Search results for: clinical quality

Authors: Hamisu Idi

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The present study focuses on studying the impact of influencer recommendation in the quality of cement production. Exploratory research was done on monthly basis, where data were obtained from secondary source i.e. the record kept by an automated recompilation machine. The machine keeps all the records of the mills downtime which the process manager checks for validation and refer the fault (if any) to the department responsible for maintenance or measurement taking so as to prevent future occurrence. The findings indicated that the product of the Ashaka Cement Plc. were considered as qualitative, since all the production processes were found to be in control (preset specifications) with the exception of the natural cause of variation which is normal in the production process as it will not affect the outcome of the product. It is reduced to the bearest minimum since it cannot be totally eliminated. It is also hopeful that the findings of this study would be of great assistance to the management of Ashaka cement factory and the process manager in particular at various levels in the monitoring and implementation of statistical process control. This study is therefore of great contribution to the knowledge in this regard and it is hopeful that it would open more research in that direction.

Keywords: cement, quality, variation, assignable cause, common cause

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Authors: John M. Frimpong, Matilda K. Owusu-Bio, Caleb Annan

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Business today is highly competitive, and the automobile industry is no exception. Therefore, it is necessary to determine the customer value and service quality measures that lead to customer satisfaction which in turn lead to customer loyalty. However, in the automobile industry, the role of logistics service support in these relationships cannot be undermined. It could be inferred that logistics service supports and its management has a direct correlation with customer service and or service quality. But this is not always the same for all industries. Therefore, this study was to investigate how automobile companies implement the concept of customer service through logistics service supports. In order to ascertain this, two automobile companies in Ghana were selected, and these are Toyota Ghana Limited and Mechanical Lloyd Company Ltd. The study developed a conceptual model to depict the study’s objectives from which questionnaires were developed from for data collection. Respondents were made up of customers and staff of the two companies. The findings of the study revealed that the automobile industry partly attributes their customer satisfaction to the customer value, service quality or customer value. It shows a positive relationship between logistics service supports and service quality and customer value. However, the results indicate that customer satisfaction is not predicted by logistics services. This implies that in the automobile industry, it is not always the case that when customer service is implemented through logistics service supports, it leads to customer satisfaction. Therefore, there is the need for all players and stakeholders in the automobile industry investigate other factors which help to increase customer satisfaction in addition to logistics service supports. It is recommended that logistics service supports should be geared towards meeting customer expectations and not just based on the organization’s standards and procedures. It is necessary to listen to the voice of the customer to tailor the service package to suit the needs and expectations of the customer.

Keywords: customer loyalty, customer satisfaction, customer service, customer value, logistics service supports

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Authors: Pham Van Hung, Nguyen Trong Hieu, Le Quoc Dinh, Nguyen Kiem Chien, Le Dinh Hieu

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The article focuses on the study of automatic flight control on missiles during operation. The quality standards and characteristics of missile operations are very strict, requiring high stability and accurate response to commands within a relatively wide range of work. The study analyzes the linear transfer function model of the Missile Roll channel to facilitate the development of control systems. A two-loop control structure for the Missile Roll channel is proposed, with the inner loop controlling the Missile Roll rate and the outer loop controlling the Missile Roll angle. To determine the optimal control parameters, a genetic algorithm is applied. The study uses MATLAB simulation software to implement the genetic algorithm and evaluate the quality of the closed-loop system. The results show that the system achieves better quality than the original structure and is simple, reliable, and ready for implementation in practical experiments.

Keywords: genetic algorithm, roll chanel, two-loop control structure, missile

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Authors: Pugazhenthan Thangaraju

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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.

Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia

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Authors: Mohammad Hadi Khorashadi Zadeh, Amin Karkon, Seyd Mohammad Reza Mashhoori ‎

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the technology of Computer audit played a major role in the progress and ‎prospects of a proper application to improve the quality and efficiency of audit ‎work. But due to the technical complexity and the specific risks of computer ‎audit, it should be shown effective in audit and preventive action. Mainly through ‎research in this paper, we proposes the causes of audit risk in a computer ‎environment and the risk of further proposals for measures to control, to some ‎extent reduce the risk of computer audit and improve the audit quality.‎

Keywords: computer auditing, risk, measures to prevent, information technology

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Authors: Sajid Abas, Jon Pyo Hong, Jung-Ryun Le, Seungryong Cho

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Computed tomography and laminography are heavily investigated in a compressive sensing based image reconstruction framework to reduce the dose to the patients as well as to the radiosensitive devices such as multilayer microelectronic circuit boards. Nowadays researchers are actively working on optimizing the compressive sensing based iterative image reconstruction algorithm to obtain better quality images. However, the effects of the sampled data’s properties on reconstructed the image’s quality, particularly in an insufficient sampled data conditions have not been explored in computed laminography. In this paper, we investigated the effects of two data properties i.e. sampling density and data incoherence on the reconstructed image obtained by conventional computed laminography and a recently proposed method called spherical sinusoidal scanning scheme. We have found that in a compressive sensing based image reconstruction framework, the image quality mainly depends upon the data incoherence when the data is uniformly sampled.

Keywords: computed tomography, computed laminography, compressive sending, low-dose

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Authors: Chana Pavneet

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Background: In more recent years in dentistry, a greater emphasis has been placed on competency-based education (CBE) programmes. Undergraduate and postgraduate curriculums have been reformed to reflect these changes, and adopting a CBE approach has shown to be beneficial to trainees and places an emphasis on continuous lifelong learning. The literature is vast; however, very little work has been done specifically to the assessment of competence in dentistry and even less so in oral surgery. The majority of the literature tends to opinion pieces. Some small-scale studies have been undertaken in this area researching assessment tools which can be used to assess competence in oral surgery. However, there is a lack of general consensus on the preferable assessment methods. The aim of this review is to identify the assessment methods available and their usefulness. Methods: Electronic databases (Medline, Embase, and the Cochrane Database of systematic reviews) were searched. PRISMA guidelines were followed to identify relevant papers. Abstracts of studies were reviewed, and if they met the inclusion criteria, they were included in the review. Papers were reviewed against the critical appraisal skills programme (CASP) checklist and medical education research quality instrument (MERQSI) to assess their quality and identify any bias in a systematic manner. The validity and reliability of each assessment method or tool were assessed. Results: A number of assessment methods were identified, including self-assessment, peer assessment, and direct observation of skills by someone senior. Senior assessment tended to be the preferred method, followed by self-assessment and, finally, peer assessment. The level of training was shown to affect the preferred assessment method, with one study finding peer assessment more useful in postgraduate trainees as opposed to undergraduate trainees. Numerous tools for assessment were identified, including a checklist scale and a global rating scale. Both had their strengths and weaknesses, but the evidence was more favourable for global rating scales in terms of reliability, applicability to more clinical situations, and easier to use for examiners. Studies also looked into trainees’ opinions on assessment tools. Logbooks were not found to be significant in measuring the competence of trainees. Conclusion: There is limited literature exploring the methods and tools which assess the competence of oral surgery trainees. Current evidence shows that the most favourable assessment method and tool may differ depending on the stage of training. More research is required in this area to streamline assessment methods and tools.

Keywords: competence, oral surgery, assessment, trainees, education

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Authors: Thirakorn Maneerat, Darunee Jongudomkarn, Jiraporn Khiewyoo

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Family quality of life of families who have persons with disabilities is a core concern in government services and community health promotion to deal with the multidimensionality of today’s health and societal issues. The number of families who have persons with disabilities in Thailand is gradually increasing. However, facilitation and evaluation of such family quality of life are limited by the lack of feasible tools. As a consequence, service provided for the families is not optimally facilitated and evaluated. This paper is part of a larger project which is aimed to develop a scale for measuring of family quality of life of families who have persons with developmental disabilities in Thailand, presenting the results of a three-round Delphi method involving 11 experts. The study was obtained during December 2013 to May 2014. The first round consisted of open-ended questionnaire and content analysis of the answers. The second round comprised a 5-point Likert scale structured questionnaire based on the first round analysis, with required the experts to identify the most relevant studied tool aspects. Their feedbacks levels of agreements were statistic analysis using the median, interquartile range and quartile deviation. The included criteria for items acceptance were greater than 3.50 of the median, lesser than 1.50 of interquartile range, and 0.65 or less of a quartile deviation. Finally, the proposed questionnaire was structured and validated by the experts in the third round. The results found that across all three rounds, the experts achieved 100% agreement on the five factors regarding to quality of life of a family who have person with disability were considered. These five factors with 38 items were included: 1) 10 items of family interactions; 2) 9 items of child rearing; 3) 7 items of physical and material resources; 4) 5 items of social-emotional status; and 7 items of disability-related services and welfare. Next step of the study was examined the construct validity by using factor analysis methods.

Keywords: tool development, family quality of life scale, person with disability, Delphi study

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Authors: Manjunath A. P., Al-Ajmi G. M., Al Shukri M., Girija S

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Introduction: This study aimed to compare the ability of hysteroscopy and ultrasonography to diagnose uterine polyps. To correlate the ultrasonography and hystroscopic findings with various clinical factors and histopathology of uterine polyps. Methods: This is a retrospective study conducted at the Department of Obstetrics and Gynaecology at Sultan Qaboos University Hospital from 2014 to 2019. All women undergoing hysteroscopy for suspected uterine polyps were included. All relevant data were obtained from the electronic patient record and analysed using SPSS. Results: A total of 77 eligible women were analysed. The mean age of the patients was 40 years. The clinical risk factors; obesity, hypertension, and diabetes mellitus, showed no significant statistical association with the presence of uterine polyps (p-value>0.005). Although 20 women (52.6%) with uterine polyps had thickened endometrium (>11 mm), however, there is no statistical association (p-value>0.005). The sensitivity and specificity of ultrasonography in the detection of uterine polyp were 39% and 65%, respectively. Whereas for hysteroscopy, it was 89% and 20%, respectively. The prevalence of malignant and premalignant lesions were 1.85% and 7.4%, respectively. Conclusion: This study found that obesity, hypertension, and diabetes mellitus were not associated with the presence of uterine polyps. There was no association between thick endometrium and uterine polyps. The sensitivity is higher for hysteroscopy, whereas the specificity is higher for sonography in detecting uterine polyps. The prevalence of malignancy was very low in uterine polyps.

Keywords: endometrial polyps, hysteroscopy, ultrasonography, premalignant, malignant

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Authors: Brendan Mooney

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Context: Feelings and emotions are commonly misunderstood and the terms often used interchangeably, leading to potential negative impacts on individuals' mental well-being and relationships. The distinction between these two fundamentally different experiences of human life is crucial for effective psychological practice and communication. Research Aim: The aim of this study is to outline the disparities between feelings and emotions, emphasising the significance of this differentiation in psychological practice to enhance clients' observation, decision-making, problem-solving, and communication skills. Methodology: This research utilises a conceptual model developed by the author in 2017 based on clinical experience, client observations, and feedback. The model serves to guide effective clinical practice by providing clear definitions and understanding of feelings versus emotions. Case study examples were utilised to support the efficacy of the model. Findings: The study highlights that recognising and expressing feelings rather than emotions is more empowering and conducive to resolving unresolved issues, thereby fostering better psychological well-being and interpersonal relationships. Theoretical Importance: This research underscores the importance of clarifying fundamental definitions related to feelings and emotions in enhancing psychological interventions and preventing various relationship conflicts and individual issues. Data Collection and Analysis Procedures: Data was collected through the author's clinical experience and interactions with clients, informing the development of the Feeling Emotions Mental (FEM) model. Analysis involved synthesising observations and feedback to elucidate the distinctions between feelings and emotions. Questions Addressed: What are the disparities between feelings and emotions? How does the confusion between these two fundamentally different experiences of human life impact individuals' mental well-being and relationships? Why is it essential to differentiate between feelings and emotions in psychological practice? Conclusion: The study advocates for a clear understanding of feelings versus emotions to support clients in addressing unresolved issues and improving their overall psychological functioning and communication skills, thereby preventing potential conflicts and relationship challenges.

Keywords: couples, mental, misinformation, misunderstanding, relationships

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Authors: Mohammed S. Bhader, Abdullah A. Ghaddaf, Anas Alamoudi, Amal Abualola, Renad Kalantan, Noura Alkhulaifi, Ibrahim Halawani, Mohammed Alhindi

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Background: Noninvasive neurally adjusted ventilatory assist (NAVA) is a relatively new mode of noninvasive ventilation with promising clinical and patient-ventilator outcomes for preterm infants. The aim of this systematic review was to compare NAVA to nasal continuous or positive airway pressure (NCPAP) or intermittent positive airway pressure (NIPP) for preterm infants. Methods: We searched the online databases Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared NAVA to NCPAP or NIPP for preterm infants < 37 weeks gestational age. We sought to evaluate the following outcomes: noninvasive intubation failure rate, desaturation rate, the fraction of inspired oxygen (FiO2), and length of stay in the neonatal intensive care unit (NICU). We used the mean difference (MD) to represent continuous outcomes, while the odds ratio (OR) was used to represent dichotomous outcomes. Results: A total of 11 RCTs that enrolled 429 preterm infants were deemed eligible. NAVA showed similar clinical outcomes to NCPAP or NIPP with respect to noninvasive intubation failure (RR for NAVA versus NCPAP: 0.82, 95% confidence interval (CI): 0.49 to 1.37), desaturation rate (RR for NAVA versus NCPAP: 0.69, 95%CI: 0.36 to 1.29; RR for NAVA versus NIPP: 0.58, 95%CI: 0.08 to 4.25), FiO2 (MD for NAVA versus NCPAP: –0.01, 95%CI: –0.04 to 0.02; MD for NAVA versus NIPP: –7.16, 95%CI: –22.63 to 8.31), and length of stay in the NICU (MD for NAVA versus NCPAP: 1.34, 95%CI: –4.17 to 6.85). Conclusion: NAVA showed similar clinical and ventilator-related outcomes compared to the usual care noninvasive respiratory support measures NCPAP or NIPP for preterm infants.

Keywords: preterm infants, noninvasive neurally adjusted ventilatory assist, NIV-NAVA, non-invasive ventilation, nasal continuous or positive airway pressure, NCPAP, intermittent positive airway pressure ventilation, NIPP, respiratory distress syndrome, RDS

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Authors: Shammael Selorfia

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The Quality improvement project aimed to improve junior doctors and nurses’ knowledge and confidence in diagnosing and managing delirium on inpatient surgical wards in a tertiary hospital. The study aimed to develop a standardised assessment and management checklist for all staff working with patients who were presenting with signs of delirium. The aim of the study was to increase confidence of staff at dealing with delirium and improve the quality of referrals that were being sent to the Mental Health Liaison team over a 6-month period. A significant proportion of time was being spent by the Mental Health Liaison triage nurses on referrals for delirium. Data showed 28% of all delirium referrals from surgical teams were being closed at triage reflecting a poor standard of quality of those referrals. A qualitative survey of junior doctors in 6 surgical specialties in a UK tertiary hospital was conducted. These specialties include general surgery, vascular, plastic, urology, neurosurgery, and orthopaedics. The standardised checklist was distributed to all surgical wards. A comparison was made between the Mental health team caseload of delirium before intervention was compared and after. A Qualitative survey at end of 3-month cycle and compare overall caseload on Mental Health Liaison team to pre-QIP data with aim to improve quality of referrals and reduce workload on Mental Health Liaison team. At the end of the project cycle, we demonstrated an improvement in the quality of referrals with a decrease in the percentage of referrals being closed at triage by 8%. Our surveys also indicated an increase in the knowledge of official trust delirium guidelines and confidence at managing the patients. This project highlights that a new approach to delirium using multi-component interventions is needed, where the diagnosis of delirium is shared amongst medical and nursing staff, and everyone plays role in management. The key is improving awareness of delirium and encouraging the use of recognized diagnostic tools and official guidelines. Recommendations were made to the trust on how to implement a long-lasting change.

Keywords: delirium, surgery, quality, improvement

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Authors: Lingerew Nebere Kassie, Ping-Yu Chang, Hsin-Hua Huang, , Chaw-Son Chen

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Transient electromagnetic (TEM) data plays a crucial role in hydrogeological and environmental applications, providing valuable insights into geological structures and resistivity variations. However, the presence of noise often hinders the interpretation and reliability of these data. Our study addresses this issue by utilizing a FASTSNAP system for the TEM survey, which operates at different modes (low, medium, and high) with continuous adjustments to discretization, gain, and current. We employ a denoising approach that processes the raw data obtained from each acquisition mode to improve signal quality and enhance data reliability. We use a signal-averaging technique for each mode, increasing the signal-to-noise ratio. Additionally, we utilize wavelet transform to suppress noise further while preserving the integrity of the underlying signals. This approach significantly improves the data quality, notably suppressing severe noise at late times. The resulting denoised data exhibits a substantially improved signal-to-noise ratio, leading to increased accuracy in parameter estimation. By effectively denoising TEM data, our study contributes to a more reliable interpretation and analysis of underground structures. Moreover, the proposed denoising approach can be seamlessly integrated into existing ground-based TEM data processing workflows, facilitating the extraction of meaningful information from noisy measurements and enhancing the overall quality and reliability of the acquired data.

Keywords: data quality, signal averaging, transient electromagnetic, wavelet transform

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Authors: Pedro Gomes, Luís Sá Castelo, António Lopes, Marta Maio, Pedro Mota, Adélia Avelar, António Marques Dias

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Introduction: Total Knee Arthroplasty (TKA) has contributed to improvement of patient`s quality of life, although it has been associated with some complications including component loosening and polyethylene wear. To prevent these complications various fixation techniques have been employed. Hybrid TKA with cemented tibial and cementless femoral components have shown favourable outcomes, although it still lack of consensus in the literature. Objectives: To evaluate the clinical and radiographic results of hybrid versus cemented TKA with an average 5 years follow-up and analyse the survival rates. Methods: A retrospective study of 125 TKAs performed in 92 patients at our institution, between 2006 to 2008, with a minimum follow-up of 2 years. The same prosthesis was used in all knees. Hybrid TKA fixation was performed in 96 knees, with a mean follow-up of 4,8±1,7 years (range, 2–8,3 years) and 29 TKAs received fully cemented fixation with a mean follow-up of 4,9±1,9 years (range, 2-8,3 years). Selection for hybrid fixation was nonrandomized and based on femoral component fit. The Oxford Knee Score (OKS 0-48) was evaluated for clinical assessment and Knee Society Roentgenographic Evaluation Scoring System was used for radiographic outcome. The survival rate was calculated using the Kaplan-Meier method, with failures defined as revision of either the tibial or femoral component for aseptic failures and all-causes (aseptic and infection). Analysis of survivorship data was performed using the log-rank test. SPSS (v22) was the computer program used for statistical analysis. Results: The hybrid group consisted of 72 females (75%) and 24 males (25%), with mean age 64±7 years (range, 50-78 years). The preoperative diagnosis was osteoarthritis (OA) in 94 knees (98%), rheumatoid arthritis (RA) in 1 knee (1%) and Posttraumatic arthritis (PTA) in 1 Knee (1%). The fully cemented group consisted of 23 females (79%) and 6 males (21%), with mean age 65±7 years (range, 47-78 years). The preoperative diagnosis was OA in 27 knees (93%), PTA in 2 knees (7%). The Oxford Knee Scores were similar between the 2 groups (hybrid 40,3±2,8 versus cemented 40,2±3). The percentage of radiolucencies seen on the femoral side was slightly higher in the cemented group 20,7% than the hybrid group 11,5% p0.223. In the cemented group there were significantly more Zone 4 radiolucencies compared to the hybrid group (13,8% versus 2,1% p0,026). Revisions for all causes were performed in 4 of the 96 hybrid TKAs (4,2%) and 1 of the 29 cemented TKAs (3,5%). The reason for revision was aseptic loosening in 3 hybrid TKAs and 1 of the cemented TKAs. Revision was performed for infection in 1 hybrid TKA. The hybrid group demonstrated a 7 years survival rate of 93% for all-cause failures and 94% for aseptic loosening. No significant difference in survivorship was seen between the groups for all-cause failures or aseptic failures. Conclusions: Hybrid TKA yields similar intermediate-term results and survival rates as fully cemented total knee arthroplasty and remains a viable option in knee joint replacement surgery.

Keywords: hybrid, survival rate, total knee arthroplasty, orthopaedic surgery

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Authors: E. Abustam, M. Yusuf, M. I. Said

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One of functional properties of the meat is decrease of water holding capacity (WHC) during rigor mortis. At the time of pre-rigor, WHC is higher than post-rigor. The decline of WHC has implication to the other functional properties such as decreased cooking lost and yields resulting in lower elasticity and compactness of processed meat product. In many cases, the addition of phosphate in the meat will increase the functional properties of the meat such as WHC. Furthermore, liquid smoke has also been known in increasing the WHC of fresh meat. For food safety reasons, liquid smoke in the present study was used as a substitute to phosphate in production of chicken nuggets. This study aimed to know the effect of substitution of phosphate with liquid smoke on the quality of nuggets made from post-rigor chicken thigh and breast. The study was arranged using completely randomized design of factorial pattern 2x3 with three replications. Factor 1 was thigh and breast parts of the chicken, and factor 2 was different levels of liquid smoke in substitution to phosphate (0%, 50%, and 100%). The thigh and breast post-rigor broiler aged 40 days were used as the main raw materials in making nuggets. Auxiliary materials instead of meat were phosphate, liquid smoke at concentration of 10%, tapioca flour, salt, eggs and ice. Variables measured were flexibility, shear force value, cooking loss, elasticity level, and preferences. The results of this study showed that the substitution of phosphate with 100% liquid smoke resulting high quality nuggets. Likewise, the breast part of the meat showed higher quality nuggets than thigh part. This is indicated by high elasticity, low shear force value, low cooking loss, and a high level of preference of the nuggets. It can be concluded that liquid smoke can be used as a binder in making nuggets of chicken post-rigor.

Keywords: liquid smoke, nugget quality, phosphate, post-rigor

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Authors: Eze Chinwe Catherine, Orji Nkiru Marykate, Anyaegbunam L. C., Igbodika M.C.

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Uterine Leiomyomata (ULs) are the most frequently occurring pelvic and gynaecologic tumors in premenopausal women, occurring globally with a prevalence of 21.4%. UL represents a major public health problem in African women; therefore, this study aimed to reveal public health impact and risk factors associated with uterine leiomyomata among women in Imo state. A convenience sample of 2965 women was studied for gynaecological cases from October 2020 to March 2021 at the selected clinics of study. Eligible women were recruited to participate in a non interventional descriptive cross-sectional study. Data on socio demographic and gynaecological characteristics, BMI, parity, age, age at menarche, knowledge, attitudes, and perception were collected using a structured questionnaire, guided interviews, anthropometrics, and haematological tests. These were analyzed using SPSS Version 23. Associations between continuous variables were analysed appropriately and tested at 95% confidence level and standard error of 5%. A total of 652(22.0%) were diagnosed having uterine Leiomyomata (UL), and the overall prevalence of UF at clinics/Diagnostic centre in Imo State was 22%. A total of 652 women (46.1%) responded. More than half of the women had a parity of zero (1623: 54.8%), 664 (22.4%) had a parity of 1-2, and 491 (16.6%) had a parity of 3-4. Majority (68.6%) indicated that they experience an irregular menstrual cycle, and a similar proportion (67%) number experience pelvic pain. Age was found as a significant associating factor of uterine fibroids in this study (p=0.046, χ2= 6.158), lowest among the women between 16 to 25 years old and highest among the women between 36 – 45 years of age. The rate of UF was found to be 62.1% on the studied women menarche age of 11 years old or less while it was approximately 18% among the women whose age at menarche were at least 14 years old. Education ((p=0.003, χ²= 13.826), residency (p=0.066, χ²= 3.372). BMI (p= 0.000, χ²=102.36) were significantly associated with the risk of UL. Some of the Clinical presentation includes anaemia, abdominal pelvic mass, and infertility. The poor positive perception was obtained on the general perception (16.7%) as well as on treatment seeking behavior (28%). The study concluded that UL had a significant impact on health related quality of life on respondents due to its relatively high prevalence and their probable impact on patient’s quality of life.UL was especially prevalent in women aged between 36 to 45 years, nulliparous women, and women of higher BMI. Community enlightenment to enhance knowledge, attitude, and perception on fibroids and risk factors necessary to ensure early diagnosis and presentation, including patient centered treatment option.

Keywords: fibroids, prevalence, risk factors, body mass index, menarche, anaemia, KAP

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Authors: J. Dutton, L. Knight

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Achieving quality and respectful maternal health care is part of the global agenda to improve reproductive health and achieve universal reproductive rights. Barriers to quality of care in South African maternal health facilities exist at both systemic and individual levels. Addition to this, the normalization of gender violence within South Africa has a large impact on people seeking health care as well as those who provide care within health facilities. The hierarchical environment of South Africa’s public health system penalizes both patients and providers who battle to assume any assessable power. This paper explores how systemic and individual level barriers to quality of care affect the midwifery profession within South African maternal health services and create, at times, an environment of enmity rather than care. This paper analyzes and discusses the data collected from in-depth, semi-structured interviews with nurses and midwives at three maternal health facilities in South Africa. This study has taken a holistic approach to understand the realities of nurses and midwives in order to explore the ways in which experience informs their practice and treatment of pregnant women. Through collecting and analyzing narratives, linkages between nurses and midwives day-to-day and historical experiences and disrespectful care have been made. Findings from this study show that barriers to quality of care take form in complex and interrelated ways. The physical structure of the health facility, human resource shortages, and the current model of maternal health care, which often lacks a person-centered approach, is entangled within personal beliefs and attitudes of what it means to be a midwife to create an environment that is often not conducive to a positive birthing experience. This entanglement sits within a society of high rates of violence, inequality, and poverty. Having teased out the nuances of each of these barriers and the multiple ways they reinforce each other, the findings of this paper demonstrate that birth, and the work of a midwife, are situated in a mode of discipline and punishment within this context. For analytical purposes, this paper has broken down the individual barriers to quality care and discusses the current and historical significance before returning to the interrelated forms in which barriers to quality maternal health care manifest. In conclusion this paper questions the role of agency in the ability to subvert systemic barriers to quality care and ideas around shifting attitudes and beliefs of and about midwives. International and local policies and guidelines have a role to play in realizing such shifts, however, as this paper suggests, when policy does not speak to the local context there is the risk of it contributing to frustrations and impeding the path to quality and respectful maternal health care.

Keywords: disrespect and abuse in childbirth, midwifery, South African maternal health care, quality of care

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Authors: Judith Klostermann, Miguel Segura, Wilma Jans, Dragana Bojovic, Isadora Christel Jimenez, Francisco Doblas-Reyees, Judit Snethlage

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The Climate Data Store (CDS), developed by the Copernicus Climate Change Service (C3S) implemented by the European Centre for Medium-Range Weather Forecasts (ECMWF) on behalf of the European Union, is intended to become a key instrument for exploring climate data. The CDS contains both raw and processed data to provide information to the users about the past, present and future climate of the earth. It allows for easy and free access to climate data and indicators, presenting an important asset for scientists and stakeholders on the path for achieving a more sustainable future. The C3S Evaluation and Quality Control (EQC) is assessing the quality of the CDS by undertaking a comprehensive user requirement assessment to measure the users’ satisfaction. Recommendations will be developed for the improvement and expansion of the CDS datasets and products. User requirements will be identified on the fitness of the datasets, the toolbox, and the overall CDS service. The EQC function of the CDS will help C3S to make the service more robust: integrated by validated data that follows high-quality standards while being user-friendly. This function will be closely developed with the users of the service. Through their feedback, suggestions, and contributions, the CDS can become more accessible and meet the requirements for a diverse range of users. Stakeholders and their active engagement are thus an important aspect of CDS development. This will be achieved with direct interactions with users such as meetings, interviews or workshops as well as different feedback mechanisms like surveys or helpdesk services at the CDS. The results provided by the users will be categorized as a function of CDS products so that their specific interests will be monitored and linked to the right product. Through this procedure, we will identify the requirements and criteria for data and products in order to build the correspondent recommendations for the improvement and expansion of the CDS datasets and products.

Keywords: climate data store, Copernicus, quality, user engagement

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Authors: M. Prema Kumar, P. Rajesh Kumar

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The increasing interest in image fusion (combining images of two or more modalities such as infrared and visible light radiation) has led to a need for accurate and reliable image assessment methods. This paper gives a novel approach of merging the information content from several videos taken from the same scene in order to rack up a combined video that contains the finest information coming from different source videos. This process is known as video fusion which helps in providing superior quality (The term quality, connote measurement on the particular application.) image than the source images. In this technique different sensors (whose redundant information can be reduced) are used for various cameras that are imperative for capturing the required images and also help in reducing. In this paper Image fusion technique based on multi-resolution singular value decomposition (MSVD) has been used. The image fusion by MSVD is almost similar to that of wavelets. The idea behind MSVD is to replace the FIR filters in wavelet transform with singular value decomposition (SVD). It is computationally very simple and is well suited for real time applications like in remote sensing and in astronomy.

Keywords: multi sensor image fusion, MSVD, image processing, monochrome video

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Authors: Monika Jurkeviciute, Amia Enam, Johanna Torres Bonilla, Henrik Eriksson

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Introduction: Many evaluations of eHealth interventions conclude that the evidence for improved clinical outcomes is limited, especially when the intervention is short, such as one year. Often, evaluation design does not address the feasibility of achieving clinical outcomes. Evaluations are designed to reflect upon clinical goals of intervention without utilizing the opportunity to illuminate effects on organizations and cost. A comprehensive design of evaluation can better support decision-making regarding the effectiveness and potential transferability of eHealth. Hence, the purpose of this paper is to present a feasible and comprehensive design of evaluation for eHealth intervention, including the design process in different contexts. Methodology: The situation of limited feasibility of clinical outcomes was foreseen in the European Union funded project called “DECI” (“Digital Environment for Cognitive Inclusion”) that is run under the “Horizon 2020” program with an aim to define and test a digital environment platform within corresponding care models that help elderly people live independently. A complex intervention of eHealth implementation into elaborate care models in four different countries was planned for one year. To design the evaluation, a participative approach was undertaken using Pettigrew’s lens of change and transformations, including context, process, and content. Through a series of workshops, observations, interviews, and document analysis, as well as a review of scientific literature, a comprehensive design of evaluation was created. Findings: The findings indicate that in order to get evidence on clinical outcomes, eHealth interventions should last longer than one year. The content of the comprehensive evaluation design includes a collection of qualitative and quantitative methods for data gathering which illuminates non-medical aspects. Furthermore, it contains communication arrangements to discuss the results and continuously improve the evaluation design, as well as procedures for monitoring and improving the data collection during the intervention. The process of the comprehensive evaluation design consists of four stages: (1) analysis of a current state in different contexts, including measurement systems, expectations and profiles of stakeholders, organizational ambitions to change due to eHealth integration, and the organizational capacity to collect data for evaluation; (2) workshop with project partners to discuss the as-is situation in relation to the project goals; (3) development of general and customized sets of relevant performance measures, questionnaires and interview questions; (4) setting up procedures and monitoring systems for the interventions. Lastly, strategies are presented on how challenges can be handled during the design process of evaluation in four different countries. The evaluation design needs to consider contextual factors such as project limitations, and differences between pilot sites in terms of eHealth solutions, patient groups, care models, national and organizational cultures and settings. This implies a need for the flexible approach to evaluation design to enable judgment over the effectiveness and potential for adoption and transferability of eHealth. In summary, this paper provides learning opportunities for future evaluation designs of eHealth interventions in different national and organizational settings.

Keywords: ehealth, elderly, evaluation, intervention, multi-cultural

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Authors: M. A. Nogueira, M. Thimotheo, G. C. Ripamonte, S. C. C. Aguiar, M. H. S. Ulian, J. C. Goncalves Netto, I. C. Boleli

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Increasing in the relative humidity during the last incubation day is a usual practice in the commercial hatchery to facilitate hatching. This study analyzed whether higher relative humidity improves eclodibility as well as chick quality, and alters the hatch window. Fertile eggs (65- 67g) produced by 53 weeks old broiler breeders (Cobb 500®) were incubated at 37.5°C and 31°C in the wet bulb in incubators with automatic control of temperature and egg turning (1 each hour). Two-hundred ten were distributed randomly in three treatments: 31°C in the wet bulb from internal pipping (BI-31), 33°C from internal pipping (BI-33), and 33°C from external pipping (BE-33), all three hatchers maintained at 37.5°C and without egg turning. For this, eggs were checked for internal pipping by ovoscopy and external pipping by visual observation through the transparent cover of the incubators each hour from day 18 of incubation. No significant differences in the hatchability (BI-31:79.61%, BI-33:77.63%, BE-33:80.77%; by Q-square test, P > 0.05). Absence of significant effects of the treatments were also observed for incubation duration (BI-31:488.58 h, BI-33:488.30 h, BE-33:489.04 h), and chick body weight (BI-31: 49.40g, BI-33: 49.74g, BE-33: 49.34g) and quality scores (BI-31: 90.02, BI-33: 87.56, BE-33: 92.28 points), by variance analysis (P > 0.05). However, BI-33 increased the incidence of feathering and leg problems and remaining of alantoic membrane, and BE-33 increased the incidence of problems with feathering, navel and yolk sac and reduced the leg problems, compared to BI-31. In sum, the results show higher relative humidity from internal or external pipping did not influence hatchability and incubation duration, but reduced chick quality, affecting the incubation efficiency.

Keywords: chick quality, hatchability, hatcher humidity, incubation duration

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Authors: Cinzia Cruder, Deborah Falla, Francesca Mangili, Laura Azzimonti, Liliana Araujo, Aaron Williamon, Marco Barbero

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Background and aims: According to the existing literature, musicians are at risk to experience a range of musculoskeletal painful conditions. Recently, digital technology has been developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing analysis. Additionally, the association between pain drawing (PD) variables and clinical features in musicians with pain were explored. Materials and Methods: One hundred fifty-eight musicians (90 women and 68 men; age 22.4±3.6 years) were recruited from Swiss and UK conservatoires. Participants were asked to complete a survey including both background musical information and clinical features, the Quick Dash (QD) questionnaire and the digital PDs. Results: Of the 158 participants, 126 musicians (79.7%) reported having pain, with more prevalence in the areas of the neck and shoulders, the lower back and the right arm. The mean of pain extent was 3.1% ±6.5. The mean of QD was larger for musicians showing the presence of pain than for those without pain. Additionally, the results indicated a positive correlation between QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity. Conclusions: The high prevalence of pain among musicians has been confirmed using a digital PD. In addition, positive correlations between pain extent and upper limb disability has been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.

Keywords: pain location, pain extent, musicians, pain drawings

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Authors: Abdurraheem A. Yakub

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Housing is one of the needs of mankind and is one of the best indicators of a person’s standard of living. This research was set out to analyze the housing qualities and conditions in Kano. Primary data was collected through both Personal observations where the researcher carried out an inspection of the study area prior to interview/implementation of questionnaires and took into consideration the type of housing units, construction materials and services available as well as the environmental condition of the study area. This was followed by an interview which was done through personal contact with the various people related to the study. In the course of doing that, questions were asked orally and notes were taken to record the responses. Thereafter, the Questionnaire was implemented which was earlier designed to elicit information from households in the study area using well-structured questions related to the type of facilities provided in the housing unit, types of houses and response with regard to quality of their houses and neighborhoods, tenure of house. The research work looked at the prevailing housing qualities and conditions and the state of the existing facilities and amenities within the environment and offered recommendations on policies and measures that could help improve the situation.

Keywords: housing provision, housing quality, housing standard, housing condition, housing affordability and housing facilities

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Authors: Yaser Meeralam, Walaa Alharthi, Hadeel Ashi, Alaa Bakhsh, Kholood Aljabri, Ebtihal Bin Salim

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Background:Basidiobolusranrum causes one of the rare fungal diseases that infects mainly immunocompetent individuals. Gastrointestinal Basidiobolomycosis (GIB) is a rare and uncommon form of this fungal infection. It’s still ambiguous how this fungus is reaching the gastrointestinal tract leading to Gastrointestinal Basidiobolomycosis. Objective: To summarize the clinical features, imaging, and histopathological of patients diagnosed with GIB in our institution. Patients and methods: A series of five cases of patients who diagnosed by basidiobolomycosis in King Abdullah Medical City, Makkah, Saudi Arabia, which reviewed by latest literature related to diagnosis and treatment. Results: Most of the patients were externally evaluated and were initially misdiagnosed. Some of them were suspected of colonic malignancy, other presumed to have hepatic hemangioma and fistulizing crohn’s disease. The definitive diagnosis is often based on histopathological examination and fungal culture of the surgically resected mass. An optimum standardized treatment of basidiobolomycosis has not yet been established. Conclusion: Deeper knowledge of clinical characteristics, diagnosis, and treatment of basidiobolomycosis will allow early initiating of treatment with a subsequent positive impact on the patients’ outcome. More studies are needed to establish a definite treatment.

Keywords: gastrointestinal infection, crohn's mimics, malignancy mimics, fungal infection

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Authors: Monday O. Ale, Adebukola A. Akintade, Olasunbo O. Orungbemi

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Fermentation as an important operation in the processing of cocoa beans is now affected by the recent climate change across the globe. The major requirement for effective fermentation is the ability of the material used to retain sufficient heat for the required microbial activities. Apart from the effects of climate on the rate of heat retention, the materials used for fermentation plays an important role. Most Farmers still restrict fermentation activities to the use of traditional methods. Improving on cocoa fermentation in this era of climate change makes it necessary to work on other materials that can be suitable for cocoa fermentation. Therefore, the objective of this study was to determine the effects of fermentation techniques on the quality of cocoa beans. The materials used in this fermentation research were heap-leaves (traditional), stainless steel, plastic tin, plastic basket and wooden box. The period of fermentation varies from zero days to 10 days. Physical and chemical tests were carried out for variables in quality determination in the samples. The weight per bean varied from 1.0-1.2 g after drying across the samples and the major color of the dry beans observed was brown except with the samples from stainless steel. The moisture content varied from 5.5-7%. The mineral content and the heavy metals decreased with increase in the fermentation period. A wooden box can conclusively be used as an alternative to heap-leaves as there was no significant difference in the physical features of the samples fermented with the two methods. The use of a wooden box as an alternative for cocoa fermentation is therefore recommended for cocoa farmers.

Keywords: fermentation, effects, fermentation materials, period, quality

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Authors: Nuo Xu, Kok Hun Goh, Jeyatharan Kumarasamy

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Pile load testing is significant during foundation construction due to its traditional role of design validation and routine quality control of the piling works. In order to verify whether piles can take loadings at specified settlements, piles will have to undergo working load test where the test load should normally up to 150% of the working load of a pile. Selection or sampling of piles for the working load test is done subject to the number specified in Singapore National Annex to Eurocode 7 SS EN 1997-1:2010. This paper presents an innovative way to rationalize the number of pile load test by adopting statistical analysis approach and looking at the coefficient of variance of pile elastic modulus using a case study at Singapore Tuas depot. Results are very promising and have shown that it is possible to reduce the number of working load test without influencing the reliability and confidence on the pile quality. Moving forward, it is suggested that more load test data from other geological formations to be examined to compare with the findings from this paper.

Keywords: elastic modulus of pile under soil interaction, jurong formation, kentledge test, pile load test

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Authors: George Shaker, Maike Eylert

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Recurrent urinary tract infections (UTIs) in patients with mesh implants, particularly following pelvic or abdominal surgeries, pose significant clinical challenges. This paper investigates whether flexible cystoscopy is an essential diagnostic and therapeutic tool in managing such patients. With the increasing prevalence of mesh-related complications, it is crucial to explore how diagnostic procedures like cystoscopy can aid in identifying mesh-associated issues that contribute to recurrent UTIs. While flexible cystoscopy is commonly used to evaluate lower urinary tract conditions, its necessity in cases involving patients with mesh implants remains under debate. This study aims to determine the value of flexible cystoscopy in identifying complications such as mesh erosion, fistula formation, and chronic inflammation, which may contribute to recurrent infections. The research compares patients who underwent flexible cystoscopy to those managed without this procedure, examining the diagnostic yield of cystoscopy in detecting mesh-related complications. Furthermore, the study investigates the relationship between recurrent UTIs and the mechanical effects of mesh on the urinary tract, as well as the potential for cystoscopy to guide treatment decisions, such as mesh removal or revision. The results indicate that while flexible cystoscopy can identify mesh-related complications in some cases, its routine use may not be necessary for all patients with recurrent UTIs and mesh. The study emphasizes the importance of patient selection, clinical history, and symptom severity in deciding whether to employ cystoscopy. In cases where there are clear signs of mesh erosion or unexplained recurrent infections despite standard treatments, cystoscopy proves valuable. However, the study also highlights potential risks and discomfort associated with the procedure, suggesting that cystoscopy should be reserved for select cases where non-invasive methods fail to provide clarity. The research concludes that while flexible cystoscopy remains a valuable tool in certain cases, its routine use for all patients with recurrent UTIs and mesh is not justified. The paper provides recommendations for clinical guidelines, emphasizing a more personalized approach to diagnostics that considers the patient’s overall condition, infection history, and mesh type.

Keywords: flexible cystoscopy, recurrent urinary tract infections, mesh implants, mesh erosion, diagnostic procedures, urology

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Authors: Ibtisam Al-Zaru

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Background: Worldwide, depression among coronary artery disease (CAD) patients is considered a serious problem that may cause many complications and negative consequences; particularly serious being increased mortality and morbidity rate. Studying depression among CAD patients in Jordan has not been investigated thoroughly and thus a need for further studies has been a priority. Aims: To assess depression in non-hospitalized Jordanian patients with CAD; to describe the relationship between socio-demographic data, health related factors, and depression; and to examine the best predictors of depression in non-hospitalized Jordanian patients with CAD. Method: A cross-sectional-descriptive design was used to collect data from 174 non-hospitalized Jordanian patients diagnosed with CAD in outpatients’ cardiac clinics, using a self- administered questionnaires and Cardiac Depression Scale. Results: 53.4% of CAD patients reported mild/moderate, and severe depressive symptoms. Significant relationships between depressive symptoms and some demo-clinical characteristics (i.e. being female gender; having of chronic disease and surgical history; being physically inactive, and perceived their sexual activity, physical and psychological as poor). The preceding factors are also found to be statistically significant predictors for depression among this patients’ group. Conclusion: Jordanian patients with CAD had various levels of severity regarding their depressive symptoms. Therefore, health care providers need to introduce depression assessment and treatment in cardiac rehabilitation to control depression and its impact on the patient. Consequently, such control will reduce co-morbidity, mortality, complications and health costs among CAD patients and enhance the quality of their lives.

Keywords: coronary artery disease, predictors, depression, prevalence

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Authors: Kiurski S. Jelena, Aksentijević M. Snežana, Kecić S. Vesna, Oros B. Ivana

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The prosperity of electronic equipment in photocopying environment not only has improved work efficiency, but also has changed indoor air quality. Considering the number of photocopying employed, indoor air quality might be worse than in general office environments. Determining the contribution from any type of equipment to indoor air pollution is a complex matter. Non-methane hydrocarbons are known to have an important role of air quality due to their high reactivity. The presence of hazardous pollutants in indoor air has been detected in one photocopying shop in Novi Sad, Serbia. Air samples were collected and analyzed for five days, during 8-hr working time in three-time intervals, whereas three different sampling points were determined. Using multiple linear regression model and software package STATISTICA 10 the concentrations of occupational hazards and micro-climates parameters were mutually correlated. Based on the obtained multiple coefficients of determination (0.3751, 0.2389, and 0.1975), a weak positive correlation between the observed variables was determined. Small values of parameter F indicated that there was no statistically significant difference between the concentration levels of non-methane hydrocarbons and micro-climates parameters. The results showed that variable could be presented by the general regression model: y = b0 + b1xi1+ b2xi2. Obtained regression equations allow to measure the quantitative agreement between the variation of variables and thus obtain more accurate knowledge of their mutual relations.

Keywords: non-methane hydrocarbons, photocopying process, multiple regression analysis, indoor air quality, pollutant emission

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Authors: Mina Kargozari, Isabel Revilla Martin, Ángel A. Carbonell-Barrachina

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Different formulations of Turkish fermented sausages (sucuks) prepared with camel meat-hump (CH), camel meat-beef fat (CB), beef-hump (BH) and beef-beef fat (BB), were characterized. The sausages were analytically compared to determine differences in proximate composition and total cholesterol content (TCC), quality parameters such as fatty acids profile and fat quality characteristics, and lipid oxidation parameters including peroxide value, thiobarbituric acid-reactive substances (TBARS) and resulted carbonyl compounds. The PUFAs/SFAs ratio was higher in CB and BB samples than CH and BH (p<0.05). The higher calculated atherogenic and thrombogenic indexes (AI and TI) were obtained from the samples made with hump (p< 0.05) as a result of high amounts of their SFAs. The CH sausages contained high amount of total fat (p<0.05) among all samples. The CB sucuks exhibited the highest protein content and the lowest TCC and rancidity at the end of ripening (p<0.05). The TBARS results showed that beef fat samples were more susceptible to lipid oxidation. Moreover, no significant difference (p<0.05) was observed for the values of short aldehydes among the sucuk samples excepting nonanal. This study demonstrated that supplementing camel meat for the production of dry-fermented sausage resulted in high quality products with good functional and nutritional characteristics.

Keywords: fermented sausages, quality properties, SPME, total cholesterol content

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