Search results for: patient related elbow evaluation scale

Authors: Sukaesi Marianti

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This study aims to develop the Relational Mobility Scale for the Indonesian population and to investigate its psychometric properties. New items of the scale were created taking into account the Indonesian population which consists of two parallel forms (A and A’). This study uses 30 newly orchestrated items while keeping in mind the characteristics of the targeted population. The scale was administered to 433 public high school students in Malang, Indonesia. Construct validity of its factor structure was demonstrated using exploratory factor analysis and confirmatory factor analysis. The result exhibits that he model fits the data, and that the delayed alternate form method shows acceptable result. Results yielded that 21 items of the three-dimensional Relational Mobility Scale is suitable for measuring relational mobility in high school students of Indonesian population.

Keywords: confirmatory factor analysis, delayed alternate form, Indonesian population, relational mobility scale

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Authors: Gizem Batman, Mehmet Bora Küçükalpelli, Cenk Di̇nç

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Nowadays, electric trucks are anticipated to become much more prevalent in the foreseeable future. However, the necessity to investigate the occurrence of thermal runaway phenomenon in the batteries has arisen, and the safety concerns are supported by past events. This article addresses the phenomenon of battery thermal runaway and examines the implications at the vehicle level. Different battery thermal runaway scenarios are evaluated by giving priority to the components that affect customer safety and customer degree evaluation with CAE tools, regulations, related tests. This evaluation aims to support the efforts of the trucking industry to attain safer, greener, more sustainable, and more effective energy storage solutions.

Keywords: thermal runaway, EV truck, heat protection, battery

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Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

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Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

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Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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Authors: Jinyong Yao, Hongzhi Li, Chao Du, Jiao Li

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Reliability of long-term storage products is related to the availability of the whole system, and the evaluation of storage life is of great necessity. These products are usually highly reliable and little failure information can be collected. In this paper, an analytical method based on data from accelerated storage life test is proposed to evaluate the reliability index of the long-term storage products. Firstly, singularities are eliminated by data normalization and residual analysis. Secondly, with the pre-processed data, the degradation path model is built to obtain the pseudo life values. Then by life distribution hypothesis, we can get the estimator of parameters in high stress levels and verify failure mechanisms consistency. Finally, the life distribution under the normal stress level is extrapolated via the acceleration model and evaluation of the true average life available. An application example with the camera stabilization device is provided to illustrate the methodology we proposed.

Keywords: accelerated storage life test, failure mechanisms consistency, life distribution, reliability

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Authors: Hui Ling Chen

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This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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Authors: Nafdha Thajudeen

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Hijamah therapy is one of the leading alternative & complementary modalities in the World. It is a kind of detoxification, rejuvenation, and blood purification method. It comes under Ilaj bil Tadbeer (Regimental therapy) in the Unani medical system. In diabetes, hands and foot care in people is very important because of slow blood circulation, where blood sometimes is not able to fully penetrate the capillaries. Hijamah therapy works upon the following two principles- Tanqiyae Mawad (Evacuation of morbid humor) and Imalae Mawad (Diversion of humor). The aim of this study was to find out the effectiveness of hijamah therapy on the numbness of legs in a diabetic patient. This case study was carried out in Ayurvedic Research Hospital (Non-Communicable Diseases), Ninthavur, Sri Lanka. A 63 years old female diabetic patient came to the clinic with the complain of numbness in both feet for one year. The treatment history of the patient revealed that she had taken western medicine for her complaints for 7 months. In her first visit, wet cupping was done on local and distal points. The patient said there was a remarkable improvement; internal medicines were given to keep the sugar level in normal with some external applications. Every week, wet cupping was done on the same points, with repeating the same medicines. Foot numbness was fully cured within one month. The finding of this study shows that the complaint of numbness in the diabetic patient was treated with hijamah therapy with internal & external medicine. This case study can be concluded as hijamah therapy is very effective in treating diabetic numbness. This single case study may be the entrance for future clinical studies

Keywords: Hijamah therapy, Ilaj bil thadbeer, diabetes, numbness

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Authors: Salam Abukhadrah

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This research advocates for the use of feminist evaluation (FE) as a tool of great potential in policy and program assessment in relation to women’s empowerment. This research explores the journey of women’s place into the evaluation and international development. Moreover, this research presents a case example of the use of FE on the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), in Ganaparthi village in rural India, in Andhra Pradesh state (AP). This evaluation is formed on the basis of women’s empowerment framework that seeks to examine empowerment as a process and an end in itself rather than as just simplified quantifiable outcomes. This framework is used to conduct in-depth semi-structured interviews that are later cross-validated by a focus group discussion. In addition, this evaluation draws on secondary data from the MGNREGA website and on extracted data from the National Family Health Survey of AP.

Keywords: feminist evaluation, MGNREGA, women’s empowerment, case example, India

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Authors: Reinzo Vittorio B. Cardenas, Heather Venice L. Abogado, Andrea Therese V. Afable, Rhea D. Avillanoza, Marie Abegail P. Ayagan, Catherine D. Bantayan

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As the Internet provides fast and reliable health-related information, the tendency to self-diagnose increases to further understand medical jargon in a diagnosis with a physician and decreases costly consultation fees. The study aimed to explore and understand the factors affecting online health-seeking behaviors in middle-income class adults in Metro Manila. The study was conducted from March to April of 2021 with a sample size of 200 individuals aged 20 to 49 years old. The study was delivered via an online survey that used a questionnaire adapted from the research of Lee et al. (2015). Specifically, the survey consisted of three sections: assessing web-based health-seeking behaviors, consultation with health professionals, and participants' hesitancy to consult with physicians, which used a mix of a 5-point Likert-type scale with multiple responses and multiple-choice options. The results showed that the age and educational attainment of the respondents had a negative effect while presenting a positive effect of socio-economic status on health-seeking behavior. Lastly, there was a significant effect of participant’s hesitancy for professional consultation on their health-seeking behavior. The results gleaned from the study indicated that various individual and socio-economic factors might significantly affect one’s health-seeking behaviors. Although hesitancy had a significant effect on the spectrum of health-seeking behaviors, this does not imply that certain factors are specifically related to an individual’s tendency to seek health information. This information instead becomes essential in understanding the patient-physician relationship and giving patients a more holistic treatment.

Keywords: health-seeking behavior, health information, Internet, physician consultation

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Authors: I. Dumand, C. Clesse, M. Decker, C. Savini, J. Lighezzolo-Alnot

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In the landscape of French psychiatry, long-term institutionalization of patients with severe and disabling chronics disorders is common. Faced with the failures of classical reinsertion, sometimes these users are hurriedly considered as 'insortables'. However, this representation is often swayed by the current behavior of the patient observed through the clinical observation. Unfortunately, it seems that this way of proceeding can not integrate the potentialities of the institutionalized patients and their possible evolution. Therefore, in order not to make hasty conclusions about the life perspectives of these individuals, it seems essential to associate with clinical observation a psycho social rehabilitation diagnosis. Multidisciplinary, it combine all the aspects that make up the life of the subject (the life aspirations, psycho social determinants, family support, cognitive potential, symptoms ...). In this paper, we will rank these different aspects necessary prerequisites to the realization of a psycho social rehabilitation diagnosis. Then, we will specifically speak of the issue of psychological evaluation. By adopting an integrative approach combining neuro psychological tools (Grober and Buschke, Stroop, WCST, AIPSS, WAIS, Eyes test ...) and projective tools interpreted under a psycho dynamic angle (Rorschach, TAT ..) we think that we can grasp the patient in his globality. Thus, during this process we will justify the interest of combining a cognitive and a psycho affective approach, we will identify the different items assessed and their future implications on the everyday life of the users. Finally, we show that this diagnosis can give a chance to reintegration to 30% of patients considered as ''insortables''. In conclusion, we will highlight the importance of this process dear to the community psychology emphasizing in the same time the interests of this approach in terms of empowerment, recovery and quality of life.

Keywords: assessment, potentiality, psychosocial rehabilitation diagnosis, tools

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Authors: Tomoya Oshiro, Hiroko Ono

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Japan's aging population is increasing due to the decrease in birthrate. It causes various problems like the decrease in the gross domestic product of the country. The reason is why the local government of Japan has been on the way to a sustainable city recently. Then it is essential to get control of an urban structure to make the compact city successful. There are many kinds of paper about the compact city; however, the paper about a compact city of the island-type city is less. The purpose of this study is to clarify difference of urban structure between an island-type and a general city type. The method which has conducted in this research has two steps. First of all, by using evaluation indexes in the handbook, we evaluated the urban structures among each same -population-class cities from 50,000 to 100,000 people. Next, to clear the difference about the urban structure and feature between island-type and general-type cities compare the radar chart which is composed with each evaluation indexes of urban structure. Moreover, in order to clarify the relationship between evaluation indexes and the place of residence by using GIS software to show up population density on the map. As a result of this research, the management of local government and the local economy in evaluation indexes are indicated to be negative point in comparison of island-type cities with general cities. However, evaluation indexes of safety/security and low-carbon/energy are proved to be positive point. The research to find the difference features of the island-type of urban structure proves that the management of local government or the local economy is negative point in these island-type cities. In addition, the public transportation coverage in Miyako Island, Sado Island, and Amakusa Island show low value compare with other islands and average value. Relationship between evaluation indexes of an urban structure and the place of residence prove that the place of residence is related to public transportation coverage. If the place of residence is spread out, the public transportation coverage will be decreased. The results of this research reveal that the finances in island-type cities are negative point compare to general cities. This problem is caused by declining population. In addition, the place of residence is related to the public transportation coverage. Even though, it needs a much money to increase the public transportation coverage. It is possibly to cause other problems furthermore the aspect of finance is influenced by that as well. The conclusion in this research suggests that it is important for creating the compact city in island-type cities that we first need to address solving the problems about the management of local government and the local economy.

Keywords: sustainable city, comparative analysis, geographic information system, urban structure

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Authors: Angelica S. Valeriani, Lorenzo Biasiolo

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In recent years, the scale of the impact of climate change and its related side effects has become ever more massive and devastating. Sustainable Development Goals (SDGs), promoted by United Nations, aim to front issues related to climate change, among others. In particular, the project CROWD4SDG focuses on a bunch of SDGs since it promotes environmental activities and climate-related issues. In this context, we developed a prototype of an application, under advanced development considering web design, that focuses on SDG 13 (SDG on climate action) by providing users with useful instruments to face environmental crises and climate-related disasters. Our prototype is thought and structured for both web and mobile development. The main goal of the application, POLI4SDG, is to help users to get through emergency services. To this extent, an organized overview and classification prove to be very effective and helpful to people in need. A careful analysis of data related to environmental crises prompted us to integrate the user contribution, i.e., exploiting a core principle of Citizen Science, into the realization of a public catalog, available for consulting and organized according to typology and specific features. In addition, gender equality and opportunity features are considered in the prototype in order to allow women, often the most vulnerable category, to have direct support. The overall description of the application functionalities is detailed. Moreover, the implementation features and properties of the prototype are discussed.

Keywords: crowdsourcing, social media, SDG, climate change, natural disasters, gender equality

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Authors: Ijaz Ul Haq, Fiorenzo Franceschini

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The distributed manufacturing methodology brings a new concept of decentralized manufacturing operations close to the proximity of end users. A preliminary scale, to measure distributed capacity and evaluate positioning of firms, is developed in this research. In the first part of the paper, a literature review has been performed which highlights the explorative nature of the studies conducted to present definitions and classifications due to novelty of this topic. From literature, five dimensions of distributed manufacturing development stages have been identified: localization, manufacturing technologies, customization and personalization, digitalization and democratization of design. Based on these determinants a conceptual scale is proposed to measure the status of distributed manufacturing of a generic firm. A multiple case study is then conducted in two steps to test the conceptual scale and to identify the corresponding level of distributed potential in each case study firm.

Keywords: distributed manufacturing, distributed capacity, localized production, ordinal scale

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Authors: Ricardo Chaves, Carlos Vasconcelos

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Candidates to join the Naval Academy have to take a set of physical tests, which is crucial for a high level of physical fitness. Thus, the planning of physical exercises for candidates to the Naval School must take into account the improvement of their physical fitness. The aim of this study was to investigate the impact of a 6-month exercise program to improve the physical fitness of an individual who will apply for the Naval Academy. This was a non-experimental pre-post-evaluation study. The patient was male, had 18 years old, and a body mass index of 21.1 kg.m². The patient participated in a 6-month aerobic and strength exercise program (3 sessions per week, 75 minutes duration each session). Physical fitness tests were performed according to the physical fitness requirements for entry into the Naval academy (muscle strength [maximum number of lifts and maximum number of sit-ups for 1 minute]; aerobic fitness [2.4 km run and 200 m swimming test]) before (baseline) and after the exercise intervention (6 months). Regarding muscle strength, in the abdominal test, the improvements between the pre-test (39 abdominals.) and post-test (61 abdominals) were 56.4%. For elevations, there was an increase in its number by 150% between the pre-test (4 elevations) and post-test (10 elevations). With regard to aerobic fitness, in the 2.4 km race, there was an evolution of 32.0% between the pre-test (16.46 min.) and the post-test (12.42 min.). For the 200-meter swimming test, there was a negative variation of 2% between the pre-test (2.25 min.) and post-test (2.28 min). A 6-month aerobic and strength exercise program leads to a positive evolution in the muscular strength of the patient. Regarding aerobic fitness, opposite results were found, with a positive evolution in the 2.4 km running test and a negative evolution in the swimming test. In future exercise programs for the improvement of the physical fitness of candidates for the Naval Academy, more emphasis has to be done on specific swimming training.

Keywords: case study, exercise program, Naval Academy, physical fitness

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Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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Authors: Carlos Alberto Ríos-Reyes, Efraín Casadiego-Quintero

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We propose a generalized workflow for mineralogy investigation of unconventional reservoirs using multi-scale imaging and pore-scale analyses. This workflow can be used for the integral evaluation of these resources. The Cretaceous La Luna Formation´s mudstones in the Middle Magdalena Valley Basin (Colombia) inherently show a heterogeneous pore system with organic and inorganic pores. For this reason, it is necessary to carry out the integration of high resolution 2D images of mapping by conventional petrography, scanning electron microscopy and quantitative evaluation of minerals by scanning electron microscopy to describe their organic and inorganic porosity to understand the transport mechanism through pores. The analyzed rocks show several pore types, including interparticle pores, organoporosity, intraparticle pores, intraparticle pores, and microchannels and/or microfractures. The existence of interconnected pores in pore system of these rocks promotes effective pathways for primary gas migration and storage space for residual hydrocarbons in mudstones, which is very useful in this type of gas reservoirs. It is crucial to understand not only the porous system of these rocks and their mineralogy but also to project the gas flow in order to design the appropriate strategies for the stimulation of unconventional reservoirs. Keywords: mudstones; La Luna Formation; gas storage; migration; hydrocarbon.

Keywords: mudstones, La luna formation, gas storage, migration, hydrocarbon

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Authors: Faizan Rathore, Naveed Sultan, Humphrey O. Connor

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This study was carried out from Jan '12-Dec'12 to assess current practice in Kerry General Hospital against the age-related indicators for colonoscopies. A total of 1474 colonoscopies were performed,1177(79.9%) were diagnostic and 297 (20.1%) were therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal which made up the majority of the total diagnoses, 1330 (90.2%) of colonoscopies occurred without any complications. Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases. Patient discomfort was higher in younger patients as evidenced by 98 cases aged <75 , followed by 11 cases aged 75-80, 2 cases aged 81-85 and 1 case aged >86. Highest percentage of poor tolerance was found in 14 (1.1%) of total patients <75, 1 (0.8%) of total patients aged 75-80, 1(1.7%) of total patients in age group 81-85 and none (0%) in age group >86. We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in the presence of other comorbidities in elderly is questionable.

Keywords: colonoscopy, elderly patients, utility, tolerance

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Authors: A. Kherraf, M. Bouziane, L. Azzouzi, R. Habbal

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Introduction: Hypocalcaemia is a rare cause of heart failure. We report the clinical case of a young patient with reversible dilated cardiomyopathy secondary to hypocalcaemia in the context of hyperparathyroidism. Clinical case: We report the clinical case of a 23-year-old patient with a history of thyroidectomy for papillary thyroid carcinoma 3 years previously, who presented to the emergency room with a progressive onset dyspnea and edema of the lower limbs. Clinical examination showed hypotension at 90/70 mmHg, tachycardia at 102 bpm, and edema of the lower limbs. The ECG showed a regular sinus rhythm with a prolonged corrected QT interval to 520ms. The chest x-ray showed cardiomegaly. Echocardiography revealed dilated cardiomyopathy with biventricular dysfunction and a left ventricular ejection fraction of 45%, as well as moderate mitral insufficiency by restriction of the posterior mitral leaflet, moderate tricuspid insufficiency, and a dilated inferior vena cava with a pulmonary arterial pressure estimated at 46 mmHg. Blood tests revealed severe hypocalcemia at 38 mg / l with normal albumin and thyroxine levels, as well as hyperphosphatemia and increased TSH. The patient received calcium intake and vitamin D supplementation and was treated with beta blockers, ACE inhibitors, and diuretics with good progress and progressive normalization of cardiac function. Discussion: The cardiovascular manifestations of hypocalcaemia usually appear with deeply low serum calcium levels. This can lead to hypotension, arrhythmias, ventricular fibrillation, prolonged QT interval, or even heart failure. Heart failure is a rare and serious complication of hypocalcemia but most often characterized by complete normalization of myocardial function after treatment. The etiology of the hypocalcaemia, in this case, was probably related to accidental parathyroid removal during thyroidectomy. This is why careful monitoring of calcium levels is recommended after surgery. Conclusion: Hypocalcemic heart failure is rare but reversible heart disease. Systematic monitoring of serum calcium should be performed in all patients after thyroid surgery to avoid any complications related to hypoparathyroidism.

Keywords: hypocalcemia, heart failure, thyroid surgery, hypoparathyroidism

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Authors: Juan Sepúlveda

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Energy is a fundamental component in sustainability, the access and use of this resource is related with economic growth, social improvements, and environmental impacts. In this sense, energy efficiency has been studied as a factor that enhances the positive impacts of energy in communities; however, the implementation of efficiency requires strong policy and strategies that usually rely on individual measures focused in independent dimensions. In this paper, the problem of energy efficiency as a multi-objective problem is studied, using scientometric analysis to discover trends and patterns that allow to identify the main variables and study approximations related with a further development of models to integrate energy efficiency and MCA into policy making for small communities.

Keywords: energy efficiency, MCA, scientometric, trends

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Authors: Benedikt Munzar, Jagraj Singh, Alice Mei, David Musheyev, Sandeep Gandhi

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Clostridium is a gram-positive, anaerobic, spore-forming rod that is not commonly identified as a primary human pathogen. Here is presented a case of a 60-year-old patient with a history of opioid use disorder who underwent a number of abdominal surgeries for small bowel obstruction. His hospital course was complicated by Clostridium glycolicum infection, resulting in an acute abdomen. The patient clinically improved with antibiotic therapy. A thorough review of the National Institute of Health database revealed that only a small number of cases have been reported since 2007, with the last postsurgical cases documented in 2009 and the last clinical case documented in 2012. Clostridium glycolicum infections have been noted in patients with immunosuppressive conditions or those undergoing medical treatments that compromise immune function. This case was unusual due to the patient being immunocompetent. We suggest that a case of an acute abdomen should consider this organism as an etiological agent.

Keywords: acute abdomen, bacterial infection, clostridium glycolicum, Meckel’s diverticulum, pneumoperitoneum, small bowel obstruction

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Authors: Abrar R. Al-Hasan

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Despite the widespread use of social media by consumers and marketers, empirical research investigating their economic value in the healthcare industry still lags. This study explores the impact of the use of social media marketing efforts on a hospital's brand equity and, ultimately, consumer response. Using social media data from Twitter and Facebook, along with an online and offline survey methodology, data is analyzed using logistic regression models. A random sample of (728) residents of the Kuwaiti population is used. The results of this study found that social media marketing efforts (SMME) in terms of use and validation lead to higher hospital brand equity and in turn, patient loyalty and patient visit. The study highlights the impact of SMME on hospital brand equity and patient response. Healthcare organizations should guide their marketing efforts to better manage this new way of marketing and communicating with patients to enhance their consumer loyalty and financial performance.

Keywords: brand equity, healthcare marketing, patient visit, social media, SMME

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Authors: Megan Glyde, Louise Dye, David Keane, Ed Sutherland

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Background: Typically patient education is provided either verbally, in the form of written material, or with a multimedia-based tool such as videos, CD-ROMs, DVDs, or via the internet. By providing patients with effective educational tools, this can help to meet their information needs and subsequently empower these patients and allow them to participate within medical-decision making. Video education may have some distinct advantages compared to other modalities. For instance, whilst eHealth is emerging as a promising modality of patient education, an individual’s ability to access, read, and navigate through websites or online modules varies dramatically in relation to health literacy levels. Literacy levels may also limit patients’ ability to understand written education, whereas video education can be watched passively by patients and does not require high literacy skills. Other benefits of video education include that the same information is provided consistently to each patient, it can be a cost-effective method after the initial cost of producing the video, patients can choose to watch the videos by themselves or in the presence of others, and they can pause and re-watch videos to suit their needs. Health information videos are not only viewed by patients in formal educational sessions, but are increasingly being viewed on websites such as YouTube. Whilst there is a lot of anecdotal and sometimes misleading information on YouTube, videos from government organisations and professional associations contain trustworthy and high-quality information and could enable YouTube to become a powerful information dissemination platform for patients and carers. This systematic review will examine the efficacy of video education to improve treatment or illness-related knowledge in patients with various long-term conditions, in comparison to other modalities of education. Methods: Only studies which match the following criteria will be included: participants will have a long-term physical health condition, video education will aim to improve treatment or illness related knowledge and will be tested in isolation, and the study must be a randomised controlled trial. Knowledge will be the primary outcome measure, with modality preference, anxiety, and behaviour change as secondary measures. The searches have been conducted in the following databases: OVID Medline, OVID PsycInfo, OVID Embase, CENTRAL and ProQuest, and hand searching for relevant published and unpublished studies has also been carried out. Screening and data extraction will be conducted independently by 2 researchers. Included studies will be assessed for their risk of bias in accordance with Cochrane guidelines, and heterogeneity will also be assessed before deciding whether a meta-analysis is appropriate or not. Results and Conclusions: Appropriate synthesis of the studies in relation to each outcome measure will be reported, along with the conclusions and implications.

Keywords: long-term condition, patient education, systematic review, video

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Authors: Yuan-lin Liu, Ye Li, Tian Xia

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There are some shortcomings in Chinese existing taxi management modes. This paper suggests to establish the third-party comprehensive information management platform and put forward an evaluation model based on credit. Four indicators are used to evaluate the drivers’ credit, they are passengers’ evaluation score, driving behavior evaluation, drivers’ average bad record number, and personal credit score. A weighted clustering method is used to achieve credit level evaluation for taxi drivers. The management of taxi industry is based on the credit level, while the grade of the drivers is accorded to their credit rating. Credit rating determines the cost, income levels, the market access, useful period of license and the level of wage and bonus, as well as violation fine. These methods can make the credit evaluation effective. In conclusion, more credit data will help to set up a more accurate and detailed classification standard library.

Keywords: credit, mobile internet, e-hailing taxi, management mode, weighted cluster

Procedia PDF Downloads 325

Authors: Faizah Asiri, Mohammed Fathy, Saeed Alghamdi, Nahlah Ayoub, Faisal Asiri

Abstract:

Background: - The strategies for this study were based on the toxic effect of long-term inhalation of Benzene on hormones and liver enzymes and various parameters related to it. The following databases were searched: benzene, hepatotoxic, benzene metabolism, hormones, testosterone, hemotoxic, and prolonged exposure. A systematic strategy is designed to search the literature that links benzene with the multiplicity and different types of intoxication or the medical abbreviations of diseases relevant to benzene exposure. Evidence suggests that getting rid of inhaled gasoline is by exhalation. Absorbed benzene is metabolized by giving phenolic acid as well as meconic acid, followed by urinary excretion of conjugate sulfates and glucuronides. Materials and Methods :- This work was conducted in the Al-Khadra laboratory in Taif 2020/2021 and aimed to measure some of the possible endocrinal and liver toxicities associated with benzene's long-term exposure in Saudi Arabia at the station workers who are considered the most exposed category to gasoline. One hundred ten station workers were included in this study. They were divided into four patient groups according to the chronic exposure rate to benzene, one control group, and three other groups of exposures. As follows: patient Group 1 (controlled group), patient Group 2 (exposed less than 1y), patient Group 3 (exposed 1-5 y), patient Group 4 (more than 5). Each group is compared with blood sample parameters (ALT, FSH and Testosterone, TSH). Blood samples were drawn from the participants, and statistical tests were performed. Significant change (p≤0.05) was examined compared to the control group. Workers' exposure to benzene led to a significant change in hematological, hormonal, and hepatic factors compared to the control group. Results:- The results obtained a relationship between long-term exposure to benzene and a decrease in the level of testosterone and FSH hormones, including that it poses a toxic risk in the long term (p≤0.05) when compared to the control. We obtained results confirming that there is no significant coloration between years of exposure and TSH level (p≤0.05) when compared to the control. Conclusion:- We conclude that some hormones and liver enzymes are affected by chronic doses of benzene through inhalation after our study was on the group most exposed to benzene, which is gas station workers.

Keywords: toxicities, benzene, hormones, station workers

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Authors: Sohail Zafar, Sardar Javaid Iqbal Khan

Abstract:

We use a parametric approach within a translog cost function framework to estimate the economies of scale in National Bank of Pakistan from 1997 to 2013. The results indicate significant economies of scale throughout the sample at aggregates and disaggregates taking in account size subject to stipulation ownership. The factor markets often produce scale inefficiencies in the banking of developing countries like Pakistan such inefficiencies are common due to distortion in factor markets leading to the use of inappropriate factor proportions. The findings suggest that National Bank of Pakistan diversify their asset portfolios that it has cost advantage, therefore, expansion in size should be encouraged under current technology because it appears to be cost effective. In addition, our findings support the implementation of universal banking model in Pakistan.

Keywords: scale economies, cost function, disaggregates, aggregates

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Authors: Tomas Barnak, Libor Matejka

Abstract:

The aim of this study is to create a standard application using multi-criteria evaluation in the field of forensic engineering. This situation can occur in the professional assessment in several cases such as when it is necessary to consider more criteria variant of the structural subsystems, more variants according to several criteria based on a court claim, which requires expert advice. A problematic situation arises when it is necessary to clearly determine the ranking of the options according to established criteria, and reduce subjective evaluation. For the procurement in the field of construction which is based on the prepared text of the law not only economic criteria but also technical, technological and environmental criteria will be determined. This fact substantially changes the style of evaluation of individual bids. For the above-mentioned needs of procurement, the unification of expert’s decisions and the use of multi-criteria assessment seem to be a reasonable option. In the case of experimental verification when using multi-criteria evaluation of alternatives construction subsystem the economic, technical, technological and environmental criteria will be compared. The core of the solution is to compare a selected number of set criteria, application methods and evaluation weighting based on the weighted values assigned to each of the criteria to use multi-criteria evaluation methods. The sequence of individual variations is determined by the evaluation of the importance of the values of corresponding criteria concerning expertise in the problematic of outside wall constructional subsystems.

Keywords: criteria, expertise, multi-criteria evaluation, outside wall subsystems

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Authors: Mehmet Bulent Topkaya, Mustafa Yildirim

Abstract:

Wastewater treatment systems are designed and used to minimize adverse impacts of the wastewater on the environment before discharging. Various treatment options for wastewater treatment have been developed, and each of them has different performance characteristics and environmental impacts (e.g. material and land usage, energy consumption, greenhouse gas emission, water and soil emission) during construction, operation or maintenance phases. Assessing the environmental impacts during these phases are essential for the overall evaluation of the treatment systems. In this study, wastewater treatment options, such as vegetated land treatment, constructed wetland, rotating biological contactor, conventional activated sludge treatment, membrane bioreactor, extended aeration and stabilization pond are evaluated. The comparison of the environmental impacts is conducted under the assumption that the effluents will be discharged to sensitive and less sensitive areas respectively. The environmental impacts of each alternative are evaluated by life cycle assessment (LCA) approach. For this purpose, data related to energy usage, land requirement, raw material consumption, and released emissions from the life phases were collected with inventory studies based on field studies and literature. The environmental impacts were assessed by using SimaPro 7.1 LCA software. As the scale of the LCA results is global, an MS-Excel based decision support tool that includes the LCA result is developed in order to meet also the local demands. Using this tool, it is possible to assign weight factors on the LCA results according to local conditions by using Analytical Hierarchy Process and finally the most environmentally appropriate treatment option can be selected.

Keywords: analytical hierarchy process, decision support system, life cycle assessment, wastewater treatment

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Authors: Iwona Kasior

Abstract:

Purpose: Pelvic organ prolapse is the descent of pelvic organs into the vaginal opening. Currently, few trials have been conducted to determine the influence of pelvic floor muscle training in decreasing stage or symptoms associated with pelvic organ prolapse. The purpose of this case study is to determine whether pelvic floor muscle training can decrease the stage of pelvic organ prolapse and related symptoms. Case Presentation: This is the case of a 55-year-old female; recently diagnosed with midline cystocele, stage three. She has undergone corrective surgery that failed. She has now resorted to managing the condition with a home exercise regimen of voluntary pelvic floor muscle contractions, topical vaginal crème prescribed by her gynecologist, and slight lifestyle modifications. Methods: The patient was treated by a physical therapist for evaluation, vaginal exam, and educated in the ‘knack’ maneuver, lifestyle modifications, and proper technique of performing pelvic floor muscle contractions. The subject continued with a home exercise program with a specific regimen of pelvic floor muscle contractions and topical vaginal crème. Outcome: As determined by her physical therapist and the subject, her pelvic floor muscle strength had increased following the pelvic floor muscle training regimen and the use of the ‘knack’ maneuver. The subject reported a small decrease in the size of bulging prolapse and related symptoms of dryness, odor, vaginal discomfort, and the sensation of descent. Conclusion: Pelvic floor muscle training helped to lessen the degree of the prolapse, but not significantly enough to decrease the diagnosed stage.

Keywords: Kegel exercises, pelvic floor, pelvic organ prolapse, physical therapy

Procedia PDF Downloads 194

Authors: Vishal Kumar Singh

Abstract:

Bioprocess development is a time-constrained activity aimed at harnessing the full potential of culture performance in an ambience that is not natural to cells. Even with the use of chemically defined media and feeds, a significant amount of time is devoted in identifying the apt operating parameters. In addition, the scale-up of these processes is often accompanied by loss of antibody titer and product quality, which further delays the commercialization of the drug product. In such a scenario, the investigation of this disparity of culture performance is done by further experimentation at a smaller scale that is representative of at-scale production bioreactors. These scale-down model developments are also time-intensive. In this study, a computation fluid dynamics-based multi-objective scaling approach has been illustrated to speed up the process transfer. For the implementation of this approach, a transient multiphase water-air system has been studied in Ansys CFX to visualize the air bubble distribution and volumetric mass transfer coefficient (kLa) profiles, followed by the design of experiment based parametric optimization approach to define the operational space. The proposed approach is completely in silico and requires minimum experimentation, thereby rendering a high throughput to the overall process development.

Keywords: bioprocess development, scale up, scale down, computation fluid dynamics, multi-objective, Ansys CFX, design of experiment

Procedia PDF Downloads 82

Authors: Yen-Hsia Lin, Ya-Fang Cheng, Hui-Zhu Chen, Chi-Hui Tiao

Abstract:

This is a case study of a 70-year-old man suffering from Type 2 diabetes mellitus and hyperglycemia hyperosmolarity state. He was admitted into the intensive care unit from the 20th to 26th of October, 2015. After receiving relevant information through open-ended conversations, observation, and physical assessment, as well as the psychological, social and spiritual holistic nursing assessment, several clinical health problems such as unstable blood sugar, impaired skin integrity and lack of self-care management knowledge were identified by the author. During the period of care, the patient was encouraged to share and express his feelings, an active listening and initiating approach from the nursing team had led to the understanding of why the patient refused to use insulin. This knowledge enabled the nursing team to manage patient care by educating the patient with self-care management skills, such as foot wound care and insulin injection skills to slow the deterioration of complications. Also, the implementation of appropriate diet and exercise routine to improve patients’ style. By enhancing self-care ability in diabetic patients, they are able to return home with the skill to improve better quality life style.

Keywords: hyperglycemia hyperosmolar state, type2 diabetes Mellitu, diabetes Mellitu foot care, intensive care

Procedia PDF Downloads 146