Search results for: compression system management.

Authors: Grazia Disciglio, Annalisa Tarantino, Emanuele Tarantino

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The production system of Foggia province (Apulia, Southern Italy) is characterized by the presence of numerous agro-food industries whose activities include the processing of vegetables products that release large quantities of wastewater. The reuse in agriculture of these wastewaters offers the opportunity to reduce the costs of their disposal and minimizing their environmental impact. In addition, in this area, which suffers from water shortage, the use of agro-industrial wastewater is essential in the very intensive irrigation cropping systems. The present investigation was carried out in years 2009 and 2010 to monitor the physico-chemical and microbiological characteristics of the industrial wastewater (IWW) from the secondary treatment plant of the 'Industrial Area of Foggia'. The treatment plant released on average about 567,000 m3y-1 of IWW, which distribution was not uniform over the year. The monthly values were about 250,000 m3 from November to June and about 90,000 m3 from July to October. The obtained results revealed that IWW was characterized by low values of Total Suspended Solids (TSS), Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), Electrical Conductivity (EC) and Sodium Absorption Rate (SAR). An occasional presence of heavy metal and high concentration of total phosphorus, total nitrogen, ammoniacal nitrogen and microbial organisms (Escherichia coli and Salmonella) were observed. Due to the presence of this pathogenic microorganisms and sometimes of heavy metals, which may raise sanitary and environmental problems in order to the possible irrigation reuse of this IWW, a tertiary treatment of wastewater based on filtration and disinfection in line are recommended. Researches on the reuse of treated IWW on crops (olive, artichoke, industrial tomatoes, fennel, lettuce etc.) did not show significant differences among the irrigated plots for most of the soil and yield characteristics.

Keywords: agroindustrial wastewater, irrigation, microbiological characteristic, physico-chemical characteristics

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Authors: Kunkanit Sutamchai, Kate E. Rowlands

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Recent public ethical scandals in many organizations around the world have raised concern about organizational ethics, which have, in turn, made ethical behaviors and conducts on the part of leaders become more critical topics in organizational studies. However, current research on the benefits of mindfulness within the workplace contexts has predominantly focused on stress reduction and work performance enhancement, while the aspects of ethical behavior development have been far less investigated in mindfulness research in the organizational and management fields. Only recently has there been an emerging call for organizational researchers and practitioners to study mindfulness concepts and practices from the original Buddhist perspectives given that ethics is regarded as a foundation for Buddhist mindfulness. Yet little, if any, empirical research on the contributions of mindfulness practices to ethical leadership has been done in Eastern Buddhist contexts. Therefore, this study aims to explore the extent to which and how Buddhist-based mindfulness practices can influence organizational leaders’ ethical values and practices. On this basis, Thailand was selected as a context of study due to a predominantly Buddhist society and culture. Qualitative data were gathered through in-depth semi-structured interviews with twenty executive leaders from various private organizations in Thailand, who practice Buddhist-based mindfulness meditation regularly. The findings from this study shed light on the role Buddhist-based mindfulness practices can play in promoting ethical behavior among executive leaders in Thailand. The results also suggest that ethical values and practices influenced by Buddhist-based mindfulness practices are well aligned with the elements appeared in the inter-disciplinary and cross-cultural ethical leadership framework, namely: humane, justice, sustainability and responsibility, and moderation. This study concludes that the integration of ethical dimensions to mindfulness practices may provide promising opportunities for ethical leadership development, particularly in the context of Thailand. This could contribute significantly to the future development of both organizations and society at large. The study also suggests that mindfulness interventions in organizational contexts should place more explicit emphasis on ethics. This may be done by relating the ethical principles underlying Buddhist-based mindfulness to other ethical systems in different contexts and cultures where they can be aligned.

Keywords: Buddhism, ethical leadership, leadership development, mindfulness, Thailand, training

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Authors: G. Judakova, M. Bause

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The ability to model and simulate numerically natural gas flow in pipelines has become of high importance for the design of pipeline systems. The understanding of the formation of hydrate particles and their dynamical behavior is of particular interest, since these processes govern the operation properties of the systems and are responsible for system failures by clogging of the pipelines under certain conditions. Mathematically, natural gas flow can be described by multiphase flow models. Using the two-fluid modeling approach, the gas phase is modeled by the compressible Euler equations and the particle phase is modeled by the pressureless Euler equations. The numerical simulation of compressible multiphase flows is an important research topic. It is well known that for nonlinear fluxes, even for smooth initial data, discontinuities in the solution are likely to occur in finite time. They are called shock waves or contact discontinuities. For hyperbolic and singularly perturbed parabolic equations the standard application of the Galerkin finite element method (FEM) leads to spurious oscillations (e.g. Gibb's phenomenon). In our approach, we use stabilized FEM, the streamline upwind Petrov-Galerkin (SUPG) method, where artificial diffusion acting only in the direction of the streamlines and using a special treatment of the boundary conditions in inviscid convective terms, is added. Numerical experiments show that the numerical solution obtained and stabilized by SUPG captures discontinuities or steep gradients of the exact solution in layers. However, within this layer the approximate solution may still exhibit overshoots or undershoots. To suitably reduce these artifacts we add a discontinuity capturing or shock capturing term. The performance properties of our numerical scheme are illustrated for two-phase flow problem.

Keywords: two-phase flow, gas-particle mixture, inviscid two-fluid model, euler equation, finite element method, streamline upwind petrov-galerkin, shock capturing

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Authors: Nefzi Ahlem, Aydi Ben Abdallah Rania, Jabnoun-Khiareddine Hayfa, Ammar Nawaim, Mejda Daami-Remadi

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Fusarium Crown and Root Rot (FCRR) caused by Fusarium oxysporum f. sp. radicis-lycopersici (FORL) is a serious tomato (Solanum lycopersicum L.) disease in Tunisia. Its management is very difficult due to the long survival of its resting structures and to the luck of genetic resistance. In this work, we explored the wild Solanaceae species Withania somnifera, growing in the Tunisian Centre-East, as a potential source of biocontrol agents effective in FCRR suppression and tomato growth promotion. Seven fungal isolates were shown able to colonize tomato roots, crowns, and stems. Used as conidial suspensions or cell-free culture filtrates, all tested fungal treatments significantly enhanced tomato growth parameters by 21.5-90.3% over FORL-free control and by 27.6-93.5% over pathogen-inoculated control. All treatments significantly decreased the leaf and root damage index by 28.5-92.8 and the vascular browning extent 9.7-86.4% over FORL-inoculated and untreated control. The highest disease suppression ability (decrease by 86.4-92.8% in FCRR severity) over pathogen-inoculated control and by 81.3-88.8 over hymexazol-treated control) was expressed by I6 based treatments. This endophytic fungus was morphologically characterized and identified using rDNA sequencing gene as Fusarium sp. I6 (MG835371). This fungus was shown able to reduce FORL radial growth by 58.5–83.2% using its conidial suspension or cell-free culture filtrate. Fusarium sp. I6 showed chitinolytic, proteolytic and amylase activities. The current study clearly demonstrated that Fusarium sp. (I6) is a promising biocontrol candidate for suppressing FCRR severity and promoting tomato growth. Further investigations are required for elucidating its mechanism of action involved in disease suppression and plant growth promotion.

Keywords: antifungal activity, associated fungi, Fusarium oxysporum f. sp. radicis-lycopersici, Withania somnifera, tomato growth

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Authors: Mohamed Shafi Bin Mahboob Ali

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Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.

Keywords: synchronous, colon, tumor, adenocarcinoma

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Authors: Sonia Barbouchi, Meriem Samcha

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Scale deposition during water injection into aquifer of oil reservoirs is a serious problem experienced in the oil production industry. One of the primary causes of scale formation and injection well plugging is mixing two waters which are incompatible. Considered individually, the waters may be quite stable at system conditions and present no scale problems. However, once they are mixed, reactions between ions dissolved in the individual waters may form insoluble products. The purpose of this study is to identify the causes of well plugging in a southern Tunisian oilfield, where fresh water has been injected into the producing wells to counteract the salinity of the formation waters and inhibit the deposition of halite. X-ray diffraction (XRD) mineralogical analysis has been carried out on scale samples collected from the blocked well. Two samples collected from both formation water and injected water were analysed using inductively coupled plasma atomic emission spectroscopy, ion chromatography and other standard laboratory techniques. The results of complete waters analysis were the typical input parameters, to determine scaling tendency. Saturation indices values related to CaCO3, CaSO4, BaSO4 and SrSO4 scales were calculated for the water mixtures at different share, under various conditions of temperature, using a computerized scale prediction model. The compatibility study results showed that mixing the two waters tends to increase the probability of barite deposition. XRD analysis confirmed the compatibility study results, since it proved that the analysed deposits consisted predominantly of barite with minor galena. At the studied temperatures conditions, the tendency for barite scale is significantly increasing with the increase of fresh water share in the mixture. The future scale inhibition and removal strategies to be implemented in the concerned oilfield are being derived in a large part from the results of the present study.

Keywords: compatibility study, produced water, scaling, water injection

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Authors: Marianna Ciaccia, Gennaro Agrimi, Isabella Pisano, Maurizio Bettiga, Silvia Rapacioli, Giulia Mensa, Monica Marzagalli

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Objective: Untargeted metabolomic analysis of extracellular metabolites is a powerful approach that focuses on comprehensively profiling in the extracellular space. In this study, we applied extracellular metabolomic analysis to investigate the metabolism of two probiotic microorganisms with health benefits that extend far beyond the digestive tract and the immune system. Methods: Analytical techniques employed in extracellular metabolomic analysis encompass various technologies, including mass spectrometry (MS), which enables the identification of metabolites present in the fermentation media, as well as the comparison of metabolic profiles under different experimental conditions. Multivariate statistical analysis techniques like principal component analysis (PCA) or partial least squares-discriminant analysis (PLS-DA) play a crucial role in uncovering metabolic signatures and understanding the dynamics of metabolic networks. Results: Different types of supernatants from fermentation processes, such as dairy-free, not dairy-free media and media with no cells or pasteurized, were subjected to metabolite profiling, which contained a complex mixture of metabolites, including substrates, intermediates, and end-products. This profiling provided insights into the metabolic activity of the microorganisms. The integration of advanced software tools has facilitated the identification and characterization of metabolites in different fermentation conditions and microorganism strains. Conclusions: In conclusion, untargeted extracellular metabolomic analysis, combined with software tools, allowed the study of the metabolites consumed and produced during the fermentation processes of probiotic microorganisms. Ongoing advancements in data analysis methods will further enhance the application of extracellular metabolomic analysis in fermentation research, leading to improved bioproduction and the advancement of sustainable manufacturing processes.

Keywords: biotechnology, metabolomics, lactic bacteria, probiotics, postbiotics

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Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee

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For an operator in a nuclear power plant, human error is one of the most dreaded factors that may result in unexpected accidents. The possibility of human errors may be low, but the risk of them would be unimaginably enormous. Thus, for accident prevention, it is quite indispensable to analyze the influence of any factors which may raise the possibility of human errors. During the past decades, not a few research results showed that performance of human operators may vary over time due to lots of factors. Among them, stress is known to be an indirect factor that may cause human errors and result in mental illness. Until now, not a few assessment tools have been developed to assess stress level of human workers. However, it still is questionable to utilize them for human performance anticipation which is related with human error possibility, because they were mainly developed from the viewpoint of mental health rather than industrial safety. Stress level of a person may go up or down with work time. In that sense, if they would be applicable in the safety aspect, they should be able to assess the variation resulted from work time at least. Therefore, this study aimed to compare their applicability for safety purpose. More than 10 kinds of work stress tools were analyzed with reference to assessment items, assessment and analysis methods, and follow-up measures which are known to close related factors with work stress. The results showed that most tools mainly focused their weights on some common organizational factors such as demands, supports, and relationships, in sequence. Their weights were broadly similar. However, they failed to recommend practical solutions. Instead, they merely advised to set up overall counterplans in PDCA cycle or risk management activities which would be far from practical human error prevention. Thus, it was concluded that application of stress assessment tools mainly developed for mental health seemed to be impractical for safety purpose with respect to human performance anticipation, and that development of a new assessment tools would be inevitable if anyone wants to assess stress level in the aspect of human performance variation and accident prevention. As a consequence, as practical counterplans, this study proposed a new scheme for assessment of work stress level of a human operator that may vary over work time which is closely related with the possibility of human errors.

Keywords: human error, human performance, work stress, assessment tool, time-variant, accident prevention

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Authors: Mimoza Canga, Vito Malagnino, Giulia Malagnino, Irene Malagnino

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Objective: The objective of this study was to compare the effectiveness of Mtwo and RaCe rotary instruments, in cleaning and shaping root canals curvature. Material and Method: The present study was conducted on 160 simulated canals in resin blocks, with an angle curvature 15°-30°. These 160 simulated canals were divided into two groups, where each group consisted of 80 blocks. Each group was divided into two subgroups (n=40 canals each). The simulated canals subgroups were prepared with Mtwo and RaCe rotary nickel-titanium instruments. The root canals were measured at four different points of reference, starting at 13 mm from the orifice. In the first group, the canals were prepared using Mtwo rotary system (VDW, Munich, Germany). The Mtwo files used were: 10/0.04, 15/0.05, 20/0.06, and 25/0.06. These instruments entered in the full length of the canal. Each file was rotated in the canal until it reached the apical point. In the second group, the canals were prepared using RaCe instruments (La Chaux-De-Fonds, Switzerland), performing the crown down technique, using the torque electric control motor (VDWCO, Munich, Germany), with 600 RPM and 2n/cm as follow: ≠40/0.10, ≠35/0.08, ≠30/0.06, ≠25/0.04, ≠25/0.02. The data were recorded using SPSS version 23 software (Microsoft, IL, USA). Data analysis was done using ANOVA test. Results: The results obtained by using the Mtwo rotary instruments, showed that these instruments were able to clean and shape in the right-to-left motion curved canals, at different levels, without any deviation, and in perfect symmetry, with a P-value=0.000. The data showed that the greater the depth of the root canal, the greater the deviations of the RaCe rotary instruments. These deviations occurred in three levels, which are: S2(P=0.004), S3( P=0.007), S4(P=0.009). The Mtwo files can go deeper and create a greater angle in S4 level (21°-28°), compared to RaCe instruments with an angle equal to 19°-24°. Conclusion: The present study noted a clinically significant difference between Mtwo rotary instruments and RaCe rotary files used for the canal preparation and indicated that Mtwo instruments are a better choice for the curved canals.

Keywords: canal curvature, canal preparation, Mtwo, RaCe, resin blocks

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Authors: S. AlBustan, B. AlGhannam

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This oral presentation discusses a proposal for a study that evaluates the usability of an evidence based application named ProxTalker App. The significance of this study will inform administration and faculty staff at the Department of Communication Sciences Disorders (CDS), College of Life Sciences, Kuwait University whether the app is a suitable tool to use for CDS students. A case study will be used involving a sample of CDS students taking practicum and internship courses during the academic year 2018/2019. The study will follow a process used by previous study. The process of calculating SUS is well documented and will be followed. ProxTalker App is an alternative and augmentative tool that speech language pathologist (SLP) can use to customize boards for their clients. SLPs can customize different boards using this app for various activities. A board can be created by the SLP to improve and support receptive and expressive language. Using technology to support therapy can aid SLPs to integrate this ProxTalker App as part of their clients therapy. Supported tools, games and motivation are some advantages of incorporating apps during therapy sessions. A quantitative methodology will be used. It involves the utilization of a standard tool that was the was adapted to the Arabic language to accommodate native Arabic language users. The tool that will be utilized in this research is the Arabic Standard Usability Scale (A-SUS) questionnaire which is an adoption of System Usability Scale (SUS). Standard usability questionnaires are reliable, valid and their process is properly documented. This study builds upon the development of A-SUS, which is a psychometrically evaluated questionnaire that targets Arabic native speakers. Results of the usability will give preliminary indication of whether the ProxTalker App under investigation is appropriate to be integrated within the practicum and internship curriculum of CDS. The results of this study will inform the CDS department of this specific app is an appropriate tool to be used for our specific students within our environment because usability depends on the product, environment, and users.

Keywords: A-SUS, communication disorders practicum, evidence based app, Standard Usability Scale

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Authors: Amos Sunday Onikanni, Bashir Lawal, Babatunji Emmanuel Oyinloye, Gomaa Mostafa-Hedeab, Mohammed Alorabi, Simona Cavalu, Augustine O. Olusola, Chih-Hao Wang, Gaber El-Saber Batiha

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The increasing global burden of diabetes mellitus has called for the search for a therapeutic alternative that offers better activities and safety than conventional chemotherapy. Herein, we evaluated the neuroprotective and antioxidant properties of different fractions (ethyl acetate, N-butanol and residual aqueous) of Clompanus pubescens leaves in streptozotocin (STZ)-induced diabetic rats. Our results revealed a significant elevation in the levels of blood glucose, pro-inflammatory cytokines, lipid peroxidation, neuronal activities of acetylcholinesterase, butyrylcholinesterase, nitric oxide, epinephrine, norepinephrine, and Na+/K+-ATPase in diabetic non treated rats. In addition, decreased levels of enzymatic and non-enzymatic antioxidants were observed. Treatment with different fractions of C. pubescens leaves resulted in a significant reversal of the biochemical alteration and improved the neurocognitive deficit in STZ-induced diabetic rats. However, the ethyl-acetate fraction demonstrated higher activities than the other fractions and was characterized for its phytoconstituents, revealing the presence of Gallic acid (713.00 ppm), catechin (0.91 ppm), ferulic acid (0.98 ppm), rutin (59.82 ppm), quercetin (3.22 ppm) and kaempferol (4.07 ppm). Our molecular docking analysis revealed that these compounds exhibited different binding affinities and potentials for targeting BChE/AChE/ IL-1 β/Na+-K+-ATPase. However, only Kampferol and ferulic exhibited good drug-like, ADMET, and permeability properties suitable for use as a neuronal drug target agent. Hence, the ethyl-acetate fraction of C. pubescent leaves could be considered a source of promising bioactive metabolite for the treatment and management of cognitive impairments related to type II diabetes mellitus.

Keywords: diabetes mellitus, neuroprotective, antioxidant, pro-inflammatory cytokines

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

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Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

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Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

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Authors: Malak Alasli

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Hungarians come to use geographic names that are foreign to their environment and language in diverse settings, hence the aim of trying to adapt them to their own linguistic context. The Maghreb region (Morocco, Algeria, and Tunisia) uses both Arabic and French in presenting the place names. Consequently, the lexicographical treatment of the toponym will, therefore, consist of both the presentation of the toponymic term and the pronunciation of the entries. The motivation behind this approach is the need for a better identification of the place in question by avoiding ambiguities, and for more respect to the heritage by conforming to the right use of toponyms both in written as well as in oral practice. The goal is to provide Hungarians with a set of data by attempting a system of transliteration from French/Arabic to Hungarian, where the place names of the Maghreb are transliterated for more efficient usage. To examine the importance of toponyms’ pronunciation, the latter were collected from several 20th and 21st Hungarian school atlases. Most people meet, for the first time, foreign place names in school, hence the choice of solely extracting place names from school atlases as sample data. Interviews targeted university students, where they were asked to pronounce the place names collected. Results revealed the intricacy behind the pronunciation. Two main conclusions emerged; Hungarian students encountered challenges reading the toponyms, and Arabic speakers could not identify the names either, which causes a cut in communication. Ergo, the importance of elaborating on the pronunciation of toponyms. Concordance is where you find variants of a name. Therefore, a chart was put forward including all the name variants obtained from various references with their Arabic transcription indicating any changes that may have occurred, and the origin of the denomination (Roman, Berber, etc.). A case will also be added for comments and observations. This work embraces a dual purpose. It will provide information to Hungarians on the official names of foreign places in case of occurring changes; for instance, 'El-goléa, Algeria' (used in a latest edition of a school atlas) has now the official name of 'El Ménia'. It will also serve as a reference for knowing the correct and precise forms of place names’ pronunciation.

Keywords: concordance, onomastics, settlement names, school atlases

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Authors: Vacharee Svamivastu

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This research investigates the application of geometrical relationship to the ancient religious assembly hall (Vihara) housing a reclining Buddha statue of Thailand's Kamphaeng Phet Historical Park. The study utilizes the archaeological and wooden roof structure remains of the Vihara as the prima facie evidence, supplemented with evidence from other active archaeological sites with architectural kinship as well as Buddhist ideology. At present, the wooden roofs of the Vihara fell prey to the elements and there remain only the base, columns and enclosing walls. Unlike typical Viharas whose floor plan are of rectangular shape, the floor plan of the Vihara housing the reclining Buddha is of square configuration of 25x25m. Further observation has revealed the utilization of large laterite boulders as the principal construction material of the assembly hall (Vihara) columns. The laterite columns are of square shape (1x1m) and various heights (H), ranging from 3.50m to 5.50m. The erection of the Vihara required a total of 36 laterite columns. The pattern of columns arrangement is of two rows of inner columns, two rows of outer columns and two rows of verandah columns. The space between pairs of the verandah columns was stacked with laterite blocks of varying sizes to form the Vihara walls with small openings for ventilation. Upon applying the geometrical relationship-grid system to the Vihara, the results reveal that the placement of the columns was deliberately and masterfully undertaken such that the center of the square-shaped Vihara is conspicuously spacious so as to accommodate the sacred reclining Buddha statue. The elegance of the Vihara demonstrates the ingenious application of geometrical relationship to transforming a space into a structure (i.e. Vihara) of architectural and religious significance.

Keywords: geometrical relationship, the religious assembly hall, Vihara, Kamphaeng Phet School of Master Builder

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Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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Authors: Josee Charette

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The academic and educational success of migrant students is a current issue in education, especially in western societies such in the province of Quebec, in Canada. For people who immigrate with school-age children, the success of the family’s migratory project is often measured by the benefits drawn by children from the educational institutions of their host society. In order to support the academic achievement of their children, migrant parents try to develop practices that derive from their representations of school and related challenges inspired by the socio-cultural context of their country of origin. These findings lead us to the following question: How does strategies implemented by migrant parents to manage the representational distance between school of their country of origin and school of their host society support or not the academic and educational success of their child? In the context of a qualitative exploratory approach, we have made interviews in the French , English and Spanish languages with 32 newly immigrated parents and 10 of their children. Parents were invited to complete a network of free associations about «School in Quebec» as a premise for the interview. The objective of this paper is to present strategies implemented by migrant parents to manage the distance between their representations of schools in their country of origin and in the host society, and to explore the influence of this management on their child’s academic and educational trajectories. Data analysis led us to develop various types of strategies, such as continuity, adaptation, resources mobilization, compensation and "return to basics" strategies. These strategies seem to be part of a continuum from oppositional-conflict scenario, in which parental strategies act as a risk factor, to conciliator-integrator scenario, in which parental strategies act as a protective factor for migrant students’ academic and educational success. In conclusion, we believe that our research helps in highlighting strategies implemented by migrant parents to support their child’s academic and educational success in the host society and also helps in providing a more efficient support to migrant parents and contributes to develop a wider portrait of migrant students’ academic achievement.

Keywords: academic and educational achievement of immigrant students, family’s migratory project, immigrants parental strategies, representational distance between school of origin and school of host society

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Authors: Ivan Gunass Govender, Andrea Giampiccoli

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A developmental state should use community engagement to facilitate socio-economic development for disadvantaged groups and individual members of society through empowerment, social justice, sustainability, and self-reliance. In this regard, community-based tourism (CBT) as a growing market should be an indigenous effort aided by external facilitation. Since this form of tourism presents its own preconditions, characteristics, and challenges, it could be guided by higher education institutions engagement. In particular, the facilitation should not only serve to assist the community members to reach their own goals; but rather also focus on learning through knowledge creation and sharing with the engagement of higher education institutions. While the increased relevance of CBT has produced various CBT manuals (or handbooks/guidelines) documents aimed to ‘teach’ and assist various entities in CBT development, this research aims to analyse the current monitoring & evaluation (M&E) manuals and thereafter, propose an M&E model for CBT. It is important to mention that all too often effective monitoring is seldom carried out thus risking the long-term sustainability and improvement of the CBT ventures. Therefore, the proposed model will also consider some inputs external to the tourism field, but in relation to local economic development (LED) matters from the previously proposed development monitoring and evaluation system framework. M&E should be seen as fundamental components of any CBT initiative, and the whole CBT intervention should be evaluated. In this context, M&E in CBT should go beyond strict ‘numerical’ economic matters and should be understood in a holistic development. In addition, M&E in CBT should not consider issues in various ‘compartments’ such as tourists, tourism attractions, CBT owners/participants, and stakeholder engagement but as interdependent components of a macro-ecosystem. Finally, the external facilitation process should be structured in a way to promote community self-reliance in both the intervention and the M&E process. The research will attempt to propose an M&E model for CBT so as to enhance the CBT possibilities of long-term growth and success through effective collaborations with key stakeholders.

Keywords: community-based tourism, community-engagement, monitoring and evaluation, stakeholders

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: Shengxin Yu

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Earthquakes can cause varying degrees of damage to building and bridge structures. Traditional laminated natural rubber bearings (NRB) exhibit inadequate energy dissipation and restraint, particularly under near-fault ground motions, resulting in excessive displacements in the superstructure. This paper presents a composite natural rubber bearing (NFUD-NRB) incorporating two types of shape memory alloy (SMA) U-shaped dampers (UD). The bearing exhibits adjustable features, predominantly characterized by partial self-centering and multi-level energy dissipation, facilitated by nickel-titanium-based SMA (NiTi-SMA) and iron-based SMA (Fe-SMA) UDs. The hysteresis characteristics of NFUD-NRB can be tailored by manipulating the configuration of NiTi-SMA and Fe-SMA UDs. Firstly, the proposed bearing's geometric configuration and working principle are introduced. The rationality of the modeling strategy for the bearing is validated through existing experimental results. Parameterized numerical simulations are subsequently performed to investigate the partially self-centering behavior of NFUD-NRB. The findings indicate that NFUD-NRB can attain the anticipated nonlinear behavior and deliver adequate energy dissipation. Finally, the impact of NFUD-NRB on improving the seismic resilience of highway bridges is examined using the OpenSees software, with particular emphasis on the seismic performance of NFUD-NRB under near-fault ground motions. System-level analysis reveals that bridge systems equipped with NFUD-NRBs exhibit satisfactory residual deformations and higher energy dissipation than those equipped with traditional NRBs. Moreover, NFUD-NRB markedly mitigates the detrimental impacts of near-fault ground motions on the main structure of bridges.

Keywords: partially self-centering behavior, energy dissipation, natural rubber bearing, shape memory alloy, U-shaped damper, numerical investigation, near-fault ground motion

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Authors: Katarzyna Socha, Konrad Mielcarek, Grzegorz Kangowski, Renata Markiewicz-Zukowska, Anna Puscion-Jakubik, Jolanta Soroczynska, Maria H. Borawska

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Nuts have high nutritional value. They are a good source of polyunsaturated fatty acids, dietary fiber, vitamins (B₁, B₆, E, K) and minerals: magnesium, selenium, zinc (Zn). Zn is an essential element for proper functioning and development of human organism. Due to antioxidant and anti-inflammatory properties, Zn has an influence on immunological and central nervous system. It also affects proper functioning of reproductive organs and has beneficial impact on the condition of skin, hair, and nails. The objective of this study was estimation of Zn content in edible nuts. The research material consisted of 10 types of nuts, 12 samples of each type: almonds, brazil nuts, cashews, hazelnuts, macadamia nuts, peanuts, pecans, pine nuts, pistachios, and walnuts. The samples of nuts were digested in concentrated nitric acid using microwave mineralizer (Berghof, Germany). The concentration of Zn was determined by flame atomic absorption spectrometry method with Zeeman background correction (Hitachi, Japan). The accuracy of the method was verified on certified reference material: Simulated Diet D. The statistical analysis was performed using Statistica v. 13.0 software. For comparison between the groups, t-Student test was used. The highest content of Zn was shown in pine nuts and cashews: 78.57 ± 21.9, 70.02 ± 10,2 mg/kg, respectively, significantly higher than in other types of nuts. The lowest content of Zn was found in macadamia nuts: 16.25 ± 4.1 mg/kg. The consumption of a standard 42-gram portion of almonds, brazil nuts, cashews, peanuts, pecans, and pine nuts covers the daily requirement for Zn above 15% of recommended daily allowances (RDA) for women, while in the case of men consumption all of the above types of nuts, except peanuts. Selected types of nuts can be a good source of Zn in the diet.

Keywords: atomic absorption spectrometry, microelement, nuts, zinc

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Authors: Mohamed M. A. Abumandour

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The red swamp freshwater crayfish breathe through three types of feather-like trichobranchiate gills; podobranchiae, arthrobranchiae and pleurobranchiae. All gills have the same general structure and appearance; plume-like with single broad setiferous, and single axis. The gill consists of axis with numerous finger-like filaments, having three morphological types; round, pointed and somewhat hooked shaped. The direction of filaments vary according their position; in middle region were nearly perpendicular to gill axis while in the apex were nearly parallel to axis. There were characteristic system of gill spines on; central axis (two types were distinguishable by presence of socket), basal plate, setobranch (long non-branched and short multidenticulate) and on the bilobed epipodal plate. There are four shape of spinated-like distal region of setobranch seta; two pointed processes (longitudinal arrangement and irregular arranged) and two broad processes (transverse triangular and multidenticulate). The bilobed epipodal plate devoid from any filaments and extended from outer side of podobranchiae as triangular basal part then extended between the gills as cord-like middle part then pass under the gill to lies against the thoracic body wall. By SEM, the apical part of bilobed epipodal plate have serrated free border and corrugated surface while the middle part have none serrated free border. There are two methods of gill cleaning mechanism in crayfish; passive and active method. The passive method occurred by; setae of setobranch, branchiostegite, bilobed epipodal plate, setiferous arthrodial lamellae and reversing the respiratory water through a narrow spaced branchial chamber.

Keywords: crayfis, gill spines, setobranch, gill setae, cleaning mechanisms

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Authors: Pierre F. Gerard, Frederic F. Leymarie, William Latham

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Architects have developed a series of objective evaluations, using spatial analysis tools such as Isovist, that show how certain spatial qualities are beneficial to specific human activities hosted in the built environments. In return, they can build more adapted environments by tuning those spatial qualities in their design. In parallel, virtual reality technologies have been developed by engineers with the dream of creating a system that immerses users in a new form of spatial experiences. They already have demonstrated a useful range of benefits not only in simulating critical events to assist people in acquiring new skills, but also to enhance memory retention, to name just a few. This paper investigates the effects of two spatial qualities, openness, and complexity, on cognitive performance within immersive virtual environments. Isovist measure is used to design a series of room settings with different levels of each spatial qualities. In an empirical study, each room was then used by every participant to solve a navigational puzzle game and give a rating of their spatial experience. They were then asked to fill in a questionnaire before solving the visual-spatial memory quiz, which addressed how well they remembered the different rooms. Findings suggest that those spatial qualities have an effect on some of the measures, including navigation performance and memory retention. In particular, there is an order effect for the navigation puzzle game. Participants tended to spend a longer time in the complex room settings. Moreover, there is an interaction effect while with more open settings, participants tended to perform better when in a simple setting; however, with more closed settings, participants tended to perform better in a more complex setting. For the visual-spatial memory quiz, participants performed significantly better within the more open rooms. We believe this is a first step in using virtual environments to enhance participant cognitive performances through better use of specific spatial qualities.

Keywords: architecture, navigation, spatial cognition, virtual reality

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Authors: Javier Ascanio Villabona, Brayan Eduardo Tarazona Romero, Camilo Leonardo Sandoval Rodriguez, Arly Dario Rincon, Omar Lengerke Perez

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Efficient energy consumption in the housing sector in relation to refrigeration is a concern in the construction and rehabilitation of houses in tropical areas. Thermal comfort is aggravated by heat gain on the roof surface by heat gains. Thus, in the group of passive cooling techniques, one of the practices and technologies in solar control that provide improvements in comfortable conditions are thermal insulation or geometric changes of the roofs. On the other hand, methods with reflection and radiation are the methods used to decrease heat gain by facilitating the removal of excess heat inside a building to maintain a comfortable environment. Since the potential of these techniques varies in different climatic zones, their application in different zones should be examined. This research is based on the experimental study of a prototype of a roof radiator as a method of passive cooling in homes, which was developed through an experimental research methodology making measurements in a prototype built by means of the paradigm of appropriate technology, with the aim of establishing an initial behavior of the internal temperature resulting from the climate of the external environment. As a starting point, a selection matrix was made to identify the typologies of passive cooling systems to model the system and its subsequent implementation, establishing its constructive characteristics. Step followed by the measurement of the climatic variables (outside the prototype) and microclimatic variables (inside the prototype) to obtain a database to be analyzed. As a final result, the decrease in temperature that occurs inside the chamber with respect to the outside temperature was evidenced. likewise, a linearity in its behavior in relation to the variations of the climatic variables.

Keywords: appropriate technology, enveloping, energy efficiency, passive cooling

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Authors: J. E. Cobbinah

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One of the most challenging issues confronting schools is good leadership succession planning. Experts argue that, although the idea of leadership succession planning is one of the strategies or practices that can help sustain improvement and promote continuity of good leadership, seem to have been neglected in many schools over the years. Appointment of head teachers in senior high schools is based on long service or one’s ability to demonstrate his/her competence in a leadership selection interview. There is no clear and well-structured leadership succession plan, before leadership position is filled, while school leadership succession planning seem to be an issue that nobody talks about. In faith-based schools the issue is even worse, because religious groups impose whoever they consider strong in the faith on schools as leaders, irrespective of the individual competence, ability to take up challenges associated with individuals’ preparedness to take up leadership position. Therefore, the present study examined the nature (including type) of leadership succession plans in faith-based senior high schools and its associated challenges. Convergent mixed method design was employed to effectively achieve the objectives of the study. The data collection strategies involved the use of interviews, questionnaires, and reviews of secondary data. The data was gathered from students, school leaders (head teachers, deputy heads, and head of departments), selected parents teachers associated members, school management committee members and members from school governors. The results show that governors of faith-based schools are making efforts to enhance education quality, by making school leadership accountable, the absence and the neglect of clear, and well-structured leadership succession plan has some negative outcomes. Unsustainable students’ academic performance, lack of support from existing staffs and senior leaders and lack of support in the implementation of school improvement plan. It would be concluded that, faith-based schools should focus on leadership competence and abilities in the selection process of potential school leaders to achieve a good succession plan rather than appointing leaders who are affiliates of one’s faith.

Keywords: school leadership, succession planning, faith-based schools, school governors

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Authors: Blessings Masuku

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Background: Considering that Africa is urbanizing faster than any other region globally, managing cities in the global South has become the centerpiece for the New Urban Agenda (i.e., a shared vision of how we rethink, rebuild, and manage our cities for a better and more sustainable future). This study is centered on governance and planning of urban informality practices with particular reference to the relationship between the state, informal actors (e.g., informal traders and informal dwellers), and other city stakeholders who are public space users (commuters, businesses, and environmental activists), and how informal actors organize themselves to lobby the state and claim for their rights in the city, and how they navigate their everyday livelihood strategies. Aim: The purpose of this study is to examine and interrogate contemporary approaches, policy and regulatory frameworks to urban spatial planning and management of informality in one of South Africa’s busiest and major cities, Johannesburg. Setting: The study uses the metropolitan region of the city of Johannesburg, South Africa to understand how this contemporary industrial city manages urban informality practices, including the use of public space, land zoning and street life, and paying a closer look at what progress has been made and gaps in their inclusive urban policy frameworks. Methods: This study utilized a qualitative approach that includes surveys (open-ended questions), archival research (i., e policy and other key document reviews), and key interviews mainly with city officials, and informality actors. A thematic analysis was used to analyze the data collected. Contribution: This study contributes to large urban informality scholarship in the global South cities by exploring how major cities particularly in Africa regulate and manage informality patterns and practices in their quest to build “utopian” smart cities. This study also brings a different perspective on the hacking ways used by the informal actors to resist harsh regulations and remain invisible in the city, which is something that previous literature has barely delved in-depth.

Keywords: inclusive planning and governance, infrastructure systems, livelihood strategies urban informality, urban space

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Authors: Xue Wang, Liwei Fan

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Renewable energy technology innovation is an important way to realize the energy transformation. Our government has issued a series of policies to guide and support the development of renewable energy. The implementation of these policies will affect the further development, utilization and technological innovation of renewable energy. In this context, it is of great significance to systematically sort out and evaluate the renewable energy technology innovation policy for improving the existing policy system. Taking the 190 renewable energy technology innovation policies issued during 2005-2021 as a sample, from the perspectives of policy issuing departments and policy keywords, it uses text mining and content analysis methods to analyze the current situation of the policies and conduct a semantic network analysis to identify the core issuing departments and core policy topic words; A PMC (Policy Modeling Consistency) index model is built to quantitatively evaluate the selected policies, analyze the overall pros and cons of the policy through its PMC index, and reflect the PMC value of the model's secondary index The core departments publish policies and the performance of each dimension of the policies related to the core topic headings. The research results show that Renewable energy technology innovation policies focus on synergy between multiple departments, while the distribution of the issuers is uneven in terms of promulgation time; policies related to different topics have their own emphasis in terms of policy types, fields, functions, and support measures, but It still needs to be improved, such as the lack of policy forecasting and supervision functions, the lack of attention to product promotion, and the relatively single support measures. Finally, this research puts forward policy optimization suggestions in terms of promoting joint policy release, strengthening policy coherence and timeliness, enhancing the comprehensiveness of policy functions, and enriching incentive measures for renewable energy technology innovation.

Keywords: renewable energy technology innovation, content analysis, policy evaluation, PMC index model

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Authors: Sergo Esadze

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Seismic resistance norms require calculation of cantilevers on vertical components of the base seismic acceleration. Long span cantilevers, as a rule, must be calculated as a separate construction element. According to the architectural-planning solution, functional purposes and environmental condition of a designing buildings/structures, long span cantilever construction may be of very different types: both by main bearing element (beam, truss, slab), and by material (reinforced concrete, steel). A choice from these is always linked with bearing construction system of the building. Research of vertical seismic vibration of these constructions requires individual approach for each (which is not specified in the norms) in correlation with model of seismic load. The latest may be given both as deterministic load and as a random process. Loading model as a random process is more adequate to this problem. In presented paper, two types of long span (from 6m – up to 12m) reinforcement concrete cantilever beams have been considered: a) bearing elements of cantilevers, i.e., elements in which they fixed, have cross-sections with large sizes and cantilevers are made with haunch; b) cantilever beam with load-bearing rod element. Calculation models are suggested, separately for a) and b) types. They are presented as systems with finite quantity degree (concentrated masses) of freedom. Conditions for fixing ends are corresponding with its types. Vertical acceleration and vertical component of the angular acceleration affect masses. Model is based on assumption translator-rotational motion of the building in the vertical plane, caused by vertical seismic acceleration. Seismic accelerations are considered as random processes and presented by multiplication of the deterministic envelope function on stationary random process. Problem is solved within the framework of the correlation theory of random process. Solved numerical examples are given. The method is effective for solving the specific problems.

Keywords: cantilever, random process, seismic load, vertical acceleration

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Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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Authors: Hossein Ghaedamini, Salman Farahbakhsh, Alireza Amirbeigi, Zahra Saghafi, Salman Daneshi, Alireza Ghaedamini

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Background: Assessing the challenges of clinical education of medical students is one of the most important and sensitive parts of medical education. The aim of this study was to investigate the views and experiences of Kerman medical students on the factors that facilitate and inhibit the quality of clinical education. Materials and Methods: This research was qualitative and used a phenomenological approach. The study population included medical interns of Kerman University of Medical Sciences in 1400. The method of data collection was in-depth interviews with participants. Data were encoded and analyzed by Claizey stepwise model. Results: First, about 540 primary codes were extracted in the form of two main themes (facilitators and inhibitors) and 10 sub-themes including providing motivational models and creating interest in interns, high scientific level of professors and the appropriate quality of their teaching, the use of technology in the clinical education process, delegating authority and freedom of action and more responsibilities to interns, inappropriate treatment of some officials, professors, assistants and department staff with their interns, inadequate educational programming, lack of necessary cooperation and providing inappropriate treatment by clinical training experts for interns, inadequate evaluation method in clinical training for interns, poor quality mornings, the unefficiency of grand rounds, the inappropriate way of evaluating clinical training for interns, the lack of suitable facilities and conditions with the position of a medical intern, and the hardwork of some departments were categorized. Conclusion: Clinical education is always mixed with special principles and subtleties, and special attention to facilitators and inhibitors in this process has an important role in improving its quality.

Keywords: clinical education, medical students, qualitative study, education

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