe fecal incontinence with mucus leakage, pelvic pain, weight loss, and hypoalbuminemia. Clinical examination exhibited severe perineal descent, a large rectocele, poor anal squeeze, and a poor defecatory technique. After a trial of nonoperative therapies addressing his defecatory dysfunction, and Helicobacter pylori eradication, surgical resection was offered due to severe symptoms with ongoing incontinence and protein loss with no other reasonable options. A robotic abdominoperineal resection with a permanent colostomy was performed, followed by an uncomplicated recovery. Our observation of coexisting mechanical pelvic floor changes in this patient lends weight to the concept of a prolapse-related phenomenon in the pathophysiology of this rare condition.

Keywords: cap polyposis, pelvic dysfunction, fecal incontinence, case report

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Authors: Akinwale Adeyinka

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Critical natural resources such as clean ground water, fertile topsoil, and biodiversity are diminishing at an exponential rate, orders of magnitude above that at which they can be regenerated. Based on news on world population record, over 6 billion people on earth, and almost a quarter million added each day, the scale of human activity and environmental impact is unprecedented. Soaring human population growth over the past century has created a visible challenge to earth’s life support systems. In addition, the world faces an onslaught of other environmental threats including degenerated global climate change, global warming, intensified acid rain, stratospheric ozone depletion and health threatening pollution. Overpopulation and the use of deleterious technologies combine to increase the scale of human activities to a level that underlies these entire problems. These intensifying trends cannot continue indefinitely, hopefully, through increased understanding and valuation of ecosystems and their services, earth’s basic life-support system will be protected for the future.To say the fact, human civilization is now the dominant cause of change in the global environment. Now that our relationship to the earth has change so utterly, we have to see that change and understand its implication. These are actually 2 aspects to the challenges which we should believe. The first is to realize that our power to harm the earth can indeed have global and even permanent effects. Second is to realize that the only way to understand our new role as a co-architect of nature is to see ourselves as part of a complex system that does operate according to the same simple rules of cause and effect we are used to. So understanding the physical/biological dimension of earth system is an important precondition for making sensible policy to protect our environment. Because we believe Sustainable Development Is a matter of reconciling respect for the environment, social equity and economic profitability. Also, we strongly believe that environmental protection is naturally about reducing air and water pollution, but it also includes the improvement of the environmental performance of existing process. That is why we should always have it at the heart of our business that the environmental problem is not our effect on the environment so much as our relationship with the environment. We should always think of being environmental friendly in our operation.

Keywords: Stratospheric ozone depletion ion , Climate Change, global warming, social equity and economic profitability

Procedia PDF Downloads 337

Authors: Teerapon Pirom, Ura Pancharoen

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Amoxicillin is an antibiotic which is widely used to treat various infections in both human beings and animals. However, when amoxicillin is released into the environment, it is a major problem. Amoxicillin causes bacterial resistance to these drugs and failure of treatment with antibiotics. Liquid membrane is of great interest as a promising method for the separation and recovery of the target ions from aqueous solutions due to the use of carriers for the transport mechanism, resulting in highly selectivity and rapid transportation of the desired metal ions. The simultaneous processes of extraction and stripping in a single unit operation of liquid membrane system are very interesting. Therefore, it is practical to apply liquid membrane, particularly the HFSLM for industrial applications as HFSLM is proved to be a separation process with lower capital and operating costs, low energy and extractant with long life time, high selectivity and high fluxes compared with solid membranes. It is a simple design amenable to scaling up for industrial applications. The extraction and recovery for (Amoxicillin) through the hollow fiber supported liquid membrane (HFSLM) using aliquat336 as a carrier were explored with the experimental data. The important variables affecting on transport of amoxicillin viz. extractant concentration and operating time were investigated. The highest AMOX- extraction percentages of 85.35 and Amoxicillin stripping of 80.04 were achieved with the best condition at 6 mmol/L [aliquat336] and operating time 100 min. The extraction reaction order (n) and the extraction reaction rate constant (kf) were found to be 1.00 and 0.0344 min-1, respectively.

Keywords: aliquat336, amoxicillin, HFSLM, kinetic

Procedia PDF Downloads 275

Authors: J. Punj, R. K. Pandey, V. Darlong, K. Thangavel

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Background: Dural puncture epidural (DPE) technique has been introduced recently for labour analgesia however, no study has compared ropivacaine and levobupivacaine for the same. Methods: The primary aim of the study was to compare time to onset of the Numerical Pain Rating Score (NPRS) ≤ 1 in labour analgesia with both drugs. After obtaining ethics and patient consent, ASA I and ASA II parturient with single foetus in vertex presentation and cervical dilatation <5.0 cm were included. DPE was performed with 16/ 26 G combined spinal epidural (CSE) technique, and parturients randomized into two groups. In Group R ( Ropivacaine) 20 ml 0.125% ropivacaine+ fentanyl 2µg/ml was injected to a maximum of 20 ml in 20 minutes and in Group L (Levobupivacaine), 20 ml 0.125% levobupivacaine + fentanyl 2µg/ml was injected. Outcomes were assessed at 0.5,2,4,6,8,10,12,14,16,18,20 and 30 minutes, then every 90 minutes until delivery. Appropriate statistical analysis was done, and p value of <0.05 was considered statistically significant. Results: The median time to onset of NPRS ≤1 in both groups was comparable (group R= 16 minutes vs group L= 18 minutes (p = 0.076). Volume of drug for NPR ≤1 in both groups was also comparable (Group R 15.95± 2.03 ml vs Group L 16.35 ± 1.34 ml (p=0.47). Conclusion: DPE with 16 G epidural needle and 26 gauge spinal needle with both 0.125% ropivacaine and 0.125% levobupivacaine results in similar efficacy of labour analgesia.

Keywords: dural puncture epidural, labour analgesia, obstetric analgesia, hypotension

Procedia PDF Downloads 88

Authors: Ishfaq A. Bukhari, Bassem Yousef Sheikh, Abdulrahman Almotrefi, Osama Yousaf, Amer Mahmood

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Olive oil is the primary source of fat in the Mediterranean diet which is associated with a low mortality for cardiovascular disease. Olive oil is rich in monounsaturated fatty acids, and has been reported for variety of beneficial cardiovascular effects including blood pressure lowering, anti-platelet, anti-diabetic and anti-inflammatory effects. Growing number evidences from preclinical and clinical studies have shown that olive oil improves insulin resistance, decrease vessels stiffness and prevent thromboembolism. We evaluated the effects of olive against streptozotocin-induced physiological disorders in the animal models of diabetes and ischemia and reperfusion (I/R)- induced cardiac arrhythmias. Diabetes was induced in male rats with a single intraperitoneal injection of streptozotocin (60 mg/kg), rats were treated for two months with olive oil (1 ml/kg p.o). Control animals received saline. Blood glucose, body weight were monitored every 14 days. At the end of the treatment rats were sacrificed hearts were isolated for mounting on langedorff’s apparatus. The blood glucose and body weight was not significantly different in the control and olive treated animals. The control diabetic animals exhibited 100% incidence of I/R –induced ventricular fibrillation which was reduced to 0% with olive oil, treatment. The duration of ventricular fibrillation reduced from 98.8± 2.3 (control) to 0 seconds in the olive oil treated group. Diltiazem, a calcium channel blocker (1 µm/L) showed similar results and protected the I/R-induced cardiac disorders. The biochemical analysis of the cardiac tissues showed that diabetes and I/R produce marked pathological changes in the cardiomyocytes including decreased glutathione (GSH) and increased oxidative stress (Malondialdehyde; MDA). Pretreatment of animals with olive oil (1 ml/kg p.o) increased GSH and MDA levels. Olive oil also improved the diabetic-induced histopathological changes in the cardiomyocytes. These finding indicates that olive possesses cardiac protective properties. Further studies are under way in our lab to explore the mechanism of the cardio-protective effect of olive oil.

Keywords: diabeties, ischemia-reperfusion, olive oil, rats heart

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Authors: Jonathan Bolduc

Abstract:

Studies have demonstrated the effectiveness of music training approaches to help children with language disabilities. Because music is closely associated with a number of cognitive functions, including language, it has been hypothesized that musical skills transfer to other domains. Research suggests that music training strengthens basic auditory processing skills in dyslexic children and may ameliorate phonological deficits. Furthermore, music instruction has the particular advantage of being non-literacy-based, thus removing the frustrations that can be associated with reading and writing activities among children with specific learning disabilities. In this study, we assessed the effect of implementing an intensive music program on the development of language skills (phonological and reading) in 4- to 9-year-old children. Seventeen children (N=17) participated in the study. The experiment took place over 6 weeks in a controlled environment. Eighteen lessons of 40 minutes were offered during this period by two music specialists. The Dalcroze, Orff, and Kodaly approaches were used. A series of qualitative measures were implemented to document the contribution of music training to this population. Currently, the data is being analyzed. The first results show that learning music seems to significantly improve verbal memory. We already know that language disabilities are considered one of the main causes of school dropout as well as later professional and social failure. We aim to corroborate that an integrated music education program can provide children with language disabilities with the same opportunities to develop and succeed in school as their classmates. Scientifically, the results will contribute to advance the knowledge by identifying the more effective music education strategies to improve the overall development of children worldwide.

Keywords: music education, music, art education, language diasabilities

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Authors: Eugene Ivanov, Eduardo del-Rio, Igor Kapchenko, Maija Nystrӧm, Juha Kotila

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Series of low modulus beta Ti alloy billets and powders can be produced in commercial quantities using a combination of electron beam melting (EBM) and EIGA atomization processes. In the present study, TNZT alloy powder was produced and processed in the EOSINT M290 laser sintering system to produce parts for mechanical testing. Post heat treatments such as diffusion annealing to reduce internal stresses or hot isostatic pressing to remove closed pores were not applied. The density can visually be estimated to be > 99,9 %. According to EDS study Nb, Zr, and Ta are distributed homogeneously throughout the printed sample. There are no indications for any segregation or chemical inhomogeneity, i.e. variation of the element distribution. These points to the fact that under the applied experimental conditions the melt generated by the laser rapidly cools down in the SLM (Selective Laser Melting) process. The selective laser sintering yielded dense structures with relatively good surface quality. The mechanical properties, especially the elongation (24%) along with tensile strength ( > 500MPa) and modulus of elasticity (~60GPa), were found to be promising compared to titanium alloys in general.

Keywords: beta titanium alloys, additive manufacturing, powder, implants

Procedia PDF Downloads 227