Search results for: fracture clinic

Authors: Kushal Gowda Jayaram, Joseph Huret, Jonathan Quibel, Walter-John Chitty, Gilbert Henaff

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Thermal aging is one of the concerns for the long-term operation of nuclear power plants. Indeed, components in the primary circuit undergo thermal aging while exposed to the chemically active environment of Pressurized Water Reactors (PWRs) over time. Among the materials used in the reactor components, Alloy 690 can be found in some critical components for nuclear safety. Despite its importance, research on the effect of thermal aging on the microstructural changes and low cycle fatigue (LCF) behavior of Alloy 690 remains limited. This study aims to assess the impact of thermal aging on the fatigue life of Alloy 690. The as-received sample underwent aging at 420°C for 4000 hours, representing the equivalent aging of 60 years in reactor working conditions. First, the characterization of the area and density of intergranular and intragranular precipitates was performed to understand the microstructural changes in the aged specimen. Then, low cycle fatigue tests were conducted on the as received and aged samples at varying strain amplitudes. To investigate the influence of thermal aging on the fatigue behavior of Alloy 690, fracture surfaces were analyzed to estimate fatigue crack growth rates based on striation spacing measurements. Additionally, the axially cut fractured samples have undergone analysis using Electron Backscatter Diffraction (EBSD) to understand the effect of aging on strain localization near the crack path. Results indicate that while the characterization of the area and density of intergranular precipitates in the aged specimen (for 2000 hours, approximately 30 years) showed no significant changes, there was a slight increase in the area and density of intragranular precipitates under the same conditions.

Keywords: alloy 690, thermal aging, low cycle fatigue, precipitates

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Authors: Kamrun N. Keya, Nasrin A. Kona, Ruhul A. Khan

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Pineapple leaf fiber (PALF) reinforced polypropylene (PP) based composites were fabricated by a conventional compression molding technique. In this investigation, PALF composites were manufactured using different percentages of fiber, which were varying from 25-50% on the total weight of the composites. To fabricate the PALF/PP composites, untreated and treated fibers were selected. A systematic study was done to observe the physical, mechanical and interfacial behavior of the composites. In this study, mechanical properties of the composites such as tensile, impact and bending properties were observed precisely. It was found that 45wt% of fiber composites showed better mechanical properties than others. Maximum tensile strength (TS) and bending strength (BS) was observed, 65 MPa and 50 MPa respectively, whereas the highest tensile modulus (TM) and bending modulus (BM) was examined, 1.7 GPa and 0.85 GPa respectively. The PALF/PP based composites were treated with irradiated under gamma radiation (the source strength 50 kCi Cobalt-60) of various doses (2.5 kGy to 10 kGy). The effect of gamma radiation on the composites was also investigated, and it found that the effect of 5.0 kGy (i.e. units for radiation measurement is 'gray', kGy=kilogray ) gamma dose showed better mechanical properties than other doses. The values of TS, BS, TM, and BM of the irradiated (5.0 kGy) composites were found to improve by 19%, 23%, 17% and 25 % over non-irradiated composites. After flexural testing, fracture sides of the untreated and treated both composites were studied by scanning electron microscope (SEM). SEM results of the treated PALF/PP based composites showed better fiber-matrix adhesion and interfacial bonding than untreated PALF/PP based composites. Water uptake and soil degradation tests of untreated and treated composites were also investigated.

Keywords: PALF, polypropylene, compression molding technique, gamma radiation, mechanical properties, scanning electron microscope

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Authors: Mihail Nagea, Olivera Lupescu, Nicolae Ciurea, Alexandru Dimitriu, Alina Grosu

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Introduction: As severe open injuries are more and more frequent in modern traumatology, threatening not only the integrity of the affected limb but even the life of the patients, new methods desired to cope with the consequences of these traumas were described. Vacuum therapy is one such method which has been described as enhancing healing in trauma with extensive soft-tissue injuries, included those with septic complications. Material and methods: Authors prospectively analyze 15 patients with severe lower limb trauma with MESS less than 6, with considerable soft tissue loss following initial debridement and fracture fixation. The patients needed serial debridements and vacuum therapy was applied after delayed healing due to initial severity of the trauma, for an average period of 12 days (7 - 23 days).In 7 cases vacuum therapy was applied for septic complications. Results: Within the study group, there were no local complications; secondary debridements were performed for all the patients and vacuum system was re-installed after these debridements. No amputations were needed. Medical records were reviewed in order to compare the outcome of the patients: the hospital stay, anti-microbial therapy, time to healing of the bone and soft tissues (there is no standard group to be compared with) and the result showed considerable improvements in the outcome of the patients. Conclusion: Vacuum therapy improves healing of the soft tissues, including those infected; hospital stay and the number of secondary necessary procedures are reduced. Therefore it is considered a valuable support in treating trauma of the limbs with severe soft tissue injuries.

Keywords: complex injuries, negative pressure, open fractures, wound therapy

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Authors: Yahya Asanoglu, Celaletdin Ergun

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Ceramic-matrix composites (CMC) have significant prominence in various engineering applications because of their heat resistance associated with an ability to withstand the brittle type of catastrophic failure. In this study, specific raw materials have been chosen for the purpose of having suitable CMC material for high-temperature dielectric applications. CMC material will be manufactured through the polymer infiltration and pyrolysis (PIP) method. During the manufacturing process, vacuum infiltration and autoclave will be applied so as to decrease porosity and obtain higher mechanical properties, although this advantage leads to a decrease in the electrical performance of the material. Time and temperature adjustment in pyrolysis parameters provide a significant difference in the properties of the resulting material. The mechanical and thermal properties will be investigated in addition to the measurement of dielectric constant and tangent loss values within the spectrum of Ku-band (12 to 18 GHz). Also, XRD, TGA/PTA analyses will be employed to prove the transition of precursor to ceramic phases and to detect critical transition temperatures. Additionally, SEM analysis on the fracture surfaces will be performed to see failure mechanism whether there is fiber pull-out, crack deflection and others which lead to ductility and toughness in the material. In this research, the cost-effectiveness and applicability of the PIP method will be proven in the manufacture of CMC materials while optimization of pyrolysis time, temperature and cycle for specific materials is detected by experiment. Also, several resins will be shown to be a potential raw material for CMC radome and antenna applications. This research will be distinguished from previous related papers due to the fact that in this research, the combination of different precursors and fabrics will be experimented with to specify the unique cons and pros of each combination. In this way, this is an experimental sum of previous works with unique PIP parameters and a guide to the manufacture of CMC radome and antenna.

Keywords: CMC, PIP, precursor, quartz

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Authors: Selman Cagman

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A detailed analysis is made within an organized industrial zone (OIZ) that has 1165 production facilities such as manufacturing of furniture, fabricated metal products (machinery and equipment), food products, plastic and rubber products, machinery and equipment, non-metallic mineral products, electrical equipment, textile products, and manufacture of wood and cork products. In this OIZ, a field study is done by choosing some facilities that can represent the whole OIZ sectoral distribution. In this manner, there are 207 facilities included to the site visit, and there is a 17 questioned survey carried out with each of them to assess their inputs, outputs, and waste amounts during manufacturing processes. The survey result identify that MDF/Particleboard and chipboard particles, textile, food, foam rubber, sludge (treatment sludge, phosphate-paint sludge, etc.), plastic, paper and packaging, scrap metal (aluminum shavings, steel shavings, iron scrap, profile scrap, etc.), slag (coal slag), ceramic fracture, ash from the fluidized bed are the wastes come from these facilities. As a result, there are 5 industrial symbiosis projects established with this study. One of the projects is a 2.840 kW capacity Integrated Biomass Based Waste Incineration-Energy Production Facility running on 35.000 tons/year of MDF particles and chipboard waste. Another project is a biogas plant with 225 tons/year whey, 100 tons/year of sesame husk, 40 tons/year of burnt wafer dough, and 2.000 tons/year biscuit waste. These two plants investment costs and operational costs are given in detail. The payback time of the 2.840 kW plant is almost 4 years and the biogas plant is around 6 years.

Keywords: industrial symbiosis, energy, biogas, waste to incineration

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Authors: Sang Koo Jeon, Seung Hoon Nahm, Oh Heon Kwon

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The unit cell of solid oxide fuel cell (SOFC) must be stacked as several layers type to obtain the high power. The most of researcher have concerned about the performance of stacked SOFC rather than the structural stability of stacked SOFC and especially interested how to design for reducing the electrical loss and improving the high efficiency. Consequently, the stacked SOFC able to produce the electrical high power and related parts like as manifold, gas seal, bipolar plate were developed to optimize the stack design. However, the unit cell of SOFC was just layered on the interconnector without the adhesion and the hydrogen and oxygen were injected to the interfacial layer in the high temperature. On the operating condition, the interfacial layer can be the one of the weak point in the stacked SOFC. Therefore the evaluation of the structural safety for the failure is essentially needed. In this study, interfacial adhesion between SOFC and metal adhesive was estimated in the high temperature environment. The metal adhesive was used to strongly connect the unit cell of SOFC with interconnector and provide the electrical conductivity between them. The four point bending test was performed to measure the interfacial adhesion. The unit cell of SOFC and SiO2 wafer were diced and then attached by metal adhesive. The SiO2 wafer had the center notch to initiate a crack from the tip of the notch. The modified stereomicroscope combined with the CCD camera and system for measuring the length was used to observe the fracture behavior. Additionally, the interfacial adhesion was evaluated in the high temperature condition because the metal adhesive was affected by high temperature. Also the specimen was exposed in the furnace during several hours and then the interfacial adhesion was evaluated. Finally, the interfacial adhesion energy was quantitatively determined and compared in the each condition.

Keywords: solid oxide fuel cell (SOFC), metal adhesive, adhesion, high temperature

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Authors: Yvonne Nanaama Brew, Bismark Jampim Abrokwah

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Children with disabilities in Ghana are not routinely registered, and this can imply that they may be neglected in national policy planning since global estimates may not be near the exact numbers. Although there are some studies with reports on the prevalence of disability among children in Ghana, reliable information on the prevalence, types of disability in children, and children who die with disabilities in the Greater Accra region are lacking. The current study seeks to investigate the incidence of disability among children two to fourteen years at selected districts in the Greater Accra region of Ghana. A cross-sectional design is adapted with a quantitative method for this study. Parents with disabled children who access child welfare clinics at the Greater Accra regional hospital, Maamobi hospital, Ga west, and Ga south district hospitals will be selected through purposive sampling for the study. An adapted UNICEF structured Ten Questions will be used to collect relevant data about participants. The responses to the questions will be either 'Yes' or 'No'. Parents with children who answer 'Yes' to a disability and purposively sampled parents with children who answer 'No' to disability will be invited to Child Health Clinic at the Greater Accra regional hospital for a free clinical assessment. Data will be entered into Microsoft Office Excel 2013 and imported into STATA version 15 for analysis. The study is expected to provide reliable disaggregated data on less than fourteen years of children with disabilities in the Greater Accra region. The findings and recommendations of the study will demonstrate the importance of early detection of disability and facilitate more quality and holistic planning of appropriate programmes that best safeguard the rights of children with disabilities in Ghana. It will help in policy and decision-making on children less than fourteen years with disabilities in Ghana. Also, findings will be useful for health facilities in Ghana to plan services for disabled children. Finally, the study is expected to add to the guides for the National Council of Persons with Disabilities to fulfill its legal mandate for disabled persons in Ghana.

Keywords: prevalence, disability, children, Ghana

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Authors: Monireh Ahmadi Bani, Adel Khorramrouz, Lalenoor Morvarid, Bagheri Mahtab

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Background:- Foot disorders are common in musculoskeletal problems. Plantar pressure distribution measurement is one the most important part of foot disorders diagnosis for quantitative analysis. However, the association of plantar pressure and foot disorders is not clear. With the growth of dataset and machine learning methods, the relationship between foot disorders and plantar pressures can be detected. Significance of the study:- The purpose of this study was to predict the probability of common foot disorders based on peak plantar pressure distribution and center of pressure during walking. Methodologies:- 2323 participants were assessed in a foot therapy clinic between 2015 and 2021. Foot disorders were diagnosed by an experienced physician and then they were asked to walk on a force plate scanner. After the data preprocessing, due to the difference in walking time and foot size, we normalized the samples based on time and foot size. Some of force plate variables were selected as input to a deep neural network (DNN), and the probability of any each foot disorder was measured. In next step, we used support vector machine (SVM) and run dataset for each foot disorder (classification of yes or no). We compared DNN and SVM for foot disorders prediction based on plantar pressure distributions and center of pressure. Findings:- The results demonstrated that the accuracy of deep learning architecture is sufficient for most clinical and research applications in the study population. In addition, the SVM approach has more accuracy for predictions, enabling applications for foot disorders diagnosis. The detection accuracy was 71% by the deep learning algorithm and 78% by the SVM algorithm. Moreover, when we worked with peak plantar pressure distribution, it was more accurate than center of pressure dataset. Conclusion:- Both algorithms- deep learning and SVM will help therapist and patients to improve the data pool and enhance foot disorders prediction with less expense and error after removing some restrictions properly.

Keywords: deep neural network, foot disorder, plantar pressure, support vector machine

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Authors: Yori Gidron, Laura Caton, Irit Ben-Aharon

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Background: Many patients and even certain clinicians attribute cancer development to psychosocial factors. Yet, empirical data supports more the prognostic role, rather than the etiological role, of psychosocial factors in cancer. Part of the inconsistency may result from not considering possible moderating factors in the etiological role of psychosocial factors. One important candidate moderating factor is the vagal nerve, whose activity is indexed by heart-rate variability (HRV). The vagal nerve may prevent cancer since it reduces inflammation on the one hand, and since it increases anti-tumor immunity on the other hand. This study examined the moderating role of the vagus in the relation between life threatening events (LTE) and cancer development. Method: We re-analyzed data from the Lifelines Dutch longitudinal cohort study of over 150,000 people. The present study included 82,751 adults, who initially were cancer-free. We extracted information on background factors (e.g., age, gender, fat consumption), whether they ever experienced LTE, HRV and cancer diagnosis as reported by patients in annual clinic visits. HRV was derived from brief ECGs. Results: Of the full sample, 1011 people developed cancer during a follow-up. In the full sample, LTE significantly predicted cancer development (R.R = 1.063 p < .01) and HRV significantly predicted a reduced risk of cancer development (R.R = .506 p <.001). Importantly, LTE significantly predicted cancer only when HRV was low (R.R = 1.056, 95% CI: 1.007 - 1.108, p < .05) but not when HRV was high (R.R = 1.014; 95% CI: 0.916 - 1.122, p > 0.05), independent of confounders. Conclusions: To the best of our knowledge, this is the first study showing in a large sample that LTE predict cancer development, and that this occurs only when vagal nerve activity (HRV) is relatively low. These results could result from lack of vagal modulation of inflammation and also from lack of vagal modulation of stress responses. Results are in line with the cancer-protective role of the vagus. HRV needs to be routinely monitored in the population and future intervention trials need to examine whether vagal nerve activation can prevent cancer in people with LTE and with other cancer risk factors.

Keywords: cancer development, life-events, moderation, vagal nerve

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Authors: Hye Kyung Kim, Myung-Gyou Kim, Kang-Hyun Leem

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Postmenopausal osteoporosis is characterized by low bone density which leads to increased bone fragility and greater susceptibility to fracture. Current treatments for osteoporosis are dominated by drugs that inhibit bone resorption although they also suppress bone formation that may contribute to pathogenesis of osteonecrosis. To restore the extensive bone loss, there is a great need for anabolic treatments that induce osteoblasts to build new bone. Pre-osteoblastic cells produce proteins of the extra-cellular matrix, including type I collagen at first, and then to successively produce alkaline phosphatase (ALP) and osteocalcin during differentiation to osteoblasts. Finally, osteoblasts deposit calcium. Present study investigated the effects of egg yolk peptide (EYP) on osteogenic activities and bone matrix gene expressions in human osteoblastic MG-63 cells. The effects of EYP on cell proliferation, alkaline phosphatase (ALP) activity, collagen synthesis, and mineralization were measured. The expression of osteogenic genes including COL1A1 (collagen, type I, alpha 1), ALP, BGLAP (osteocalcin), and SPP1 (secreted phosphoprotein 1, osteopontin) were measured by quantitative realtime PCR. EYP dose-dependently increased MG-63 cell proliferation, ALP activity, collagen synthesis, and calcium deposition. Furthermore, COL1A1, ALP, and SPP1 gene expressions were increased by EYP treatment. Present study suggested that EYP treatment enhanced osteogenic activities and increased bone matrix osteogenicgenes. These results could provide a mechanistic explanation for the bone-strengthening effects of EYP.

Keywords: egg yolk peptide, osteoblastic MG-63 cells, alkaline phosphatase, collagen synthesis, osteogenic genes, COL1A1, osteocalcin, osteopontin

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Authors: Amine Rezzoug, Selsabil Rokia Laraba, Mourad Ancer, Said Abdi

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Composite materials are taking center stage in different fields thanks to their mechanical characteristics and their ease of preparation. Environmental constraints have led to the development of composite with natural reinforcements. The sandwich structure has the advantage to have good flexural proprieties for low density, which is why it was chosen in this work. The development of these materials is related to an energy saving strategy and environmental protection. The present work refers to the study of the development and characterization of sandwiches composites based on hybrids laminates with natural reinforcements (Alfa and Jute), a metal fabric was introduced into composite in order to have a compromise between weight and properties. We use different configurations of reinforcements (jute, metallic fabric) to develop laminates in order to use them as thin facings for sandwiches materials. While the core was an epoxy matrix reinforced with Alfa short fibers, a chemical treatment sodium hydroxide was cared to improve the adhesion of the Alfa fibers. The mechanical characterization of our materials was made by the tensile and bending test, to highlight the influence of jute and Alfa. After testing, the fracture surfaces are observed by scanning electron microscopy (SEM). Optical microscopy allowed us to calculate the degree of porosity and to observe the morphology of the individual layers. Laminates based on jute fabric have shown better results in tensile test as well as to bending, compared to those of the metallic fabric (100%, 65%). Sandwich Panels were also characterized in terms of bending test. Results we had provide, shows that this composite has sufficient properties for possible replacing conventional composite materials by considering the environmental factors.

Keywords: bending test, bio-composites, sandwiches, tensile test

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Authors: Selamat Muliadi

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This study aimed to explain conceptual the role of Zakat on sustainable economic development by Rumah Zakat. Rumah Zakat is a philanthropic institution that manages zakat and other social funds through community empowerment programs. In running the program, including economic empowerment and socio health services are designed for these recipients. Rumah Zakat's connection with the establisment of Sustainable Development Goals (SDGs) which is to help impoverished recipients economically and socially. It’s an important agenda that the government input into national development, even the region. The primary goal of Zakat on sustainable economic development, not only limited to economic variables but based on Islamic principles, has comprehensive characteristics. The characteristics include moral, material, spiritual, and social aspects. In other words, sustainable economic development is closely related to improving people’s living standard (Mustahiq). The findings provide empiricial evidence regarding the positive contribution and effectiveness of zakat targeting in reducing poverty and improve the welfare of people related with the management of zakat. The purpose of this study was to identify the role of Zakat on sustainable economic development, which was applied by Rumah Zakat. This study used descriptive method and qualitative analysis. The data source was secondary data collected from documents and texts related to the research topic, be it books, articles, newspapers, journals, or others. The results showed that the role of zakat on sustainable economic development by Rumah Zakat has been quite good and in accordance with the principle of Islamic economics. Rumah Zakat programs are adapted to support intended development. The contribution of the productive program implementation has been aligned with four goals in the Sustainable Development Goals, i.e., Senyum Juara (Quality Education), Senyum Lestari (Clean Water and Sanitation), Senyum Mandiri (Entrepreneur Program) and Senyum Sehat (Free Maternity Clinic). The performance of zakat in the sustainable economic empowerment community at Rumah Zakat is taking into account dimensions such as input, process, output, and outcome.

Keywords: Zakat, social welfare, sustainable economic development, charity

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Authors: Mireya Mateo Gomez

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The purpose of this study was to examine the perceptions first-generation Mexican origin mothers living in San Diego have on postpartum depression (PPD), with a special focus on social influences and cultural beliefs towards those meanings. This study also aimed to examine possible PPD help-seeking behaviors that first-generation Mexican origin mothers can perform. The Health Belief Model (HBM) and Social Ecological Model (SEM) were the guiding theoretical frameworks for this study. Data for this study were collected from three focus groups, four in-depth interviews, and the distribution of an acculturation survey (ARSMA II). There were a total of 15 participants, in which participant’s mean age was 45, and the mean age migrated to the United States being 22. Most participants identified as being married, born in Southern or Western Mexico, and with a strong Mexican identity in relation to the ARSMA survey. Participants identified four salient PPD perceptions corresponding to the interpersonal level of SEM. These four main perceptions were: 1) PPD affecting the identity of motherhood; 2) PPD being a natural part of a mother’s experience but mitigated by networks; 3) PPD being a U.S. phenomenon due to family and community breakdown; and 4) natural remedies as a preferred PPD treatment. In regard to themes relating to help seeking behaviors, participants identified seven being: 1) seeking help from immediate family members; 2) practicing home remedies; 3) seeking help from a medical professional; 4) obtaining help from a clinic or organization; 5) seeking help from God; 6) participating in PPD support groups; and 7) talking to a friend. It was evident in this study that postpartum depression is not a well discussed topic within the Mexican immigrant population. In relation to the role culture and social influences have on PPD perceptions, most participants shared hearing or learning about PPD from their family members or friends. Participants also stated seeking help from family members if diagnosed with PPD and seeking out home remedies. This study as well provides suggestions to increase the awareness of PPD among the Mexican immigrant community.

Keywords: cultural beliefs, health belief model, Mexican origin mothers, perceptions, postpartum depression social ecological model

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Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

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Authors: Wan-I Lee, Nelio Mendoza Figueredo

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The impact of COVID-19 has a significant effect on all sectors of society globally. Health information technology (HIT) has become an effective health strategy in this age of distancing. In this regard, Mobile Health (mHealth) plays a critical role in managing patient and provider workflows during the COVID-19 pandemic. Therefore, the users' perception of service quality about mHealth services plays a significant role in shaping confidence and subsequent behaviors regarding the mHealth users' intention of use. This study's objective was to explore levels of user attributes analyzed by a qualitative method of how health practitioners and patients are satisfied or dissatisfied with using mHealth services; and analyzed the users' intention in the context of Taiwan during the COVID-19 pandemic. This research explores the experienced usability of a mHealth services during the Covid-19 pandemic. This study uses qualitative methods that include in-depth and semi-structured interviews that investigate participants' perceptions and experiences and the meanings they attribute to them. The five cases consisted of health practitioners, clinic staff, and patients' experiences using mHealth services. This study encourages participants to discuss issues related to the research question by asking open-ended questions, usually in one-to-one interviews. The findings show the positive and negative attributes of mHealth service quality. Hence, the significant importance of patients' and health practitioners' issues on several dimensions of perceived service quality is system quality, information quality, and interaction quality. A concept map for perceptions regards to emergency uses' intention of mHealth services process is depicted. The findings revealed that users pay more attention to "Medical care", "ease of use" and "utilitarian benefits" and have less importance for "Admissions and Convenience" and "Social influence". To improve mHealth services, the mHealth providers and health practitioners should better manage users' experiences to enhance mHealth services. This research contributes to the understanding of service quality issues in mHealth services during the COVID-19 pandemic.

Keywords: COVID-19, mobile health, service quality, use intention

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Authors: Stanzin Gawa, Nalini Ranjan Kumar, Gohar Bilal Wani, Vinay Maruti Hatte, A. Vinay

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Rainbow trout (Oncorhynchus mykiss) and Brown trout (Salmo trutta fario) are the two species of trout which were once introduced by British in waters of Kashmir has well adapted to favorable climatic conditions. Cold water fisheries are one of the emerging sectors in Kashmir valley and trout holds an important place Jammu and Kashmir fisheries. Realizing the immense potential of trout culture in Kashmir region, the state fisheries department started privatizing trout culture under the centrally funded scheme of RKVY in which they provide 80 percent subsidy for raceway construction and supply of feed and seed for the first year since 2009-10 and at present there are 362 private trout farms. To cater the growing demand for trout in the valley, it is important to understand the bottlenecks faced in the propagation of trout culture. Value chain analysis provides a generic framework to understand the various activities and processes, mapping and studying linkages is first step that needs to be done in any value chain analysis. In Kashmir, it is found that trout hatcheries play a crucial role in insuring the continuous supply of trout seed in valley. Feed is most limiting factor in trout culture and the farmer has to incur high cost in payment and in the transportation of feed from the feed mill to farm. Lack of aqua clinic in the Kashmir valley needs to be addressed. Brood stock maintenance, breeding and seed production, technical assistance to private farmer, extension services have to be strengthened and there is need to development healthier environment for new entrepreneurs. It was found that trout farmers do not avail credit facility as there is no well define credit scheme for fisheries in the state. The study showed weak institutional linkages. Research and development should focus more on applied science rather than basic science.

Keywords: trout, Kashmir, value chain, linkages, culture

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Authors: Zhala Ahmad, Zainab Lazim, Haider Hamzah

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Bacterial resistance is a pressing global health issue, with multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) strains to pose a serious threat. In this context, researchers are investigating effective, safe, and affordable metabolites to combat these pathogens. This study focuses on gum essential oil (GEO) extracted from Pistacia atlantica and its activity and the mechanism of action against XDR Gram-negative Acinetobacter baumannii. GEO was extracted by hydrodistillation and analyzed using GC-MS. Eleven A. baumannii isolates were collected from the ward environment of Burn and Plastic Surgery Hospital in Al Sulaymaniyah City, Iraq. They were identified using the VITEK 2 system, 16S rRNA gene, and confirmed with the blaₒₓₐ₋₅₁ gene; A. baumannii ATCC 19606 was used as a reference strain. The isolates were identified as resistant to twelve different antibiotics spanning six distinct antibiotic classes while showing susceptibility to tetracycline and trimethoprim. Over 40 chemical constituents were detected in the gum's essential oils, with α-pinene being the most abundant. GEO was found to inhibit the growth of A. baumannii isolates; the minimum inhibitory concentration (MIC) of GEO was 2.5 µl/ml. GEO induced protein leakage, phosphate, and potassium ion efflux, distorted cell morphology, and cell death in the tested bacteria. GEO exhibited bacterial clearance and anti-adhesion activity using Band-Aids. This study's findings suggest that GEO could be used as a potential alternative treatment for infectious diseases caused by XRD pathogens, shedding further light on the importance of GEO in biomedical applications. Future studies must focus on generating clinically feasible sources of GEO for testing in small animal models before proceeding to human trials, ensuring safe and effective translation from the laboratory to the clinic.

Keywords: antibiotic resistance, Acinetobacter baumannii, essential oils, Pistacia atlantica, alpha-pinene

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Authors: Seada Hussen, Frie Ayalew

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Integrating different energy resources, like solar PV and hydro, is used to ensure reliable power to rural communities like Hara village in Ethiopia. Hybrid power system offers power supply for rural villages by providing an alternative supply for the intermittent nature of renewable energy resources. The intermittent nature of renewable energy resources is a challenge to electrifying rural communities in a sustainable manner with solar resources. Major rural villages in Ethiopia are suffering from a lack of electrification, that cause our people to suffer deforestation, travel for long distance to fetch water, and lack good services like clinic and school sufficiently. The main objective of this project is to provide a balanced, stable, reliable supply for Hara village, Ethiopia using solar power with a pumped hydro energy storage system. The design of this project starts by collecting data from villages and taking solar irradiance data from NASA. In addition to this, geographical arrangement and location are also taken into consideration. After collecting this, all data analysis and cost estimation or optimal sizing of the system and comparison of solar with pumped hydro and solar with battery storage system is done using Homer Software. And since solar power only works in the daytime and pumped hydro works at night time and also at night and morning, both load will share to cover the load demand; this need controller designed to control multiple switch and scheduling in this project fuzzy logic controller is used to control this scenario. The result of the simulation shows that solar with pumped hydro energy storage system achieves good results than with a battery storage system since the comparison is done considering storage reliability, cost, storage capacity, life span, and efficiency.

Keywords: pumped hydro storage, solar energy, solar PV, battery energy storage, fuzzy logic controller

Procedia PDF Downloads 53

Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

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Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Correlation, Hypertension, Iraq, Risk factors

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Authors: Ahmed Assem Abd El Rahim

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BACKGROUND: Low back pain (LBP) is enormously common health problem& most of subjects experience it at some point of their life. Kinesio-taping is one of therapy methods introduced for studied cases with nonspecific low back pain. OBJECTIVES: to look at how Kinesio-taping affects studied cases with non-specific low back pain in terms of discomfort, range of motion, & back muscular strength. SUBJECTS: 40 mechanical LBP patients aged 20-40 years had been assigned haphazardly into two groups, They had been selected from outpatient clinic, KasrAl-AiniHospital, Cairo university. Methods: GroupA: 20 patients received the I-shape KT longitudinally & conventional physiotherapy program. Group B:20 studied cases received application of the KT Horizontally & conventional physiotherapy program. pain had been measured by visual analog scale, Range of motion had been measured by Roland Morris Disability Questionnaire (RMDQ), & strength had been measured by an isokinetic dynamometer before & after therapy. Therapy sessions had been three times weekly for four weeks. RESULTS: Groups (A & B) discovered decrease in pain& disability and rise in their flexion, extension ROM & peak torque of trunk extensor after end of 4 weeks of program. mean values of pain scale after therapy had been 3.7 and 5.04 in groups A & B. mean values of Disability scale after treatment had been 7.87.and 9.35 in groups A & B. mean values of ROM of flexion had been 28.06, and 24.53 in groups A & B. mean values of ROM of extension had been 13.43 & 10.73 in groups A & B. mean values of Peak torque of lumbar extensors were 65.43 and 63.22 in groups A & B. Though, participants who received the I-shape KT longitudinally as well as conventional physiotherapy program (group A), discovered more reduction in pain& disability and more improvement in ROM of flexion, extension, and Peak torque of lumbar extensors value (P<0.001) after therapy program CONCLUSION: Therapeutic longitudinal Kinesio-taping application with conventional physiotherapy will be more valuable than Therapeutic horizontal Kinesio-taping application with conventional physiotherapy when treating nonspecific low back pain studied cases.

Keywords: Kinesio taping, function, low back pain, muscle power

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Authors: Aliseydi Bozkurt

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Objectives: Benign prostatic hyperplasia (BPH) is the most common benign disease, and prostate cancer (PC) is malign disease of the prostate gland. Transrectal ultrasound-guided biopsy (TRUS-bx) is one of the most important diagnostic tools in PC diagnosis. Identifying men at increased risk for having a biopsy detectable prostate cancer should consider prostate specific antigen density (PSAD), f/t PSA Ratio, an estimate of prostate volume. Method: We retrospectively studied 269 patients who had a prostate specific antigen (PSA) score of 4 or who had suspected rectal examination at any PSA level and received TRUS-bx between January 2015 and June 2018 in our clinic. TRUS-bx was received by 12 experienced urologists with 12 quadrants. Prostate volume was calculated prior to biopsy together with TRUS. Patients were classified as malignant and benign at the end of pathology. Age, PSA value, prostate volume in transrectal ultrasonography, corpuscle biopsy, biopsy pathology result, the number of cancer core and Gleason score were evaluated in the study. The success rates of PV, PSAD, and f/tPSA were compared in all patients and those with PSA 2.5-10 ng/mL and 10.1-30 ng/mL tp foresee prostate cancer. Result: In the present study, in patients with PSA 2.5-10 ng/ml, PV cut-off value was 43,5 mL (n=42 < 43,5 mL and n=102 > 43,5 mL) while in those with PSA 10.1-30 ng/mL prostate volüme (PV) cut-off value was found 61,5 mL (n=31 < 61,5 mL and n=36 > 61,5 mL). Total PSA values in the group with PSA 2.5-10 ng/ml were found lower (6.0 ± 1.3 vs 6.7 ± 1.7) than that with PV < 43,5 mL, this value was nearly significant (p=0,043). In the group with PSA value 10.1-30 ng/mL, no significant difference was found (p=0,117) in terms of total PSA values between the group with PV < 61,5 mL and that with PV > 61,5 mL. In the group with PSA 2.5-10 ng/ml, in patients with PV < 43,5 mL, f/t PSA value was found significantly lower compared to the group with PV > 43,5 mL (0.21 ± 0.09 vs 0.26 ± 0.09 p < 0.001 ). Similarly, in the group with PSA value of 10.1-30 ng/mL, f/t PSA value was found significantly lower in patients with PV < 61,5 mL (0.16 ± 0.08 vs 0.23 ± 0.10 p=0,003). In the group with PSA 2.5-10 ng/ml, PSAD value in patients with PV < 43,5 mL was found significantly higher compared to those with PV > 43,5 mL (0.17 ± 0.06 vs 0.10 ± 0.03 p < 0.001). Similarly, in the group with PSA value 10.1-30 ng/mL PSAD value was found significantly higher in patients with PV < 61,5 mL (0.47 ± 0.23 vs 0.17 ± 0.08 p < 0.001 ). The biopsy results suggest that in the group with PSA 2.5-10 ng/ml, in 29 of the patients with PV < 43,5 mL (69%) cancer was detected while in 13 patients (31%) no cancer was detected. While in 19 patients with PV > 43,5 mL (18,6%) cancer was found, in 83 patients (81,4%) no cancer was detected (p < 0.001). In the group with PSA value 10.1-30 ng/mL, in 21 patients with PV < 61,5 mL (67.7%) cancer was observed while only in10 patients (32.3%) no cancer was seen. In 5 patients with PV > 61,5 mL (13.9%) cancer was found while in 31 patients (86.1%) no cancer was observed (p < 0.001). Conclusions: Identifying men at increased risk for having a biopsy detectable prostate cancer should consider PSA, f/t PSA Ratio, an estimate of prostate volume. Prostate volume in PC was found lower.

Keywords: prostate cancer, prostate volume, prostate specific antigen, free/total PSA ratio

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Authors: Warnakulasuriya Arachichige Malisha Ann Rosary Fernando, Udalamatta Gamage Omila Chalanka Jinadasa, Bihini Pabasara Amandi Amarasinghe, Manul Thisuraka Mandalawatta, Uthpala Samarakoon, Manori Gamage

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The surge in sexually transmitted diseases (STDs) has become a critical public health crisis demanding urgent attention and action. Like many other nations, Sri Lanka is grappling with a significant increase in STDs due to a lack of education and awareness regarding their dangers. Presently, the available applications for tracking and managing STDs cover only a limited number of easily detectable infections, resulting in a significant gap in effectively controlling their spread. To address this gap and combat the rising STD rates, it is essential to leverage technology and data. Employing technology to enhance the tracking and management of STDs is vital to prevent their further propagation and to enable early intervention and treatment. This requires adopting a comprehensive approach that involves raising public awareness about the perils of STDs, improving access to affordable healthcare services for early detection and treatment, and utilizing advanced technology and data analysis. The proposed mobile application aims to cater to a broad range of users, including STD patients, recovered individuals, and those unaware of their STD status. By harnessing cutting-edge technologies like image detection, symptom-based identification, prevention methods, doctor and clinic recommendations, and virtual counselor chat, the application offers a holistic approach to STD management. In conclusion, the escalating STD rates in Sri Lanka and across the globe require immediate action. The integration of technology-driven solutions, along with comprehensive education and healthcare accessibility, is the key to curbing the spread of STDs and promoting better overall public health.

Keywords: STD, machine learning, NLP, artificial intelligence

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Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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Authors: Sarah Saad Alamer, Shujon Mohammed Alazzam, Amjad Khater Alanazi, Mohamed Ahmed Sankari, Jana Sameer Sendy, Saleh Al-Khaldi, Khaled Allam, Amani Badawi

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Background: Self-medication is defined as the selection of medicines by individuals to treat self-diagnosed. There are a lot of concerns about the safety of long-term use of nonprescription ophthalmic drugs, which may lead to a variety of serious ocular complications. Topical steroids can produce severe eye-threatening complications, including the elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage. In recent times, many OTC ophthalmic preparations have been possible without a prescription. Objective: In our study, we aimed to determine the prevalence of self-medication ocular topical steroid practice and associated factors among adult ophthalmic patients attending King Saud medical city. Methods: This study was conducted as a cross-sectional study, targeting participants aged 18 years old or above who had used topical steroids eye drops to determine the prevalence of self-medication ocular topical steroid practice and associated factors among adult patients attending ophthalmology clinic in King Saud Medical City (KSMC) in the central region. Results: A total of 308 responses, 92(29.8%) were using ocular topical, 58(18.8%) with prescription, 5(1.6%) without prescription, 29(9.4%) with and without prescription while 216(70.1%) did not use it. The frequency of using ocular topical steroids without a prescription among participants was 11(12%) once and 33 (35%) many times. 26(28.3%) were having complication, mostly 11(12.4%) eye infection, 8(9%) Glaucoma, 6 (6.7%) Cataracts. Reasons for self-medication ocular topical steroid practice among participants were 14 (15.2%) repeated symptoms, 11(15.2%) had heard an advice from a friend, 11 (15.2%) thought they had enough knowledge. Conclusion: Our study reveals that, even though detecting a high level of knowledge and acceptable practices and attitudes among participants, the incidence of self-medication with steroid eye drops was observed. This practice is mainly due to participants having repeated symptoms and thinking they have enough knowledge. Increasing the education level of patients on self-medication steroid eye drops practice and it is associated complications would help reduce the incidence of self-medication steroid eye drops practice.

Keywords: self-medication, ophthalmic medicine, steroid eye drop, over the counter

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Authors: Balaji Devanathan, Gokul G., Abilash S., Abhishek Yadav, Sudhir K. Gupta

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Background: As an alternative to the traditional autopsy, a virtual autopsy is carried out using scanning and imaging technologies, mainly post-mortem computed tomography (PMCT). This facility aims to supplement traditional autopsy results and reduce or eliminate internal dissection in subsequent autopsies. For emotional and religious reasons, the deceased's relatives have historically disapproved such interior dissection. The non-invasive, objective, and preservative PMCT is what friends and family would rather have than a traditional autopsy. Additionally, it aids in the examination of the technologies and the benefits and drawbacks of each, demonstrating the significance of contemporary imaging in the field of forensic medicine. Results: One hundred falls resulting in fatalities was analysed by the writers. Before the autopsy, each case underwent a PMCT examination using a 16-slice Multi-Slice CT spiral scanner. By using specialised software, MPR and VR reconstructions were carried out following the capture of the raw images. The accurate detection of fractures in the skull, face bones, clavicle, scapula, and vertebra was better observed in comparison to a routine autopsy. The interpretation of pneumothorax, Pneumoperitoneum, pneumocephalus, and hemosiuns are much enhanced by PMCT than traditional autopsy. Conclusion. It is useful to visualise the skeletal damage in fall from height cases using a virtual autopsy based on PMCT. So, the ideal tool in traumatising patients is a virtual autopsy based on PMCT scans. When assessing trauma victims, PMCT should be viewed as an additional helpful tool to traditional autopsy. This is because it can identify additional bone fractures in body parts that are challenging to examine during autopsy, such as posterior regions, which helps the pathologist reconstruct the victim's life and determine the cause of death.

Keywords: PMCT, fall from height, autopsy, fracture

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Authors: Joy Cao, Min Zhou

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Purpose: Acute Type A aortic dissection is a well-known cause of extremely high mortality rate. A highly accurate and cost-effective non-invasive predictor is critically needed so that the patient can be treated at earlier stage. Although various CFD approaches have been tried to establish some prediction frameworks, they are sensitive to uncertainty in both image segmentation and boundary conditions. Tedious pre-processing and demanding calibration procedures requirement further compound the issue, thus hampering their clinical applicability. Using the latest physics informed deep learning methods to establish an accurate and cost-effective predictor framework are amongst the main goals for a better Type A aortic dissection treatment. Methods: Via training a novel physics-informed deep residual network, with non-invasive 4D MRI displacement vectors as inputs, the trained model can cost-effectively calculate all these biomarkers: aortic blood pressure, WSS, and OSI, which are used to predict potential type A aortic dissection to avoid the high mortality events down the road. Results: The proposed deep learning method has been successfully trained and tested with both synthetic 3D aneurysm dataset and a clinical dataset in the aortic dissection context using Google colab environment. In both cases, the model has generated aortic blood pressure, WSS, and OSI results matching the expected patient’s health status. Conclusion: The proposed novel physics-informed deep residual network shows great potential to create a cost-effective, non-invasive predictor framework. Additional physics-based de-noising algorithm will be added to make the model more robust to clinical data noises. Further studies will be conducted in collaboration with big institutions such as Cleveland Clinic with more clinical samples to further improve the model’s clinical applicability.

Keywords: type-a aortic dissection, deep residual networks, blood flow modeling, data-driven modeling, non-invasive diagnostics, deep learning, artificial intelligence.

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Authors: Andres Bautista, Alicia Porras, Juan P. Casas, Maribel Silva

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The Colombian aeronautical industry has stimulated research in the mechanical behavior of materials under different loading conditions aircrafts are generally exposed during its operation. The Calima T-90 is the first military aircraft built in the country, used for primary flight training of Colombian Air Force Pilots, therefore, it may be exposed to adverse operating situations such as hard landings which cause impact loads on the aircraft that might produce the impact fatigue phenomenon. The Calima T-90 structure is mainly manufactured by composites materials generating assemblies and subassemblies of different components of it. The main method of bonding these components is by using adhesive joints. Each type of adhesive bond must be studied on its own since its performance depends on the conditions of the manufacturing process and operating characteristics. This study aims to characterize the typical adhesive joints of the aircraft under usual loads. To this purpose, the evaluation of the effect of adhesive thickness on the mechanical performance of the joint under quasi-static loading conditions, constant amplitude fatigue and cyclic impact fatigue using single lap-joint specimens will be performed. Additionally, using a double cantilever beam specimen, the influence of the thickness of the adhesive on the crack growth rate for mode I delamination failure, as a function of the critical energy release rate will be determined. Finally, an analysis of the fracture surface of the test specimens considering the mechanical interaction between the substrate (composite) and the adhesive, provide insights into the magnitude of the damage, the type of failure mechanism that occurs and its correlation with the way crack propagates under the proposed loading conditions.

Keywords: adhesive, composites, crack propagation, fatigue

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Authors: Ilja Käch, Abdul R. Jandali, Nadja Zechmann-Müller

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Introduction: We discuss the treatment of two young male patients suffering from scaphoid non-union after a traumatic scaphoid fracture. The currently propagated techniques for treating a scaphoid non-union in children are either the operative reconstruction of the scaphoid or the conservative treatment with splinting in a scaphoid cast. Cases: In the first case, we operated on a 13 years old male patient with a posttraumatic scaphoid non-union in the middle third with a humpback deformity. We resected the middle third of the scaphoid and grafted the defect with an iliac crest bone, and the DISI-Deformity was reduced. Fixation was performed with K-Wires and immobilisation in a scaphoid cast. In the second case a 13 years old male patient also with a posttraumatic scaphoid non-union in the middle third and humpback deformity, DISI-deformity, was treated conservatively. Immobilisation in a scaphoid cast for four months was performed. Results: Operative: One year postoperatively the patient achieved a painless free arc of motion. Flexion/Extension 70/0/60°, Radial-/Ulnarduction 30/0/30° and Pro-/Supination 90/0/90°. The computer tomogram showed complete consolidation and bony fusion of the iliac crest bone. Conservative: Six to eight months after conservative treatment the patient demonstrated painless motion and AROM Flexion/Extension 80/0/80°, Radial-/Ulnarduction and Pro-/Supination in maximum range. Complete consolidation in the computer tomogram with persistent humpback- and DISI deformity. Conclusion: In the literature, both techniques are described, either the operative scaphoid reconstruction or the conservative treatment with splinting. In our cases, both the operative and conservative treatments showed comparable good results. However, the humpback- and DISI deformity can only be addressed with a surgical approach.

Keywords: scaphoid, non-union, trauma, operative vs. non operative

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Authors: Jiyoung Kim, Chae Weon Chung

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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

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Authors: Sirajo Abubakar, Ismail Ahmad Abir, Muhammad Sabiu Bala, Muhammad Mustapha Adejo, Aravind Shanmugaveloo

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Over the years, land subsidence has been a serious threat mostly to urban areas. Land subsidence is the sudden sinking or gradual downward settling of the ground’s surface with little or no horizontal motion. In most areas, land subsidence is a slow process that covers a large area; therefore, it is sometimes left unnoticed. South of Johor is the area of interest for this project because it is going through rapid urbanization. The objective of this research is to evaluate and identify potential deformations in the south of Johor using integrated remote sensing and 2D resistivity methods. Synthetic aperture radar interferometry (InSAR) which is a remote sensing technique has the potential to map coherent displacements at centimeter to millimeter resolutions. Persistent scatterer interferometry (PSI) stacking technique was applied to Sentinel-1 data to detect the earth deformation in the study area. A dipole-dipole configuration resistivity profiling was conducted in three areas to determine the subsurface features in that area. This subsurface features interpreted were then correlated with the remote sensing technique to predict the possible causes of subsidence and uplifts in the south of Johor. Based on the results obtained, West Johor Bahru (0.63mm/year) and Ulu Tiram (1.61mm/year) are going through uplift due to possible geological uplift. On the other end, East Johor Bahru (-0.26mm/year) and Senai (-1.16mm/year) undergo subsidence due to possible fracture and granitic boulders loading. Land subsidence must be taken seriously as it can cause serious damages to infrastructures and human life. Monitoring land subsidence and taking preventive actions must be done to prevent any disasters.

Keywords: interferometric synthetic aperture radar, persistent scatter, minimum spanning tree, resistivity, subsidence

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