Search results for: emergency period

Authors: Radha Krishan, Deepak Khare, Bhaskar R. Nikam, Ayush Chandrakar

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Every irrigation project is planned considering long-term historical climatic conditions; however, the prompt climatic shift and change has come out with such circumstances which were inconceivable in the past. Considering this fact, scrutiny of rainfall and temperature trend has been carried out over the command area of Eastern Ganga Canal project for pre-climate shift period and post-climate shift periods in the present study. Non-parametric Mann-Kendall and Sen’s methods have been applied to study the trends in annual rainfall, seasonal rainfall, annual rainy day, monsoonal rainy days, average annual temperature and seasonal temperature. The results showed decreasing trend of 48.11 to 42.17 mm/decade in annual rainfall and 79.78 tSo 49.67 mm/decade in monsoon rainfall in pre-climate to post-climate shift periods, respectively. The decreasing trend of 1 to 4 days/decade has been observed in annual rainy days from pre-climate to post-climate shift period. Trends in temperature revealed that there were significant decreasing trends in annual (-0.03 ºC/yr), Kharif (-0.02 ºC/yr), Rabi (-0.04 ºC/yr) and summer (-0.02 ºC/yr) season temperature during pre-climate shift period, whereas the significant increasing trend (0.02 ºC/yr) has been observed in all the four parameters during post climate shift period. These results will help project managers in understanding the climate shift and lead them to develop alternative water management strategies.

Keywords: climate shift, rainfall trend, temperature trend, Mann-Kendall test, sen slope estimator, eastern Ganga canal command

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Authors: Ella Tyuryumina, Alexey Neznanov

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This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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Authors: P. Donnelly, G. Mitchell

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Traumatic Brain Injury (TBI) is a major contributor to the global burden of disease; despite its ubiquity, there is significant variation in diagnosis, prognosis, and treatment between clinicians. This study aims to examine the spectrum of approaches that currently exist at a Level 1 Trauma Centre in Australasia by surveying Emergency Physicians and Neurosurgeons on those aspects of mTBI. A pilot survey of 17 clinicians (Neurosurgeons, Emergency Physicians, and others who manage patients with mTBI) at a Level 1 Trauma Centre in Brisbane, Australia, was conducted. The objective of this study was to examine the importance these clinicians place on various elements in their approach to the diagnosis, prognostication, and treatment of mTBI. The data were summarised, and the descriptive statistics reported. Loss of consciousness and post-traumatic amnesia were rated as the most important signs or symptoms in diagnosing mTBI (median importance of 8). MRI was the most important imaging modality in diagnosing mTBI (median importance of 7). ‘Number of the Previous TBIs’ and Intracranial Injury on Imaging’ were rated as the most important elements for prognostication (median importance of 9). Education and reassurance were rated as the most important modality for treating mTBI (median importance of 7). There was a statistically insignificant variation between the specialties as to the importance they place on each of these components. In this Australian tertiary trauma center, there appears to be variation in how clinicians approach mTBI. This study is underpowered to state whether this is between clinicians within a specialty or a trend between specialties. This variation is worthwhile in investigating as a step toward a unified approach to diagnosing, prognosticating, and treating this common pathology.

Keywords: mild traumatic brain injury, adult, clinician, survey

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Authors: Angelis P. Barlampas

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An 89 years old woman came to the emergency department complaining of long-lasting headaches and nausea. A CT examination was performed, and a homogeneous midline anterior cranial fossa lesion was revealed, which was situated near the base and measured 2,4 cm in diameter. The patient was allergic, and an i.v.c injection could not be done on the spot, and neither could an MRI exam because of metallic implants. How could someone narrow down the differential diagnosis? The interhemispheric meningioma is usually a silent midline lesion with no edema, and most often presents as a homogeneous, solid type, isodense, or slightly hyperdense mass ( usually the smallest lesions as this one ). Of them, 20-30% have some calcifications. Hyperostosis is typical for meningiomas that abut the base of the skull but is absent in the current case, presumably of a more cephalad location that is borderline away from the bone. Because further investigation could not be done, as the patient was allergic to the contrast media, some other differential options should be considered. Regarding the site of the lesion, the most common other entities to keep in mind are the following: Metastasis, tumor of skull base, abscess, primary brain tumors, meningioma, giant aneurysm of the anterior cerebral artery, olfactory neuroblastoma, interhemispheric meningioma, giant aneurysm of the anterior cerebral artery, midline lesion. Appearance will depend on whether the aneurysm is non-thrombosed, or partially, or completely thrombosed. Non-contrast: slightly hyperdense, well-defined round extra-axial mass, may demonstrate a peripheral calcified rim, olfactory neuroblastoma, midline lesion. The mass is of soft tissue attenuation and is relatively homogeneous. Focal calcifications are occasionally present. When an intracranial extension is present, peritumoral cysts between it and the overlying brain are often present. Final diagnosis interhemispheric meningioma (Known from the previous patient’s history). Meningiomas come from the meningocytes or the arachnoid cells of the meninges. They are usually found incidentally, have an indolent course, and their most common location is extra-axial, parasagittal, and supratentorial. Other locations include the sphenoid ridge, olfactory groove, juxtasellar, infratentorial, intraventricular, pineal gland area, and optic nerve meningioma. They are clinically silent entities, except for large ones, which can present with headaches, changes in personality status, paresis, or symptomatology according to their specific site and may cause edema of the surrounding brain tissue. Imaging findings include the presence of calcifications, the CSF cleft sign, hyperostosis of adjacent bone, dural tail, and white matter buckling sign. After i.v.c. injection, they enhance brightly and homogenously, except for large ones, which may exhibit necrotic areas or may be heavily calcified. Malignant or cystic variants demonstrate more heterogeneity and less intense enhancement. Sometimes, it is inevitable that the needed CT protocol cannot be performed, especially in the emergency department. In these cases, the radiologist must focus on the characteristic imaging features of the unenhanced lesion, as well as in previous examinations or a known lesion history, in order to come to the right report conclusion.

Keywords: computed tomography, emergency radiology, metastasis, tumor of skull base, abscess, primary brain tumors, meningioma, giant aneurysm of the anterior cerebral artery, olfactory neuroblastoma, interhemispheric meningioma

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Authors: R. Unnikrishnan, K. Shankar

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In the case of high-speed fighter aircrafts, seat ejection is designed mainly for the safety of the pilot in case of an emergency. Strong windblast due to the high velocity of flight is one main difficulty in clearing the tail of the aircraft. Excessive G-forces generated, immobilizes the pilot from escape. In most of the cases, seats are ejected out of the aircrafts by explosives or by rocket motors attached to the bottom of the seat. Ejection forces are primarily in the vertical direction with the objective of attaining the maximum possible velocity in a specified period of time. The safe ejection parameters are studied to estimate the critical time of ejection for various geometries and velocities of flight. An equivalent analytical 2-dimensional biomechanical model of the human spine has been modelled consisting of vertebrae and intervertebral discs with a lumped mass approach. The 24 vertebrae, which consists of the cervical, thoracic and lumbar regions, in addition to the head mass and the pelvis has been designed as 26 rigid structures and the intervertebral discs are assumed as 25 flexible joint structures. The rigid structures are modelled as mass elements and the flexible joints as spring and damper elements. Here, the motions are restricted only in the mid-sagittal plane to form a 26 degree of freedom system. The equations of motions are derived for translational movement of the spinal column. An ejection force with a linearly increasing acceleration profile is applied as vertical base excitation on to the pelvis. The dynamic vibrational response of each vertebra in time-domain is estimated.

Keywords: biomechanical model, lumped mass, seat ejection, vibrational response

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Neelima Meravi, Santosh Prajapati

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The present study was conducted over a period of three years on fly ash dyke. The physicochemical analysis of fly ash (pH, WHC, BD, porosity, EC% OC & available P, heavy metal content etc.) was performed before and after the growth of plant species. Fly ash was analyzed after concentrated nitric acid digestion by atomic absorption spectrophotometer AAS-7000b(Shimadzu) for heavy metals. The dyke was colonized by the propagules of native species over a period of time, and it was observed that fly ash was contaminated by heavy metals and plants were able to ameliorate the metal concentration of dyke. The growth of plant species also improved the condition of fly ash so that it can be used for agricultural purposes. Phytosociological studies of the fly ash dyke were performed so that these plants may be used for reclamation of fly ash for subsequent use in agriculture.

Keywords: fly ash, heavy metals, IVI, phytosociology, reclamation

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Authors: Yasmine Essafi Zouari, Aya Nasreddine

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Following a long inflationary period from the post-war era to the mid-1980s (+10.1% annually), France went through a moderate inflation period between 1986 and 2001 (+2.1% annually) and even lower inflation between 2002 and 2016 (+1.4% annually). In 2022, inflation in France increased rapidly and reached 4.5% over one year in March, according to INSEE estimates. Over a long period, even low inflation has an impact on portfolio value and households’ purchasing power. In such a context, inflation hedging should remain an important issue for investors. In particular, long-term investors, who are concerned with the protection of their wealth, seek to hold effective hedging assets. Considering a mixed-asset portfolio composed of housing assets (residential real estate in 150 Grand Paris communes) as well as financial assets, and using both correlation and regression analysis, results confirm the attribute of the direct housing investment as an inflation hedge especially particularly against its unexpected component. Further, cash and bonds were found to provide respectively a partial and an over hedge against unexpected inflation. Stocks act as a perverse hedge against unexpected inflation and provide no significant positive hedge against expected inflation.

Keywords: direct housing, inflation, hedging ability, optimal portfolio, Grand Paris metropolis

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Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Background and aims: While in Western countries, unilateral spinal anesthesia has been widely practiced for a long time, it remains little known in the local anesthesia community, and has not been the object of many studies. However, it is a simple, practical and effective technique. Our objective was to evaluate this practice in emergency anesthesia management in frail patients and to compare it with conventional spinal anesthesia. Methods: This is a prospective, observational, comparative study between hypobaric unilateral and conventional spinal anaesthesia for hip fracture surgery carried out in the operating room of the university military hospital of Staoueli. The work was spread over of 12-month period from 2019 to 2020. The parameters analyzed were hemodynamic variations, vasopressor use, block efficiency, postoperative adverse events, and postoperative morphine consumption. Results: -75 cases (mean age 72±14 years) -Group1= 41 patients (54.6%) divided into (ASA1=14.6% ASA2=60.98% ASA3=24.39%) single shoot spinal anaesthesia -Group2= 34 patients (45.3%) divided into (ASA1=2.9%, ASA2=26.4% ASA3=61.7%, ASA4=8.8%) unilateral hypobaric spinal anesthesia. -Hemodynamic variations were more severe in group 1 (51% hypotension) compared to 30% in group 2 RR=1.69 and odds ratio=2.4 -these variations were more marked in the ASA3 subgroup (group 1=70% hypotension versus group 2=30%) with an RR=2.33 and an odds ratio=5.44 -39% of group 1 required vasoactive drugs (15mg +/- 11) versus 32% of group 2 (8mg+/- 6.49) - no difference in the use of morphine in post-op. Conclusions: Within the limits of the population studied, this work demonstrates the clinical value of unilateral spinal anesthesia in ortho-trauma surgery in the frail patient.

Keywords: spinal anaesthesia, vasopressor, morphine, hypobaric unilateral spinal anesthesia, ropivacaine, hip surgery, eldery, hemodynamic

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Authors: Thi Phuong Chi Nguyen

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Although consumer ethnocentrism has been widely studied in academic research since 1987, somehow it is still considered as a new and unknown concept in marketing theory and practice. By analyzing the content, three mainstreams of consumer ethnocentrism were found including economic, management and marketing approaches. The present study indicated that the link between consumer ethnocentrism and consumer behaviours varies across countries. Consumers in developing countries might be both patriotic about their home countries and curious about foreign cultures at the same time. The most important finding is identifying three main periods in the chronological development of consumer ethnocentrism research. The first period, spanning from 1987 to 1995, was characterized by the introduction of the consumer ethnocentrism concepts and scales, the unidimensionality and the adaptation of the standard CETSCALE version. The second period 1996-2005 witnessed the replication of CETSCALE in various fields, as well as an increase in the volume of researches in developing and emerging countries; the exploration of determinants and the begin of multidimensionality. In the third period from 2006 to present, all variables related to CET were syntherized within the theory of planne behavior. Consumer ethnocentrism analyses were conducted even in less-developed countries and in groups of countries within longitudinal studies. The results from this study showed many inadequacies relating to consumer ethnocentrism in the context of globalisation for further researches to examine.

Keywords: CETSCALE, consumer behavior, consumer ethnocentrism, business, marketing

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Authors: S. Benbellil-Tafoughalt, J. M. Koene

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Growth strategies are often plastic and influenced by environmental conditions. Terrestrial gastropods are particularly affected by seasonal and climatic variables, and growth rate and size at maturity are key traits in their life history. Therefore, we investigated juvenile growth of Helix aperta snails under four combinations of temperature and photoperiod using two sets of young snails, born in the laboratory from adults collected in either the autumn (aestivating snails) or spring (active snails). Parental snails were collected from Bakaro (Northeastern Algeria). Higher temperature increased adult size and reduced time to reproduction. Long day photoperiod also increased the final body weight, but had no effect on the length of the growth period. The season of birth had significant effects on length of the growth period and weight of hatchings, whereas this weight difference disappeared by adulthood. The spring snails took less time to develop and reached similar adult body weight as the autumn snails. These differences may be due to differences in egg size or quality between the snails from different seasons. More rapid growth in spring snails results in larger snails entering aestivation, a period with size-related mortality in this species.

Keywords: growth, Hélix aperta, photoperiod, temperature

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Authors: Fatemeh Havas Beigi

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The purpose of this study is to identify the objectives of a multicultural curriculum for the primary education period from the perspective of ethnic teachers and education experts and cultural professionals. The research paradigm is interpretive, the research approach is qualitative, the research strategy is content analysis, the sampling method is purposeful and it is a snowball, and the sample of informants in the research for Iranian ethnic teachers and experts until the theoretical saturation was estimated to be 67 people. The data collection tools used were based on semi-structured interviews and individual interviews and focal interviews were used to collect information. The data format was also in audio format and the first period coding and the second coding were used to analyze the data. Based on data analysis 11 Objective: Paying attention to ethnic equality, expanding educational opportunities and justice, peaceful coexistence, anti-ethnic and racial discrimination education, paying attention to human value and dignity, accepting religious diversity, getting to know ethnicities and cultures, promoting teaching-learning, fostering self-confidence, building national unity, and developing cultural commonalities for a multicultural curriculum were identified.

Keywords: objective, multicultural curriculum, connect, elementary education period

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Authors: Mary Elizabeth Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Injuries due to interpersonal violence are a common reason for emergency department (ED) visits amongst the American pediatric population. Gun violence, in particular, is associated with high morbidity, mortality as well as financial costs. Patterns of pediatric ED usage may be an indicator of risk for future violence, but very little data on the topic exists. Objective: The aims of this study were to assess for frequencies of ED usage for previous interpersonal violence, mental/behavioral issues, sexual/reproductive issues and concerns for abuse in youths presenting to EDs due to physical assault injuries (PAIs) compared to firearm injuries (FIs). Methods: In this retrospective case-control study, ED charts of children ages 8-19 years who presented with injuries due to interpersonal violent encounters from 2014-2017 were reviewed. Data was collected regarding all previous ED visits for injuries due to interpersonal violence (including physical assaults and firearm injuries), mental/behavioral health visits (including depression, suicidal ideation, suicide attempt, homicidal ideation and violent behavior), sexual/reproductive health visits (including sexually transmitted infections and pregnancy related issues), and concerns for abuse (including physical abuse or domestic violence, neglect, sexual abuse, sexual assault, and intimate partner violence). Logistic regression was used to identify predictors of gun violence based on previous ED visits amongst physical assault injured versus firearm injured youths. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed, 251 (62%) of which were due to physical assault injuries (PAIs) and 156 (38%) due to firearm injuries (FIs). The majority of both PAI and FI patients had no previous history of ED visits for violence, mental/behavioral health, sexual/reproductive health or concern for abuse (60.8% PAI, 76.3% FI). 19.2% of PAI and 13.5% of FI youths had previous ED visits for physical assault injuries (OR 0.68, P=0.24, 95% CI 0.36 to 1.29). 1.6% of PAI and 3.2% of FI youths had a history of ED visits for previous firearm injuries (OR 3.6, P=0.34, 95% CI 0.04 to 2.95). 10% of PAI and 3.8% of FI youths had previous ED visits for mental/behavioral health issues (OR 0.91, P=0.80, 95% CI 0.43 to 1.93). 10% of PAI and 2.6% of FI youths had previous ED visits due to concerns for abuse (OR 0.76, P=0.55, 95% CI 0.31 to 1.86). Conclusions: There are no statistically significant differences between physical assault-injured and firearm-injured youths in terms of ED usage for previous violent injuries, mental/behavioral health visits, sexual/reproductive health visits or concerns for abuse. However, violently injured youths in this study have more than twice the number of previous ED usage for physical assaults and mental health visits than previous literature indicates. Data comparing ED usage of victims of interpersonal violence to nonviolent ED patients is needed, but this study supports the notion that EDs may be a useful place for identification of and enrollment in interventions for youths most at risk for future violence.

Keywords: child abuse, emergency department usage, pediatric gun violence, pediatric interpersonal violence, pediatric mental health, pediatric reproductive health

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Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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Authors: Kevin Wang, Jian Ge, Yinan Zhao, Kevin Willis

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Kepler has discovered over 4000 exoplanets and candidates. However, current transit planet detection techniques based on the wavelet analysis and the Box Least Squares (BLS) algorithm have limited sensitivity in detecting minor planets with a low signal-to-noise ratio (SNR) and long periods with only 3-4 repeated signals over the mission lifetime of 4 years. This paper presents a novel precise-period transit signal detection methodology based on a new Graphics Processing Unit (GPU) Fast Folding algorithm in conjunction with a Convolutional Neural Network (CNN) to detect low SNR and/or long-period transit planet signals. A comparison with BLS is conducted on both simulated light curves and real data, demonstrating that the new method has higher speed, sensitivity, and reliability. For instance, the new system can detect transits with SNR as low as three while the performance of BLS drops off quickly around SNR of 7. Meanwhile, the GPU Fast Folding method folds light curves 25 times faster than BLS, a significant gain that allows exoplanet detection to occur at unprecedented period precision. This new method has been tested with all known transit signals with 100% confirmation. In addition, this new method has been successfully applied to the Kepler of Interest (KOI) data and identified a few new Earth-sized Ultra-short period (USP) exoplanet candidates and habitable planet candidates. The results highlight the promise for GPU Fast Folding as a replacement to the traditional BLS algorithm for finding small and/or long-period habitable and Earth-sized planet candidates in-transit data taken with Kepler and other space transit missions such as TESS(Transiting Exoplanet Survey Satellite) and PLATO(PLAnetary Transits and Oscillations of stars).

Keywords: algorithms, astronomy data analysis, deep learning, exoplanet detection methods, small planets, habitable planets, transit photometry

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Authors: Ghulam Mustafa Peerzada, Shagufta Rashid, Nadeem Bashir

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These the influence of initial reagent concentrations on the Belousov-Zhabotinsky (BZ) system with Mn2+/Mn3+ as redox catalyst, inorganic bromate as oxidant and pyrogallol as organic substrate was studied. The reactions were monitored by potentiometery in oxidation reduction potential (ORP) mode. The aforesaid reagents were mixed with varying concentrations to evolve the optimal concentrations at which the reaction system exhibited better oscillations. The various oscillatory parameters such as induction period (tin), time period (tp), frequency (v), amplitude (A) and number of oscillations (n) were derived and the dependence of concentration of the reacting species on these oscillatory parameters was interpreted on the basis of the Field-Koros-Noyes mechanism. Ferroin based BZ system with pyrogallol as organic substrate was optimized under CSTR condition at temperature of 30±0.1oC Effect of molecules like monomer and polymer as additives to the system was checked and their interaction with the system was also studied. It has been observed that the monomer affects the time period, while the polymer has its effect on the amplitude of oscillations because of monomer’s interaction with the bromine and polymer’s with that of the Ferroin.

Keywords: Belousov Zhabotinsky reaction, oscillatory parameters, polymer, pyrogallol

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Authors: Rishi Agarwal

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Digital twins are emerging as a strong technology used to imitate and monitor physical objects digitally in real time across sectors. It is not only dealing with the digital space, but it is also actuating responses in the physical space in response to the digital space processing like storage, modeling, learning, simulation, and prediction. This paper explores the application of digital twins for enhancing physical security in retail stores. The retail sector still relies on outdated physical security practices like manual monitoring and metal detectors, which are insufficient for modern needs. There is a lack of real-time data and system integration, leading to ineffective emergency response and preventative measures. As retail automation increases, new digital frameworks must control safety without human intervention. To address this, the paper proposes implementing an intelligent digital twin framework. This collects diverse data streams from in-store sensors, surveillance, external sources, and customer devices and then Advanced analytics and simulations enable real-time monitoring, incident prediction, automated emergency procedures, and stakeholder coordination. Overall, the digital twin improves physical security through automation, adaptability, and comprehensive data sharing. The paper also analyzes the pros and cons of implementation of this technology through an Emerging Technology Analysis Canvas that analyzes different aspects of this technology through both narrow and wide lenses to help decision makers in their decision of implementing this technology. On a broader scale, this showcases the value of digital twins in transforming legacy systems across sectors and how data sharing can create a safer world for both retail store customers and owners.

Keywords: digital twin, retail store safety, digital twin in retail, digital twin for physical safety

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Authors: Nejah Ben Mabrouk, Bassem Jarboui, Habib Chabchoub

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Production and distribution planning is the most important part in supply chain management. In this paper, a NP-hard production-distribution problem for one product over a multi-period horizon is investigated. The aim is to minimize the sum of costs of three items: production setups, inventories and distribution, while determining, for each period, the amount produced, the inventory levels and the delivery trips. To solve this difficult problem, we propose a bi-phase approach based on a Variable Neighbourhood Search (VNS). This heuristic is tested on 90 randomly generated instances from the literature, with 20 periods and 50, 100, 200 customers. Computational results show that our approach outperforms existing solution procedures available in the literature

Keywords: logistic, production, distribution, variable neighbourhood search

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Authors: Latif Adnane, C. E. Ait Zaouiat, M. Eddabbah

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In Wireless Body Area Networks, the issue of systems lifetime is a big challenge to complete. In this paper, we have tackled this subject to suggest some solutions. For this aim, we have studied some batteries characteristics related to human body temperature. Moreover, we have analyzed a mathematical model which defines sensors lifetime (battery lifetime). Based on this model, we note that the random access increases the energy consumption, because nodes are waking up during the whole superframe period. Results show that using scheduled mode access of IEEE 802.15.6 maximizes the lifetime function, by setting nodes in the sleep mode in the inactive period of transmission.

Keywords: battery, energy consumption, IEEE 802.15.6, lifetime, polling

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Authors: Lazurca Liliana Gina

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Different time series analysis of yearly air pollution at Suceava County, Nord-East of Romania, has been performed in this study. The trends in the atmospheric concentrations of the main gaseous and particulate pollutants in urban, industrial and rural environments across Suceava County were estimated for the period of 2008-2014. The non-parametric Mann-Kendall test was used to determine the trends in the annual average concentrations of air pollutants (NO2, NO, NOx, SO2, CO, PM10, O3, C6H6). The slope was estimated using the non-parametric Sen’s method. Trend significance was assumed at the 5% significance level (p < 0.05) in the current study. During the 7 year period, trends in atmospheric concentrations may not have been monotonic, in some instances concentrations of species increased and subsequently decreased. The trend in Suceava County is to keep a low concentration of pollutants in ambient air respecting the limit values.All the results that we obtained show that Romania has taken a lot of regulatory measures to decrease the concentrations of air pollutants in the last decade, in Suceava County the air quality monitoring highlight for the most part of the analyzed pollutants decreasing trends. For the analyzed period we observed considerable improvements in background air in Suceava County.

Keywords: pollutant, trend, air quality monitoring, Mann-Kendall

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Widya Anggraini Pamungkas, Rosana Budi Setyawati, Awaludin Fitroh Rifai, Candra Pangesti Setiawan, Anatta Wahyu Budiiman, Inayati, Joko Waluyo, Sunu Herwi Pranolo

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The increase in LPG consumption in Indonesia is not balanced with the amount of supply. The high demand for LPG due to the success of the government's kerosene-to-LPG conversion program and the Covid-19 pandemic in 2020 led to an increase in LPG consumption in the household sector and caused Indonesia's trade balance to experience a deficit. The high consumption of LPG encourages the need for alternative fuels as a substitute or which aims to substitute LPG; one of the materials that can be used is Dimethyl Ether (DME). Dimethyl ether (DME) is an organic compound with the chemical formula CH 3. OCH 3 has a high cetane number and has characteristics similar to LPG. DME can be produced from various sources, such as coal, biomass and natural gas. Based on the economic analysis conducted at 10% IRR, coal has the largest NPV of Rp. 20,034,837,497,241 with a payback period of 3.86 years, then biomass with an NPV of Rp. 10,401,526,072,850 and a payback period of 5.16. the latter is natural gas with an NPV of IDR 7,401,272,559,191 and a payback period of 6.17 years. Of the three sources of raw materials used, if the sensitivity is calculated using the selling price of DME equal to the selling price of LPG, it will get an NPV value that is greater than the NPV value when using the current DME price. The advantages of coal as a raw material for DME are not only because it is profitable, namely: low price and abundant resources, but has high greenhouse gas emissions.

Keywords: LPG, DME, coal, biomass, natural gas

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Wafaa M. Abd El-Rahim, Magda A. El-Meleigy, Eman Refaat

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This study dealing with optimization the conditions affecting the formation of extracellular lignin- degrading enzymes to achieve maximal decolorization activity of Direct Violet dye by one fungal strain. In this study Aspergillus fumigates fungal strain used for production extracellular ligninolytic enzymes for removing Direct Violet dye under different conditions: culture medium, incubation period, pH and temperatures. The results indicted that the removal efficiency of A. fumigatus was enhanced by addition glucose and peptone to the culture medium. The addition of peptone and glucose was found to increase the decolorization activity of the fungal isolate from 51.38% to 93.74% after 4 days of incubation. The highest production of extracellular lignin degrading enzymes also recorded in Direct Violet dye medium supplemented with peptone and glucose. It was also found the decolorization activity of A. fumigatus was decreased gradually by increasing the incubation period up to 4 days. Also it was found that the fungal strain can grow and produce extracellular ligninolytic enzymes which accompanied by efficient removal of Direct Violet dye in a wide pH range of 4-8. The results also found that the maximal biosynthesis of ligninolytic enzymes which accompanied with maximal removal of Direct Violet dye was obtained at a temperature of 28C. This indicates that the different conditions of culture medium, incubation period, pH and temperatures are effective on dye decolorization on the fungal biomass and played a role in Direct Violet dye removal along with enzymatic activity of A. fumigatus.

Keywords: A. fumigates, extracellular lignin- degrading enzymes, textile dye, dye removing

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Authors: Rasha Waheeb, Bjorn Andersen, Rafa Shakir

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Purpose The purpose of this study is to avoid delays that occur in emergency reconstruction projects especially in post disaster circumstances whether if they were natural or manmade due to their particular national and humanitarian importance. We presented a theoretical and practical concepts for projects management in the field of construction industry that deal with a range of global and local trails. This study aimed to identify the factors of effective delay in construction projects in Iraq that affect the time and the specific quality cost, and find the best solutions to address delays and solve the problem by setting parameters to restore balance in this study. 30 projects were selected in different areas of construction were selected as a sample for this study. Design/methodology/approach This study discusses the reconstruction strategies and delay in time and cost caused by different delay factors in some selected projects in Iraq (Baghdad as a case study).A case study approach was adopted, with thirty construction projects selected from the Baghdad region, of different types and sizes. Project participants from the case projects provided data about the projects through a data collection instrument distributed through a survey. Mixed approach and methods were applied in this study. Mathematical data analysis was used to construct models to predict delay in time and cost of projects before they started. The artificial neural networks analysis was selected as a mathematical approach. These models were mainly to help decision makers in construction project to find solutions to these delays before they cause any inefficiency in the project being implemented and to strike the obstacles thoroughly to develop this industry in Iraq. This approach was practiced using the data collected through survey and questionnaire data collection as information form. Findings The most important delay factors identified leading to schedule overruns were contractor failure, redesigning of designs/plans and change orders, security issues, selection of low-price bids, weather factors, and owner failures. Some of these are quite in line with findings from similar studies in other countries/regions, but some are unique to the Iraqi project sample, such as security issues and low-price bid selection. Originality/value we selected ANN’s analysis first because ANN’s was rarely used in project management , and never been used in Iraq to finding solutions for problems in construction industry. Also, this methodology can be used in complicated problems when there is no interpretation or solution for a problem. In some cases statistical analysis was conducted and in some cases the problem is not following a linear equation or there was a weak correlation, thus we suggested using the ANN’s because it is used for nonlinear problems to find the relationship between input and output data and that was really supportive.

Keywords: construction projects, delay factors, emergency reconstruction, innovation ANN, post disasters, project management

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Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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Authors: Melese Tadesse Morebo

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Pastoral and agro-pastoral communities in East Africa, particularly in Ethiopia, are vulnerable to climate-related risks. The aim of this study is to characterize the annual, seasonal, and monthly rainfall and temperature of the middle and lower awash areas of Ethiopia. Start of season (SOS), end of season (EOS), length of growing season (LGS), number of rainy days, and probability of dry spell occurrences were analyzed using INSTAT Plus (v3.7) software. Daily rainfall and temperature data for 33 years (1990–2022) from six stations were analyzed. The result of the study revealed that the annual rainfall in the study area as a whole showed an increasing trend, but its trend was statistically non-significant. During the study period, the Kiremt rainfall at Amibara station showed statistically significant increasing trends. The trend analysis of SOS, EOS, and LGS shows up and down trends at all stations. The mean lengths of growing seasons in the study area ranged from 20 to 61 days during the study period. In the study area, the annual mean maximum temperature ranged between 34.1°C and 38.3°C over the last three decades. All stations within the research area during the study period, the annual minimum temperature exhibited a substantial impact.

Keywords: annual rainfall, LGS, minimum temperature, Mann-Kendall test

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Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

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Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

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Background：Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods：From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results：Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

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Authors: Christian Andrä, Luisa Zimmermann, Christina Müller

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Introduction: The positive relation between physical activity and cognition is commonly known. Relevant studies show that in everyday school life active breaks can lead to improvement in certain abilities (e.g. attention and concentration). A beneficial effect is in particular attributed to moderate activity. It is still unclear whether active breaks are beneficial after relatively short phases of cognitive load and whether the postulated effects of activity really have an immediate impact. The objective of this study was to verify whether an active break after 18 minutes of cognitive load leads to enhanced attention/concentration performance, compared to inactive breaks with voluntary mobile phone activity. Methodology: For this quasi-experimental study, 36 students [age: 14.0 (mean value) ± 0.3 (standard deviation); male/female: 21/15] of a secondary school were tested. In week 1, every student’s maximum heart rate (Hfmax) was determined through maximum effort tests conducted during physical education classes. The task was to run 3 laps of 300 m with increasing subjective effort (lap 1: 60%, lap 2: 80%, lap 3: 100% of the maximum performance capacity). Furthermore, first attention/concentration tests (D2-R) took place (pretest). The groups were matched on the basis of the pretest results. During week 2 and 3, crossover testing was conducted, comprising of 18 minutes of cognitive preload (test for concentration performance, KLT-R), a break and an attention/concentration test after a 2-minutes transition. Different 10-minutes breaks (active break: moderate physical activity with 65% Hfmax or inactive break: mobile phone activity) took place between preloading and transition. Major findings: In general, there was no impact of the different break interventions on the concentration test results (symbols processed after physical activity: 185.2 ± 31.3 / after inactive break: 184.4 ± 31.6; errors after physical activity: 5.7 ± 6.3 / after inactive break: 7.0. ± 7.2). There was, however, a noticeable development of the values over the testing periods. Although no difference in the number of processed symbols was detected (active/inactive break: period 1: 49.3 ± 8.8/46.9 ± 9.0; period 2: 47.0 ± 7.7/47.3 ± 8.4; period 3: 45.1 ± 8.3/45.6 ± 8.0; period 4: 43.8 ± 7.8/44.6 ± 8.0), error rates decreased successively after physical activity and increased gradually after an inactive break (active/inactive break: period 1: 1.9 ± 2.4/1.2 ± 1.4; period 2: 1.7 ± 1.8/ 1.5 ± 2.0, period 3: 1.2 ± 1.6/1.8 ± 2.1; period 4: 0.9 ± 1.5/2.5 ± 2.6; p= .012). Conclusion: Taking into consideration only the study’s overall results, the hypothesis must be dismissed. However, more differentiated evaluation shows that the error rates decreased after active breaks and increased after inactive breaks. Obviously, the effects of active intervention occur with a delay. The 2-minutes transition (regeneration time) used for this study seems to be insufficient due to the longer adaptation time of the cardio-vascular system in untrained individuals, which might initially affect the concentration capacity. To use the positive effects of physical activity for teaching and learning processes, physiological characteristics must also be considered. Only this will ensure optimum ability to perform.

Keywords: active breaks, attention/concentration test, cognitive performance capacity, heart rate, physical activity

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