Search results for: pediatric emergency medicine

Authors: Vasile Simulescu, Jakub Mondek, Miloslav Pekař

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Hyaluronic acid (HA) is an anionic glycosaminoglycan distributed throughout connective, epithelial and neural tissues. The importance of hyaluronic acid increased in the last decades. It has many applications in medicine and cosmetics. Hyaluronic acid has been used in attempts to treat osteoarthritis of the knee via injecting it into the joint. Bovine serum albumin (also known as BSA) is a protein derived from cows, which has many biochemical applications. The aim of our research work was to compare the thermal degradation of hyaluronic acid and BSA in powder and in solution, by determining changes in molar mass and conformation, by using SEC-MALLS (size exclusion chromatography -multi angle laser light scattering). The aim of our research work was to observe the degradation in powder and in solution of different molar mass hyaluronic acid samples, at different temperatures for certain periods. The degradation of the analyzed samples was mainly observed by modifications in molar mass.

Keywords: thermal degradation, hyaluronic acid, BSA, SEC-MALLS

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Authors: J. Fernandez, R. Fernandez de Canete, J. Perea-Paizal, J. C. Ramos-Diaz

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The high prevalence of cardiovascular diseases has provoked a raising interest in the development of mathematical models in order to evaluate the cardiovascular function both under physiological and pathological conditions. In this paper, a physical model of the cardiovascular system with intrinsic regulation is presented and implemented by using the object-oriented Modelica simulation software tools.  For this task, a multi-compartmental system previously validated with physiological data has been built, based on the interconnection of cardiovascular elements such as resistances, capacitances and pumping among others, by following an electrohydraulic analogy. The results obtained under both physiological and pathological scenarios provide an easy interpretative key to analyze the hemodynamic behavior of the patient. The described approach represents a valuable tool in the teaching of physiology for graduate medical and nursing students among others.

Keywords: cardiovascular system, MODELICA simulation software, physical modelling, teaching tool

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Authors: Eugenia Jilinguirian

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In the healthcare industry, data mining is essential since it transforms the field by collecting useful data from large datasets. Data mining is the process of applying advanced analytical methods to large patient records and medical histories in order to identify patterns, correlations, and trends. Healthcare professionals can improve diagnosis accuracy, uncover hidden linkages, and predict disease outcomes by carefully examining these statistics. Additionally, data mining supports personalized medicine by personalizing treatment according to the unique attributes of each patient. This proactive strategy helps allocate resources more efficiently, enhances patient care, and streamlines operations. However, to effectively apply data mining, however, and ensure the use of private healthcare information, issues like data privacy and security must be carefully considered. Data mining continues to be vital for searching for more effective, efficient, and individualized healthcare solutions as technology evolves.

Keywords: data mining, healthcare, big data, individualised healthcare, healthcare solutions, database

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Authors: Abdu Zakari, Sai’d Jibril, Adoum A. Omar

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The leaves of Combretum molle was selected on the basis of its uses in folk medicine as insecticides. The leave extracts of Combretum molle was tested against the larvae of Artemia salina, i.e. Brine Shrimp Lethality Test (BST), Culex quinquefasciatus Say (Filaria disease vector) i.e. Larvicidal Test, using crude ethanol, n-hexane, chloroform, ethyl acetate, and methanol extracts. The methanolic extract proved to be the most effective in inducing complete lethality at minimum doses both in the BST and the Larvicidal activity test. The LC50¬ values obtained are 24.85 µg/ml and 0.4µg/ml respectively. The bioactivity-guided column chromatography afforded the pure compound ACM–3. ACM-3 was not active in the BST with LC50 value >1000µg/ml, but was active in the Larvicidal activity test with LC50 value 4.0µg/ml. ACM-3 was proposed to have the structure I, (Cholesta-β-D-Glucopyranoside).

Keywords: toxicity, larvicidal, Combretum molle, Artemia salina, Culex quinquefasciatus Say.

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Authors: S. M. Amin Hosseini, Oriol Pons, Albert de la Fuente

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After natural disasters, displaced people (DP) require important numbers of housing units, which have to be erected quickly due to emergency pressures. These tight timeframes can cause the multiplication of the environmental construction impacts. These negative impacts worsen the already high energy consumption and pollution caused by the building sector. Indeed, post-disaster housing, which is often carried out without pre-planning, usually causes high negative environmental impacts, besides other economic and social impacts. Therefore, it is necessary to establish a suitable strategy to deal with this problem which also takes into account the instability of its causes, like changing ratio between rural and urban population. To this end, this study aims to present a model that assists decision-makers to choose the most suitable building technology for post-disaster housing units. This model focuses on the alternatives sustainability and fulfillment of the stakeholders’ satisfactions. Four building technologies have been analyzed to determine the most sustainability technology and to validate the presented model. In 2003, Bam earthquake DP had their temporary housing units (THUs) built using these four technologies: autoclaved aerated concrete blocks (AAC), concrete masonry unit (CMU), pressed reeds panel (PR), and 3D sandwich panel (3D). The results of this analysis confirm that PR and CMU obtain the highest sustainability indexes. However, the second life scenario of THUs could have considerable impacts on the results.

Keywords: sustainability, post-disaster temporary housing, integrated value model for sustainability assessment, life cycle assessment

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Authors: Hang Ju, Changmin Zhu

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The development level of the BeiDou Navigation Satellite System (BDS) can strongly reflect national defense strength as an important spatial information infrastructure. BDS can be not only used for military purposes, such as intelligence gathering, nuclear explosion monitoring, emergency communications, but also for location services, transportation, mapping, precision agriculture. In order to ensure the national defense security and the wide application of BDS in civil and military areas, BDS must be autonomous and controllable. As a complex system of knowledge-intensive, knowledge transformation runs through the whole process of research and development, production, operation, and maintenance of BDS. Based on the perspective of knowledge transformation, this paper expounds on the meaning of socialization, externalization, combination, and internalization of knowledge transformation, and the coupling relationship of autonomy and control on the basis of analyzing the status quo and problems of the autonomy and control of BDS. The autonomous and controllable framework of BDS based on knowledge transformation is constructed from six dimensions of management capability, R&D capability, technical capability, manufacturing capability, service support capability, and application capability. It can provide support for the smooth implementation of information security policy, provide a reference for the autonomy and control of the upstream and downstream industrial chains in Beidou, and provide a reference for the autonomous and controllable research of aerospace components, military measurement test equipment, and other related industries.

Keywords: knowledge transformation, BeiDou Navigation Satellite System, autonomy and control, framework

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Authors: Tanuj Joshi

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Smart transportation is fast emerging as a solution to modern cities’ approach mobility issues, delayed emergency response rate and high congestion on streets. Present day scenario with Google Maps, Waze, Yelp etc. demonstrates how information and communications technologies controls the intelligent transportation system. This intangible and invisible infrastructure is largely guided by the big data analytics. On the other side, the exponential increase in Indian urban population has intensified the demand for better services and infrastructure to satisfy the transportation needs of its citizens. No doubt, India’s huge internet usage is looked as an important resource to guide to achieve this. However, with a projected number of over 40 billion objects connected to the Internet by 2025, the need for systems to handle massive volume of data (big data) also arises. This research paper attempts to identify the ways of exploiting the big data variables which will aid commuters on Indian tracks. This study explores real life inputs by conducting survey and interviews to identify which gaps need to be targeted to better satisfy the customers. Several experts at Mumbai Metropolitan Region Development Authority (MMRDA), Mumbai Metro and Brihanmumbai Electric Supply and Transport (BEST) were interviewed regarding the Information Technology (IT) systems currently in use. The interviews give relevant insights and requirements into the workings of public transportation systems whereas the survey investigates the macro situation.

Keywords: smart transportation, mobility issue, Mumbai transportation, big data, data analysis

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Authors: Abu Zafor Sadek

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Pharmaceuticals were one of the least impacted business sectors during the corona pandemic as they are the center point of Covid-19 fight. Emergency use authorization, unproven indication of some commonly used drugs, self-medication, research and production capacity of an individual country, capacity of producing vaccine by many countries, Active Pharmaceutical Ingredients (APIs) related uncertainty, information gap among manufacturer, practitioners and user, export restriction, duration of lock-down, lack of harmony in transportation, disruption in the regulatory approval process, sudden increased demand of hospital items and protective equipment, panic buying, difficulties in in-person product promotion, e-prescription, geo-politics and associated issues added a new dimension to this industry. Although the industry maintains a reasonable growth throughout Covid-19 days; however, it has been characterized by both long- and short-term effects. Short-term effects have already been visible to so many countries, especially those who are import-dependent and have limited research capacity. On the other hand, it will take a few more time to see the long-term effects. Nevertheless, supply chain disruption, changes in strategic planning, new communication model, squeezing of job opportunity, rapid digitalization are the major short-term effects, whereas long-term effects include a shift towards self-sufficiency, growth pattern changes of certain products, special attention towards clinical studies, automation in operations, the increased arena of ethical issues etc. Therefore, this qualitative and exploratory study identifies the post-covid-19 landscape of the global pharmaceutical industry.

Keywords: covid-19, pharmaceutical, businees, landscape

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Authors: C. Bala Prashanth Reddy, B. Abhinay, C. Sreekar, D. V. Shobhana Priscilla

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The project aims in designing an emergency pacemaker which is capable of giving shocks to a human heart which has stopped working suddenly. A pacemaker is a machine commonly used by cardiologists. This machine is used in order to shock a human’s heart back into usage. The way the heart works is that there are small cells called pacemakers sending electrical pulses to cardiac muscles that tell the heart when to pump blood. When these electrical pulses stop, the heart stops beating. When this happens, a pacemaker is used to shock the heart muscles and the pacemakers back into action. The way this is achieved is by rubbing the two panels of the pacemaker together to create an adequate electrical current, and then the heart gets back to the normal state. The project aims in designing a system which is capable of continuously displaying the heart beat and blood pressure of a person on LCD. The concerned doctor gets the heart beat and also the blood pressure details continuously through the GSM Modem in the form of SMS alerts. In case of abnormal condition, the doctor sends message format regarding the amount of electric shock needed. Automatically the microcontroller gives the input to the pacemaker which in turn gives the shock to the patient. Heart beat monitor and display system is a portable and a best replacement for the old model stethoscope which is less efficient. The heart beat rate is calculated manually using stethoscope where the probability of error is high because the heart beat rate lies in the range of 70 to 90 per minute whose occurrence is less than 1 sec, so this device can be considered as a very good alternative instead of a stethoscope.

Keywords: missing R wave, PWM, demand pacemaker, heart

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Authors: Zhenzhong Yang

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Herbal medicines are important supplements to chemical drugs and usually consist of a complex mixture of constituents. The current quality control strategy of herbal medicines is mainly based on chemical markers, which largely failed to owe to the markers, not reflecting the herbal medicines’ multiple mechanisms of action. Herein, a bioactive chemical markers based strategy was proposed and applied to the quality assessment and control of herbal medicines. This strategy mainly includes the comprehensive chemical characterization of herbal medicines, bioactive chemical markers identification, and related quantitative analysis methods development. As a proof-of-concept, this strategy was applied to a Panax notoginseng derived herbal medicine. The bioactive chemical markers based strategy offers a rational approach for quality assessment and control of herbal medicines.

Keywords: bioactive chemical markers, herbal medicines, quality assessment, quality control

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Authors: Stacey Herzog, Mitchell McCleary, Istvan Kovacs

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Purpose: Maximal strength and maximal power are key athletic abilities in many sports disciplines. In recent years, velocity-based training (VBT) with a relatively high 75-85% 1RM resistance has been popularized in preparation for powerlifting and various other sports. The purpose of this study was to discover differences between beginner/intermediate and advanced lifters’ push/press performances after a heavy resistance-based BP training program. Methods: A six-week, three-workouts per week program was administered to 52 young, physically active adults (age: 22.4±5.1; 12 female). The majority of the participants (84.6%) had prior experience in bench pressing. Typical workouts began with BP using 75-95% 1RM in the 1-5 repetition range. The sets in the lower part of the range (75-80% 1RM) were performed with velocity-focus as well. The BP sets were followed by seated dumbbell presses and six additional upper-body assistance exercises. Pre- and post-tests were conducted on five test exercises: one-repetition maximum BP (1RM), calculated relative strength index: BP/BW (RSI), four-repetition maximal-effort dynamic BP for peak concentric velocity with 80% 1RM (4RV), 4-repetition ballistic pushups (BPU) for height (4PU), and seated medicine ball toss for distance (MBT). For analytic purposes, the participant group was divided into two subgroups: self-indicated beginner or intermediate initial resistance training status (BITS) [n=21, age: 21.9±3.6; 10 female] and advanced initial resistance training status (ATS) [n=31, age: 22.7±5.9; 2 female]. Pre- and post-test results were compared within subgroups. Results: Paired-sample t-tests indicated significant within-group improvements in all five test exercises in both groups (p < 0.05). BITS improved 18.1 lbs. (13.0%) in 1RM, 0.099 (12.8%) in RSI, 0.133 m/s (23.3%) in 4RV, 1.55 in. (27.1%) in BPU, and 1.00 ft. (5.8%) in MBT, while the ATS group improved 13.2 lbs. (5.7%) in 1RM, 0.071 (5.8%) in RSI, 0.051 m/s (9.1%) in 4RV, 1.20 in. (13.7%) in BPU, and 1.15 ft. (5.5%) in MBT. Conclusion: While the two training groups had different initial resistance training backgrounds, both showed significant improvements in all test exercises. As expected, the beginner/intermediate group displayed better relative improvements in four of the five test exercises. However, the medicine ball toss, which had the lightest resistance among the tests, showed similar relative improvements between the two groups. These findings relate to two important training principles: specificity and transfer. The ATS group had more specific experiences with heavy-resistance BP. Therefore, fewer improvements were detected in their test performances with heavy resistances. On the other hand, while the heavy resistance-based training transferred to increased power outcomes in light-resistance power exercises, the difference in the rate of improvement between the two groups disappeared. Practical applications: Based on initial training status, S&C coaches should expect different performance gains in maximal strength training-specific test exercises. However, the transfer from maximal strength to a non-training-specific performance category along the F-v curve continuum (i.e., light resistance and high velocity) might not depend on initial training status.

Keywords: exercise, power, resistance training, strength

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Authors: Wissem Abdaoui, Ilhem Mokhtari, Adel Gouri, Benouareth Djamel Eddine

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Contracted in a health facility, hospital-acquired infections are a major public health problem in recent years. The increase of nosocomial infections is partly related to diagnostic and therapeutic advances in medicine. The aim of our study was to isolate and diagnose some types of bacteria that are circulating in the hospital by performing different samples at two medical services: Pulmonary and Infectious Diseases. The antibiotic susceptibility tests were performed for bacterial isolates. The results have shown that there is a predominance of enterobacteria followed by the staphylococcus with its two species epidermidis ans saprophyticus. The study of the antibiogramme identified that some of these bacteria have a resistant profile against all the tested antibiotics. The fight against nosocomial infections is difficult because it must act on several factors: quality of care, safety of the hospital environment, hygiene, wearing gloves etc. are all areas that should be of heightened vigilance and preventive measures.

Keywords: nosocomial infection, isolation, identification, sensitivity and resistance to antibiotics

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Authors: Le Nguyen Binh, Luong Xuan Binh, Le Van Tuan, Tran Binh Duong, Truong Nguyen Khanh Hung, Do Le Hoang Son, Pham Quang Vinh, Hoang Quoc Huy, Nguyen Bach, Nguyen Quoc Khanh Le, Jiunn Horng Kang

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Introduction: Traumatic hip dislocation is an emergency in young adult which can cause avascular necrosis of femoral head or osteoarthritis of hip joint. The reasons for these may be the loose body of bony or chondral fragments, which are difficult to be detected on CT scan or MRI. In those cases, Hip arthroscopy may be the method of choice for diagnosis and treatment of loose bodies in hip joint after traumatic dislocation. Methods: A case report is performed. A 55-year-old male patient was under hip arthroscopy to retrieve the loose body in the right hip joint. Results: The patient’s hip was reduced under anesthesia in the opeation room. Xray and CT scan post-reduction showed that his right hip was wide and a small fragment of femoral head (< 5mm) locking inside the joint. A hip arthroscopy was done to take the fragment out. Post-operation, the patient went under rehabilition. After 6 months, he can walk with full-weight bearing; no further dislocaion was noted, and the Harris score was 84 points. Conclusions: Although acute traumatic injury of hip joint is usually treated with open surgeries, these methods have many drawbacks, such as soft tissue destruction, blood-loss,….Despite its technical requirement, hip arthroscopy is less invasive and effective treatment. Therefore, it may be an alternative treatment for a traumatic hip injury and can be applied frequently in the near future.

Keywords: hip dislocation, hip arthroscopy, hip osteoarthritis, acute hip trauma

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Authors: Kamini Kaushal

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Medicinal plants of Ayurveda are effective in the treatment of cervical cancer. The aim of this paper is to assess anti cancerous activities of these medicinal plants against cancer. Most of the medicinal plants in Ayurveda are using to treat cervical cancer as name of disease as treatment of YONI VYAPADA. The selected plants has been studied scientifically in India and evidence based written since Vedic era. The compilation results showed potential anti cervical cancer activity of the tested plants. There plants are remaining under the dark due to lack of awareness, lack of popularity and barrier of language. Now this is the time to eye opener regarding the classical text and clinical evidences, so that we can give the hope to world's affected women from this disease. World is waiting for such type of remedy which is having zero side effects, low cost and effective.

Keywords: anti cancerous, cervical cancer, ayurveda, medicinal plants, scientific study, classical text

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Authors: Abdu Umar Adamu, Maimuna Ibrahim

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In this present work, a locally used medicinal plant, namely: Aspillia kotschyi belonging to the Compositae family, was extracted using methanolic and petroleum ether 60-80OC. The extracts were subjected to microwave plasma Atomic Emission Spectroscopy (MPES) to determine the following metals Se, Ag, Fe, Cu, Ni, As, Co, Mn, and Al. From the result, Ag, Cu, Ni, and Co are of very negligible concentrations in the plant extract. However, Seleniun is found to be 0.530 (mg/kg) in the plant methanolic extract. Iron, on the other hand, was found to be 3.712 (mg/kg) in the plant extract. Arsenic was found to be 0.506 and 1.301 (mg/kg) in both methanolic and petroleum spirit extracts of the plant material. The concentration of aluminium was found to be of the range of 3.050mg/kg in the plant. Functional group analysis of the plant extracts was also carried out using Fourier transform infrared (FTIR) spectroscopy which showed the presence of some functional groups. The results of this study suggest some merit in the popular use of the plant in herbal medicine.

Keywords: Aspillia kotschyi, functional group, FTIR, MPES

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Authors: Stanley Yap, Chong Wei Ying, Leow Hon Wei

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Purpose: In Malaysia, an effective financial planning is vital to accumulate wealth and financial independence. However, retirees are required to resume working due to insufficient pension fund. This study examines how the financial decision in retirement planning is being made based on the net worth from the household. Design/methodology/approach: This study uses financial data from a married working couple with children to evaluate their composition of financial position. Numerous financial methods are made pertaining to net worth analysis, insurance needs analysis, investment portfolio rebalancing, estate planning, education planning and retirement planning to enhance the financial decision. Findings: Our results show, firstly, financial planning is essential to achieve financial independence; secondly, insurance needs, education and retirement funding are the most significant for household. Thirdly, current resources are critical to maintain family lifestyle after retirement, emergency funds for critical illness, and the long term children education funding. Practical implications: Refer to the findings, sufficient net worth is priority in financial planning. Different suggestions for household include reduction of unnecessary expenses, re-allocate of cash flow, adequate insurance coverage and re-balancing of investment portfolios to accumulate wealth. It is a challenge to obtain financial independence, hence, there is a need to increase the literature on financial planning. Originality/value: To the best of our knowledge, this is the important paper that uses financial information from household to provide solutions to enhance the efficiency of financial planning industry.

Keywords: net worth, financial planning, wealth and financial independence, retirement planning

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Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

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Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Luay Alsalmi

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Background: Facial filler is the most common type of cosmetic surgery next to botox. Permanent filler is preferred nowadays due to the low cost brought about by non-recurring injection appointments. However, such fillers pose a higher risk for complications, with even greater adverse effects when the procedure is done using unknown dermal filler injections. AIM: This study aimed to establish an algorithm to categorize and manage patients that receive permanent fillers. Materials and Methods: Twelve participants were presented to the service through emergency or as outpatient from November 2015 to May 2021. Demographics such as age, sex, date of injection, time of onset, and types of complications were collected. After examination, all cases were managed based on an algorithm established. FACE-Q was used to measure overall satisfaction and psychological well-being. Results: The algorithm to diagnose and manage these patients effectively with a high satisfaction rate was established in this study. All participants were non-smoker females with no known medical comorbidities. The algorithm presented determined the treatment plan when faced with complications. Results revealed high appearance-related psychosocial distress was observed prior to surgery, while it significantly dropped after surgery. FACE-Q was able to establish evidence of satisfactory ratings among patients prior to and after surgery. Conclusion: This treatment algorithm can guide the surgeon in formulating a suitable plan with fewer complications and a high satisfaction rate.

Keywords: facial filler, FACE-Q, psycho-social stress, botox, treatment algorithm

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Authors: Sinan Yapici, Hayrettin Eroglu

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The discharge of the aqueous radionuclides wastes used for the diagnoses of diseases and treatments of patients in nuclear medicine can cause fatal health problems when the radionuclides and its stable daughter component mix with underground water. Tl-201, which is one of the radionuclides commonly used in the nuclear medicine, is a toxic substance and is converted to its stable daughter component Hg-201, which is also a poisonous heavy metal: Tl201 → Hg201 + Gamma Ray [135-167 Kev (12%)] + X Ray [69-83 Kev (88%)]; t1/2 = 73,1 h. The purpose of the present work was to remove Tl-201 radionuclides from aqueous solution by biosorption on the solid bio wastes of food and cosmetic industry as bio sorbents of prina from an olive oil plant, rose residue from a rose oil plant and tea residue from a tea plant, and to make a comparison of the biosorption efficiencies. The effects of the biosorption temperature, initial pH of the aqueous solution, bio sorbent dose, particle size and stirring speed on the biosorption yield were investigated in a batch process. It was observed that the biosorption is a rapid process with an equilibrium time less than 10 minutes for all the bio sorbents. The efficiencies were found to be close to each other and measured maximum efficiencies were 93,30 percent for rose residue, 94,1 for prina and 98,4 for tea residue. In a temperature range of 283 and 313 K, the adsorption decreased with increasing temperature almost in a similar way. In a pH range of 2-10, increasing pH enhanced biosorption efficiency up to pH=7 and then the efficiency remained constant in a similar path for all the biosorbents. Increasing stirring speed from 360 to 720 rpm enhanced slightly the biosorption efficiency almost at the same ratio for all bio sorbents. Increasing particle size decreased the efficiency for all biosorbent; however the most negatively effected biosorbent was prina with a decrease in biosorption efficiency from about 84 percent to 40 with an increase in the nominal particle size 0,181 mm to 1,05 while the least effected one, tea residue, went down from about 97 percent to 87,5. The biosorption efficiencies of all the bio sorbents increased with increasing biosorbent dose in the range of 1,5 to 15,0 g/L in a similar manner. The fit of the experimental results to the adsorption isotherms proved that the biosorption process for all the bio sorbents can be represented best by Freundlich model. The kinetic analysis showed that all the processes fit very well to pseudo second order rate model. The thermodynamics calculations gave ∆G values between -8636 J mol-1 and -5378 for tea residue, -5313 and -3343 for rose residue, and -5701 and -3642 for prina with a ∆H values of -39516 J mol-1, -23660 and -26190, and ∆S values of -108.8 J mol-1 K-1, -64,0, -72,0 respectively, showing spontaneous and exothermic character of the processes. An empirical biosorption model in the following form was derived for each biosorbent as function of the parameters and time, taking into account the form of kinetic model, with regression coefficients over 0.9990 where At is biosorbtion efficiency at any time and Ae is the equilibrium efficiency, t is adsorption period as s, ko a constant, pH the initial acidity of biosorption medium, w the stirring speed as s-1, S the biosorbent dose as g L-1, D the particle size as m, and a, b, c, and e are the powers of the parameters, respectively, E a constant containing activation energy and T the temperature as K.

Keywords: radiation, diosorption, thallium, empirical modelling

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Authors: Min Jee Lee, Young Sun Park, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Yoon Seon Lee, Kyung Soo Lim, Won Young Kim

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Background: Acute myocardial infarction (AMI) concomitant with acute aortic syndrome (AAS) is rare but prompt recognition of concomitant AAS is crucial, especially in patients with ST-segment elevation myocardial infarction (STEMI) because misdiagnosis with early thrombolytic or anticoagulant treatment may result in catastrophic consequences. Objectives: This study investigated the clinical features of patients of STEMI concomitant with AAS that may lead to the diagnostic clue. Method: Between 1 January 2010 and 31 December 2014, 22 patients who were the initial diagnosis of acute coronary syndrome (AMI and unstable angina) and AAS (aortic dissection, intramural hematoma and ruptured thoracic aneurysm) in our emergency department were reviewed. Among these, we excluded 10 patients who were transferred from other hospital and 4 patients with non-STEMI, leaving a total of 8 patients of STEMI concomitant with AAS for analysis. Result: The mean age of study patients was 57.5±16.31 years and five patients were Standford type A and three patients were type B aortic dissection. Six patients had ST-segment elevation in anterior leads and two patients had in inferior leads. Most of the patients had acute onset, severe chest pain but no patients had dissecting nature chest pain. Serum troponin I was elevated in three patients but all patients had D-dimer elevation. Aortic regurgitation or regional wall motion abnormality was founded in four patients. However, widened mediastinum was seen in all study patients. Conclusion: When patients with STEMI have elevated D-dimer and widened mediastinum, concomitant AAS may have to be suspected.

Keywords: aortic dissection, myocardial infarction, ST-segment, d-dimer

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Authors: Souhir Chelly, Asma Ben Cheikh, Hela Ghali, Salwa Khefacha, Lamine Dhidah, Mohamed Ben Rejeb, Houyem Said Latiri

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The hospital risk management department is firstly involved in the methodological analysis of grade zero sterilization incidents. The system is based on a subsequent analysis process in compliance with the ongoing requirements of the Haute Autorité de santé (HAS) for a reactive approach to risk, allowing to identify failures and start the appropriate preventive and corrective measures. The use of the association of litigation and risk management (ALARM) method makes easier the grade zero analysis and brings to light the team or institutional, organizational, temporal, individual factors representative of undesirable effects. Two main factors come out again from this analysis, pre-disinfection step of the emergency block unsupervised instrumentalist intern was poorly done since she did not remove the battery from micro air motor. At the sterilization unit, the worker who was not supervised by the nurse did the conditioning of the motor without having checked it if it still contained the battery. The main cause is that the management of human resources was inadequate at both levels, the instrumental trainee in the block who was not supervised by his supervisor and the worker of the sterilization unit who was not supervised by the responsible nurse. There is a lack of research help, advice, and collaboration. The difficulties encountered during this type of analysis are multiple. The first is based on its necessary acceptance by the various actors of care involved, which should not perceive it as a tool leading to individual punishment, but rather as a means to improve their practices.

Keywords: ALARM (Association of Litigation and Risk Management Method), incident, risk management, sterilization

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Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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Authors: Marju Ben Sayed, Shigeko Haruyama

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Among all kinds of natural disaster, the flood is a common feature in rapidly urbanizing Dhaka city. In this research, assessment of flood risk of Dhaka metropolitan area has been investigated by using an integrated approach of GIS, remote sensing and socio-economic data. The purpose of the study is to measure the flooding risk concerning with the flood protection embankment in big flooding events (1988, 1998 and 2004) and urbanization of Dhaka metropolitan zone. In this research, we considered the Dhaka city into two parts; East Dhaka (outside the flood protection embankment) and West Dhaka (inside the flood protection embankment). Using statistical data, we explored the socio-economic status of the study area population by comparing the density of population, land price and income level. We have drawn the cross section profile of the flood protection embankment into three different points for realizing the flooding risk in the study area, especially in the big flooding year (1988, 1998 and 2004). According to the physical condition of the study area, the land use/land cover map has been classified into five classes. Comparing with each land cover unit, historical weather station data and the socio-economic data, the flooding risk has been evaluated. Moreover, we compared between DEM data and each land cover units to find out the relationship with flood. It is expected that, this study could contribute to effective flood forecasting, relief and emergency management for a future flood event in Dhaka city.

Keywords: land use, land cover change, socio-economic, Dhaka city, GIS, flood

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Authors: Celine Delacroix

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Analyses of global emission scenarios demonstrate that slowing population growth could lead to substantial emissions reductions and play an important role to avoid dangerous climate change. For this reason, the advancement of individual reproductive rights might represent a valid climate change mitigation and adaptation option. With this focus, we reflected on population ethics and the ethical dilemmas associated with environmental degradation and climate change. We conducted a mixed-methods qualitative data study consisting of an online survey followed by in-depth interviews with stakeholders of the reproductive health and rights and environmental sustainability movements to capture the ways in which the linkages between family planning, population growth, and environmental sustainability are perceived by these actors. We found that the multi-layered marginalization of this issue resulted in two processes, the polarization of opinions and its eschewal from the public fora through population reductionism. Our results indicate that stakeholders of the reproductive rights and environmental sustainability movements find that population size and family planning influence environmental sustainability and overwhelmingly find that the reproductive health and rights ideological framework should be integrated in a wider sustainability frame reflecting environmental considerations. This position, whilst majoritarily shared by all participants, was more likely to be adopted by stakeholders of the environmental sustainability sector than those from the reproductive health and rights sector. We conclude that these processes, taken in the context of a context of a climate emergency, threaten to weaken the reproductive health and rights movement.

Keywords: environmental sustainability, family planning, population growth, population ethics, reproductive rights

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Authors: Taguekou Kenfack Alexie

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For a long time, refugee protection has constituted one of the main concerns of the international community as a whole and for the South African government in particular.The focus of this paper is on the challenges refugees face in accessing their rights in South Africa. In particular, it analyses the legal framework for the protection of the socio economic rights of refugees under international law, regional and domestic law and the extent to which the rights have been realized. The main hypothesis of the study centered on the fact that the social protection of refugees in South Africa is in conformity with international standards. To test this hypothesis, the qualitative research method was applied. Refugee related legal instruments were analyzed as well as academic publications, organizational reports and internet sources. The data analyzed revealed that there has been enormous progress in meeting international standards in the areas of education, emergency relief and assistance, protection of women and refugee children. The results also indicated that much remain to be desired in such areas as nutrition, shelter, health care, freedom of movement and very importantly, employment and social security. The paper also seeks to address the obstacles which prevent the proper treatment of refugees and to make recommendations as how the South African government can better regulate the treatment of refugees living in its territory.Recommendations include the amendment of the legal instruments that provide the normative framework for protection and improvement of protection policies to reflect the changing dynamics.

Keywords: international community, refugee, socioeconomic rights, social protection

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Authors: B. A. Parate, K. D. Deodhar, V. K. Dixit, V. V. Rao

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This article outlines the ballistics of main seat ejection cartridges for aircraft application. The ballistics of main seat ejection cartridges plays a vital role during the ejection of the pilot in an emergency. The ballistic parameters such as maximum pressure, time is taken to reach the maximum pressure, and time required to reach half the maximum pressure contributes to the spinal injury of the pilot. Therefore, the evaluations of these parameters are very critical during various stages of development. Elaborate testing was carried out for main seat ejection cartridges on seat ejection tower (SET) at different operating temperatures considering physiological limits. As these trials are cumbersome in nature, a vented vessel (VV) testing facility was devised to lay down the performance parameters at hot and cold temperature conditions. Single base (SB) propellant having hepta-tubular configuration is selected as the main filling. Gun powder plays the role of a booster based on ballistic requirements. The evaluation methodology of various performance parameters of main seat ejection cartridges is explained in this paper. Physiological parameters such as maximum seat ejection velocity, acceleration, and rate of rising of acceleration are also experimentally determined on seat ejection tower. All the parameters are observed well within physiological limits. This paper addresses the internal ballistic of main seat ejection cartridges, propellant selection, its calculation, and evaluation of various performance parameters for an aircraft application.

Keywords: ballistics of seat ejection, ejection seat, gas generator, gun propulsion, main seat ejection cartridges, maximum pressure, performance parameters, propellant, progressive burning and vented vessel

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Authors: Mustafa M. Donma, Orkide Donma

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Anthropometric measurements are essential for obesity studies. Waist circumference (WC) is the most frequently used measure, and along with hip circumference (HC), it is used in most equations derived for the evaluation of obese individuals. Morbid obesity is the most severe clinical form of obesity, and such individuals may also exhibit some clinical findings leading to metabolic syndrome (MetS). Then, it becomes a requirement to discriminate morbid obese children with (MOMetS+) and without (MOMetS-) MetS. Almost all obesity indices can differentiate obese (OB) children from children with normal body mass index (N-BMI). However, not all of them are capable of making this distinction. A recently introduced anthropometric obesity index, waist circumference + hip circumference/2 ((WC+HC)/2), was confirmed to differ OB children from those with N-BMI, however it has not been tested whether it will find clinical usage for the differential diagnosis of MOMetS+ and MOMetS-. This study was designed to find out the availability of (WC+HC)/2 for the purpose and to compare the possible preponderance of it over some other anthropometric or fat-based obesity indices. Forty-five MOMetS+ and forty-five MOMetS- children were included in the study. Participants have submitted informed consent forms. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Anthropometric measurements were performed. Body mass index (BMI), waist-to-hip circumference (W/H), (WC+HC)/2, trunk-to-leg fat ratio (TLFR), trunk-to-appendicular fat ratio (TAFR), trunk fat+leg fat/2 ((trunk+leg fat)/2), diagnostic obesity notation model assessment index-2 (D2I) and fat mass index (FMI) were calculated for both groups. Study data was analyzed statistically, and 0.05 for p value was accepted as the statistical significance degree. Statistically higher BMI, WC, (WC+HC)/2, (trunk+leg fat)/2 values were found in MOMetS+ children than MOMetS- children. No statistically significant difference was detected for W/H, TLFR, TAFR, D2I, and FMI between two groups. The lack of difference between the groups in terms of FMI and D2I pointed out the fact that the recently developed fat-based index; (trunk+leg fat)/2 gives much more valuable information during the evaluation of MOMetS+ and MOMetS- children. Upon evaluation of the correlations, (WC+HC)/2 was strongly correlated with D2I and FMI in both MOMetS+ and MOMetS- groups. Neither D2I nor FMI was correlated with W/H. Strong correlations were calculated between (WC+HC)/2 and (trunk+leg fat)/2 in both MOMetS- (r=0.961; p<0.001) and MOMetS+ (r=0.936; p<0.001) groups. Partial correlations between (WC+HC)/2 and (trunk+leg fat)/2 after controlling the effect of basal metabolic rate were r=0.726; p<0.001 in MOMetS- group and r=0.932; p<0.001 in MOMetS+ group. The correlation in the latter group was higher than the first group. In conclusion, recently developed anthropometric obesity index (WC+HC)/2 and fat-based obesity index (trunk+leg fat)/2 were of preponderance over the previously introduced classical obesity indices such as W/H, D2I and FMI during the differential diagnosis of MOMetS+ and MOMetS- children.

Keywords: children, hip circumference, metabolic syndrome, morbid obesity, waist circumference

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Authors: Agnieszka Fryźlewicz, Jowita Kras, Mikołaj Sadowski, Agnieszka Łapczuk-Krygier, Agnieszka Kącka-Zych Radomir Jasiński

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Nicotines are a group of compounds containing conjugated pyridine and pyrrolidine molecular segments. They are widely applied in medicine, pharmacy, and agriculture. Namely as researched treatment of Alzheimer, depression, Parkinson's, Tourette syndrome, general nervous and mental disorders. Furthermore, nicotine itself is used as a stimulant, animal repellent and was widely applied as an insecticide. In our work, we obtained nicotine analogues with possible applications in agriculture. The synthesis employed [3+2] cycloaddition (32CA) reactions, occurring between pirydyl-functionalised nitrones and conjugated nitroalkenes, that allowed us to fully regio- and stereoselectively obtain product. Moreover, cycloaddition reaction realizes rapidly in mild conditions with the full atomic economy, thus fitting into “green chemistry” trends.

Keywords: nicotine, isoxazolidine, 1-3-dipolar cycloaddition, green chemistry, biological and pharmacological activity

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Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz

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We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.

Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation

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