Search results for: urban background sites

Authors: Mohaammad Ahmadpanah, Amineh Akhondi, Mohammad Haghighi, Ali Ghaleiha, Leila Jahangard, Elham Salari

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Background: Working memory includes the capability to keep and manipulate information in a short period of time. This capability is the basis of complicated judgments and has been attended to as the specific and constant character of individuals. Children with attention deficit and hyperactivity are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilizes a new approach with suitable tasks and methods for training active memory and assessment of the effects of the trainings. Participants: The children participating in this study were of 7-15 year age, who were diagnosed by the psychiatrist and psychologist as hyperactive and attention deficit based on DSM-IV criteria. The intervention group was consisted of 8 boys and 6 girls with the average age of 11 years and standard deviation of 2, and the control group was consisted of 2 girls and 5 boys with an average age of 11.4 and standard deviation of 3. Three children in the test group and two in the control group were under medicinal therapy. Results: Working memory training meaningfully improved the performance in not-trained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of non-verbal, complicated reasoning tasks. In addition, motional activities – measured based on the number of head movements during computerized measuring program – was meaningfully reduced in the medication group. The results of the second test showed that training similar exercise to teenagers and adults results in the improvement of cognition functions, as in hyperactive people. Discussion: The results of this study showed that the performance of working memory is improved through training, and these trainings are extended and generalized in other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal. They had also a positive and meaningful impact on the moving activities of hyperactive children.

Keywords: attention deficit hyperactivity disorder, working memory, non-medical treatment, children

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Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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Authors: Umberto Di Staso, Marco Soave, Alessio Giori, Federico Prandi, Raffaele De Amicis

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The increasing availability of information about earth surface elevation (Digital Elevation Models DEM) generated from different sources (remote sensing, Aerial Images, Lidar) poses the question about how to integrate and make available to the most than possible audience this huge amount of data. In order to exploit the potential of 3D elevation representation the quality of data management plays a fundamental role. Due to the high acquisition costs and the huge amount of generated data, highresolution terrain surveys tend to be small or medium sized and available on limited portion of earth. Here comes the need to merge large-scale height maps that typically are made available for free at worldwide level, with very specific high resolute datasets. One the other hand, the third dimension increases the user experience and the data representation quality, unlocking new possibilities in data analysis for civil protection, real estate, urban planning, environment monitoring, etc. The open-source 3D virtual globes, which are trending topics in Geovisual Analytics, aim at improving the visualization of geographical data provided by standard web services or with proprietary formats. Typically, 3D Virtual globes like do not offer an open-source tool that allows the generation of a terrain elevation data structure starting from heterogeneous-resolution terrain datasets. This paper describes a technological solution aimed to set up a so-called “Terrain Builder”. This tool is able to merge heterogeneous-resolution datasets, and to provide a multi-resolution worldwide terrain services fully compatible with CesiumJS and therefore accessible via web using traditional browser without any additional plug-in.

Keywords: Terrain Builder, WebGL, Virtual Globe, CesiumJS, Tiled Map Service, TMS, Height-Map, Regular Grid, Geovisual Analytics, DTM

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Authors: G. Venkatesha, Urs Samarth, H. K. Ramaraju, Arun Kumar Sharma

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The projection for Groundwater states that the total domestic water demand for greater Bangalore would increase from 1,170 MLD in 2010 to 1,336 MLD in 2016. Dependence on groundwater is ever increasing due to rapid Industrialization & Urbanization. It is estimated that almost 40% of the population of Bangalore is dependent on groundwater. Due to the unscientific disposal of domestic and industrial waste generated, groundwater is getting highly polluted in the city. The scale of this impact will depend mainly upon the water-service infrastructure, the superficial geology and the regional setting. The quality of ground water is equally important as that of quantity. Jointed and fractured granites and gneisses constitute the major aquifer system of BBMP area. Two new observatory Borewells were drilled and lithology report has been prepared. Petrographic Analysis (XRD/XRF) and Water quality Analysis were carried out as per the standard methods. Petrographic samples were analysed by collecting chip of rock from the borewell for every 20ft depth, most of the samples were similar and samples were identified as Biotite-Gneiss, Schistose Amphibolite. Water quality analysis was carried out for individual chemical parameters for two borewells drilled. 1st Borewell struck water at 150ft (Total depth-200ft) & 2nd struck at 740ft (Total depth-960ft). 5 water samples were collected till end of depth in each borewell. Chemical parameter values such as, Total Hardness (360-348, 280-320) mg/ltr, Nitrate (12.24-13.5, 45-48) mg/ltr, Chloride (104-90, 70-70)mg/ltr, Fe (0.75-0.09, 1.288-0.312)mg/ltr etc. are calculated respectively. Water samples were analysed from various parts of BBMP covering 750 sq kms, also thematic maps (IDW method) of water quality is generated for these samples for Post-Monsoon season. The study aims to explore the sub-surface Lithological layers and the thickness of weathered zone, which indirectly helps to know the Groundwater pollution source near surface water bodies, dug wells, etc. The above data are interpreted for future ground water resources planning and management.

Keywords: lithology, petrographic, pollution, urbanization

Procedia PDF Downloads 288

Authors: Heitor Oliveira, Gabriele De-Waal, Juergen Schmenger, Lynsey Godfrey, Tibor Kovacs

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Rheolaser MASTER™ makes use of multiple scattering of light, caused by scattering objects in a continuous medium (such as droplets and particles in colloids), to characterize the viscoelasticity of soft materials. It offers an alternative to conventional rheometers to characterize viscoelasticity of products such as hair cosmetics. Up to six simultaneous measurements at controlled temperature can be carried out simultaneously (10-15 min), and the method requires only minor sample preparation work. Conversely to conventional rheometer based methods, no mechanical stress is applied to the material during the measurements. Therefore, the properties of the exact same sample can be monitored over time, like in aging and stability studies. We determined the elastic index (EI) of water/emulsion mixtures (1 ≤ fat alcohols (FA) ≤ 5 wt%) and emulsion/gel-network mixtures (8 ≤ FA ≤ 17 wt%) and compared with the elastic/sorage mudulus (G’) for the respective samples using a TA conventional rheometer with flat plates geometry. As expected, it was found that log(EI) vs log(G’) presents a linear behavior. Moreover, log(EI) increased in a linear fashion with solids level in the entire range of compositions (1 ≤ FA ≤ 17 wt%), while rheometer measurements were limited to samples down to 4 wt% solids level. Alternatively, a concentric cilinder geometry would be required for more diluted samples (FA > 4 wt%) and rheometer results from different sample holder geometries are not comparable. The plot of the rheolaser output parameters solid-liquid balance (SLB) vs EI were suitable to monitor product aging processes. These data could quantitatively describe some observations such as formation of lumps over aging time. Moreover, this method allowed to identify that the different specifications of a key raw material (RM < 0.4 wt%) in the respective gel-network (GN) product has minor impact on product viscoelastic properties and it is not consumer perceivable after a short aging time. Broadening of a RM spec range typically has a positive impact on cost savings. Last but not least, the photon path length (λ*)—proportional to droplet size and inversely proportional to volume fraction of scattering objects, accordingly to the Mie theory—and the EI were suitable to characterize product destabilization processes (e.g., coalescence and creaming) and to predict product stability about eight times faster than our standard methods. Using these parameters we could successfully identify formulation and process parameters that resulted in unstable products. In conclusion, Rheolaser allows quick and reliable characterization of viscoelastic properties of hair cosmetics that are related to their performance and stability. It operates in a broad range of product compositions and has applications spanning from the formulation of our hair cosmetics to fast release criteria in our production sites. Last but not least, this powerful tool has positive impact on R&D development time—faster delivery of new products to the market—and consequently on cost savings.

Keywords: colloids, hair cosmetics, light scattering, performance and stability, soft materials, viscoelastic properties

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Authors: Theodore Panton

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As cities in the United States experience critical housing shortages, mass timber presents the opportunity to address this crisis in housing supply while taking advantage of the carbon-positive benefits of sustainably forested wood fiber. Mass timber, however, currently has a low level of adoption in residential multifamily structures due to the risk-averse nature of change within the construction financing, Architecture / Engineering / Contracting (AEC) communities, as well as various agency approval challenges. This study demonstrates how mass timber can be used within the cost and feasibility parameters of a typical multistory residential structure and ultimately address the need for dense urban housing. This study will utilize The Garden District, a mixed-use market-rate housing project in Woodinville, Washington, as a case study to illuminate the potential of mass timber in this application. The Garden District is currently in final stages of permit approval and will commence construction in 2023. It will be the tallest dowel-laminated timber (DLT) residential structure in the United States when completed. This case study includes economic, technical, and design reference points to demonstrate the relevance of the use of this system and its ability to deliver “triple bottom line” results. In terms of results, the study establishes scalable and repeatable approaches to project design and delivery of mass timber in multifamily residential uses and includes economic data, technical solutions, and a summary of end-user advantages. This study discusses the third party tested systems for satisfying acoustical requirements within dwelling units, a key to resolving the use of mass timber within multistory residential use. Lastly, the study will also compare the mass timber solution with a comparable cold formed steel (CFS) system with a similar program, which indicates a net carbon savings of over three million tons over the life cycle of the building.

Keywords: DLT, dowell laminated timber, mass timber, market rate multifamily

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Authors: Elif D. Oguz Erkal, David Krackhardt, Erica Cochran-Hameen

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Even though social network analysis (SNA) is an abundantly studied concept for many organizations and industries, a clear SNA approach to the project teams has not yet been adopted by the construction industry. The main challenges for performing SNA in construction and the apparent reason for this gap is the unique and complex structure of each construction project, the comparatively high circulation of project team members/contributing parties and the variety of authentic problems for each project. Additionally, there are stakeholders from a variety of professional backgrounds collaborating in a high-stress environment fueled by time and cost constraints. Within this case study on Project RE, a design & build project performed at the Urban Design Build Studio of Carnegie Mellon University, social network analysis of the project design team will be performed with the main goal of applying social network theory to construction project environments. The research objective is to determine a correlation between the network of how individuals relate to each other on one’s perception of their own professional strengths and weaknesses and the communication patterns within the team and the group dynamics. Data is collected through a survey performed over four rounds conducted monthly, detailed follow-up interviews and constant observations to assess the natural alteration in the network with the effect of time. The data collected is processed by the means of network analytics and in the light of the qualitative data collected with observations and individual interviews. This paper presents the full ethnography of this construction design team of fourteen architecture students based on an elaborate social network data analysis over time. This study is expected to be used as an initial step to perform a refined, targeted and large-scale social network data collection in construction projects in order to deduce the impacts of social networks on project performance and suggest better collaboration structures for construction project teams henceforth.

Keywords: construction design teams, construction project management, social network analysis, team collaboration, network analytics

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Authors: Himanshu Sharma, Karthik Kumar, Harish Kumar

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The major problem in crop cultivation is the occurrence of multiple crop diseases. During the growth stage, timely identification of crop diseases is paramount to ensure the high yield of crops, lower production costs, and minimize pesticide usage. In most cases, crop diseases produce observable characteristics and symptoms. The Surveyors usually diagnose crop diseases when they walk through the fields. However, surveyor inspections tend to be biased and error-prone due to the nature of the monotonous task and the subjectivity of individuals. In addition, visual inspection of each leaf or plant is costly, time-consuming, and labour-intensive. Furthermore, the plant pathologists and experts who can often identify the disease within the plant according to their symptoms in early stages are not readily available in remote regions. Therefore, this study specifically addressed early detection of leaf scald, red rot, and eyespot types of diseases within sugarcane plants. The study proposes a computer vision-based approach using a convolutional neural network (CNN) for automatic identification of crop diseases. To facilitate this, firstly, images of sugarcane diseases were taken from google without modifying the scene, background, or controlling the illumination to build the training dataset. Then, the testing dataset was developed based on the real-time collected images from the sugarcane field from India. Then, the image dataset is pre-processed for feature extraction and selection. Finally, the CNN-based Visual Geometry Group (VGG) model was deployed on the training and testing dataset to classify the images into diseased and healthy sugarcane plants and measure the model's performance using various parameters, i.e., accuracy, sensitivity, specificity, and F1-score. The promising result of the proposed model lays the groundwork for the automatic early detection of sugarcane disease. The proposed research directly sustains an increase in crop yield.

Keywords: automatic classification, computer vision, convolutional neural network, image processing, sugarcane disease, visual geometry group

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Authors: Xinli Chi, Xiaoqi Wei

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Background: Body-mind theory refers to the concept that the mind and body are interconnected; in this case, combining aerobic exercise and mindfulness-based training may be beneficial for mind-body health; however, there is limited evidence regarding their effects and potential mechanisms among Chinese university students. Therefore, the current study aims to examine the preliminary effects and feasibility of the combined intervention on depressive and insomnia symptoms, as well as to explore the underlying mechanisms. Methods: This is a two-arm pilot study of a randomized, controlled trial. Sixty-one Chinese university students were randomly allocated to 8-week combined intervention group (aerobic exercise plus mindfulness, N = 36) or control group (N = 36). In addition, 8 participants in combined intervention group were later volunteer to engage in semi-structured interview. The Self-Rating Depression Scale (SDS) and the Youth Self-Rating Insomnia Scales (YSIS) were used to measure depressive and insomnia symptoms, respectively. The intervention outcome and feasibility were tested by repeated-measures ANOVA, mediation model, and qualitative analysis. Results: The study included 31 participants in the intervention group and 30 participants in the control group, all of whom completed pre-test and post-test questionnaires. The results of the repeated-measures ANOVA showed that the combined intervention was effective in reducing depressive and insomnia symptoms among university students. Moreover, the mediation analysis suggested that improvement in insomnia symptoms might be a significant mechanism for the combined intervention. Qualitative analysis identified two main themes: “Helpful aspects of mind-body state” (including 7 sub-themes) and “Factors that influence the training effects” (including 3 sub-themes). Conclusions: The study confirmed the preliminary effect and feasibility of the combined intervention of mindfulness and aerobic exercise, while also exploring the potential mechanisms underlying this effect. Additionally, qualitative data provided valuable insights for optimizing future protocols.

Keywords: combined intervention, mindfulness, aerobic exercise, depressive symptoms, insomnia symptoms

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Authors: Sobhan Sobhani

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This study examined the behavioral patterns of student and their determinants according to the "symbolic interaction" sociological perspective in the form of 7 hypotheses. Behavioral patterns of students were classified in 8 categories: religious, scientific, political, artistic, sporting, national, parents and teachers. They were evaluated by student opinions by a five-point Likert rating scale. The statistical population included all male and female students of Islamic Azad University, Behabahan branch, among which 600 patients (268 females and 332 males) were selected randomly. The following statistical methods were used: frequency and percentage, mean, t-test, Pearson correlation coefficient and multi-way analysis of variance. The results obtained from statistical analysis showed that: 1-There is a significant difference between male and female students in terms of disposition to religious figures, artists, teachers and parents. 2-There is a significant difference between students of urban and rural areas in terms of assuming behavioral patterns of religious, political, scientific, artistic, national figures and teachers. 3-The most important criterion for selecting behavioral patterns of students is intellectual understanding with the pattern. 4-The most important factor influencing the behavioral patterns of male and female students is parents followed by friends. 5-Boys are affected by teachers, the Internet and satellite programs more than girls. Girls assume behavioral patterns from books more than boys. 6-There is a significant difference between students in human sciences, technical, medical and engineering disciplines in terms of selecting religious and political figures as behavioral patterns. 7-There is a significant difference between students belonging to different subcultures in terms of assuming behavioral patterns of religious, scientific and cultural figures. 8-Between the first and fourth year students in terms of selecting behavioral patterns, there is a significant difference only in selecting religious figures. 9-There is a significant negative correlation between the education level of parents and the selection of religious and political figures and teachers. 10-There is a significant negative correlation between family income and the selection of political and religious figures.

Keywords: behavioral patterns, behavioral patterns, male and female students, Islamic Azad University

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Authors: Sheikha Turki Alketbi

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Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

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Authors: Tania Mannan, Rahelee Zinnat, Fatema Jebunnesa, Israt Ara Hossain

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Background: Exposure to arsenic has known toxic effects but the effect on pregnancy outcomes is not as widely documented especially in women with diabetes. Growing evidence has suggested a potential role of arsenic exposure in the development of gestational diabetes mellitus (GDM). Therefore, we aimed to investigate the association of urinary arsenic (UAs) with birth outcomes in GDM subjects. Methods: Under an observational cross-sectional design a total of 263 GDM subjects (age in years, M±SD, 21±3.7) residing in an arsenic affected area of Bangladesh, were subjected to a 2 sample OGTT at the third trimester of gestation. Among them, 73 GDM and 190 non-GDM subjects enrolled in this study. Clinical and anthropometric measurements were done by standard techniques. Degree of chronic arsenic exposure was assessed by the level of UAs level. According to World Health Organization (WHO) criteria, GDM was diagnosed and neonatal outcomes using APGAR (Activity Pulse Grimace Appearance Respirations) Score, birth weight and size were assessed by a specialist obstetrician. Serum glucose was measured by the Glucose Oxidase method and UAs level was determined by ultraviolet/visible spectrophotometry. Result: Out of the 263 pregnant women, 28% developed GDM. Urinary Arsenic was significantly higher in the GDM as compared to the non-GDM group [UAs, µg/l, M±SD (range), 204.2±67.0 (67.0-377.0) vs 77.3±38.1 (22.0-99.0), p < 0.001]. Activity Pulse Grimace Appearance Respirations Score of the neonates from GDM mothers was significantly lower compared to the neonates from non-GDM mothers [APGAR Score, M±SD, 4.7±0.8 vs. 6.4±0.7, p<0.001]. Pearson’s correlation analysis in GDM subjects revealed that UA levels were found to have a significant positive correlation with both fasting and postprandial serum glucose levels (p < 0.001) and (p < 0.001) respectively. Again, a significant inverse correlation of UAs with birth weight and size was observed (p < 0.001). The APGAR Score of the neonates were found to have a significant negative correlation (p < 0.001) with UAs level. Conclusion: The effect of chronic arsenic exposure is associated with glucose intolerance during pregnancy and it also adversely affects birth outcomes. The study suggests further research on the impact of total arsenic exposure on pregnancy outcomes.

Keywords: APGAR score, arsenic exposure, birth outcome, gestational diabetes mellitus,

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Authors: Omar Khan, Shana Krstevska, Edwin George, Veronica Gorden, Fen Bao, Christina Caon, NP-C, Carla Santiago, Imad Zak, Navid Seraji-Bozorgzad

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Objective: To quantify cellular injury in the substantia nigra (SN) in patients with Parkinson's disease (PD) and to examine the effect of rasagiline of tissue injury in the SN in patients with PD. Background: N-acetylaspartate (NAA) quantified with MRS is a reliable marker of neuronal metabolic function. Fractional anisotropy (FA) and mean diffusivity (MD) obtained with DTI, characterize tissue alignment and integrity. Rasagline, has been shown to exert anti-apototic effect. We applied these advanced MRI techniques to examine: (i) the effect of rasagiline on cellular injury and metabolism in patients with early PD, and (ii) longitudinal changes seen over time in PD. Methods: We conducted a prospective longitudinal study in patients with mild PD, naive to dopaminergic treatment. The imaging protocol included multi-voxel proton-MRS and DTI of the SN, acquired on a 3T scanner. Scans were performed at baseline and month 3, during which the patient was on no treatment. At that point, rasagiline 1 mg orally daily was initiated and MRI scans are were obtained at 6 and 12 months after starting rasagiline. The primary objective was to compare changes during the 3-month period of “no treatment” to the changes observed “on treatment” with rasagiline at month 12. Age-matched healthy controls were also imaged. Image analysis was performed blinded to treatment allocation and period. Results: 25 patients were enrolled in this study. Compared to the period of “no treatment”, there was significant increase in the NAA “on treatment” period (-3.04 % vs +10.95 %, p= 0.0006). Compared to the period of “no treatment”, there was significant increase in following 12 month in the FA “on treatment” (-4.8% vs +15.3%, p<0.0001). The MD increased during “no treatment” and decreased in “on treatment” (+2.8% vs -7.5%, p=0.0056). Further analysis and clinical correlation are ongoing. Conclusions: Advanced MRI techniques quantifying cellular injury in the SN in PD is a feasible approach to investigate dopaminergic neuronal injury and could be developed as an outcome in exploratory studies. Rasagiline appears to have a stabilizing effect on dopaminergic cell loss and metabolism in the SN in PD, that warrants further investigation in long-term studies.

Keywords: substantia nigra, Parkinson's disease, MRI, neuronal loss, biomarker

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Authors: Marwa Mamdouh Shaban, Nagat Saied Habib, Shireen Ezz El-Din Taha, Eman Mahmoud Seif El-Naser

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Background: Dental nurses and dentists were constantly exposed to a number of specific work related health risk factors which develop and intensify with years. Awareness regarding these work-related health risk factors and implementation of preventive health care measures could provide a safe work environment for all dental nurses and dentists. Aim of the study: to assess the work-related health risk factors among dental nurses and dentists and preventive health care measures applied among dental nurses and dentists. Research design: A descriptive design was utilized. Sample: Convenience sample of 50 dental nurses and 150 dentists were included in the current study. Setting: This study was conducted at the dental clinics at faculty of oral and dental medicine, Al-Kasr Al Ainy Hospital. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a-Socio-demographic data sheet, b-Work-related health risk factors questionnaire, and c-structured observational checklist. Results: The most common work risk factors prevailing among dental nurses were emotional exhaustion (82%), low back pain (76%) and latex allergy (62%) and the most common work risk factors prevailing among dentists were percutaneous exposure incident (100%), emotional exhaustion (100%) and low back pain (93.3%). Also, statistically significant negative correlation (r=-0.274, at p = 0.045) between the incidence of chemical health risk factors and application of chemical preventive measures among dental nurses. A statistically significant negative correlation (r=-0.177, at p = 0.030) between the incidences of mechanical health risk factors among dentists and application of mechanical preventive measures. Conclusion: The studied dental nurses and dentists exposed to many work related health risk factors as latex allergy, percutaneous exposure incidents, low back pain and emotional exhaustion related to inappropriate application of preventive health care measures. Recommendation: Raise awareness of dental nurses and dentists about work-related health risk factors, design and implement health education program for preventive health care measures.

Keywords: work-related risk factors, preventive measures, nurses, dentists

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Authors: Lucy Horrobin, Rebecca Fores

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Background: Muay Thai is an increasingly popular combat sport worldwide. Further academic research in the sport will contribute to its professional development. This research sought to produce normative data in relation to the physical and physiological characteristics of professional Muay Thai boxers, as, currently no such data exists. The ultimate aim being to inform appropriate training programs and to facilitate coaching. Methods: N = 9 professional, adult, male Muay Thai boxers were assessed for the following anthropometric, physical and physiological characteristics, using validated methods of assessment: body fat, hamstring flexibility, maximal dynamic upper body strength, lower limb peak power, upper body muscular endurance and aerobic capacity. Raw data scores were analysed for mean, range and SD and where applicable were expressed relative to body mass (BM). Results: Results showed similar characteristics to those found in other combat sports. Low percentages of body fat (mean±SD) 8.54 ± 1.16 allow for optimal power to weight ratios. Highly developed aerobic capacity (mean ±SD) 61.56 ± 5.13 ml.min.kg facilitate recovery and power maintenance throughout bouts. Lower limb peak power output values of (mean ± SD) 12.60 ± 2.09 W/kg indicate that Muay Thai boxers are amongst the most powerful of combat sport athletes. However, maximal dynamic upper body strength scores of (mean±SD) 1.14 kg/kg ± 0.18 were in only the 60th percentile of normative data for the general population and muscular endurance scores (mean±SD) 31.55 ± 11.95 and flexibility scores (mean±SD) 19.55 ± 11.89 cm expressed wide standard deviation. These results might suggest that these characteristics are insignificant in Muay Thai or under-developed, perhaps due to deficient training programs. Implications: This research provides the first normative data of physical and physiological characteristics of Muay Thai boxers. The findings of this study would aid trainers and coaches when designing effective evidence-based training programs. Furthermore, it provides a foundation for further research relating to physiology in Muay Thai. Areas of further study could be determining the physiological demands of a full rules bout and the effects of evidence-based training programs on performance.

Keywords: fitness testing, Muay Thai, physiology, strength and conditioning

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Authors: Maria Bonolo Mathevula

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Background: Children are important members of communities playing major role in the future of any given country (Pera, Fails, Gelsomini, &Garzotto, 2018). Visual Perceptual Skills (VPSs) in children are important health aspect of early childhood development through the Foundation Phases in school. Subsequently, children should undergo visual screening before commencement of schooling for early diagnosis ofVPSs anomalies because the primary role of VPSs is to capacitate children with academic performance in general. Aim : The aim of this study was to determine the anomalies of visual VPSs amongst school children in Foundation Phase. The study’s objectives were to determine the prevalence of VPSs anomalies amongst school children in Foundation Phase; Determine the relationship between children’s academic and VPSs anomalies; and to investigate the relationship between VPSs anomalies and refractive error. Methodology: This study was a mixed method whereby triangulated qualitative (interviews) and quantitative (questionnaire and clinical data) was used. This was, therefore, descriptive by nature. The study’s target population was school children in Foundation Phase. The study followed purposive sampling method. School children in Foundation Phase were purposively sampled to form part of this study provided their parents have given a signed the consent. Data was collected by the use of standardized interviews; questionnaire; clinical data card, and TVPS standard data card. Results: Although the study is still ongoing, the preliminary study outcome based on data collected from one of the Foundation Phases have suggested the following:While VPSs anomalies is not prevalent, it, however, have indirect relationship with children’s academic performance in Foundation phase; Notably, VPSs anomalies and refractive error are directly related since majority of children with refractive error, specifically compound hyperopic astigmatism, failed most subtests of TVPS standard tests. Conclusion: Based on the study’s preliminary findings, it was clear that optometrists still have a lot to do in as far as researching on VPSs is concerned. Furthermore, the researcher recommends that optometrist, as the primary healthcare professionals, should also conduct the school-readiness pre-assessment on children before commencement of their grades in Foundation phase.

Keywords: foundation phase, visual perceptual skills, school children, refractive error

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Authors: Rachel Byrne

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Background: Due to patient and student safety concerns, combined with clinical teachers being redeployed to clinical practice, COVID-19 has resulted in a reduction in face-to-face teaching sessions for medical students. Traditionally such sessions are particularly important for final year medical students, especially in preparing for their final practical exams. A reduced student presence on the wards has also resulted in fewer opportunities for junior doctors to provide teaching sessions. This has implications for junior doctors achieving their own curriculum outcomes for teaching, as well as potentially hindering the development of a future interest in medical education. Aims: The aims of the study are 1) To create a safe face-to-face teaching environment during COVID-19 which focussed on exam preparation for final year medical students, 2) To provide a platform for doctors to gain teaching experience, 3 ) to enable doctors to gain feedback or assessments on their teaching, 4) To create beginners guide to designing a new teaching program for future junior doctors. Methods: We created a program of timed clinical stations consisting of four sessions every five weeks during the student’s medicine attachment. Each session could be attended by 6 students and consisted of 6 stations ran by junior doctors, with each station following social distancing and personal protective equipment requirements. Junior doctors were asked to design their own stations. The sessions ran out-of-hours on weekday evenings and were optional for the students. Results: 95/95 students and 20/40 doctors involved in the programme completed feedback. 100% (n=95) of students strongly agreed/agreed that sessions were aimed at an appropriate level and provided constructive feedback. 100% (n=95) of students stated they felt more confident in their abilities and would recommend the session to peers. 90% (n=18) of the teachers strongly agreed/agreed that they felt more confident in their teaching abilities and that the sessions had improved their own medical knowledge. 85% (n=17) of doctors had a teaching assessment completed, and 83% (n=16) said the program had made them consider a career in medical education. The difficulties of creating such a program were highlighted throughout, and a beginner’s guide was created with the hopes of helping future doctors who are interested in teaching address the common obstacles.

Keywords: COVID-19, education, safety, medical

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Authors: Caroline Bradbury-Jones, Maria Clark, Eleanor Molloy, Nicki Ward

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Background: Significant developments in the protection of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) rights culminated in their inclusion in the Equality Act 2010. This provides legal protection against discrimination including the Public Sector Equality Duty requiring public bodies to consider all individuals when carrying out their day-to-day work. In the UK, whilst the Higher Education sector has made some commitment to eliminating discrimination and addressing LGBTQ inclusivity, there are two particular problems specifically affecting students on professional programmes: -All students will come into contact with LGBTQ patients/clients/students and need to be equipped to respond appropriately to their diverse needs but evidence suggests that this is not always the case. -Many LGBTQ students have specific concerns on professional placements; often ‘going back in the closet’ or feeling uncertain how to respond to questions about their personal lives and being reticent to challenge discrimination against LGBTQ patients/clients/students for fear of reprisal. Study aim: To investigate how best to prepare all students to deal with the issue of gender and sexual diversity and to support LGBTQ students in negotiating (non) disclosure in practice placements. Methods: This multi-method study was conducted in 2017 in the UK. It comprised a student survey, focus group interview with students and a national benchmarking exercise. Findings: Preliminary findings are that there is considerable variation across professional programmes regarding the preparation of students to respond to LGBTQ issues. Similarly, there is considerable difference between the level of preparedness experienced by students irrespective of whether they identify as LGBTQ. Discussion: Nationally there are a number of ‘best practice’ examples that we share in this presentation. These contain important details and guidance about how to better prepare university students for professional practice, and to contribute to eliminating discrimination and addressing LGBTQ inclusivity. Conclusions: The presentation will appeal to delegates who are interested in the equality agenda regarding LGBTQ people. The study findings will be discussed and debated to explore their impact on higher education and learning and to identify ways to integrate best practice into professional curricula across the UK and beyond.

Keywords: diversity, equality, practice, sexuality, students, university

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Authors: A. Terfous, Y. Liu, A. Ghenaim, P. A. Garambois

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With increasing urbanization worldwide, it is crucial to sustainably manage sediment flows in urban networks and especially in stormwater detention basins. One key aspect is to propose optimized designs for detention tanks in order to best reduce flood peak flows and in the meantime settle particles. It is, therefore, necessary to understand complex flows patterns and sediment deposition conditions in stormwater detention basins. The aim of this paper is to study flow structure and particle deposition pattern for a given tank geometry in view to control and maximize sediment deposition. Both numerical simulation and experimental works were done to investigate the flow and sediment distribution in a storm tank with a cavity. As it can be indicated, the settle distribution of the particle in a rectangular tank is mainly determined by the flow patterns and the bed shear stress. The flow patterns in a rectangular tank differ with different geometry, entrance flow rate and the water depth. With the changing of flow patterns, the bed shear stress will change respectively, which also play an influence on the particle settling. The accumulation of the particle in the bed changes the conditions at the bottom, which is ignored in the investigations, however it worth much more attention, the influence of the accumulation of the particle on the sedimentation should be important. The approach presented here is based on the resolution of the Reynolds averaged Navier-Stokes equations to account for turbulent effects and also a passive particle transport model. An analysis of particle deposition conditions is presented in this paper in terms of flow velocities and turbulence patterns. Then sediment deposition zones are presented thanks to the modeling with particle tracking method. It is shown that two recirculation zones seem to significantly influence sediment deposition. Due to the possible overestimation of particle trap efficiency with standard wall functions and stick conditions, further investigations seem required for basal boundary conditions based on turbulent kinetic energy and shear stress. These observations are confirmed by experimental investigations processed in the laboratory.

Keywords: storm sewers, sediment deposition, numerical simulation, experimental investigation

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Authors: Masami Usui

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After 9/11, the American literary scene was confronted with new perspectives that enabled both writers and readers to recognize the hidden aspects of their political, economic, legal, social, and cultural phenomena. There appeared an argument over new and challenging multicultural aspects after 9/11 and this argument is presented by a tension of space related to 9/11. In Amy Waldman’s the Submission (2011), designing both the memorial park and the family network has a significant meaning in establishing the progress of understanding from multiple perspectives. The most intriguing and controversial topic of racism is reflected in the Submission, where one young architect’s blind entry to the competition for the memorial of Ground Zero is nominated, yet he is confronted with strong objections and hostility as soon as he turns out to be a Muslim named Mohammad Khan. This ‘Khan’ issue, immediately enlarged into a social controversial issue on American soil, causes repeated acts of hostility to Muslim women by ignorant citizens all over America. His idea of the park is to design a new concept of tracing the cultural background of the open space. Against his will, his name is identified as the ‘ingredient’ of the networking of the resistant community with his supporters: on the other hand, the post 9/11 hysteria and victimization is presented in such family associations as the Angry Family Members and Grieving Family Members. These rapidly expanding networks, whether political or not, constructed by the internet, embody the contemporary societal connection and representation. The contemporary quest for the significance of human relationships is recognized as a quest for global peace. Designing both the memorial park and the communication networks strengthens a process of facing the shared conflicts and healing the survivors’ trauma. The tension between the idea and networking of the Garden for the memorial site and the collapse of Ground Zero signifies the double mission of the site: to establish the space to ease the wounded and to remember the catastrophe. Reading the design of these icons of 9/11 in the Submission means that decoding the myth of globalization and its representations in this century.

Keywords: American literature, cultural studies, globalization, literature of catastrophe

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Authors: Jefferson S. Galanza, Jewel An Mischelle R.Camcam, Alyssa Karryl C. Co, Stephanie P. De Guzman, Jet Jet K. Dongui-is, Rodolfo Dane C. Frias, Ovelle C. Jueco, Harvey L. Matbagan, Victoria Luzette T. Rillon, Christelle Romyna H. Saruca, Jeanette Roma M. Villasper

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Background: Amidst numerous studies conducted on learning styles of students from a variety of courses, levels and school, a recent study recommended a great need for research on learning styles of student nurses. Moreover, related literatures have not been found exploring both the learning and teaching style of student nurses. Aims: The study aimed to determine the learning and teaching styles of student nurses and if there is an association between them. It also intended to discover whether student nurses are unimodal or multimodal in their styles and identified which faculty teaching style affords maximum outcome for student’s learning styles. Methods: Quantitative Descriptive-Correlational design was used. Participants were randomly selected 312 student nurses at School of Nursing X, Baguio City, Philippines. The questionnaire utilized a modified version of an adopted tool from Fleming’s VARK learning style version 7.2 (Visual, Auditory, Reader/Writer, Kinaesthetic) and Grasha’s teaching styles (Formal Authority, Demonstrator, Facilitator, Delegator). SPSS 19 was used for statistical treatment of data, where Chi square was used for the correlation of unimodal learning and teaching styles. Results/Finding: Majority of student nurses’ learning style is Kinesthetic and their teaching style is Demonstrator, which was also found to be significantly associated. Moreover, 8 out of 10 students are Unimodal in their learning and teaching modalities. In general, their preferred faculty teaching style is similar to their teaching style, which supports the concept, that teachers teach the way they learn. Conclusion: Study concludes that student nurses’ learning styles and teaching styles are varied, which exemplifies the uniqueness of every learner.This diversity in styles provided more evidence that a variety of mode of teaching and learning should be used by faculty and students to increase learning outcome and academic achievement. Recommendation: Future studies could be carried out in various schools of nursing utilizing faculty as respondents. Conduct assessment of learning style at the onset of classes/clinical placements so that faculty will become aware of the diversity of learners leading them to deliver diverse teaching methods.

Keywords: learning, learning styles, teaching styles, student nurses

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Authors: Maria Angela Bedini, Fabio Bronzini

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The risk of natural disasters affects all the countries of the world, whether it refers to seismic events or tsunamis or hydrogeological disasters. In most cases, the risk can be considered in its three components: hazard, exposure, vulnerability (and urban vulnerability). The aim of this paper is to evaluate how the Italian scientific community has related the contribution of these three components, superimposing the three different maps that summarize the fundamental structure of the risk. Based on the three components considered, the study applies the Regional Planning methodology on the three phases of the risk protection and mitigation process: the prevention phase, the emergency intervention phase, the post-disaster phase. The paper illustrates the Italian experience of the pre-during-post-earthquake intervention. Main results: The study deepens these aspects in the belief that “a historical center” and an “island” can present similar problems at the international level, both in the phase of prevention (earthquake, tsunamis, hydrogeological disasters), in emergency phase (protocols and procedures of intervention) and in the post-disaster phase. The conclusions of the research identify the need to plan in advance how to deal with the post-disaster phase and consider it a priority with respect to the simple reconstruction of destroyed buildings. In fact the main result of the post-disaster intervention must be the return and the social and economic support of the indigenous population, and not only the construction of new housing and equipment. In this sense, the results of the research show that the elderly inhabitants of a historic center can be compared to the indigenous population of an atoll of fishermen, as both constitute the most important resource: the human resource. Their return in conditions of security testifies, with their presence, the culture, customs, and values rooted in the history of a people.

Keywords: post-disaster interventions, risk of natural disasters in Italy and abroad, seismic events in Italy, social and economic protection and support for the native population of historical centers

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Authors: N. Kashif, M. K. Naseer

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This is an undeniable fact that parents are the very first role model for their children and children are the silent observers and followers of their parents. The environment they would be provided will leave either positive or negative lasting impact on their physical and mental behavior and abilities to grow, progress and conquer. This paper focuses on the observation particularly in South Asian countries where females have been facing problems in accessing education and getting financially independent or stable. This paper emphasizes on a survey conducted in rural areas of Punjab State in Pakistan. It explains how the parents’ educational background, financial status, conservative and interdependent accommodation style influence a prominent inequality of giving their female child right to study and get empowered. The forces behind this gender discrimination are not limited to parents’ life style impact but also include some major social problems like distant schools, gender-based harassment, and threat, insecurities, employment opportunities, so on. As a grass root level solution, it is proposed to develop an institution which collects data regarding child birth in their region and can contact the parent when their child is ready to start school. Building up trust based relationship with parents is the most crucial and significant factor. Secondly, celebrities and public figures can play an extraordinary role in running a campaign to advocate and encourage people living in rural areas, villages and small towns. All possible solutions can never be implemented without the support of the state government. Therefore, this paper invites more thoughtful actions, properly planned strategies, initiators to take the lead and make a platform for those who are underprivileged and deprived of their basic rights. Any country, where female constitute 49% of its entire population can never progress without promoting female empowerment and their right to compulsory education, and it is never late or impossible to admit the facts and practically start a flexible solution- oriented approach.

Keywords: employment opportunities, female empowerment, gender based harassment, gender discrimination, inequality, parents' life style impact

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Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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Authors: Woldegerima G. Medhin, Tadele Araya

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Background: Rabies is acute viral encephalitis affecting mainly carnivores and insectivorous but can affect any mammal. Case fatality rate is 100% once clinical signs appear. Rabies has a worldwide distribution in continental regions of Asia and Africa. Globally, rabies is responsible for more than 61000 human deaths annually. An estimation of human mortality rabies in Asia and Africa annually exceed 35172 and 21476 respectively. Ethiopia approximately 2900 people were estimated to die of rabies annually, Tigary region approximately 98 people were estimated to die annually. The aim of this study is to analyze trends, describe, and evaluate the ten years rabies data in Tigray, Ethiopia. Methods: We conducted descriptive epidemiological study from 15-30 February, 2023 of rabies exposure and death in humans by reviewing the health management information system report from Tigray Regional Health Bureau and vaccination coverage of dog population from 2013 to 2022. We used case definition, suspected cases are those bitten by the dogs displaying clinical signs consistent with rabies and confirmed cases were deaths from rabies at time of the exposure. Results: A total 21031 dog bites and 375 deaths report of rabies and 18222 post exposure treatments for humans in Tigray region were used. A suspected rabies patients had shown an increasing trend from 2013 to 2015 and 2018 to 2019. Overall mortality rate was 19/1000 in Tigray. Majority of suspected patients (45%) were age <15 years old. An estimated by Agriculture Bureau of Tigray Region about 12000 owned and 2500 stray dogs are available in the region, but yearly dog vaccination remains low (50%). Conclusion: Rabies is a public health problem in Tigray region. It is highly recommended to vaccinate individually owned dogs and concerned sectors should eliminate stray dogs. Surveillance system should strengthen for estimating the real magnitude, launch preventive and control measures.

Keywords: rabies, Virus, transmision, prevalence

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Authors: Shamim Akhtar

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The purpose of the present research was to analyse the performance level of district administrators and school heads teachers at secondary school level. The sample of the study was head teachers and teachers of secondary schools. In survey three scales were used, two scales were for the head teachers, one five point scale was for analysing the working efficiency of educational administrators and other seven points scale was for head teachers for analysing their own performance and one another seven point rating scale similar to head teacher was for the teachers for analysing the working performance of their head teachers. The results of the head teachers’ responses revealed that the performance of their District Educational Administrators was average and for the performance efficiency of the head teachers, researcher constructed the rating scales on seven parameters of management likely academic management, personnel management, financial management, infra-structure management, linkage and interface, student’s services, and managerial excellence. Results of percentages, means, and graphical presentation on different parameters of management showed that there was an obvious difference in head teachers and teachers’ responses and head teachers probably were overestimating their efficiency; but teachers evaluated that they were performing averagely on majority statements. Results of t-test showed that there was no significance difference in the responses of rural and urban teachers but significant difference in male and female teachers’ responses showed that female head teachers were performing their responsibilities better than male head teachers in public sector schools. When efficiency of the head teachers on different parameters of management were analysed it was concluded that their efficiency on academic and personnel management was average and on financial management and on managerial excellence was highly above of average level but on others parameters like infra-structure management, linkage and interface and on students services was above of average level on most statements but highly above of average on some statements. Hence there is need to improve the working efficiency in academic management and personnel management.

Keywords: educational administration, educational management, parameters of management, education

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Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

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Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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Authors: S. Kershaw, P. J. Barry, K. Webb

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Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.

Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices

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Authors: Yi Li, Rui Lu, Lianjun Wang

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With the rapid development of chemical industry, the consumption of volatile organic compounds (VOCs) has increased extensively. In the process of VOCs production and application, plenty of them have been transferred to environment. As a result, it has led to pollution problems not only in soil and ground water but also to human beings. Thus, it is important to develop a sensitive and cost-effective analytical method for trace VOCs detection in environment. Surface-enhanced Raman Spectroscopy (SERS), as one of the most sensitive optical analytical technique with rapid response, pinpoint accuracy and noninvasive detection, has been widely used for ultratrace analysis. Based on the plasmon resonance on the nanoscale metallic surface, SERS technology can even detect single molecule due to abundant nanogaps (i.e. 'hot spots') on the nanosubstrate. In this work, a self-supported flexible silver nitrate (AgNO3)/ethylene-propylene copolymer (EPM) hybrid nanofibers was fabricated by electrospinning. After an in-situ chemical reduction using ice-cold sodium borohydride as reduction agent, numerous silver nanoparticles were formed on the nanofiber surface. By adjusting the reduction time and AgNO3 content, the morphology and dimension of silver nanoparticles could be controlled. According to the principles of solid-phase extraction, the hydrophobic substance is more likely to partition into the hydrophobic EPM membrane in an aqueous environment while water and other polar components are excluded from the analytes. By the enrichment of EPM fibers, the number of hydrophobic molecules located on the 'hot spots' generated from criss-crossed nanofibers is greatly increased, which further enhances SERS signal intensity. The as-prepared Ag/EPM hybrid nanofibers were first employed to detect common SERS probe molecule (p-aminothiophenol) with the detection limit down to 10-12 M, which demonstrated an excellent SERS performance. To further study the application of the fabricated substrate for monitoring hydrophobic substance in water, several typical VOCs, such as benzene, toluene and p-xylene, were selected as model compounds. The results showed that the characteristic peaks of these target analytes in the mixed aqueous solution could be distinguished even at a concentration of 10-6 M after multi-peaks gaussian fitting process, including C-H bending (850 cm-1), C-C ring stretching (1581 cm-1, 1600 cm-1) of benzene, C-H bending (844 cm-1 ,1151 cm-1), C-C ring stretching (1001 cm-1), CH3 bending vibration (1377 cm-1) of toluene, C-H bending (829 cm-1), C-C stretching (1614 cm-1) of p-xylene. The SERS substrate has remarkable advantages which combine the enrichment capacity from EPM and the Raman enhancement of Ag nanoparticles. Meanwhile, the huge specific surface area resulted from electrospinning is benificial to increase the number of adsoption sites and promotes 'hot spots' formation. In summary, this work provides powerful potential in rapid, on-site and accurate detection of trace VOCs using a portable Raman.

Keywords: electrospinning, ethylene-propylene copolymer, silver nanoparticles, SERS, VOCs

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Authors: Rawia M. Khalil, Ghada Abd-Elbary, Mona Basha, Ghada E. A. Awad, Hadeer A. Elhashemy

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Background: Bacterial infections of the eye are the clinical conditions responsible for ocular morbidity and blindness. Conjunctivitis is an inflammation of the conjunctiva, due to Staphylococcus aureus. Lomefloxacin HCl (LXN) is a third generation flouroquinolone antibiotic with a broad spectrum against wide range of bacteria and very effective against Staph infections especially in conjunctiva (conjunctivitis). The present study aims to develop and evaluate novel ocular proniosomal gels of Lomefloxacin Hcl (LXN); in order to improve its ocular bioavailability for the management of bacterial conjunctivitis. Materials and methods: Proniosomes were prepared by coacervation phase separation method using different types of nonionic surfactants (Span 60,40,20,Tween 20,40,60,80,Brij 35,98,72) solely and as mixtures with Span® 60. The formed gels were characterized for entrapment efficiency, vesicle size and in vitro drug release. The optimum proniosomal gel; P-LXN 7 were characterized for pH measurement, transmission electron microscopy (TEM) and differential scanning calorimetry (DSC) as well as Stability study and microbiological evaluation .The results revealed that only Span 60 was able to form stable LXN proniosomal gel when used individually while the other nonionic surfactants formed gels only in combination with Span 60 at different ratios. The optimum proniosomal gel; P-LXN 7 (Span60:Tween60, 9:1) appeared as spherical shaped vesicles having high entrapment efficiency (>80 %), appropriate vesicle size (187 nm) as well as controlled drug release over 12h. DSC confirmed the amorphous nature and the uniformity of LXN inclusion within the vesicles. Physical stability study did not show any significant changes in appearance or entrapment efficiency or vesicle size after storage for 3 months at 4°C. Ocular irritancy test revealed that P-LXN 7 was safe, well tolerable and suitable for ocular delivery. In vivo antibacterial activity of P-LXN 7 evaluated using the susceptibility test and topical therapy of induced ocular conjunctivitis confirmed the enhanced antibacterial therapeutic efficacy of the LXN-proniosomal gel compared to the commercially available LXN eye drops; Orchacin®. Conclusions: Our results suggest that proniosomal gels could provide a promising carrier of LXN for efficient ocular treatment of bacterial conjunctivitis.

Keywords: bacterial conjunctivitis, lomefloxacin HCl, ocular drug delivery, proniosomes

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