Search results for: patient safety

Authors: Basavaraj R. Endigeri, S. G. Sarganachari

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Steel is widely used in machine parts, structural equipment and many other applications. In many steel structural elements, holes of different shapes and orientations are made with a view to satisfy the design requirements. The presence of holes in steel elements creates stress concentration, which eventually reduce the mechanical strength of the structure. Therefore, it is of great importance to investigate the state of stress around the holes for the safety and properties design of such elements. By literature survey, it is known that till date, there is no analytical solution to reduce the stress concentration by providing auxiliary holes at a definite location and radii in a steel plate. The numerical method can be used to determine the optimum location and radii of auxiliary holes. In the present work plate with an elliptical hole, for a steel material subjected to uniaxial load is analyzed and the effect of stress concentration is graphically represented .The introduction of auxiliary holes at a optimum location and radii with its effect on stress concentration is also represented graphically. The finite element analysis package ANSYS 11.0 is used to analyse the steel plate. The analysis is carried out using a plane 42 element. Further the ANSYS optimization model is used to determine the location and radii for optimum values of auxiliary hole to reduce stress concentration. All the results for different diameter to plate width ratio are presented graphically. The results of this study are in the form of the graphs for determining the locations and diameter of optimal auxiliary holes. The graph of stress concentration v/s central hole diameter to plate width ratio. The Finite Elements results of the study indicates that the stress concentration effect of central elliptical hole in an uniaxial loaded plate can be reduced by introducing auxiliary holes on either side of the central circular hole.

Keywords: finite element method, optimization, stress concentration factor, auxiliary holes

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Authors: Diana Peninger

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Over 10% of couples in the U.S. have infertility problems, with roughly 40% traceable to the male partner. Yet, little attention has been given to improving men’s contribution to the conception process. One solution that is showing promise in increasing conception rates for IVF and other assisted reproductive technology treatments is a first-of-its-kind semen collection that has been engineered to mitigate sperm damage caused by traditional collection methods. Patients are able to collect semen at home and deliver to clinics within 48 hours for use in fertility analysis and treatment, with less stress and improved specimen viability. This abstract will share these findings along with expert insight and tips to help attendees understand the key role sperm collection plays in addressing and treating reproductive issues, while helping to improve patient outcomes and success. Our research was to determine if male reproductive outcomes can be increased by improving sperm specimen health with a focus on technology. We utilized a redesigned semen collection cup (patented as the Device for Improved Semen Collection/DISC—U.S. Patent 6864046 – known commercially as a ProteX) that met a series of physiological parameters. Previous research demonstrated significant improvement in semen perimeters (motility forward, progression, viability, and longevity) and overall sperm biochemistry when the DISC is used for collection. Animal studies have also shown dramatic increases in pregnancy rates. Our current study compares samples collected in the DISC, next-generation DISC (DISCng), and a standard specimen cup (SSC), dry, with the 1 mL measured amount of media and media in excess ( 5mL). Both human and animal testing will be included. With sperm counts declining at alarming rates due to environmental, lifestyle, and other health factors, accurate evaluations of sperm health are critical to understanding reproductive health, origins, and treatments of infertility. An increase in the health of the sperm as measured by extensive semen parameter analysis and improved semen parameters stable for 48 hours, expanding the processing time from 1 hour to 48 hours were also demonstrated.

Keywords: reprodutive, sperm, male, infertility

Procedia PDF Downloads 105

Authors: Luna Degife, Desalegn Belay, Yoseph Worku, Tigist Tesfaye, Assefa Tufa, Abyot Bekele, Zegeye Hailemariam, Abay Hagos

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Half of the world’s population is at risk of Dengue Fever (DF), a highly under-recognized and underreported mosquito-borne viral disease with high prevalence in the tropical and subtropical regions. Globally, an estimated 50 to 200 million cases and 20, 000 DF deaths occur annually as per the world health organization report. In Ethiopia, the first outbreak occurred in 2013 in Diredawa administration city. Afterward, three outbreaks have been reported from the eastern part of the country. We received a report of the fifth DF outbreak for Ethiopia and the second for Diredawa city on October 4, 2015. We conducted the investigation to confirm the outbreak, identify the risk factors for the repeatedly occurrence of the disease and implement control measures. We conducted un- matched case-control study and defined a suspected DF case as any person with fever of 2-7 days and 2 or more of the following: a headache, arthralgia, myalgia, rash, or bleeding from any part of the body. Controls were residents of Diredawa city without DF symptoms. We interviewed 70 Cases and 140 controls from all health facilities in Diredawa city from October 7 to 15; 2015. Epi Info version 7.1.5.0 was used to analyze the data and multivariable logistic regression was conducted to assess risk factors for DF. Sixty-nine blood samples were collected for Laboratory confirmation.The mean age for cases was 23.7±9.5 standard deviation (SD) and for controls 31.2±13 SD. Close contact with DF patient (Adjusted odds ratio (AOR)=5.36, 95% confidence interval(CI): 2.75-10.44), nonuse of long-lasting insecticidal nets (AOR=2.74, 95% CI: 1.06-7.08) and availability of stagnant water in the village (AOR=3.61, 95% CI:1.31-9.93) were independent risk factors associated with higher rates of the disease. Forty-two samples were tested positive. Endemicity of DF is becoming a concern for Diredawa city after the first outbreak. Therefore, effective vector control activities need to be part of long-term preventive measures.

Keywords: dengue fever, Diredawa, outbreak, risk factors, second

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Authors: Zakieh Rostamzadeh, Zahra Shirmohammadi

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Human cytomegalovirus is a species of the cytomegalovirus family of viruses, which in turn is a member of the viral family known as herpesviridae or herpesviruses. Although they may be found throughout the body, HCMV infections are frequently associated with the salivary glands. HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised such as HIV-infected persons, organ transplant recipients, or newborn infants. After infection, HCMV has an ability to remain latent within the body over long periods. Cytomegalovirus (CMV) causes infection in immunocompromised, hemophilia patients and those who received blood transfusion frequently. This study aimed at determining the prevalence of cytomegalovirus (CMV) antibodies in hemophilia patients. Materials and Methods: A retrospective observational study was carried out in Urmia, North West of Iran. The study population comprised a sample of 50 hemophilic patients born after 1985 and have received blood factors in West Azerbaijan. The exclusion criteria include: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling. All samples were evaluated with the method of ELISA, with a certain kind of kit and by a certain laboratory. Results: Fifty hemophiliacs from 250 patients registered with Urmia Hemophilia Society were enrolled in the study including 43 (86%) male, and 7 (14%) female. The mean age of patients was 10.3 years, range 3 to 25 years. None of patients had risk factors mentioned above. Among our studied population, 34(68%) had hemophilia A, 1 (2%) hemophilia B, 8 (16%) VWF, 3(6%) factor VII deficiency, 1 (2%) factor V deficiency, 1 (2%) factor X deficiency, 1 (2%). Sera of 50 Hemodialysis patients were investigated for CMV-specific immunoglobulin G (IgG) and IgM. % 91.89 patients were anti-CMV IgG positive and %40.54 was seropositive for anti-CMV IgM. 37.8% patient had serological evidence of reactivation and 2.7% of patients had the primary infection. Discussion: There was no relationship between the antibody titer and: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling.

Keywords: bioinformatics, biomedicine, cytomegalovirus, immunocompromise

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Authors: Selim M. Khan, Aaron A. Goodarzi, Joshua M. Taron, Tryggve Rönnqvist

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Indoor air quality, a prime determinant of health, is strongly influenced by the presence of hazardous radon gas within the built environment. As a health issue, dangerously high indoor radon arose within the 20th century to become the 2nd leading cause of lung cancer. While the 21st century building metrics and human behaviors have captured, contained, and concentrated radon to yet higher and more hazardous levels, the issue is rapidly worsening in Canada. It is established that Canadians in the Prairies are the 2nd highest radon-exposed population in the world, with 1 in 6 residences experiencing 0.2-6.5 millisieverts (mSv) radiation per week, whereas the Canadian Nuclear Safety Commission sets maximum 5-year occupational limits for atomic workplace exposure at only 20 mSv. This situation is also deteriorating over time within newer housing stocks containing higher levels of radon. Deep machine learning (LSTM) algorithms were applied to analyze multiple quantitative and qualitative features, determine the most important contributory factors, and predicted radon levels in the known past (1990-2020) and projected future (2021-2050). The findings showed gradual downwards patterns in Sweden, whereas it would continue to go from high to higher levels in Canada over time. The contributory factors found to be the basement porosity, roof insulation depthness, R-factor, and air dynamics of the indoor environment related to human window opening behaviour. Building codes must consider including these factors to ensure adequate indoor ventilation and healthy living that can prevent lung cancer in non-smokers.

Keywords: radon, building metrics, deep learning, LSTM prediction model, lung cancer, canada, sweden

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Authors: Ghadeer Mohammad Said El-Sheikh, Samer Mohamad Shalhoob

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Medical equipment operation state is a valid reflection of health care organizations' performance, where such equipment highly contributes to the quality of healthcare services on several levels in which quality improvement has become an intrinsic part of the discourse and activities of health care services. In healthcare organizations, clinical and biomedical engineering departments play an essential role in maintaining the safety and efficiency of such equipment. One of the most challenging topics when it comes to such sophisticated equipment is the lifespan of medical equipment, where many factors will impact such characteristics of medical equipment through its life cycle. So far, many attempts have been made in order to address this issue where most of the approaches are kind of arbitrary approaches and one of the criticisms of existing approaches trying to estimate and understand the lifetime of a medical equipment lies under the inquiry of what are the environmental factors that can play into such a critical characteristic of a medical equipment. In an attempt to address this shortcoming, the purpose of our study rises where in addition to the standard technical factors taken into consideration through the decision-making process by a clinical engineer in case of medical equipment failure, the dimension of environmental factors shall be added. The investigations, researches and studies applied for the purpose of supporting the decision making process by a clinical engineers and assessing the lifespan of healthcare equipment’s in the Lebanese society was highly dependent on the identification of technical criteria’s that impacts the lifespan of a medical equipment where the affecting environmental factors didn’t receive the proper attention. The objective of our study is based on the need for introducing a new well-designed plan for evaluating medical equipment depending on two dimensions. According to this approach, the equipment that should be replaced or repaired will be classified based on a systematic method taking into account two essential criteria; the standard identified technical criteria and the added environmental criteria.

Keywords: technical, environmental, healthcare, characteristic of medical equipment

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Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

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Authors: Erwin Geroleo, Higinio Mappala

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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.

Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy

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Authors: Benjamin Osei-Tutu, Henrietta Awewole Kolson

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Background: Acute gastroenteritis is one of the frequently reported Out-Patient Department (OPD) cases. However, the causative pathogens of these cases are rarely identified at the OPD due to delay in laboratory results or failure to obtain specimens before antibiotics is administered. Method: A retrospective review of surveillance data from the Adentan Municipality, Accra, Ghana that were recorded in the National foodborne disease surveillance system of Ghana, was conducted with the main aim of describing the epidemiology and food practice of cases reported from the Adentan Municipality. The study involved a retrospective review of surveillance data kept on patients who visited health facilities that are involved in foodborne disease surveillance in Ghana, from January 2015 to December 2016. Results: A total of 375 cases were reviewed and these were classified as viral hepatitis (hepatitis A and E), cholera (Vibrio cholerae), dysentery (Shigella sp.), typhoid fever (Salmonella sp.) or gastroenteritis. Cases recorded were all suspected case and the average cases recorded per week was 3. Typhoid fever and dysentery were the two main clinically diagnosed foodborne illnesses. The highest number of cases were observed during the late dry season (Feb to April), which marks the end of the dry season and the beginning of the rainy season. Relatively high number of cases was also observed during the late wet seasons (Jul to Oct) when the rainfall is the heaviest. Home-made food and street vended food were the major sources of suspected etiological food, recording 49.01% and 34.87% of the cases respectively. Conclusion: Majority of cases recorded were classified as gastroenteritis due to the absence of laboratory confirmation. Few cases were classified as typhoid fever and dysentery based on clinical symptoms presented. Patients reporting with foodborne diseases were found to consume home meal and street vended foods as their predominant source of food.

Keywords: accra, etiologic food, food poisoning, gastroenteritis, illness, surveillance

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Authors: Weaam Aldeeban, Majd Aljamali, Lama A. Youssef

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Background & Objective: Warfarin is considered a problematic drug due to its narrow therapeutic window and wide inter-individual response variations, which are attributed to demographic, environmental, and genetic factors, particularly single nucleotide polymorphism (SNPs) in the genes encoding VKORC1 and CYP2C9 involved in warfarin's mechanism of action and metabolism, respectively. CYP2C9*2rs1799853 and CYP2C9*3rs1057910 alleles are linked to reduced enzyme activity, as carriers of either or both alleles are classified as moderate or slow metabolizers, and therefore exhibit higher sensitivity of warfarin compared with wild type (CYP2C9*1*1). Our study aimed to assess the frequency of *1, *2, and *3 alleles in the CYP2C9 gene in a cohort of Syrian patients receiving a maintenance dose of warfarin for different indications, the impact of genotypes on warfarin dosing, and the frequency of adverse effects (i.e., bleedings). Subjects & Methods: This retrospective cohort study encompassed 94 patients treated with warfarin. Patients’ genotypes were identified by sequencing the polymerase chain reaction (PCR) specific products of the gene encoding CYP2C9, and the effects on warfarin therapeutic outcomes were investigated. Results: Sequencing revealed that 43.6% of the study population has the *2 and/or *3 SNPs. The mean weekly maintenance dose of warfarin was 37.42 ± 15.5 mg for patients with the wild-type allele (CYP2C9*1*1), whereas patients with one or both variants (*2 and/or *3) demanded a significantly lower dose (28.59 ±11.58 mg) of warfarin, (P= 0.015). A higher percentage (40.7%) of patients with allele *2 and/or *3 experienced hemorrhagic accidents compared with only 17.9% of patients with the wild type *1*1, (P = 0.04). Conclusions: Our study proves an association between *2 and *3 genotypes and higher sensitivity to warfarin and a tendency to bleed, which necessitates lowering the dose. These findings emphasize the significance of CYP2C9 genotyping prior to commencing warfarin therapy in order to achieve optimal and faster dose control and to ensure effectiveness and safety.

Keywords: warfarin, CYP2C9, polymorphisms, Syrian, hemorrhage

Procedia PDF Downloads 127

Authors: Omer Yeni

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Ground strata failure or fall-of-ground is one of the underground mines' most prominent catastrophic risks. Mining companies use various methods/technics to prevent and critically control the associated risks. Some of those are safety by design, excavation methods, ground support, training, and competency, which all require quality control and assurance activities to confirm their efficiencies and performances and identify improvement opportunities through monitoring. However, many mining companies use quality control (QC) methods without quality assurance (QA), and they call it QA/QC together as a habit. From a simple definition, QC is a method of detecting defects, and QA is a method of preventing defects. Testing the final products at the end of the production line is not the way of proper QA/QC application but testing every component before assembly and the final product once completed. The installed ground support elements are some final products mining companies use to prevent ground strata failure. Testing the final product (i.e., rock bolt pull testing, shotcrete strength test, etc.) with QC methods only while those areas are already accessible; is not like testing an airplane full of passengers right after the production line or testing a car after the sale. Can only QC methods be called QA/QC? Can QA/QC activities be numerically scored for each critical control implemented to assess ground strata failure potential? Can numerical scores be used to identify Geotechnical Risk Rating (GRR) to determine the ground strata failure risk and its probability? This paper sets out to provide a specific QA/QC methodology to manage and confirm efficiencies and performances of the implemented critical controls and a numerical approach through the Geotechnical Risk Rating (GRR) process to assess ground strata failure risk to determine the gaps where proactive action is required to evaluate the probability of ground strata failures in underground mines.

Keywords: fall of ground, ground strata failure, QA/QC, underground

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Authors: David Lloyd, David Owen, Martin Jardine

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Introduction: European weight regulations with respect to food products require a full understanding of regulation guidelines to assure regulatory compliance. It is suggested that the complexity of regulation leads to practices which result to over filling of food packages by food processors. Purpose: To establish current practices by food processors and the financial, sustainable and societal impacts on the food supply chain of ineffective food production practices. Methods: An analysis of food packing controls with 10 companies of varying food categories and quantitative based research of a further 15 food processes on the confidence in weight control analysis of finished food packs within their organisation. Results: A process floor analysis of manufacturing operations focussing on 10 products found over fill of packages ranging from 4.8% to 20.2%. Standard deviation figures for all products showed a potential for reducing average weight of the pack whilst still retain the legal status of the product. In 20% of cases, an automatic weight analysis machine was in situ however weight packs were still significantly overweight. Collateral impacts noted included the effect of overfill on raw material purchase and added food miles often on a global basis with one raw material alone creating 10,000 extra food miles due to the poor weight control of the processing unit. A case study of a meat and bakery product will be discussed with the impact of poor controls resulting from complex legislation. The case studies will highlight extra energy costs in production and the impact of the extra weight on fuel usage. If successful a risk assessment model used primarily on food safety but adapted to identify waste /sustainability risks will be discussed within the presentation.

Keywords: legislation, overfill, profile, waste

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Authors: Hye Jin Choi, Mirim Jin, Jeong June Choi

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Green tea, which is one of the most popular of tea, contains various ingredients that help health. Epigallocatechin gallate (EGCG) is one of the main active polyphenolic compound possessing diverse biologically beneficial effects such as anti-oxidation, anti-cancer founding in green tea. This study was performed to investigate the anti-diabetic effect of high-purity EGCG ( > 98%) in a spontaneous diabetic mellitus animal model, db/db mouse. Four-week-old male db/db mice, which was induced to diabetic mellitus by the high-fat diet, were orally administered with high-purity EGCG (10, 50 and 100 mg/kg) for 4 weeks. Daily weight and diet efficiency were examined, and blood glucose level was assessed once a week. After 4 weeks of EGCG administration, fasting blood glucose level was measured. Then, the mice were sacrificed and total abdominal fat was sampled to examine the change in fat weight. Plasma was separated from the blood and the levels of aspartate amino-transferase (ALT) and alanine amino-transferase (AST) were investigated. As results, blood glucose and body weight were significantly decreased by EGCG treatment compared to the control group. Also, the amount of abdominal fat was down-regulated by EGCG. However, ALT and AST levels, which are indicators of liver function, were similar to those of control group. Taken together, our study suggests that high purity EGCG is capable of treating diabetes mellitus based in db / db mice with safety and has a potent to develop a therapeutics for metabolic disorders. This work was supported by Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry (IPET) through High Value-added Food Technology Development Program, funded by Ministry of Agriculture, Food and Rural Affairs (MAFRA) (317034-03-2-HD030)

Keywords: anti-diabetic effect, db/db mouse, diabetes mellitus, green tea, epigallocatechin gallate

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Authors: Di Luo, Maria Buchberger, Anja Pickhard

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Objectives: The purpose of this study was to assess and compare the diagnostic accuracy of four common morphological approaches, including sonography, computed tomography (CT), positron emission tomography/computed tomography (PET/CT), and magnetic resonance imaging (MRI) for the evaluation of cervical lymph node metastases in head and neck squamous cell carcinoma (HNSCC) patients. Material and Methods: Included in this retrospective study were 26 patients diagnosed with HNSCC between 2010 and 2011 who all underwent sonography, CT, PET/CT, and MRI imaging before neck dissection. Morphological data were compared to the corresponding histopathological results. Statistical analysis was performed with SPSS statistic software (version 26.0), calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of cervical lymph node metastases. Results: The 5-year survival rate of the patient collective was 55.5%.Risk factors for survival included initial primary tumor stage, initial lymph node stage, initial metastasis status, and therapeutic approaches. Cox regression showed initial metastasis status(HR 8.671, 95%CI 1.316-57.123, p=0.025) and therapeutic approaches(HR 6.699, 95%CI 1.746-25.700, p=0.006)to be independent predictive risk factors for survival. Sensitivity was highest for MRI (96% compared to 85% for sonography and 89% for CT and PET/CT). Specificity was comparable with 95 % for CT and 98 % for sonography and PET/CT, but only 68% for MRI. While the MRI showed the least PPV (34%) compared to all other methods (85% for sonography,75% for CT, and 86% for PET/CT), the NPV was comparable in all methods(98-99%). The overall accuracy of cervical lymph node metastases detection was comparable for sonography, CT, and PET/CT with 96%,97%,94%, respectively, while MRI had only 72% accuracy. Conclusion: Since the initial status of metastasis is an independent predictive risk factor for patients’ survival, efficient detection is crucial to plan adequate therapeutic approaches. Sonography, CT, and PET/CT have better diagnostic accuracy than MRI for the evaluation of cervical lymph node metastases in HNSCC patients.

Keywords: cervical lymph node metastases, diagnostic accuracy, head and neck squamous carcinoma, risk factors, survival

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Authors: Sara Cumming, Julianne DiSanto, Leah Burton

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Homelessness in Canada is a persistent problem. It has been widely argued that the best tactic for eradicating homelessness is to approach social issues from a Housing First perspective—an approach that centers on quickly moving people into permanent and independent housing and then providing them additional support and services as needed. It is recognized that life skills training is both necessary and an effective way to reduce cyclical homelessness; however, there is a scarcity of research on effective ways to teach life skills; this problem was exacerbated in a pandemic context, where in-person delivery was severely restricted or no longer possible. Very little attention has been paid to the diverse cultural needs of clients in a multicultural context and the need to foster cultural knowledge/awareness in individuals to successfully contribute to the cultural safety of communities. This research attempts to fill these gaps in the literature and in practice by employing a community-engaged research (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, equity, diversity, and inclusion (EDI) informed life skill learning management system. We employed a triangulation methodology for this research. An environmental scan was conducted for best practices. Two separate Creative Problem Solving Sessions were held with over 100 front-line workers, managers, and executive directors who work with homeless populations. Quantitative and open-ended surveys were completed by over 200 individuals with experience with homelessness. All sections of this research aimed to discover the areas of skills that individuals need to maintain housing and to ascertain what a more client-driven EDI approach to life skills training should include. This research will showcase which life skills are deemed essential for homeless and precariously housed individuals.

Keywords: homelessness, Housing First, life skills, community engaged research

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Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

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Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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Authors: Umit Cali

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The integration of intermittent energy sources like wind farms into the electricity grid has become an important challenge for the utilization and control of electric power systems, because of the fluctuating behaviour of wind power generation. Wind power predictions improve the economic and technical integration of large amounts of wind energy into the existing electricity grid. Trading, balancing, grid operation, controllability and safety issues increase the importance of predicting power output from wind power operators. Therefore, wind power forecasting systems have to be integrated into the monitoring and control systems of the transmission system operator (TSO) and wind farm operators/traders. The wind forecasts are relatively precise for the time period of only a few hours, and, therefore, relevant with regard to Spot and Intraday markets. In this work predictive data mining techniques are applied to identify a statistical and neural network model or set of models that can be used to predict wind power output of large onshore and offshore wind farms. These advanced data analytic methods helps us to amalgamate the information in very large meteorological, oceanographic and SCADA data sets into useful information and manageable systems. Accurate wind power forecasts are beneficial for wind plant operators, utility operators, and utility customers. An accurate forecast allows grid operators to schedule economically efficient generation to meet the demand of electrical customers. This study is also dedicated to an in-depth consideration of issues such as the comparison of day ahead and the short-term wind power forecasting results, determination of the accuracy of the wind power prediction and the evaluation of the energy economic and technical benefits of wind power forecasting.

Keywords: renewable energy sources, wind power, forecasting, data mining, big data, artificial intelligence, energy economics, power trading, power grids

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Authors: Wadha Alqahtani

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In recent times, polymers have seen a great surge in interest in the field of medicine, particularly chemotherapeutics. One recent innovation is the conversion of polymeric materials into “polymeric nanoparticles”. These nanoparticles can be designed and modified to encapsulate and transport drugs selectively to cancer cells, minimizing collateral damage to surrounding healthy tissues, and improve patient quality of life. In this study, we have synthesized pseudo-branched polyester polymers from bio-based small molecules, including sorbitol, glutaric acid and a propargylic acid derivative to further modify the polymer to make it “click-able" with an azide-modified target ligand. Melt polymerization technique was used for this polymerization reaction, using lipase enzyme catalyst NOVO 435. This reaction was conducted between 90- 95 °C for 72 hours. The polymer samples were collected in 24-hour increments for characterization and to monitor reaction progress. The resulting polymer was purified with the help of methanol dissolving and filtering with filter paper then characterized via NMR, GPC, FTIR, DSC, TGA and MALDI-TOF. Following characterization, these polymers were converted to a polymeric nanoparticle drug delivery system using solvent diffusion method, wherein DiI optical dye and chemotherapeutic drug Taxol can be encapsulated simultaneously. The efficacy of the nanoparticle’s apoptotic effects were analyzed in-vitro by incubation with prostate cancer (LNCaP) and healthy (CHO) cells. MTT assays and fluorescence microscopy were used to assess the cellular uptake and viability of the cells after 24 hours at 37 °C and 5% CO2 atmosphere. Results of the assays and fluorescence imaging confirmed that the nanoparticles were successful in both selectively targeting and inducing apoptosis in 80% of the LNCaP cells within 24 hours without affecting the viability of the CHO cells. These results show the potential of using biodegradable polymers as a vehicle for receptor-specific drug delivery and a potential alternative for traditional systemic chemotherapy. Detailed experimental results will be discussed in the e-poster.

Keywords: chemotherapeutic drug, click chemistry, nanoparticle, prostat cancer

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Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

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Authors: Alshutwi Sitah

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Many countries around the world are struggling to maintain an adequate number of nurses. Inadequate nursing staffing could compromise the quality of patient care. Among many factors that contribute to registered nurses (RN) turnover, the influence of work–family conflict (WFC) has gained little attention. WFC was found to be significantly associated with increased turnover intention (TI) among employees. Furthermore, WFC has been linked to a number of negative consequences, including lower job satisfaction and organizational commitment, sleep insufficiency, insomnia symptoms, obesity, cardiovascular diseases, sleep insufficiency, and high cholesterol. In an effort to find strategies to manage the consequences of WFC, many behavioral, psychological, and career scholars have focused on the role of supervisor support. Family Supportive Supervisor Behaviors (FSSB) has been found to be a promising approach contributing to the reduction of TI in employees’ experiencing WFC. Despite the importance of work–family issues and the influence of FSSB, limited studies have been conducted among the nursing population and none were found that included a sample from Saudi Arabia. Therefore, the main Purpose of this study was to evaluate the influence of FSSB on the relationship among WFC, Stress, and TI in Saudi Arabian registered nurses. Method: A cross-sectional study. Sample: Convenience sampling; 113 Saudi female nurse. Result: Fifty percent of nurses intended to leave their workplace, 68 % of nurses reported having a conflict between work and family, and 44% reported having a high level of stress. A significant positive correlation was found between WFC and TI (r= .43, P < 0.01). A negative correlation was found between FSSB and TI (r= -.53, P < 0.01). Both WFC and stress were associated with TI; however, these associations were buffered (weaken), when nurses had higher FSSB. Conclusion: The FSSB could be seen as a tool to help married, female nurses to demonstrate their professional role without compromising their family responsibilities. Nurses’ turnover is a complex issue that may require multiple prevention strategies; however, enhancing FSSB could be a key resource for maintaining a positive workplace environment and reducing TI.

Keywords: turnover intention, work-family conflict, supervisor support, nursing retention

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Authors: Jonathan Rodriguez, Dominga Guerrero, Surupa Shaw

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Automobiles are modeled in various forms, and they interact with air when in motion. Aerodynamics is the study of such interactions where solid bodies affect the way air moves around them. The shape of solid bodies can impact the ease at which they move against the flow of air; due to which any additional freightage, or loads, impact its aerodynamics. It is important to transport people and cargo safely. Despite the various safety measures, there are a large number of vehicle-related accidents. This study precisely explores the effects an automobile experiences, with added cargo and covers. The addition of these items changes the original vehicle shape and the approved design for safe driving. This paper showcases the effects of the changed vehicle shape and design via experimental testing conducted on a physical 1:27 scale and CAD model of an F-150 pickup truck, the most common pickup truck in the United States, with differently shaped loads and weight traveling at a constant speed. The additional freightage produces unwanted drag or lift resulting in lower fuel efficiencies and unsafe driving conditions. This study employs an adjustable external shell on the F-150 pickup truck to create a controlled aerodynamic geometry to combat the detrimental effects of additional freightage. The results utilize colored powder [ which acts as a visual medium for the interaction of air with the vehicle], to highlight the impact of the additional freight on the automobile’s external shell. This will be done along with simulation models using Altair CFD software of twelve cases regarding the effects of an added load onto an F-150 pickup truck. This paper is an attempt toward standardizing the geometric design of the external shell, given the uniqueness of every load and its placement on the vehicle; while providing real-time data to be compared to simulation results from the existing literature.

Keywords: aerodynamics, CFD, freightage, pickup cover

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Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

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Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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Authors: Yuzhen Hu, Sirui Wang

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As a training base for intellectual talents, universities have a large number of students. Teaching is a primary activity in universities, and during the teaching process, a large number of people gather both inside and outside the teaching buildings, posing a strong risk of close contact. The class schedule is the fundamental basis for teaching activities in universities and plays a crucial role in the management of teaching order. Different class schedules can lead to varying degrees of indoor gatherings and trajectories of class attendees. In recent years, highly contagious diseases have frequently occurred worldwide, and how to reduce the risk of infection has always been a hot issue related to public safety. "Reducing gatherings" is one of the core measures in epidemic prevention and control, and it can be controlled through scientific scheduling in specific environments. Therefore, the scientific prevention and control goal can be achieved by considering the reduction of the risk of excessive gathering of people during the course schedule arrangement. Firstly, we address the issue of personnel gathering in various pathways on campus, with the goal of minimizing congestion and maximizing teaching effectiveness, establishing a nonlinear mathematical model. Next, we design an improved genetic algorithm, incorporating real-time evacuation operations based on tracking search and multidimensional positive gradient cross-mutation operations, considering the characteristics of outdoor crowd evacuation. Finally, we apply undergraduate course data from a university in Harbin to conduct a case study. It compares and analyzes the effects of algorithm improvement and optimization of gathering situations and explores the impact of path blocking on the degree of gathering of individuals on other pathways.

Keywords: the university timetabling problem, risk prevention, genetic algorithm, risk control

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

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

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

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Authors: Nadia Naseem, Farwa Batool, Nasir Mehmood, AbdulHannan Nagi

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Background: The incidence and mortality of breast cancer vary significantly in geographically distinct populations. In Pakistan, breast cancer has shown an increase in incidence in young females and is characterized by more aggressive behavior. The tumor suppressor TP53 gene is a crucial genetic factor that plays a significant role in breast carcinogenesis. This study investigated the TP53 mutations in molecular subtypes of both nodes negative and positive breast cancer in young Pakistani patients. Material and Methods: p53, Estrogen Receptor (ER), Progesterone Receptor (PR), Her-2 neu and Ki 67 expressions were analyzed immunohistochemically in a series of 75 node negative (A) and 75 node positive (B) young (aged: 19-40 years) breast cancer patients diagnosed between 2014 to 2017 at two leading hospitals of Punjab, Pakistan. Tumor tissue specimens and peripheral blood samples were examined for TP53 mutations by direct sequencing of the gene (exons 4-9). The relation of TP53 mutations to these markers and clinicopathological data was investigated. Results: Mean age of the patients was 32.4 + 9.1 SD. Invasive breast carcinoma was the most frequent histological variant (A=92%, B=94.6%). Grade 3 carcinoma was the commonest grade (A=72%, B=81.3%). Triple negative cases (ER-, PR-, Her-2) formed most of the molecular subtypes (A=44%, B=50.6%). A total of 17.2% (A: 6.6%, B: 10.6%) patients showed TP53 mutations. Mutations were significantly more frequent in triple negative cases (A: 74.8%, B: 62.2%) compared to HER2-positive patients (P < 0.0001). In the multivariate analysis of the whole patient group, the independent prognosticator were triple negative cases (P=0.021), TP53 overexpression by IHC (P=0.001) and advanced-stage disease (P=0.007). No statistically significant correlation between TP53 mutations and clinicopathological parameters was found (P < 0.05). Conclusions: It is concluded that TP53 mutations are infrequently present in breast carcinoma of young Pakistani population and there was no significant correlation between p53 mutation and early onset disease. Immunohistochemically detected TP53 expression in our resource-constrained to set up can be beneficial in predicting mutations at the younger age in our population.

Keywords: immunohistochemistry (IHC), invasive breast carcinoma (IBC), Pakistan, TP53

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Authors: Mohammad H. Yarmohammadian, Mehdi Nasr Isfahani, Elham Anbari

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Introduction: The awareness of using chemical, biological, and nuclear agents in everyday industrial and non-industrial incidents has increased recently; release of these materials can be accidental or intentional. Since hospitals are the forefronts of confronting Chemical, Biological, Radiological and Nuclear( CBRN) incidents, the goal of the present research was to provide a generic protocol for CBRN incidents through a comparative review of CBRN protocols and guidelines of different countries and reviewing various books, handbooks and papers. Method: The integrative approach or research synthesis was adopted in this study. First a simple narrative review of programs, books, handbooks, and papers about response to CBRN incidents in different countries was carried out. Then the most important and functional information was discussed in the form of a generic protocol in focus group sessions and subsequently confirmed. Results: Findings indicated that most of the countries had various protocols, guidelines, and handbooks for hazardous materials or CBRN incidents. The final outcome of the research synthesis was a 50 page generic protocol whose main topics included introduction, definition and classification of CBRN agents, four major phases of incident and disaster management cycle, hospital response management plan, equipment, and recommended supplies and antidotes for decontamination (radiological/nuclear, chemical, biological); each of these also had subtopics. Conclusion: In the majority of international protocols, guidelines, handbooks and also international and Iranian books and papers, there is an emphasis on the importance of incident command system, determining the safety degree of decontamination zones, maps of decontamination zones, decontamination process, triage classifications, personal protective equipment, and supplies and antidotes for decontamination; these are the least requirements for such incidents and also consistent with the provided generic protocol.

Keywords: hospital, CBRN, decontamination, generic protocol, CBRN Incidents

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Authors: Khue Do Phan

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Nike has been confronted by the press with their harsh working conditions, underpayment and highly-labor intensive requirement to their manufacturing workers and hiring of underage workers in Vietnam, Nike's largest production center. To analyze this topic critically through an international relations perspective, theory of dependency will be used to criticize the notion of exploitation of resources from developed countries towards developing countries. Theory of economic liberalism will be used to support the notion private property, the free market and generally capitalism as beneficial to both developing and developed countries. Workers are mentally, physically and sexually abused in the factories. In addition to this, their working conditions consist of improper training, lack of safety equipment, exposure of chemicals (glues and pants), their average wage is below the minimum wage in their country; the workers have to work around 60 hours or more a week. Even Nike says that the conditions are regulated often to make sure the workers get a voice to have their work rights and safe working environment. The monitors come to analyze the factories but in the end talk to the employers, whom are the direct abusers to the employees. Health benefits are rarely granted to the employees; they are forced to pay their bills first then the company will reimburse them later. They would also get in trouble for using the bathroom, taking a lunch break or sick days off because this would mean it would decrease their hours of work, leading to an even lower wage and a really angry employer. Of course with the press criticizing Nike’s lack of respect for human rights and working rights, Nike has been working on policy making and implementation to deal with the abuses. Due to its large chains and a great number of outsourcing host countries, the changes that Nike wish or attempt to make have not be in effect as quickly nor spreading to all countries it holds accountable for in its outsourcing factories.

Keywords: dependency theory, economic liberalism, human rights, outsource

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Authors: Jin Lin, Shouxiang Lu, Kim Meow Liew

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In a fire accident, fire smoke often poses a serious threat to human safety especially in the enclosed space such as submarine and space-crafts environment. Efficient removal of the hazardous gas products particularly a large amount of CO and CO₂ gases from these confined space is critical for the security of the staff and necessary for the post-fire environment recovery. In this work, Cu-Mn-Ce composite oxide catalysts coupled with CO₂ sorbents were prepared using wet impregnation method, solid-state impregnation method and wet/solid-state impregnation method. The as-prepared samples were tested dynamically and isothermally for CO oxidation and CO₂ sorption and further characterized by the X-ray diffraction (XRD), nitrogen adsorption and desorption, and field emission scanning electron microscopy (FE-SEM). The results showed that all the samples were able to catalyze CO into CO₂ and capture CO₂ in situ by chemisorption. Among all the samples, the sample synthesized by the wet/solid-state impregnation method showed the highest catalytic activity toward CO oxidation and the fine ability of CO₂ sorption. The sample prepared by the solid-state impregnation method showed the second CO oxidation performance, while the coupled sample using the wet impregnation method exhibited much poor CO oxidation activity. The various CO oxidation and CO₂ sorption properties of the samples might arise from the different dispersed states of the CO₂ sorbent in the CO catalyst, owing to the different preparation methods. XRD results confirmed the high-dispersed sorbent phase in the samples prepared by the wet and solid impregnation method, while that of the sample prepared by wet/solid-state impregnation method showed the larger bulk phase as indicated by the high-intensity diffraction peaks. Nitrogen adsorption and desorption results further revealed that the latter sample had a higher surface area and pore volume, which were beneficial for the CO oxidation over the catalyst. Hence, the Cu-Mn-Ce oxide catalyst coupled with CO₂ sorbent using wet/solid-state impregnation method could be a good choice for fire smoke removal in the enclosed space.

Keywords: CO oxidation, CO₂ sorption, preparation methods, smoke removal

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Authors: Katherine van Kampen, Reva Qiu, Patricia Farrugia

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Orthopedic surgery has fallen behind when it comes to gender diversity despite medical school classes reaching gender parity. Studies have shown that orthopedic surgery would require 117 years to reach gender parity with the trainee population, the longest time than any other specialty, including neurosurgery, urology, and otolaryngology. The barriers that face women in orthopedic surgery have been well researched, with contributing factors being on-going stereotypes of the field, lack of women mentors, and gender roles outside of the hospital. Furthermore, women in orthopedic surgery face barriers to achieve promotion, publications, and leadership roles leading to a “leaky pipeline,” resulting in less and less women in key academic roles in the field. It is a complex topic with barriers and challenges faced in medical school, residency, and throughout employment. Our scoping review seeks to understand these challenges across a temporal timeline and to further characterize such barriers and the driving factors behind them. To this date, authors did not find a scoping review that seeks to look broadly at factors impacting the decreased amount of women entering orthopedics and the factors that cause women to hit a “glass ceiling”, the idea that women will not achieve the same success as men despite the same qualifications, upon entering the field. This scoping review is the first of its kind to attempt to summarize the large body of research focusing on women in orthopedic surgery from the preconceptions in medical school impacting their desire to pursue orthopedics all the way to employment, including challenges to academic success and financial success. Literature databases will be searched with the following key terms: women, gender inequity, workforce, orthopedics, and citations will be hand searched and collected. Articles included will discuss gender inequality within orthopedics with non-english, patient related articles excluded. Full-text review will seek to characterize the specific barriers faced by women across medical school, residency, and employment. Themes that are expected to be highlighted are workforce data, women in orthopedic leadership, medical student perspectives on the specialty, and gender bias and discrimination in the field.

Keywords: orthopedics, gender equity, workforce, women in surgery

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