Search results for: a case report

Authors: Ahmed Emad Ahmed, Mostafa El Abd, Ahmed Wakeb, Moahmmed Eissa

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Soil modification and reinforcing aims to increase soil shear strength and stiffness. In this report, different amounts of cement were added to the soil to explore its effect on shear strength and penetration using 3 tests. The first test is proctor compaction test which was conducted to determine the optimal moisture content and maximum dry density. The second test was direct shear test which was conducted to measure shear strength of soil. The third experiment was California bearing ratio test which was done to measure the penetration in soil. Each test was done different amount of times using different amounts of cement. The results from every test show that cement improve soil shear strength properties and stiffness.

Keywords: soil stabilized, soil, mechanical properties of soil, soil stabilized with a portland cement

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Authors: Martin Böhmer, Agatha Dabrowski, Boris Otto

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The trend of digitization significantly changes the role of data for enterprises. Data turn from an enabler to an intangible organizational asset that requires management and qualifies as a tradeable good. The idea of a networked economy has gained momentum in the data domain as collaborative approaches for data management emerge. Traditional organizational knowledge consequently needs to be extended by comprehensive knowledge about data. The knowledge about data is vital for organizations to ensure that data quality requirements are met and data can be effectively utilized and sovereignly governed. As this specific knowledge has been paid little attention to so far by academics, the aim of the research presented in this paper is to conceptualize it by proposing a “data knowledge model”. Relevant model entities have been identified based on a design science research (DSR) approach that iteratively integrates insights of various industry case studies and literature research.

Keywords: data management, digitization, industry 4.0, knowledge engineering, metamodel

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Authors: Edlira Donefski, Tina Donefski, Lorenc Ekonomi

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Edgeworth Approximation, Bootstrap, and Monte Carlo Simulations have considerable impacts on achieving certain results related to different problems taken into study. In our paper, we have treated a financial case related to the effect that has the components of a cash-flow of one of the most successful businesses in the world, as the financial activity, operational activity, and investment activity to the cash and cash equivalents at the end of the three-months period. To have a better view of this case, we have created a vector autoregression model, and after that, we have generated the impulse responses in the terms of asymptotic analysis (Edgeworth Approximation), Monte Carlo Simulations, and residual bootstrap based on the standard errors of every series created. The generated results consisted of the common tendencies for the three methods applied that consequently verified the advantage of the three methods in the optimization of the model that contains many variants.

Keywords: autoregression, bootstrap, edgeworth expansion, Monte Carlo method

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Authors: Maria Valeria De Bonis, Gianpaolo Ruocco

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Nowadays, computational modeling is paving new design and verification ways in a number of industrial sectors. The technology is ripe to challenge some case in the Bioengineering and Medicine frameworks: for example, looking at the strategical and ethical importance of oncology research, efforts should be made to yield new and powerful resources to tumor knowledge and understanding. With these driving motivations, we approach this gigantic problem by using some standard engineering tools such as the mathematics behind the biomass transfer. We present here some bacterial colonization studies in complex structures. As strong analogies hold with some tumor proliferation, we extend our study to a benchmark case of solid tumor. By means of a commercial software, we model biomass and energy evolution in arbitrary media. The approach will be useful to cast virtualization cases of cancer growth in human organs, while augmented reality tools will be used to yield for a realistic aid to informed decision in treatment and surgery.

Keywords: bacteria, simulation, tumor, precision medicine

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Authors: Tawanda Mushiri, Charles Mbohwa

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When an external load is applied to one of its ends, a pipe’s bends cross section tends to deform significantly both in and out of its end plane. This shell type behaviour characteristic of pipe bends and mainly due to their curves geometry accounts for their greater flexibility. This added flexibility is also accompanied by stressed and strains that are much higher than those present in a straight pipe. The primary goal of this research is to study the elastic-plastic behaviour of pipe bends under out of plane moment loading. It is also required to study the effects of changing the value of the pipe bend factor and the value of the internal pressure on that behaviour and to determine the value of the limit moments in each case. The results of these analyses are presented in the form of load deflection plots for each load case belonging to each model. From the load deflection curves, the limit moments of each case are obtained. The limit loads are then compared to those computed using some of the analytical and empirical equation available in the literature. The effects of modelling parameters are also studied. The results obtained from small displacement and large displacement analyses are compared and the effects of using a strain hardened material model are also investigated. To better understand the behaviour of pipe elbows under out of plane bending and internal pressure, it was deemed important to know how the cross section deforms and to study the distribution of stresses that cause it to deform in a particular manner. An elbow with pipe bend factor h=0.1 to h=1 is considered and the results of the detailed analysis are thereof examined.

Keywords: elasto-plastic, finite element analysis, pipe bends, simulation

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Authors: Gayan Mapitiya

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Maintaining good occupational health and safety (OHS) performance is significant at the coalface, especially in industries such as mining, power, and construction. Coalface workers are vulnerable to high OHS risks such as working at heights, working with mobile plants and vehicles, working with underground and above ground services, chemical emissions, radiation hazards and explosions at everyday work. To improve OHS performance of workers, OHS key performance indicators (KPIs) (for example, lost time injuries (LTI), serious injury frequency rate (SIFR), total reportable injury frequency rate (TRIFR) and number of near misses) are widely used by managers in making OHS business decisions such as investing in safety equipment and training programs. However, in many organizations, workers at the coalface hardly see any relevance or value addition of OHS KPIs to their everyday work. Therefore, the aim of the study was to understand why coalface workers perceive that OHS KPIs are not practically relevant to their jobs. Accordingly, this study was conducted as a qualitative case study focusing on a large electricity and gas firm in Australia. Semi-structured face to face interviews were conducted with selected coalface workers to gather data on their attitude towards OHS KPIs. The findings of the study revealed that workers at the coalface generally have no understanding of the purpose of KPIs, the meaning of each KPI, origin of KPIs, and how KPIs are correlated to organizational performance. Indeed, KPIs are perceived as ‘meaningless obstacles’ imposed on workers by managers without a rationale. It is recommended to engage coalface workers (a fair number of representatives) in both KPIs setting and revising processes while maintaining a continuous dialogue between workers and managers in regards OHS KPIs.

Keywords: KPIs, coalface, OHS risks, case-study

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Authors: Adie, Julius Undiukeye

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This research investigated the practice of academic leadership succession planning in Nigerian higher education institutions, drawing on the lived experiences of the academic staff of the case study institutions. It is multi-case study research that adopts a qualitative research method. Ten participants (mainly academic staff) were used as the study sample. The study was guided by four research questions. Semi-structured interviews and archival information from official documents formed the sources of data. The data collected was analyzed using the Constant Comparative Technique (CCT) to generate empirical insights and facts on the subject of this paper. The following findings emerged from the data analysis: firstly, there was no formalized leadership succession plan in place in the institutions that were sampled for this study; secondly, despite the absence of a formal succession plan, the data indicates that academics believe that succession planning is very significant for institutional survival; thirdly, existing practices of succession planning in the sampled institutions, takes the forms of job seniority ranking, political process and executive fiat, ad-hoc arrangement, and external hiring; and finally, data revealed that there are some barriers to the practice of succession planning, such as traditional higher education institutions’ characteristics (e.g. external talent search, shared governance, diversity, and equality in leadership appointment) and the lack of interest in leadership positions. Based on the research findings, some far-reaching recommendations were made, including the urgent need for the ‘formalization’ of leadership succession planning by the higher education institutions concerned, through the design of an official policy framework.

Keywords: academic leadership, succession, planning, higher education

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Authors: Brandon Ko

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Whether it’s a kitchen staff or a law firm, many groups tend to have homogenous characteristics of race, gender, interests, and goals. Social groups are not typically random samples of the population and will usually have common identifiers. According to Blau, age, sex, and education all play salient roles in shaping relationships within members of society. So if there is some degree of homogeneity within groups, the question arises whether this is beneficial or harmful to a group’s effectiveness. There has been much disagreement in the scientific community as to whether the presence of homophily benefits or hinders an athletic team's cohesiveness. For this paper, a comparative study of research of soccer case studies that followed various, youth players was studied against examinations of the effects that such a culture has on athletes. The case studies were used as evidence to determine what kind of homophily existed within the soccer camps. One case study followed several European developmental clubs such as Bayern Munich and Barcelona. Another study followed eight different players, four of each gender, implementing a similar method of interviewing, observing, and questioning. The individual and team goals of each athlete were reviewed to see which teams and players were ego-oriented and which were team-oriented. Additionally, there had been little research done on the relationship between homophily and how it applies to the sport community, suggesting the need to develop this neglected problem in applied psychology. This paper argues that the benefits of an egalitarian culture and stronger relations with people of a similar socio-demographic outweigh the liabilities of cohesion like being stereotyped and a lack of network outside the group as produced by homophily in athletic competition.

Keywords: group cohesion, homophily, sports psychology, youth athletics

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Authors: Tony Mann

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This paper sets out the case for involving and engaging employees/workers/stakeholders/staff in any significant change that is being considered by the senior executives of the organization. It establishes the rationale, the approach, the methodology of engagement and the benefits of a participative approach. It challenges the new norm of imposing change for fear of resistance and instead suggests that involving people has better outcomes and a longer-lasting impact. Various strategic models are introduced and illustrated to explain how the process can be most effective. The paper highlights one model in particular (the Process Iceberg® Organizational Change model) that has proven to be instrumental in developing effective change. Its use is demonstrated in its various forms and explains why so much change fails to address the key elements and how we can be more productive in managing change. ‘Participation’ in change is too often seen as negative, expensive and unwieldy. The paper aims to show that another model: UIA=O+E, can offset the difficulties and, in fact, produce much more positive and effective change.

Keywords: facilitation, stakeholders, buy-in, digital workshops

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Authors: Lutpi Ginanjar

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Environmental hygiene is indispensable for people to live healthy, safe and peaceful. In a small environment, the cleanliness of the environment is very easy to overcome, but on the larger environment requires a more complicated management and considerable investments. In general environmental hygiene are managed by the Department of Hygiene and Landscaper. Found a good management, but much less good management. The difficulties that are often encountered on waste management also caused public awareness itself. In addition, communities have difficulty in making a report about the rubbish because not dibangunnyasistem good information. Essai aims to build information systems environment clean especially the handling of waste in the city of Bandung, West Java province. The system was built with PHP software. Expected results obtained after the construction of the information system of environmental hygiene can be demonstrated to the community will be the health of the environment.

Keywords: information systems, SMS gateway, management, software, PHP

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Authors: Sahbi Farhani

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This study investigates the relationship between external debt and military spending in case of India over the period of 1970–2012. In doing so, we have applied the structural break unit root tests to examine stationarity properties of the variables. The Auto-Regressive Distributed Lag (ARDL) bounds testing approach is used to test whether cointegration exists in presence of structural breaks stemming in the series. Our results indicate the cointegration among external debt, military spending, debt servicing, and economic growth. Moreover, military spending and debt servicing add in external debt. Economic growth helps in lowering external debt. The Vector Error Correction Model (VECM) analysis and Granger causality test reveal that military spending and economic growth cause external debt. The feedback effect also exists between external debt and debt servicing in case of India.

Keywords: external debt, military spending, ARDL approach, India

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Authors: Martin Jelínek, Petr Květon

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The presented study focuses on relations between violent videogames playing and various types of antisocial behavior, namely bullying (verbal, indirect, and physical), physical aggression and delinquency. Relevant relationships were also examined with respect to gender. Violent videogames exposure (VGV) was measured by respondents’ most favored games and self-evaluation of its level of violence and frequency of playing. Antisocial behaviors were assessed by self-report questionnaires. The research sample consisted of 333 (166 males, 167 females) primary and secondary school students at the age between 10 and 19 years (m=14.98, sd=1.77). It was found that violent videogames playing is associated with physical aggression (rho=0.288, 95% CI [0.169;0.400]) and bullying (rho=0.369, 95% CI [0.254;0.476]). By means of gender, these relations were slightly weaker in males (VGV - physical aggression: rho=0.104, 95% CI [-0.061;0.264], VGV – bullying: rho=.200, 95% CI [0.032;0.356]) than in females (VGV - physical aggression: rho=0.257, 95% CI [0.089;0.411], VGV – bullying: rho=0.279, 95% CI [0.110;0.432]).

Keywords: aggression, bullying, gender, violent video games

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Authors: Mariela González, Zoraide Lugli

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Objective: to determine the relationship between perceived social support and adherence to therapy in patients who have been placed BioEnteric intragastric balloon (BIB). Material and method: 75 obese (56 women and 19 men) between 18 and 65 years (M = 39.29, SD = 11.82), who attended five centers in the city of Caracas, where he carried out this procedure. We used Social Support Scale and treatment adherence behavior respectively. The procedure was contacted the centers and the sample was selected. Subsequently, the inventories were applied before and the month after the before and three months after the balloon set. Results: Show that participants were characterized by moderate levels in the variables. On the other hand, those who perceive that they perceived support from friends are those who report adherence to therapy. Conclusions: From the results, it is suggested promote social support networks, which could be essential to achieve and maintain adherence to therapy in patients with BioEnterics intragastric balloon.

Keywords: BioEnteric intragastric balloon, perceived social support, adherence to therapy, patients

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Authors: G. Rosaz, V. Semblanet, S. Calatroni, A. Sublet, M. Taborelli

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We report in this paper the design and qualification of a cylindrical unbalanced magnetron source. The dedicated magnetic assemblies were simulated using a finite element model. A hall-effect magnetic probe was then used to characterize those assemblies and compared to the theoretical magnetic profiles. These show a good agreement between the expected and actual values. The qualification of the different magnetic assemblies was then performed by measuring the ion flux density reaching the surface of the sample to be coated using a commercial retarding field energy analyzer. The strongest unbalanced configuration shows an increase from 0.016 A.cm^-2 to 0.074 A.cm^-2 of the ion flux density reaching the sample surface compared to the standard balanced configuration for a pressure 5.10^-3 mbar and a plasma source power of 300 W.

Keywords: ion energy distribution function, magnetron sputtering, niobium, unbalanced, SRF cavities, thin film

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Authors: Hasibe Caballero-Gomez, Richard Pepino

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Childhood lead poisoning is an issue that continues to plague major U.S. cities. Lead poisoning has been linked to decreases in academic achievement and IQ at levels as low as 5 ug/dL. Despite efforts from the Philadelphia Health Department to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels (EBLLs) above the CDC reference level for diagnosis. This problem disproportionately affects low-income Black communities. At the moment, remediation is costly, and with the current policies in place, comprehensive remediation seems unrealistic. This research investigates community engagement policy and the ways pre-exisiting resources in target communities can be adjusted to decrease childhood lead poisoning. The study was done with two methods: content analysis and case studies. The content analysis includes 12 interviews from stakeholders and five published policy recommendations. The case studies focus on Baltimore, Chicago, Rochester, and St. Louis, four cities with significant childhood lead poisoning. Target communities were identified by mapping five factors that indicate a higher risk for lead poisoning. Seven priority zipcodes were identified for the model developed in this study. For these urban centers, 28 policy solutions and suggestions were identified, with three being identified at least four times in the content analysis and case studies. These three solutions create an interdependent model that offers increased community awareness and engagement with the issue that could potentially improve health and social outcomes for at-risk children.

Keywords: at-risk populations, community engagement, environmental justice, policy translation

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Authors: Pasquale Porcu, Mireille Vonlanthen, Gerardo Zaragoza-Galán, Ernesto Rivera

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In this work, we report the synthesis of a novel series of dendritic molecules bearing donor-acceptor groups (pyrene-bodipy) with potential applications in energy transfer. Initially, first and second generation Fréchet type dendrons (Py2-G1OH and Py4-G2OH) were prepared from 1-pyrenylbutanol and 3,5-dihydroxybenzylic alcohol. These compounds were further linked to a bodipy unit via an esterification reaction in order to obtain the desired products (Bodipy-G1Py2) and Bodipy-G2Py4). These compounds were fully characterized by FTIR and 1H and 13C NMR spectroscopy and their molecular weights were determined by MALDITOF. The optical and photophysical properties of these molecules were evaluated by absorbance and fluorescence spectroscopy, in order to compare their behaviour with other analogue molecules.

Keywords: bodipy, dendritic molecules, optical properties, pyrene

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Authors: Tomas Mitkus, Vaida Nedzinskaitė-Mitkė

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The objective of this study is to identify and explore how adequate is modern innovation support mechanism to developed creative industries. We argue that current development and support strategy for creative industries, although acknowledge high correlation between innovation and creativity, do not seek to improve conditions to promote systematic innovation development in the creative sector. Using the Lithuanian animation industry as a case study, this paper will examine innovation contribution to creativity and, for that matter, the competitiveness of animation enterprises. This paper proposes insights that contribute to theoretical and practical discussions on how creative profile companies build national and international competitiveness through innovations. The conclusions suggest that development of creative industries could greatly benefit if policymakers would implement tools that would encourage creative profile enterprises to invest in to development of innovation at a constant rate.

Keywords: creative industries, innovation policy, innovation, management

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Authors: Shruti Soudi, Anushka Nayak

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Altruism is a voluntary helping behavior that is not motivated by rewards. The empathy-altruism hypothesis states that altruistic behavior results from empathy, a constant emotional response between the helper and the individual in need. Individual variances in familiar ways of thinking, feeling, and acting are called personalities. The personality of an individual determines their behavior. More importantly, Adler was among the first psychologists to document the importance of birth order on personality. The present study aims to understand the influence of personality and birth order on altruism. A questionnaire consisting of standardized tools to measure altruism (Hindi Self Report Altruism Scale) and personality (Big Five Personality Inventory) will aid in studying the relationship between these variables among young adults in India. A statistical analysis of the data will be completed using ANOVA and T-Test in the SPSS Software.

Keywords: altruism, personality, birth order, ANOVA, young adults

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Authors: Aizati N. A. Daud, Jorieke E. H. Bergman, Wilhelmina S. Kerstjens-Frederikse, Pieter Van Der Vlies, Eelko Hak, Rolf M. F. Berger, Henk Groen, Bob Wilffert

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Prenatal use of SRIs was previously associated with Congenital Heart Anomalies (CHA). The aim of the study is to explore whether pharmacogenetics plays a role in this teratogenicity using a gene-environment interaction study. A total of 33 case-mother dyads and 2 mother-only (children deceased) registered in EUROCAT Northern Netherlands were included in a case-only study. Five case-mother dyads and two mothers-only were exposed to SRIs (paroxetine=3, fluoxetine=2, venlafaxine=1, paroxetine and venlafaxine=1) in the first trimester of pregnancy. The remaining 28 case-mother dyads were not exposed to SRIs. Ten genes that encode the enzymes or proteins important in determining fetal exposure to SRIs or its mechanism of action were selected: CYPs (CYP1A2, CYP2C9, CYP2C19, CYP2D6), ABCB1 (placental P-glycoprotein), SLC6A4 (serotonin transporter) and serotonin receptor genes (HTR1A, HTR1B, HTR2A, and HTR3B). All included subjects were genotyped for 58 genetic variations in these ten genes. Logistic regression analyses were performed to determine the interaction odds ratio (OR) between genetic variations and SRIs exposure on the risk of CHA. Due to low phenotype frequencies of CYP450 poor metabolizers among exposed cases, the OR cannot be calculated. For ABCB1, there was no indication of changes in the risk of CHA with any of the ABCB1 SNPs in the children and their mothers. Several genetic variations of the serotonin transporter and receptors (SLC6A4 5-HTTLPR and 5-HTTVNTR, HTR1A rs1364043, HTR1B rs6296 & rs6298, HTR3B rs1176744) were associated with an increased risk of CHA, but with too limited sample size to reach statistical significance. For SLC6A4 genetic variations, the mean genetic scores of the exposed case-mothers tended to be higher than the unexposed mothers (2.5 ± 0.8 and 1.88 ± 0.7, respectively; p=0.061). For SNPs of the serotonin receptors, the mean genetic score for exposed cases (children) tended to be higher than the unexposed cases (3.4 ± 2.2, and 1.9 ± 1.6, respectively; p=0.065). This study might be among the first to explore the potential gene-environment interaction between pharmacogenetic determinants and SRIs use on the risk of CHA. With small sample sizes, it was not possible to find a significant interaction. However, there were indications for a role of serotonin receptor polymorphisms in fetuses exposed to SRIs on fetal risk of CHA which warrants further investigation.

Keywords: gene-environment interaction, heart defects, pharmacogenetics, serotonin reuptake inhibitors, teratogenicity

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Authors: Aymen Laadhari

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We present in this paper a fully implicit finite element method tailored for the numerical modeling of inextensible fluidic membranes in a surrounding Newtonian fluid. We consider a highly simplified version of the Canham-Helfrich model for phospholipid membranes, in which the bending force and spontaneous curvature are disregarded. The coupled problem is formulated in a fully Eulerian framework and the membrane motion is tracked using the level set method. The resulting nonlinear problem is solved by a Newton-Raphson strategy, featuring a quadratic convergence behavior. A monolithic solver is implemented, and we report several numerical experiments aimed at model validation and illustrating the accuracy of the proposed method. We show that stability is maintained for significantly larger time steps with respect to an explicit decoupling method.

Keywords: finite element method, level set, Newton, membrane

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Authors: K. M. Etmimi, A. A. Sghayer, A. M. Gsiea, A. M. Abutruma

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Relatively few chemical species can be incorporated into diamond during CVD growth, and until recently the uptake of oxygen was thought to be low perhaps as a consequence of a short surface residence time. Within the literature, there is speculation regarding spectroscopic evidence for O in diamond, but no direct evidence. For example, the N3 and OK1 EPR centres have been tentatively assigned models made up from complexes of substitutional N and substitutional oxygen. In this study, we report density-functional calculations regarding the stability, electronic structures, geometry and hyperfine interaction of substitutional oxygen in diamond and show that the C2v, S=1 configuration very slightly lower in energy than the other configurations (C3v, Td, and C2v with S=0). The electronic structure of O in diamond generally gives rise to two defect-related energy states in the band gap one a non-degenerate a1 state lying near the middle of the energy gap and the other a threefold-degenerate t2 state located close to the conduction band edges. The anti-bonding a1 and t2 states will be occupied by one to three electrons for O+, O and O− respectively.

Keywords: DFT, oxygen, diamond, hyperfine

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Authors: Agnė Mikalauskaitė, Renata Karpicz, Vitalijus Karabanovas, Arūnas Jagminas

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The use of biocompatible precursors for the synthesis and stabilization of fluorescent gold nanoclusters (NCs) with strong red photoluminescence creates an important link between natural sciences and nanotechnology. Herein, we report the cost-effective synthesis of Au nanoclusters by templating and reduction of chloroauric acid with the cheap amino acid food supplements. This synthesis under the optimized conditions leads to the formation of biocompatible Au NCs having good stability and intense red photoluminescence, peaked at 680 to 705 nm, with a quantum yield (QY) of ≈7% and the average lifetime of up to several µs. The composition and luminescent properties of the obtained NCs were compared with ones formed via well-known bovine serum albumin reduction approach. Our findings implied that synthesized Au NCs tend to accumulate in more tumorigenic breast cancer cells (line MDA-MB-213) and after dialysis can be prospective for bio imagining.

Keywords: gold nanoclusters, proteins, materials chemistry, red-photoluminescence, bioimaging

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Authors: Aurora Cerri, Niko Pullojani

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Long-term differential settlement between the bridge structure and the bridge embankment typically results in an abrupt grade change, causing driver discomfort, impairing driver safety, and exerting a potentially excessive impact traffic loading on the abutment. This paper has analysed a case of study showing the effect of an approaching slab realized in a bridge constructed at Tirane-Elbasan Motorway. The layer thickness under the slab is modeled as homogenous, the slab is a reinforced concrete structure and over that the asphaltic layers take place. Analysis indicates that reinforced concrete approaching slab distributes the stresses quite uniformly into the road fill layers and settlements varies in a range less than 2.50 cm in the total slab length of 6.00 m with a maximum slope of 1/240. Results taken from analytical analysis are compared with topographic measurements done on field and they carry great similarities.

Keywords: approach slab, bridge, road pavement, differential settlement

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Authors: Elizabeth Laguaite, Alexandria Purdy

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

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

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Authors: Aakriti Chetan Shah, Elle Sein

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Background/purpose: Group B Streptococcus(GBS) is the leading cause of severe early onset infection in newborns, with the incidence of Early Onset Group B Streptococcus (EOGBS) in the UK and Ireland rising from 0.48 to 0.57 per 1000 births from 2000 to 2015. A WHO study conducted in 2017, has shown that 38.5% of cases can result in stillbirth and infant deaths. This is an important problem to consider as 20% of women worldwide have GBS colonisation and can suffer from these detrimental effects. Current Royal College of Obstetricians and Midwives (RCOG) guidelines do not recommend bacteriological screening for pregnant women due to its low sensitivity in antenatal screening correlating with the neonate having GBS but advise a patient information leaflet be given to pregnant women. However, a Healthcare Safety Investigation Branch (HSIB) 2019 learning report found that only 50% of trusts and health boards reported giving GBS information leaflets to all pregnant mothers. Therefore, this audit aimed to assess current practices of information dissemination about GBS at Chelsea & Westminster (C&W) Hospital. Methodology: A quantitative cross-sectional study was carried out using a questionnaire based on the RCOG GBS guidelines and the HSIB Learning report. The study was conducted in antenatal clinics at Chelsea & Westminster Hospital, from 29th January 2021 to 14th February 2021, with twenty-two practicing obstetricians and midwives participating in the survey. The main outcome measure was the proportion of obstetricians and midwives who disseminate information about GBS to pregnant women, and the reasons behind why they do or do not. Results: 22 obstetricians and midwives responded with 18 complete responses. Of which 12 were obstetricians and 6 were midwives. Only 17% of clinical staff routinely inform all pregnant women about GBS, and do so at varying timeframes of the pregnancy, with an equal split in the first, second and third trimester. The primary reason for not informing women about GBS was influenced by three key factors: Deemed relevant only for patients at high risk of GBS, lack of time in clinic appointments and no routine NHS screening available. Interestingly 58% of staff in the antenatal clinic believe it is necessary to inform all women about GBS and its importance. Conclusion: It is vital for obstetricians and midwives to inform all pregnant women about GBS due to the high prevalence of incidental carriers in the population, and the harmful effects it can cause for neonates. Even though most clinicians believe it is important to inform all pregnant women about GBS, most do not. To ensure that RCOG and HSIB recommendations are followed, we recommend that women should be given this information at 28 weeks gestation in the antenatal clinic. Proposed implementations include an information leaflet to be incorporated into the Mum and Baby app, an informative video and end-to-end digital clinic documentation to include this information sharing prompt.

Keywords: group B Streptococcus, early onset sepsis, Antenatal care, Neonatal morbidity, GBS

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Authors: Hacer Y. Teke, Sultan Pehlivan, Mustafa Karapırlı, Asude Gökmen, Sait Özsoy

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The case is here presented of a patient with DMD with electrocardiograph findings within normal limits who underwent spinal surgery then developed the rarely seen complication of cardiac tamponade which resulted in death. A 17-year old male with DMD was admitted to hospital for spinal surgery. Due to a postoperative drop in hemoglobin, blood transfusion was administered to the patient, no complication developed and he was discharged on the third day. Four days after discharge, the patient worsened at home and an ambulance was called. Before the nearest hospital was reached, the patient died in the ambulance. An autopsy was performed. A fatal but rarely seen complication of Acute Myocardial Infarction (AMI) is myocardial rupture. 85% of ruptures occur in the first week of AMI but just as they can be seen on the day of the infarct, they can also be seen 2 weeks later. The case presented here had infarction findings related to different times and in different areas.

Keywords: duchenne muscular dystrophy, myocardial infarction, myocardial rupture, anesthesia

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Authors: E. O. E. Nnadi

Abstract:

Transportation is a critical factor in the economic growth and development of any nation, region or state. Good transportation network supports every sector of the economy like the manufacturing, transportation and encourages investors thereby affect the overall economic prosperity. The paper evaluates the impact of transportation on the economic growth of Nigeria using south eastern states as a case study. The choice of the case study is its importance as the commercial and industrial nerve of the country. About 200 respondents who are of different professions such as dealers in goods, transporters, contractors, consultants, bankers were selected and a set of questionnaire were administered to using the systematic sampling technique in the five states of the region. Descriptive statistics and relative importance index (RII) technique was employed for the analysis of the data gathered. The findings of the analysis reveal that Nigeria has the least effective ratio per population in Africa of 949.91 km/Person. Conclusion was drawn to improve road network in the area and the country as a whole to enhance the economic activities of the people.

Keywords: economic growth, south-east, transportation, transportation cost, Nigeria

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Authors: Yesim Sucullu Karadag, Pinar Kurt, Sule Bilen, Nese Subutay Oztekin, Fikri Ak

Abstract:

Background: Primary cervical dystonia is thought to be a purely motor disorder. But recent studies revealed that patients with dystonia had additional non-motor features. Sensory and psychiatric disturbances could be included into the non-motor spectrum of dystonia. The Basal Ganglia receive inputs from all cortical areas and throughout the thalamus project to several cortical areas, thus participating to circuits that have been linked to motor as well as sensory, emotional and cognitive functions. However, there are limited studies indicating cognitive impairment in patients with cervical dystonia. More evidence is required regarding neurocognitive functioning in these patients. Objective: This study is aimed to investigate neurocognitive profile of cervical dystonia patients in comparison to healthy controls (HC) by employing a detailed set of neuropsychological tests in addition to self-reported instruments. Methods: Totally 29 (M/F: 7/22) cervical dystonia patients and 30 HC (M/F: 10/20) were included into the study. Exclusion criteria were depression and not given informed consent. Standard demographic, educational data and clinical reports (disease duration, disability index) were recorded for all patients. After a careful neurological evaluation, all subjects were given a comprehensive battery of neuropsychological tests: Self report of neuropsychological condition (by visual analogue scale-VAS, 0-100), RAVLT, STROOP, PASAT, TMT, SDMT, JLOT, DST, COWAT, ACTT, and FST. Patients and HC were compared regarding demographic, clinical features and neurocognitive tests. Also correlation between disease duration, disability index and self report -VAS were assessed. Results: There was no difference between patients and HCs regarding socio-demographic variables such as age, gender and years of education (p levels were 0.36, 0.436, 0.869; respectively). All of the patients were assessed at the peak of botulinum toxine effect and they were not taking an anticholinergic agent or benzodiazepine. Dystonia patients had significantly impaired verbal learning and memory (RAVLT, p<0.001), divided attention and working memory (ACTT, p<0.001), attention speed (TMT-A and B, p=0.008, 0.050), executive functions (PASAT, p<0.001; SDMT, p= 0.001; FST, p<0.001), verbal attention (DST, p=0.001), verbal fluency (COWAT, p<0.001), visio-spatial processing (JLOT, p<0.001) in comparison to healthy controls. But focused attention (STROOP-spontaneous correction) was not different between two groups (p>0.05). No relationship was found regarding disease duration and disability index with any neurocognitive tests. Conclusions: Our study showed that neurocognitive functions of dystonia patients were worse than control group with the similar age, sex, and education independently clinical expression like disease duration and disability index. This situation may be the result of possible cortical and subcortical changes in dystonia patients. Advanced neuroimaging techniques might be helpful to explain these changes in cervical dystonia patients.

Keywords: cervical dystonia, neurocognitive impairment, neuropsychological test, dystonia disability index

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Authors: Nastaran Ahmadpour Samani, Shahram Talebi

Abstract:

Added mass is an important quantity in analysis of the motion of a submerged object ,which can be calculated by solving the equation of potential flow around the object . Here, we consider systems in which a square object is submerged in a channel of fluid and moves parallel to the wall. The corresponding added mass at a given distance from the wall d and for the object size s (which is the side of square object) is calculated via lattice Blotzmann simulation . By changing d and s separately, their effect on the added mass is studied systematically. The simulation results reveal that for the systems in which d > 4s, the distance does not influence the added mass any more. The added mass increases when the object approaches the wall and reaches its maximum value as it moves on the wall (d -- > 0). In this case, the added mass is about 73% larger than which of the case d=4s. In addition, it is observed that the added mass increases by increasing of the object size s and vice versa.

Keywords: Lattice Boltzmann simulation , added mass, square, variable size

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Authors: Christakis Chatzichristou, Elias Kranos

Abstract:

Architectural awards, especially if they are given by the state, recognize excellence in the field and, at the same time, strongly contribute to the making of the architectural culture of a place. The present research looks at the houses that have been awarded through such a system in Cyprus in order to discuss the values promoted, directly or not, by such a setup which is quite similar to other prestigious award systems such as the Mies van de Rohe Prize in Europe. In fact, many of the projects signed out through the state award system end up being selected to represent the country for the European awards. The residential architecture encouraged by such systems is quite interesting in that the most public of institutions influence how the most private unit of society is architecturally accommodated. The methodology uses both qualitative as well as quantitative research tools in order to analyze: the official state call for entries to the competition; the final report of the evaluation committee; the spatial characteristics of the houses through the Space Syntax methodology; the statements of the architects regarding their intentions and the final outcome; the feelings of the owners and users of the houses regarding the design process as well as the degree of satisfaction regarding the final product. The above-mentioned analyses allow for a more thorough discussion regarding not only the values promoted explicitly by the system through the brief that describes what the evaluation committee is looking for but also the values that are actually being promoted indirectly through the results of the actual evaluation itself. The findings suggest that: the strong emphasis in brief on bioclimatic design and issues of sustainability weakens significantly, if at all present, in the actual selection process; continuous improvement seems to be fuzzily used as a concept; most of the houses tend to have a similar spatial genotype; most of the houses have similar aesthetic qualities; discrepancies between the proposed lifestyle through the design and the actual use of the spaces do not seem to be acknowledged in the evaluation as an issue; the temporal factor seems to be ignored as the projects are required to be ‘finished projects’ as though the users and their needs do not change through time. The research suggests that, rather than preserving a critical attitude regarding the role of the architect in society, the state award system tends, like any other non-reflective social organism, to simply promote its own unexamined values as well as prejudices. This is perhaps more evident in the shared aesthetic character of the awarded houses and less so in the hidden spatial genotype to which they belong. If the design of houses is indeed a great opportunity for architecture to contribute in a more deliberate manner to the evolution of society, then what the present study shows is that this opportunity seems to be largely missed. The findings may serve better less as a verdict and more as a chance for introspection and discussion.

Keywords: award systems, houses, spatial genotype, aesthetic qualities

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