Search results for: dialysis adequacy

Authors: Mazlynda Md Yusuf, Wafa' Mahadzir, Mohamad Yazis Ali Basah

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Nowadays, financing long-term care for elderly people is a crucial issue, either towards the family members or the care institution. Corresponding with the growing number of ageing population in Malaysia, there’s a need of concern on the uncertaintiness of future family care and the need for long-term care services. Moreover, with the increasing cost of living, children feels the urge of needing to work and receive a fixed monthly income that results to sending their elderly parents to care institutions. Currently, in Malaysia, the rates for private nursing homes can amount up to RM 4,000 per month excluding medical treatments and other recurring expenses. These costs are expected to be paid using their Employees Provident Fund (EPF) savings that they accumulate during their working years, especially for those working under private sectors. Hence, this study identifies the adequacy of EPF in funding the cost of long-term care service during old age. This study used a hypothetical simulation model to simulate different scenarios. The findings of this study could be used for individuals to prepare on the importance of planning for retirement, especially with the increasing cost of long-term care services.

Keywords: long-term care cost, employees provident fund Malaysia, ageing population, Malaysian elderly

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Authors: Fabiana Souza Orlandi, Izabel Cristina Chavez Gomes, Barbara Isabela De Paula Morais, Ana Carolina Ottaviani

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Chronic Kidney Disease (CKD) is considered a public health problem. Patients who present CKD in their more advanced stages usually present several biopsychosocial changes, which may include pain. Pain can be considered subjective and personal, and its perception is characterized as a multidimensional experience. The objective of this study was to evaluate the level and descriptors of pain of adults and elderly patients with chronic kidney disease, through the Multidimensional Pain Evaluation Scale (EMADOR). This is a descriptive cross-sectional study with a quantitative approach. The sample consisted of 100 subjects with CKD in hemodialysis treatment at a Renal Replacement Therapy Service in the interior of the state of São Paulo. Data were collected through an individual interview, using a Sociodemographic Characterization and Multidimensional Pain Evaluation Scale (EMADOR). All ethical precepts were respected. The majority of the respondents were men (61.0%), white (56.0%) and with a high school education (34.0%). Regarding the pain of the individuals, 89 patients reported pain, with Chronic Pain predominating (50.0%, n = 50), followed by Acute Pain (39.0%, n = 39). Of the subjects who presented acute pain most of the 89.0% described the pain felt as unbearable, and of those who presented chronic pain, 35.0% described the pain felt as painful, unbearable and uncomfortable. It was concluded that there was a significant presence of pain, being the chronic pain dominant in the studied population. Faced with such factors, the present study motivates researches in this population, in order to establish interventions with the objective of improving the quality of life of these individuals.

Keywords: pain, chronic kidney disease, dialysis, evaluation

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Authors: Ntandoyenkosi Moyo

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Majority of rural Eastern Cape villages of South Africa households do not have access to safe water supply. Due to changes in climatic conditions for example higher temperatures, these sources become not reliable in supplying adequate and safe water to the population. These rural populations due to the drying up of water resources have to find other alternative ways to get water. Climate change has an impact on the reliability of water resources and this has an impact on rural communities. This study seeks to establish what alternative ways do people use when affected by unfavorable conditions like less rainfall and increased temperatures. The study also seeks to investigate any local and provincial intervention in the provision of water to the village. Interventions can be in the form of programmes or initiatives that involve water supply strategies. The community should participate fully in making sure that their place is serviced. The study will identify households with improved sources (JOJO tanks) and those with unimproved sources (rivers) and investigate what alternatives they resort to when their sources dry up. The study also investigates community views on whether they have any challenges of water supply (reliability and adequacy) as required by section 27(1) (b) of the constitution which states that everyone should have access to safe and clean water.

Keywords: rural water resources, temperature, improved sources, unimproved sources

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Authors: Min Wu, Shuming Shen, Xuhong Yang, Rencheng Tang

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Every year, numerous organic wastes from fiber byproducts of the wool textile industry, poor quality raw wools not fit for spinning, horns, nails and feathers from butchery are disposed. These wastes are abundant in keratin which is a renewable material. Wool fiber/keratin/PVA composites with different proportions were prepared in this study, and the influence of the proportions on their structure and properties were studied, aiming to understand the potential application of keratin in the field of biomedicine, degradable wrapper, and cosmetics film, and provide a new way to reuse keratin wastes. The urea / sodium sulfide / sodium dodecyl sulfate (SDS) method was used to dissolve the wool. After filtration and dialysis, the wool keratin solution was achieved. Then the keratin solution and polyvinal (PVA) solution were blended in different proportions, and the wool fibers cut into a certain length were cast into the blended solution. Thereby, various wool fiber/keratin/PVA composite films with different proportions were formed through pouring the solution into a flat box and drying at room temperature. The surface morphology, molecular structure, and mechanical property of the composite films were studied. The results showed that, there are α-helix structure, β-sheet and random coil conformations in the pure keratin film, as well as in the wool fiber. Compared with wool fiber, the crystallinity of keratin decreased. PVA can obviously improve the mechanical property of the blended film. When the blended ratio of keratin and PVA is 20:80, the mechanical property of the blended film is greatly improved. The composite films with 8%-16% of wool fibers have better flexibility than those without wool fibers.

Keywords: composite film, keratin, mechanical property, morphological structure, PVA, wool fiber

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Authors: Souheila Zemmouchi

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Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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Authors: Myriam Ferreira

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Websites and social networks allow museums to divulge their works by new and attractive means. Besides, these technologies provide tools to generate a new history of art’s contents and promote visits to their installations. At the same time, museums are proposing more and more activities to families, children and young people. However, these activities usually take place in the museum’s physical installations, while websites and social networks seem to be mainly targeted to adults. The problem is that being children and young people digital natives, they feel apart from museums, so they need a presence of museums in digital means to feel attracted to them. Some institutions are making efforts to fill this vacuum. In this paper, resources designed specifically for children and teenagers have been selected from websites and social networks of five Spanish Museums: Prado Museum, Thyssen Museum, Guggenheim Museum, America Museum and Cerralbo Museum. After that, we have carried out an investigation in a school with children and teenagers between 11 and 15 years old. Those young people have been asked about their valuation of those web pages and social networks, with quantitative-qualitative questions. The results show that the least rated resources were videos and social networks because they were considered ‘too serious’, while the most rated were games and augmented reality. These ratings confirm theoretical papers that affirm that the future of technologies applied to museums is edutainment and interaction.

Keywords: children, museums, social networks, teenagers, websites

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Authors: Ayeni Margaret Foluso, K. A. Omotayo

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This study investigated the impact of selected environmental variables as determinants of students’ achievements in biology in secondary schools. The selected environmental variables are class size and laboratory adequacy. The purpose was to find out whether these environmental variables can bring about improvement in the learning of biology by Senior Secondary School Students. The study design used was descriptive research of the survey type. Two instruments were used that is, Biology Achievement Test and School Environment Questionnaire .The population of the study consisted of all Biology students in both public and private Senior Secondary Schools class III (SSIII) in all the three selected states in South West Nigeria. A sample of 900 Biology students and 45 Biology Teachers from both public and private Senior Secondary Schools Class III were used. Two research hypotheses were generated for the study. The data collected were subjected to both descriptive statistics of mean and standard deviation; and the inferential statistics of regression Analyses was employed to test the hypotheses formulated. From the results, it was revealed that the selected environmental variables had influence on the students’ achievement in biology.

Keywords: environmental variables, determinants, students’ achievement, school science

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Authors: Ashraf Mohammed M. Eid, Hossam El Badry

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The bored pile friction resistance may be affected by many factors such as the method of construction, pile length and diameter, the soil properties, as well as the depth below ground level. These factors can be represented analytically to study the influence of diameter on the unit skin friction. In this research, the Egyptian Code of soil mechanics is used to assess the skin friction capacity for either the ordinary pile diameter as well as for the large pile diameter. The later is presented in the code and through the work of some researchers based on the results of investigations adopted for a sufficient number of field tests. The comparative results of these researchers with respect to the Egyptian Code are used to check the adequacy of both methods. Based on the results of this study, the traditional static formula adopted for piles of diameter less than 60 cm may be continually used for larger piles by correlating the analyzed formulae. Accordingly, the corresponding modified angle of internal friction is concluded demonstrating a reduction of shear strength due to soil disturbance along the pile shaft. Based on this research the difference between driven piles and bored piles constructed in same soil can be assessed and a better understanding can be evaluated for the effect of different factors on pile skin friction capacity.

Keywords: large piles, static formula, friction piles, sandy soils

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Authors: Aran Dezhban, Hooshang Dolatshahi Pirooz

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The phenomenon of corrosion, especially in the Persian Gulf region, is the main cause of the deterioration of offshore platforms, due to the high corrosion of its water. This phenomenon occurs mostly in the area of water spraying, threatening the members of the first floor of the jacket, legs, and piles in this area. In the current study, the effect of bracing arrangement on the Capacity Curve and Reserve Strength Ratio of Fixed-Type Offshore Platforms is investigated. In order to continue the operation of the platform, two modes of robust and damaged structures are considered, while checking the adequacy of the platform capacity based on the allowable values of API RP-2SIM regulations. The platform in question is located in the Persian Gulf, which is modeled on the OpenSEES software. In this research, the Nonlinear Pushover Analysis has been used. After validation, the Capacity Curve of the studied platforms is obtained and then their Reserve Strength Ratio is calculated. Results are compared with the criteria in the API-2SIM regulations.

Keywords: fixed-type jacket structure, structural integrity management, nonlinear pushover analysis, robust and damaged structure, reserve strength ration, capacity curve

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Authors: W. Pungchompoo, A. Richardson, L. Brindle

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Background: The developing of a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire) is an essential instrument for evaluation health services provision of older persons with ESRD in Thailand. The focus of the questionnaire was on symptoms, symptom control and the health care needs of older people with ESRD who are managed without dialysis. Objective: The objective of this study was to develop and adapt VOICES to make it suitable for use in a population survey in Thailand. Methods: The mixed methods exploratory sequential design was focussed on modifying an instrument. Data collection: A cognitive interviewing technique was implemented, using two cycles of data collection with a sample of 10 bereaved carers and a prototype of the Thai VOICES questionnaire. Qualitative study was used to modify the developing a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire). Data analysis: The data were analysed by using content analysis. Results: The revisions to the prototype questionnaire were made. The results were used to adapt the VOICES questionnaire for use in a population-based survey with older ESRD patients in Thailand. Conclusions: A culturally specific questionnaire was generated during this second phase and issues with questionnaire design were rectified.

Keywords: VOICES-ESRD/Thai questionnaire, cognitive interviewing, end of life survey, health services provision, older persons with ESRD

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Authors: Swati Gupta, Shagun Sodhani, Dhaval Patel, Biplab Banerjee

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It is generic that news sources publish news in different broad categories. These categories can either be generic such as Business, Sports, etc. or time-specific such as World Cup 2015 and Nepal Earthquake or both. It is up to the news agencies to build the categories. Extracting news categories automatically from numerous online news sources is expected to be helpful in many applications including news source recommendations and time specific news category extraction. To address this issue, existing systems like DMOZ directory and Yahoo directory are mostly considered though they are mostly human annotated and do not consider the time dynamism of categories of news websites. As a remedy, we propose an approach to automatically extract news category URLs from news websites in this paper. News category URL is a link which points to a category in news websites. We use the news category URL as a prior knowledge to develop a news source recommendation system which contains news sources listed in various categories in order of ranking. In addition, we also propose an approach to rank numerous news sources in different categories using various parameters like Traffic Based Website Importance, Social media Analysis and Category Wise Article Freshness. Experimental results on category URLs captured from GDELT project during April 2016 to December 2016 show the adequacy of the proposed method.

Keywords: news category, category network, news sources, ranking

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Authors: Neeraj Gupta, Jitendra Mahakud

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The banking system plays a major role in the Indian economy. Banking system is the payment gateway of most of the financial transactions. Banking has gone a major transition that is still in progress. Recent banking reforms after liberalization in 1991 have led to the establishment of the foreign banks in the country. The foreign banks are not listed in the Indian stock markets and have increased the competition leading to the capture of the significant share in the revenue from the public sector banks which are still the major players in the Indian banking sector. The performance of the banking sector depends on the internal (bank specific) as well as the external (market specific and macroeconomic) factors. Profitability in banking sector is affected by numerous factors which can be internal or external. The present study examines these internal and external factors which are likely to effect the profitablilty of the Indian banks. The sample consists of a panel dataset of 64 commercial banks in India, consisting of 1088 observations over the years from 1998 to 2016. The GMM dynamic panel estimation given by Arellano and Bond has been used. The study revealed that the variables capital adequacy ratio, deposit, age, labour productivity, non-performing asset, inflation and concentration have significant effect on performance measured.

Keywords: banks in India, bank performance, bank productivity, banking management

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Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

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The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

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Authors: Noora Al-Shanfari, M. Mazharul Islam

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The cumulative incidence function (CIF) is a fundamental approach for analyzing survival data in the presence of competing risks, which estimates the marginal probability for each competing event. Parametric modeling of CIF has the advantage of fitting various shapes of CIF and estimates the impact of covariates with maximum efficiency. To calculate the total CIF's covariate influence using a parametric model., it is essential to parametrize the baseline of the CIF. As the CIF is an improper function by nature, it is necessary to utilize an improper distribution when applying parametric models. The Gompertz distribution, which is an improper distribution, is limited in its applicability as it only accounts for monotone hazard shapes. The generalized Gompertz distribution, however, can adapt to a wider range of hazard shapes, including unimodal, bathtub, and monotonic increasing or decreasing hazard shapes. In this paper, the generalized Gompertz distribution is used to parametrize the baseline of the CIF, and the parameters of the proposed model are estimated using the maximum likelihood approach. The proposed model is compared with the existing Gompertz model using the Akaike information criterion. Appropriate statistical test procedures and model-fitting criteria will be used to test the adequacy of the model. Both models are applied to the ‘colon’ dataset, which is available in the “biostat3” package in R.

Keywords: competing risks, cumulative incidence function, improper distribution, parametric modeling, survival analysis

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi

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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.

Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus

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Authors: Muhammad Ridho Fakhrin, Leni Sagita Riantini, Yusuf Latief

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Based on the 2015-2019 RPJMN data, the realization of toll road infrastructure development in Indonesia experienced a delay of 49% or 904 km of the total plan. One of the major causes of delays in development is caused by institutional factors. The case study taken in this research is the construction of the Trans Sumatra Toll Road (JTTS). The purpose of this research is to identify the institutional forms, functions, roles, duties, and responsibilities of each stakeholder and the risks that occur in the Trans Sumatra Toll Road Infrastructure Development. Risk analysis is implemented on functions, roles, duties, responsibilities of each existing stakeholder and is carried out at the Funding Stage, Technical Planning Stage, and Construction Implementation Stage in JTTS. This research is conducted by collecting data through a questionnaire survey, then processed using statistical methods, such as homogeneity, data adequacy, validity, and reliability test, continued with risk assessment based on a risk matrix. The results of this study are the evaluation and development of institutional functions in risk-based JTTS development can improve time performance and minimize delays in the construction process.

Keywords: institutional, risk management, time performance, toll road

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Authors: Cynthia G. Esquerre, Amparo Iris Zavaleta

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Extremophiles constitute a potentially valuable source of proteases for the development of biotechnological processes; however, the number of available studies in the literature is limited compared to mesophilic counterparts. Therefore, in this study, Peruvian halophilic microorganisms were characterized to select suitable proteolytic strains that produce active proteases under exigent conditions. Proteolysis was screened using the streak plate method with gelatin or skim milk as substrates. After that, proteolytic microorganisms were selected for phenotypic characterization and screened by a semi-quantitative proteolytic test using a modified method of diffusion agar. Finally, proteolysis was evaluated using partially purified extracts by ice-cold ethanol precipitation and dialysis. All analyses were carried out over a wide range of NaCl concentrations, pH, temperature and substrates. Of a total of 60 strains, 21 proteolytic strains were selected, of these 19 were extreme halophiles and 2 were moderates. Most proteolytic strains demonstrated differences in their biochemical patterns, particularly in sugar fermentation. A total of 14 microorganisms produced extracellular proteases, 13 were neutral, and one was alkaline showing activity up to pH 9.0. Proteases hydrolyzed gelatin as the most specific substrate. In general, catalytic activity was efficient under a wide range of NaCl (1 to 4 M NaCl), temperature (37 to 55 °C) and after an ethanol exposition performed at -20 °C for 24 hours. In conclusion, this study reported 14 candidates extremely halophiles producing extracellular proteases capable of being stable and active on a wide range of NaCl, temperature and even long lasting ethanol exposition.

Keywords: biotechnological processes, ethanol exposition, extracellular proteases, extremophiles

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Authors: Bouthiba Amina

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The estimation of the statistics bound to the precipitation represents a vast domain, which puts numerous challenges to meteorologists and hydrologists. Sometimes, it is necessary, to approach in value the extreme events for sites where there is little, or no datum, as well as their periods of return. The search for a model of the frequency of the heights of daily rains dresses a big importance in operational hydrology: It establishes a basis for predicting the frequency and intensity of floods by estimating the amount of precipitation in past years. The most known and the most common approach is the statistical approach, It consists in looking for a law of probability that fits best the values observed by the random variable " daily maximal rain " after a comparison of various laws of probability and methods of estimation by means of tests of adequacy. Therefore, a frequent analysis of the annual series of daily maximal rains was realized on the data of 54 pluviometric stations of the pond of high and average. This choice was concerned with five laws usually applied to the study and the analysis of frequent maximal daily rains. The chosen period is from 1970 to 2013. It was of use to the forecast of quantiles. The used laws are the law generalized by extremes to three components, those of the extreme values to two components (Gumbel and log-normal) in two parameters, the law Pearson typifies III and Log-Pearson III in three parameters. In Algeria, Gumbel's law has been used for a long time to estimate the quantiles of maximum flows. However, and we will check and choose the most reliable law.

Keywords: return period, extreme flow, statistics laws, Gumbel, estimation

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Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Kamel Abd Elaziz Mohamed

Abstract:

Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: Aruna Kemisola Kehinde, Oyinloye Michael Ajide, Aboluje Oluwafemi Bolarinwa

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The development of the nation's overall growth is directly impacted by the vital substructure of the transportation system. The majority of developing countries experience issues with road transportation, including limited and low-quality infrastructure. The study assessed intra-city road infrastructure in Ado-Ekiti with a view to identifying its adequacy and functionality for efficient transport in the town. To this end, the study examined the locations of the road infrastructure, characteristics of the road infrastructure, and condition of the road infrastructure. A systematic random sampling method was adopted to select respondents for the study. Data were sourced from both primary and secondary sources. A 2.5% of 20,160 households, amounting to 503 households, was used as the sample size. Data analysis was based on responses from 500 questionnaires retrieved, and the data were analyzed using descriptive statistics. The results of this study showed that based on the locations of road infrastructure, disparity exists in the distribution of infrastructure amongst the major roads. Inferences from the results gathered also demonstrated that the infrastructure that is available is very much less than the non-available infrastructure. About 50% of the respondents are satisfied that the condition of road infrastructure in Ado-Ekiti is fair. The study's recommendations for the Ekiti state government include quantifying the number of existing road infrastructure, establishing a state maintenance board to expedite their renovation, and diversifying its goals for providing road infrastructure through public-private partnership (PPP) agreements with the private sector.

Keywords: road transportation, infrastructure, availability, intra-city

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Authors: Parsa Mahdavi, M. Amin Hariri-Ardebili

Abstract:

The development of accurate machine learning and deep learning models traditionally demands hands-on expertise and a solid background to fine-tune hyperparameters. With the continuous expansion of datasets in various scientific and engineering domains, researchers increasingly turn to machine learning methods to unveil hidden insights that may elude classic regression techniques. This surge in adoption raises concerns about the adequacy of the resultant meta-models and, consequently, the interpretation of the findings. In response to these challenges, automated machine learning (AutoML) emerges as a promising solution, aiming to construct machine learning models with minimal intervention or guidance from human experts. AutoML encompasses crucial stages such as data preparation, feature engineering, hyperparameter optimization, and neural architecture search. This paper provides a comprehensive overview of the principles underpinning AutoML, surveying several widely-used AutoML platforms. Additionally, the paper offers a glimpse into the application of AutoML on various engineering datasets. By comparing these results with those obtained through classical machine learning methods, the paper quantifies the uncertainties inherent in the application of a single ML model versus the holistic approach provided by AutoML. These examples showcase the efficacy of AutoML in extracting meaningful patterns and insights, emphasizing its potential to revolutionize the way we approach and analyze complex datasets.

Keywords: automated machine learning, uncertainty, engineering dataset, regression

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Authors: Sihyun Chae, Ryoto Arai, Waldo Concepcion, Paula Popescu

Abstract:

The kidneys perform an important role in the human hormones that regulate the blood pressure, produce an active form of vitamin D and control the production of red blood cells. Kidney disease can cause health problems, such as heart disease. Also, increase the chance of having a stroke or heart attack. There are mainly to types of treatments for kidney disease, dialysis, and kidney transplant. For a better quality of life, the kidney transplant is desirable. However, kidney transplant can cause antibody reaction and patients’ body would be attacked by immune system of their own. For solving that issue, patients with transplanted kidney always take immunosuppressive drugs which can hurt kidney as side effects. Patients willing to do a kidney transplant have a waiting time of 3.6 years in average searching to find an appropriate kidney, considering there are almost 96,380 patients waiting for kidney transplant. There is a promising method to solve these issues: bioartificial kidney. Our membrane is specially designed with unique perforations capable to filter the blood cells separating the white blood cells from red blood cells. White blood cells will not pass through the encapsulated kidney preventing the immune system to attack the new organ and eliminating the need of a matching donor. It is possible to construct life-time long encapsulation without needing pumps or a power supply on the cell’s separation method preventing futures surgeries due the Cross-Channel Flow inside the device. This technology allows the possibility to use an animal kidney, prevent cancer cells to spread through the body, arm and leg transplants in the future. This project aims to improve the quality of life of patients with kidney disease.

Keywords: kidney encapsulation, immunosuppression filter, leukocyte filter, leukocyte

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Authors: Josif Figueroa, Kush Bubbar, Greg Young-Morris

Abstract:

The reliability evaluation of composite generation and bulk transmission systems is crucial for ensuring a reliable supply of electrical energy to significant system load points. However, evaluating adequacy indices using probabilistic methods like sequential Monte Carlo Simulation can be computationally expensive. Despite this, it is necessary when time-varying and interdependent resources, such as renewables and energy storage systems, are involved. Recent advances in solving power network optimization problems and parallel computing have improved runtime performance while maintaining solution accuracy. This work introduces CompositeSystems, an open-source Composite System Reliability Evaluation tool developed in Julia™, to address the current deficiencies of commercial and non-commercial tools. This work introduces its design, validation, and effectiveness, which includes analyzing two different formulations of the Optimal Power Flow problem. The simulations demonstrate excellent agreement with existing published studies while improving replicability and reproducibility. Overall, the proposed tool can provide valuable insights into the performance of transmission systems, making it an important addition to the existing toolbox for power system planning.

Keywords: open-source software, composite system reliability, optimization methods, Monte Carlo methods, optimal power flow

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Authors: Noof Eid Al Shammari

Abstract:

Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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Authors: Kakali Bhadra

Abstract:

Binding of small molecules to DNA and recently to RNA, continues to attract considerable attention for developing effective therapeutic agents for control of gene expression. This work focuses towards understanding interaction of harmalol, a dihydro beta-carboline alkaloid, with different nucleic acid motifs viz. double stranded CT DNA, single stranded A-form poly(A), double-stranded A-form of poly(C)·poly(G) and clover leaf tRNAphe by different spectroscopic, calorimetric and molecular modeling techniques. Results of this study converge to suggest that (i) binding constant varied in the order of CT DNA > poly(C)·poly(G) > tRNAphe > poly(A), (ii) non-cooperative binding of harmalol to poly(C)·poly(G) and poly(A) and cooperative binding with CT DNA and tRNAphe, (iii) significant structural changes of CT DNA, poly(C)·poly(G) and tRNAphe with concomitant induction of optical activity in the bound achiral alkaloid molecules, while with poly(A) no intrinsic CD perturbation was observed, (iv) the binding was predominantly exothermic, enthalpy driven, entropy favoured with CT DNA and poly(C)·poly(G) while it was entropy driven with tRNAphe and poly(A), (v) a hydrophobic contribution and comparatively large role of non-polyelectrolytic forces to Gibbs energy changes with CT DNA, poly(C)·poly(G) and tRNAphe, and (vi) intercalated state of harmalol with CT DNA and poly(C)·poly(G) structure as revealed from molecular docking and supported by the viscometric data. Furthermore, with competition dialysis assay it was shown that harmalol prefers hetero GC sequences. All these findings unequivocally pointed out that harmalol prefers binding with ds CT DNA followed by ds poly(C)·poly(G), clover leaf tRNAphe and least with ss poly(A). The results highlight the importance of structural elements in these natural beta-carboline alkaloids in stabilizing different DNA and RNA of various motifs for developing nucleic acid based better therapeutic agents.

Keywords: calorimetry, docking, DNA/RNA-alkaloid interaction, harmalol, spectroscopy

Procedia PDF Downloads 216

Authors: Mahmoudi Marwa, Bahim Nadhem, Aydi Abdelwaheb, Issaoui Wissal, S. Najet

Abstract:

This work represents a coupling between the geographic information system (GIS) and the multicriteria analysis aiming at the selection of an artificial recharge site by the treated wastewater for the Ariana governorate. On regional characteristics, bibliography and available data on artificial recharge, 13 constraints and 5 factors were hierarchically structured for the adequacy of an artificial recharge. The factors are subdivided into two main groups: environmental factors and economic factors. The adopted methodology allows a preliminary assessment of a recharge site, the weighted linear combination (WLC) and the analytical hierarchy process (AHP) in a GIS. The standardization of the criteria is carried out by the application of the different membership functions. The form and control points of the latter are defined by the consultation of the experts. The weighting of the selected criteria is allocated according to relative importance using the AHP methodology. The weighted linear combination (WLC) integrates the different criteria and factors to delineate the most suitable areas for artificial recharge site selection by treated wastewater. The results of this study showed three potential candidate sites that appear when environmental factors are more important than economic factors. These sites are ranked in descending order using the ELECTRE III method. Nevertheless, decision making for the selection of an artificial recharge site will depend on the decision makers in force.

Keywords: artificial recharge site, treated wastewater, analytical hierarchy process, ELECTRE III

Procedia PDF Downloads 151

Authors: Margarida Maria Cabugueira Csutódio dos Santos, Joana Filipa Pintéus Pereira

Abstract:

The way children understand the concept of health and illness influences their reaction in contexts where these concepts are present (e.g.,illness; vaccination). The recognition of the importance of children's beliefs/representations about health and disease has led to the development of models that seek to explain the development process of these concepts. In the construction of their representations, children are influenced not only by their cognitive competence but also by their life experiences. In the last 3 years, children have experienced a pandemic health crisis that has exposed them to anomalous and stressful situations. Objective: the aim of this study was (1) to identify children’s representations about disease (including symptoms, causes, control/treatment) and prevention (including health procedures and vaccines) and (2) whether COVID19 is mentioned and influences their representations. Methodology: a qualitative study in which 67 children with 7 to 10 years old (mean 8,8) participated. A semi-structured interview was used following the Bibace and Walsh model, focusing on the representation of the disease and its prevention. Results show a marked influence of the lived experience with regard to causes of the disease, disease control and treatment, and adherence to vaccination. Age-dependent differences were found with older children being able to talk about illness and contamination process and younger displaying more basic, concrete and rigid representations. Conclusions: The results of this study bring clues to the adequacy of communication with the child in the context of health and illness and discriminately in a future health pandemic crisis.

Keywords: childen, health beliefs, pediatrics, covid19, vaccines

Procedia PDF Downloads 69

Authors: Abdurrauf M. Gusbi, Mahmud H. Arhima, Abdurrahim A. Elouzi, Ebtisam A. Benomran, Salsabeela Elmezwghi, Aram Elhatan, Nafesa Elgusbi

Abstract:

Mass poisonings with methanol are rare but occur regularly both in developed and in non-developing countries. As a result of the tragedy that happened in the city of Tripoli Libya in March during year 2013 a number of patients were admitted to Tripoli Medical Center and Tripoli Central Hospital suffering from poisoning following ingestion of methanol by mistake. Our aims have been formulated to collect Information about those cases as much as we can from the archiving departments from the two hospitals including the number of cases that had been admitted, recovered patients and died victims. This retrospective study was planned to find out the reasons which allow those patients to drink methanol in our Muslim community and also the role of pharmacist to prevent such a disaster that claimed the lives of many people. During this tragedy 291 ospitalized patients their ages between 16-32 years old were admitted to both hospitals, total number of died 189 (121 at Tripoli medical center) and (68 at Tripoli central hospital), demographic data also shows that most of them are male (97%) and (3% female), about 4% of the patients foreigners and 96% were Libyans. There were a lot of obstacles and poor facilities at the time of patient admission as recognized in many cases including lack of first line of treatment. The morbidity was high due to the lack of antidote and availability of dialysis machines at this two main hospitals in Tripoli also according to survey done to the medical staff and also a random number of medical students shows about 28% have no idea about the first aid procedure used for methanol poisoning cases and this due to the absence of continuing education for all medical staff through the establishment of training courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.

Keywords: ethanol, fomepizole, methanol, poisoning

Procedia PDF Downloads 349