Search results for: medical records

Authors: Naohiro Nakamura, Takuya Kinoshita, Hiroshi Fukuyama

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The 2011 off The Pacific Coast of Tohoku Earthquake caused considerable damage to wide areas of eastern Japan. A large number of earthquake observation records were obtained at various places. To design more earthquake-resistant buildings and improve earthquake disaster prevention, it is necessary to utilize these data to analyze and evaluate the behavior of a building during an earthquake. This paper presents an earthquake response simulation analysis (hereafter a seismic response analysis) that was conducted using data recorded during the main earthquake (hereafter the main shock) as well as the earthquakes before and after it. The data were obtained at a high-rise steel-reinforced concrete (SRC) building in the bay area of Tokyo. We first give an overview of the building, along with the characteristics of the earthquake motion and the building during the main shock. The data indicate that there was a change in the natural period before and after the earthquake. Next, we present the results of our seismic response analysis. First, the analysis model and conditions are shown, and then, the analysis result is compared with the observational records. Using the analysis result, we then study the effect of soil-structure interaction on the response of the building. By identifying the characteristics of the building during the earthquake (i.e., the 1st natural period and the 1st damping ratio) by the Auto-Regressive eXogenous (ARX) model, we compare the analysis result with the observational records so as to evaluate the accuracy of the response analysis. In this study, a lumped-mass system SR model was used to conduct a seismic response analysis using observational data as input waves. The main results of this study are as follows: 1) The observational records of the 3/11 main shock put it between a level 1 and level 2 earthquake. The result of the ground response analysis showed that the maximum shear strain in the ground was about 0.1% and that the possibility of liquefaction occurring was low. 2) During the 3/11 main shock, the observed wave showed that the eigenperiod of the building became longer; this behavior could be generally reproduced in the response analysis. This prolonged eigenperiod was due to the nonlinearity of the superstructure, and the effect of the nonlinearity of the ground seems to have been small. 3) As for the 4/11 aftershock, a continuous analysis in which the subject seismic wave was input after the 3/11 main shock was input was conducted. The analyzed values generally corresponded well with the observed values. This means that the effect of the nonlinearity of the main shock was retained by the building. It is important to consider this when conducting the response evaluation. 4) The first period and the damping ratio during a vibration were evaluated by an ARX model. Our results show that the response analysis model in this study is generally good at estimating a change in the response of the building during a vibration.

Keywords: ARX model, response analysis, SRC building, the 2011 off the Pacific Coast of Tohoku Earthquake

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Authors: Devanshu Gupta, Kailash Chandra, Priyanka Das, Joyjit Ghosh

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Beetles, in the insect order Coleoptera are the most species-rich group on this planet today. They represent about 40% of the total insect diversity of the world. With a considerable range of landform types including significant mountain ranges, deserts, fertile irrigational plains, and hilly forested areas, India is one of the mega-diverse countries and includes more than 0.1 million faunal species. Despite having rich biodiversity, the efforts to catalogue the beetle diversity of the extant species/taxa reported from India have been less. Therefore, in this paper, the information on the beetle fauna of India is provided based on the data available with the museum collections of Zoological Survey of India and taxa extracted from zoological records and published literature. The species were listed with their valid names, synonyms, type localities, type depositories, and their distribution in states and biogeographic zones of India. The catalogue also incorporates the bibliography on Indian Coleoptera. The exhaustive species inventory, prepared by us include distributional records from Himalaya, Trans Himalaya, Desert, Semi-Arid, Western Ghats, Deccan Peninsula, Gangetic Plains, Northeast, Islands, and Coastal areas of the country. Our study concludes that many of the species are still known from their type localities only, so there is need to revisit and resurvey those collection localities for the taxonomic evaluation of those species. There are species which exhibit single locality records, and taxa-specific biodiversity assessments are required to be undertaken to understand the distributional range of such species. The primary challenge is taxonomic identifications of the species which were described before independence, and the type materials are present in overseas museums. For such species, taxonomic revisions of the different group of beetles are required to solve the problems of identification and classification.

Keywords: checklist, taxonomy, museum collections, biogeographic zones

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Authors: Semra Sirin Kiris

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Nonlinear dynamic analysis is permitted to be used for structures without any restrictions. The important issue is the selection of the design earthquake to conduct the analyses since quite different response may be obtained using ground motion records at the same general area even resulting from the same earthquake. In seismic design codes, the method requires scaling earthquake records based on site response spectrum to a specified hazard level. Many researches have indicated that this limitation about selection can cause a large scatter in response and other charecteristics of ground motion obtained in different manner may demonstrate better correlation with peak seismic response. For this reason influence of eleven different ground motion parameters on the peak displacement of reinforced concrete systems is examined in this paper. From conducting 7020 nonlinear time history analyses for single degree of freedom systems, the most effective earthquake parameters are given for the range of the initial periods and strength ratios of the structures. In this study, a hysteresis model for reinforced concrete called Q-hyst is used not taken into account strength and stiffness degradation. The post-yielding to elastic stiffness ratio is considered as 0.15. The range of initial period, T is from 0.1s to 0.9s with 0.1s time interval and three different strength ratios for structures are used. The magnitude of 260 earthquake records selected is higher than earthquake magnitude, M=6. The earthquake parameters related to the energy content, duration or peak values of ground motion records are PGA(Peak Ground Acceleration), PGV (Peak Ground Velocity), PGD (Peak Ground Displacement), MIV (Maximum Increamental Velocity), EPA(Effective Peak Acceleration), EPV (Effective Peak Velocity), teff (Effective Duration), A95 (Arias Intensity-based Parameter), SPGA (Significant Peak Ground Acceleration), ID (Damage Factor) and Sa (Spectral Response Spectrum).Observing the correlation coefficients between the ground motion parameters and the peak displacement of structures, different earthquake parameters play role in peak displacement demand related to the ranges formed by the different periods and the strength ratio of a reinforced concrete systems. The influence of the Sa tends to decrease for the high values of strength ratio and T=0.3s-0.6s. The ID and PGD is not evaluated as a measure of earthquake effect since high correlation with displacement demand is not observed. The influence of the A95 is high for T=0.1 but low related to the higher values of T and strength ratio. The correlation of PGA, EPA and SPGA shows the highest correlation for T=0.1s but their effectiveness decreases with high T. Considering all range of structural parameters, the MIV is the most effective parameter.

Keywords: earthquake parameters, earthquake resistant design, nonlinear analysis, reinforced concrete

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Authors: Andrew Anis Fakhrey Mosaad

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Introduction: Sports- and physical activity-related injuries may be more likely if there is a genetic predisposition, improper coaching and/or training, and no follow-up care from sports medicine. Goal: To evaluate the frequency of injuries among athletes receiving care at a sportsfocused physical therapy clinic. Methods: The survey of injuries in athletes' treatment records over a period of eight years of activity was done to obtain data. The data collected included: the patient's features, the sport, the type of injury, the injury's characteristics, and the body portion injured. Results: The athletes were drawn from 1090 patient/athlete records, had an average age of 25, participated in 44 different sports, and were 75% men on average. Joint injuries were the most frequent type of injury, then damage to the muscles and bones. The most prevalent type of injury was chronic (47%), while the knee, ankle, and shoulder were the most frequently damaged body parts. The most injured athletes were seen in soccer, futsal, and track and field, respectively, out of all the sports. Conclusion: The most popular sport among injured players was soccer, and the most common injury type was joint damage, with the knee being the most often damaged body area. The majority of the injuries were chronic.

Keywords: sports injuries, athletes, joint injuries, injured players

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Authors: Artem A. Krylov

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Instrumental seismological researches in water areas are complicated and expensive, that leads to the lack of strong motion records in most offshore regions. In the same time the number of offshore industrial infrastructure objects, such as oil rigs, subsea pipelines, is constantly increasing. The empirical Green’s function technique proved to be very effective for accelerograms synthesis under the conditions of poorly described seismic wave propagation medium. But the selection of suitable small earthquake record in offshore regions as an empirical Green’s function is a problem because of short seafloor instrumental seismological investigation results usually with weak micro-earthquakes recordings. An approach based on moving average smoothing in the frequency domain is presented for preliminary processing of weak micro-earthquake records before using it as empirical Green’s function. The method results in significant waveform correction for modeled event. The case study for 2009 L’Aquila earthquake was used to demonstrate the suitability of the method. This work was supported by the Russian Foundation of Basic Research (project № 18-35-00474 mol_a).

Keywords: accelerogram synthesis, empirical Green's function, marine seismology, microearthquakes

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma

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Authors: Peter Antwi Buah, Yingbin Zhang, Jianxian He, Chenlin Xiang, Delali Atsu Y. Bakah

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Near-fault ground motions with velocity pulses are considered to cause significant damage to structures or slopes compared to ordinary ground motions without velocity pulses. The double pulsed pulse-like ground motion is as well known to be stronger than the single pulse. This study has numerically justified this perspective by studying the dynamic response of a homogeneous rock slope subjected to four pulse-like and two non-pulse-like ground motions using the Fast Lagrangian Analysis of Continua in 3 Dimensions (FLAC3D) software. Two of the pulse-like ground motions just have a single pulse. The results show that near-fault ground motions with velocity pulses can cause a higher dynamic response than regular ground motions. The amplification of the peak ground acceleration (PGA) in horizontal direction increases with the increase of the slope elevation. The seismic response of the slope under double pulse ground motion is stronger than that of the single pulse ground motion. The PGV amplification factor under the effect of the non-pulse-like records is also smaller than those under the pulse-like records. The velocity pulse strengthens the earthquake damage to the slope, which results in producing a more strong dynamic response.

Keywords: velocity pulses, dynamic response, PGV magnification effect, elevation effect, double pulse

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Authors: Nizar Abu-Jaber

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Late Pleistocene and Holocene carbonate crusts in the south of Jordan were studied using a combination of field documentation, petrography, geochemical and isotopic techniques. These surficial crusts and vein deposits appear to have formed as a result of interaction between near-surface groundwater, surficial soil and sediments and rising carbon dioxide. Rising mantle CO2 dissolves in the water to create carbonic acid, which in turn dissolves the calcite in the soil in the sediments. When the pH rises later due to degassing, the carbonate crusts are left in the places where the water was flowing in veins, channels and interfaces between high and low permeability materials. The crusts have the potential for being important records of natural and human agencies on the landscape of the area. They reflect the isotopic composition of the waters in which they precipitated in, and also contain isotopic information about the aeolian calcium fluxes affecting the area (using strontium isotopes). Moreover, changing stream valley base levels can be identified and measured, which can help quantify the rates of tectonic movement. Finally, human activities such and channel construction and terrace building can be identified and traced temporally and spatially using these deposits.

Keywords: anthropogenic change, carbonate crusts, environmental change, Jordan

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Authors: Eugenia Jilinguirian

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

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

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Authors: Awad Hassoup, Sayed Abdallah, Mohamed Dahy

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Northern Egypt is known to be seismically active from the past several thousand years, based on the historical records and documents of eyewitnesses on one- hand and instrumental records on the other hand. Instrumental, historical and pre- historical seismicity data indicate that large destructive earthquakes have occurred quite frequently in the investigated area. The interaction of the African, Arabian, Eurasian plates and Sinai sub-plate is the main factor behind the seismicity of northern part of Egypt. All earthquakes occur at shallow depth and are concentrated at four seismic zones, these zones including the Gulfs of Suez and Aqaba, around the entrance of the Gulf of Suez and the fourth one is located at the south- west of great Cairo (Dahshour area). The seismicity map of the previous zones shows that the activity is coincide with the major tectonic trends of the Suez rift, Aqaba rift with their connection with the great rift system of the Red Sea and Gulf of Suez- Cairo- Alexandria trend. On the other hand, the focal mechanisms of some earthquakes occurred inside the studied area and having small to moderate size show a variety of patterns. The most predominant type is normal faulting.

Keywords: Northern Egypt, seismic active zone, seismicity, focal mechanism

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Authors: Omar Asad Ahmad, Mohammed Awwad

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Concrete is one of the essential elements that used in different types of construction these days, but it has many problems when interacts with environmental elements such as water, air, temperature, dust, and humidity. Also concrete made with Portland cement has certain characteristics: it is relatively strong in compression but weak in tension and tends to be brittle. These disadvantages make concrete limited to use in certain conditions. The most common problems appears on concrete are manifested by tearing, cracking, corrosion and spalling, which will lead to do some defect in concrete then in the whole construction, The fundamental objective of this research was to provide information about the hardened properties of concrete achieved by using easily available local raw materials in Jordan to support the practical work with partners in assessing the practicability of the mixes with polypropylene, and to facilitate the introduction of polypropylene fiber concrete (PFC) technology into general construction practice. Investigate the effect of the polypropylene fibers in PCC mixtures and on materials properties such as compressive strength, and tensile strength. Also to investigate the use of polypropylene fibers in plain cubes and cylindrical concrete to improve its compressive and tensile strengths to reduce early cracking and inhibit later crack growth. Increasing the hardness of concrete in this research is the main purpose to measure the deference of compressive strength and tensile strength between plain concrete and concrete mixture with polypropylene fibers different additions and to investigate its effect on reducing the early and later cracking problem. To achieve the goals of research 225 concrete test sample were prepared to measure it’s compressive strength and tensile strength, the concrete test sample were three classes (A,B,C), sub-classified to standard , and polypropylene fibers added by the volume of concrete (5%, 10%, 15%, and 20%). The investigation of polypropylene fibers mixture with concrete shows that the strengths of the cement are increased and the cracking decreased. The results show that for class A the recommended addition were 5% of polypropylene fibers additions for compressive strength and 10 % for tensile strength revels the best compressive strength that reach 26.67 Mpa and tensile strength that reach 2.548 Mpa records. Achieved results show that for classes B and C the recommend additions were 10 % polypropylene fibers revels the best compressive strength records where they reach 21.11 and 33.78 Mpa, records reach for tensile strength 2.707 and 2.65 Mpa respectively.

Keywords: polypropylene, effects, compressive, tensile, strengths, concrete, construction

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Asima Mehaboob Khan, Rizwan Taj

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Purpose: This study aims to estimate the knowledge, attitude and practices of medical ethics among young healthcare professionals. Method: A qualitative descriptive study was conducted among young healthcare professionals from both public and private sector medical institutions. Using the convenience sampling technique, 272 healthcare professionals participated in this study. A pre-structured modified questionnaire was used to collect the data. Descriptive analyses were executed for each variable. Result: About 76.47% of healthcare professional considers the importance of adequate knowledge of medical ethics, and 82.24% declared lecture, seminars and clinical discussion as the source of their medical knowledge of biomedical ethics. About 42.44% of healthcare professionals exhibited a negative attitude toward medical ethics, 57.72% showed a mildly positive attitude, whereas 1.10% and 0.74% indicated a moderately positive attitude and a highly positive attitude towards medical ethics. Similarly, the level of practice according to medical ethics is also very poor among young healthcare professionals. 34.56% of healthcare professionals deviated from medical ethics during their clinical practices, whereas 0.74% showed a good level of medical practice according to medical ethics. Conclusion: It is concluded in this research study that young healthcare professionals have adequate theoretical knowledge of medical ethics but are not properly trained to perform their clinical practices according to the guidelines of medical ethics. Furthermore, their professional attitude is poorly developed to maintain medical ethics during their clinical practices.

Keywords: knowledge, attitude, practices, medical ethics

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Authors: Lucie Cote, Sonia McFadden

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Mental health problems in the workplace are currently one of the main causes of absences. Research work has highlighted the importance of a collaborative process involving the stakeholders in the return-to-work process and has established the best management practices to ensure a successful return-to-work. However, very few studies have specifically explored the combination of various management models and determined whether they could satisfy the needs of the stakeholders. The objective of this study is to analyze two models for managing the return to work: the ‘medical-administrative’ and the ‘support of the worker’ in order to understand the actions and actors involved in these models. The study also aims to explore whether these models meet the needs of the actors involved in the management of the return to work. A qualitative case study was conducted in a Canadian federal organization. An abundant internal documentation and semi-directed interviews with six managers, six workers and four human resources professionals involved in the management of records of employees returning to work after a mental health problem resulted in a complete picture of the return to work management practices used in this organization. The triangulation of this data facilitated the examination of the benefits and limitations of each approach. The results suggest that the actions of management for employee return to work from both models of management ‘support of the worker’ and ‘medical-administrative’ are compatible and can meet the needs of the actors involved in the return to work. More research is needed to develop a structured model integrating best practices of the two approaches to ensure the success of the return to work.

Keywords: return to work, mental health, management models, organizations

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Authors: N. Akhavan, Sh. Tavousi Tafreshi, A. Ghasemi

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Seismic behavior of irregular structures through the past decades indicate that the stated buildings do not have appropriate performance. Among these subjects, the current paper has investigated the behavior of special steel moment frame with different configuration of soft storey vertically. The analyzing procedure has been evaluated with respect to incremental dynamic analysis (IDA), and numeric process was carried out by OpenSees finite element analysis package. To this end, nine 2D steel frames, with different numbers of stories and irregularity positions, which were subjected to seven pairs of ground motion records orthogonally with respect to Ibarra-Krawinkler deterioration model, have been investigated. This paper aims at evaluating the response of two-dimensional buildings incorporating soft storey which subjected to bi-directional seismic excitation. The IDAs were implemented for different stages of PGA with various ground motion records, in order to determine maximum inter-storey drift ratio. According to statistical elements and fracture range (standard deviation), the vulnerability or exceedance from above-mentioned cases has been examined. For this reason, fragility curves for different placement of soft storey in the first, middle and the last floor for 4, 8, and 16 storey buildings have been generated and compared properly.

Keywords: special steel moment frame, soft storey, incremental dynamic analysis, fragility curve

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Authors: Samrawit Tamrat Gebretsadik

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Recurrent wheezing is a common respiratory symptom among children, often indicative of underlying airway inflammation and hyperreactivity. Understanding the prevalence and associated factors of recurrent wheezing in specific age groups is crucial for targeted interventions and improved respiratory health outcomes. This study aimed to investigate the prevalence and associated factors of recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College in Ethiopia. A cross-sectional study design was employed, involving structured interviews with parents/guardians, medical records review, and clinical examination of children. Data on demographic characteristics, environmental exposures, family history of respiratory diseases, and socioeconomic status were collected. Logistic regression analysis was used to identify factors associated with recurrent wheezing. The study included X 6-year-old children, with a prevalence of recurrent wheezing found to be Y%. Environmental exposures, including tobacco smoke exposure (OR = Z, 95% CI: X-Y), indoor air pollution (OR = Z, 95% CI: X-Y), and presence of pets at home (OR = Z, 95% CI: X-Y), were identified as significant risk factors for recurrent wheezing. Additionally, a family history of asthma or allergies (OR = Z, 95% CI: X-Y) and low socioeconomic status (OR = Z, 95% CI: X-Y) were associated with an increased likelihood of recurrent wheezing. The impact of recurrent wheezing on the quality of life of affected children and their families was also assessed. Children with recurrent wheezing experienced a higher frequency of respiratory symptoms, increased healthcare utilization, and decreased physical activity compared to their non-wheezing counterparts. In conclusion, recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College is associated with various environmental, genetic, and socioeconomic factors. These findings underscore the importance of targeted interventions aimed at reducing exposure to known triggers and improving respiratory health outcomes in this population. Future research should focus on longitudinal studies to further elucidate the causal relationships between risk factors and recurrent wheezing and evaluate the effectiveness of preventive strategies.

Keywords: wheezing, inflammation, respiratory, crucial

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Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu

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Objective: This study analyzed three criminal judicial cases. We applied the damage analysis of the two vehicles to verify other evidence, such as dashboard camera records of each accident, reconstruct the scenes, and pursue the truth. Methods: Evidence analysis, the method is to collect evidence and the reason for the results in judicial procedures, then analyze the involved damage evidence to verify other evidence. The collision damage analysis method is to inspect the damage to the vehicles and utilize the principles of tool mark analysis, Newtonian physics, and vehicle structure to understand the relevant factors when the vehicles collide. Results: Case 1: Sedan A turned right at the T junction and collided with Scooter B, which was going straight on the left road. The dashboard camera records showed that the left side of Sedan A’s front bumper collided with the body of Scooter B and rider B. After the analysis of the study, the truth was that the front of the left side of Sedan A impacted the right pedal of Scooter B and the right lower limb of rider B. Case 2: Sedan C collided with Scooter D on the left road at the crossroads. The dashboard camera record showed that the left side of the Sedan C’s front bumper collided with the body of Scooter D and rider D. After the analysis of the study, the truth was that the left side of the Sedan C impacted the left side of the car body and the front wheel of Scooter D and rider D. Case 3: Sedan E collided with Scooter F on the right road at the crossroads. The dashboard camera record showed that the right side of the Sedan E’s front bumper collided with the body of Scooter F and rider F. After the analysis of the study, the truth was that the right side of the front bumper and the right side of the Sedan F impacted the Scooter. Conclusion: The application of collision damage analysis in the reconstruction of a sedan-scooter collision could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the road safety policy.

Keywords: evidence analysis, collision damage analysis, accident reconstruction, sedan-scooter collision, dashboard camera records

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Authors: Sepehr Moradi, Mehdi Asadi Rad

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The aim of this study is to evaluate and compare chest weight of pure and mixed races Kabood 30-day Pigeons to investigate about their sex, race, and some auxiliary variables. In this paper, 62 pieces of pigeons as 31 male and female pairs with equal age are studied randomly. A natural incubation was done from each pair. All produced chickens were slaughtered at 30 days age after 12 hours hunger. Then their chests were weighted by a scale with one gram precision. A covariance analysis was used since there were many auxiliary variables and unequal observations. SAS software was used for statistical analysis. Mean weight of chests in pure race (Kabood-Kabood) with 8 records, 123.8±32.3g and mixed races of Kabood-Namebar, Kabood-Parvazy, Kabood-Tizpar, Namebar-Kabood, Tizpar-Kabood, and Parvazi-Kabood with 8, 8, 6, 12, 10, and 10 records were 139.4±23.5, 7/122±23.8, 124.7±30.1, 50.3±29.3, 51.4±26.4, and 137±28.6 gr, respectively. Mean weight of 30-day chests in male and female sex were 87.3±2.5 and 82.7±2.6g, respectively. Difference chest weight of 30-day chests of Kabood-Kabood race with Kabood-Namebar, Kabood-Parvazi, Tizpar-Kabood, Kabood-Tizpar, Namebar-Kabood and Parvazi-Kabood mixed races was not significant. Effect of sex was also significant in 5% level (P<0.05), but mutual effect of sex and race was not significant. Auxiliary variable of father weight was significant in 1% level (p < 0.01), but auxiliary variable of mother weight was not significant. The results showed that most and least weights belonged to Kabood-Namebar and Namebar-Kabood.

Keywords: squab, Kabood race, 30-day chest weight, pigeons

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Authors: Ashfaq M. Naikwadi

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Decided cases of medical negligence, mostly are not settled in the lower courts. Majority of them reach up to the apex courts. This is mostly due to different interpretations of the term medical negligence. After studying various cases of medical negligence it is found that in most of the cases the doctors/hospitals are not held liable. There are different interpretations of law concerning medical services. Globally the principles deciding medical negligence are same, viz. Legal duty of care - breach of that duty - direct causation resulting in damages. Since ordinary negligence is not punishable by law, doctors/hospitals have defenses to save themselves from liability. Complaints of negligence come to the courts whose judges mostly are not oriented with medical services or health sciences. Matters of medical negligence are decided on the basic principles of reasonableness and prudence or by relying on the expert’s opinion. Deciding reasonableness or prudence is a complex issue in case of medical services. Again expert opinion is also questionable as an expert in case of medical negligence is appointed from the same field and same faculty. There is a chance of favoritism to the doctor/hospital. The concept of vicarious liability is not widely applied to in many of the medical negligence cases. Established cases used as precedents were studied to understand the basic principles in deciding medical negligence. This paper evaluates the present criteria in interpreting medical negligence and concludes with suggesting reforms required to be made in deciding matters of medical negligence under the consumer laws.

Keywords: consumer, doctors, laws, medical negligence

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Authors: Preethy Mary Donald, Renjith George Pallivathukal

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Dens evaginatus (DE) is a rare developmental anomaly characterized by a slender enamel-covered tubercle which projects from the occlusal surface of an otherwise normal premolar. DE can often interfere normal occlusion and can lead to complications like sensitivity, pulpal exposure and temporo mandibular joint problems. The orthopantomographs (OPGs) and dental records of patients under the age of 20 who attended the faculty of dentistry, Melaka-Manipal Medical College were examined for DE. Results: The prevalence of DE was 23% among the study group. Males presented with a higher prevalence of 67% and females with 33%. The prevalence of Dens evaginatus was distributed as 28% in maxillary central incisor, 52% in maxillary lateral incisors, 12% in mandibular second premolars. Prevalence in permanent dentitions appeared to be higher than deciduous dentition. The bilateral occurrence of Dens evaginatus is an interesting phenomenon. 57% of the cases of the DE were bilateral.

Keywords: deciduous dentition, dens evaginatus, permanent dentition, prevalence

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Authors: Aneta Nitsch-Osuch, Beata Pawlus, Maria Pawlak

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Introduction: Recently, the number of parents who refuse to vaccinate their children or present so-called hesitant behaviors has increased in many developed countries. The study aimed to analyze the completeness and timeliness of vaccinations against hepatitis B and tuberculosis in neonates in a single maternity hospital in Warsaw (Poland). Material and Methods: We analyzed medical records of children born in the hospital between 1st January 2015 and 31st December 2016 and calculated the proportion of newborns not vaccinated on time. Results: The percentage of unvaccinated newborns was similar in the analyzed years: 7.2% in 2015 and 6.7% in 2016. Parental decisions rather than medical contraindications caused non-immunization (4.3% vs. 2.9% in 2015, and 4.7% vs. 2% in 2016). Most parents refused both vaccinations (81%-84%), whereas 7-8% refused only hep B vaccination, and 9-11% refused alone tuberculosis vaccination. The majority of hesitant parents decided to delay both vaccinations (70-80%), while 10-11% of parents chose to delay only one vaccination (hep B). In consecutive years, an increase in the percentage of parents delaying tuberculosis vaccination was reported (10 vs. 19%). Discussion: The increase in the number of newborns who are not correctly vaccinated just after birth due to their parents' decision should be considered non-gradual, both for hepatitis B and tuberculosis. It is necessary to implement effective educational and informative measures targeted at future parents to reinforce positive attitudes towards vaccinations and to dispel doubts about them among parents who are hesitant.

Keywords: hepatitis B, tuberculosis, immunization, new-borns, coverage rate

Procedia PDF Downloads 566

Authors: Zuhairah Abdul Hadi, Mohd Nazir bin Md. Zabit, Zuriadah Ismail

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Metacognitive has been empirically evidenced to be one important element influencing learning outcomes. Expert learners engage in metacognition by monitoring and controlling their thinking, and listing, considering and selecting the best strategies to achieve desired goals. Studies also found that good critical thinkers engage in more metacognition and people tend to activate more metacognition when solving complex problems. This study extends past studies by performing a qualitative analysis to understand metacognitive patterns among two high and two low performing groups by carefully examining video and audio records taken during Problem-based learning activities. High performing groups are groups with majority members scored well in Watson Glaser II Critical Thinking Appraisal (WGCTA II) and academic achievement tests. Low performing groups are groups with majority members fail to perform in the two tests. Audio records are transcribed and analyzed using schemas adopted from past studies. Metacognitive statements are analyzed using three stages model and patterns of metacognitive are described by contexts, components, and levels for each high and low performing groups.

Keywords: academic achievement, critical thinking, metacognitive, problem-based learning

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Authors: Jiani Gao, Qingping Luo, Xinlei Fang

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In order to try to achieve better rights and interests for both doctors and patients in the new medical environment, the paper will focus on the renewal and development of medical buildings. In today's highly developed society, many factors have a profound guiding significance for the development of medical buildings. By doing social research, the paper has found that these factors come from all aspects. These factors include the optimization of traditional medical model, rapid alternation of medical technology and equipment, the reform of the social, medical security system, changes in the age structure of the population, the birth of intelligent medical care under the Internet, and the deepening of the concept of green sustainable building development, etc. The purpose of this paper is to capture sensitively these various factors that may affect the evolution of medical buildings in the context of the current era, and to put forward, by using an adaptable development strategy, some feasible suggestions on the design of medical buildings when facing these changes and challenges. Specifically speaking, the adaptable development strategy includes some basic principles and methods, such as using modular design, adopting scalable streamline, selecting a long-span structural system and using replaceable materials and components, etc.

Keywords: medical architecture, adaptable development, medical model, space design

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Authors: Shannon Glaspy, Gerald Boon, Jack Lambert

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Studies on AE of highly active antiretroviral therapy (HAART) in children and adolescents are rare. The aim of this study is to observe the frequency of treatment limiting adverse drug reactions against years on ARVs and specific ARV regimen. Methods: A retrospective cohort study was conducted in East London, South Africa. All patient files in the pediatric (0 – 18 years) ARV cohort were examined, selecting only those patients started on HAART. ARV regimen changes explicitly due to AE, age on ARV treatment onset, age of AE onset, and gender were extrapolated. Eligible subjects were obtained from patient folders, anonymized and cross-referenced with data obtained from electronic records. A total of 1120 patients [592 male (52.9%) and 528 female (47.1%)] were charted by incidence and year. Additional information was extrapolated in cases where the patient experienced lipodystrophy and lipoatrophy to include the number of years on ARVs prior to the onset of the AE. Results: Of the 1120 HIV infected children of the hospital cohort, a total of 105 (9.37%) AE (53.3% male) observed were deemed eligible for the study due to completeness of medical history and agreement between electronic records and paper files. The AE cited were as follows: lipoatrophy 62 (5.53% of all subjects), lipodystrophy 27 (2.41%), neuropathy 9 (0.8%), anemia 2 (0.17%), Steven Johnsons Syndrome 1 (0.08%), elevated LFTs 1 (0.8%), breast hypertrophy (0.08%), gastritis 1 (0.08%) and rash 1 (0.08%). The most prevalence ARV regimens associated with the onset of the AE are: D4T/3TC/EFV 72 cases (64.86% of all AE), D4T/3TC/LOPr 24 cases (21.62%). Lipoatrophy and lipodystrophy combined represent 84.76% (89 cases) of all adverse events documented in this cohort. Within the 60 cases of lipoatrophy, the average number of years on ARVs associated with an AE is 3.54, with 14 cases experiencing an AE between 0-2 years of HAART. Within the 29 cases of lipodystrophy, the average number of years on ARVs associated with an AE is 3.89, with 4 cases experiencing an AE between 0-2 years on HAART. The regimen D4T/3TC/EFV is associated with 43 cases (71.66%) of lipoatrophy and 21 cases (72.41%) of lipodystrophy. D4T/3TC/LOPr is associated with 15 cases (25%) of lipoatrophy and 7 cases (24.14%) of lipodystrophy. The frequency of AE associated with ARV regimens could be misrepresented due to prevalence of different 1st line regimens which were not captured in this study, particularly with the systematic change of 1st line drugs from D4T to ABC in 2010. Conclusion: In this descriptive study we found a 9.37% prevalence of AE were significant enough to be treatment limiting among our cohort. Lipoatrophy accounted for 59.04% of all documented AE. Overall, D4T/3TC/EFV was associated with 64.86% of all AE, 71.66% of lipoatrophy cases and 72.41% of lipodystrophy cases.

Keywords: ARV, adverse events, HAART, pediatric

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Authors: Bang Haeyong

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Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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Authors: Burçin Saltık, Levent Genç

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In this study, it was aimed to determine a route for identification of rice cultivation areas within Thrace and Marmara regions of Turkey using remote sensing and GIS. Landsat 8 (OLI-TIRS) imageries acquired in production season of 2013 with 181/32 Path/Row number were used. Four different seasonal images were generated utilizing original bands and different transformation techniques. All images were classified individually using supervised classification techniques and Land Use Land Cover Maps (LULC) were generated with 8 classes. Areas (ha, %) of each classes were calculated. In addition, district-based rice distribution maps were developed and results of these maps were compared with Turkish Statistical Institute (TurkSTAT; TSI)’s actual rice cultivation area records. Accuracy assessments were conducted, and most accurate map was selected depending on accuracy assessment and coherency with TSI results. Additionally, rice areas on over 4° slope values were considered as mis-classified pixels and they eliminated using slope map and GIS tools. Finally, randomized rice zones were selected to obtain maximum-minimum value ranges of each date (May, June, July, August, September images separately) NDVI, LSWI, and LST images to test whether they may be used for rice area determination via raster calculator tool of ArcGIS. The most accurate classification for rice determination was obtained from seasonal LSWI LULC map, and considering TSI data and accuracy assessment results and mis-classified pixels were eliminated from this map. According to results, 83151.5 ha of rice areas exist within study area. However, this result is higher than TSI records with an area of 12702.3 ha. Use of maximum-minimum range of rice area NDVI, LSWI, and LST was tested in Meric district. It was seen that using the value ranges obtained from July imagery, gave the closest results to TSI records, and the difference was only 206.4 ha. This difference is normal due to relatively low resolution of images. Thus, employment of images with higher spectral, spatial, temporal and radiometric resolutions may provide more reliable results.

Keywords: landsat 8 (OLI-TIRS), LST, LSWI, LULC, NDVI, rice

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Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann

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Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.

Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Lucas B. Naves, Maria José Abreu

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Reprocessing single-use device has attracted interesting on the medical environment over the last decades. The reprocessing technique was sought in order to reduce the cost of purchasing the new medical device, which can achieve almost double of the price of the reprocessed product. In this manuscript, we have done a literature review, aiming the reuse of medical device that was firstly designed for single use only, but has become, more and more, effective on its reprocessing procedure. We also show the regulation, the countries which allows this procedure, the classification of these device and also the most important issue concerning the re-utilization of medical device, how to minimizing the risk of gram positive and negative bacteria, avoid cross-contamination, hepatitis B (HBV), and C (HCV) virus, and also human immunodeficiency virus (HIV).

Keywords: reusing, reprocessing, single-use medical device, HIV, hepatitis B and C

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Authors: Narupon Kunbootsri, P. Sirasaporn

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Frozen shoulder is a common problem present by pain and limit range of motion. The prevalence of frozen shoulder showed 18-31% of population. The effect of frozen shoulder lead to limit activities daily living life, high medical care cost and so on. Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom relate to physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder relate to onset of symptom, range of motion and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, range of motion and obtaining physical modalities were recorded. There was a statistically significant increase in shoulder flexion [mean difference 38.88 with 95%CI were [16.00-61.77], shoulder abduction [mean difference 48.47 with 95%CI were 16.07-90.59], shoulder internal rotation [mean difference 22.36 with 95%CI were 2.81-37.18] and shoulder external rotation [mean difference 32.12 with 95%CI were [(-2.47)-(46.91)]. In addition, the onset of symptom was 76.42±46.90 days. And the physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, range of motions, onset of symptom, physiotherapy, physical modality

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