Search results for: patient monitoring

Authors: Amenah Galo, Mohammed Farid, Kareem Alsharkawy, Robert Warner, Karthikeyan Srinivasan, Haitham Khalil, Ruth Waters

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Introduction: The cessation of elective surgery, particularly breast reconstruction, continue to be affected by the COVID-19 pandemic. The restructuring of medical services and staff redeployment severely affected the ability to return to normality for surgical specialties. The aim of this study is to determine the decline in breast reconstruction affected by the COVID-19 pandemic in a tertiary center. Methods: A retrospective review of breast reconstruction cases (autologous, non-autologous) or mastectomies Pre- COVID (March 2019-March 2020) and during COVID (March 2020- March 2021) at Queen Elizabeth Hospital, Birmingham, were collated. Data included patient demographics, BMI, previous and recent reconstruction, length of hospital stay, and mastectomies, including risk-reducing. Results: The number of patients who had breast reconstruction was significantly lower during COVID (n=62) compared to pre-COVID (n=199). The mean age (pre-COVID 51, COVID 59 years), BMI (Pre-COVID and COVID = 27), previous reconstruction (pre-COVID n=101, 51%, COVID n=33, 53%) and length hospital stay was less during COVID (3 days) compared to Pre-COVID (4 days). The proportion of risk-reducing mastectomies and reconstruction during COVID (32%, n=20) were higher than pre-COVID (21%, n=41). A higher proportion rate of autologous reconstruction (DIEP 56, TRAM 17) Pre-COVID compared to COVID (DIEP 22, TRAM 7). Implant reconstructions were higher during COVID (n=19, 31%) than pre-COVID (n=31, 16%). Conclusion: The lack of regular provision for breast reconstruction continues to decline during the pandemic. This will have a tremendous impact on waiting lists without a timeline for reconstruction to offer patients. An international survey highlights the disparities in offering breast reconstruction and strategies to rectify this issue.

Keywords: breast reconstruction, COVID-19 pandemic, mastectomy, autologous, implant

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Authors: Gaya Bin Noon, Thoko Hanjahanja-Phiri, Laura Xavier Fadrique, Plinio Pelegrini Morita, Hélène Vaillancourt, Jennifer Teague, Tania Donovska

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Active Assisted Living (AAL) refers to systems designed to improve the quality of life, aid in independence, and create healthier lifestyles for care recipients. As the population ages, there is a pressing need for non-intrusive, continuous, adaptable, and reliable health monitoring tools to support aging in place. AAL has great potential to support these efforts with the wide variety of solutions currently available, but insufficient efforts have been made to address concerns arising from the integration of AAL into care. The purpose of this research was to (1) explore the integration of AAL technologies and data into the clinical pathway, and (2) map data access and governance for AAL technology in order to develop standards for use by policy-makers, technology manufacturers, and developers of smart communities for seniors. This was done through four successive research phases: (1) literature search to explore existing work in this area and identify lessons learned; (2) modeling of the continuum of care; (3) adapting a framework for data governance into the AAL context; and (4) interviews with stakeholders to explore the applicability of previous work. Opportunities for standards found in these research phases included a need for greater consistency in language and technology requirements, better role definition regarding who can access and who is responsible for taking action based on the gathered data, and understanding of the privacy-utility tradeoff inherent in using AAL technologies in care settings.

Keywords: active assisted living, aging in place, internet of things, standards

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Authors: Akbar Cahyadhi Pratama Putra, Tantri Utami Widhaningtyas, M. Randy Aswin

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Indonesia as an archipelagic nation have very long coastline which have large potential marine resources, one of that is the mangrove ecosystems. Lapindo mudflow disaster in Sidoarjo, East Java requires mudflow flowed into the sea through the river Brantas and Porong. Mud material that transported by river flow is feared dangerous because they contain harmful substances such as heavy metals. This study aims to map the mangrove ecosystem seen from its density and knowing how big the impact of a disaster on the Lapindo mud to mangrove ecosystem and accompanied by efforts to address the mangrove ecosystem that maintained continuity. Mapping coastal mangrove conditions of Sidoarjo was done using remote sensing products that Landsat 7 ETM + images with dry months of recording time in 2002, 2006, 2009, and 2014. The density of mangrove detected using NDVI that uses the band 3 that is the red channel and band 4 that is near IR channel. Image processing was used to produce NDVI using ENVI 5.1 software. NDVI results were used for the detection of mangrove density is 0-1. The development of mangrove ecosystems of both area and density from year to year experienced has a significant increase. Mangrove ecosystems growths are affected by material deposition area of Lapindo mud on Porong and Brantas river estuary, where the silt is growing medium suitable mangrove ecosystem and increasingly growing. Increasing the density caused support by public awareness to prevent heavy metals in the material so that the Lapindo mud mangrove breeding done around the farm.

Keywords: archipelagic nation, mangrove, Lapindo mudflow disaster, NDVI

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Authors: Andile Mkhohlakali, Tien-Chien Jen, James Tshilongo, Happy Mabowa

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Among different parameters, oxygen is one of the most important analytes of interest, dissolved oxygen (DO) concentration is very crucial and significant for various areas of physical, chemical, and environmental monitoring. Herein we report oxygen-sensitive luminophores -based lanthanum(III) trifluoromethanesulfonate), [La]³⁺ was encapsulated into SiO₂-based xerogel matrix. The nanosensor is composed of organically modified silica nanoparticles, doped with the luminescent oxygen–sensitive lanthanum(III) trifluoromethanesulfonate complex. The precursor materials used for sensing film were triethyl ethoxy silane (TEOS) and (3-Mercaptopropyltriethoxysilane) (MPTMS- TEOS) used for SiO2-baed matrices. Brunauer–Emmett–Teller (BET), and BJH indicate that the SiO₂ transformed from microporous to mesoporous upon the addition of La³⁺ luminophore with increased surface area (SBET). The typical amorphous SiO₂ based xerogels were revealed with X-Ray diffraction (XRD) and Selected Area Electron Diffraction (SAED) analysis. Scanning electron microscope- (SEM) and transmission electron microscope (TEM) showed the porous morphology and reduced particle for SiO₂ and La-SiO₂ xerogels respectively. The existence of elements, siloxane networks, and thermal stability of xerogel was confirmed by energy dispersive spectroscopy (EDS), Fourier-transform infrared spectroscopy (FTIR), and Thermographic analysis (TGA). UV-Vis spectroscopy and photoluminescence (PL) have been used to characterize the optical properties of xerogels. La-SiO₂ demonstrates promising characteristic features of an active sensing film for dissolved oxygen in the water. Keywords: Sol-gel, ORMOSILs, encapsulation, Luminophores quenching, O₂-sensing

Keywords: sol-gel, ORMOSILs, luminophores quenching, O₂-sensing

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Authors: Rudy Bahouth, Farouk Benmeddour, Emmanuel Moulin, Jamal Assaad

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Guided ultrasonic waves are used in Non-Destructive Testing (NDT) and Structural Health Monitoring (SHM) for inspection and damage detection. Recently, wireless data transmission using ultrasonic waves in solid metallic channels has gained popularity in some industrial applications such as nuclear, aerospace and smart vehicles. The idea is to find a good substitute for electromagnetic waves since they are highly attenuated near metallic components due to Faraday shielding. The proposed solution is to use ultrasonic guided waves such as Lamb waves as an information carrier due to their capability of propagation for long distances. In addition to this, valuable information about the health of the structure could be extracted simultaneously. In this work, the reliable frequency bandwidth for communication is extracted experimentally from dispersion curves at first. Then, an experimental platform for wireless communication using Lamb waves is described and built. After this, coherent demodulation algorithm used in telecommunications is tested for Amplitude Shift Keying, On-Off Keying and Binary Phase Shift Keying modulation techniques. Signal processing parameters such as threshold choice, number of cycles per bit and Bit Rate are optimized. Experimental results are compared based on the average Bit Error Rate. Results have shown high sensitivity to threshold selection for Amplitude Shift Keying and On-Off Keying techniques resulting a Bit Rate decrease. Binary Phase Shift Keying technique shows the highest stability and data rate between all tested modulation techniques.

Keywords: lamb waves communication, wireless communication, coherent demodulation, bit error rate

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Authors: Ling-Lang Huang, Yih-Jer Wu

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Empathy is crucial for a patient-physician relationship and medical professionalism. Internet activity, gaming, or even addiction, have been more and more common among medical students. However, there’s been no report showing whether internet behavior has a substantial impact on empathy in medical students to our best knowledge. All year-2 medical students taking the optional course 'Narrative, Comprehension, and Communication' were enrolled. Internet behaviors are divided into two groups, 'internet users without online gaming (IU)' and 'internet users with online gaming (IG)', each group was further divided into 3 groups according to their average online retention time each day (< 2, 2 - 6, > 6 hours). Empathy was evaluated by the scores of the reports and humanities reflection after watching indicated movies, and by self-measured empathy questionnaire. All students taking the year-2 optional course 'Narrative, Comprehension, and Communication' were enrolled. As compared with students in the IU group, those in the IG group had significantly lower scores for the reports (81.3 ± 3.7 vs. 86.4 ± 5.1, P = 0.014). If further dividing the students into 5 groups (IU < 2, IU 2-6, IG < 2, IG 2 - 6, and IG > 6 hours), the scores were significantly and negatively correlated to online gaming with longer hours (r = -0.556, P = 0.006). However, there was no significant difference between IU and IG groups (33.0 ± 5.4 vs. 34.8 ± 3.2, P = n.s.), in terms of scores in the self-measured empathy questionnaire, neither was there any significant trend of scores along with longer online hours across the 5 groups (r = -0.164, P = n.s.). To date, there has been no evidence showing whether different internet behaviors (with or without online gaming) have distinct impacts on empathy. Although all of the medical students had a similarly good self-perception for empathy, our data suggested that online gaming did have a negative impact on their actual expression of empathy. Our observation has brought up an important issue for pondering: May IT- or gaming-assisted medical learning actually harm students’ empathy? In conclusion, this data suggests that long hours of online gaming harms expression of empathy, though all medics think themselves a person of high empathy.

Keywords: empathy. Internet, medical students, online gaming

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Authors: Haiyoung Jung, Mi Joung Leem, Sun Hwa Lee

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Background & Objective: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic abnormality that results in an inadequate amount of G6PD, leading to increased susceptibility of red blood cells to reactive oxygen species and hemolysis. The present study aimed to evaluate the careSTARTTM S1 analyzer for measuring G6PD activity to hemoglobin (Hb) ratio. Methods: Precision for G6PD activity and hemoglobin measurement was evaluated using control materials with two levels on five repeated runs per day for five days. The analytic performance of the careSTARTTM S1 analyzer was compared with spectrophotometry in 40 patient samples. Reference ranges suggested by the manufacturer were validated in 20 healthy males and females each. Results: The careSTARTTM S1 analyzer demonstrated precision of 6.0% for low-level (14~45 U/dL) and 2.7% for high-level (60~90 U/dL) control in G6PD activity, and 1.4% in hemoglobin (7.9~16.3 u/g Hb). A comparison study of G6PD to Hb ratio between the careSTARTTM S1 analyzer and spectrophotometry showed an average difference of 29.1% with a positive bias of the careSTARTTM S1 analyzer. All normal samples from the healthy population were validated for the suggested reference range for males (≥2.19 U/g Hb) and females (≥5.83 U/g Hb). Conclusion: The careSTARTTM S1 analyzer demonstrated good analytical performance and can replace the current spectrophotometric measurement of G6PD enzyme activity. In the aspect of the management of clinical laboratories, it can be a reasonable option as a point-of-care analyzer with minimal handling of samples and reagents, in addition to the automatic calculation of the ratio of measured G6PD activity and Hb concentration, to minimize any clerical errors involved with manual calculation.

Keywords: POCT, G6PD, performance evaluation, careSTART

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Authors: Shedy Maharani Nariswari, Prima Agustia Nova, I. Made Kariasa

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Background. Heart Failure (HF) is a chronic and progressive condition associated with significant morbidity, mortality, health care expenditures, and a high readmission rate over the years. Self‐care is essential to manage chronic heart failure in the long term, and it is related to better outcomes and can enhance the quality of life. Objective. The aims of this study were to describe the relationship between self-care behavior and quality of life among heart failure patients in East Jakarta, Indonesia. Methods. This study used a correlational-descriptive design with a cross-sectional study, the sampling method used purposive sampling method. Self-care was measured using Self-care Heart Failure Index version 6.2, and quality of life was measured using The Minnesota Living with Heart Failure. Pearson correlation and Spearman-rho correlations are used to analyze the data. Results. We recruited 103 patients with HF in both outpatient and inpatient ward: mean age 59.26 ± 11.643 years, 63.1% male. Patients with higher levels of education were associated with higher self-care maintenance (p= 0.007). The patient's average quality of life is quite high, with a score of 72,07 ± 16,89. There were a significant relationship among self-care maintenance (r=0,305, p=0,001), self-care management (r=0,330, p=0,001), and self-care confidence (r=0,335, p=0,001) towards the quality of life. Most participants have inadequate self-care maintenance, self-care management, and self-care confidence (score < 70), while the score of quality of life is categorized as poor. Conclusion. The self-care behaviors were limited among patients living with HF in Indonesia yet was associated with better quality of life. It is necessary to promote health related to knowledge and adherence to self-care behavior so that it can improve the quality of life of heart failure patients. This study can be used as a reference to promote self-care among patients with heart failure, it can help to enhance their quality of life.

Keywords: heart failure, self-care maintenance, self-care management, self-care confidence, quality of life

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Authors: Zarabizan Zakaria, Syuhaida Ismail, Aminah Md. Yusof

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Project management process starts from the planning stage up to the stage of completion (handover of buildings, preparation of the final accounts and the closing balance). This process is not easy to implement efficiently and effectively. The issue of delays in construction is a major problem for construction projects. These delays have been blamed mainly on inefficient traditional construction practices that continue to dominate the current industry. This is due to several factors, such as environments of construction technology, sophisticated design and customer demands that are constantly changing and influencing, either directly or indirectly, the practice of management. Among the identified influences are physical environment, social environment, information environment, political and moral atmosphere. Therefore, this paper is emerged to determine the problem and issues in the final account closing in construction projects, and it establishes the need to embrace Supply Chain Management (SCM) and then elucidates the need and strategies for the development of a delay reduction framework. At the same time, this paper provides effective measures to avoid or at least reduce the delay to the optimum level. Allowing problems in the closure declaration to occur without proper monitoring and control can leave negative impact on the cost and time of delivery to the end user. Besides, it can also affect the reputation or image of the agency/department that manages the implementation of a contract and consequently may reduce customer's trust towards the agencies/departments. It is anticipated that the findings reported in this paper could address root delay contributors and apply SCM tools for their mitigation for the better development of construction project.

Keywords: final account closing, construction project, construction delay, supply chain management

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Authors: Molly Pui Man Wong

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In this study, a blended and interactive e-learning Courseware that our team developed will be introduced, and our team’s experiences on how the e-learning Courseware and the flipped classroom benefit student learning in bioethics in the medical program will be shared. This study is a continuation of the previously established study, which provides a summary of the well-developed e-learning Courseware in a blended learning approach and an update on its efficiency and efficacy. First, a collection of animated videos capturing selected topics of bioethics and related ethical issues and dilemma will be introduced. Next, a selection of problem-based learning videos (“simulated doctor-patient role play”) with pop-up questions and discussions will be further discussed. Our recent findings demonstrated that these activities launched by the Courseware strongly engaged students in bioethics education and enhanced students’ critical thinking and creativity, which were consistent with the previous data in the preliminary studies. Moreover, the educational benefits of the online art exhibition, art jamming, and competition will be discussed, through which students could express bioethics through arts and enrich their learning in medical research in an interactive, fun, and entertaining way, strengthening their interests in bioethics. Furthermore, online survey questionnaires and focus group interviews were conducted. Consistent with the preliminary studies, our results indicated that implementing the e-learning Courseware with a flipped classroom in bioethics education enhanced both active learning and student engagement. In conclusion, our Courseware not only reinforces education in art, bioethics, and medicine but also benefits students in understanding and critical thinking in socio-ethical issues and serves as a valuable learning tool in bioethics teaching and learning.

Keywords: bioethics, courseware, e-learning, flipped classroom

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Authors: Zainab Alghali Elsaid Muhammed

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Background : IBS is a gastrointestinal disorder characterized by a variety of symptoms that occur concurrently. It is very common and is associated with high levels of psychiatric comorbidities, all of which have a negative impact on the patient's quality of life. Abdominal pain, diarrhea, constipation, excess gas, and bloating are common symptoms of IBS. Objectives : The purpose of this study is to determine the prevalence of IBS among medical students and intern doctors in Sudan, as well as the risk factors associated with it. Study design: This cross-sectional study was carried out in Sudan from April to July 2022. All participants completed a six-part online questionnaire. The ROME IV criteria questionnaire was used to make an IBS diagnosis. Participants completed the hospital anxiety and depression questionnaire in order to be diagnosed with anxiety and depression. Results : 600 participants filled out the questionnaire. The overall prevalence of IBS was found to be 42%, with females being the most affected. Intern doctors had higher IBS rates (30.0%) than medical students, but this was not statistically significant. Single status (p =0.079), good GPAs (p =0.00), had significant associations with IBS occurrence. Other significantly associated habits were sleeping less than 8 hours (p =0.013), two cups or less of coffee per day (p = 0.109), No smoking (p =0.001), and No exercise (p =0.00, IBS participants were also found to have a significant relationship with abnormal anxiety (p =0.00) and borderline depression (p=0.0156). Conclusion : The high prevalence of IBS in this study suggests that medical students and interns are unable to recognize their symptoms. The main IBS predictors in this study were suffering from anxiety or depression, having an insufficient income, sleeping less than 8 hours per day, working/ studying more than 8 hours per day, and not performing any type of exercise.

Keywords: irritable bowel syndrome, sudan, HADS, rome IV, medical students

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Authors: Semiu Bello

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Since the discovery of HIV/AIDS in 1981, it has been a major global challenge and its ravaging consequences have had negative imprints on both the affected and infected people. The challenge of HIV/AIDS does not only affect the developing countries of the world, the developed nations have had their share of the experiences. The disease has, therefore, attracted the attentions of national governments and international donor agencies with huge financial investments toward the eradication of the virus and its global menace. Socially, however, people living with HIV/AIDS have had to battle with an array of social challenges in regards to the infection; the social stigmas, which seem to be more prevalent in underdeveloped and developing societies. The social stigmas with which people living with HIV/AIDS have suffered from include, but not limited, to social isolation, group avoidance, loss of jobs, public ridicule and non-appointment to official and government positions. Given this background, this study examines the roles of therapeutic communication otherwise called patient-provider communication within a clinical environment, focusing on Olabisi Onabanjo University Teaching Hospital (OOUTH) Sagamu, Nigeria as a case study. In other words, this study will investigate the level of interpersonal communication, interactions, and relationships that often take place between people living with HIV/AIDS and health care providers including doctors, nurses and social workers. This study will methodologically adopt the in-depth interview to interview six members of people living with HIV/AIDS at OOUTH. The dimensions of the data will determine the policy prescriptions of this study, which as envisage, may contribute to the improved use of therapeutic communication by health care providers and may thereof improve the psychology of people living with HIV/AIDS in the face of any social stigma.

Keywords: health care providers, people living with HIV/AIDS, social stigma, therapeutic communication

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Authors: Suchana Marahatta, Sabina Bhattarai, Bishnu Hari Paudel, Dilip Thakur

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Background: Every year thousands of patients develop nerve damage and disabilities as a result of leprosy which can be prevented by early detection and treatment. So, early detection and treatment of nerve function impairment is of paramount importance in leprosy. Objectives: To assess the electrophysiological pattern of the peripheral nerves in leprosy patients and to compare it with clinical assessment tools. Materials and Methods: In this comparative cross-sectional study, 74 newly diagnosed leprosy patients without reaction were enrolled. They underwent thorough evaluation for peripheral nerve function impairment using clinical tests [i.e. nerve palpation (NP), monofilament (MF) testing, voluntary muscle testing (VMT)] and nerve conduction study (NCS). Clinical findings were compared with that of NCS using SPSS version 11.5. Results: NCS was impaired in 43.24% of leprosy patient at the baseline. Among them, sensory NCS was impaired in more patients (32.4%) in comparison to motor NCS (20.3%). NP, MF, and VMT were impaired in 58.1%, 25.7%, and 9.4% of the patients, respectively. Maximum concordance of monofilament testing and sensory NCS was found for sural nerve (14.7%). Likewise, the concordance of motor NP and motor NCS was the maximum for ulnar nerve (14.9%). When individual parameters of the NCS were considered, amplitude was found to be the most frequently affected parameter for both sensory and motor NCS. It was impaired in 100% of cases with abnormal NCS findings. Conclusion: Since there was no acceptable concordance between NCS findings and clinical findings, we should consider NCS whenever feasible for early detection of neuropathy in leprosy. The amplitude of both sensory nerve action potential (SNAP) and compound nerve action potential (CAMP) could be important determinants of the abnormal NCS if supported by further studies.

Keywords: leprosy, nerve function impairment, neuropathy, nerve conduction study

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

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Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

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Authors: Nuruddeen Abubakar Adamu

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Background: Global health nursing describes health-related work across borders and focuses more on the differences between the nurses’ role between countries and identified why nursing care in particular country differs from another. It also helps in analyzing the health issues and concerns that transcend national borders class, race, ethnicity and culture. The primary objective of this study is to introduce the concept of global health nursing. And the article also argues for the need for global health nursing. Methods This review assesses available evidence, both published and unpublished, on issues relating to the global health nursing and the nurse's role in global health. The review is qualitative based. Results: Globalization, modern technologies, travel, migration and changes in diseases trend globally has made the nursing role to become more diverse and less traditional. These issues change the nurse’s role in the healthcare industry to become enormous and very challenging. This article considers response to issues of emerging global health nursing concept, challenges, purposes, global health nursing activities in both developed and developing countries and the nurse's role globally in maternal-newborn health; preparedness for advocacy in global health within a framework of social justice, equity; and health system strengthening globally. Conclusion: Global health nursing goes beyond the intervention to care for a patient with a particular health problem but, however health is interconnected to political, economic and social context and therefore this explains the need of a multi-professional and multi-sectoral approach to achieve the goal of global health and the need for global health nursing. Global health equity can be promoted and if the profile of nursing and nurses will be raised and enable nurses to be aware of global health issues so as to enable them to work to their full maximum potential, to attain greater health outcome and wellness.

Keywords: global health nursing, double burden of diseases, globalization, health equity

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Authors: Ranjith Menon, Abathar Aladi, Hans-Christean Nahser, Maneesh Bhojak, Sacha Nevin, Paul Eldridge

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Background: Spontaneous subarachnoid haemorrhage (SAH) accounts for approximately 5% of all strokes. Patients with spontaneous SAH (as shown by CT or lumbar puncture) undergo investigations to identify or exclude an underlying structural cause, typically cerebral aneurysm. However in 10 - 20% of cases, no structural cause is found. This includes more than one imaging modality (intracranial MRA, CTA, 4DCTA and/or DSA) and in some spinal MRI. Objective: To determine; 1) If an underlying structural or vascular cause can be identified in non-aneurysmal SAH patients by comparing different imaging modalities at presentation and at follow-up. 2) If MRI spine in patients with non-aneurysmal SAH reveals an underlying SAH cause. 3)The functional outcome at discharge. Results: We performed a retrospective analysis of all non-traumatic SAH patients admitted to the Walton centre from January 2009 to December 2015. There were 1457 patients with non-traumatic SAH admitted to the Walton centre of whom 21.8% (n=300) patients were diagnosed with non-aneurysmal SAH. Males were 65.6% and females were 43.3%. The presenting symptoms were sudden onset headache (93.6%), the focal neurological deficit (12%), loss of consciousness (10.6%) and others (6%). About 285 patients received 2 modalities of imaging (CTA & DSA), 192 received 3 modalities of imaging (CTA, MRA & DSA) and 137 received MRI spine (51/137 whole spine). The modified Rankin Score at discharge were: mRS 0 = 292 (97.33%), mRS 1-2 = 6, mRS 6 = 1 (cardiac arrest in IHD patient) and unknown in 1. Follow-up imaging at 3 to 6 months in 190 (63.3%) patients did not identify an underlying cause. Conclusion: This retrospective analysis concludes that non-aneurysmal SAH has a good functional outcome. A single imaging modality (CTA (4DCTA) or MRA or DSA) was adequate to exclude an underlying cause of SAH and a delayed imaging failed to identify a cause. Routinely performing MRI spine in this group of patients appears not to be necessary according to this evidence.

Keywords: stroke, non-aneurysmal subarachnoid haemorrhage, neuroimaging, modified rankin score

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Authors: Helena M. Wilhelm, Paulo O. Fernandes, Laís P. Dill, Kethlyn G. Moscon

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The use of vegetable oil (or natural ester) as an insulating fluid in electrical transformers is a trend that aims to contribute to environmental preservation since it is biodegradable and non-toxic. Besides, vegetable oil has high flash and combustion points, being considered a fire safety fluid. However, vegetable oil is usually less stable towards oxidation than mineral oil. Both insulating fluids, mineral and vegetable oils, need to be tested periodically according to specific standards. Oxidation stability can be determined by the induction period measured by conductivity method (Rancimat) by monitoring the effectivity of oil’s antioxidant additives, a methodology already developed for food application and biodiesel but still not standardized for insulating fluids. Besides adequate oxidation stability, fluids must be compatible with transformer's construction materials under normal operating conditions to ensure that damage to the oil and parts of the transformer does not occur. ASTM standard and Brazilian normative differ in parameters evaluated, which reveals the need to regulate tests for each oil type. The aim of this study was to assess oxidation stability and compatibility of vegetable oils to suggest the best way to assure a viable performance of vegetable oil as transformer insulating fluid. The determination of the induction period for several vegetable insulating oils from the local market by using Rancimat was carried out according to BS EN 14112 standard, at different temperatures (110, 120, and 130 °C). Also, the compatibility of vegetable oil was assessed according to ASTM and ABNT NBR standards. The main results showed that the best temperature for use in the Rancimat test is 130 °C, which allows a better observation of conductivity change. The compatibility test results presented differences between vegetable and mineral oil standards that should be taken into account in oil testing since materials compatibility and oxidation stability are essential for equipment reliability.

Keywords: compatibility, Rancimat, natural ester, vegetable oil

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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Authors: Asmamaw Yehun, Tsegaye Kassa, Addisu Hunegnaw, Martin Vermeer

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There are various models to estimate the neutral atmospheric parameter values, such as in-suite and reanalysis datasets from numerical models. Accurate estimated values of the atmospheric parameters are useful for weather forecasting and, climate modeling and monitoring of climate change. Recently, Global Navigation Satellite System (GNSS) measurements have been applied for atmospheric sounding due to its robust data quality and wide horizontal and vertical coverage. The Global Positioning System (GPS) solutions that includes tropospheric parameters constitute a reliable set of data to be assimilated into climate models. The objective of this paper is, to estimate the neutral atmospheric parameters such as Wet Zenith Delay (WZD), Precipitable Water Vapour (PWV) and Total Zenith Delay (TZD) using six selected GPS stations in the equatorial regions, more precisely, the Ethiopian GPS stations from 2012 to 2015 observational data. Based on historic estimated GPS-derived values of PWV, we forecasted the PWV from 2015 to 2030. During data processing and analysis, we applied GAMIT-GLOBK software packages to estimate the atmospheric parameters. In the result, we found that the annual averaged minimum values of PWV are 9.72 mm for IISC and maximum 50.37 mm for BJCO stations. The annual averaged minimum values of WZD are 6 cm for IISC and maximum 31 cm for BDMT stations. In the long series of observations (from 2012 to 2015), we also found that there is a trend and cyclic patterns of WZD, PWV and TZD for all stations.

Keywords: atmosphere, GNSS, neutral atmosphere, precipitable water vapour

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Authors: Ranitha Guna Selvi D, Ramakrishnan R, Mohideen Abdul Kader

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Purpose: To study the role of Vision centers in managing preventable blindness through refractive error correction in Rural South India. Methods: A retrospective analysis of patients attending 15 Vision centers in Rural South India from a period of January 2021 to December 2021 was done. Medical records of 10,85,81 patients both new and reviewed, 79,562 newly registered patients and 29,019 review patient’s from15 Vision centers were included for data analysis. All the patients registered at the vision center underwent basic eye examination, including visual acuity, IOP measurement, Slit-lamp examination, retinoscopy, Fundus examination etc. Results: A total of 1,08,581 patients were included in the study. Of the total 1,08,581 patients, 79,562 were newly registered patients at Vision center and 29,019 were review patients. Males were 52,201(48.1%) and Females were 56,308(51.9) among them. The mean age of all examined patients was 41.03 ± 20.9 years (Standard deviation) and ranged from 01 – 113 years. Presenting mean visual acuity was 0.31 ± 0.5 in the right eye and 0.31 ± 0.4 in the left eye. Of the 1,08,581 patients 22,770 patients had refractive error in right eye and 22,721 patients had uncorrected refractive error in left eye. Glass prescription was given to 17,178 (15.8%) patients. 8,109 (7.5%) patients were referred to the base hospital for specialty clinic expert opinion or for cataract surgery. Conclusion: Vision center utilizing teleconsultation for comprehensive eye screening unit is a very effective tool in reducing the avoidable visual impairment caused due to uncorrected refractive error. Vision Centre model is believed to be efficient as it facilitates early detection and management of uncorrected refractive errors.

Keywords: refractive error, uncorrected refractive error, vision center, vision technician, teleconsultation

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Authors: T. A. Rosy, M. R. I. Talukdar, N. S. Juyena, F. Y. Bari, M. N. Islam

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The ovarian follicular dynamics, vaginal electrical resistance (VER) and progesterone (P4) and estrogen (E2) profiles were investigated during estrus cycle in four indigenous ewes. Daily VER values were recorded with heat detector. The follicles were observed and measured by trans-rectal ultrasonography. Blood was collected daily for hormonal profiles. Results showed a significant variation in VER values (P<0.05) at estrus in regards to ewes and cycles. The day difference between two successive lower values in VER waves ranged from 13-17 days which might indicate the estrus cycle in indigenous ewes. Trans-rectal ultrasonography of ovaries revealed the presence of two to four waves of follicular growth during the study period. Results also showed that follicular diameter was negatively correlated with VER values. Study of hormonal profiles by ELISA revealed a positive correlation between E2 concentration and development of follicle and negative correlation between P4 concentration and development of follicle. The concentrations of estradiol increased at the time of estrus and then fall down in a basal level. Development of follicular size was accompanied by an increase in the concentration of serum estradiol. Inversely, when follicles heed to ovulation concentration of progesterone starts to fall down and after ovulation it turns its way to the zenith and remains at this state until next ovulatory follicle comes to its maximum diameter. This study could help scientists to set up a manipulative reproductive technique for improving genetic values of sheep in Bangladesh.

Keywords: ovarian follicle, hormonal profile, sheep, ultrasonography, vaginal electrical resistance

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Authors: Emmanuel Chibuogu Asogwa, Tochukwu Sunday Belonwu

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An urgent demand for creative solutions has been created by the rapid expansion of medical knowledge, the complexity of patient care, and the requirement for more precise decision-making. As a solution to this problem, the creation of a Medical Intelligent Process Model (MIPM) utilizing ontology-based appears as a promising way to overcome this obstacle and unleash the full potential of healthcare systems. The development of a Medical Intelligent Process Model (MIPM) using ontology-based techniques is motivated by a lack of quick access to relevant medical information and advanced tools for treatment planning and clinical decision-making, which ontology-based techniques can provide. The aim of this work is to develop a structured and knowledge-driven framework that leverages ontology, a formal representation of domain knowledge, to enhance various aspects of healthcare. Object-Oriented Analysis and Design Methodology (OOADM) were adopted in the design of the system as we desired to build a usable and evolvable application. For effective implementation of this work, we used the following materials/methods/tools: the medical dataset for the test of our model in this work was obtained from Kaggle. The ontology-based technique was used with Confusion Matrix, MySQL, Python, Hypertext Markup Language (HTML), Hypertext Preprocessor (PHP), Cascaded Style Sheet (CSS), JavaScript, Dreamweaver, and Fireworks. According to test results on the new system using Confusion Matrix, both the accuracy and overall effectiveness of the medical intelligent process significantly improved by 20% compared to the previous system. Therefore, using the model is recommended for healthcare professionals.

Keywords: ontology-based, model, database, OOADM, healthcare

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Authors: A. Golshani, M. Gharizade Varnusefaderani, S. Majidian

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Underground structures are of those structures that have uncertainty in design procedures. That is due to the complexity of soil condition around. Under passing tunnels are also such affected structures. Despite geotechnical site investigations, lots of uncertainties exist in soil properties due to unknown events. As results, it possibly causes conflicting settlements in numerical analysis with recorded values in the project. This paper aims to report a case study on a specific under passing tunnel constructed by New Austrian Tunnelling Method in Iran. The intended tunnel has an overburden of about 11.3m, the height of 12.2m and, the width of 14.4m with 2.5 traffic lane. The numerical modeling was developed by a 2D finite element program (PLAXIS Version 8). Comparing displacement histories at the ground surface during the entire installation of initial lining, the estimated surface settlement was about four times the field recorded one, which indicates that some local unknown events affect that value. Also, the displacement ratios were in a big difference between the numerical and field data. Consequently, running several numerical back analyses using laboratory and field tests data, the geotechnical parameters were accurately revised to match with the obtained monitoring data. Finally, it was found that usually the values of soil parameters are conservatively low-estimated up to 40 percent by typical engineering judgment. Additionally, it could be attributed to inappropriate constitutive models applied for the specific soil condition.

Keywords: NATM, surface displacement history, numerical back-analysis, geotechnical parameters

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Authors: Aylin Mohammadalipour Tofighi

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Marine-based geoengineering methods, proposed to mitigate climate change, operate primarily through two mechanisms: reducing atmospheric carbon dioxide levels and diminishing solar absorption by the oceans. While these approaches promise beneficial outcomes, they are fraught with environmental, legal, ethical, and political challenges, necessitating robust international governance. This paper underscores the critical role of international cooperation within the governance framework, offering a focused analysis of existing international environmental mechanisms applicable to marine-based geoengineering governance. It evaluates the efficacy and limitations of current international legal structures, including treaties and organizations, in managing marine-based geoengineering, noting significant gaps such as the absence of specific regulations, dedicated international entities, and explicit governance mechanisms such as monitoring. To rectify these problems, the paper advocates for concrete steps to bolster international cooperation. These include the formulation of dedicated marine-based geoengineering guidelines within international agreements, the establishment of specialized supervisory entities, and the promotion of transparent, global consensus-building. These recommendations aim to foster governance that is environmentally sustainable, ethically sound, and politically feasible, thereby enhancing knowledge exchange, spurring innovation, and advancing the development of marine-based geoengineering approaches. This study emphasizes the importance of collaborative approaches in managing the complexities of marine-based geoengineering, contributing significantly to the discourse on international environmental governance in the face of rapid climate and technological changes.

Keywords: climate change, environmental law, international cooperation, international governance, international law, marine-based geoengineering, marine law, regulatory frameworks

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Authors: Arundhuti Devi, Gitumani Devi, Krishna G. Bhattacharyya

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The goal of this study was to assess the characteristics of the airborne dust created by opencast coal mining and its relation to population hospitalization risk for skin and lung diseases in Margherita Coalfield, Assam, India. Air samples were collected for 24 h in three 8-h periods. For the collection of particulate matter (PM10) and total suspended particulate matter (SPM) samples, respiratory dust samplers with glass microfiber filter papers were used. PM10 was analyzed for Cu, Cd, Cr, Mn, Zn, Ni, Fe and Pb with Flame Atomic Absorption Spectrophotometer (FAAS). SPM and PM10 concentrations were respectively found to be as high as 1,035 and 265.85 μg/m³ in work zone air. The concentration of metals associated with PM10 showed values higher than the permissible limits. It was observed that the average concentrations of the metals Fe, Pb, Ni, Zn, and Cu were very high during the winter month of December, those of Cd and Cr were high during the month of May and Mn was high during February. The morphology of the particles studied with scanning electron microscopy (SEM) gave significant results. Due to opencast coal mining, the air in the work zone, as well as the general ambient air, was found to be highly polluted with respect to dust. More than 8000 patient records maintained by the hospital authority were collected from three hospitals in the area. The highest percentage of people suffering from lung diseases are found in Margherita Civil Hospital (~26.77%) whereas most people suffering from skin diseases reported for treatment in the ESIC hospital (47.47%). Both PM10 and SPM were alarmingly high, and the results were in conformity with the high incidence of lung and other respiratory diseases in the study area.

Keywords: heavy metals, open cast coal mining, PM10, respiratory diseases

Procedia PDF Downloads 302

Authors: Chun-Yuan Chen, Ming-Chang Li, Xiu-Hui Wen, Yi-Ching Tu

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The objective of this study explores GPS (Global Positioning System) applied to trace construction vehicles such as trucks or cranes, help to pattern the earth-dumping stations of traffic construction in Taiwan. Traffic construction in this research is defined as the engineering of high-speed railways, expressways, and which that distance more than kilometers. Audit the location and check the compliance with regulations of earth-dumping stations is one of important tasks in Taiwan EPA. Basically, the earth-dumping station was known as one source of particulate matter from air pollution during construction process. Due to GPS data can be analyzed quickly and be used conveniently, this study tried to find out dumping stations by modeling vehicles tracks from GPS data during work cycle of construction. The GPS data updated from 13 vehicles related to an expressway construction in central Taiwan. The GPS footprints were retrieved to Keyhole Markup Language (KML) files so that can pattern the tracks of trucks by computer applications, the data was collected about eight months- from Feb. to Oct. in 2017. The results of GPS footprints identified dumping station and outlined the areas of earthwork had been passed to the Taiwan EPA for on-site inspection. Taiwan EPA had issued advice comments to the agency which was in charge of the construction to prevent the air pollution. According to the result of this study compared to the commonly methods in inspecting environment by manual collection, the GPS with KML patterning and modeling method can consumes less time. On the other hand, through monitoring the GPS data from construction vehicles could be useful for administration to development and implementation of strategies in environmental management.

Keywords: automatic management, earth-dumping station, environmental management, Global Positioning System (GPS), particulate matter, traffic construction

Procedia PDF Downloads 157

Authors: Shu-Pin Huang, Pai-Chi Teng, Hao-Han Chang, Chia-Hsin Liu, Yung-Lun Lin, Shu-Chi Wang, Hsin-Chih Yeh, Chih-Pin Chuu, Jiun-Hung Geng, Li-Hsin Chang, Wei-Chung Cheng, Chia-Yang Li

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The emergence of immune checkpoint inhibitors (ICIs) targeting proteins like PD-1 and PD-L1 has changed the treatment paradigm of bladder cancer. However, not all patients benefit from ICIs, with some experiencing early death. There's a significant need for biomarkers associated with the PD-1 pathway in bladder cancer. Current biomarkers focus on tumor PD-L1 expression, but a more comprehensive understanding of PD-1-related biology is needed. Our study has developed a seven-gene risk score panel, employing a comprehensive bioinformatics strategy, which could serve as a potential prognostic and predictive biomarker for bladder cancer. This panel incorporates the FYN, GRAP2, TRIB3, MAP3K8, AKT3, CD274, and CD80 genes. Additionally, we examined the relationship between this panel and immune cell function, utilizing validated tools such as ESTIMATE, TIDE, and CIBERSORT. Our seven-genes panel has been found to be significantly associated with bladder cancer survival in two independent cohorts. The panel was also significantly correlated with tumor infiltration lymphocytes, immune scores, and tumor purity. These factors have been previously reported to have clinical implications on ICIs. The findings suggest the potential of a PD-1 pathway-based transcriptomic panel as a prognostic and predictive biomarker in bladder cancer, which could help optimize treatment strategies and improve patient outcomes.

Keywords: bladder cancer, programmed cell death protein 1, prognostic biomarker, immune checkpoint inhibitors, predictive biomarker

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Authors: Q. Rzina, M. Lahrouni, S. Rida, N. Saadaoui, Y. Almossaid, K. Oufdou, K. Fares

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Many organic solid wastes are produced in the world. Poultry manure (PM), municipal organic wastes (MOW) and sugar beet lime sludge (LS) are produced in large quantities in Morocco. The co-composting of these organic wastes was investigated. The recycling and the valorization of such wastes is environmentally and economically beneficial especially for PM which is known source of bacterial pathogens. The aerobic biodegradation process was carried out by using three windrows of variable compositions: C1 prepared without LS (only MOW were composted with PM), C2 prepared from MOW plus PM and10% LS; and the last one C3 from MOW plus PM and 20% LS. The main process physico-chemical parameters (temperature, pH, humidity and C/N) and microbiological populations (mesophilic and thermophilic flora, total coliform, fecal coliform, Streptococci, Staphylococcus aureus and mesophilic fungi) were monitored over three months to ascertain the compost maturity and to ensure the compost hygienic aspect. The final products were characterized by their relatively high organic matter content, and low C/N ratio of 10.6-10.9. The organic matter degradation was reached approximately 59% for C2 and C3. In addition, the monitoring of the microbial population showed that the produced composts are mature and hygienic. The agronomic valorization of the final composts was tested on radish plant with tree level of composts and poultry manure without composting. The primary results of field trial showed a growth of radish plant biomass and root development without any phytotoxicity detected which reflects the quality of the composts produced. As for poultry manure it allowed to have a better results than other composts because of its readily available nitrogen.

Keywords: compost, municipal organic wastes, poultry manure, radish crop, sugar beet lime sludge

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Authors: Samuel Nderitu Muchiri, Tracy Wangechi Maina

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Truck drivers face a myriad of challenges in their profession. Enhancements in logistics effectiveness can be pivotal in propelling economic developments. The specific objective of the study was to assess the influence of driver distraction on crash risk. The study is significant as it elucidates best practices that truck drivers can embrace in an effort to enhance road safety. These include amalgamating behaviors that enable drivers to fruitfully execute multifaceted functions such as finding and following routes, evading collisions, monitoring speed, adhering to road regulations, and evaluating vehicle systems’ conditions. The analysis involved an empirical review of ten previous studies related to the research topic. The articles revealed that driver distraction plays a substantial role in road accidents and other crucial road security incidents across the globe. Africa depends immensely on the freight transport sector to facilitate supply chain operations. Several studies indicate that drivers who operate primarily on rural roads, such as those found in Sub-Saharan Africa, have an increased propensity to engage in distracted activities such as cell phone usage while driving. The findings also identified the need for digitalization in truck driving operations, including carrier management techniques such as fatigue management, artificial intelligence, and automating functions like cell phone usage controls. The recommendations can aid policymakers and commercial truck carriers in deepening their understanding of driver distraction and enforcing mitigations to foster road safety.

Keywords: truck drivers, distraction, digitalization, crash risk, road safety

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