Search results for: diagnostic tests

Authors: Olfat Shaker, Miriam Wadie, Reham Ali, Ayman Yosry

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Colorectal cancer (CRC) is a major cause of mortality and morbidity and accounts for over 9% of cancer incidence worldwide. Silent information regulator 2 homolog 1 (SIRT1) gene is located in the nucleus and exert its effects via modulation of histone and non-histone targets. They function in the cell via histone deacetylase (HDAC) and/or adenosine diphosphate ribosyl transferase (ADPRT) enzymatic activity. The aim of this work was to study the relationship between SIRT1 polymorphism and its protein level in colorectal cancer patients in comparison to control cases. This study includes 2 groups: thirty healthy subjects (control group) & one hundred CRC patients. All subjects were subjected to: SIRT-1 serum level was measured by ELISA and gene polymorphisms of rs12778366, rs375891 and rs3740051 were detected by real time PCR. For CRC patients clinical data were collected (size, site of tumor as well as its grading, obesity) CRC patients showed high significant increase in the mean level of serum SIRT-1 compared to control group (P<0.001). Mean serum level of SIRT-1 showed high significant increase in patients with tumor size ≥5 compared to the size < 5 cm (P<0.05). In CRC patients, percentage of T allele of rs12778366 was significantly lower than controls, CC genotype and C allele C of rs 375891 were significantly higher than control group. In CRC patients, the CC genotype of rs12778366, was 75% in rectosigmoid and 25% in cecum & ascending colon. According to tumor size, the percentage of CC genotype was 87.5% in tumor size ≥5 cm. Conclusion: serum level of SIRT-1 and T allele, C allele of rs12778366 and rs 375891 respectively can be used as diagnostic markers for CRC patients.

Keywords: CRC, SIRT1, polymorphisms, ELISA

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Authors: Abdullah Al Faruque, Ram Balachandar

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Series of laboratory tests were carried out to study the extent of scour caused by a three-dimensional wall jets exiting from a square cross-section nozzle and into a non-cohesive sand beds. Previous observations have indicated that the effect of the tailwater depth was significant for densimetric Froude number greater than ten. However, the present results indicate that the cut off value could be lower depending on the value of grain size-to-nozzle width ratio. Numbers of equations are drawn out for a better scaling of numerous scour parameters. Also suggested the empirical prediction of scour to predict the scour centre line profile and plan view of scour profile at any particular time.

Keywords: densimetric froude number, jets, nozzle, sand, scour, tailwater, time

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Authors: M. Cortés, E. Vera, O. Rojas

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The research studies of the kinetics of the corrosion process that attacks concrete and occurs within sewerage systems agree on the amount of variables that interfere in the process. This study aims to check the impact of the pH levels of the corrosive environment and the concrete surface, the concentrations of chemical sulfuric acid, and in turn, measure the resistance of concrete to this attack under controlled laboratory conditions; it also aims to contribute to the development of further research related to the topic, in order to compare the impact of biogenic sulfuric acid and chemical sulfuric acid involvement on concrete structures, especially in scenarios such as sewerage systems.

Keywords: acid sulfuric, concrete, corrosion, biogenic

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Authors: Juan Li, Hui Tian, Min Wang

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In China, under the considerable pressure of 'Gaokao' –the highly competitive college entrance examination, high school teachers and parents often worry that doing physical activity would take away the students’ precious study time and may have a negative impact on the academic grades. There was a tendency to achieve high academic scores at the cost of physical exercise. Therefore, the purpose of this study was to examine the relationship between the physical fitness and academic achievement of Chinese high school students. The participants were 968 grade one (N=457) and grade two students (N=511) with an average age of 16 years from three high schools of different levels in Beijing, China. 479 were boys, and 489 were girls. One of the schools is a top high school in China, another is a key high school in Beijing, and the other is an ordinary high school. All analyses were weighted using SAS 9.4 to ensure the representatives of the sample. The weights were based on 12 strata of schools, sex, and grades. Physical fitness data were collected using the scores of the National Physical Fitness Test, which is an annual official test administered by the Ministry of Education in China. It includes 50m run, sits and reach test, standing long jump, 1000m run (for boys), 800m run (for girls), pull-ups for 1 minute (for boys), and bent-knee sit-ups for 1 minute (for girls). The test is an overall evaluation of the students’ physical health on the major indexes of strength, endurance, flexibility, and cardiorespiratory function. Academic scores were obtained from the three schools with the students’ consent. The statistical analysis was conducted with SPSS 24. Independent-Samples T-test was used to examine the gender group differences. Spearman’s Rho bivariate correlation was adopted to test for associations between physical test results and academic performance. Statistical significance was set at p<.05. The study found that girls obtained higher fitness scores than boys (p=.000). The girls’ physical fitness test scores were positively associated with the total academic grades (rs=.103, p=.029), English (rs=.096, p=.042), physics (rs=.202, p=.000) and chemistry scores (rs=.131, p=.009). No significant relationship was observed in boys. Cardiorespiratory fitness had a positive association with physics (rs=.196, p=.000) and biology scores (rs=.168, p=.023) in girls, and with English score in boys (rs=.104, p=.029). A possible explanation for the greater association between physical fitness and academic achievement in girls rather than boys was that girls showed stronger motivation in achieving high scores in whether academic tests or fitness tests. More driven by the test results, girls probably tended to invest more time and energy in training for the fitness test. Higher fitness levels were associated with an academic benefit among girls generally in Chinese high schools. Therefore, physical fitness needs to be given greater emphasis among Chinese adolescents and gender differences need to be taken into consideration.

Keywords: physical fitness; adolescents; academic achievement; high school

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Authors: Noureddine Mahmoudi

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The use of natural fibers in the development of composite materials is a sector in full expansion. These fibers were used for their low cost, their availability and their renewable character. The fibers of the palm (palm tree) were used as reinforcement in polypropylene (PP). The date palm fibers have some potential because of their ecological and economic interest. Both unmodified and compatibilized fibers are used. Compatibilization was carried out with the use of maleic anhydride copolymers. The morphology and mechanical properties were characterized by electron microscopy scanning (SEM) and tensile tests. The influence of fiber content on mechanical properties of composite PP / date palm has been evaluated and demonstrated, that the maximum stress and elongation decreases with increasing fiber volume rate. On the other hand, an increase of the tensile modulus has been noticed, but after the fibers improvement, the maximum stress increases significantly up to 25% weight.

Keywords: plant fiber, palm, SEM, compatibilizer

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Authors: Raj Kumar Rajak, Bharat Mishra

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Bio-batteries represent an entirely new long-term, reasonable, reachable and ecofriendly approach to produce sustainable energy. In the present experimental work, we have studied the effect of generation of power by bio-battery using different electrode pairs. The tests show that it is possible to generate electricity using cow dung as an electrolyte. C-Mg electrode pair shows maximum voltage and SCC (Short Circuit Current) while C-Zn electrode pair shows less OCV (Open Circuit Voltage) and SCC. We have chosen C-Zn electrodes because Mg electrodes are not economical. By the studies of different electrodes and cow dung, it is found that C-Zn electrode battery is more suitable. This result shows that the bio-batteries have the potency to full fill the need of electricity demand for lower energy equipment.

Keywords: bio-batteries, electricity, cow-dung, electrodes, non-conventional

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Authors: Seok Hong Min, Tae Kwon Ha

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In this study, thermal fatigue properties of 400 series ferritic stainless steels have been evaluated in the temperature ranges of 200-800oC and 200-900oC. Systematic methods for control of temperatures within the predetermined range and measurement of load applied to specimens as a function of temperature during thermal cycles have been established. Thermal fatigue tests were conducted under fully constrained condition, where both ends of specimens were completely fixed. It has been revealed that load relaxation behavior at the temperatures of thermal cycle was closely related with the thermal fatigue property. Thermal fatigue resistance of 430J1L stainless steel is found to be superior to the other steels.

Keywords: ferritic stainless steel, automotive exhaust, thermal fatigue, microstructure, load relaxation

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Authors: Seyedeh Belin Tavakoly Sany, Rosli Hashim, Majid Rezayi, Aishah Salleh

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The primary objectives of this study were to investigate the distribution and composition of the macrobenthic community and their response to environmental parameters in the North Port, west coastal waters of Malaysia. A total of 25 species were identified, including 13 bivalvia, 4 gastropoda, and 3 crustacea. The other taxa were less diversified. There were no temporal changes in the macrobenthic community composition, but significant effects (p < 0.05) on the benthic community composition were found on a spatial scale. The correlation analyses and similarity tests were in good agreement, confirming the significant response of macrobenthic community composition to variations of environmental parameters.

Keywords: distribution, macrobenthic community, diversity, North Port, Malaysia

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Authors: M. Irfan Fareed, Muhammad Tahir, Alvina Gul Kazi

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Castor bean (Ricinus communis; family Euphorbiaceae) is cultivated for the production of oil and as an ornamental plant throughout tropical regions. Leaf samples from castor bean plants with leaf curl and vein thickening were collected from areas around Okara (Pakistan) in 2011. PCR amplification using diagnostic primers showed the presence of a begomovirus and subsequently the specific pair (BurNF 5’- CCATGGTTGTGGCAGTTGATTGACAGATAC-3’, BurNR 5’- CCATGGATTCACGCACAGGGGAACCC-3’) was used to amplify and clone the whole genome of the virus. The complete nucleotide sequence was determined to be 2,759 nt (accession No. HE985227). Alignments showed the highest levels of nucleotide sequence identity (98.8%) with Cotton leaf curl Burewala virus (CLCuBuV; accession No. JF416947) No. JF416947). The virus in castor beans lacks on intact C2 gene, as is typical of CLCuBuV in cotton. An amplification product of ca. 1.4 kb was obtained in PCR with primers for betasatellites and the complete nucleotide sequence of a clone was determined to be 1373 nt (HE985228). The sequence showed 96.3% nucleotide sequence identity to the recombinant Cotton leaf curl Multan betasatellite (CLCuMB; JF502389). This is the first report of CLCuBuV and its betasatellite infecting castor bean, showing this plant species as an alternate host of the virus. Already many alternate host have been reported from different alternate host like tobacco, tomato, hibiscus, okra, ageratum, Digera arvensis, habiscus, Papaya and now in Ricinus communis. So, it is suggested that these alternate hosts should be avoided to grow near cotton growing regions.

Keywords: Ricinus communis, begomovirus, betasatellite, agriculture

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Authors: Juha Kettunen

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This study presents a project that tests and adjusts active European learning and teaching methods in Indonesian universities to increase their external impact on enterprises and other organizations; it also assesses the implementation of the Erasmus+ projects funded by the European Union. The project is based on the approach of innovation pedagogy that responds to regional development needs and integrates applied research and development projects into education to create capabilities for students to participate in development work after graduation. The assessment of the Erasmus+ project resulted in many improvements that can be made to achieve higher quality and innovativeness. The results of this study are useful for those who want to improve the applied research and development projects of higher education institutions.

Keywords: higher education, innovations, social network, project management

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Authors: Ayşe Eldem, Fatih Başçiftçi

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Braille alphabet is an important tool that enables visually impaired individuals to have a comfortable life like those who have normal vision. For this reason, new applications related to the Braille alphabet are being developed. In this study, a new Refreshable Braille Display was developed to help visually impaired individuals learn the Braille alphabet easier. By means of this system, any text downloaded on a computer can be read by the visually impaired individual at that moment by feeling it by his/her hands. Through this electronic device, it was aimed to make learning the Braille alphabet easier for visually impaired individuals with whom the necessary tests were conducted.

Keywords: visually impaired individual, Braille, Braille display, refreshable Braille display, USB

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Authors: Adeola Adenikinju, Olusanya E. Olubusoye, Lateef O. Akinpelu, Dilinna L. Nwobi

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Since the enactment of the Fiscal Responsibility Act (2007), the Federal Government of Nigeria (FGN) has made public its fiscal budget and the subsequent implementation report. A critical review of these documents shows significant variations in the five macroeconomic variables which are inputs in each Presidential budget; oil Production target (mbpd), oil price ($), Foreign exchange rate(N/$), and Gross Domestic Product growth rate (%) and inflation rate (%). This results in underperformance of the Federal budget expected output in terms of non-oil and oil revenue aggregates. This paper evaluates first the existing variance between budgeted and actuals, then the relationship and causality between the determinants of Federal fiscal budget assumptions, and finally the determinants of FGN’s Gross Oil Revenue. The paper employed the use of descriptive statistics, the Autoregressive distributed lag (ARDL) model, and a Profit oil probabilistic model to achieve these objectives. This model permits for both the static and dynamic effect(s) of the independent variable(s) on the dependent variable, unlike a static model that accounts for static or fixed effect(s) only. It offers a technique for checking the existence of a long-run relationship between variables, unlike other tests of cointegration, such as the Engle-Granger and Johansen tests, which consider only non-stationary series that are integrated of the same order. Finally, even with small sample size, the ARDL model is known to generate a valid result, for it is the dependent variable and is the explanatory variable. The results showed that there is a long-run relationship between oil revenue as a proxy for budget performance and its determinants; oil price, produced oil quantity, and foreign exchange rate. There is a short-run relationship between oil revenue and its determinants; oil price, produced oil quantity, and foreign exchange rate. There is a long-run relationship between non-oil revenue and its determinants; inflation rate, GDP growth rate, and foreign exchange rate. The grangers’ causality test results show that there is a mono-directional causality between oil revenue and its determinants. The Federal budget assumptions only explain 68% of oil revenue and 62% of non-oil revenue. There is a mono-directional causality between non-oil revenue and its determinants. The Profit oil Model describes production sharing contracts, joint ventures, and modified carrying arrangements as the greatest contributors to FGN’s gross oil revenue. This provides empirical justification for the selected macroeconomic variables used in the Federal budget design and performance evaluation. The research recommends other variables, debt and money supply, be included in the Federal budget design to explain the Federal budget revenue performance further.

Keywords: ARDL, budget performance, oil price, oil quantity, oil revenue

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Authors: Richu J. Babu, Sony Mathew, Sharon Rony Jacob, Soney C. George, Jibin C. Jacob

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Human hair is a non-biodegradable waste available in plenty throughout the world but is rarely explored for applications in engineering fields. Tensile strength of human hair ranges from 170 to 220 MPa. This property of human hair can be made use in the field of making bio-composites[1]. The composite is prepared by commixing the human hair and natural rubber in a two roll mill along with additives followed by vulcanization. Here the concentration of the human hair is varied by fine-tuning the fiber length as 20 mm and sundry tests like tensile, abrasion, tear and hardness were conducted. While incrementing the fiber length up to a certain range the mechanical properties shows superior amendments.

Keywords: human hair, natural rubber, composite, vulcanization, fiber loading

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Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

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Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

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Authors: M. Regis, E. Marin, S. Fusi, M. Pressacco, L. Fedrizzi

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Electron Beam Melting (EBM) process was used to prepare porous scaffolds with controlled porosity to ensure optimal levels of osteointegration for different trabeculae sizes. Morphological characterization by means of SEM analyses was carried out to assess pore dimensions; tensile, compression and adhesion tests have been carried out to determine the mechanical behavior. The results indicate that EBM process allows the creation of regular and repeatable porous scaffolds. Mechanical properties greatly depend on pore dimension and on bulk-pore ratio. Adhesion resistance meets the normative requirements, and the overall performance of the produced structures is compatible with potential orthopaedic applications.

Keywords: additive manufacturing, orthopaedic implants, osteointegration, trabecular structures

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Authors: Martonovich Noa, Maman David, Alfandari Liad, Behrbalk Eyal.

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Introduction: The human body is designed for upright standing and walking, with the lower extremities and axial skeleton supporting weight-bearing. Constant weight-bearing on joints not meant for this action can lead to various pathologies, as seen in wheelchair users. Handstand practitioners use their wrists as weight-bearing joints during activities, but little is known about wrist injuries in this population. This study aims to investigate the epidemiology of wrist pain among handstand practitioners, as no such data currently exist. Methods: The study is a cross-sectional online survey conducted among athletes who regularly practice handstands. Participants were asked to complete a three-part questionnaire regarding their workout regimen, training habits, and history of wrist pain. The inclusion criteria were athletes over 18 years old who practice handstands more than twice a month for at least 4 months. All data were collected using Google Forms, organized and anonymized using Microsoft Excel, and analyzed using IBM SPSS 26.0. Descriptive statistics were calculated, and potential risk factors were tested using asymptotic t-tests and Fisher's tests. Differences were considered significant when p < 0.05. Results: This study surveyed 402 athletes who regularly practice handstands to investigate the prevalence of chronic wrist pain and potential risk factors. The participants had a mean age of 31.3 years, with most being male and having an average of 5 years of training experience. 56% of participants reported chronic wrist pain, and 14.4% reported a history of distal radial fracture. Yoga was the most practiced form, followed by Capoeira. No significant differences were found in demographic data between participants with and without chronic wrist pain, and no significant associations were found between chronic wrist pain prevalence and warm-up routines or protective aids. Conclusion: The lower half of the body is meant to handle weight-bearing and impact, while transferring the load to upper extremities can lead to various pathologies. Athletes who perform handstands are particularly prone to chronic wrist pain, which affects over half of them. Warm-up sessions and protective instruments like wrist braces do not seem to prevent chronic wrist pain, and there are no significant differences in age or training volume between athletes with and without the condition. Further research is needed to understand the causes of chronic wrist pain in athletes, given the growing popularity of sports and activities that can cause this type of injury.

Keywords: handstand, handbalance, wrist pain, hand and wrist surgery, yoga, calisthenics, circus, capoeira, movement.

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Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

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Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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Authors: A. Bahmanpour, I. Eames, C. Klettner, A. Dimakopoulos

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We develop a new set of diagnostic tools to analyze inundation into a model district using three-dimensional CFD simulations, with a view to generating a database against which to test simpler models. A three-dimensional model of Oregon city with different-sized groups of building next to the coastline is used to run calculations of the movement of a long period wave on the shore. The initial and boundary conditions of the off-shore water are set using a nonlinear inverse method based on Eulerian spatial information matching experimental Eulerian time series measurements of water height. The water movement is followed in time, and this enables the pressure distribution on every surface of each building to be followed in a temporal manner. The three-dimensional numerical data set is validated against published experimental work. In the first instance, we use the dataset as a basis to understand the success of reduced models - including 2D shallow water model and reduced 1D models - to predict water heights, flow velocity and forces. This is because models based on the shallow water equations are known to underestimate drag forces after the initial surge of water. The second component is to identify critical flow features, such as hydraulic jumps and choked states, which are flow regions where dissipation occurs and drag forces are large. Finally, we describe how future tsunami inundation models should be modified to account for the complex effects of buildings through drag and blocking.Financial support from UCL and HR Wallingford is greatly appreciated. The authors would like to thank Professor Daniel Cox and Dr. Hyoungsu Park for providing the data on the Seaside Oregon experiment.

Keywords: computational fluid dynamics, extreme events, loading, tsunami

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Authors: A. H. Meysami

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In this paper, the hot compression tests were carried on X45CrNiW189 valve steel (X45) in the temperature range of 1000–1200°C and the strain rate range of 0.004–0.5 s^(-1) in order to study the high temperature softening behavior of the steel. For the exact prediction of flow stress, the effective stress - effective strain curves were obtained from experiments under various conditions. On the basis of experimental results, the dynamic recrystallization fraction (DRX), AGS, hot deformation and activation energy behavior were investigated. It was found that the calculated results were in a good agreement with the experimental flow stress and microstructure of the steel for different conditions of hot deformation.

Keywords: X45CrNiW189, valve steel, hot compression test, dynamic recrystallization, hot deformation

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Authors: Raphael Zanella

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This works deals with the finite element approximation of axisymmetric problems. The weak formulation of the heat equation under the axisymmetry assumption is established for continuous finite elements. The weak formulation is implemented in a C++ solver with implicit march-in-time. The code is verified by space and time convergence tests using a manufactured solution. The solving of an example problem with an axisymmetric formulation is compared to that with a full-3D formulation. Both formulations lead to the same result, but the code based on the axisymmetric formulation is much faster due to the lower number of degrees of freedom. This confirms the correctness of our approach and the interest in using an axisymmetric formulation when it is possible.

Keywords: axisymmetric problem, continuous finite elements, heat equation, weak formulation

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Authors: Zülfiye Bıkmaz, Aytolan Yıldırım

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This study was planned as a descriptive regressive study in order to determine the relationship between the competency levels of working nurses, the levels of competency expected by nursing students, the critical thinking disposition of nurses, their perceived autonomy levels, and certain socio demographic characteristics. It is also a methodological study with regard to the intercultural adaptation of the Nursing Competence Scale (NCS) in both working and student samples. The sample of the study group of nurses at a university hospital for at least 6 months working properly and consists of 443 people filled out questionnaires. The student group, consisting of 543 individuals from the 4 public university nursing 3rd and 4th grade students. Data collection tools consisted of a questionnaire prepared in order to define the socio demographic, economic, and personal characteristics of the participants, the ‘Nursing Competency Scale’, the ‘Autonomy Subscale of the Sociotropy – Autonomy Scale’, and the ‘California Critical Thinking Disposition Inventory’. In data evaluation, descriptive statistics, nonparametric tests, Rasch analysis and correlation and regression tests were used. The language validity of the ‘NCS’ was performed by translation and back translation, and the context validity of the scale was performed with expert views. The scale, which was formed into its final structure, was applied in a pilot application from a group consisting of graduate and student nurses. The time constancy of the test was obtained by analysis testing retesting method. In order to reduce the time problems with the two half reliability method was used. The Cronbach Alfa coefficient of the scale was found to be 0.980 for the nurse group and 0.986 for the student group. Statistically meaningful relationships between competence and critical thinking and variables such as age, gender, marital status, family structure, having had critical thinking training, education level, class of the students, service worked in, employment style and position, and employment duration were found. Statistically meaningful relationships between autonomy and certain variables of the student group such as year, employment status, decision making style regarding self, total duration of employment, employment style, and education status were found. As a result, it was determined that the NCS which was adapted interculturally was a valid and reliable measurement tool and was found to be associated with autonomy and critical thinking.

Keywords: nurse, nursing student, competence, autonomy, critical thinking, Rasch analysis

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Authors: Sneha Shankar, Orlando Buendia, Will Evans

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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.

Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis

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Authors: C. M. Williams, R. English, P. King, I. M. Brown

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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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Authors: Suphaporn Rattanaphinanchai

Abstract:

The purpose of this study is to 1) describe and analyze the travel motivations of tourists visiting Phi Phi Islands after the Tsunami in 2004 and 2) to better understand whether there are significant differences in the tourists’ motivations in visiting Phi Phi Island after the Tsunami hit across tourists with different demographic profile. This study used Phi Phi Islands, which was damaged by the 2004 Indian Ocean tsunami as a case study. The instrument used in the present study is a self-administered questionnaire. A survey with 200 questionnaires was collected in May - December, 2015. Descriptive statistics, Independent Sample Mean T-tests, and Analysis of Variances was used to analyze the data. The result of the study showed that beauty of nature, good climate, and relaxing atmosphere motivated tourists in visiting Phi Phi Islands after the tsunami.

Keywords: motivation, Thailand, Thai tourism, Thai beaches

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Authors: Dinoo Kirthinanda, Sujani Wijeratne

Abstract:

Pseudohyperkalaemia is a common benign in vitro phenomenon caused by the release of potassium ions (K+) from cells during specimen processing. Analysis of haemolysed blood samples for predominantly intracellular electrolytes may lead to re-investigation and potentially harmful interventions. We report a case of a 52-year male with myeloproliferative disease manifested as Polycythaemia Rubra Vera, Hypertension and hypertensive nephropathy with stage 3 chronic kidney disease admitted to Neuro-intensive care unit (NICU) with an intra-cerebral haemorrhage secondary to hypertensive bleed. His initial blood investigations showed hyperkalemia with serum K+ 6.2 mmol/L yet the bedside arterial blood gas analysis yielded K+ of 4.6 mmol/L. The patient was however given hyperkalemia regime twice based on venous electrolyte analysis. The discrepancy between the bedside electrolyte analysis using arterial blood and venous blood prompted further evaluation. The 12 lead Electrocardiogram showed U waves and sinus bradycardia corresponding to the serum K+ of 2.8 mmol/L on arterial blood gas analysis. Immediate K+ replacement ensured the patient did not develop life-threatening cardiac complications. Pseudohyperkalaemia may pose diagnostic challenges in the absence of detectable haemolysis and should be suspected in susceptible patients with normal Electrocardiogram and Glomerular Filtration Rate to avoid potentially life-threatening interventions. When in doubt, rapid analysis of arterial blood gas may be useful for accurate quantification of potassium.

Keywords: patient safety, pseudohyperkalaemia, haemolysis, myeloproliferative disorder

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Authors: Alexander Buhr, Klaus Ehrenfried

Abstract:

Trackside induced airflow velocities, also known as slipstream velocities, are an important criterion for the design of high-speed trains. The maximum permitted values are given by the Technical Specifications for Interoperability (TSI) and have to be checked in the approval process. For train manufactures it is of great interest to know in advance, how new train geometries would perform in TSI tests. The Reynolds number in moving model experiments is lower compared to full-scale. Especially the limited model length leads to a thinner boundary layer at the rear end. The hypothesis is that the boundary layer rolls up to characteristic flow structures in the train wake, in which the maximum flow velocities can be observed. The idea is to enlarge the boundary layer using roughness elements at the train model head so that the ratio between the boundary layer thickness and the car width at the rear end is comparable to a full-scale train. This may lead to similar flow structures in the wake and better prediction accuracy for TSI tests. In this case, the design of the roughness elements is limited by the moving model rig. Small rectangular roughness shapes are used to get a sufficient effect on the boundary layer, while the elements are robust enough to withstand the high accelerating and decelerating forces during the test runs. For this investigation, High-Speed Particle Image Velocimetry (HS-PIV) measurements on an ICE3 train model have been realized in the moving model rig of the DLR in Göttingen, the so called tunnel simulation facility Göttingen (TSG). The flow velocities within the boundary layer are analysed in a plain parallel to the ground. The height of the plane corresponds to a test position in the EN standard (TSI). Three different shapes of roughness elements are tested. The boundary layer thickness and displacement thickness as well as the momentum thickness and the form factor are calculated along the train model. Conditional sampling is used to analyse the size and dynamics of the flow structures at the time of maximum velocity in the train wake behind the train. As expected, larger roughness elements increase the boundary layer thickness and lead to larger flow velocities in the boundary layer and in the wake flow structures. The boundary layer thickness, displacement thickness and momentum thickness are increased by using larger roughness especially when applied in the height close to the measuring plane. The roughness elements also cause high fluctuations in the form factors of the boundary layer. Behind the roughness elements, the form factors rapidly are approaching toward constant values. This indicates that the boundary layer, while growing slowly along the second half of the train model, has reached a state of equilibrium.

Keywords: boundary layer, high-speed PIV, ICE3, moving train model, roughness elements

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Authors: Falntina Ahmad Alata, Natheer Abu Obeid

Abstract:

This paper is a research report of an experimental study on a proposed typology system to diagnose and evaluate the affordances of varying architectural environments. The study focused on architectural environments which have been developed with a shift in their use of adaptive reuse. The novelty in the newly developed environments was tested in terms of human responsiveness and interaction using a variety of selected cases. The study is a follow-up on previous research by the same authors, in which a typology of 16 categories of environmental affordances was developed and introduced. The current study introduced other new categories, which together with the previous ones establish what could be considered a basic language of affordance typology. The experiment was conducted on ten architectural environments while adopting two processes: 1. Diagnostic process, in which the environments were interpreted in terms of their affordances using the previously developed affordance typology, 2. The evaluation process, in which the diagnosed environments were evaluated using measures of emotional experience and architectural evaluation criteria of beauty, economy and function. The experimental study demonstrated that the typology system was capable of diagnosing different environments in terms of their affordances. It also introduced new categories of human interaction: “multiple affordances,” “conflict affordances,” and “mix affordances.” The different possible combinations and mixtures of categories demonstrated to be capable of producing huge numbers of other newly developed categories. This research is an attempt to draw a roadmap for designers to diagnose and evaluate the affordances within different architectural environments. It is hoped to provide future guidance for developing the best possible adaptive reuse according to the best affordance category within their proposed designs.

Keywords: affordance theory, affordance categories, architectural environments, architectural evaluation criteria, adaptive reuse environment, emotional experience, shift in use environment

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Authors: Parastou Kharazmi, Folke Björk

Abstract:

Some of the main causes for degradation of polymeric materials are thermal aging, hydrolysis, oxidation or chemical degradation by acids, alkalis or water. The first part of this paper provides a brief summary of advances in technology, methods and specification of composite materials for relining as a rehabilitation technique for sewage systems. The second part summarizes an investigation on frequently used composite materials for relining in Sweden, the rubber filled epoxy composite and reinforced polyester composite when they were immersed in deionized water or in dry conditions, and elevated temperatures up to 80°C in the laboratory. The tests were conducted by visual inspection, microscopy, Dynamic Mechanical Analysis (DMA), Differential Scanning Calorimetry (DSC) as well as mechanical testing, three point bending and tensile testing.

Keywords: composite, epoxy, polyester, relining, sewage

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Authors: Min Ho Kwon, Woo Young Jung, Hyun Su Seo

Abstract:

A Polymer Cement Mortar (PCM) has been widely used as the material of repair and restoration work for concrete structure; however a PCM usually induces an environmental pollutant. Therefore, there is a need to develop PCM which is less impact to environments. Usually, UM resin is known to be harmless to the environment. Accordingly, in this paper, the properties of the PCM using UM resin were studied. The general cement mortar and UM resin was mixed in the specified ratio. A certain percentage of PVA fibers, steel fibers and mixed fibers (PVA fiber and steel fiber) were added to enhance the flexural strength. The flexural tests were performed in order to investigate the flexural strength of each PCM. Experimental results showed that the strength of proposed PCM using UM resin is improved when they are compared with general cement mortar.

Keywords: polymer cement mortar, UM resin, compressive strength, PVA fiber, steel fiber

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