Search results for: Greek public hospital sector

Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena

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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.

Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure

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Authors: Mohammad Iqbal Malik

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Economic development of a country depends on its business ethics and values. Islamic teachings provide obvious guidelines in this regard. Mutual understanding, honesty and ethics possess central place in Islamic teachings. These teachings not only prohibit from amalgamation, black-marketing, hoarding and deception but also force to treat a customer amiably. Business ethics are broad spectrum in Islamic society due to these high moral values. One can estimate the importance of business ethics in Islam for economic development in Islamic society is evident by the Hadith of Prophet Muhammad (PBUH) in which He excluded a trader from Muslim community who did not behave in good manners with his clients. In this study we present impact of business ethics on economic development of a Muslim society. This study is based on basic teachings of Quran and Sunnah, Fiqh, Economics and other books. This study explores the behavior of Muslim traders and reveals useful inferences. Policy makers, traders, academia, scholars, and general public may learn lessons from this study with respect to business ethics in Islamic perspective.

Keywords: ethics, business, Islam, economic perspective

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Naeem Ahmed

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Social work is a professional activity based on the approach of “helping people to help themselves” (Stroup). Social work education and practice both are based on humanitarian philosophy in which social workers try to increase the happiness of the society and to reduce the problems of society. Labour welfare is a specialised field of social work which especially focuses on welfare of organised and unorganised labour. In India labour is facing numerous problems in both organised and unorganised sectors because of ignorance, illiteracy, high rate of unemployment etc. In most of the Indian social work institutions we have this specialization with different names like Human Resource Management or Industrial Relation and Personnel Management or Industrial Relations and Labour Welfare or Industrial Social Work etc. Field work practice is integrated part of social work education curriculum in all specialised field. In India we have different field work practice models being followed in different institutions. The main objective of this paper is to prepare a universal field work practicum model in the field of labour welfare. This paper is exploratory in nature, researcher used personal experience and secondary data (model of field work practice in different institutions like Aligarh Muslim University, Pondicherry University, Central University of Karnataka, University of Lucknow, MJP Rohilkhand University Bareilly etc.) Researcher found that there is an immediate need to upgrade the curriculum or field work practice in this particular field, as more than 40 percent of total population engaged in either unorganised or organised sector (NSSO 2011-12) and they are not aware about their rights. In this way a social worker can play an important role in existing labour welfare facilities by making them aware.

Keywords: field work, labour welfare, organised labour, social work practice, unorganised labour

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Authors: Raha Bahreini

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This paper discusses the roll-back of women’s sexual and reproductive rights in the Islamic Republic of Iran, which has come in the wake of a striking shift in the country’s official population policies. Since the late 1980s, Iran has won worldwide praise for its sexual and reproductive health and services, which have contributed to a steady decline in the country’s fertility rate–from 7.0 births per women in 1980 to 5.5 in 1988, 2.8 in 1996 and 1.85 in 2014. This is owed to a significant increase in the voluntary use of modern contraception in both rural and urban areas. In 1976, only 37 per cent of women were using at least one method of contraception; by 2014 this figure had reportedly risen to a high of nearly 79 per cent for married girls and women living in urban areas and 73.78 per cent for those living in rural areas. Such progress may soon be halted. In July 2012, Iran’s Supreme Leader Ayatollah Sayed Ali Khamenei denounced Iran’s family planning policies as an imitation of Western lifestyle. He exhorted the authorities to increase Iran’s population to 150 to 200 million (from around 78.5 million), including by cutting subsidies for contraceptive methods and dismantling the state’s Family and Population Planning Programme. Shortly thereafter, Iran’s Minister of Health and Medical Education announced the scrapping of the budget for the state-funded Family and Population Planning Programme. Iran’s Parliament subsequently introduced two bills; the Comprehensive Population and Exaltation of Family Bill (Bill 315), and the Bill to Increase Fertility Rates and Prevent Population Decline (Bill 446). Bill 446 outlaws voluntary tubectomies, which are believed to be the second most common method of modern contraception in Iran, and blocks access to information about contraception, denying women the opportunity to make informed decisions about the number and spacing of their children. Coupled with the elimination of state funding for Iran’s Family and Population Programme, the move would undoubtedly result in greater numbers of unwanted pregnancies, forcing more women to seek illegal and unsafe abortions. Bill 315 proposes various discriminatory measures in the areas of employment, divorce, and protection from domestic violence in order to promote a culture wherein wifedom and child-bearing is seen as women’s primary duty. The Bill, for example, instructs private and public entities to prioritize, in sequence, men with children, married men without children and married women with children when hiring for certain jobs. It also bans the recruitment of single individuals as family law lawyers, public and private school teachers and members of the academic boards of universities and higher education institutes. The paper discusses the consequences of these initiatives which would, if continued, set the human rights of women and girls in Iran back by decades, leaving them with a future shaped by increased inequality, discrimination, poor health, limited choices and restricted freedoms, in breach of Iran’s international human rights obligations.

Keywords: family planning and reproductive health, gender equality and empowerment of women, human rights, population growth

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Authors: Taif Rocky, Uttam Saha, Mahobul Islam

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With a rapid urbanisation in Bangladesh, waste management remains one of the core challenges. Turning municipal waste into biogas for mass usage is a solution that Bangladesh needs to adopt urgently. Practical Action with its commitment to challenging poverty with technological justice has piloted such idea in Gaibandha. The initiative received immense success and drew the attention of policy makers and practitioners. We believe, biogas from waste can highly contribute to meet the growing demand for energy in the country at present and in the future. Practical Action has field based experience in promoting small scale and innovative technologies. We have proven track record in integrated solid waste management. We further utilized this experience to promote waste to biogas at end users’ level. In 2011, we have piloted a project on waste to biogas in Gaibandha, a northern secondary town of Bangladesh. With resource and support from UNICEF and with our own innovative funds we have established a complete chain of utilizing waste to the renewable energy source and organic fertilizer. Biogas is produced from municipal solid waste, which is properly collected, transported and segregated by private entrepreneurs. The project has two major focuses, diversification of biogas end use and establishing a public-private partnership business model. The project benefits include Recycling of Wastes, Improved institutional (municipal) capacity, Livelihood from improved services and Direct Income from the project. Project risks include Change of municipal leadership, Traditional mindset, Access to decision making, Land availability. We have observed several outcomes from the initiative. Up scaling such an initiative will certainly contribute for sustainable cleaner and healthier urban environment and urban poverty reduction. - It reduces the unsafe disposal of wastes which improve the cleanliness and environment of the town. -Make drainage system effective reducing the adverse impact of water logging or flooding. -Improve public health from better management of wastes. -Promotes usage of biogas replacing the use of firewood/coal which creates smoke and indoor air pollution in kitchens which have long term impact on health of women and children. -Reduce the greenhouse gas emission from the anaerobic recycling of wastes and contributes to sustainable urban environment. -Promote the concept of agroecology from the uses of bio slurry/compost which contributes to food security. -Creates green jobs from waste value chain which impacts on poverty alleviation of urban extreme poor. -Improve municipal governance from inclusive waste services and functional partnership with private sectors. -Contribute to the implementation of 3R (Reduce, Reuse, Recycle) Strategy and Employment Creation of extreme poor to achieve the target set in Vision 2021 by Government of Bangladesh.

Keywords: kitchen waste, secondary town, biogas, segregation

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Authors: K. Govender, M. Sinclair

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This paper demonstrates a proof of concept whereby shorter trips and land use densification can be promoted through an alternative approach to planning and implementation of road infrastructure in the South African context. It briefly discusses how the development of the Compact City concept relies on a combination of promoting shorter trips and densification through a change in focus in road infrastructure provision. The methodology developed in this paper uses a traffic model to test the impact of synthesized deterrence functions on congestion locations in the road network through the assignment of traffic on the study network. The results from this study demonstrate that intelligent planning of road infrastructure can indeed promote reduced urban sprawl, increased residential density and mixed-use areas which are supported by an efficient public transport system; and reduced dependence on the freeway network with a fixed road infrastructure budget. The study has resonance for all cities where urban sprawl is seemingly unstoppable.

Keywords: compact cities, densification, road infrastructure planning, transportation modelling

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Authors: Nichole Haag, Kimberly Velk, Tyler McCune, Chun Wu

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Methicillin/multiple-resistant Staphylococcus aureus (MRSA) are infectious bacteria that are resistant to common antibiotics. A previous in silico study in our group has identified a hypothetical protein SAV1226 as one of the potential drug targets. In this study, we reported the bioinformatics characterization, as well as cloning, expression, purification and kinetic assays of hypothetical protein SAV1226 from methicillin/vancomycin-resistant Staphylococcus aureus Mu50 strain. MALDI-TOF/MS analysis revealed a low degree of structural similarity with known proteins. Kinetic assays demonstrated that hypothetical protein SAV1226 is neither a domain of an ATP dependent dihydroxyacetone kinase nor of a phosphotransferase system (PTS) dihydroxyacetone kinase, suggesting that the function of hypothetical protein SAV1226 might be misannotated on public databases such as UniProt and InterProScan 5.

Keywords: Methicillin-resistant Staphylococcus aureus, dihydroxyacetone kinase, essential genes, drug target, phosphoryl group donor

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Authors: Băilă Diana Irinel, Păcurar Răzvan, Păcurar Ancuța

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Although the volumes of fibre reinforced polymer composites (FRPs) used for aircraft applications is a relatively small percentage of total use, the materials often find their most sophisticated applications in this industry. In aerospace, the performance criteria placed upon materials can be far greater than in other areas – key aspects are light-weight, high-strength, high-stiffness, and good fatigue resistance. Composites were first used by the military before the technology was applied to commercial planes. Nowadays, composites are widely used, and this has been the result of a gradual direct substitution of metal components followed by the development of integrated composite designs as confidence in FRPs has increased. The airplane uses a range of components made from composites, including the fin and tailplane. In the last years, composite materials are increasingly used in automotive applications due to the improvement of material properties. In the aerospace and automotive sector, the fuel consumption is proportional to the weight of the body of the vehicle. A minimum of 20% of the cost can be saved if it used polymer composites in place of the metal structures and the operating and maintenance costs are alco very low. Glass fiber-epoxy composites are widely used in the making of aircraft and automobile body parts and are not only limited to these fields but also used in ship building, structural applications in civil engineering, pipes for the transport of liquids, electrical insulators in reactors. This article was establish the high-performance of composite material, a type glass-epoxy used in automotive and aeronautic domains, concerning the tensile and flexural tests and SEM analyzes.

Keywords: glass-epoxy composite, traction and flexion tests, SEM analysis, acoustic emission (AE) signals

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Authors: Fergal Fouhy, Alan O’Keeffe, Sean Costelloe, Michael Clarkson

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Background: Sarcoidosis is a systemic, non-infectious disease of unknown aetiology, characterized by non-caseating granulomatous inflammation. The lung is most often affected (90%); however, the condition can affect all organs, including the kidneys. There is limited evidence describing the incidence and characteristics of renal involvement in sarcoidosis. Serum angiotensin-converting enzyme (ACE) is a recognised biomarker used in the diagnosis and monitoring of sarcoidosis. Methods: A single-centre, retrospective cohort study of patients presenting to Cork University Hospital (CUH) in 2015 with first-time elevations of serum ACE was performed. This included an initial database review of ACE and other biochemistry results, followed by a medical chart review to confirm the presence or absence of sarcoidosis and management thereof. Acute kidney injury (AKI) was staged using the AKIN criteria, and chronic kidney disease (CKD) was staged using the KDIGO criteria. Follow-up was assessed over five years tracking serum creatinine, serum calcium, and estimated glomerular filtration rates (eGFR). Results: 119 patients were identified as having a first raised serum ACE in 2015. Seventy-nine male patients and forty female patients were identified. The mean age of patients identified was 47 years old. 11% had CKD at baseline. 18% developed an AKI at least once within the next five years. A further 6% developed CKD during this time period. 13% developed hypercalcemia. The patients within the lowest quartile of serums ACE had an incidence of sarcoidosis of 5%. None of this group developed hypercalcemia, 23% developed AKI, and 7% developed CKD. Of the patients with a serum ACE in the highest quartile, almost all had documented diagnoses of sarcoidosis with an incidence of 96%. 3% of this group developed hypercalcemia, 13% AKI and 3% developed CKD. Conclusions: There was an unexpectedly high incidence of AKI in patients who had a raised serum ACE. Not all patients with a raised serum ACE had a confirmed diagnosis of sarcoidosis. There does not appear to be a relationship between increased serum ACE levels and increased incidence of hypercalcaemia, AKI, and CKD. Ideally, all patients should have biopsy-proven sarcoidosis. This is an initial study that should be replicated with larger numbers and including multiple centres.

Keywords: sarcoidosis, acute kidney injury, chronic kidney disease, hypercalcemia

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Authors: Chutikarn Sriviboon

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The objectives of this research were to study the operation of the Labor Fund and to investigate the needs for money and assistance from Thai laborers both from within the system and out of the system and to compare between the assistance from domestic and international funds. The population of this study included three labor groups: group one was laborer in the system who were the members of saving cooperative, group two was laborer in the system who were not the members of saving cooperative, and group three was laborer who were not in the system. This was a mixed research of quantitative and qualitative methods. The findings can be categorized into four parts. First, the labor fund was beneficial to Thai laborers by giving access to government funds but the weakness was found to be poor public relations. Second, the labor funds should extend their assistance to laborer in the system who was not the members of saving cooperative. Third, the comparison between domestic labor funds and international labor funds revealed that there were no international funds which provided assistance the same way as Thai labor funds. Finally, there was a need to improve the management of labor funds and to provide long term assistance to Thai labors.

Keywords: effectiveness, quality, labor funds, service

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Authors: Tao Feng, Xiaomei Ma, Xian Guo, Jing Wang

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Named Data Network (NDN) is one of the future Internet architecture, all nodes (i.e., hosts, routers) are allowed to have a local cache, used to satisfy incoming requests for content. However, depending on caching allows an adversary to perform attacks that are very effective and relatively easy to implement, such as content pollution attack. In this paper, we use a method of secure network coding based on homomorphic signature system to solve this problem. Firstly ,we use a dynamic public key technique, our scheme for each generation authentication without updating the initial secret key used. Secondly, employing the homomorphism of hash function, intermediate node and destination node verify the signature of the received message. In addition, when the network topology of NDN is simple and fixed, the code coefficients in our scheme are generated in a pseudorandom number generator in each node, so the distribution of the coefficients is also avoided. In short, our scheme not only can efficiently prevent against Intra/Inter-GPAs, but also can against the content poisoning attack in NDN.

Keywords: named data networking, content polloution attack, network coding signature, internet architecture

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Authors: C. Malça, P. Gonçalves, N. Alves, A. Mateus

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Regardless of the manufacturing process used, subtractive or additive, material, purpose and application, produced components are conventionally solid mass with more or less complex shape depending on the production technology selected. Aspects such as reducing the weight of components, associated with the low volume of material required and the almost non-existent material waste, speed and flexibility of production and, primarily, a high mechanical strength combined with high structural performance, are competitive advantages in any industrial sector, from automotive, molds, aviation, aerospace, construction, pharmaceuticals, medicine and more recently in human tissue engineering. Such features, properties and functionalities are attained in metal components produced using the additive technique of Rapid Prototyping from metal powders commonly known as Selective Laser Melting (SLM), with optimized internal topologies and varying densities. In order to produce components with high strength and high structural and functional performance, regardless of the type of application, three different internal topologies were developed and analyzed using numerical computational tools. The developed topologies were numerically submitted to mechanical compression and four point bending testing. Finite Element Analysis results demonstrate how different internal topologies can contribute to improve mechanical properties, even with a high degree of porosity relatively to fully dense components. Results are very promising not only from the point of view of mechanical resistance, but especially through the achievement of considerable variation in density without loss of structural and functional high performance.

Keywords: additive manufacturing, internal topologies, porosity, rapid prototyping, selective laser melting

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Authors: Arniyati Ahmad, Christopher Johnson, Timothy Storer

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Cyber exercises used to assess the preparedness of a community against cyber crises, technology failures and critical information infrastructure (CII) incidents. The cyber exercises also called cyber crisis exercise or cyber drill, involved partnerships or collaboration of public and private agencies from several sectors. This study investigates organisation cyber resilience (OCR) of participation sectors in cyber exercise called X Maya in Malaysia. This study used a principal based cyber resilience survey called C-Suite Executive checklist developed by World Economic Forum in 2012. To ensure suitability of the survey to investigate the OCR, the reliability test was conducted on C-Suite Executive checklist items. The research further investigates the differences of OCR in ten Critical National Infrastructure Information (CNII) sectors participated in the cyber exercise. The One Way ANOVA test result showed a statistically significant difference of OCR among ten CNII sectors participated in the cyber exercise.

Keywords: critical information infrastructure, cyber resilience, organisation cyber resilience, reliability test

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

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Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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Authors: Cengiz Demir, Recep Keşli, Gülşah Aşık

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Objective: This study was carried out with the purpose of defining by using the E test method and determining the antibiotic resistance profiles of Gram-negative anaerobic bacilli isolated from various clinical specimens obtained from patients with suspected anaerobic infections and referred to Medical Microbiology Laboratory of Afyon Kocatepe University, ANS Application and Research Hospital. Methods: Two hundred and seventy eight clinical specimens were examined for isolation of the anaerobic bacteria in Medical Microbiology Laboratory between the 1st November 2014 and 30th October 2015. Specimens were cultivated by using Scheadler agar that 5% defibrinated sheep blood added, and Scheadler broth. The isolated anaerobic Gram-negative bacilli were identified conventional methods and Vitek 2 (ANC ID Card, bioMerieux, France) cards. Antibiotic resistance rates against to penicillin G, clindamycin, cefoxitin, metronidazole, moxifloxacin, imipenem, meropenem, ertapenem and doripenem were determined with E-test method for each isolate. Results: Of the isolated twenty-eight anaerobic gram negative bacilli fourteen were identified as the B. fragilis group, 9 were Prevotella group, and 5 were Fusobacterium group. The highest resistance rate was found against penicillin (78.5%) and resistance rates against clindamycin and cefoxitin were found as 17.8% and 21.4%, respectively. Against to the; metronidazole, moxifloxacin, imipenem, meropenem, ertapenem and doripenem, no resistance was found. Conclusion: Since high rate resistance has been detected against to penicillin in the study penicillin should not be preferred in empirical treatment. Cefoxitin can be preferred in empirical treatment; however, carrying out the antibiotic sensitivity testing will be more proper and beneficial. No resistance was observed against carbapenem group antibiotics and metronidazole; so that reason, these antibiotics should be reserved for treatment of infectious caused by resistant strains in the future.

Keywords: anaerobic gram-negative bacilli, anaerobe, antibiotics and resistance profiles, e-test method

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Authors: Mehrdad HassanZadeh Dugoori, Iman Mohammadali Tajrishi

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Since Iran's nuclear program became public in 2002, the International Atomic Energy Agency (IAEA) has been unable to confirm Tehran's assertions that its nuclear activities are exclusively for peaceful purposes and that it has not sought to develop nuclear weapons. The United Nations Security Council has adopted six resolutions since 2006 requiring Iran to stop enriching uranium - which can be used for civilian purposes, but also to build nuclear bombs, which Iran never follow this strategy- and co-operate with the IAEA. Four resolutions have included progressively expansive sanctions to persuade Tehran to comply. The US and EU have imposed additional sanctions on Iranian oil exports and banks since 2012. In this article we reassess the sanction dimensions of Iran and the influences. Then according to the last agreement between P5+1 and Iran in 15 July 2015, we mention reconstruction strategies for oil export markets of Iran and the operational program for one million barrel of crude oil sales per day. These strategies are the conclusion of focus group and brain storming with Iran's oil and gas managers during content analysis.

Keywords: post-sanction, oil market, reconstruction, marketing, strategy

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Authors: Natalia Ortega

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Safety Culture (SCU) involves various perceptual, psychological, behavioral, and managerial factors. It has been shown that creating and maintaining an SCU is one way to reduce and prevent accidents and fatalities. In the construction sector, safety attitude, knowledge, and a supportive environment are predictors of safety behavior. The highest possible proportion of safety behavior among employees can be achieved by improving their safety attitude and knowledge. Accordingly, top management's commitment to safety is vital in shaping employees' safety attitude; therefore, the first step to improving employees' safety attitude is the genuine commitment of top management to safety. One of the factors affecting the successful implementation of health and safety promotion programs is the construction industry's subcontracting model. The contractual model's complexity, combined with the need for coordination among diverse stakeholders, makes it challenging to implement, manage, and follow up on health and well-being initiatives. The Systems theoretic accident model and process (STAMP) concept has expanded global consideration in recent years, increasing research attention. STAMP focuses attention on the role of constraints in safety management. The findings discover a growth of the research field from the definition in 2004 by Leveson and is being used across multiple domains. A systematic literature review of this novel model aims to meet the safety goals for human space exploration with a powerful and different approach to safety management, safety-driven design, and decision-making. Around two hundred studies have been published about applying the model. However, every single model for safety requires time to transform into research and practice, be tested and debated, and grow further and mature.

Keywords: stamp, risk management, accident prevention, safety culture, systems thinking, construction industry, safety

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Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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Authors: Jackson Simon Lusagalika, Lai Hsin-Chih, Dai Yu-Tung

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Particles with an aerodynamic diameter of 2.5 meters or less are referred to as "fine particulate matter" (PM₂.₅) are easily inhaled and can go deeper into the lungs than other particles in the atmosphere, where it may have detrimental health consequences. In this study, we use a hybrid model that combined CMAQ and AERMOD as well as initial meteorological fields from the Weather Research and Forecasting (WRF) model to study the impact of power plant PM₂.₅ emissions in South Taiwan since it frequently experiences higher PM₂.₅ levels. A specific date of March 3, 2022, was chosen as a result of a power outage that prompted the bulk of power plants to shut down. In some way, it is not conceivable anywhere in the world to turn off the power for the sole purpose of doing research. Therefore, this catastrophe involving a power outage and the shutdown of power plants offers a great occasion to evaluate the impact of air pollution driven by this power sector. As a result, four numerical experiments were conducted in the study using the Continuous Emission Data System (CEMS), assuming that the power plants continued to function normally after the power outage. The hybrid model results revealed that power plants have a minor impact in the study region. However, we examined the accumulation of PM₂.₅ in the study and discovered that once the vortex at 925hPa was established and moved to the north of Taiwan's coast, the study region experienced higher observed PM₂.₅ concentrations influenced by meteorological factors. This study recommends that decision-makers take into account not only control techniques, specifically emission reductions, but also the atmospheric and meteorological implications for future investigations.

Keywords: PM₂.₅ concentration, powerplants, hybrid air quality model, CEMS, Vorticity

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Authors: Amin Padash, Javad Kazem Zadeh Khoiy, Hossein Vahidi

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Purpose: The mechanization system for the urban services was implemented in Tehran City in the year 2004 to promote the collection of domestic wastes; in 2010, in order to achieve the objectives of the project of urban services mechanization and qualitative promotion and improve the urban living environment, sustainable development and optimization of the recyclable solid wastes collection systems as well as other dry and non-organic wastes and conformity of the same to the modern urban management methods regarding integration of the mechanized urban services contractors and recycling contractors and in order to better and more correct fulfillment of the waste separation and considering the success of the mechanization plan of the dry wastes in most of the modern countries. The aim of this research is analyzing of Environmental Risk Assessment of the mechanization waste collection scheme in Tehran. Case Study: Tehran, the capital of Iran, with the population of 8.2 million people, occupies 730 km land expanse, which is 4% of total area of country. Tehran generated 2,788,912 ton (7,641 ton/day) of waste in year 2008. Hospital waste generation rate in Tehran reaches 83 ton/day. Almost 87% of total waste was disposed of by placing in a landfill located in Kahrizak region. This large amount of waste causes a significant challenge for the city. Methodology: To conduct the study, the methodology proposed in the standard Mil-St-88213 is used. This method is an efficient method to examine the position in opposition to the various processes and the action is effective. The method is based on the method of Military Standard and Specialized in the military to investigate and evaluate options to locate and identify the strengths and weaknesses of powers to decide on the best determining strategy has been used. Finding and Conclusion: In this study, the current status of mechanization systems to collect waste and identify its possible effects on the environment through a survey and assessment methodology Mil-St-88213, and then the best plan for action and mitigation of environmental risk has been proposed as Environmental Management Plan (EMP).

Keywords: environmental risk assessment, mechanization waste collection scheme, Mil-St-88213

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Authors: Ruel A. Welch

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Since the introduction of ServiceNow, the UK’s Science Museum Group’s (SMG) ICT service desk portal. There has not been an analysis of the tools available to SMG staff for just-in-time knowledge acquisition (knowledge management systems) and reporting ICT incidents with a focus on an aspect of professional identity, namely, gender. This study is conducted in the milieu of UK museums, galleries, arts, academic, charitable, and cultural heritage sectors. Numerous authors suggest that males and females experience ICT usage differently. Therefore, it is important for SMG to investigate the apparent disparities so that solutions can be derived to minimize this digital divide if one exists. It is acknowledged at SMG that there are challenges with keeping up with an ever-changing digital landscape. Subsequently, this entails the rapid upskilling of staff and developing an infrastructure that supports just-in-time technological knowledge acquisition and reporting technology-related issues. This problem was addressed by analyzing ServiceNow ICT incident reports and reports from knowledge articles from a six-month period from February to July. This study found a statistically significant relationship between gender and reporting an ICT incident. There is also a significant relationship between gender and the priority level of ICT incidents. Interestingly, there is no statistically significant relationship between gender and reading knowledge articles. Additionally, there is no statistically significant relationship between gender and reporting an ICT incident related to the knowledge article that was read by staff. The knowledge acquired from this study is useful to service desk management practice as it will help to inform the creation of future knowledge articles and ICT incident reporting processes.

Keywords: digital divide, ICT service desk practice, knowledge management systems, workplace learning

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Authors: Lars Andersen

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The development of design and engineering in large construction projects are characterized by an increased degree of flattening out of formal structures, extended use of parallel and integrated processes (‘Integrated Concurrent Engineering’) and an increased number of expert disciplines. The integration process is based on ongoing collaborations, dialogues, intercommunication and comments on each other’s work (iterations). This process based on reciprocal communication between actors and disciplines triggers value creation. However, communication between equals is not in itself sufficient to create effective decision making. The complexity of the process and time pressure contribute to an increased risk of a deficit of decisions and loss of process control. The paper refers to a study that aims at developing a resilient decision-making system that does not come in conflict with communication processes based on equality between the disciplines in the process. The study includes the construction of a hospital, following the phases design, engineering and physical building. The Research method is a combination of formative process research, process tracking and phenomenological analyses. The study tracked challenges and problems in the building process to the projection substrates (drawing and models) and further to the organization of the engineering and design phase. A comparative analysis of traditional and new ways of organizing the projecting made it possible to uncover an implicit material order or structure in the process. This uncovering implied a development of a material process perspective. According to this perspective the complexity of the process is rooted in material-functional differentiation. This differentiation presupposes a structuring material (the skeleton of the building) that coordinates the other types of material. Each expert discipline´s competence is related to one or a set of materials. The architect, consulting engineer construction etc. have their competencies related to structuring material, and inherent in this; coordination competence. When dialogues between the disciplines concerning the coordination between them do not result in agreement, the disciplines with responsibility for the structuring material decide the interface issues. Based on these premises, this paper develops a self-organized expert-driven interdisciplinary decision-making system.

Keywords: collaboration, complexity, design, engineering, materiality

Procedia PDF Downloads 217

Authors: Ghassan Kbar, Shady Aly, Ibrahim Alsharawy, Akshay Bhatia, Nur Alhasan, Ronaldo Enriquez

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The Smart Help for persons with disability (PWD) is a part of the project SMARTDISABLE which aims to develop relevant solution for PWD that target to provide an adequate workplace environment for them. It would support PWD needs smartly through smart help to allow them access to relevant information and communicate with other effectively and flexibly, and smart editor that assist them in their daily work. It will assist PWD in knowledge processing and creation as well as being able to be productive at the work place. The technical work of the project involves design of a technological scenario for the Ambient Intelligence (AmI) - based assistive technologies at the workplace consisting of an integrated universal smart solution that suits many different impairment conditions and will be designed to empower the Physically disabled persons (PDP) with the capability to access and effectively utilize the ICTs in order to execute knowledge rich working tasks with minimum efforts and with sufficient comfort level. The proposed technology solution for PWD will support voice recognition along with normal keyboard and mouse to control the smart help and smart editor with dynamic auto display interface that satisfies the requirements for different PWD group. In addition, a smart help will provide intelligent intervention based on the behavior of PWD to guide them and warn them about possible misbehavior. PWD can communicate with others using Voice over IP controlled by voice recognition. Moreover, Auto Emergency Help Response would be supported to assist PWD in case of emergency. This proposed technology solution intended to make PWD very effective at the work environment and flexible using voice to conduct their tasks at the work environment. The proposed solution aims to provide favorable outcomes that assist PWD at the work place, with the opportunity to participate in PWD assistive technology innovation market which is still small and rapidly growing as well as upgrading their quality of life to become similar to the normal people at the workplace. Finally, the proposed smart help solution is applicable in all workplace setting, including offices, manufacturing, hospital, etc.

Keywords: ambient intelligence, ICT, persons with disability PWD, smart application, SHW

Procedia PDF Downloads 417

Authors: Ratih Julistina, M. Agoes Moelyadi

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Innovation in aviation technology evolved rapidly by time to time for acquiring the most favorable value of utilization and is usually denoted by efficiency parameter. Nature always become part of inspiration, and for this sector, many researchers focused on studying the behavior of flying animal to comprehend the fundamental, one of them is birds. Experimental testing has already conducted by several researches to seek and calculate the efficiency by putting the object in wind tunnel. Hence, computational simulation is needed to conform the result and give more visualization which is based on Reynold Averaged Navier-Stokes equation solution for unsteady case in time-dependent viscous flow. By creating model from simplification of the real bird as a rigid body, those are Hawk which has low aspect ratio and Swift with high aspect ratio, subsequently generating the multi grid structured mesh to capture and calculate the aerodynamic behavior and characteristics. Mimicking the motion of downstroke and upstroke of bird flight which produced both lift and thrust, the sinusoidal function is used. Simulation is carried out for varied of flapping frequencies within upper and lower range of actual each bird’s frequency which are 1 Hz, 2.87 Hz, 5 Hz for Hawk and 5 Hz, 8.9 Hz, 13 Hz for Swift to investigate the dependency of frequency effecting the efficiency of aerodynamic characteristics production. Also, by comparing the result in different condition flights with the morphology of each bird. Simulation has shown that higher flapping frequency is used then greater aerodynamic coefficient is obtained, on other hand, efficiency on thrust production is not the same. The result is analyzed from velocity and pressure contours, mesh movement as to see the behavior.

Keywords: characteristics of aerodynamic, efficiency, flapping frequency, flapping wing, unsteady simulation

Procedia PDF Downloads 236

Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki

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Transport infrastructures are high-cost, long-term investments that serve as vital foundations for the operation of a region or nation and are essential to a country’s or business’s economic development and prosperity, by improving well-being and generating jobs and income. The development of appropriate financing options is of key importance in the decision making process in order develop viable transport infrastructures. The development of transport infrastructure has increasingly been shifting toward alternative methods of project financing such as Public Private Partnership (PPPs) and hybrid forms. In this paper, a methodological decision-making framework based on the evaluation of the financial viability of transportation infrastructure for different financial schemes is presented. The framework leads to an assessment of the financial viability which can be achieved by performing various financing scenarios analyses. To illustrate the application of the proposed methodology, a case study of rail transport infrastructure financing scenario analysis in Greece is developed.

Keywords: rail transport infrastructure, financial viability, scenario analysis, rail project feasibility

Procedia PDF Downloads 273

Authors: Merey M. Sarsengeldin, Alexandr S. Kolokhmatov, Galiya Seidaliyeva, Alexandr Ozerov, Sanim T. Imatayeva

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This series of interdisciplinary studies is an attempt to investigate and develop a scalable model of fair socioeconomic relations on the base of blockchain using positive psychology techniques and Machine Learning algorithms for data analytics. In this particular study, we use hyperinteraction approach and intuition to investigate their influence on 'wisdom of crowds' via created mobile application which was created for the purpose of this research. Along with the public blockchain and private Decentralized Autonomous Organization (DAO) which were elaborated by us on the base of Ethereum blockchain, a model of fair financial relations of members of DAO was developed. We developed a smart contract, so-called, Fair Price Protocol and use it for implementation of model. The data obtained from mobile application was analyzed by ML algorithms. A model was tested on football matches.

Keywords: blockchain, Naïve Bayes algorithm, hyperinteraction, intuition, wisdom of crowd, decentralized autonomous organization

Procedia PDF Downloads 164

Authors: Mohammad Al-Refai, Majed Wakid

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Introduction: Soil-transmitted diseases (STD) are caused by intestinal worms that are transmitted via various routes into the human body resulting in various clinical manifestations. The intestinal worms causing these infections are known as soil transmitted helminths (STH), including Hook worms, Ascaris lumbricoides (A. lumbricoides), Trichuris trichiura (T. trichiura), and Strongyloides sterocoralis (S. sterocoralis). Objectives: The aim of this study was to investigate the prevalence of STH among newly arrived expatriate labors in Jeddah city, Saudi Arabia, using three different techniques (direct smears, sedimentation concentration, and real-time PCR). Methods: A total of 188 stool specimens were collected and investigated at the parasitology laboratory in the Special Infectious Agents Unit at King Fahd Medical Research Center, King Abdulaziz University in Jeddah, Saudi Arabia. Microscopic examination of wet mount preparations using normal saline and Lugols Iodine was carried out, followed by the formal ether sedimentation method. In addition, real-time PCR was used as a molecular tool to detect several STH and hookworm speciation. Results: Out of 188 stool specimens analyzed, in addition to STH parasite, several other types were detected. 9 samples (4.79%) were positive for Entamoeba coli, 7 samples (3.72%) for T. trichiura, 6 samples (3.19%) for Necator americanus, 4 samples (2.13%) for S. sterocoralis, 4 samples (2.13%) for A. lumbricoides, 4 samples (2.13%) for E. histolytica, 3 samples (1.60%) for Blastocystis hominis, 2 samples (1.06%) for Ancylostoma duodenale, 2 samples (1.06%) for Giardia lamblia, 1 sample (0.53%) for Iodamoeba buetschlii, 1 sample (0.53%) for Hymenolepis nana, 1 sample (0.53%) for Endolimax nana, and 1 sample (0.53%) for Heterophyes heterophyes. Out of the 35 infected cases, 26 revealed single infection, 8 with double infections, and only one triple infection of different STH species and other intestinal parasites. Higher rates of STH infections were detected among housemaids (11 cases) followed by drivers (7 cases) when compared to other occupations. According to educational level, illiterate participants represent the majority of infected workers (12 cases). The majority of workers' positive cases were from the Philippines. In comparison between laboratory techniques, out of the 188 samples screened for STH, real-time PCR was able to detect the DNA in (19/188) samples followed by Ritchie sedimentation technique (18/188), and direct wet smear (7/188). Conclusion: STH infections are a major public health issue to healthcare systems around the world. Communities must be educated on hygiene practices and the severity of such parasites to human health. As far as drivers and housemaids come to close contact with families, including children and elderlies. This may put family members at risk of developing serious side effects related to STH, especially as the majority of workers were illiterate, lacking the basic hygiene knowledge and practices. We recommend the official authority in Jeddah and around the kingdom of Saudi Arabia to revise the standard screening tests for newly arrived workers and enforce regular follow-up inspections to minimize the chances of the spread of STH from expatriate workers to the public.

Keywords: expatriate labors, Jeddah, prevalence, soil transmitted helminths

Procedia PDF Downloads 143

Authors: S. O. Uwaifo

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The paper examines the pivotal role of the library in university education through the provision of a wide range of information materials (print and non- print) required for the teaching, learning and research activities of the university. However certain impediments to the effectiveness of Nigerian university libraries, such as financial constraints, high foreign exchange, global disparities in accessing the internet, lack of local area networks, erratic electric power supply, absence of ICT literacy, poor maintenance culture, etc., were identified. Also, the necessity of repositioning Nigerian university libraries for effective information provision and delivery was stressed by pointing out their dividends, such as users’ access to Directory of Open Access Journals (DOAJ), Online Public Access Catalogue (OPAC), Institutional Repositories, Electronic Document Delivery, Social Media Networks, etc. It therefore becomes necessary for the libraries to be repositioned by way of being adequately automated or digitized for effective service delivery, in this age of globalization. Based on the identified barriers by this paper, some recommendations were proffered.

Keywords: repositioning, Nigerian university libraries, effective information provision and delivery, globalization

Procedia PDF Downloads 320