Search results for: local coronary artery disease

Authors: Jaehyung Jung, Kiman Kim, Heesang Eum

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Solar cell is one of the main technologies to reduce greenhouse gas (GHG). Thereby, accurate estimation of greenhouse gas reduction by solar cell technology is crucial to consider strategic applications of the solar cell. The bottom-up approach using operating data such as operation time and efficiency is one of the methodologies to improve the accuracy of the estimation. In this study, alternative GHG reductions from solar cell technology were estimated by a bottom-up approach to indirect emission source (scope 2) in Korea, 2015. In addition, the scenario-based analysis was conducted to assess the effect of technological change with respect to efficiency improvement and rate of operation. In order to estimate GHG reductions from solar cell activities in operating condition levels, methodologies were derived from 2006 IPCC guidelines for national greenhouse gas inventories and guidelines for local government greenhouse inventories published in Korea, 2016. Indirect emission factors for electricity were obtained from Korea Power Exchange (KPX) in 2011. As a result, the annual alternative GHG reductions were estimated as 21,504 tonCO2eq, and the annual average value was 1,536 tonCO2eq per each solar cell technology. Those results of estimation showed to be 91% levels versus design of capacity. Estimation of individual greenhouse gases (GHGs) showed that the largest gas was carbon dioxide (CO2), of which up to 99% of the total individual greenhouse gases. The annual average GHG reductions from solar cell per year and unit installed capacity (MW) were estimated as 556 tonCO2eq/yr•MW. Scenario analysis of efficiency improvement by 5%, 10%, 15% increased as much as approximately 30, 61, 91%, respectively, and rate of operation as 100% increased 4% of the annual GHG reductions.

Keywords: bottom-up approach, greenhouse gas (GHG), reduction, scenario, solar cell

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Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

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Authors: Monjur E-Khoda Tarafdar

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Institutional autonomy and academic freedom corresponding to accountability are seen as a core concept of university governance. Universities are crucial factors in search of truth for knowledge production and dissemination. Academic leaders are the pivots to progressively influence the university governance. Therefore, in a continuum of debate about autonomy and accountability in the aspect of perception, academic leadership has been studied. Having longstanding acquaintance in the field the researcher has been instrumental to gain lived experiences of the informants in this qualitative study. Case studies are useful to gain an understanding of the complexities of a particular site to preserve a sense of wholeness of the site being investigated. Thus, multiple case study approach has been employed with a sample size of seventy-one. Such large size of informants was interviewed in order to capture a wider range of views that exist in Bangladesh. This qualitative multiple case study has engaged in-depth interviewing method of academic leaders and policy makers of three case universities. Open-ended semi-structured questionnaires are used to have a comprehensive understanding of how the perception of autonomy and accountability of academic leaders has impacted university governance in the context of Bangladesh. The paper has interpreted the voices of the informants and distinguished both the transformational and transactional style of academic leaderships in local university settings against the globally changed higher education demography. The study finds contextual dissimilarity in the perspectives of autonomy and accountability of academic leadership towards university governance. Unaccountability results in losing autonomous power and collapsing academic excellence. Since accountability grows competitiveness and competence, the paper also focuses on how academic leaders abuse the premise of academic loyalty to universities.

Keywords: academic loyalty, accountability, autonomy, leadership, perception, university governance

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Authors: Stephen Olusanmi Akintayo, Ilesanmi Fadahunsi

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The ability of Lactic acid bacteria (LAB) to grow and survive in milk is being exploited in industrial and biotechnological applications. Although considerable studies have been reported on the fermentation of milk, however, not so much work has been documented on the selection of LAB strains from milk of the Nigerian local cattle breeds for their starter culture potentials. A total of 110 LAB were isolated from raw milk of Sokoto gudali cattle breed. The isolates were screened for their proteolytic activities on skimmed milk media with isolates A07, F06 and A01 showing the highest zone of clearance of 18.5mm, 18.5mm, and 18.0mm respectively and were selected for the studies of their growth in different constituents of milk. A01, F06, and A07 were identified as Pediococcus acidilactici, Lactococcus raffinolactis, and Leuconostoc mesenteriodes respectively using cultural, biochemical, physiological and molecular characterization techniques. Leuconostoc mesenteriodes showed the highest growth in all the milk components that were used in this study. The three LAB species selected showed a growth range of 6.46 log cfu/ml to 10.91 log cfu/ml in lactose with Leuconostoc mesenteriodes showing the highest growth of 10.91 log cfu/ml while Pediococcus acidilactici recorded the lowest growth of 9.78 log cfu/ml. In medium containing leucine as the only amino acid, the viable counts of Pediococcus acidilactici, Lactococcus raffinolactis and Leuconostoc mesenteriodes in log cfu/ml at zero hour were 6.39, 6.36 and 6.38 respectively which increased to 9.31 log cfu/ml, 9.21 log cfu/ml, 9.92 log cfu/ml respectively after 24 hours. Similarly, in all other substrates (casein, lysine, glutamic acid, aspartic acid, stearic acid and oleic acid ) tested in this study, Leuconostoc mesenteriodes showed the highest growth. It was observed that the highest quantity of lactic acid (15.31mg/ml) was produced by Leuconostoc mesenteriodes. The same trend was also observed in the production of diacetyl and hydrogen peroxide by the three tested microorganisms. Due to its ability to grow maximally in milk components, Leuconostoc mesenteriodes shows potential as starter culture for milk fermentation.

Keywords: Leuconostoc mesenteriodes, lactic acid bacteria, Sokoto gudali, starter culture

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Authors: Ndou Rembuluwani Moddy, Daniel Ter Goon, Takalani Grace Tshitangano, Lindelani Fhumudzani Mushaphi

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Obesity is a global public health problem. The study aimed to determine the risk factors associated with and the consequences of obesity among residents of Tshikota, Makhado Municipality, Limpopo Province, South Africa. A cross-sectional study involving 318 randomly selected adults aged 18-45 years residing at Tshikota, Makhado Local Municipality, South Africa. Sociodemographic information includes age, gender, educational level, occupation, behavioral lifestyle, environmental, psychological, and family history. Anthropometric, blood pressure, and blood glucose measurements followed standard procedure. The prevalence of obesity and overweight was 35.5% and 28.6%, respectively. About 75.2% of obese do not engage in physical activity. Most participants (63.5%) take meals three times a day, and 19.2% do not skip breakfast. Most participants do not have access to fruits and vegetables. Participants who were pre-hypertensive were 92(28.9%) and 32(10.1%) were in Stage 1 hypertension. Of the participants with Class 1 obesity, 40.9% were pre-hypertensive, and 15.2% were in Stage 1 hypertension. In Class 2 obesity, 37.8% were pre-hypertensive, and 26.7% were in Stage 1 hypertension. There was a significant difference between BMI and blood pressure among participants (p=0.00). About 6.1% of the participants in Class 1 obesity were at high risk, and 3.0% were at very high risk of glucose levels. Regarding cholesterol levels, 65 (20.4%) were at borderline, and 17(5.3%) were at high risk. There was no significant difference in BMI and cholesterol levels among participants (p= 0.20). The prevalence of obesity and overweight was high among residents of this setting. Age, marital and educational status, and employment were significantly associated with obesity. An obesity awareness campaign is crucial, and the availability of supermarkets and full-service grocery stores would provide accessibility to healthy food such as fruits and vegetables.

Keywords: obesity, overweight, risk factors, adults.

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Authors: Vishnu Raj, Chockalingam Prathap

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The objective of this study was to explore the impact of variation in the exit annular area on the local flow field features and the flame stability of an annular premixed swirl burner (unconfined) operated with premixed n-butane air mixture at equivalence ratio (ϕ) = 1, 1 bar, and 300K. A swirl burner with an axial swirl generator having a swirl number of 1.5 was used. Three different burner heads were chosen to have the exit area increased from 100%, 160%, and 220% resulting in inner and outer diameters and cross-sectional areas as (1) 10mm&15mm, 98mm2 (2) 17.5mm&22.5mm, 157mm2 and (3) 25mm & 30mm, 216mm2. The bulk velocity and Reynolds number based on the hydraulic diameter and unburned gas properties were kept constant at 12 m/s and 4000. (i) Planar PIV with TiO2 seeding particles and (ii) OH* chemiluminescence were used to measure the velocity fields and reaction zones of the swirl flames at 5Hz, respectively. Velocity fields and the jet spreading rates measured at the isothermal and reactive conditions revealed that the presence of a flame significantly altered the flow field in the radial direction due to the gas expansion. Important observations from the flame measurements were: the height and maximum width of the recirculation bubbles normalized by the hydraulic diameter, and the jet spreading angles for the flames for the three exit area cases were: (a) 4.52, 1.95, 28ᵒ, (b) 6.78, 2.37, 34ᵒ, and (c) 8.73, 2.32, 37ᵒ. The lean blowout was also measured, and the respective equivalence ratios were: 0.80, 0.92, and 0.82. LBO was relatively narrow for the 157mm2 case. For this case, particle image velocimetry (PIV) measurements showed that Turbulent Kinetic Energy and turbulent intensity were relatively high compared to the other two cases, resulting in higher stretch rates and narrower lean blowout (LBO).

Keywords: chemiluminescence, jet spreading rate, lean blowout, swirl flow

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Authors: Maserapelo Gladys Serapelwane, Eva Mofatiki Manyedi

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Background: Unfair labour practices on staff is a worldwide concern, which creates conflicts and disharmony among health workers. It is found that nursing staff members are unfairly treated without a valid reason in primary health care (PHC) facilities and predominantly in developing countries, and South Africa is not excluded. Objectives: The purpose of the study was to explore and describe the experiences of operational managers regarding unfair labour practices on staff by their local area managers and describe the perceptions of operational managers towards such treatment. Methods: A qualitative, descriptive, exploratory, and contextual research approach was considered appropriate for the study. In this study, the population comprised operational managers working in the PHC facilities of Northwest Province, South Africa. Purposive sampling was used to select participants for the study and focus group interviews were used to interview 23 operational managers. Ethical measures were applied throughout the study. Findings: The six phases of thematic analysis were used to analyze data collected for the study. Two themes that emerged are experiences of factors related to unfair labour practices in the PHC facilities and perceptions regarding how to improve their working conditions. The categories that were found in the first themes were favouritism and discrimination. In the second theme, in-service training and transparency regarding staff training and development emerged. Recommendations comprised, among others, training on the concepts of quality in the workplace and reinforcement of transparency regarding granting of study leave and attending workshops. Conclusion: Operational managers in the PHC facilities experienced unfair labour practices as evidenced by favouritism.

Keywords: unfair labour practices, primary health care facilities, operational managers, North West Province

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Authors: Loïc Chrislin Nguedjio, S. Jerome Afoutou, Rostand Moutou Pitti, Benoit Blaysat, Frédéric Dubois, Naman Recho, Pierre Kisito Talla

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The safety and durability of structures remain challenging fields that continue to draw the attention of designers. One widely adopted approach is fracture mechanics, which provides methods to evaluate crack stability in complex geometries and under diverse loading conditions. The global energy approach is particularly comprehensive, as it calculates the energy release rate required for crack initiation and propagation using path-independent integrals. This study aims to extend these invariant integrals to include path-independent integrals, with the goal of enhancing the accuracy of failure predictions. The ultimate objective is to create more robust materials while optimizing structural safety and durability. By integrating the real and virtual field method with the virtual crack closure technique, a new formulation of the M-integral is introduced. This formulation establishes a direct relationship between local stresses on the crack faces and the opening displacements, allowing for an accurate calculation of fracture energy. The analytical calculations are grounded in the assumption that the energy needed to close a crack virtually is equal to the energy released during its opening. This novel integral is implemented in a finite element code using Cast3M to simulate cracking criteria within a wood material context. Initially, the numerical calculations are focused on plane strain conditions, but they are later extended to three-dimensional environments, taking into account the orthotropic nature of wood.

Keywords: energy release rate, path-independent integrals, virtual crack closure, orthotropic material

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Authors: Mohammed Abdullah Alshahrani

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The research focuses on investigating the use of partial least squares (PLS) methodology for addressing challenges associated with high-dimensional correlated data. Recent technological advancements have led to experiments producing data characterized by a large number of variables compared to observations, with substantial inter-variable correlations. Such data patterns are common in chemometrics, where near-infrared (NIR) spectrometer calibrations record chemical absorbance levels across hundreds of wavelengths, and in genomics, where thousands of genomic regions' copy number alterations (CNA) are recorded from cancer patients. PLS serves as a widely used method for analyzing high-dimensional data, functioning as a regression tool in chemometrics and a classification method in genomics. It handles data complexity by creating latent variables (components) from original variables. However, applying PLS can present challenges. The study investigates key areas to address these challenges, including unifying interpretations across three main PLS algorithms and exploring unusual negative shrinkage factors encountered during model fitting. The research presents an alternative approach to addressing the interpretation challenge of predictor weights associated with PLS. Sparse estimation of predictor weights is employed using a penalty function combining a lasso penalty for sparsity and a Cauchy distribution-based penalty to account for variable dependencies. The results demonstrate sparse and grouped weight estimates, aiding interpretation and prediction tasks in genomic data analysis. High-dimensional data scenarios, where predictors outnumber observations, are common in regression analysis applications. Ordinary least squares regression (OLS), the standard method, performs inadequately with high-dimensional and highly correlated data. Copy number alterations (CNA) in key genes have been linked to disease phenotypes, highlighting the importance of accurate classification of gene expression data in bioinformatics and biology using regularized methods like PLS for regression and classification.

Keywords: partial least square regression, genetics data, negative filter factors, high dimensional data, high correlated data

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Authors: Ammaarah Gamieldien

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Depression is a very common and serious mental illness that has a significant impact on both the social and economic aspects of sufferers worldwide. This study aimed to investigate the association between body mass index (BMI), blood pressure, and lipid profiles with mental health symptoms in university students. Secondary objectives included the associations between the variables (BMI, blood pressure, and lipids) with themselves, as they are key factors in cardiometabolic disease. Sixty-three (63) students participated in the study. Thirty-two (32) were assigned to the control group (minimal-mild depressive symptoms), while 31 were assigned to the depressive group (moderate to severe depressive symptoms). Montgomery-Asberg Depression Rating Scale (MADRS) and Beck Depression Inventory (BDI) were used to assess depressive scores. Anthropometric measurements such as weight (kg), height (m), waist circumference (WC), and hip circumference were measured. Body mass index (BMI) and ratios such as waist-to-hip ratio (WHR) and waist-to-height ratio (WtHR) were also calculated. Blood pressure was measured using an automated AfriMedics blood pressure machine, while lipids were measured using a CardioChek plus analyzer machine. Statistics were analyzed via the SPSS statistics program. There were no significant associations between anthropometric measurements and depressive scores (p > 0.05). There were no significant correlations between lipid profiles and depression when running a Spearman’s rho correlation (P > 0.05). However, total cholesterol and LDL-C were negatively associated with depression, and triglycerides were positively associated with depression after running a point-biserial correlation (P < 0.05). Overall, there were no significant associations between blood pressure measurements and depression (P > 0.05). However, there was a significant moderate positive correlation between systolic blood pressure and MADRS scores in males (P < 0.05). Depressive scores positively and strongly correlated to how long it takes participants to fall asleep. There were also significant associations with regard to the secondary objectives. This study indicates the importance of determining the prevalence of depression among university students in South Africa. If the prevalence and factors associated with depression are addressed, depressive symptoms in university students may be improved.

Keywords: depression, blood pressure, body mass index, lipid profiles, mental health symptoms

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Authors: Ugahara Bin Mahyuddin Yunus

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In English Language Teaching, it cannot be denied that the backgrounds of English teachers do affect the way they teach English to their students, which in turn will affect their students’ English learning itself. Thus, it is very important to understand who the English teachers are so that how they teach English to their students can be understood. One of their backgrounds that is essential to be highlighted is their culture. Certainly, they wittingly or not will bring the perspectives and values of their culture into their daily teaching practices. In other words, their cultural identities do shape how they teach their students. Cultural identities themselves actually consist of some elements, one of which is regional identity. Indeed, the culture of the region in which English teachers identify with has impact on their beliefs and actions during teaching. For this reason, this study aims to understand how the regional identity of English teachers influence the way they teach English to their students. This study is a qualitative study conducted in a multilingual and multicultural setting, namely Aceh, Indonesia. Here, four Acehnese English teachers were involved as the research participants. In addition, this study adopted poststructuralist perspective to identity as the theoretical framework. Three research instruments were used in this study, namely semi-structured interviews, classroom observation, and teacher journal. The data gained from these instruments were then analyzed by using thematic analysis. Obviously, the research about the regional identity of English teachers in English Language Teaching has been studied worldwide. However, little is still known about it in Indonesian context, let alone Indonesia itself is a super diverse country with 34 regions. As a result, this study presents a good opportunity to advance the knowledge of how the regional identity construction of English teachers in this setting is. The findings of the study revealed that their regional identity construction in teaching was highly influenced by their indigenous language and religious faith. Even, how they teach English in classroom, in fact, is related to these two things. The conclusion that can be drawn from this study is for these English teachers, in fact, their regional identity itself constitutes their use of local language and religious identity, which are considered by them as their core identity.

Keywords: English language teaching, English teachers, identity construction, regional identity

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Authors: Elron Fouten

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Recently, debates surrounding the social relevance of psychology in South Africa have focussed on how the growing neoliberal rationality within academia has again resulted in the discipline catering to the needs of powerful social groupings to protect its own economic interests, rather than producing socially relevant knowledge. Consequently, this study aimed to conduct a content analysis of the recent research output of psychology masters students, to establish whether it has produced research that addresses local and national psychosocial issues and as such deemed socially relevant knowledge. The study sampled clinical, counselling, and research psychology masters theses from 16 South African universities submitted between 1998 and 2017. Overall, 2001 theses were sampled, which were analysed using qualitative content analysis predominantly based on the descriptive categories identified in similar studies using published journal articles. Results indicated that empirical qualitative theses, using systems-oriented theory and post-modern frameworks were most prevalent. Further, traditional topics within psychology had relatively more weighting compared to more social topics. Although a significant number of theses recruited participants from working-class or poor backgrounds, there was an overreliance on participants from urban areas located in some of the country’s wealthiest provinces. Despite a strong adult-centric focus, trends regarding participants’ race and gender roughly resembled current population demographics. Overall, the results indicate that psychology in South Africa, at least at university-level, is to some extent trying to engage with national psychosocial concerns. However, there are still several key areas which need to be addressed to ensure the continued social relevance of the discipline.

Keywords: adult-centric, content analysis, relevance, psychosocial

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Authors: Li-Ching Lin, Yu-Tzu Dai

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Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

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Authors: Sawarni Hasibuan, Juliza Hidayati

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Competitiveness and sustainability issues not only put pressure on big companies, but also small and medium enterprises (SMEs). SMEs Batik Bogor is one of the local culture-based creative industries in Bogor city which is also dealing with the issue of sustainability. The purpose of this research is to develop framework of sustainability at SMEs Batik Indonesia case of SMEs Batik Bogor by integrating innovation of cleaner production in its supply chain. The approach used is desk study, field survey, in-depth interviews, and benchmarking best practices of SMEs sustainability. In-depth interviews involve stakeholders to identify the needs and standards of sustainability of SMEs Batik. Data analysis was done by benchmarking method, Multi Dimension Scaling (MDS) method, and Strength, Weakness, Opportunity, Threat (SWOT) analysis. The results recommend the framework of sustainability for SMEs Batik in Indonesia. The sustainability status of SMEs Batik Bogor is classified as Moderate Sustainable. Factors that support the sustainability of SMEs Batik Bogor such is a strong commitment of top management in adopting cleaner production innovation and creativity approach. Successful cleaner production innovations are implemented primarily in the substitution of dye materials from toxic to non-toxic, reducing the intensity of non-renewable energy use, as well as the reuse and recycle of solid waste. “Mosaic Batik” is one of the innovations of solid waste utilization of batik waste produced by company R&D center that gives benefit to three pillars of sustainability, that is financial benefit, environmental benefit, and social benefit. The sustainability of SMEs Batik Bogor cannot be separated from the support of Bogor City Government which proactively facilitates the promotion of sustainable innovation produced by SMEs Batik Bogor.

Keywords: cleaner production innovation, creativity, SMEs Batik, sustainability supply chain

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Authors: Abhishek Kumar Gupta

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Atomistic Molecular Dynamics (MD) Simulations have been performed to study the effect of monovalent salt i.e. NaCl concentration (Cs) and chain degree of neutralization (f) on the structure and dynamics of anionic poly(methacrylic acid) (PMA) in dilute aqueous solutions. In the present study, the attention is to unveil the conformational structure, hydrogen-bonding, local polyion-counterion structure, h-bond dynamics, chain dynamics and thermodynamic enthalpy of solvation of a-PMA in dilute aqueous solutions as a function of salt concentration, Cs and f. The results have revealed that at low salt concentration, the conformational radius of gyration (Rg) increases and then decreases reaching a maximum in agreement with the reported light scattering experimental results. The Rg at f = 1 shows a continual decrease and acquire a plateau value at higher salt concentration in agreement with results obtained by light scattering experiments. The radial distribution functions between PMA, salt and water atoms has been computed with respect to atom and centre-of-mass to understand the intermolecular structure in detail. The results pertaining to PMA chain conformations and hydrogen bond autocorrelation function showcasing the h-bond dynamics will be presented. The results pertaining to chain dynamics will be presented. The results pertaining to counterion condensation on the PMA chain shows greater condensation of Na+ ions on to the carboxylate ions with increase in salt concentration. Moreover, the solvation enthalpy of the system as a function of salt concentration will be presented.

Keywords: conformations, molecular dynamics simulations, NaCl concentration, radial distribution functions

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Authors: Parisa Göker, Hilal Kahveci, Özlem Candan Hergül

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Humans are generating culture while being in touch with nature. Along with skills, local knowledge based on experience, and many other subjects developed within this process, 'culture' offers humans a chance to survive. For this reason, culture forms the equipment for humans, which facilitates their survival in all ecosystems. Together with technology, quick consumption of natural sources and overuse culture of humans have brought up the eco-village concept. Ecovillages are ecologically, economically, socio-culturally, and spiritually sustainable settlement models. It is known that the eco-village approach is applying a proper methodology on behalf of integrative and versatile solution generation. Today, the eco-village approach, introducing a radical criticism to the understanding of civilization and consumption culture and deeming urban solutions inadequate as a spatial reflection to civilization and consumption culture, while making a difference about integrative solution offering with multidimensional features, along with the goal of creating self-sufficient communities, is creating solutions on the subject of both reducing the ecological footprint of humans and to provide social order and also to solve the injustice seen in terms of income and life standards. In this study, environmental issues, sustainable development, and environmental sustainability topics are examined within the context of eco-tourism and eco-village. Alongside this, the natural and cultural landscape values of Kurşunlu village which are located in Bilecik province’s Gölpazarı county, and a contextual frame is created for the facilitation of sustainability in the event of dynamizing the Kurşunlu village in terms of tourism-oriented activities.

Keywords: eco village, sustainability, rural landscape, cultural landscape

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Authors: Rajaram Mahat, Roshan Khadka

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Nepal has remained a land of diverse people and culture consisting more than hundred ethnic and caste groups with 92 different languages. Each ethnic and cast group have their own common culture. Kathmandu, the capital city of Nepal is one of the multi-ethnic, lingual and cultural ancient places. Dozens of monuments with the history of more than thousand years are located in Kathmandu Valley. More or less all of the heritage site have been affected by devastating earthquake in April and May 2015. This study shows the most popular tourist and pilgrim’s destination like Kathmandu Darbar Square, Bhaktapur Darbarsquare, Patan Darbar Square, Swayambhunath temple complex, Dharahara Tower, Pasupatinath Hindu Religious Complex etc. have been massively destroyed. This paper analyses the socio economic consequence to the community people of world heritage site after devastating earthquake in Kathmandu Valley. Initial findings indicate that domestic and international current tourists flow have decreased by 41% and average 23% of local craft shop, curio shop, hotel, restaurant, grocery store, footpath shop including employment of tourist guide have been closed down as well as travel & tour business has decreased by 12%. Supply chain effect is noticeably shown in particular collapsed world heritage sites. It has also seen negative impact to National economy as well. This study has recommended to government of Nepal and other donor to reconstruct the collapse world heritage sites and to preserve the other existing world heritage site with treatment of earthquake resist structure as soon as possible.

Keywords: world heritage, community, earthquake, supply chain effect

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Authors: Gourg Ebrahim Shafik Eskandar

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater like a knife or a scalpel, there is evidence of surgery performed in ancient Egypt during the dynastic period (323 – 3200 BC). The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus (recipes from 863 to 877). The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however we have not received a lengthy explanation of the various surgeries and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancient egypt, egypt, surgical imaging, surgery in the stone age

Procedia PDF Downloads 23

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

Abstract:

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

Procedia PDF Downloads 143

Authors: Muhammad Habib, Lin Tang, Guoliang Xue, Attaur Rahman, Myong-Ho Kim, Soonil Lee, Xuefan Zhou, Yan Zhang, Dou Zhang

Abstract:

Designing a high-performance, lead-free ceramic has become a cutting-edge research topic due to growing concerns about the toxic nature of lead-based materials. In this work, a convenient strategy of compositional design and domain engineering is applied to the lead-fee BiFeO₃-BaTiO₃ ceramics, which provides a flexible polarization-free-energy profile for domain switching. Here, simultaneously enhanced dynamic piezoelectric constant (d33* = 772 pm/V) and a good thermal-stability (d33* = 26% over the temperature of 20-180 ᵒC) are achieved with a high Curie temperature (TC) of 432 ᵒC. This high piezoelectric strain performance is collectively attributed to multiple effects such as thermal quenching, suppression of defect charges by donor doping, chemically induced local structure heterogeneity, and electric field-induced phase transition. Furthermore, the addition of BT content decreased octahedral tilting, reduced anisotropy for domain switching and increased tetragonality (cₜ/aₜ), providing a wider polar length for B-site cation displacement, leading to high piezoelectric strain performance. Atomic-resolution transmission electron microscopy and piezoelectric force microscopy combined with X-ray diffraction results strongly support the origin of high piezoelectricity. The high and temperature-stable piezoelectric strain response of this work is superior to those of other lead-free ceramics. The synergistic approach of composition design and the concept present here for the origin of high strain response provides a paradigm for the development of materials for high-temperature piezoelectric actuator applications.

Keywords: Piezoelectric, BiFeO3-BaTiO3, Quenching, Temperature-insensitive

Procedia PDF Downloads 83

Authors: Hadjer Messabih

Abstract:

The M’zab architecture has preserved its identity that was able to endure for centuries conserving practically the same way of life and the same building techniques since the 11th century. Even more, the newly built ksar Tafilelt is also designed to meet the local tradition. In 1996, a community led project was initiated to build a “new ksar” named Tafilelt based on a traditional form of community-led cooperative housing. It is a unique experience in the field of community housing that reproduces traditional architectural patterns while addressing contemporary ways of life with their expected modern comfort. This research is based on the hypothesis that the process of producing ksar Tafilelt is culturally responsive to a conservative community that was characterized by certain values which were transmitted to this ksar manifesting as cultural continuity. It aims at investigating what type of cultural continuity manifests itself in the co-production of ksar Tafilelt and the way the settlement and its houses are produced and inhabited, as well as the new emerging values and adaptive transition in social relations. The research methodology is based on a combination of questionnaires, in depth interviews, photography, and site visit to record and demonstrate how these buildings respond to peoples’ needs. Post Occupancy Evaluation (POE) is also employed in order to understand the lessons that can be learned from this project. Finally, this study proves that the cultural continuity that was transmitted from the Ibadi community is sill manifested in ksar Tafilelt, which provided strong religious bonds and a strong sense of community. The research findings have resulted in a number of lessons and principles that can be learnt from the project of ksar Tafilelt which can inform future practices of housing provision and design in Algeria and other countries.

Keywords: community-led cooperative housing, conservative community, cultural continuity, post occupancy evaluation

Procedia PDF Downloads 142

Authors: Neslihan Demirci, Serdar Durdağı

Abstract:

Mycobacterium tuberculosis is still a worldwide disease-causing agent that, according to WHO, led to the death of 1.5 million people from tuberculosis (TB) in 2020. The bacteria reside in macrophages located specifically in the lung. There is a known quadruple drug therapy regimen for TB consisting of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB). Over the past 60 years, there have been great contributions to treatment options, such as recently approved delamanid (OPC67683) and bedaquiline (TMC207/R207910), targeting mycolic acid and ATP synthesis, respectively. Also, there are natural compounds that can block the tryptophanyl-tRNA synthetase (TrpRS) enzyme, chuangxinmycin, and indolmycin. Yet, already the drug resistance is reported for those agents. In this study, the newly released TrpRS enzyme structure is investigated for potential inhibitor drugs from already synthesized molecules to help the treatment of resistant cases and to propose an alternative drug for the quadruple drug therapy of tuberculosis. Maestro, Schrodinger is used for docking and molecular dynamic simulations. In-house library containing ~8000 compounds among FDA-approved indole-containing compounds, a total of 57 obtained from the ChemBL were used for both ATP and tryptophan binding pocket docking. Best of indole-containing 57 compounds were subjected to hit expansion and compared later with virtual screening workflow (VSW) results. After docking, VSW was done. Glide-XP docking algorithm was chosen. When compared, VSW alone performed better than the hit expansion module. Best scored compounds were kept for ten ns molecular dynamic simulations by Desmond. Further, 100 ns molecular dynamic simulation was performed for elected molecules according to Z-score. The top three MMGBSA-scored compounds were subjected to steered molecular dynamic (SMD) simulations by Gromacs. While SMD simulations are still being conducted, ponesimod (for multiple sclerosis), vilanterol (β₂ adrenoreceptor agonist), and silodosin (for benign prostatic hyperplasia) were found to have a significant affinity for tuberculosis TrpRS, which is the propulsive force for the urge to expand the research with in vitro studies. Interestingly, top-scored ponesimod has been reported to have a side effect that makes the patient prone to upper respiratory tract infections.

Keywords: drug repurposing, molecular dynamics, tryptophanyl-tRNA synthetase, tuberculosis

Procedia PDF Downloads 123

Authors: Somayeh Bahrami, Seyed Jalal Dehghani Firoozabadi

Abstract:

Environmental governance is an interdisciplinary concept in political ecology and environmental policy focusing on the necessity of embedding the environmental issues in all levels of decision-making and act of states. Similar to sustainable development the concept of environmental governance believes that economic and political life of societies and countries need to be considered as a subset of the environment. This concept has been accepted by North Countries, those that have done the most irreparable environmental damage since the Industrial Revolution. Although North Countries are more responsible for damage to the environment, considering the global fluidity logic of environmental challenges, such an impression doesn’t cause developing countries to disavow responsibility for regional and international cooperation to protect the environment. Establishing an environmental governance at all levels of local, national, regional and global is one of the most significant ways to improve sustainable development. Given to the various political and economic difficulties developing countries including the Middle East face, building environmental governance in these countries is difficult but feasible, as these difficulties have not impeded their mutual partnership for confronting joint environmental issues. However, the environmental issues wouldn’t be solved only by mutual partnership but by establishing environmental governance, establishing regional environmental institutions (an introduction to building Regional Environmental Governance) and delegation of some environmental authorities to the mentioned institutions. The research is aimed at examining necessities, opportunities, and barriers to establishing Regional Environmental Governance in the Middle East. Therefore, this research seeks to answer the question of whether establishing Regional Environmental Governance is possible in the Middle East and if so then why. This study used descriptive-analytical methods and the inferential methodology has been used to reach the goals. Data has been collected by using library and internet sources as well as news sources on the basis of objective-historical data.

Keywords: environmental democracy (ED), environmental governance (EG), middle east (ME), regional environmental governance (REG)

Procedia PDF Downloads 456

Authors: C. Silvestros, K. Mellou, T. Georgakopoulou, A. Koustenis, E. Kokkinou, C. Botsi, A. Terzidis

Abstract:

'PHILOS – Emergency health response to refugee crisis' is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP) funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. One of the main objectives of the program is the immunization coverage of the target – population to assure the prevention of vaccine-preventable diseases. The program foresees vaccination needs assessment of children hosted at camps at the mainland and implementation of interventions to cover the vaccination gaps in co-operation with the Ministry of Health. The National Immunization Advisory Committee in Greece recommended that MMR (Measles, Mumps, and Rubella), PCV (Pneumococcal conjugate vaccine) and HEXA (diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b) vaccines should be performed in priority. Recording was completed at 24 camps (May - June 2017); 3381 children (0-18 years) were recorded. The median number of children hosted at each camp was 95 (range: 5-553). For 68% of the children, the WHO vaccination booklet was available. 44%, 48.5% and 61% of the children were vaccinated with at least one dose of PCV, HEXA, and MMR, respectively. The proportion of vaccinated children for the three vaccines mentioned above is significantly lower for the remaining doses; PCV (second dose 8%, third dose 1.3%), HEXA (second dose 13%, third dose 2.7%, forth dose 0.1%) and MMR (second dose 23%). None of the 37 (10 from Afghanistan, 3 from Bangladesh, 23 from Pakistan, 1 from Syria) recorded unaccompanied children did not have a WHO vaccination booklet and were considered unvaccinated. There is no differentiation in vaccination coverage among different ethnicities. Massive catch up vaccination was performed at 4 camps, and 671 vaccinations were performed (245 PCV, 307 HEXA, and 119 MMR). Similar interventions are planned for all camps of the country. Recording reveled gaps in vaccination coverage of the population, mainly because of the mobility of the population, the influx of refugees- which is still ongoing- and new births. Mass vaccination campaigns are considered vital in order to increase vaccination coverage, and continuous efforts are needed in order all children living at the camps to have full access to the National Childhood Immunization Program.

Keywords: vaccine preventable, refugee–migrants camps, vaccination coverage, PCV, MMR, HEXA

Procedia PDF Downloads 185

Authors: Akintunde Alo

Abstract:

The incessant encroachments into the forest ecosystem by the farmers and local contractors constitute a major threat to the conservation of genetic resources and biodiversity in Nigeria. To propose a viable monitoring system, this study employed Geographic Information System (GIS) technology to assess the changes that occurred for a period of five years (between 2011 and 2016) in Ikere forest reserve. Landsat imagery of the forest reserve was obtained. For the purpose of geo-referencing the acquired satellite imagery, ground-truth coordinates of some benchmark places within the forest reserve was relied on. Supervised classification algorithm, image processing, vectorization and map production were realized using ArcGIS. Various land use systems within the forest ecosystem were digitized into polygons of different types and colours for 2011 and 2016, roads were represented with lines of different thickness and colours. Of the six land-use delineated, the grassland increased from 26.50 % in 2011 to 45.53% in 2016 of the total land area with a percentage change of 71.81 %. Plantations of Gmelina arborea and Tectona grandis on the other hand reduced from 62.16 % in 2011 to 27.41% in 2016. The farmland and degraded land recorded percentage change of about 176.80 % and 8.70 % respectively from 2011 to 2016. Overall, the rate of deforestation in the study area is on the increase and becoming severe. About 72.59% of the total land area has been converted to non-forestry uses while the remnant 27.41% is occupied by plantations of Gmelina arborea and Tectona grandis. Interestingly, over 55 % of the plantation area in 2011 has changed to grassland, or converted to farmland and degraded land in 2016. The rate of change over time was about 9.79 % annually. Based on the results, rapid actions to prevail on the encroachers to stop deforestation and encouraged re-afforestation in the study area are recommended.

Keywords: land use change, forest reserve, satellite imagery, geographical information system

Procedia PDF Downloads 357

Authors: Salina Yahya Saddick

Abstract:

Ovarian cancer remains the most lethal gynecological malignancy due to the lack of highly sensitive and specific screening tools for detection of early-stage disease. The OSE provides the progenitor cells for 90% of human ovarian cancers. Recent morphologic, immunohistochemical and molecular genetic studies have led to the development of a new paradigm for the pathogenesis and origin of epithelial ovarian cancer (EOC) based on a ualistic model of carcinogenesis that divides EOC into two broad categories designated Types I and II which are characterized by specific mutations, including KRAS, BRAF, ERBB2, CTNNB1, PTEN PIK3CA, ARID1A, and PPPR1A, which target specific cell signaling pathways. Type 1 tumors rarely harbor TP53. type I tumors are relatively genetically stable and typically display a variety of somatic sequence mutations that include KRAS, BRAF, PTEN, PIK3CA CTNNB1 (the gene encoding beta catenin), ARID1A and PPP2R1A but very rarely TP53 . The cancer stem cell (CSC) hypothesis postulates that the tumorigenic potential of CSCs is confined to a very small subset of tumor cells and is defined by their ability to self-renew and differentiate leading to the formation of a tumor mass. Potential protein biomarker miRNA, are promising biomarkers as they are remarkably stable to allow isolation and analysis from tissues and from blood in which they can be found as free circulating nucleic acids and in mononuclear cells. Recently, genomic anaylsis have identified biomarkers and potential therapeutic targets for ovarian cancer namely, FGF18 which plays an active role in controlling migration, invasion, and tumorigenicity of ovarian cancer cells through NF-κB activation, which increased the production of oncogenic cytokines and chemokines. This review summarizes update information on epithelial ovarian cancers and point out to the most recent ongoing research.

Keywords: epithelial ovarian cancers, somatic sequence mutations, cancer stem cell (CSC), potential protein, biomarker, genomic analysis, FGF18 biomarker

Procedia PDF Downloads 380

Authors: Annapurna Basavaraju, Arianna Mastrodonato, Franz Heitmeir

Abstract:

The Advisory Council for Aeronautics Research in Europe (ACARE) is creating awareness for the overall reduction of NOx emissions by 80% in its vision 2020. Hence this promotes the researchers to work on novel technologies, one such technology is the use of alternative fuels. Among these fuels hydrogen is of interest due to its one and only significant pollutant NOx. The influence of NOx formation due to hydrogen combustion depends on various parameters such as air pressure, inlet air temperature, air to fuel jet momentum ratio etc. Appropriately, this research is motivated to investigate the impact of the air to fuel jet momentum ratio onto the NOx formation in a hydrogen combustion chamber for aircraft engines. The air to jet fuel momentum is defined as the ratio of impulse/momentum of air with respect to the momentum of fuel. The experiments were performed in an existing combustion chamber that has been previously tested for methane. Premix of the reactants has not been considered due to the high reactivity of the hydrogen and high risk of a flashback. In order to create a less rich zone of reaction at the burner and to decrease the emissions, a forced internal recirculation flow has been achieved by integrating a plate similar to honeycomb structure, suitable to the geometry of the liner. The liner has been provided with an external cooling system to avoid the increase of local temperatures and in turn the reaction rate of the NOx formation. The injected air has been preheated to aim at so called flameless combustion. The air to fuel jet momentum ratio has been inspected by changing the area of fuel inlets and keeping the number of fuel inlets constant in order to alter the fuel jet momentum, thus maintaining the homogeneity of the flow. Within this analysis, promising results for a flameless combustion have been achieved. For a constant number of fuel inlets, it was seen that the reduction of the fuel inlet diameter resulted in decrease of air to fuel jet momentum ratio in turn lowering the NOx emissions.

Keywords: combustion chamber, hydrogen, jet momentum, NOx emission

Procedia PDF Downloads 292

Authors: Ahmed Hefny Mohamed El-Badwy

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases, and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater, like a knife or a scalpel, there is evidence of surgery performed in ancient Egypt during the dynastic period (323 – 3200 BC). The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods, including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise, its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus (recipes from 863 to 877). The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however, we have not received a lengthy explanation of the various surgeries, and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancientegypt, egypt, archaeology, the ancient egyptian

Procedia PDF Downloads 69

Authors: Yulinda Rizky Pratiwi, Fuji Anugrah Emily

Abstract:

Management of Occupational Safety and Health (OSH) are appropriately applied properly by all workers and pekarya in the company. K3 management application also has become very important to prevent accidents. Violation of the rules regarding the K3 has often occurred from time to time. By 2015 the number of occurrences of a violation of the K3 or so-called unsafe action tends to increase. Until finally in January 2016, the number increased drastically unsafe action. Trigger increase in the number of unsafe action is a decrease in the quality of management practices K3. While the application of K3 management performed by each individual thought to be influenced by the attitude and observation guide the actions of each of the individual. In addition to the decline in the quality of K3 management application may result in increased likelihood of accidents and losses for the company as well as the local co-workers. The big difference in the number of unsafe action is very significant in the month of January 2016, making the company Pertamina as the national oil company must do a lot of effort to keep track of how the implementation of K3 management on every worker and pekarya, one at PT Pertamina EP Cepu Field Asset IV. To consider the effort to control the implementation of K3 management can be seen from the attitude and observation guide the actions of the workers and pekarya. By using Multiple Linear Regression can be seen the influence of attitude and action observation guide workers and pekarya the K3 management application that has been done. The results showed that scores K3 management application of each worker and pekarya will increase by 0.764 if the score pekarya worker attitudes and increase one unit, whereas if the score Reassurance action guidelines and pekarya workers increased by one unit then the score management application K3 will increase by 0.754.

Keywords: occupational safety and health, management of occupational safety and health, unsafe action, multiple linear regression

Procedia PDF Downloads 230

Authors: Abhishek Oswal

Abstract:

Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

Procedia PDF Downloads 144