Search results for: Hayatabad Medical Complex

Authors: Mohammad U. A. Khan, Md. D. Hossain

Abstract:

Background: Department of Physiology finds difficulty in managing ‘subjects’ in practical procedure. To avoid this difficulty fellow examinees of other group may be used as subjects. Objective: To find out the merits and demerits of using fellow examinees as subjects in the practical procedure. Method: This cross-sectional descriptive study was conducted in the Department of Physiology, Noakhali Medical College, Bangladesh during May-June’14. Forty-two 1st year undergraduate medical students from a selected public medical college of Bangladesh were enrolled for the study purposively. Consent of students and authority was taken. Eighteen of them were selected as subjects and designated as subject-examinees. Other fellow examinees (non-subject) examined their blood pressure and pulse as part of ‘observed structured practical examination’ (OSPE). The opinion of all examinees regarding the merits and demerits of using fellow examinee as subjects in the practical procedure was recorded. Result: Examinees stated that they could perform their practical procedure without nervousness (24/42, 57.14%), accurately and comfortably (14/42, 33.33%) and subjects were made available without wasting time (2/42, 4.76%). Nineteen students (45.24%) found no disadvantage and 2 (4.76%) felt embracing when the subject was of opposite sex. The subject-examinees narrated that they could learn from the errors done by their fellow examinee (11/18, 61.1%). 75% non-subject examinees expressed their willingness to be subject so that they can learn from their fellows’ error. Conclusion: Using fellow examinees as subjects is beneficial for both the non-subject and subject examinees. Funding sources: Navana, Beximco, Unihealth, Square & Acme Pharma, Bangladesh Ltd.

Keywords: physiology, teaching, practical, OSPE

Procedia PDF Downloads 153

Authors: Moaawia Abdulgader Gdara

Abstract:

This work presents a study of Carbone dioxide generation and migration in the Bahi sandstone reservoir over the EPSA 120/136 (conc 72). En Naga Sub Basin, Sirte Basin Libya. The Lower Cretaceous Bahi Sandstone is the result of deposition that occurred between the start of the Cretaceous rifting that formed the area's Horsts, Grabens and Cenomanian marine transgression. Bahi sediments were derived mainly from those Nubian sediments exposed on the structurally higher blocks, transported short distances into newly forming depocenters such as the En Naga Sub-basin and were deposited by continental processes over the Sirte Unconformity (pre-Late Cretaceous surface) Bahi Sandstone facies are recognized in the En Naga Sub-basin within different lithofacies distribution over this sub-base. One of the two lithofacies recognized in the Bahi is a very fine to very coarse, subangular to angular, pebbly and occasionally conglomeratic quartz sandstone, which is commonly described as being compacted but friable. This sandstone may contain pyrite and minor kaolinite. This facies was encountered at 11,042 feet in F1-72 well, and at 9,233 feet in L1-72. Good, reservoir quality sandstones are associated with paleotopographic highs within the sub-basin and around its margins where winnowing and/or deflationary processes occurred. The second Bahi Lithofacies is a thinly bedded sequence dominated by shales and siltstones with subordinate sandstones and carbonates. The sandstones become more abundant with depth. This facies was encountered at 12,580 feet in P1 -72 and at 11,850 feet in G1a -72. This argillaceous sequence is likely the Bahi sandstone's lateral facies equivalent deposited in paleotopographic lows, which received finer-grained material. The Bahi sandstones are generally described as a good reservoir rock, which after prolific production tests for the drilled wells makes Bahi sandstones the principal reservoir rocks for CO₂ where large volumes of CO₂ gas have been discovered in the Bahi Formation on and near EPSA 120/136, (conc 72). CO₂ occurs in this area as a result of the igneous activity of the Al Harouge Al Aswad complex. Igneous extrusive have been pierced in the subsurface and are exposed at the surface. Bahi CO₂ prospectivity is thought to be excellent in the central to western areas of EPSA 120/136 (CONC 72) where there are better reservoir quality sandstones associated with Paleostructural highs. Condensate and gas prospectivity increases to the east as the CO₂ productivity decreases with distance away from the Al Haruj Al Aswad igneous complex. To date, it has not been possible to accurately determine the volume of these strategically valuable reserves, although there are positive indications that they are very large. Three main structures (Barrut I, En Naga A and En Naga O) are thought to be prospective for the lower Cretaceous Bahi sandstone development. These leads are the most attractive on EPSA 120/136 for the deep potential.

Keywords: En Naga Sub Basin, Al Harouge Al Aswad's Igneous complex, carbon dioxide generation, migration in the Bahi sandstone reservoir, lower cretaceous Bahi Sandstone

Procedia PDF Downloads 104

Authors: Huixin Wei, Shibin Wang, Linan Li, Lei Zhou, Xinhao Tu

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Facial skin is a biomedical material with complex mechanical properties of anisotropy, viscoelasticity, and hyperelasticity. The mechanical properties of facial skin are crucial for a number of applications including facial plastic surgery, animation, dermatology, cosmetic industry, and impact biomechanics. Skin is a complex multi-layered material which can be broadly divided into three main layers, the epidermis, the dermis, and the hypodermis. Collagen fibers account for 75% of the dry weight of dermal tissue, and it is these fibers which are responsible for the mechanical properties of skin. Many research on the anisotropic mechanical properties are mainly concentrated on in vitro, but there is a great difference between in vivo and in vitro for mechanical properties of the skin. In this study, we presented a method to measure the mechanical properties of facial skin in vivo. Digital image correlation (DIC) and indentation tests were used to obtain the experiment data, including the deformation of facial surface and indentation force-displacement curve. Then, the experiment was simulated using a finite element (FE) model. Application of Computed Tomography (CT) and reconstruction techniques obtained the real tissue geometry. A three-dimensional FE model of facial skin, including a bi-layer system, was obtained. As the epidermis is relatively thin, the epidermis and dermis were regarded as one layer and below it was hypodermis in this study. The upper layer was modeled as a Gasser-Ogden-Holzapfel (GOH) model to describe hyperelastic and anisotropic behaviors of the dermis. The under layer was modeled as a linear elastic model. In conclusion, the material properties of two-layer were determined by minimizing the error between the FE data and experimental data.

Keywords: facial skin, indentation test, finite element, digital image correlation, computed tomography

Procedia PDF Downloads 113

Authors: Moaawia Abdulgader Gdara

Abstract:

This work presents a study of carbon dioxide generation and migration in the Bahi sandstone reservoir over the EPSA 120/136 (conc 72), En Naga Sub Basin, Sirte Basin, Libya. The Lower Cretaceous Bahi Sandstone is the result of deposition that occurred between the start of the Cretaceous rifting that formed the area's Horsts, Grabens, and Cenomanian marine transgression. Bahi sediments were derived mainly from those Nubian sediments exposed on the structurally higher blocks, transported short distances into newly forming depocenters such as the En Naga Sub-basin, and were deposited by continental processes over the Sirte Unconformity (pre-Late Cretaceous surface). Bahi Sandstone facies are recognized in the En Naga Sub-basin within different lithofacies distributed over this sub-base. One of the two lithofacies recognized in the Bahi is a very fine to very coarse, subangular to angular, pebbly, and occasionally conglomeratic quartz sandstone, which is commonly described as being compacted but friable. This sandstone may contain pyrite, minor kaolinite. This facies was encountered at 11,042 feet in F1-72 well and at 9,233 feet in L1-72. Good, reservoir quality sandstones are associated with paleotopographic highs within the sub-basin and around its margins where winnowing and/or deflationary processes occurred. The second Bahi Lithofacies is a thinly bedded sequence dominated by shales and siltstones with subordinate sandstones and carbonates. The sandstones become more abundant with depth. This facies was encountered at 12,580 feet in P1 -72 and at 11,850 feet in G1a -72. This argillaceous sequence is likely the Bahi sandstone's lateral facies equivalent deposited in paleotopographic lows, which received finer grained material. The Bahi sandstones are generally described as a good reservoir rock, which after prolific production tests for the drilled wells that makes Bahi sandstones the principal reservoir rocks for CO₂ where large volumes of CO₂ gas have been discovered in the Bahi Formation on and near EPSA 120/136, (conc 72). CO₂ occurs in this area as a result of the igneous activity of the Al Harouge Al Aswad complex. Igneous extrusive have been pierced in the subsurface and are exposed at the surface. Bahi CO₂ prospectivity is thought to be excellent in the central to western areas of EPSA 120/136 (CONC 72), where there are better reservoir quality sandstones associated with Paleostructural highs. Condensate and gas prospectivity increases to the east as the CO₂ prospectivity decreases with distance away from the Al Haruj Al Aswad igneous complex. To date, it has not been possible to accurately determine the volume of these strategically valuable reserves, although there are positive indications that they are very large. Three main structures (Barrut I, En Naga A, and En Naga O) are thought to be prospective for the lower Cretaceous Bahi sandstone development. These leads are the most attractive on EPSA 120/136 for the deep potential.

Keywords: En Naga Sub Basin, Al Harouge Al Aswad’s Igneous Complex, carbon dioxide generation and migration in the Bahi sandstone reservoir, lower cretaceous Bahi sandstone

Procedia PDF Downloads 107

Authors: Sajjad Izadpanah, Seyed Hadi Ghaderi, Morteza Sayah Irani, Mahdi Gerdooei

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In this research work, a sophisticated yield criterion known as BBC2003, capable of describing planar anisotropic behaviors of aluminum alloy sheets, was integrated into the commercial finite element code ABAQUS/Standard via a user subroutine. The complete formulation of the implementation process using a fully implicit integration scheme, i.e., the classic backward Euler method, is presented, and relevant aspects of the yield criterion are introduced. In order to solve nonlinear differential and algebraic equations, the line-search algorithm was adopted in the user-defined material subroutine (UMAT) to expand the convergence domain of the iterative Newton-Raphson method. The developed subroutine was used to simulate a challenging computational problem with complex stress states, i.e., deep drawing of an anisotropic aluminum alloy AA3105. The accuracy and stability of the developed subroutine were confirmed by comparing the numerically predicted earing and thickness variation profiles with the experimental results, which showed an excellent agreement between numerical and experimental earing and thickness profiles. The integration of the BBC2003 yield criterion into ABAQUS/Standard represents a significant contribution to the field of computational mechanics and provides a useful tool for analyzing the mechanical behavior of anisotropic materials subjected to complex loading conditions.

Keywords: BBC2003 yield function, plastic anisotropy, fully implicit integration scheme, line search algorithm, explicit and implicit integration schemes

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Authors: Umar Javed, Kristen Blann, Philip Adalikwu, Maryam Sahraei, John McMaine

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The soil conservation service curve number (SCS-CN) is a widely used method to assess direct runoff depth based on specific rainfall events. “Actual” estimated runoff depth was estimated by subtracting the change in soil moisture from the depth of precipitation for each discrete rain event during the growing seasons from 2021 to 2023. Fields under investigation were situated in a HUC-12 watershed in southeastern South Dakota selected for a common soil series (Nora-Crofton complex and Moody-Nora complex) to minimize the influence of soil texture on soil moisture. Two soil moisture probes were installed from May 2021 to October 2023, with exceptions during planting and harvest periods. For each field, “Textbook” CN estimates were derived from the TR-55 table based on corresponding mapped land use land cover LULC class and hydrologic soil groups from web soil survey maps. The TR-55 method incorporated HSG and crop rotation within the study area fields. These textbook values were then compared to actual CN values to determine the impact of tillage practices on CN and runoff. Most fields were mapped as having a textbook C or D HSG, but the HSG of actual CNs was that of a B or C hydrologic group. Actual CNs were consistently lower than textbook CNs for all management practices, but actual CNs in conventionally tilled fields were the highest (and closest to textbook CNs), while actual CNs in no-till fields were the lowest. Preliminary results suggest that no-till practice reduces runoff compared to conventional till. This research highlights the need to use CNs that incorporate agricultural management to more accurately estimate runoff at the field and watershed scale.

Keywords: curve number hydrology, hydrologic soil groups, runoff, tillage practices

Procedia PDF Downloads 50

Authors: Shahroz Khan, Erkan Gunpinar, Kemal Mart

Abstract:

Recently parametric design techniques became a vital concept in the field of Computer Aided Design (CAD), which helps to provide sophisticated platform to the designer in order to automate the design process in efficient time. In these techniques, design process starts by parameterizing the important features of design models (typically the key dimensions), with the implementation of design constraints. The design constraints help to retain the overall shape of the model while modifying its parameters. However, the process of initializing an appropriate number of design parameters and constraints is the crucial part of parametric design techniques, especially for complex surface models such as yacht hull. This paper introduces a method to create complex surface models in favor of parametric design techniques, a method to define the right number of parameters and respective design constraints, and a system to implement design parameters in contract to design constraints schema. For this, in our proposed approach the design process starts by dividing the yacht hull into three sections. Each section consists of different shape lines, which form the overall shape of yacht hull. The shape lines are created using Cubic Bezier Curves, which allow larger design flexibility. Design parameters and constraints are defined on the shape lines in 3D design space to facilitate the designers for better and individual handling of parameters. Afterwards, shape modifiers are developed, which allow the modification of each parameter while satisfying the respective set of criteria and design constraints. Such as, geometric continuities should be maintained between the shape lines of the three sections, fairness of the hull surfaces should be preserved after modification and while design modification, effect of a single parameter should be negligible on other parameters. The constraints are defined individually on shape lines of each section and mutually between the shape lines of two connecting sections. In order to validate and visualize design results of our shape modifiers, a real time graphic interface is created.

Keywords: design parameter, design constraints, shape modifies, yacht hull

Procedia PDF Downloads 301

Authors: Carolyn Hatch, Laurent Simon

Abstract:

Urban mobility and the transportation industry are undergoing a transformation, shifting from an auto production-consumption model that has dominated since the early 20th century towards new forms of personal and shared multi-modality [1]. This is shaped by key forces such as climate change, which has induced a shift in production and consumption patterns and efforts to decarbonize and improve transport services through, for instance, the integration of vehicle automation, electrification and mobility sharing [2]. Advanced innovation practices and platforms for experimentation and validation of new mobility products and services that are increasingly complex and multi-stakeholder-oriented are shaping this new world of mobility. Transportation hubs – such as airports - are emblematic of these disruptive forces playing out in the mobility industry. Airports are emerging as the core of innovation ecosystems on and around contemporary mobility issues, and increasingly recognized as complex public/private nodes operating in many societal dimensions [3,4]. These include urban development, sustainability transitions, digital experimentation, customer experience, infrastructure development and data exploitation (for instance, airports generate massive and often untapped data flows, with significant potential for use, commercialization and social benefit). Yet airport innovation practices have not been well documented in the innovation literature. This paper addresses this gap by proposing a model of airport innovation that aims to equip airport stakeholders to respond to these new and complex innovation needs in practice. The methodology involves: 1 – a literature review bringing together key research and theory on airport innovation management, open innovation and innovation ecosystems in order to evaluate airport practices through an innovation lens; 2 – an international benchmarking of leading airports and their innovation practices, including such examples as Aéroports de Paris, Schipol in Amsterdam, Changi in Singapore, and others; and 3 – semi-structured interviews with airport managers on key aspects of organizational practice, facilitated through a close partnership with the Airport Council International (ACI), a major stakeholder in this research project. Preliminary results find that the most successful airports are those that have shifted to a multi-stakeholder, platform ecosystem model of innovation. The recent entrance of new actors in airports (Google, Amazon, Accor, Vinci, Airbnb and others) have forced the opening of organizational boundaries to share and exchange knowledge with a broader set of ecosystem players. This has also led to new forms of governance and intermediation by airport actors to connect complex, highly distributed knowledge, along with new kinds of inter-organizational collaboration, co-creation and collective ideation processes. Leading airports in the case study have demonstrated a unique capacity to force traditionally siloed activities to “think together”, “explore together” and “act together”, to share data, contribute expertise and pioneer new governance approaches and collaborative practices. In so doing, they have successfully integrated these many disruptive change pathways and forced their implementation and coordination towards innovative mobility outcomes, with positive societal, environmental and economic impacts. This research has implications for: 1 - innovation theory, 2 - urban and transport policy, and 3 - organizational practice - within the mobility industry and across the economy.

Keywords: airport management, ecosystem, innovation, mobility, platform, transport hubs

Procedia PDF Downloads 182

Authors: Niharika Keot, Manabendra Sarma

Abstract:

A thorough investigation of Ln3+ complexes with more than one inner-sphere water molecule is crucial for designing high relaxivity contrast agents (CAs) used in magnetic resonance imaging (MRI). This study accomplished a comparative stability analysis of two hexadentate (H3cbda and H3dpaa) and two heptadentate (H4peada and H3tpaa) ligands with Ln3+ ions. The higher stability of the hexadentate H3cbda and heptadentate H4peada ligands has been confirmed by the binding affinity and Gibbs free energy analysis in aqueous solution. In addition, energy decomposition analysis (EDA) reveals the higher binding affinity of the peada4− ligand than the cbda3− ligand towards Ln3+ ions due to the higher charge density of the peada4− ligand. Moreover, a mechanistic overview of water exchange kinetics has been carried out based on the strength of the metal–water bond. The strength of the metal–water bond follows the trend Gd–O47 (w) > Gd–O39 (w) > Gd–O36 (w) in the case of the tris-aquated [Gd(cbda)(H2O)3] and Gd–O43 (w) > Gd–O40 (w) for the bis-aquated [Gd(peada)(H2O)2]− complex, which was confirmed by bond length, electron density (ρ), and electron localization function (ELF) at the corresponding bond critical points. Our analysis also predicts that the activation energy barrier decreases with the decrease in bond strength; hence kex increases. The 17O and 1H hyperfine coupling constant values of all the coordinated water molecules were different, calculated by using the second-order Douglas–Kroll–Hess (DKH2) approach. Furthermore, the ionic nature of the bonding in the metal–ligand (M–L) bond was confirmed by the Quantum Theory of Atoms-In-Molecules (QTAIM) and ELF along with energy decomposition analysis (EDA). We hope that the results can be used as a basis for the design of highly efficient Gd(III)-based high relaxivity MRI contrast agents for medical applications.

Keywords: MRI contrast agents, lanthanide chemistry, thermodynamic stability, water exchange kinetics

Procedia PDF Downloads 84

Authors: Dong Wu, Michael Grenn

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Managing software projects effectively is crucial for meeting deadlines, ensuring quality, and managing resources well. Traditional methods often struggle with predicting project timelines accurately due to uncertain schedules and complex data. This study addresses these challenges by combining time prediction algorithms with Large Language Models (LLMs). It makes use of real-world software project data to construct and validate a model. The model takes detailed project progress data such as task completion dynamic, team Interaction and development metrics as its input and outputs predictions of project timelines. To evaluate the effectiveness of this model, a comprehensive methodology is employed, involving simulations and practical applications in a variety of real-world software project scenarios. This multifaceted evaluation strategy is designed to validate the model's significant role in enhancing forecast accuracy and elevating overall management efficiency, particularly in complex software project environments. The results indicate that the integration of time prediction algorithms with LLMs has the potential to optimize software project progress management. These quantitative results suggest the effectiveness of the method in practical applications. In conclusion, this study demonstrates that integrating time prediction algorithms with LLMs can significantly improve the predictive accuracy and efficiency of software project management. This offers an advanced project management tool for the industry, with the potential to improve operational efficiency, optimize resource allocation, and ensure timely project completion.

Keywords: software project management, time prediction algorithms, large language models (LLMS), forecast accuracy, project progress prediction

Procedia PDF Downloads 80

Authors: Yasser R. Shaban

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A practical multipurpose device for medical isotopes production is most wanted for clinical centers and researches. Unfortunately, the major supply of these radioisotopes currently comes from aging sources, and there is a great deal of uneasiness in the domestic market. There are also many cases where the cost of certain radioisotopes is too high for their introduction on a commercial scale even though the isotopes might have great benefits for society. The medical isotopes such as radiotracers PET (Positron Emission Tomography), Technetium-99 m, and Iodine-131, Lutetium-177 by is feasible to be generated by a single unit named IEMC (Inertial Electrostatic Magnetic Confinement). The IEMC fusion vessel is the upgrading unit of the Inertial Electrostatic Confinement IEC fusion vessel. Comprehensive experimental works on IEC were carried earlier with promising results. The principle of inertial electrostatic magnetic confinement IEMC fusion is based on forcing the binary fuel ions to interact in the opposite directions in ions cyclotrons orbits with different kinetic energies in order to have equal compression (forces) and with different ion cyclotron frequency ω in order to increase the rate of intersection. The IEMC features greater fusion volume than IEC by several orders of magnitude. The particles rate from the IEMC approach are projected to be 8.5 x 10¹¹ (p/s), ~ 0.2 microampere proton, for D/He-3 fusion reaction and 4.2 x 10¹² (n/s) for D/T fusion reaction. The projected values of particles yield (neutrons and protons) are suitable for medical isotope productions on-site by a single unit without any change in the fusion vessel but only the fuel gas. The PET radiotracers are usually produced on-site by medical ion accelerator whereas Technetium-99m (Tc-99m) is usually produced off-site from the irradiation facilities of nuclear power plants. Typically, hospitals receive molybdenum-99 isotope container; the isotope decays to Tc-99mwith half-life time 2.75 days. Even though the projected current from IEMC is lesser than the proton current from the medical ion accelerator but still the IEMC vessel is simpler, and reduced in components and power consumption which add a new value of populating the PET radiotracers in most clinical centers. On the other hand, the projected neutrons flux from the IEMC is lesser than the thermal neutron flux at the irradiation facilities of nuclear power plants, but in the IEMC case the productions of Technetium-99m is suggested to be at the resonance region of which the resonance integral cross section is two orders of magnitude higher than the thermal flux. Thus it can be said the net activity from both is evened. Besides, the particle accelerator cannot be considered a multipurpose particles production unless a significant change is made to the accelerator to change from neutrons mode to protons mode or vice versa. In conclusion, the projected fusion yield from IEMC is a straightforward since slightly change in the primer IEC and ion source is required.

Keywords: electrostatic versus magnetic confinement fusion vessel, ion source, medical isotopes productions, neutron activation

Procedia PDF Downloads 343

Authors: M. Nekri, A. Khelladi

Abstract:

The world wide web network is a network with a complex topology, the main properties of which are the distribution of degrees in power law, A low clustering coefficient and a weak average distance. Modeling the web as a graph allows locating the information in little time and consequently offering a help in the construction of the research engine. Here, we present a model based on the already existing probabilistic graphs with all the aforesaid characteristics. This work will consist in studying the web in order to know its structuring thus it will enable us to modelize it more easily and propose a possible algorithm for its exploration.

Keywords: clustering coefficient, preferential attachment, small world, web community

Procedia PDF Downloads 272

Authors: Gabriel Wainer

Abstract:

Modeling and Simulation methods have been used to better analyze the behavior of complex physical systems, and it is now common to use simulation as a part of the scientific and technological discovery process. M&S advanced thanks to the improvements in computer technology, which, in many cases, resulted in the development of simulation software using ad-hoc techniques. Formal M&S appeared in order to try to improve the development task of very complex simulation systems. Some of these techniques proved to be successful in providing a sound base for the development of discrete-event simulation models, improving the ease of model definition and enhancing the application development tasks; reducing costs and favoring reuse. The DEVS formalism is one of these techniques, which proved to be successful in providing means for modeling while reducing development complexity and costs. DEVS model development is based on a sound theoretical framework. The independence of M&S tasks made possible to run DEVS models on different environments (personal computers, parallel computers, real-time equipment, and distributed simulators) and middleware. We will present a historical perspective of discrete-event M&S methodologies, showing different modeling techniques. We will introduce DEVS origins and general ideas, and compare it with some of these techniques. We will then show the current status of DEVS M&S, and we will discuss a technological perspective to solve current M&S problems (including real-time simulation, interoperability, and model-centered development techniques). We will show some examples of the current use of DEVS, including applications in different fields. We will finally show current open topics in the area, which include advanced methods for centralized, parallel or distributed simulation, the need for real-time modeling techniques, and our view in these fields.

Keywords: modeling and simulation, discrete-event simulation, hybrid systems modeling, parallel and distributed simulation

Procedia PDF Downloads 323

Authors: M. A. Brown, K. Hugill, D. Meredith

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Since the establishment of midwifery, as a professional identity in its own right, in the early years of the 20th century, midwifery-led models of childbirth have prevailed in many parts of the world. However, in many locations midwives’ scope of practice remains underdeveloped or absent. In Qatar, all births take place in hospital and are under the professional jurisdiction of obstetricians, predominately supported by internationally trained nurse-midwives and obstetric nurses. The strategic vision for health services in Qatar endorsed a desire to provide women with the ‘Best Care Always’ and the introduction of midwifery was seen as a way to achieve this. In 2015 the process of recruiting postgraduate educated Clinical Midwife Specialists from international sources began. The midwives were brought together to initiate an in hospital and community service transformation plan. This plan set out a series of wide-ranging actions to transform maternity and neonatal services to make care safer and give women more health choices. Change in any organization is a complex and dynamic process. This is made even more complex when multifaceted professional and cross cultural factors are involved. This presentation reports upon the motivations and challenges that exist and the progress around introducing a multicultural midwifery model of childbirth care in the state of Qatar. The paper examines and reflects upon the drivers and unique features of childbirth in the country. Despite accomplishments, progress still needs to be made in order to fully implement sustainable changes to further improve care and ensure women and neonates get the ‘Best Care Always’. The progress within the transformation plan highlights how midwifery may coexist with competing models of maternity care to create an innovative, eclectic and culturally sensitive paradigm that can best serve women and neonatal health needs.

Keywords: culture, managing change, midwifery, neonatal, service transformation plan

Procedia PDF Downloads 150

Authors: Svitlana Antonenko, Gennady Telegeev

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Introductive statement: The development of chronic myeloid leukemia (CML) is caused by Bcr-Abl oncoprotein. Modern treatments with tyrosine kinase inhibitors are greatly complicated by the mutational variability of the Bcr-Abl oncoprotein, which causes drug resistance. Therefore, there is an urgent need to develop new approaches to the treatment of the disease, which will allow modeling the level of Bcr-Abl oncoprotein in the cell. Promising in this direction is the identification of proteases that can selectively promote cellular proteolysis of oncoproteins. The aim of the study was to study the effect of the interaction of Bcr-Abl with deubiquitinase USP1 on the level of oncoprotein in CML cells. Methodology: K562 cells were selected for the experiment. Сells were incubated with ML323 inhibitor for 24 hours. Precipitation of endogenous proteins from K562 cell lysate was performed using anti-Bcr-Abl antibodies. Cell lysates and precipitation results were studied by Western blot. Subcellular localization of proteins was studied by immunofluorescence analysis followed by confocal microscopy. The results were analyzed quantitatively and statistically. Major findings: The Bcr-Abl/USP1 protein complex was detected in CML cells, and it was found that inhibition of USP1 deubiquitinating activity by the compound ML323 leads to disruption of this protein complex and a decrease in the level of Bcr-Abl oncoprotein in cells. The interaction of Bcr-Abl with USP1 may result in deubiquitination of the oncoprotein, which disrupts its proteasomal degradation and leads to the accumulation of CML in cells. Conclusion: We believe that the interaction of oncoprotein with USP1 may be one of the prerequisites that contribute to malignant cell transformation due to the deubiquitination of oncoprotein, which leads to its accumulation and disease progression. A correlation was found between the deubiquitinating activity of USP1 and the level of oncoprotein in CML cells. Thus, we identify deubiquitinase USP1 as a promising therapeutic target for the development of a new strategy for the treatment of CML by modulating the level of Bcr-Abl in the cell.

Keywords: chronic myeloid leukemia, Bcr-Abl, USP1, deubiquitination Bcr-Abl, K562 cell

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Authors: Yi-An Liao, Lu-Wei Kuo, Yu-Jen Shih, Yao-Hui Huang

Abstract:

Abstract—Imidacloprid (IMI, a widely used pesticide, iImidacloprid (IMI), a widely used pesticide, is known to affect the bee populations. A sulfate radical-based oxidation method was utilized to remove the commercial pesticide consisted of IMI, dimethylacetamide, N-methyl-2-pyrrolidone, and methanol (TOC0 = 497 ppm). The experimental results evidenced that sulfate radicals created by UV activation (254nm, 6.4 mW/cm2) of S2O82- could remove 97% of total organic carbon (TOC) from the synthetic wastewater in 4 h using 120 mM of oxidant dosage. The dose of oxidant, temperature and the light flux were the key factors to further improve the mineralization efficiency, while the ferrous ions decreased the efficacy of UV/S2O82- reaction due to the competition of UV-adsorption by complex formation of FeSO4+.s known to affect the bee populations. A sulfate radical-based oxidation method was utilized to remove the commercial pesticide consisted of IMI, dimethylacetamide, N-methyl-2-pyrrolidone, and methanol (TOC0 = 497 ppm). The experimental results evidenced that sulfate radicals created by UV activation (254nm, 6.4 mW/cm2) of S2O82- could remove 97% of total organic carbon (TOC) from the synthetic wastewater in 4 h using 120 mM of oxidant dosage. The dose of oxidant, temperature and the light flux were the key factors to further improve the mineralization efficiency, while the ferrous ions decreased the efficacy of UV/S2O82- reaction due to the competition of UV-adsorption by complex formation of FeSO4+.

Keywords: organic nitrogen, photochemical oxidation, imidacloprid, UV-persulfate, mineralization

Procedia PDF Downloads 209

Authors: Atiwit Sinyoo, Sekh Thanprasertsuk, Sithiporn Agthong, Pasakorn Watanatada, Shaun Peter Qureshi, Saknan Bongsebandhu-Phubhakdi

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Background: Since the SARS-CoV-2 virus became extensively disseminated throughout the world, online learning has become one of the most hotly debated topics in educational reform. While some studies have already shown the advantage of online learning, there are still questions concerning how online learning affects students’ learning behavior and academic achievement when each student learns in a different way. Hence, we aimed to develop a guide for preclinical medical students to avoid drawbacks and get benefits from online learning that possibly a double-edged sword. Methods: We used a multiple-choice questionnaire to evaluate the learning behavior of second-year Thai medical students in the neuroscience course. All traditional face-to-face lecture classes were video-recorded and promptly posted to the online learning platform throughout this course. Students could pick and choose whatever classes they wanted to attend, and they may use online learning as often as they wished. Academic performance was evaluated as summative score, spot exam score and pre-post-test improvement. Results: More frequently students used online learning platform, the less they attended lecture classes (P = 0.035). High proactive online learners (High PO) who were irregular attendee (IrA) had significantly lower summative scores (P = 0.026), spot exam score (P = 0.012) and pre-post-test improvement (P = 0.036). In the meanwhile, conditional attendees (CoA) who only attended classes with attendance check had significantly higher summative score (P = 0.025) and spot exam score (P = 0.001) if they were in the High PO group. Conclusions: The benefit and drawbacks edges of using an online learning platform were demonstrated in our research. Based on this double-edged sword effect, we believe that online learning is a valuable learning strategy, but students must carefully plan their study schedule to gain the “benefit edge” meanwhile avoiding its “drawback edge”.

Keywords: academic performance, assessment, attendance, online learning, preclinical medical students

Procedia PDF Downloads 161

Authors: Bharti Bhandari, Bharati Mehta, Sabyasachi Sircar

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Medical education is advancing in India, with its advancement newer innovations are being incorporated in teaching and assessment methodology. Our study focusses on a teaching innovation that is more student-centric than teacher-centric and is the need of the day. The teaching innovation was carried out in 1st year MBBS students of our institute. Students were assigned control and test groups. Priming was done for the students in the test group with an open-book MCQ based test in a particular topic before delivering formal didactic lecture on that topic. The control group was not assigned any such exercise. This was followed by formal didactic lecture on the same topic. Thereafter, both groups were assessed on the same topic. The marks were compiled and analysed using appropriate statistical tests. Students were also given questionnaire to elicit their views on the benefits of “self-priming”. The mean marks scored in theory assessment by the test group were statistically higher than the marks scored by the controls. According to students’ feedback, the ‘self-priming “process was interesting, helped in better orientation during class-room lectures and better understanding of the topic. They want it to be repeated for other topics with moderate difficulty level. Better performance of the students in the primed group validates the combination of student-centric priming model and didactic lecture as superior to the conventional, teacher-centric methods alone. If this system is successfully followed, the present teacher-centric pedagogy should increasingly give way to student-centric activities where the teacher is only a facilitator.

Keywords: medical education, open-book test, pedagogy, priming

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Authors: Ng Liang Shen, Ngahzaifa Abdul Ghani

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This research aimed at developing an early warning system for pre-diabetic and diabetics by analyzing simple and easily determinable signs and symptoms of diabetes among the people living in Malaysia using Particle Swarm Optimized Artificial. With the skyrocketing prevalence of Type 2 diabetes in Malaysia, the system can be used to encourage affected people to seek further medical attention to prevent the onset of diabetes or start managing it early enough to avoid the associated complications. The study sought to find out the best predictive variables of Type 2 Diabetes Mellitus, developed a system to diagnose diabetes from the variables using Artificial Neural Networks and tested the system on accuracy to find out the patent generated from diabetes diagnosis result in machine learning algorithms even at primary or advanced stages.

Keywords: diabetes diagnosis, Artificial Neural Networks, artificial intelligence, soft computing, medical diagnosis

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Authors: Noura Al-Ajmi, Mohammed A. Almulla

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With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.

Keywords: headache diagnosis system, prescription recommender system, expert system, backward rule-based system

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Authors: Abdelhalim. N. Mohammed, Mohammed. Y. Esmail

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In the course of recent decades, medical imaging has been dominated by the use of costly film media for review and archival of medical investigation, however due to developments in networks technologies and common acceptance of a standard digital imaging and communication in medicine (DICOM) another approach in light of World Wide Web was produced. Web technologies successfully used in telemedicine applications, the combination of web technologies together with DICOM used to design a web-based and open source DICOM viewer. The Web server allowance to inquiry and recovery of images and the images viewed/manipulated inside a Web browser without need for any preinstalling software. The dynamic site page for medical images visualization and processing created by using JavaScript and HTML5 advancements. The XAMPP ‘apache server’ is used to create a local web server for testing and deployment of the dynamic site. The web-based viewer connected to multiples devices through local area network (LAN) to distribute the images inside healthcare facilities. The system offers a few focal points over ordinary picture archiving and communication systems (PACS): easy to introduce, maintain and independently platforms that allow images to display and manipulated efficiently, the system also user-friendly and easy to integrate with an existing system that have already been making use of web technologies. The wavelet-based image compression technique on which 2-D discrete wavelet transform used to decompose the image then wavelet coefficients are transmitted by entropy encoding after threshold to decrease transmission time, stockpiling cost and capacity. The performance of compression was estimated by using images quality metrics such as mean square error ‘MSE’, peak signal to noise ratio ‘PSNR’ and compression ratio ‘CR’ that achieved (83.86%) when ‘coif3’ wavelet filter is used.

Keywords: DICOM, discrete wavelet transform, PACS, HIS, LAN

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Authors: Mohammed Husein Mohammed Rashid

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Let Τ = U |Τ| be a polar decomposition of a bounded linear operator T on a complex Hilbert space with ker U = ker |T|. T is said to be class p-w A(s,t) if (|T*|ᵗ|T|²ˢ|T*|ᵗ )ᵗᵖ/ˢ⁺ᵗ ≥|T*|²ᵗᵖ and |T|²ˢᵖ ≥ (|T|ˢ|T*|²ᵗ|T|ˢ)ˢᵖ/ˢ⁺ᵗ with 0Keywords: class p-w A (s, t), normaloid, isoloid, finite, orthogonality

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Authors: Mohamed Bualhamam

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Due to the complex nature of tourism resources of the Northern part of the United Arab Emirates (UAE), the potential of Geographical Information Systems (GIS) and Remote Sensing (RS) in resolving these issues was used. The study was an attempt to use existing GIS data layers to identify sensitive natural environment and archaeological heritage resources that may be threatened by increased urban growth and give some specific recommendations to protect the area. By identifying sensitive natural environment and archaeological heritage resources, public agencies and citizens are in a better position to successfully protect important natural lands and direct growth away from environmentally sensitive areas. The paper concludes that applications of GIS and RS in study of urban growth impact in tourism resources are a strong and effective tool that can aid in tourism planning and decision-making. The study area is one of the fastest growing regions in the country. The increase in population along the region, as well as rapid growth of towns, has increased the threat to natural resources and archeological sites. Satellite remote sensing data have been proven useful in assessing the natural resources and in monitoring the changes. The study used GIS and RS to identify sensitive natural environment and archaeological heritage resources that may be threatened by increased urban growth. The result of GIS analyses shows that the Northern part of the UAE has variety for tourism resources, which can use for future tourism development. Rapid urban development in the form of small towns and different economic activities are showing in different places in the study area. The urban development extended out of old towns and have negative affected of sensitive tourism resources in some areas. Tourism resources for the Northern part of the UAE is a highly complex resources, and thus requires tools that aid in effective decision making to come to terms with the competing economic, social, and environmental demands of sustainable development. The UAE government should prepare a tourism databases and a GIS system, so that planners can be accessed for archaeological heritage information as part of development planning processes. Applications of GIS in urban planning, tourism and recreation planning illustrate that GIS is a strong and effective tool that can aid in tourism planning and decision- making. The power of GIS lies not only in the ability to visualize spatial relationships, but also beyond the space to a holistic view of the world with its many interconnected components and complex relationships. The worst of the damage could have been avoided by recognizing suitable limits and adhering to some simple environmental guidelines and standards will successfully develop tourism in sustainable manner. By identifying sensitive natural environment and archaeological heritage resources of the Northern part of the UAE, public agencies and private citizens are in a better position to successfully protect important natural lands and direct growth away from environmentally sensitive areas.

Keywords: GIS, natural environment, UAE, urban growth

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Authors: Justin Nwabanne, Sam Omenyi, Jeremiah Chukwuneke

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This work presents structural nonlinear static analysis of a horizontal taut cable using Finite Element Analysis (FEA) method. The FEA was performed analytically to determine the tensions at each nodal point and subsequently, performed based on finite element displacement method computationally using the FEA software, ANSYS 14.0 to determine their behaviour under the influence of aerodynamic forces imposed on the cable. The convergence procedure is adapted into the method to prevent excessive displacements through the computations. The work compared the two FEA cases by examining the effectiveness of the analytical model in describing the response with few degrees of freedom and the ability of the nonlinear finite element procedure adopted to capture the complex features of cable dynamics with reference to the aerodynamic external influence. Results obtained from this work explain that the analytic FEM results without aerodynamic influence show a parabolic response with an optimum deflection at nodal points 12 and 13 with the cable weight at nodes 12 and 13 having the value -1.002936N while for the cable tension shows an optimum deflection value for nodes 12 and 13 at -189396.97kg/km. The maximum displacement for the cable system was obtained from ANSYS 14.0 as 4483.83 mm for X, Y and Z components of displacements at node number 2 while the maximum displacement obtained is 4218.75mm for all the directional components. The dynamic behaviour of a taut cable investigated has application in a typical power transmission line. Aerodynamic influences on the cables were considered using FEA approach by employing ANSYS 14.0 showed a complex modal behaviour as expected.

Keywords: aerodynamics, cable tension and weight, finite element analysis, nodal, non-linear model, optimum deflection, suspended cable, transmission line

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Authors: C. M. Sapkota, B. P. Sapkota

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Background: Continuous developments in science and technology are increasing the availability of thousands of medical devices – all of which should be of good quality and used appropriately to address global health challenges. It is obvious that bio medical devices are becoming ever more indispensable in health service delivery and among the key workforce responsible for their design, development, regulation, evaluation and training in their use: biomedical technician (BMET) is the crucial. As a pivotal member of health workforce, biomedical technicians are an essential component of the quality health service delivery mechanism supporting the attainment of the Sustainable Development Goals. Methods: The study was based on cross sectional descriptive design. Indicators measuring the quality of health services were assessed in Mechi Zonal Hospital (MZH) and Sagarmatha Zonal Hospital (SZH). Indicators were calculated based on the data about hospital utilization and performance of 2018 available in Medical record section of both hospitals. MZH had employed the BMET during 2018 but SZH had no BMET in 2018.Focus Group Discussion with health workers in both hospitals was conducted to validate the hospital records. Client exit interview was conducted to assess the level of client satisfaction in both the hospitals. Results: In MZH there was round the clock availability and utilization of Radio diagnostics equipment, Laboratory equipment. Operation Theater was functional throughout the year. Bed Occupancy rate in MZH was 97% but in SZH it was only 63%.In SZH, OT was functional only 54% of the days in 2018. CT scan machine was just installed but not functional. Computerized X-Ray in SZH was functional only in 72% of the days. Level of client satisfaction was 87% in MZH but was just 43% in SZH. MZH performed all (256) the Caesarean Sections but SZH performed only 36% of 210 Caesarean Sections in 2018. In annual performance ranking of Government Hospitals, MZH was placed in 1st rank while as SZH was placed in 19th rank out of 32 referral hospitals nationwide in 2018. Conclusion: Biomedical technicians are the crucial member of the human resource for health team with the pivotal role. Trained and qualified BMET professionals are required within health-care systems in order to design, evaluate, regulate, acquire, maintain, manage and train on safe medical technologies. Applying knowledge of engineering and technology to health-care systems to ensure availability, affordability, accessibility, acceptability and utilization of the safer, higher quality, effective, appropriate and socially acceptable bio medical technology to populations for preventive, promotive, curative, rehabilitative and palliative care across all levels of the health service delivery.

Keywords: biomedical equipment technicians, BMET, human resources for health, HRH, quality health service, rural hospitals

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Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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Authors: Loredana E. Nita, Aurica P. Chiriac, Elena Stoleru, Alina Diaconu, Tudorachi Nita

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Self-assembly processes are an attractive method to form new and complex structures between macromolecular compounds to be used for specific applications. In this context, intramolecular and intermolecular bonds play a key role during self-assembling processes in preparation of carrier systems of bioactive substances. Polyelectrolyte complexes (PECs) are formed through electrostatic interactions, and though they are significantly below of the covalent linkages in their strength, these complexes are sufficiently stable owing to the association processes. The relative ease way of PECs formation makes from them a versatile tool for preparation of various materials, with properties that can be tuned by adjusting several parameters, such as the chemical composition and structure of polyelectrolytes, pH and ionic strength of solutions, temperature and post-treatment procedures. For example, protein-polyelectrolyte complexes (PPCs) are playing an important role in various chemical and biological processes, such as protein separation, enzyme stabilization and polymer drug delivery systems. The present investigation is focused on evaluation of the PPC formation between a synthetic polypeptide (poly(aspartic acid) – PAS) and a natural protein (bovine serum albumin - BSA). The PPC obtained from PAS and BSA in different ratio was investigated by corroboration of various techniques of characterization as: spectroscopy, microscopy, thermo-gravimetric analysis, DLS and zeta potential determination, measurements which were performed in static and/or dynamic conditions. The static contact angle of the sample films was also determined in order to evaluate the changes brought upon surface free energy of the prepared PPCs in interdependence with the complexes composition. The evolution of hydrodynamic diameter and zeta potential of the PPC, recorded in situ, confirm changes of both co-partners conformation, a 1/1 ratio between protein and polyelectrolyte being benefit for the preparation of a stable PPC. Also, the study evidenced the dependence of PPC formation on the temperature of preparation. Thus, at low temperatures the PPC is formed with compact structure, small dimension and hydrodynamic diameter, close to those of BSA. The behavior at thermal treatment of the prepared PPCs is in agreement with the composition of the complexes. From the contact angle determination results the increase of the PPC films cohesion, which is higher than that of BSA films. Also, a higher hydrophobicity corresponds to the new PPC films denoting a good adhesion of the red blood cells onto the surface of PSA/BSA interpenetrated systems. The SEM investigation evidenced as well the specific internal structure of PPC concretized in phases with different size and shape in interdependence with the interpolymer mixture composition.

Keywords: polyelectrolyte – protein complex, bovine serum albumin, poly(aspartic acid), self-assembly

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Authors: Sindhu Govardhan, Kenneth G. Crowther

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Modernisation of the water sector is leading to increased connectivity and integration of emerging technologies with traditional ones, leading to new security risks. The convergence of Information Technology (IT) with Operation Technology (OT) results in solutions that are spread across larger geographic areas, increasingly consist of interconnected Industrial Internet of Things (IIOT) devices and software, rely on the integration of legacy with modern technologies, use of complex supply chain components leading to complex architectures and communication paths. The result is that multiple parties collectively own and operate these emergent technologies, threat actors find new paths to exploit, and traditional cybersecurity controls are inadequate. Our approach is to explicitly identify and draw data flows that cross trust boundaries between owners and operators of various aspects of these emerging and interconnected technologies. On these data flows, we layer potential attack vectors to create a frame of reference for evaluating possible risks against connected technologies. Finally, we identify where existing controls, mitigations, and other remediations exist across industry partners (e.g., suppliers, product vendors, integrators, water utilities, and regulators). From these, we are able to understand potential gaps in security, the roles in the supply chain that are most likely to effectively remediate those security gaps, and test cases to evaluate and strengthen security across these partners. This informs a “shared responsibility” solution that recognises that security is multi-layered and requires collaboration to be successful. This shared responsibility security framework improves visibility, understanding, and control across the entire supply chain, and particularly for those water utilities that are accountable for safe and continuous operations.

Keywords: cyber security, shared responsibility, IIOT, threat modelling

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Authors: Nour Mohamad Fayad

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Complex and extensively researched, the impact of corruption on economic growth seems to be intricate. Many experts believe that corruption reduces economic development. However, counterarguments have suggested that corruption either promotes growth and development or has no significant impact on economic performance. Clearly, there is no consensus in the economics literature regarding the possible relationship between corruption and economic development. Corruption's complex and clandestine nature, which makes it difficult to define and measure, is one of the obstacles that must be overcome when investigating its effect on an economy. In an attempt to contribute to the ongoing debate, this study examines the impact of corruption on economic growth in the Middle East and North Africa (MENA) region between 2000 and 2021 using a Customized Corruption Index-CCI and panel data on MENA countries. These countries were selected because they are understudied in the economic literature, and despite the World Bank's recent emphasis on corruption in the developing world, the MENA countries have received little attention. The researcher used Cobb-Douglas functional form to test corruption in MENA using a customized index known as Customized Corruption Index-CCI to track corruption over almost 20 years, then used the dynamic panel data. The findings indicate that there is a positive correlation between corruption and economic growth, but this is not consistent across all MENA nations. First, the relatively recent lack of data from MENA nations. This issue is related to the inaccessibility of data for many MENA countries, particularly regarding the returns on resources, private malfeasance, and other variables in Gulf countries. In addition, the researcher encountered several restrictions, such as electricity and internet outages, due to the fact that he is from Lebanon, a country whose citizens have endured difficult living conditions since the Lebanese crisis began in 2019. Demonstrating a customized index known as Customized Corruption Index-CCI that suits the characteristics of MENA countries to peculiarly measure corruption in this region, the outcome of the Customized Corruption Index-CCI is then compared to the Corruption Perception Index-CPI and Control of Corruption from World Governance Indicator-CC from WGI.

Keywords: corruption, economic growth, corruption measurements, empirical review, impact of corruption

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Authors: Mohammad Abdullah Almalki

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Background: Despite the frequent usage of ankle arthroscopy, there is limited medical literature regarding its indications, patterns of admissions, surgical outcomes, and associated complicated at Saudi Arabia. Hence, this study would highlight the surgical outcomes of such surgical approach that will assist orthopedic surgeons to detect which surgical procedure needs to be done as well as to help them regarding their diagnostic workups. Methods: At the Orthopedic Division of King Abdul‑Aziz Medical City in Riyadh and through a cross‑sectional design and convenient sampling techniques, the present study had recruited 20 subjects who fulfill the inclusion and exclusion criteria between 2016 and 2018. Data collection was carried out by a questionnaire designed and revised by an expert panel of health professionals. Results: Twenty patients were reviewed (11M and 9F) with an average age of 40.1 ± 12.2. Only 30% of the patients (5M, 1F) have no comorbidity, but 70% of patients (7M, 8F) were having at least one comorbidity. The most common indications were osteochondritis dissecans (n = 7, 35%), ankle fracture without dislocation (n = 4, 20%), and tibiotalar impingement (n = 3, 15%). Patients recorded pain in all cases (100%). The top four symptoms after pain were instability (30%, n = 6), muscle weakness (15%, n = 3) swelling (15%, n = 3), and stiffness (5%, n = 1). Two‑third of cases reached to their full healthy status and toe‑touch weight‑bearing was seen in two patients (10%). Conclusion: Ankle arthroscopy improved the rehabilitation rates in our tertiary care center. In addition, the surgical outcomes are favorable in our hospital since it has a very short length of stay, unexpended surgery, and fewest physiotherapy sessions.

Keywords: ankle, arthroscopy, indications, patterns

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