Search results for: specialized hospitals

Authors: Varsha Chorsiya, Pooja Aneja, Dhananjay Kaushik, Abhinav Yadav

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Intoduction: Women’s Health Initiatives (WHI) focuses on defining the risks and benefits of strategies that could potentially reduce the incidence of obesity, heart disease, breast cancer and colorectal cancer, and fractures in menopause women. The utility of the present research work determines to find the role of Hormone Replacement Therapy (HRT) in changing the different component of body composition during perimenopause period. Methods: A comparative cross-sectional study included 30 subjects, aged between 40 and 50 years which were assigned into 2 groups i.e. 15 subjects in HRT (Group A) and 15 subjects in non-HRT (Group B). The subjects were taken from the hospitals and clinics of Faridabad undergoing HRT in supervision of the consultant gynecologist. The informed consents were signed before including the participants in the study. The body composition and lipid profile were evaluated for all the subjects. Result and Discussion: The BMI, body density, percent body fats and fat mass in both groups showed statistically significant differences i.e. p < 0.05. Our study did not reveal any statistically significant difference between non-HRT and HRT for lipid profile composition of HDL, LDL, VLDL, ratio, triglycerides and total cholesterol although these indicators (LDL, VLDL, ratio, triglycerides and total cholesterol) showed difference clinically with a higher mean values for non-HRT as compared to HRT group. The mean value for HDL was higher for HRT group in contrast to non-HRT group. The result clearly showed that HRT group has a good lipid profile composition. Conclusion: In conclusion, our data show that HRT has statistically significant role in determining BMI, fat percent mass and fat mass. The lipid profile including LDL, HDL, VLDL, ratio, triglycerides and total cholesterol found to be clinically better in HRT group as compared to the non-HRT group. The rationale for non-significant lipid profile probably lie in the fact that hormonal changes need a particular time period and might become significant in post-menopausal period.

Keywords: body composition, hormone replacement therapy, perimenopause, women health

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Authors: Gunnar Oskarsson, Gudjon Helgi Egilsson

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Due to globalization, small and medium-sized enterprises (SME) increasingly offer their products and services in foreign markets. The main reasons are either to compensate for a decreased market share in their home market or to exploit opportunities in foreign markets, which are becoming less distant and better accessible than before. International markets are particularly important for companies located in a small economy and offering specialized products. Although more accessible, entering international markets is both expensive and difficult. In order to select the most appropriate markets, it is, therefore, important to gain an insight into the factors that have an impact on success, or potential failure. Although there has been a reasonable volume of research into the theory of internationalization, there is still a need to gain further understanding of the decision-making process of SMEs in small economies and the most important characteristics that distinguish between success and failure. The main objective of this research is to enhance knowledge on the internationalization of SMEs, including the drivers for the decision to internationalize, and the most important factors contributing to success in their internationalization activities. A qualitative approach was found to be most appropriate for this kind of research, with the objective of gaining a deeper understanding and discovering factors which impact a company’s decision-making and potential success. In-depth interviews were conducted with 14 companies in different industries located in Iceland, a country extensively dependent on export revenues. The interviews revealed several factors as drivers of internationalization and, not surprisingly, the most frequently mentioned source of motivation was that the local market is inadequate to maintain a sustainable operation. Good networking relationships were seen as a particular priority for potential success, searching for new markets was mainly carried out through the internet, although sales exhibitions and sales trips were also considered important. When it comes to the final decision as to whether a market should be considered for further analysis, economy, labor cost, legal environment, and cultural barriers were the most common factors to be weighted. The ultimate answer to successful internationalization, however, is largely dependent on a coordinated and experienced management team. The main contribution of this research is offering an insight into factors affecting decision-making in the internationalization process of SMEs, based on the opinion and experience of managers of SMEs in a small economy.

Keywords: internationalization, success factors, small and medium-sized enterprises (SMEs), drivers, decision making

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Authors: Ramon Omar Rosales-Espinoza

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Pile-to-pile mechanical connections are used if the depth of the soil layers with sufficient bearing strength exceeds the original (“leading”) pile length, with the additional pile segment being termed “extension” pile. Mechanical connectors permit a safe transmission of forces from leading to extension pile while meeting strength and serviceability requirements. Common types of connectors consist of an assembly of sleeve-type external couplers, bolts, pins, and other mechanical interlock devices that ensure the transmission of compressive, tensile, torsional and bending stresses between leading and extension pile segments. While welded connections allow for a relatively simple structural design, mechanical connections are advantageous over welded connections because they lead to shorter installation times and significant cost reductions since specialized workmanship and inspection activities are not required. However, common practices followed to design mechanical connectors neglect important aspects of the assembly response, such as stress concentration around pin/bolt holes, torsional stresses from the installation process, and interaction between the forces at the installation (torsion), service (compression/tension-bending), and removal stages (torsion). This translates into potentially unsatisfactory designs in terms of the ultimate and service limit states, exhibiting either reduced strength or excessive deformations. In this study, the experimental response under compressive forces of a type of mechanical connector is presented, in terms of strength, deformation and failure modes. The tests revealed that the type of connector used can safely transmit forces from pile to pile. Using the results from the compressive tests, an analysis model was developed using the finite element (FE) method to study the interaction of forces under installation and service stages of a typical mechanical connector. The response of the analysis model is used to identify potential areas for design optimization, including size, gap between leading and extension piles, number of pin/bolts, hole sizes, and material properties. The results show the design of mechanical connectors should take into account the interaction of forces present at every stage of their life cycle, and that the torsional stresses occurring during installation are critical for the safety of the assembly.

Keywords: piles, FEA, steel, mechanical connector

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Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

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SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

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Authors: F. Sahnoune, M. Belhamel, M. Zelmat

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Solar thermal systems available today provide reliability, efficiency and significant environmental benefits. In housing, they can satisfy the hot water demand and reduce energy bills by 60 % or more. Additionally, collective systems or large scale solar thermal systems are increasingly used in different conditions for hot water applications and space heating in hotels and multi-family homes, hospitals, nursing homes and sport halls as well as in commercial and industrial building. However, in situ real performance data for collective solar water heating systems has not been extensively outlined. This paper focuses on the study of real energy performances of a collective solar water heating system using the remote monitoring technique in Algerian climatic conditions. This is to ensure proper operation of the system at any time, determine the system performance and to check to what extent solar performance guarantee can be achieved. The measurements are performed on an active indirect heating system of 12 m2 flat plate collector’s surface installed in Algiers and equipped with a various sensors. The sensors transmit measurements to a local station which controls the pumps, valves, electrical auxiliaries, etc. The simulation of the installation was developed using the software SOLO 2000. The system provides a yearly solar yield of 6277.5 KWh for an estimated annual need of 7896 kWh; the yearly average solar cover rate amounted to 79.5%. The productivity is in the order of 523.13 kWh / m²/year. Simulation results are compared to measured results and to guaranteed solar performances. The remote monitoring shows that 90% of the expected solar results can be easy guaranteed on a long period. Furthermore, the installed remote monitoring unit was able to detect some dysfunctions. It follows that remote monitoring is an important tool in energy management of some building equipment.

Keywords: large-scale solar water heater, real energy performance, remote monitoring, solar performance guarantee, tool to promote solar water heater

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Authors: Oshma Chakoory, Sophie Comtet-Marre, Pierre Peyret

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Metagenomic classifiers are widely used for the taxonomic profiling of metagenomic data and estimation of taxa relative abundance. Small subunit rRNA genes are nowadays a gold standard for the phylogenetic resolution of complex microbial communities, although the power of this marker comes down to its use as full-length. We benchmarked the performance and accuracy of rRNA-specialized versus general-purpose read mappers, reference-targeted assemblers and taxonomic classifiers. We then built a pipeline called RiboTaxa to generate a highly sensitive and specific metataxonomic approach. Using metagenomics data, RiboTaxa gave the best results compared to other tools (Kraken2, Centrifuge (1), METAXA2 (2), PhyloFlash (3)) with precise taxonomic identification and relative abundance description, giving no false positive detection. Using real datasets from various environments (ocean, soil, human gut) and from different approaches (metagenomics and gene capture by hybridization), RiboTaxa revealed microbial novelties not seen by current bioinformatics analysis opening new biological perspectives in human and environmental health. In a study focused on corals’ health involving 20 metagenomic samples (4), an affiliation of prokaryotes was limited to the family level with Endozoicomonadaceae characterising healthy octocoral tissue. RiboTaxa highlighted 2 species of uncultured Endozoicomonas which were dominant in the healthy tissue. Both species belonged to a genus not yet described, opening new research perspectives on corals’ health. Applied to metagenomics data from a study on human gut and extreme longevity (5), RiboTaxa detected the presence of an uncultured archaeon in semi-supercentenarians (aged 105 to 109 years) highlighting an archaeal genus, not yet described, and 3 uncultured species belonging to the Enorma genus that could be species of interest participating in the longevity process. RiboTaxa is user-friendly, rapid, allowing microbiota structure description from any environment and the results can be easily interpreted. This software is freely available at https://github.com/oschakoory/RiboTaxa under the GNU Affero General Public License 3.0.

Keywords: metagenomics profiling, microbial diversity, SSU rRNA genes, full-length phylogenetic marker

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Authors: Eimar Yadir Quintero Tapias

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Background: Science is not generally self-correcting; many clinical studies end with the same conclusion "more research is needed." This study hypothesizes that first, we need a better appraisal of the available (and unavailable) evidence instead of creating more of the same false inquiries. Methods: Systematic review of ClinicalTrials.gov study records using the following Boolean operators: (food OR nut OR milk OR egg OR shellfish OR wheat OR peanuts) AND (allergy OR allergies OR hypersensitivity OR hypersensitivities). Variables included the status of the study (e g., active and completed), availability of results, sponsor type, sample size, among others. To determine the rates of non-publication in journals indexed by PubMed, an advanced search query using the specific Number of Clinical Trials (e.g., NCT000001 OR NCT000002 OR...) was performed. As a prophylactic measure to prevent P-hacking, data analyses only included descriptive statistics and not inferential approaches. Results: A total of 2092 study records matched the search query described above (date: September 13, 2019). Most studies were interventional (n = 1770; 84.6%) and the remainder observational (n = 322; 15.4%). Universities, hospitals, and research centers sponsored over half of these investigations (n = 1208; 57.7%), 308 studies (14.7%) were industry-funded, and 147 received NIH grants; the remaining studies got mixed sponsorship. Regarding completed studies (n = 1156; 55.2%), 248 (21.5%) have results available at the registry site, and 417 (36.1%) matched NCT numbers of journal papers indexed by PubMed. Conclusions: The internal and external validity of human research is critical for the appraisal of medical evidence. It is imperative to analyze the entire dataset of clinical studies, preferably at a patient-level anonymized raw data, before rushing to conclusions with insufficient and inadequate information. Publication bias and non-registration of clinical trials limit the evaluation of the evidence concerning therapeutic interventions for food allergy, such as oral and sublingual immunotherapy, as well as any other medical condition. Over half of the food allergy human research remains unpublished.

Keywords: allergy, clinical trials, immunology, systematic reviews

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Authors: Ahmed Eid, Amita Gupta

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Abstract: Background: Background Medical gases are estimated to contribute to 5% of the carbon footprints produced by hospitals, Desflurane has the largest impact, but all increase significantly when used with N2O admixture. Climate Change Act 2008, we must reduce our carbon emission by 80% of the 1990 baseline by 2050.NHS carbon emissions have reduced by 18.5% (2007-2017). The NHS Long Term Plan has outlined measures to achieve this objective, including a 2% reduction by transforming anaesthetic practices. FGF is an important variable that determines the utilization of inhalational agents and can be tightly controlled by the anaesthetist. Aims and Objectives Environmental safety, Identification of areas of high N20 and different anaesthetic agents used across the St Helier operating theatres and consider improvising on the current practice. Methods: Data was collected from St Helier operating theatres and retrieved daily from Care Station 650 anaesthetic machines. 60 cases were included in the sample. Collected data (average flow rate, amount and type of agent used, duration of surgery, type of surgery, duration, and the total amount of Air, O2 and N2O used. AAGBI impact anaesthesia calculator was used to identify the amount of CO2 produced and also the cost per hour for every pt. Communication via reminder emails to staff emphasized the significance of low-flow anaesthesia and departmental meeting presentations aimed at heightening awareness of LFA, Distribution of AAGBI calculator QR codes in all theatres enables the calculation of volatile anaesthetic consumption and CO2e post each case, facilitating informed environmental impact assessment. Results: A significant reduction in the flow rate use in the 2nd sample was observed, flow rate usage between 0-1L was 60% which means a great reduction of the consumption of volatile anaesthetics and also Co2e. By using LFA we can save money but most importantly we can make our lives much greener and save the planet.

Keywords: low flow anesthesia, sustainability project, N₂0, Co2e

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Authors: Mohamed F. Othman

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Manchester, Britain has become the destination of immigrants from different parts of the world. As a result, it is currently home to over 150 different ethnic languages. The present study investigates minority language policy and planning at the micro-level of the city. In order to get an in-depth investigation of such a policy, it was decided to cover it from two angles: the first is the policy making process. This was aimed at getting insights on how decisions regarding the provision of government services in minority languages are taken and what criteria are employed. The second angle is the service provider; i.e. the different departments in Manchester City Council (MCC), the NHS, the courts, and police, etc., to obtain information on the actual provisions of services. Data was collected through semi-structured interviews with different personnel representing different departments in MCC, solicitors, interpreters, etc.; through the internet, e.g. the websites of MCC, NHS, courts, and police, etc.; and via personal observation of provisions of community languages in government services. The results show that Manchester’s language policy is formulated around two concepts that work simultaneously: one is concerned with providing services in community languages in order to help minorities manage their life until they acquire English, and the other with helping the integration of minorities through encouraging them to learn English. In this regard, different government services are provided in community languages, though to varying degrees, depending on the numerical strength of each individual language. Thus, it is concluded that there is awareness in MCC and other government agencies working in Manchester of the linguistic diversity of the city and there are serious attempts to meet this diversity in their services. It is worth mentioning here that providing such services in minority languages are not meant to support linguistic diversity, but rather to maintain the legal right to equal opportunities among the residents of Manchester and to avoid any misunderstanding that may result due to the language barrier, especially in such areas as hospitals, courts, and police. There is actually no explicitly-mentioned language policy regarding minorities in Manchester; rather, there is an implied or covert policy resulting from factors that are not explicitly documented. That is, there are guidelines from the central government, which emphasize the principle of equal opportunities; then the implementation of such guidelines requires providing services in the different ethnic languages.

Keywords: community language, covert language policy, micro-language policy and planning, minority language

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Authors: Alberto Jiménez-Vargas, Manuel de Jesús Palacios-Gallegos, Miguel Ángel Hernández-López, Rafael Campos-Amezcua, Julio Cesar Solís-Sanchez

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An optimal wind turbine blade design must be able of capturing as much energy as possible from the wind source available at the area of interest. Many times, an optimal design means the use of large quantities of material and complicated processes that make the wind turbine more expensive, and therefore, less cost-effective. For the construction and installation of a wind turbine, the blades may cost up to 20% of the outline pricing, and become more important due to they are part of the rotor system that is in charge of transmitting the energy from the wind to the power train, and where the static and dynamic design loads for the whole wind turbine are produced. The aim of this work is the develop of a blade fluid-structure interaction (FSI) simulation that allows the identification of the major damage zones during the normal production situation, and thus better decisions for design and optimization can be taken. The simulation is a dynamic case, since we have a time-history wind velocity as inlet condition instead of a constant wind velocity. The process begins with the free-use software NuMAD (NREL), to model the blade and assign material properties to the blade, then the 3D model is exported to ANSYS Workbench platform where before setting the FSI system, a modal analysis is made for identification of natural frequencies and modal shapes. FSI analysis is carried out with the two-way technic which begins with a CFD simulation to obtain the pressure distribution on the blade surface, then these results are used as boundary condition for the FEA simulation to obtain the deformation levels for the first time-step. For the second time-step, CFD simulation is reconfigured automatically with the next time-step inlet wind velocity and the deformation results from the previous time-step. The analysis continues the iterative cycle solving time-step by time-step until the entire load case is completed. This work is part of a set of projects that are managed by a national consortium called “CEMIE-Eólico” (Mexican Center in Wind Energy Research), created for strengthen technological and scientific capacities, the promotion of creation of specialized human resources, and to link the academic with private sector in national territory. The analysis belongs to the design of a rotor system for a 5 kW wind turbine design thought to be installed at the Isthmus of Tehuantepec, Oaxaca, Mexico.

Keywords: blade, dynamic, fsi, wind turbine

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Authors: V. L. M. F. Capellini, A. P. P. M. Maturana, N. C. M. Brondino, M. B. C. L. B. M. Peixoto, A. J. Broughton

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A paradigm shift is a process. The process of implementing inclusive education, a system constructed to support all learners, requires planning, identification, experimentation, and evaluation. In this vein, the purpose of the present study was to evaluate the capacity of one Brazilian state school systems to provide special education students with a quality inclusive education. This study originated at the behest of concerned families of students with special needs who filed complaints with the Municipality of Bauru, São Paulo. These families claimed, 1) children with learning differences and educational needs had not been identified for services, and 2) those who had been identified had not received sufficient specialized educational assistance (SEA) in schools across the City of Bauru. Hence, the Office of Civil Rights for the state of São Paulo (Ministério Público de São Paulo) summoned the local higher education institution, UNESP, to design a research study to investigate these allegations. In this exploratory study, descriptive data were gathered from all elementary and middle schools including 58 state schools and 17 city schools, for a total of 75 schools overall. Data collection consisted of each school's annual strategic action plan, surveys and interviews with all school stakeholders to determine their perceptions of the inclusive education available to students with Special Education Needs (SEN). The data were collected as one of four stages in a larger study which also included field observations of a focal students' experience and a continuing education course for all teachers and administrators in both state and city schools. For the purposes of this study, the researchers were interested in understanding the perceptions of school staff, parents, and students across all schools. Therefore, documents and surveys from 75 schools were analyzed for adherence to federal legislation guaranteeing students with SEN the right to special education assistance within the regular school setting. Results shows that while some schools recognized the legal rights of SEN students to receive special education, the plans to actually deliver services were absent. In conclusion, the results of this study revealed both school staff and families have insufficient planning and accessibility resources, and the schools have inadequate infrastructure for full-time support to SEN students, i.e., structures and systems to support the identification of SEN and delivery of services within schools of Bauru, SP. Having identified the areas of need, the city is now prepared to take next steps in the process toward preparing all schools to be inclusive.

Keywords: inclusion, school, special education, special needs

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Authors: Shujon Mohammed Alazzam, Sarah Saad Alamer, Omar Hassan Kasule, Lama Suliman Aleid, Mohammad Abdulaziz Alakeel, Boshra Mosleh Alanazi, Abdullah Abdulelah Altowairqi, Yahya Ali Al-Asiri

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Background: Interventional radiology (IR) is a specialized field within radiology that diagnose and treat several conditions through a minimally invasive surgical procedure that involves the use of various radiological techniques. In the last few years, the role of IR has expanded to include a variety of organ systems which have been led to an increase in demand for these Specialties. The level of knowledge regarding IR is relatively low in general. In this study, we aimed to investigate the perceptions of interventional radiology (IR) as a specialty among medical students and medical interns in Riyadh, Saudi Arabia. Methodology: This study was a cross section. The target population is medical students in January 2023 in Riyadh city, KSA. We used the questionnaire for face-to-face interviews with voluntary participants to assess their knowledge of Interventional radiology. Permission was taken from participants to use their information. Assuring them that the data in this study was used only for scientific purposes. Results: According to the inclusion criteria, a total of 314 students participated in the study. (49%) of the participants were in the preclinical years, and (51%) were in the clinical years. The findings indicate more than half of the students think that they had good information about IR (58%), while (42%) reported that they had poor information and knowledge about IR. Only (28%) of students were planning to take an elective and radiology rotation, (and 27%) said they would consider a career in IR. (73%) of the participants who would not consider a career in IR, the highest reasons in order were due to "I do not find it interesting" (45%), then "Radiation exposure" (14%). Around half (48%) thought that an IRs must complete a residency training program in both radiology and surgery, and just (36%) of the students believe that an IRs must finish training in radiology. Our data show the procedures performed by IRs that (66%) lower limb angioplasty and stenting (58%) Cardiac angioplasty or stenting. (68%) of the students were familiar with angioplasty. When asked about the source of exposure to angioplasty, the majority (46%) were from a cardiologist, (and 16%) were from the interventional radiologist. Regarding IR career prospects, (78%) of the students believe that IRs have good career prospects. In conclusion, our findings reveal that the perception and exposure to IR among medical students and interns are generally poor. This has a direct influence on the student's decision regarding IR as a career path. Recommendations to attract medical students and promote IR as a career should be increased knowledge among medical students and future physicians through early exposure to IR, and this will promote the specialty's growth; also, involvement of the Saudi Interventional Radiology Society and Radiological Society of Saudi Arabia is essential.

Keywords: knowledge, medical students, perceptions, radiology, interventional radiology, Saudi Arabia

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Authors: Nasrin Akter, Bilkis Banu, Farhana Faruque, Fatema Afrin, Sujana Haque Chowdhury, Sarder Mahmud Hossain

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Objectives: To combat the growing prevalence of hypertension in Bangladesh, it is pivotal to have an in-depth understanding of quality of life (QOL) among hypertensive people. The aim of this study was to measure QOL of hypertensive people and its determinants in a selected tertiary hospital in Dhaka city. Design & Methods: This analytical cross-sectional study was conducted among randomly selected 300 hypertensive patients from two cardiac departments of Square Hospitals Limited. Data were collected through the face-to-face interview method. WHOQOL-BREF questionnaire was used to assess the QOL. Mean scores of quality of life were analyzed through descriptive statistics. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement among different domains of WHOQOL-BREF, respectively. Chi-square test followed by binary regression analyses were used to measure the association between QOL domains and independent variables. Results: Both overall QOL and domains had a good internal consistency, (r = 0.13–0.77, p< 0.01). The QOL among hypertensive patients was found to be poor in the psychological (71%) and social (74.7%) domains and good in the environmental (63%) and physical (65%) domains. Backward binary regressions revealed that being older (p=0.01), diabetic (p=0.02), having history of COVID-19 (p=0.01), and poor monthly income (USD ≤853.14) (p=0.01) were significantly associated with poor QOL in all domain. Moreover, older age (p=0.01) and poor lifestyle (p=0.02) were significantly associated with poor overall quality of life and poor general health perception. Conclusion: The results revealed low QOL in the psychological and social domain including significant factors associated with the poor QOL in all domains. To enhance the quality of life for hypertensive patients—especially those who are older, diabetic, have lower incomes, experienced COVID-19, and maintain poor lifestyles—effective interventions and health system strengthening are crucial.

Keywords: quality of life, hypertension, WHOQOL-BREF, analytical cross-sectional study

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Authors: Glenn Auld Knierim

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Automated robotic winding of high-temperature superconductors (HTS) addresses precision, efficiency, and reliability critical to the commercialization of products. Today’s HTS materials are mature and commercially promising but require manufacturing attention. In particular to the exaggerated rectangular cross-section (very thin by very wide), winding precision is critical to address the stress that can crack the fragile ceramic superconductor (SC) layer and destroy the SC properties. Damage potential is highest during peak operations, where winding stress magnifies operational stress. Another challenge is operational parameters such as magnetic field alignment affecting design performance. Winding process performance, including precision, capability for geometric complexity, and efficient repeatability, are required for commercial production of current HTS. Due to winding limitations, current HTS magnets focus on simple pancake configurations. HTS motors, generators, MRI/NMR, fusion, and other projects are awaiting robotic wound solenoid, planar, and spherical magnet configurations. As with conventional power cables, full transposition winding is required for long length alternating current (AC) and pulsed power cables. Robotic production is required for transposition, periodic swapping of cable conductors, and placing into precise positions, which allows power utility required minimized reactance. A full transposition SC cable, in theory, has no transmission length limits for AC and variable transient operation due to no resistance (a problem with conventional cables), negligible reactance (a problem for helical wound HTS cables), and no long length manufacturing issues (a problem with both stamped and twisted stacked HTS cables). The Infinity Physics team is solving manufacturing problems by developing automated manufacturing to produce the first-ever reliable and utility-grade commercial SC cables and magnets. Robotic winding machines combine mechanical and process design, specialized sense and observer, and state-of-the-art optimization and control sequencing to carefully manipulate individual fragile SCs, especially HTS, to shape previously unattainable, complex geometries with electrical geometry equivalent to commercially available conventional conductor devices.

Keywords: automated winding manufacturing, high temperature superconductor, magnet, power cable

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Authors: Thomas P. Carroll

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The phenomenon of mindfulness has become ever more popular in an increasingly pluralist Western society. Mindfulness practice has penetrated secular contexts that would otherwise be closed to religious influence, including state schools, hospitals, and commerce. The contemporary understanding of mindfulness has its origins in Buddhist meditation. However, since Jon Kabat-Zinn’s pioneering work in Mindfulness-Based Interventions, the concept has developed and sometimes mutated into various forms of practice which are disembedded from their original spiritual philosophy. This project will explore the spiritual climate within which mindfulness is currently flourishing through dialogue with three interlocutors. The first interlocutor is the Canadian philosopher Charles Taylor whose seminal work, ‘A Secular Age’, outlines three distinct modes of secularity. Taylor examines how the conditions of belief have changed and how the self seeks meaning in an age where belief in the divine is no longer axiomatic. The next interlocutor is Czech theologian and psychotherapist Tomáš Halík who offers a unique perspective of a Catholic who belongs to a section of society outnumbered by secular counterparts, with a theological hermeneutic best described as 'Den Fremden verstehen- understanding the stranger'. Finally, Irish theologian Michael Paul Gallagher offers a theological perspective on how the Christian faith can be translated into dialogue with Irish secular culture, as well as addressing the crisis of imagination and culture rather than the crisis of faith in Ireland. These interlocutors will illustrate that there are sometimes striking differences in how to interpret the religious signs of the times. However, these approaches also reveal significant similarities in how they address and explore the meaning of religious belief and experience today. In this way, themes will emerge that will help to frame the conversation about mindfulness in the West. These themes will include; the failure of the secularization thesis to pass, the growth of a diverse marketplace of religions and beliefs and the growth of a demographic who identify as spiritual but not religious. Such research is paramount in enabling a richer dialogue between Christian faith and mindfulness in a fragmented, postmodern Western context.

Keywords: culture, mindfulness, secularism, spirituality

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

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

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

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Authors: Cecile Meier, Drago Diaz Aleman, Itahisa Perez Conesa, Jose Luis Saorin Perez, Jorge De La Torre Cantero

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In this work, two ways of creating small-sized metal sculptures are proposed: the first by means of microcasting and the second by electroforming from models printed in 3D using an FDM (Fused Deposition Modeling‎) printer or using a DLP (Digital Light Processing) printer. It is viable to replace the wax in the processes of the artistic foundry with 3D printed objects. In this technique, the digital models are manufactured with resin using a low-cost 3D FDM printer in polylactic acid (PLA). This material is used, because its properties make it a viable substitute to wax, within the processes of artistic casting with the technique of lost wax through Ceramic Shell casting. This technique consists of covering a sculpture of wax or in this case PLA with several layers of thermoresistant material. This material is heated to melt the PLA, obtaining an empty mold that is later filled with the molten metal. It is verified that the PLA models reduce the cost and time compared with the hand modeling of the wax. In addition, one can manufacture parts with 3D printing that are not possible to create with manual techniques. However, the sculptures created with this technique have a size limit. The problem is that when printed pieces with PLA are very small, they lose detail, and the laminar texture hides the shape of the piece. DLP type printer allows obtaining more detailed and smaller pieces than the FDM. Such small models are quite difficult and complex to melt using the lost wax technique of Ceramic Shell casting. But, as an alternative, there are microcasting and electroforming, which are specialized in creating small metal pieces such as jewelry ones. The microcasting is a variant of the lost wax that consists of introducing the model in a cylinder in which the refractory material is also poured. The molds are heated in an oven to melt the model and cook them. Finally, the metal is poured into the still hot cylinders that rotate in a machine at high speed to properly distribute all the metal. Because microcasting requires expensive material and machinery to melt a piece of metal, electroforming is an alternative for this process. The electroforming uses models in different materials; for this study, micro-sculptures printed in 3D are used. These are subjected to an electroforming bath that covers the pieces with a very thin layer of metal. This work will investigate the recommended size to use 3D printers, both with PLA and resin and first tests are being done to validate use the electroforming process of microsculptures, which are printed in resin using a DLP printer.

Keywords: sculptures, DLP 3D printer, microcasting, electroforming, fused deposition modeling

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Authors: Arif Anwar Surani, Salman Ali, Asif Surani, Sohaib Zahid, Akbar Shoukat Ali, Zeeshan-Ul-Hassan Usmani, Joseph Varon, Salim Surani

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Objective: Terrorism and suicidal bomb blast attacks are commonplace in Karachi, Pakistan. During the years 2000 to 2007, there were over 60 bomb explosions resulting in more than 1500 casualties. These explosions produce a wide variety of external injuries. We undertook this study to evaluate pattern of external injury produced after bomb blast attacks and to compare injury profile resulting from explosions in open versus semi-confined blast environments. Method: A retrospective, cross-sectional, study was conducted to review injuries sustained after bomb blast attacks in Karachi, Pakistan, from January 2000 to October 2007. Emergency medical records and medico legal certificates of patients presented to three major public sector hospitals of Karachi were evaluated using self-design proforma. Results: Data of 481 victims meet inclusion criteria and were incorporated for final analysis. Of these, 63.6% were injured in open spaces and 36.4% were injured in semi-confined blast environments. Lacerations were commonly encountered as external injury (47.7%) followed by penetrating wounds (15.3%). Lower and upper extremities were most commonly affected (38.6% and 19% respectively). Open and semi-confined blast environments produced a specific injury pattern and profile (p=<0.001). Conclusions: Bomb blast attacks in Karachi produce an external injury pattern consistent with other studies, with exception of an increased frequency in penetrating wounds. Semi-confined blast environments were associated with severe injuries. Further studies are required to better classify injuries and their severity based on standardized scoring systems. Effective emergency response systems must be designed to cope with mass causalities following bomb explosions.

Keywords: bomb blast attacks, injury pattern, external injury, open space, semi-confined space, blast environment

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Authors: Ivana Scidà, Francesco Alotto, Anna Osello

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Due to the importance given today to innovation, the education sector is evolving thanks digital technologies. Virtual Reality (VR) can be a potential teaching tool offering many advantages in the field of training and education, as it allows to acquire theoretical knowledge and practical skills using an immersive experience in less time than the traditional educational process. These assumptions allow to lay the foundations for a new educational environment, involving and stimulating for students. Starting from the objective of strengthening the innovative teaching offer and the learning processes, the case study of the research concerns the digitalization of MastrLAB, High Quality Laboratory (HQL) belonging to the Department of Structural, Building and Geotechnical Engineering (DISEG) of the Polytechnic of Turin, a center specialized in experimental mechanical tests on traditional and innovative building materials and on the structures made with them. The MastrLAB-VR has been developed, a revolutionary innovative training tool designed with the aim of educating the class in total safety on the techniques of use of machinery, thus reducing the dangers arising from the performance of potentially dangerous activities. The virtual laboratory, dedicated to the students of the Building and Civil Engineering Courses of the Polytechnic of Turin, has been projected to simulate in an absolutely realistic way the experimental approach to the structural tests foreseen in their courses of study: from the tensile tests to the relaxation tests, from the steel qualification tests to the resilience tests on elements at environmental conditions or at characterizing temperatures. The research work proposes a methodology for the virtualization of technical laboratories through the application of Building Information Modelling (BIM), starting from the creation of a digital model. The process includes the creation of an independent application, which with Oculus Rift technology will allow the user to explore the environment and interact with objects through the use of joypads. The application has been tested in prototype way on volunteers, obtaining results related to the acquisition of the educational notions exposed in the experience through a virtual quiz with multiple answers, achieving an overall evaluation report. The results have shown that MastrLAB-VR is suitable for both beginners and experts and will be adopted experimentally for other laboratories of the University departments.

Keywords: building information modelling, digital learning, education, virtual laboratory, virtual reality

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Authors: Mohd Fairus Humar, Ibrahim Sulaiman, Pedro Cruz, Hasry Harun

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This paper presents the propose knowledge transfer program on railway signaling and communication by Original Equipment Manufacturer (OEM) Thales Portugal. The fundamental issue is that there is no rail related course offered by local universities and colleges in Malaysia which could be an option to pursue student career path. Currently, dedicated trainings related to the rail technology are provided by in-house training academies established by the respective rail operators such as Malaysia Railway Academy (MyRA) and Rapid Rail Training Centre. In this matter, the content of training and facilities need to be strengthened to keep up-to-date with the dynamic evolvement of the rail technology. This is because rail products have evolved to be more sophisticated and embedded with high technology components which no longer exist in the mechanical form alone but combined with electronics, information technology and others. These demand for a workforce imbued with knowledge, multi-skills and competency to deal with specialized technical areas. Talent is needed to support sustainability in Southeast Asia. Keeping the above factors in mind, an Industrial Collaboration Program (ICP) was carried out to transfer knowledge on curricula of railway signaling and communication to a selected railway operators and tertiary educational institution in Malaysia. In order to achieve the aim, a partnership was formed between Technical Depository Agency (TDA), Thales Portugal and MyRA for two years with three main stages of program implementation comprising of: i) training on basic railway signaling and communication for 1 month with Thales in Malaysia; ii) training on advance railway signaling and communication for 4 months with Thales in Portugal and; iii) a series of workshop. Two workshops were convened to develop and harmonize curricula of railway signaling and communication course and were followed by one training for installation equipment of railway signaling and Controlled Train Centre (CTC) system from Thales Portugal. With active involvement from Technical Depository Agency (TDA), railway operators, universities, and colleges, in planning, executing, monitoring, control and closure, the program module of railway signaling and communication course with a lab railway signaling field equipment and CTC simulator were developed. Through this program, contributions from various parties help to build committed societies to engage important issues in relation to railway signaling and communication towards creating a sustainable future.

Keywords: knowledge transfer program, railway signaling and communication, curricula, module and teaching aid simulator

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Authors: Ricardo Torcato, Helder Morais

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The manufacture of crystal glass parts is based on obtaining the rough geometry by blowing and/or injection, generally followed by a set of manual finishing operations using cutting and grinding tools. The forming techniques used do not allow the obtainment, with repeatability, of parts with complex shapes and the finishing operations use intensive specialized labor resulting in high cycle times and production costs. This work aims to explore the digital manufacture of crystal glass parts by investigating new subtractive techniques for the automated, flexible finishing of these parts. Finishing operations are essential to respond to customer demands in terms of crystal feel and shine. It is intended to investigate the applicability of different computerized finishing technologies, namely milling and grinding in a CNC machining center with or without ultrasonic assistance, to crystal processing. Research in the field of grinding hard and brittle materials, despite not being extensive, has increased in recent years, and scientific knowledge about the machinability of crystal glass is still very limited. However, it can be said that the unique properties of glass, such as high hardness and very low toughness, make any glass machining technology a very challenging process. This work will measure the performance improvement brought about by the use of ultrasound compared to conventional crystal grinding. This presentation is focused on the mechanical characterization and analysis of the cutting forces in CNC machining of superior crystal glass (Pb ≥ 30%). For the mechanical characterization, the Vickers hardness test provides an estimate of the material hardness (Hv) and the fracture toughness based on cracks that appear in the indentation. Mechanical impulse excitation test estimates the Young’s Modulus, shear modulus and Poisson ratio of the material. For the cutting forces, it a dynamometer was used to measure the forces in the face grinding process. The tests were made based on the Taguchi method to correlate the input parameters (feed rate, tool rotation speed and depth of cut) with the output parameters (surface roughness and cutting forces) to optimize the process (better roughness using the cutting forces that do not compromise the material structure and the tool life) using ANOVA. This study was conducted for conventional grinding and for the ultrasonic grinding process with the same cutting tools. It was possible to determine the optimum cutting parameters for minimum cutting forces and for minimum surface roughness in both grinding processes. Ultrasonic-assisted grinding provides a better surface roughness than conventional grinding.

Keywords: CNC machining, crystal glass, cutting forces, hardness

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Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia

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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.

Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services

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Authors: Akinsola Oluwatosin, Udofia Samuel, Odofin Mayowa

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The study is aimed at assessing the Geographic Information System (GIS)-based spatial analysis of Survival Pattern and Treatment Outcomes of Multi-Drug Resistant Tuberculosis (MDR-TB) cases for Lagos, Nigeria, with an objective to inform priority areas for public health planning and resource allocation. Multi-drug resistant tuberculosis (MDR-TB) develops due to problems such as irregular drug supply, poor drug quality, inappropriate prescription, and poor adherence to treatment. The shapefile(s) for this study were already georeferenced to Minna datum. The patient’s information was acquired on MS Excel and later converted to . CSV file for easy processing to ArcMap from various hospitals. To superimpose the patient’s information the spatial data, the addresses was geocoded to generate the longitude and latitude of the patients. The database was used for the SQL query to the various pattern of the treatment. To show the pattern of disease spread, spatial autocorrelation analysis was used. The result was displayed in a graphical format showing the areas of dispersing, random and clustered of patients in the study area. Hot and cold spot analysis was analyzed to show high-density areas. The distance between these patients and the closest health facility was examined using the buffer analysis. The result shows that 22% of the points were successfully matched, while 15% were tied. However, the result table shows that a greater percentage of it was unmatched; this is evident in the fact that most of the streets within the State are unnamed, and then again, most of the patients are likely to supply the wrong addresses. MDR-TB patients of all age groups are concentrated within Lagos-Mainland, Shomolu, Mushin, Surulere, Oshodi-Isolo, and Ifelodun LGAs. MDR-TB patients between the age group of 30-47 years had the highest number and were identified to be about 184 in number. The outcome of patients on ART treatment revealed that a high number of patients (300) were not ART treatment while a paltry 45 patients were on ART treatment. The result shows the Z-score of the distribution is greater than 1 (>2.58), which means that the distribution is highly clustered at a significance level of 0.01.

Keywords: tuberculosis, patients, treatment, GIS, MDR-TB

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Authors: Renata Hrecska

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This research seeks to fully examine the internal employment law of international organizations by comparing it with the characteristics of the national civil service. The aim of the research is to compare the legal system that has developed over many centuries and the relatively new internal staffing regulations to find out what solution schemes can help each other through mutual legal development in order to respond effectively to the social challenges of everyday life. Generally, the rules of civil service of any country or international entity have in common that they have, in their pragmatics inherently, the characteristic that makes them serving public interests. Though behind the common base there are many differences: there is the clear fragmentation of state regulation and the unity of organizational regulation. On the other hand, however, this difference disappears to some extent: the public service regulation of international organizations can be considered uniform until we examine it within, but not outside an organization. As soon as we compare the different organizations we may find many different solutions for staffing regulations. It is clear that the national civil service is a strong model for international organizations, but the question may be whether the staffing policy of international organizations can serve the national civil service as an example, too. In this respect, the easiest way to imagine a legislative environment would be to have a single comprehensive code, the general part of which is the Civil Service Act itself, and the specific part containing specific, necessarily differentiating rules for each layer of the civil service. Would it be advantageous to follow the footsteps of the leading international organizations, or is there any speciality in national level civil service that we cannot avoid during regulating processes? In addition to the above, the personal competencies of officials working in international organizations and public administrations also show a high degree of similarity, regardless of the type of employment. Thus, the whole public service system is characterized by the fundamental and special values that a person capable of holding a public office must be able to demonstrate, in some cases, even without special qualifications. It is also interesting how we can compare the two spheres of employment in light of the theory of Lawyer Louis Brandeis, a judge at the US Supreme Court, who formulated a complex theory of profession as distinguished from other occupations. From this point of view we can examine the continuous development of research and specialized knowledge at work; the community recognition and social status; that to what extent we can see a close-knit professional organization of altruistic philosophy; that how stability grows in the working conditions due to the stability of the profession; and that how the autonomy of the profession can prevail.

Keywords: civil service, comparative law, international organizations, regulatory systems

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Stefano Barone

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Seismic retrofit of buildings through base isolation represents a consolidated protection strategy against earthquakes. It consists in decoupling the ground motion from that of the structure and introducing anti-seismic devices at the base of the building, characterized by high horizontal flexibility and medium/high dissipative capacity. This allows to protect structural elements and to limit damages to non-structural ones. For these reasons, full functionality is guaranteed after an earthquake event. Base isolation is applied extensively to both new and existing buildings. For the latter, it usually does not require any interruption of the structure use and occupants evacuation, a special advantage for strategic buildings such as schools, hospitals, and military buildings. This paper describes the application of seismic isolation to three existing masonry buildings in Italy: Villa “La Maddalena” in Macerata (Marche region), “Giacomo Matteotti” and “Plinio Il Giovane” school buildings in Perugia (Umbria region). The seismic hazard of the sites is characterized by a Peak Ground Acceleration (PGA) of 0.213g-0.287g for the Life Safety Limit State and between 0.271g-0.359g for the Collapse Limit State. All the buildings are isolated with a combination of free sliders type TETRON® CD with confined elastomeric disk and anti-seismic rubber isolators type ISOSISM® HDRB to reduce the eccentricity between the center of mass and stiffness, thus limiting torsional effects during a seismic event. The isolation systems are designed to lengthen the original period of vibration (i.e., without isolators) by at least three times and to guarantee medium/high levels of energy dissipation capacity (equivalent viscous damping between 12.5% and 16%). This allows the structures to resist 100% of the seismic design action. This article shows the performances of the supplied anti-seismic devices with particular attention to the experimental dynamic response. Finally, a special focus is given to the main site activities required to isolate a masonry building.

Keywords: retrofit, masonry buildings, seismic isolation, energy dissipation, anti-seismic devices

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Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer

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This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.

Keywords: 3D printing, nursing education, simulation, trainers

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Authors: Jasmin Cowin, Amany Alkhayat

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This paper will concentrate on a comparative analysis of both the advantages and limitations of using digital learning resources (DLRs). DLRs covered will be Virtual Reality (VR), Mobile Learning (M-learning) and Computer-Assisted Language Learning (CALL) together with their subset, Mobile Assisted Language Learning (MALL) in language education. In addition, best practices for language teaching and the application of established language teaching methodologies such as Communicative Language Teaching (CLT), the audio-lingual method, or community language learning will be explored. Education has changed dramatically since the eruption of the pandemic. Traditional face-to-face education was disrupted on a global scale. The rise of distance learning brought new digital tools to the forefront, especially web conferencing tools, digital storytelling apps, test authoring tools, and VR platforms. Language educators raced to vet, learn, and implement multiple technology resources suited for language acquisition. Yet, questions remain on how to harness new technologies, digital tools, and their ubiquitous availability while using established methods and methodologies in language learning paired with best teaching practices. In M-learning language, learners employ portable computing devices such as smartphones or tablets. CALL is a language teaching approach using computers and other technologies through presenting, reinforcing, and assessing language materials to be learned or to create environments where teachers and learners can meaningfully interact. In VR, a computer-generated simulation enables learner interaction with a 3D environment via screen, smartphone, or a head mounted display. Research supports that VR for language learning is effective in terms of exploration, communication, engagement, and motivation. Students are able to relate through role play activities, interact with 3D objects and activities such as field trips. VR lends itself to group language exercises in the classroom with target language practice in an immersive, virtual environment. Students, teachers, schools, language institutes, and institutions benefit from specialized support to help them acquire second language proficiency and content knowledge that builds on their cultural and linguistic assets. Through the purposeful application of different language methodologies and teaching approaches, language learners can not only make cultural and linguistic connections in DLRs but also practice grammar drills, play memory games or flourish in authentic settings.

Keywords: language teaching methodologies, computer-assisted language learning, mobile learning, virtual reality

Procedia PDF Downloads 238