Search results for: kidney functions and chronic renal failure

Authors: Noushin Shokouhinejad, Hasan Razmi, Reza Fekrazad, Saeed Asgary, Ammar Neshati, Hadi Assadian, Sanam Kheirieh

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This study compared the push-out bond strength of mineral trioxide aggregate (MTA) and a new endodontic cement (NEC) as root-end filling materials in root-end cavities prepared by ultrasonic technique (US) or Er,Cr:YSGG laser (L). Eighty single-rooted extracted human teeth were endodontically treated, apicectomised and randomly divided into four following groups (n = 20): US/MTA, US/NEC, L/MTA and L/NEC. In US/MTA and US/NEC groups, rooted cavities were prepared with ultrasonic retrotip and filled with MTA and NEC, respectively. In L/MTA and L/NEC groups, root-end cavities were prepared using Er, Cr:YSGG laser and filled with MTA and NEC, respectively. Each root was cut apically to create a 2 mm-thick root slice for measurement of bond strength using a universal testing machine. Then, all slices were examined to determine the mode of bond failure. Data were analysed using two-way ANOVA. Root-end filling materials showed significantly higher bond strength in root-end cavities prepared using the ultrasonic technique (US/MTA and US/NEC) (P < 0.001). The bond strengths of MTA and NEC did not differ significantly. The failure modes were mainly adhesive for MTA, but cohesive for NEC. In conclusion, bond strengths of MTA and NEC to root-end cavities were comparable and higher in ultrasonically prepared cavities.

Keywords: bond strength, Er, Cr:YSGG laser, MTA, NEC, root-end cavity

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Authors: Chung Danbi, Linton Oliver, Whang Yoon-Jae

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Supermodularity, or complementarity, is a popular concept in economics which can characterize many objective functions such as utility, social welfare, and production functions. Further, supermodular dominance captures a preference for greater interdependence among inputs of those functions, and it can be applied to examine which input set would produce higher expected utility, social welfare, or production. Therefore, we propose and justify a consistent testing for a useful implication of supermodular dominance. We also conduct Monte Carlo simulations to explore the finite sample performance of our test, with critical values obtained from the recentered bootstrap method, with and without the selective recentering, and the subsampling method. Under various parameter settings, we confirmed that our test has reasonably good size and power performance. Finally, we apply our test to compare the geographic and distant knowledge spillover in terms of their effects on social welfare using the National Bureau of Economic Research (NBER) patent data. We expect localized citing to supermodularly dominate distant citing if the geographic knowledge spillover engenders greater social welfare than distant knowledge spillover. Taking subgroups based on firm and patent characteristics, we found that there is industry-wise and patent subclass-wise difference in the pattern of supermodular dominance between localized and distant citing. We also compare the results from analyzing different time periods to see if the development of Internet and communication technology has changed the pattern of the dominance. In addition, to appropriately deal with the sparse nature of the data, we apply high-dimensional methods to efficiently select relevant data.

Keywords: supermodularity, supermodular dominance, stochastic dominance, Monte Carlo simulation, bootstrap, subsampling

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Authors: Jatuporn Juyjingam, Pitak Siriwong

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This paper presents a study of factors effecting the success and failure of social enterprise in Thailand identifying communication as one of the criteria for measuring the social impact of social enterprise. The study focused on the communication driver of the SCALERS model. The research examines how communication is viewed in Thailand social enterprise. The research aims to determine how selected social enterprise uses communication in their operations. More specifically, the study aims to 1) describe the profile of social enterprise in Thailand, 2) identify the different roles of communication in the operation of social enterprise in Thailand, 3) determine Thailand social enterprise concept of communication. The study made use of the case study and cross case study research designs. For the profiling of the social enterprises, the case study was used. The researchers made use of the cross-case research design in identifying trends across the ten social enterprises and in determining the social entrepreneurs’ concept of communication. Key informant interviews were conducted with the heads or representatives of selected social enterprises, a three-part interview schedule was used to facilitate data gathering. The three parts included are 1) Profile of social enterprise in Thailand 2) How social enterprises apply communication in their operations 3) What is the key success in using communication among social enterprise in Thailand. This study is an exploratory research.

Keywords: communication, social entrepreneurship, social enterprise, sustainability development

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Authors: Hatem Abdel Moniem Ahmed, Ragaa Mohamed Abdel Maaboud, Heba A. Mubarak

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A commercially available Stone Hair Dye (SHD) was spread in Upper Egypt and used for dying woman's hair. Paraphenyl-diamine (PPD) is the main component of SHD and reported as a toxic substance. This work aims to study the systemic effects induced in experimental animals as a result of dermal application of SHD. 21 rats were divided into three groups, and doses of SHD and PPD were applied according to body weight (25 mg/100 g body weight) for 90 days. The results revealed that insignificant decrease in RBC count and Hb level, but there were significant increases in the WBC count, AST, ALT, GPT, and total protein while creatinine level was insignificantly increased. Hepatocytes showed a lot of degenerative changes in the form of vacuolated cytoplasm and irregular deeply stained nuclei with vascular congestion and lymphocytic infiltration, while renal affection indicated the occurrence of atrophy of glomerular capillaries, hyperplasia, and widening of bowman space.

Keywords: PPD, SHD, rats and histology, biochemistry and hematology

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Authors: Mohammad H. Ruhipour, Mahdi Goharrokhi, Mahsa Ghasemi, Artadokht Ostadsarayi

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In this paper, we are aiming to study the consequences of chlorine gas leak in direct chlorine gas injection compared to using bleach (sodium hypochlorite), studying the negative effects both on the environment and individuals. This study was performed in the cooling towers of a natural fractioning unit of Bandar-e-IMAM petrochemical plant. Considering that chlorine gas is highly toxic and based on the health regulation, its release into the surrounding environment can be very dangerous for people and even fatal for individuals. We studied performing quantitative studies in the worst cases of event incidence. In addition, studying alternative methods with a lower risk was also on the agenda to select the least likely possible option causing an accident. In this paper chlorine gas release consequences have been evaluated by using PHAST software. Reaching to 10 ppm of chlorine gas concentration was basis of hazardous area determination. The results show that the full chlorine gas line rupture scenario in Pasquill category F, were worst case, and many people could be harmed around cooling towers area because of chlorine gas inhalation.

Keywords: chlorine gas, consequence modeling, cooling towers, direct chlorination, risk assessment, system failure

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Authors: Angeliki Gkiouzeli, Christine Rotonda, Elise Eby, Claire Touchet, Marie-Jo Brennstuhl, Cyril Tarquinio

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Resilience is a psychological concept of possible relevance to the development and maintenance of chronic pain (CP). It refers to the ability of individuals to maintain reasonably healthy levels of physical and psychological functioning when exposed to an isolated and potentially highly disruptive event. Extensive research in recent years has supported the importance of this concept in the CP literature. Increased levels of resilience were associated with lower levels of perceived pain intensity and better mental health outcomes in adults with persistent pain. The ongoing project seeks to include the concept of pain-specific resilience in the French literature in order to provide more appropriate measures for assessing and understanding the complexities of CP in the near future. To the best of our knowledge, there is currently no validated version of the pain-specific resilience measure, the Pain Resilience scale (PRS), for French-speaking populations. Therefore, the present work aims to address this gap, firstly by performing a linguistic and cultural translation of the scale into French and secondly by studying the internal validity and reliability of the PRS for French CP populations. The forward-translation-back translation methodology was used to achieve as perfect a cultural and linguistic translation as possible according to the recommendations of the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) group, and an online survey is currently conducted among a representative sample of the French population suffering from CP. To date, the survey has involved one hundred respondents, with a total target of around three hundred participants at its completion. We further seek to study the metric properties of the French version of the PRS, ''L’Echelle de Résilience à la Douleur spécifique pour les Douleurs Chroniques'' (ERD-DC), in French patients suffering from CP, assessing the level of pain resilience in the context of CP. Finally, we will explore the relationship between the level of pain resilience in the context of CP and other variables of interest commonly assessed in pain research and treatment (i.e., general resilience, self-efficacy, pain catastrophising, and quality of life). This study will provide an overview of the methodology used to address our research objectives. We will also present for the first time the main findings and further discuss the validity of the scale in the field of CP research and pain management. We hope that this tool will provide a better understanding of how CP-specific resilience processes can influence the development and maintenance of this disease. This could ultimately result in better treatment strategies specifically tailored to individual needs, thus leading to reduced healthcare costs and improved patient well-being.

Keywords: chronic pain, pain measure, pain resilience, questionnaire adaptation

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Authors: Marlene Rosa, Susana Lopes

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There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

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Authors: Pamela E. Mukaire

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Anemia and chronic energy deficiency are significant manifestations of poor nutritional health. Anaemia and nutritional status screening are practical ways for assessing the prevalence of iron deficiency anemia in the food insecure populations with large groups of childbearing women and children. The objective of the study was to assess anemia prevalence and other clinical manifestations of malnutrition among pairs of mothers and young children in rural Uganda. This community cross-sectional study used consecutive sampling to select 214 mothers and 214 children for the study. Data was generated using structured questionnaire, anthropometric measurements and on site analysis for anemia. Bivariable and multivariable analyses were used to assess the effect of different factors on anaemia. Of the 214 mothers, 54.2% were 25-34 years of age, 76.7% unmarried, 63% low income, and 55% had more than four children. Of the 214 children, 57% were female, 50% between 1 to 3 years of age and 35% under one year, and. Overall, 38% of the households had more 4 children under the age of 12. The prevalence of anemia was 48% for mothers and 72% for children; 20.6% of mothers had moderate to severe chronic energy deficiency, 39% had moderately-severe anaemia (10 to 7.1 g/dL). Among children, 53% had moderately-severe anaemia, and 18.2% had severe anaemia. Parity X2 =20, p < .037, number of children under 12 years living in a household X2 =10, p < .015, and child’s gender X2 =6.5, p < .038, had a significant relationship with maternal anaemia. There was a significant relationship between household income X2 =10, p < .005, marital status X2 =9, p < .011, owing a piece of land X2 =18, p < .000, owing home X2 =7, p < .036, and anaemia in children. The prevalence of anemia was high in both mothers and children. Income, marital status, owing a piece of land, owing home, number of children under age 12 in a household were associated with anaemia. Hence, efforts should be made for early diagnosis and management of anaemia deficiencies with special emphasis on those households with large number of children under age 12.

Keywords: anemia, maternal-child, nutrition, rural population

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Authors: Caroline F. Moeser

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The skin-gut axis defines the relationship between the intestinal microbiota and the development of pathological skin diseases. Low diversity within the gut can predispose to the development of allergic skin conditions, and a greater diversity of the gastrointestinal microflora has been associated with a reduction of skin flares in people with atopic dermatitis. Manipulation of the gut microflora has been used as a treatment option for several conditions in people, but there is limited data available on the use of faecal transplantation as a preventative measure in either people or dogs. Six, 4-month-old pups from a litter of ten were presented for diarrhea and/or signs of skin disease (chronic scratching, otitis externa). Of these pups, two were given probiotics with a resultant resolution of diarrhea. The other four pups were given faecal transplantation, either as a sole treatment or in combination with other treatments. Follow-up on the litter of ten pups was performed at 18 months of age. At this stage, the four pups that had received faecal transplantation had resolved all clinical signs and had no recurrence of either skin or gastrointestinal symptoms. Of the remaining six pups from the litter, all had developed at least one episode of Malassezia otitis externa within the period of 5 months to 18 months of age. Two pups had developed two Malassezia otitis infections, and one had developed three Malassezia otitis infections during this period. Favrot’s criteria for the diagnosis of canine atopic dermatitis include chronic or recurrent Malassezia infections by the age of three years. Early results from this litter predict a reduction in the development of canine atopic disease in dogs given faecal microbial transplantation. Follow-up studies at three years of age and within a larger population of dogs can enhance understanding of the impact of early faecal transplantation in the prevention of canine atopic dermatitis.

Keywords: canine atopic dermatitis, faecal microbial transplant, skin-gut axis, otitis

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Authors: Surachart Koyadun

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Introduction: Plasmodium knowlesi (P. knowlesi) malaria is a zoonotic disease that is classified as type 5 of human malaria. Commonly found in macaques (Macaca fascicularis) and (Macaca nemestrina), P. knowlesi is capable of resulting in both uncomplicated and severe malaria in humans. Situation of P. knowlesi malaria in Phang-Nga province for the past 3 years from 2020 – 2022 revealed no case report in 2020, however, a total of 14 cases had been reported in 2021 - 2022. This research aimed to 1) study the epidemiology of P. knowlesi, 2) examine the clinical manifestations of P. knowlesi patients, 3) analyze the ecology and entomology of P. knowlesi, and 4) analyze the diagnosis and treatment of P. knowlesi. Method: This research was a retrospective descriptive study/case report. The study was conducted in 14 patients with P. knowlesi malaria between 2021 and 2022 in 4 districts of Phang-Nga Province, Thailand including Thapput, Kapong, Takuapa and Khuraburi. Results: The study subjects of P. knowlesi malaria were all males. Most of them were working age groups as farmers and worked in forest or plantation areas. All had no history of blood transfusions. Most of the patients did not use mosquito nets and had a history of camping in the forest prior to the onset of fever. An analysis of all 14 sources of infection unveiled the area is home to macaques, and that area has detected Anopheles mosquito, which is the carrier of the disease. Majority of them got sick in the dry season of Thailand (December-April). The main symptoms brought to the hospital were fever, chills, headache, body aches. Laboratory findings on the first day of diagnosis were as follows: The white blood cell count was found within the normal range. In the proportion of white blood cells, eosinophils were found to be slightly higher than normal. Slight anemia was found on early examination. The platelet count was found to be below normal in all cases. Severely low platelet count (2,000 cells/mm3) was found in severe cases with multiple complications. No patient was found dead but 85.7% of complications were found, with acute renal failure being the most common. Patients with delayed diagnosis and treatment of malaria (inaccurate diagnosis or late access to the hospital) had the highest severity and complications than those who had seen the doctor since the first 3-4 days of illness or the screening of symptoms and risk history by the malaria clinic staff at vector-borne disease control unit. Conclusion and Recommendation: P. knowlesi malaria is an emerging infectious disease transmitted from animals to humans. There are challenges in epidemiology, entomology, ecology for effective surveillance, prevention and control. Early diagnosis and treatment would reduce complications and prevent death.

Keywords: malaria, plasmodium knowlesi, epidemiology, ecology, entomology, diagnosis, treatment

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Authors: Kenneth Christie

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Syria and Iraq are Arabian nightmares at the local, the regional and global levels in terms of human security and the protection of the vulnerable. Wracked by civil war, ethnic and political violence in the last 5 years in the case of Syria and 13 years in the case of Iraq, the body count now is staggering; the humanitarian crisis continues and there appears no end to this. A crisis that has claimed the lives of 200,000 people so far in Syria, sparked a humanitarian catastrophe fuelled violent Islamic extremism and exposed serious splits in the international community who appear to have no consensus. The international community’s failure to act is simply another sign of the desperate situation which has developed over conflicts that appears unsolvable in the immediate future and may be intractable in the long range. Three things are really at stake I’m going to argue in these continuing crises and how it will affect the human security dimensions of the conflict. Firstly, the protection of vulnerable individuals and civilians in the war, 2ndly, the dire consequences for regional instability as a result and thirdly the risks for minority and ethnic identities who are caught up in this, within and across these volatile borders. This paper will examine these elements and the consequences of the conflict in terms of human security, migration and development.

Keywords: human security, migration, Syria and Iraq, conflict and development

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Authors: Ben Chater, Jingbang Pan, Mark Evernden, Jie Wang

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Traditional structural steel manufacturing routes normally produce prismatic members with flat plate elements. In these members, plate instability in the lowest buckling mode often dominates failure. It is proposed in the current study to use a new technology of metal 3D printing to print steel-plated elements with predefined imperfection patterns that can lead to higher modes of failure with increased buckling resistances. To this end, a numerical modeling program is carried out to explore various combinations of predefined buckling waves with different amplitudes in stainless steel square hollow section stub columns. Their stiffness, strength, and material consumption against the traditional structural steel members with the same nominal dimensions are assessed. It is found that depending on the slenderness of the plate elements; it is possible for an ‘imperfect’ steel member to achieve up to a 30% increase in strength with just a 3% increase in the material consumption. The obtained results shed some light on the significant potential of the new metal 3D printing technology in achieving unprecedented material efficiency and economical design in the future steel construction industry.

Keywords: 3D printing, additive manufacturing, buckling resistance, steel plate buckling, structural optimisation

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Authors: Kausar Ali

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There are several ground treatment techniques which may meet the twin objectives of increasing the bearing capacity with simultaneous reduction of settlements, but the use of stone columns is one of the most suited techniques for flexible structures such as embankments, oil storage tanks etc. that can tolerate some settlement and used worldwide. However, when the stone columns in very soft soils are loaded; stone columns undergo excessive settlement due to low lateral confinement provided by the soft soil, leading to the failure of the structure. The poor performance of stone columns under these conditions can be improved by encasing the columns with a suitable geosynthetic. In this study, the effect of reinforcement on bearing capacity of composite soil has been investigated by conducting laboratory model tests on floating and end bearing long stone columns with l/d ratio of 12. The columns were reinforced by providing geosynthetic encasement over varying column length (upper 25%, 50%, 75%, and 100% column length). In this study, a group of columns has been used instead of single column, because in the field, columns used for the purpose always remain in groups. The tests indicate that the encasement over the full column length gives higher failure stress as compared to the encasement over the partial column length for both floating and end bearing long columns. The performance of end-bearing columns was found much better than the floating columns.

Keywords: geosynthetic, ground improvement, soft clay, stone column

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Authors: Valerii Dashuk

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The usage of the confidence intervals in economics and econometrics is widespread. To be able to investigate a random variable more thoroughly, joint tests are applied. One of such examples is joint mean-variance test. A new approach for testing such hypotheses and constructing confidence sets is introduced. Exploring both the value of the random variable and its deviation with the help of this technique allows checking simultaneously the shift and the probability of that shift (i.e., portfolio risks). Another application is based on the normal distribution, which is fully defined by mean and variance, therefore could be tested using the introduced approach. This method is based on the difference of probability density functions. The starting point is two sets of normal distribution parameters that should be compared (whether they may be considered as identical with given significance level). Then the absolute difference in probabilities at each 'point' of the domain of these distributions is calculated. This measure is transformed to a function of cumulative distribution functions and compared to the critical values. Critical values table was designed from the simulations. The approach was compared with the other techniques for the univariate case. It differs qualitatively and quantitatively in easiness of implementation, computation speed, accuracy of the critical region (theoretical vs. real significance level). Stable results when working with outliers and non-normal distributions, as well as scaling possibilities, are also strong sides of the method. The main advantage of this approach is the possibility to extend it to infinite-dimension case, which was not possible in the most of the previous works. At the moment expansion to 2-dimensional state is done and it allows to test jointly up to 5 parameters. Therefore the derived technique is equivalent to classic tests in standard situations but gives more efficient alternatives in nonstandard problems and on big amounts of data.

Keywords: confidence set, cumulative distribution function, hypotheses testing, normal distribution, probability density function

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Authors: Anthony Coogan

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Born’s probability interpretation of wave functions would have led to nearly identical results had he chosen a frequency interpretation instead. Logically, Born may have assumed that only one electron was under consideration, making it nonsensical to propose a frequency wave. Author’s suggestion: the actual experimental results were not of a single electron; rather, they were groups of reflected x-ray photons. The vertical waveform used by Scrhödinger in his Particle in the Box Theory makes sense if it was intended to represent a quantum leap. The author extended the single vertical panel to form a bar chart: separate panels would represent different energy levels. The proposed bar chart would be populated by reflected photons. Expansion of basic ideas: Part of Scrhödinger’s ‘Particle in the Box’ theory may be valid despite negative criticism. The waveform used in the diagram is vertical, which may seem absurd because real waves decay at a measurable rate, rather than instantaneously. However, there may be one notable exception. Supposedly, following from the theory, the Uncertainty Principle was derived – may a Quantum Leap not be represented as an instantaneous waveform? The great Scrhödinger must have had some reason to suggest a vertical waveform if the prevalent belief was that they did not exist. Complex wave forms representing a particle are usually assumed to be continuous. The actual observations made were x-ray photons, some of which had struck an electron, been reflected, and then moved toward a detector. From Born’s perspective, doing similar work the years in question 1926-7, he would also have considered a single electron – leading him to choose a probability distribution. Probability Distributions appear very similar to Frequency Distributions, but the former are considered to represent the likelihood of future events. Born’s interpretation of the results of quantum experiments led (or perhaps misled) many researchers into claiming that humans can influence events just by looking at them, e.g. collapsing complex wave functions by 'looking at the electron to see which slit it emerged from', while in reality light reflected from the electron moved in the observer’s direction after the electron had moved away. Astronomers may say that they 'look out into the universe' but are actually using logic opposed to the views of Newton and Hooke and many observers such as Romer, in that light carries information from a source or reflector to an observer, rather the reverse. Conclusion: Due to the controversial nature of these ideas, especially its implications about the nature of complex numbers used in applications in science and engineering, some time may pass before any consensus is reached.

Keywords: complex wave functions not necessary, frequency distributions instead of wave functions, information carried by light, sketch graph of uncertainty principle

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Authors: Xue Wang, Liwei Fan

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Renewable energy technology innovation is an important way to realize the energy transformation. Our government has issued a series of policies to guide and support the development of renewable energy. The implementation of these policies will affect the further development, utilization and technological innovation of renewable energy. In this context, it is of great significance to systematically sort out and evaluate the renewable energy technology innovation policy for improving the existing policy system. Taking the 190 renewable energy technology innovation policies issued during 2005-2021 as a sample, from the perspectives of policy issuing departments and policy keywords, it uses text mining and content analysis methods to analyze the current situation of the policies and conduct a semantic network analysis to identify the core issuing departments and core policy topic words; A PMC (Policy Modeling Consistency) index model is built to quantitatively evaluate the selected policies, analyze the overall pros and cons of the policy through its PMC index, and reflect the PMC value of the model's secondary index The core departments publish policies and the performance of each dimension of the policies related to the core topic headings. The research results show that Renewable energy technology innovation policies focus on synergy between multiple departments, while the distribution of the issuers is uneven in terms of promulgation time; policies related to different topics have their own emphasis in terms of policy types, fields, functions, and support measures, but It still needs to be improved, such as the lack of policy forecasting and supervision functions, the lack of attention to product promotion, and the relatively single support measures. Finally, this research puts forward policy optimization suggestions in terms of promoting joint policy release, strengthening policy coherence and timeliness, enhancing the comprehensiveness of policy functions, and enriching incentive measures for renewable energy technology innovation.

Keywords: renewable energy technology innovation, content analysis, policy evaluation, PMC index model

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Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Almutazballlah Bassam Qablan, Jihan M. Muhaidat, bana Abu Rajab

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Background: Acne vulgaris is considered one of the most common skin conditions encountered by dermatologists. It is a chronic inflammation affecting the pilosebaceous unit. Although acne vulgaris is not fatal, it leads to permanent scarring and disfigurement, and even without scarring, it has a huge effect on patients, causing negative health outcomes. Acne vulgaris patients experience psychological, and emotional ramifications as those with chronic health problems; they feel depressed, angry, anxious, and confused. Although acne is a popular disease, many thoughts and myths are still discussed about its origins and triggering factors. These myths can make you feel guilt as if you were somehow responsible for your acne. In this case control study, we want to define the relationship between two modifiable risk factors ;BMI and smoking, with acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Ramtha, Jordan in 2019/2020. A total number of 325 participants between 14 and 33 years of age were interviewed by the authors; including 163 acne vulgaris cases and 162 controls without acne vulgaris. Anthropometric measures and smoking for Acne patients and control participants were the independent variables used to assess acne. Univariate and multivariate analysis were used to compare the characteristics of people who reported acne with those with no acne. The collected data analyzed by using the Statistical Package for Social Sciences (SPSS). Results: Cigarette smoking was highly associated with controls; odds ratio 0.4 (95% CI: 0.2–0.9) , P-value = 0.018. BMI and waterpipe smoking were statistically insignificant with acne in the multivariate analysis. Conclusion: We found that cigarette smoking was protective against Acne. There was a statistically insignificant relation between BMI, waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, adolescents, BMI, smoking, case-control, risk factors

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Authors: Yutong Wan, John N. Wood

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Introduction: SCN9A encoded Nav1.7 is an ideal therapeutic target with minimal side effects for the pharmaceutical industry because SCN9A variants can cause both human gains of function pain-related mutations and loss of function pain-free mutations. This study reviews the clinical effectiveness of existing Nav1.7 inhibitors, which theoretically should be powerful analgesics. Methods: A systematic review is conducted on the effectiveness of current Nav1.7 blockers undergoing clinical trials. Studies were mainly extracted from PubMed, U.S. National Library of Medicine Clinical Trials, World Health Organization International Clinical Trials Registry, ISRCTN registry platform, and Integrated Research Approval System by NHS. Only studies with full text available and those conducted using double-blinded, placebo controlled, and randomised designs and reporting at least one analgesic measurement were included. Results: Overall, 61 trials were screened, and eight studies covering PF 05089771 (Pfizer), TV 45070 (Teva & Xenon), and BIIB074 (Biogen) met the inclusion criteria. Most studies were excluded because results were not published. All three compounds demonstrated insignificant analgesic effects, and the comparison between PF 05089771 and pregabalin/ibuprofen showed that PF 05089771 was a much weaker analgesic. All three drug candidates only have mild side effects, indicating the potentials for further investigation of Nav1.7 antagonists. Discussion: The failure of current Nav1.7 small molecule inhibitors might attribute to ignorance of the key role of endogenous systems in Nav1.7 null mutants, the lack of selectivity and blocking potency, and central impermeability. The synergistic combination of analgesic drugs, a recent UCL patent, combining a small dose of Nav1.7 blockers and opioids or enkephalinase inhibitors dramatically enhanced the analgesic effects. Conclusion: The current clinical testing Nav1.7 blockers are generally disappointing. However, the newer generation of Nav1.7 targeting analgesics has overcome the major constraints of its predecessors.

Keywords: chronic pain, Nav1.7 blockers, SCN9A, systematic review

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Authors: Daniel Y. Abebe, Jaehyouk Choi

Abstract:

Link-to-column connection in eccentrically braced frames (EBF) has been a critical problem since the link flange connected to the column fractured prior to the required link rotation. Even though the problem in link-to-column connection still exist, the use of an eccentrically braced frame (EBF) is increasing day by day as EBF have high elastic stiffness, stable inelastic response under repeated lateral loading, and excellent ductility and energy dissipation capacity. In order to address this problem, a reduced web and flange link section is proposed and evaluated in this study. Reducing the web with holes makes the link to control the failure at the edge of holes introduced. Reducing the flange allows the link to control the location at which the plastic hinge is formed. Thus, the failure supposed to occur in the link flange connected at the connection move to the web and to the reduced link flange. Nonlinear FE analysis and experimental investigations have been done on the developed links, and the result shows that the link satisfies the plastic rotation limit recommended in AICS-360-10. Design equations that define the behavior of the proposed link have been recommended, and the equations were verified through the experimental and FE analysis results.

Keywords: EBFs, earthquake disaster, link-to-column connection, reduced link section

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Authors: A. GuhaRay, C. V. S. P. Kiranmayi, S. Rudraraju

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The present study considers the effect of variation of different geotechnical random variables in the design of stone column-foundation systems for assessing the bearing capacity and consolidation settlement of highly compressible soil. The soil and stone column properties, spacing, diameter and arrangement of stone columns are considered as the random variables. Probability of failure (P_f) is computed for a target degree of consolidation and a target safe load by Monte Carlo Simulation (MCS). The study shows that the variation in coefficient of radial consolidation (c_r) and cohesion of soil (c_s) are two most important factors influencing Pf. If the coefficient of variation (COV) of c_r exceeds 20%, P_f exceeds 0.001, which is unsafe following the guidelines of US Army Corps of Engineers. The bearing capacity also exceeds its safe value for COV of c_s > 30%. It is also observed that as the spacing between the stone column increases, the probability of reaching a target degree of consolidation decreases. Accordingly, design guidelines, considering both consolidation and bearing capacity of improved ground, are proposed for different spacing and diameter of stone columns and geotechnical random variables.

Keywords: bearing capacity, consolidation, geotechnical random variables, probability of failure, stone columns

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Authors: Osama Amer, Yaser Abdel-Aty, Mohamed Abd El Hady

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The present paper illustrates an experimental approach to provide understanding of the mechanical behavior and failure mechanisms of different typologies of unreinforced three-leaf masonry walls of historical Islamic architectural heritage in Egypt. The main objective of this study is to investigate the propagation of possible cracking, ultimate load, deformations and failure mechanisms. Experimental data on interface-shear and compression tests on large scale three-leaf masonry wallets are provided. The wallets were built basically of Egyptian limestone and modified lime mortar. External wallets were built of stone blocks while the inner leaf was built of rubble limestone. Different loading conditions and dimensions of core layer for two types of collar joints (with and without shear keys) are considered in the tests. Mechanical properties of the constituent materials of masonry were tested and a database of characteristic properties was created. The results of the experiments will highlight the properties, force-displacement curves, stress distribution of multiple-leaf masonry walls contributing to the derivation of rational design rules and validation of numerical models.

Keywords: masonry, three-leaf walls, mechanical behavior, testing, architectural heritage

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Authors: Nozar Kishi, Babak Kamrani, Filmon Habte

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Natural hazards such as earthquakes and tropical storms, are very frequent and highly destructive in Japan. Japan experiences, every year on average, more than 10 tropical cyclones that come within damaging reach, and earthquakes of moment magnitude 6 or greater. We have developed stochastic catastrophe models to address the risk associated with the entire suite of damaging events in Japan, for use by insurance, reinsurance, NGOs and governmental institutions. KCC’s (Karen Clark and Company) catastrophe models are procedures constituted of four modular segments: 1) stochastic events sets that would represent the statistics of the past events, hazard attenuation functions that could model the local intensity, vulnerability functions that would address the repair need for local buildings exposed to the hazard, and financial module addressing policy conditions that could estimates the losses incurring as result of. The events module is comprised of events (faults or tracks) with different intensities with corresponding probabilities. They are based on the same statistics as observed through the historical catalog. The hazard module delivers the hazard intensity (ground motion or wind speed) at location of each building. The vulnerability module provides library of damage functions that would relate the hazard intensity to repair need as percentage of the replacement value. The financial module reports the expected loss, given the payoff policies and regulations. We have divided Japan into regions with similar typhoon climatology, and earthquake micro-zones, within each the characteristics of events are similar enough for stochastic modeling. For each region, then, a set of stochastic events is developed that results in events with intensities corresponding to annual occurrence probabilities that are of interest to financial communities; such as 0.01, 0.004, etc. The intensities, corresponding to these probabilities (called CE, Characteristics Events) are selected through a superstratified sampling approach that is based on the primary uncertainty. Region specific hazard intensity attenuation functions followed by vulnerability models leads to estimation of repair costs. Extensive economic exposure model addresses all local construction and occupancy types, such as post-linter Shinand Okabe wood, as well as concrete confined in steel, SRC (Steel-Reinforced Concrete), high-rise.

Keywords: typhoon, earthquake, Japan, catastrophe modelling, stochastic modeling, stratified sampling, loss model, ERM

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Authors: Mianheng Lai, Johnny Ching Ming Ho, Hoat Joen Pam

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Concrete-filled-steel-tube (CFST) columns are becoming increasingly popular owing to the superior behavior contributed by the composite action. However, this composite action cannot be fully developed because of different dilation properties between steel tube and concrete. During initial compression, there will be de-bonding between the constitutive materials. As a result, the strength, initial stiffness and ductility of CFST columns reduce significantly. To resolve this problem, external confinement in the form of spirals is proposed to improve the interface bonding. In this paper, a total of 14CFST columns with high-strength as well as ultra-high-strength concrete in-filled were fabricated and tested under uni-axial compression. From the experimental results, it can be concluded that the proposed spirals can improve the strength, initial stiffness, ductility and the interface bonding condition of CFST columns by restraining the lateral expansion of steel tube and core concrete. Moreover, the failure modes of confined core concrete change due to the strong confinement provided by spirals.

Keywords: concrete-filled-steel-tube, confinement, failure mode, high-strength concrete, spirals

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Authors: Zahra Khazaeipour, Ehsan Ahmadipour, Vafa Rahimi-Movaghar, Fereshteh Ahmadipour

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Research Objectives: Chronic pain is one of the common problems associated with spinal cord injuries (SCI), which causes many complications. Therefore, this study intended to evaluate the relationship between pain and demographic, injury characteristics, socio-economic and social support in individuals with spinal cord Injury in Iran. Design: Descriptive cross-sectional study. Setting: Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran, between 2012 and 2013. Participants: The participants were 140 individuals with SCI, 101 (72%) men and 39 (28%) women, with mean age of 29.4 ±7.9 years. Main Outcome Measure: The Persian version of the Brief Pain Inventory (BPI) was used to measure the pain, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Results: About 50.7% complained about having pain, which 79.3% had bilateral pain. The most common locations of pain were lower limbs and back. The most quality of pain was described as aching (41.4%), and tingling (32.9%). Patients with a medium level of education had the least pain compared to high and low level of education. SCI individuals with good economic situation reported higher frequency of having pain. There was no significant relationship between pain and social support. There was positive correlation between pain and impairment of mood, normal work, relations with other people and lack of sleep (P < 0.001). Conclusion: These findings revealed the importance of socioeconomic factors such as economic situation and educational level in understanding chronic pain in people with SCI and provide further support for the bio-psychosocial model. Hence, multidisciplinary evaluations and treatment strategies are advocated, including biomedical, psychological, and psycho-social interventions.

Keywords: pain, social support, socio-economic indicators, spinal cord injury

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Authors: Elizabeth Laguaite, Alexandria Purdy

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Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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Authors: Yang Liandong

Abstract:

The rapid development of cities has triggered a series of urban health problems. Residents' daily lives have generally changed to long-term unhealthy work and rest, and the prevalence of chronic diseases in the population is on the rise. Promoting physical activity is an effective way to enhance the population's health and reduce the risk of various chronic diseases. As the most basic unit of the city, the community is the living space where residents use the highest frequency of daily activities and also the best space carrier for people to carry out all kinds of physical activities, and its planning research is of great significance for promoting physical activities. Under special conditions, the old communities in mountainous cities present compact and three-dimensional spatial characteristics, and there are problems such as disordered spatial organization, scattered distribution, and low utilization rates. This paper selects four communities in Daxigou Street, Yuzhong District, Chongqing as the research object, analyzes the current situation of the research cases through literature combing and field investigation and interviews, and puts forward the planning strategies for promoting physical activity in old communities in mountain cities from four aspects: building a convenient and smooth public space system, creating a diversified and shared activity space, creating a beautiful and healing community landscape, and providing convenient and perfect supporting facilities, to provide a certain reference for the healthy development of old communities in mountain cities.

Keywords: physical activity, community planning, old communities in mountain cities, public space optimization, spatial fairness

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Authors: Lawrence A. Farinola

Abstract:

Four point implicit schemes for the approximation of the first and pure second order derivatives for the solution of the Dirichlet problem for one dimensional Schrodinger equation with respect to the time variable t were constructed. Also, special four-point implicit difference boundary value problems are proposed for the first and pure second derivatives of the solution with respect to the spatial variable x. The Grid method is also applied to the mixed second derivative of the solution of the Linear Schrodinger time-dependent equation. It is assumed that the initial function belongs to the Holder space C⁸⁺ᵃ, 0 < α < 1, the Schrodinger wave function given in the Schrodinger equation is from the Holder space Cₓ,ₜ⁶⁺ᵃ, ³⁺ᵃ/², the boundary functions are from C⁴⁺ᵃ, and between the initial and the boundary functions the conjugation conditions of orders q = 0,1,2,3,4 are satisfied. It is proven that the solution of the proposed difference schemes converges uniformly on the grids of the order O(h²+ k) where h is the step size in x and k is the step size in time. Numerical experiments are illustrated to support the analysis made.

Keywords: approximation of derivatives, finite difference method, Schrödinger equation, uniform error

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Authors: Mohammad Nazri Mustafa, Sh Norliza Sy Salim, Pedram Hatami Abdullah

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Civil and structural assets normally have an average of more than 30 years of design life. Adding to this advantage, the assets are normally subjected to slow degradation process. Due to the fact that repair and strengthening work for these assets are normally not dependent on plant shut down, the maintenance and integrity restoration of these assets are mostly done based on “as required” and “run to failure” basis. However unlike other industries, the exposure in oil and gas environment is harsher as the result of corrosive soil and groundwater, chemical spill, frequent wetting and drying, icing and de-icing, steam and heat, etc. Due to this type of exposure and the increasing level of structural defects and rectification in line with the increasing age of plants, assets integrity assessment requires a more defined scope and procedures that needs to be based on risk and assets criticality. This leads to the establishment of risk based inspection and proactive maintenance procedure for civil and structural assets. To date there is hardly any procedure and guideline as far as integrity assessment and systematic inspection and maintenance of civil and structural assets (onshore) are concerned. Group Technical Solutions has developed a procedure and guideline that takes into consideration credible failure scenario, assets risk and criticality from process safety and structural engineering perspective, structural importance, modeling and analysis among others. Detailed inspection that includes destructive and non-destructive tests (DT & NDT) and structural monitoring is also being performed to quantify defects, assess severity and impact on integrity as well as identify the timeline for integrity restoration. Each defect and its credible failure scenario is assessed against the risk on people, environment, reputation and production loss. This technical paper is intended to share on the established procedure and guideline and their execution in oil & gas plants. In line with the overall roadmap, the procedure and guideline will form part of specialized solutions to increase production and to meet the “Operational Excellence” target while extending service life of civil and structural assets. As the result of implementation, the management of civil and structural assets is now more systematically done and the “fire-fighting” mode of maintenance is being gradually phased out and replaced by a proactive and preventive approach. This technical paper will also set the criteria and pose the challenge to the industry for innovative repair and strengthening methods for civil & structural assets in oil & gas environment, in line with safety, constructability and continuous modification and revamp of plant facilities to meet production demand.

Keywords: assets criticality, credible failure scenario, proactive and preventive maintenance, risk based inspection

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Authors: Elisavet Arsenaki

Abstract:

Paracetamol overdose is associated with significant and possibly permanent consequences including hepatotoxicity, acute and chronic liver failure, and death. This quality improvement project explores the prevalence of accidental iatrogenic paracetamol overdose in hospital patients with a low body weight, defined as <50kg and assesses the impact of educational posters in trying to reduce it. The study included all adult inpatients on the admissions ward, a short stay ward for patients requiring 12-72 hour treatment, and consisted of three cycles. Each cycle consisted of 3 days of data collection in a given month (data collection for cycle 1 occurred in January 2022, February 2022 for cycle 2 and March 2022 for cycle 3). All patients given paracetamol had their prescribed dose checked against their charted weight to identify the percentage of adult inpatients <50kg who were prescribed 1g of paracetamol instead of 500mg. In the first cycle of the audit, data were collected from 83 patients who were prescribed paracetamol on the admissions ward. Subsequently, four A4 educational posters were displayed across the ward, on two separate occasions and with a one-month interval in between each poster display. The aim of this was to remind prescribing doctors of their responsibility to check patient body weight prior to prescribing paracetamol. Data were collected again one week after each round of poster display, from 72 and 70 patients respectively. Over the 3 cycles with a cumulative 225 patients, 15 weighed <50kg (6.67%) and of those, 5 were incorrectly prescribed 1g of paracetamol, yielding a 33.3% prevalence of accidental iatrogenic paracetamol overdose in adult inpatients. In cycle 1 of the project, 3 out of 6 adult patients weighing <50kg were overdosed on paracetamol, meaning that 50% of low weight patients were prescribed the wrong dose of paracetamol for their weight. In the second data collection cycle, 1 out of 5 <50kg patients were overdosed (20%) and in the third cycle, 1 out of 4 (25%). The use of educational posters resulted in a lower prevalence of accidental iatrogenic paracetamol overdose in low body weight adult inpatients. However, the differences observed were statistically insignificant (p value 0.993 and 0.995 respectively). Educational posters did not induce a significant decrease in the prevalence of accidental iatrogenic paracetamol overdose. More robust strategies need to be employed to further decrease paracetamol overdose in patients weighing <50kg.

Keywords: iatrogenic, overdose, paracetamol, patient, safety

Procedia PDF Downloads 110