Search results for: clinical quality

Authors: Joe Collins, Matthias Rother

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Background: Oral non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the relief of joint pain during and post-exercise. However, oral NSAIDs increase the risk of systemic side effects, even in healthy individuals, and retard recovery from muscle soreness. TDT 064 (Flexiseq®), a topical formulation containing ultra-deformable drug-free Sequessome™ vesicles, has demonstrated equivalent efficacy to oral celecoxib in reducing osteoarthritis-associated joint pain and stiffness. TDT 064 does not cause NSAID-related adverse effects. We describe clinical study data and a case report on the effectiveness of TDT 064 in reducing joint pain after exercise. Methods: Participants with a pain score ≥3 (10-point scale) 12–16 hours post-exercise were randomized to receive TDT 064 plus oral placebo, TDT 064 plus oral ketoprofen, or ketoprofen in ultra-deformable phospholipid vesicles plus oral placebo. Results: In the 168 study participants, pain scores were significantly higher with oral ketoprofen plus TDT 064 than with TDT 064 plus placebo in the 7 days post-exercise (P = 0.0240) and recovery from muscle soreness was significantly longer (P = 0.0262). There was a low incidence of adverse events. These data are supported by clinical experience. A 24-year-old male professional rugby player suffered a traumatic lisfranc fracture in March 2014 and underwent operative reconstruction. He had no relevant medical history and was not receiving concomitant medications. He had undergone anterior cruciate ligament reconstruction in 2008. The patient reported restricted training due to pain (score 7/10), stiffness (score 9/10) and poor function, as well as pain when changing direction and running on consecutive days. In July 2014 he started using TDT 064 twice daily at the recommended dose. In November 2014 he noted reduced pain on running (score 2-3/10), decreased morning stiffness (score 4/10) and improved joint mobility and was able to return to competitive rugby without restrictions. No side effects of TDT 064 were reported. Conclusions: TDT 064 shows efficacy against exercise- and injury-induced joint pain, as well as that associated with osteoarthritis. It does not retard muscle soreness recovery after exercise compared with an oral NSAID, making it an alternative approach for the treatment of joint pain during and post-exercise.

Keywords: exercise, joint pain, TDT 064, phospholipid vesicles

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Authors: G. Murtaza, H. Faiza, M. Rafiq, S. Gul, F. Raza, Sarwat Anjum

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Our objective was to investigate whether and how extensively there is a correlation between aging in men, gonadotropin hormone regulation, and a decline in sperm parameters and whether it is possible to identify an age limit beyond which the decrease in sperm feature and hormonal regulation reaches statistical significance. A total of one hundred and twenty men (age: 20–50 years) were divided into two groups; each group contained 60 males (Group A with a young age of 20–35 years and Group B with an older age of 36–50 years) who visited the Center for Reproductive Medicine (CRM) in Peshawar General Hospital (PGH) Peshawar, Pakistan. Clinical assessment and sperm analysis were investigated. Hormone testing and semen analysis were carried out in accordance with World Health Organization (WHO) guidelines. Hormone tests, sperm morphology, and the total motile spermatozoa count (TMS) were computed. SPSS 20.0 (SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. It was observed that the testosterone levels in Group A (mean = 3.770) and Group B (mean = 3.995) were comparable, with a significant P-value <0.005 in both age groups. Furthermore, similar levels are shown by follicle-stimulating hormone (FSH) (Group A mean = 19.73, Group B mean = 15.64) and luteinizing hormone (LH) (Group A mean = 12.25, Group B mean = 11.93) in both groups, with a significant P = <0.005. Sperm concentrations were most similar in Group A, with a mean of 4.44, and in Group B, with a mean of 4.42 and a significant P value of 0.005 in both groups. Additionally, it was discovered that sperm motility was higher in Group A, with a mean of 22.40 and a P-value of 0.052, which was non-significant when compared to Group B. Morphological differences were also observed in both age groups. This research found that advancing in male age does not affect sex hormone regulation; in contrast, the fraction of motile and morphologically normal spermatozoa decreases as male age increases, with the strongest evidence being when the age exceeds 40 years. To clarify the causes and clinical implications of these correlations, more research is necessary.

Keywords: gonadotropins, motility, spermatozoa, testosterone

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of ‎death in the world. Some of these deaths occur even before the patient ‎reaches the hospital. Myocardial infarction occurs as a result of ‎impaired blood supply. Because the most of these deaths are due to ‎coronary artery disease, hence the awareness of the warning signs of a ‎heart attack is essential. Some heart attacks are sudden and intense, but ‎most of them start slowly, with mild pain or discomfort, then early ‎detection and successful treatment of these symptoms is vital to save ‎them. Therefore, importance and usefulness of a system designing to ‎assist physicians in the early diagnosis of the acute heart attacks is ‎obvious.‎ The purpose of this study is to determine how well a predictive ‎model would perform based on the only patient-reportable clinical ‎history factors, without using diagnostic tests or physical exams. This ‎type of the prediction model might have application outside of the ‎hospital setting to give accurate advice to patients to influence them to ‎seek care in appropriate situations. For this purpose, the data were ‎collected on 711 heart patients in Iran hospitals. 28 attributes of clinical ‎factors can be reported by patients; were studied. Three logistic ‎regression models were made on the basis of the 28 features to predict ‎the risk of heart attacks. The best logistic regression model in terms of ‎performance had a C-index of 0.955 and with an accuracy of 94.9%. ‎The variables, severe chest pain, back pain, cold sweats, shortness of ‎breath, nausea, and vomiting were selected as the main features.‎

Keywords: Coronary heart disease, Acute heart attacks, Prediction, Logistic ‎regression‎

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Authors: E. D. Paul, F. G. Okibe, C. E. Gimba, S. Yakubu

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Some physicochemical characteristics and heavy metal concentrations of water samples collected from ten boreholes in Samaru, Zaria, Kaduna state, Nigeria were analysed in order to assess the drinking water quality. Physicochemical parameters were determined using classical methods while the heavy metals were determined using Atomic Absorption Spectrometry. Results of the analysis obtained were as follows: Temperature 29 – 310C, pH 5.74 – 6.19, Electrical conductivity 3.21 – 7.54 µs, DO 0.51 – 1.00 mg/L, BOD 0.0001 – 0.006 mg/L, COD 160 – 260 mg/L, TDS 2.08 – 4.55 mg/L, Total Hardness 97.44 – 401.36 mg/L CaCO3, and Chloride 0.97 – 59.12 mg/L. Concentrations of heavy metals were in the range; Zinc 0.000 – 0.7568 mg/L, Lead 0.000 – 0.070 mg/L and Cadmium 0.000 – 0.009 mg/L. The implications of these findings are discussed.

Keywords: ground water, water quality, heavy metals, Atomic Absorption Spectrometry (AAS)

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Authors: Atiqa Marium

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In 2015, all 193 UN Member countries adopted the 2030 Agenda for Sustainable Development, which is an ambitious 15- year plan to address some of the most pressing issues the world faces. Goal 4 is about Quality Education which highlights the importance of inclusive and quality education for sustainable development. Sustainable Development Goal 10 focuses on reducing inequalities within and among countries. In June 2019, Federal Government in Canada released “Towards Canada’s 2030 Agenda National Strategy”, which was an important step to move the 2030 Agenda forward. In April 2019, the Ontario government announced the performance-based funding model for publically assisted colleges and universities in Ontario, which is now part of the universities’ budget 2024-2025. The literature review has shown that the funding model has been implemented by different governments to achieve objectives. However, this model has also resulted in conflicting consequences like reducing university autonomy, education quality/ academic standards, and increased equity concerns. The primary focus of this paper will be to analyze the tensions and coherence between the proposed funding model for education for sustainable development goals and targets set by Canada’s 2030 Agenda National Strategy. Considering that the literature review has provided evidence that the performance-based funding model has resulted in reducing quality of education and increased equity issues in other countries, it will be interesting to see how this proposed funding will align with the SDGs of “Quality Education” and “Reduced Inequalities”. This paper will be well-suited for Volume 4, with the theme of re-visioning institutional impact and sustainability. This paper will underscore the importance of policy coherence between federal and provincial policies for higher education institutions in Ontario for better institutional impact and helping universities in the attainment of goals set in 2030 Agenda towards education for sustainable development.

Keywords: performance-based funding model, education for sustainable development, policy coherence, sustainable development gaols

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Authors: Marija Zulić, Vanda Hájková, Nina Brkić–Jovanović, Srećko Potić, Sanja Tomić

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The name cerebral palsy comes from the word cerebrum, which means the brain and the word palsy, which means seizure, and essentially refers to the movement disorder. In the clinical picture of cerebral palsy, basic neuromotor disorders are associated with other various disorders: behavioural, intellectual, speech, sensory, epileptic seizures, and bone and joint deformities. Motor speech disorders are among the most common difficulties present in people with cerebral palsy. Social participation represents an interaction between an individual and their social environment. Quality of social participation of the students with cerebral palsy at school is an important indicator of their successful participation in adulthood. One of the most important skills for the undisturbed social participation is ability of good communication. The aim of the study was to determine relation between social participation of students with cerebral palsy and presence of their speech impairment in primary schools in the Czech Republic. The study was performed in the Czech Republic in mainstream schools and schools established for the pupils with special education needs. We analysed 75 children with cerebral palsy aged between six and twelve years attending up to sixth grade by using the first and the third part of the school function assessment questionnaire as the main instrument. The other instrument we used in the research is the Gross motor function classification system–five–level classification system, which measures degree of motor functions of children and youth with cerebral palsy. Funding for this study was provided by the Grant Agency of Charles University in Prague.

Keywords: cerebral palsy, social participation, speech disorders, The Czech Republic, the school function assessment

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Authors: Stepan Hysek, Petra Gajdacova

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In recent years, alternative materials, such as annual plants or recycled and waste materials are becoming more and more popular input material for the production of composite materials. They can be used for the production of insulation boards, construction boards or furniture boards. Surface finishing of those boards is essential for utilization in furniture. However, some difficulties could occur during coating of boards from alternative materials; physical and chemical differences from conventional particleboards need to be considered. From the physical aspects, surface soundness and surface roughness mainly determine the quality of the surface. Since surface layers of boards from alternative materials have often lower density, these characteristics could be deteriorated and thus the production process needs to be optimized. Also, chemical reactions of board’s material with coating could be undesirable. The objective of this study is to evaluate the parameters affecting the surface quality of boards made form alternative materials and to find possibilities of the coating of these boards. In this study, boards of particles from rapeseed stems were produced using a laboratory press. Surface soundness, as representatives of mechanical properties and surface roughness, as representative of physical properties, were measured on boards from rapeseed stems. Results clearly indicated that produced boards had lower surface quality than commercially produced particle boards from wood. Therefore, higher thickness of surface coating on rapeseed based boards is needed.

Keywords: coating, surface, annual plant, composites, particleboard

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Authors: Mamoon Masud, Suleman Mazhar

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Indus river basin’s irrigation system in Pakistan is extremely complex, spanning over 50,000 km. Maintenance and monitoring of this demands enormous resources. This paper describes the development of a streamlined and low-cost autonomous underwater vehicle (AUV) for the monitoring of irrigation canals including water quality monitoring and water theft detection. The vehicle is a hovering-type AUV, designed mainly for monitoring irrigation canals, with fully documented design and open source code. It has a length of 17 inches, and a radius of 3.5 inches with a depth rating of 5m. Multiple sensors are present onboard the AUV for monitoring water quality parameters including pH, turbidity, total dissolved solids (TDS) and dissolved oxygen. A 9-DOF Inertial Measurement Unit (IMU), GY-85, is used, which incorporates an Accelerometer (ADXL345), a Gyroscope (ITG-3200) and a Magnetometer (HMC5883L). The readings from these sensors are fused together using directional cosine matrix (DCM) algorithm, providing the AUV with the heading angle, while a pressure sensor gives the depth of the AUV. 2 sonar-based range sensors are used for obstacle detection, enabling the vehicle to align itself with the irrigation canals edges. 4 thrusters control the vehicle’s surge, heading and heave, providing 3 DOF. The thrusters are controlled using a proportional-integral-derivative (PID) feedback control system, with heading angle and depth being the controller’s input and the thruster motor speed as the output. A flow sensor has been incorporated to monitor canal water level to detect water-theft event in the irrigation system. In addition to water theft detection, the vehicle also provides information on water quality, providing us with the ability to identify the source(s) of water contamination. Detection of such events can provide useful policy inputs for improving irrigation efficiency and reducing water contamination. The AUV being low cost, small sized and suitable for autonomous maneuvering, water level and quality monitoring in the irrigation canals, can be used for irrigation network monitoring at a large scale.

Keywords: the autonomous underwater vehicle, irrigation canal monitoring, water quality monitoring, underwater line tracking

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Authors: Khomsan Laosillapacharoen

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This research paper was aimed to analyze the current situation of the furniture industry and embark a plan to enhance the export volume of Thai furniture. This is a qualitative research which utilized meta-analysis and focus group. A total of 24 experts in both government and private sectors were interviewed. The findings revealed that Thai furniture had some advantages of access to raw material, high quality of labors, and have a unique skill. However, the threat included a tendency to have more foreign competitors in domestic market. In addition, the strategies to enhance the level of export included increase the standard quality of Thai furniture, offer new and modern designs, use marketing on the internet, use modern technology, and gain tax incentive from the government.

Keywords: export, furniture, strategies, marketing

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Authors: Zahra Khoshnood, Reza Khoshnood

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The aim of present study was to monitor the presence of Trichodina sp. in Rainbow trout, Oncorhynchus mykiss collected from various fish farms in the western provinces of Iran during January, 2013- January, 2014. Out of 675 sampled fish 335, (49.16%) were infested with Trichodina. The highest prevalence was observed in the spring and winter followed by autumn and summer. In general, the intensity of infection was low except in cases where outbreaks of Trichodiniasis endangered the survival of fish in some ponds. In light infestation Trichodina is usually present on gills, fins and skin of apparently healthy fish. Clinical signs of Trichodiniasis only appear on fish with heavy infections and cases of moderate ones that are usually exposed to one or more stress factors including, rough handling during transportation from ponds, overcrowdness, malnutrition, high of free ammonia and low of oxygen concentration. Clinical signs of Trichodiniasis in sampled fish were sluggish movement, loss of appetite, black coloration, necrosis and ulcer on different parts of the body, detached scales and excessive accumulation of mucous in gill pouches. The most obvious histopathological changes in diseased fish were sloughing of the epidermal layer, aggregation of leucocytes and melanine-carrying cells (between the dermis and hypodermis) and proliferative changes including hyperplasia and hypertrophy of the epithelial lining cells of gill filaments which resulted in fusion of secondary lamellae. Control of Trichodiniasis, has been achieved by formalin bath treatment at a concentration of 250 ppm for one hour.

Keywords: gill, histopathology, rainbow trout, Trichodina

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Authors: Magdalena Barbara Kaziuk, Ilona Hubner, Jacek Hubner, Slawomir Kroczka

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Background: The motor neuron disease is a progressive neurodegenerative disease causing malfunction. Irrespective of the form of the disease and its onset always leads to the worsening of the quality of life, with patients usually depending on the family. Materials and methods: The study included 20 persons (5 females, 15 males, aged 65,5 ± 20 years) with clinically certain or probable diagnosis of the motor neuron disease. Patients were examined three times in the period of six months. The diagnosis was established based on the criteria of El Escorial. Manual dexterity was assessed using the test of the card Rene Zazzo and the test of shading in with lines Mira Stambak. Results: All patients achieved unsatisfactory results in Rene Zazzo’s test of the card and most of the patients (60%) in Mira Stambak’s test of shading with lines. Significantly higher test results were achieved for Rene Zazzo’s test and lower test results for Mira Stambak’s test in consecutive measurements. Conclusions: Impairment of manual dexterity is present already at the moment of diagnosing the disease and is growing significantly during its course. The quality of life for MND patients undergoes gradual deterioration as a result of the malfunction.

Keywords: manual dexterity, motor neuron disease, quality of life, malfunction

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Authors: Nasrin Galehdar, Sedigheh Nadri, Elham Nazari, Isan Darvishi, Abouzar Mohammadi

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Background and aim:Nausea and vomiting are complications of cesarean section. The pharmacological and non-pharmacological approaches were applied to decrease postoperative nausea and vomiting. The aim of the present study was to compare the effects of Ondansetron and acupressure on postoperative nausea and vomiting in patients undergone an elective cesarean section. Materials and method: The study was designed as a randomized clinical trial. A total of 120 patients were allocated to two equal groups. Four mgs of Ondansetron was administered for the Ondansetron group after clamping the umbilical cord. The acupressure bracelets were fastened in the PC6 point for acupressure group for 15 minutes. The patients were monitored in terms of incidence, severity, and episodes of nausea and vomiting. The data obtained were analyzed by SPSS software version 18 with a significance level of 0.05. Results: There was no significant statistical difference in nausea severity among the groups intra-operatively, in the recovery and surgery wards. The incidence and episodes of vomiting were significantly higher in patients undergone acupressure intra-operatively, in the recovery and surgery wards (P< 0.05). No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Conclusion: No significant effect of acupressure was reported in reducing postoperative nausea and vomiting. Thus, it is suggested to perform the studies with larger size and comparing the effects of acupressure with other antiemetic medications.

Keywords: ondansetron, acupressure, nausea, vomiting

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Authors: Shourav Ahmed, M. Gulam Kibria, Kais Zaman

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Control charts graphically verify variation in quality parameters. Attribute type control charts deal with quality parameters that can only hold two states, e.g., good or bad, yes or no, etc. At present, p-control chart is most commonly used to deal with attribute type data. In construction of p-control chart using binomial distribution, the value of proportion non-conforming must be known or estimated from limited sample information. As the probability distribution of fraction non-conforming (p) is considered in hyperbinomial distribution unlike a constant value in case of binomial distribution, it reduces the risk of false detection. In this study, a statistical control chart is proposed based on hyperbinomial distribution when prior estimate of proportion non-conforming is unavailable and is estimated from limited sample information. We developed the control limits of the proposed modified p-chart using the mean and variance of hyperbinomial distribution. The proposed modified p-chart can also utilize additional sample information when they are available. The study also validates the use of modified p-chart by comparing with the result obtained using cumulative distribution function of hyperbinomial distribution. The study clearly indicates that the use of hyperbinomial distribution in construction of p-control chart yields much accurate estimate of quality parameters than using binomial distribution.

Keywords: binomial distribution, control charts, cumulative distribution function, hyper binomial distribution

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Authors: Mahdi Nasiri Tabrizi, A. Dadkhah, M. Khirkhah

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In order to study the effect of planting on yield, yield components and quality traits in bread and durum wheat varieties, a field split-plot experiment based on complete randomized design with three replications was conducted in Agricultural and Natural Resources Research Center of Razavi Khorasan located in city of Mashhad during 2013-2014. Main factor were consisted of five sowing dates (first October, fifteenth December, first March, tenth March, twentieth March) and as sub-factors consisted of different bread wheat (Bahar, Pishgam, Pishtaz, Mihan, Falat and Karim) and two durum wheat (Dena and Dehdasht). According to results of analysis variance the effect of planting date was significant on all examined traits (grain yield, biological yield, harvest index, number of grain per spike, thousands kernel weight, number of spike per square meter, plant height, the number of days to heading, the number of days to maturity, during the grain filling period, percentage of wet gluten, percentage of dry gluten, gluten index, percentage of protein). By delay in planting, majority of traits significantly decreased, except quality traits (percentage of wet gluten, percentage of dry gluten and percentage of protein). Results of means comparison showed, among planting date the highest grain yield and biological yield were related to first planting date (Octobr) with mean of production of 5/6 and 1/17 tons per hectare respectively and the highest bread quality (gluten index) with mean of 85 and percentage of protein with mean of 13% to fifth planting date also the effect of genotype was significant on all traits. The highest grain yield among of studied wheat genotypes was related to Dehdasht cultivar with an average production of 4.4 tons per hectare. The highest protein percentage and bread quality (gluten index) were related to Dehdasht cultivar with 13.4% and Falat cultivar with number of 90 respectively. The interaction between cultivar and planting date was significant on all traits and different varieties had different trend for these traits. The highest grain yield was related to first planting date (October) and Falat cultivar with an average of production of 6/7 tons per hectare while in grain yield did not show a significant different with Pishtas and Mihan cultivars also the most of gluten index (bread quality index) and protein percentage was belonged to the third planting date and Karim cultivar with 7.98 and Dena cultivar with 7.14% respectively.

Keywords: yield component, yield, planting date, cultivar, quality traits, wheat

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Authors: Edgar Gasafi, Robert Pardemann, Linus Perander

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For the production of lithium carbonate or hydroxide out of lithium bearing ores, a thermal activation (calcination/decrepitation) is required for the phase transition in the mineral to enable an acid respectively soda leaching in the downstream hydrometallurgical section. In this paper, traditional processing in Lithium industry is reviewed, and opportunities to reduce energy consumption and improve product quality and recovery rate will be discussed. The conventional process approach is still based on rotary kiln calcination, a technology in use since the early days of lithium ore processing, albeit not significantly further developed since. A new technology, at least for the Lithium industry, is fluidized bed calcination. Decrepitation of lithium ore was investigated at Outotec’s Frankfurt Research Centre. Focusing on fluidized bed technology, a study of major process parameters (temperature and residence time) was performed at laboratory and larger bench scale aiming for optimal product quality for subsequent processing. The technical feasibility was confirmed for optimal process conditions on pilot scale (400 kg/h feed input) providing the basis for industrial process design. Based on experimental results, a comprehensive Aspen Plus flow sheet simulation was developed to quantify mass and energy flow for the rotary kiln and fluidized bed system. Results show a significant reduction in energy consumption and improved process performance in terms of temperature profile, product quality and plant footprint. The major conclusion is that a substantial reduction of energy consumption can be achieved in processing Lithium bearing ores by using fluidized bed based systems. At the same time and different from rotary kiln process, an accurate temperature and residence time control is ensured in fluidized-bed systems leading to a homogenous temperature profile in the reactor which prevents overheating and sintering of the solids and results in uniform product quality.

Keywords: calcination, decrepitation, fluidized bed, lithium, spodumene

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Authors: Damaris Estrella Castillo, Zacil ha Vilchis Zapata, Leydi Peraza Gómez

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Hearing loss is an etiologically heterogeneous condition, where almost 60% is genetic in origin, 20% is due to environmental factors, and 20% have unknown causes. However, it is now known that the gene, GJB2, which encodes the connexin 26 protein, accounts for a large percentage of non-syndromic genetic hearing loss, and variants in this gene have been identified to be a common cause of hereditary hearing loss in many populations. The literature reports that the etiology in deafness helps improve family functioning but low-income countries this is difficult. Therefore, it is difficult to contribute the right of families to know about the genetic risk in future pregnancies as well as determining the certainty of being a carrier or affected. In order to assess the impact of genetic counseling and the functionality, 100 families with at least one child with profound hearing loss, were evaluated by specialists in audiology, clinical genetics and psychology. Targeted mutation analysis for one of the two known large deletions of upstream of GJB2/GJB6 gene (35delG; and including GJB2 regulatory sequences and GJB6) were performed in patients with diagnosis of non-syndromic hearing loss. Genetic counseling was given to all parents and primary caregivers, and APGAR family test was applied before and after the counseling. We analyzed a total of 300 members (children, parents) to determine the presence of the GJB2 gene mutation. Twelve patients (carriers and affected) were positive for the mutation, from 5 different families. The subsequent family APGAR testing and genetic counseling, showed that 14% perceived their families as functional, 62 % and 24 % moderately functional dysfunctional. This shows the importance of genetic counseling in the perception of family function that can directly impact the quality of life of these families.

Keywords: family dynamics, deafness, APGAR, counseling

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Authors: Bovornluck Kuosuwan, Kevin Wongleedee

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The purposes of this research was to study the level of satisfaction of international tourists in five important areas: satisfaction on visiting tourist destinations, satisfaction on tourist images, satisfaction on value for money, satisfaction on service quality, and satisfaction when compared with their expectation. A probability random sampling of 200 inbound tourists was utilized. A questionnaire was used to collect the data and small in-depth interviews were also used to get their opinions about their positive and negative evaluations of their experience travelling in Thailand. The findings revealed that the majority of respondents had a medium level of satisfaction. When examined in detail, the level of satisfaction can be ranked from highest to lowest according to the mean average as follows: visiting tourist destinations, expectations, service quality, tourist image, and value for money.

Keywords: inbound tourists, satisfaction, Thailand, international tourists

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Authors: Bing-Jing Li, Sih-Yin Wang, Tse-Chun Yeh, Yuan-Bin Chen

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Microwave dielectric ceramic materials of (Mg1-xNix)2(Ti0.95Sn0.05)O4 for x = 0.01, 0.03, 0.05, 0.07 and 0.09 were prepared and sintered at 1250–1400ºC. The microstructure and microwave dielectric properties of the ceramic materials were examined and measured. The observations shows that the content of Ni2+ ions has little effect on the crystal structure, dielectric constant, temperature coefficient of resonant frequency (τf) and sintering temperatures of the ceramics. However, the quality values (Q×f) are greatly improved due to the addition of Ni2+ ions. The present study showed that the ceramic material prepared for x = 0.05 and sintered at 1325ºC had the best Q×f value of 392,000 GHz, about 23% improvement compared with that of Mg2(Ti0.95Sn0.05)O4.

Keywords: (Mg1-xNix)2(Ti0.95Sn0.05)O4, microwave dielectric ceramics, high quality factor, high frequency wireless communication

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Authors: K. Ebrahimi, Sh. Shahid, M. Mohammadi Ghaleni, M. H. Omid

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The longitudinal dispersion coefficient is a crucial parameter for 1-D water quality analysis of riverine flows. So far, different types of empirical equations for estimation of the coefficient have been developed, based on various case studies. The main objective of this paper is to develop an empirical equation for estimation of the coefficient for a riverine flow. For this purpose, a set of tracer experiments was conducted, involving salt tracer, at three sections located in downstream of a lengthy canal. Tracer data were measured in three mixing lengths along the canal including; 45, 75 and 100m. According to the results, the obtained coefficients from new developed empirical equation gave an encouraging level of agreement with the theoretical values.

Keywords: coefficients, dispersion, river, tracer, water quality

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Authors: Noof Eid Al Shammari

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Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

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Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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Authors: Raneem Osama Salem, Ayesha Nuzhat, Fatimah Nasser Al Shehri, Nasser Al Hamdan

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Background: Recently, most medical schools around the globe are using simulation for teaching and assessing students’ clinical skills and competence. There are many obstacles that could face students and faculty when simulation sessions are introduced into undergraduate curriculum. Objective: The aim of this study is to obtain the opinion of undergraduate medical students and our faculty regarding the role of simulation in undergraduate curriculum, the simulation modalities used, and perceived barriers in implementing stimulation sessions. Methods: To address the role of simulation, modalities used, and perceived challenges to implementation of simulation sessions, a self-administered pilot tested questionnaire with 18 items using a 5 point Likert scale was distributed. Participants included undergraduate male medical students (n=125) and female students (n=70) as well as the faculty members (n=14). Result: Various learning outcomes are achieved and improved through the technology enhanced simulation sessions such as communication skills, diagnostic skills, procedural skills, self-confidence, and integration of basic and clinical sciences. The use of high fidelity simulators, simulated patients and task trainers was more desirable by our students and faculty for teaching and learning as well as an evaluation tool. According to most of the students,' institutional support in terms of resources, staff and duration of sessions was adequate. However, motivation to participate in the sessions and provision of adequate feedback by the staff was a constraint. Conclusion: The use of simulation laboratory is of great benefit to the students and a great teaching tool for the staff to ensure students learning of the various skills.

Keywords: simulators, medical students, skills, simulated patients, performance, challenges, skill laboratory

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Muhammad Atif Randhawa, Adnan Amjad, Muhammad Nadeem

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Potato (Solanum tuberosum) popularly known as ‘the king of vegetables’, has emerged as fourth most important food crop after rice, wheat and maize. Potato contains carbohydrates, minerals, vitamins and antioxidants. The antioxidants of potatoes especially vitamin C helps in reducing cancer, cardiovascular diseases and high blood pressure by binding free radicals. Physical characteristics and some major chemical properties of potato tubers at fresh and stored stages were investigated. Two varieties of potatoes, Sante (V1) having white colour and Lal moti (V2) with red colour were stored for 3 months and analysis were performed after each month interval. Physical and chemical attributes including weight loss, sprouting, specific gravity, pH, total sugars (reducing and non-reducing sugars) and vitamin C were analyzed before and after storage. Value of weight loss at zero day was null but it increased to 6.45% after 90 days on average in both cultivars and sprouting increased gradually at the end of 90 days. Moreover total sugars were 3.10% at zero day but increased to 9.30% after 90 days. Ascorbic acid was decreased during storage from 17.49(mg/100g) to 3.79. Both varieties of potato were stored at 60C and 120C temperatures with 85% relative humidity in order to prolong their acceptability in the market. The storage conditions influence the potatoes quality and consequently their acceptability to consumer. The data was analyzed statistically and clarifies that total sugars, weight loss, sprouting and specific gravity increase during the storage period while ascorbic acid (Vit-C) and pH decreased. Among both varieties that were stored at 60C and 120C, Sante (V1) was better than Lal moti (V2) due to less physicochemical and quality changes at 60C as compared to store at 120C.

Keywords: physicochemical, potato, quality attributes, storage

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Authors: Rabbia Tariq, Hannan Sajjad, Mehreen Sirshar

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Design patterns are widely used to make the process of development easier as they greatly help the developers to develop the software. Different design patterns have been introduced till now but the behavior of same design pattern may differ in different domains that can lead to the wrong selection of the design pattern. The paper aims to discover the design patterns that suits best with respect to their domain thereby helping the developers to choose an effective design pattern. It presents the comprehensive analysis of design patterns based on different methodologies that include simulation, case study and comparison of various algorithms. Due to the difference of the domain the methodology used in one domain may be inapplicable to the other domain. The paper draws a conclusion based on strength and limitation of each design pattern in their respective domain.

Keywords: design patterns, evaluation, quality assurance, software domains

Procedia PDF Downloads 522

Authors: Shoumodip Roy, Ankit Singhania, Santanu Mallick, Abhiram Jha, M. K. Agarwal, R. V. Ramna, Uttam Singh

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The quality of hot metal at any blast furnace is judged by the silicon content in it. Lower hot metal silicon not only enhances process efficiency at steel melting shops but also reduces hot metal costs. The Hot metal produced at G-Blast furnace Tata Steel Jamshedpur has a significantly higher Si content than Benchmark Blast furnaces. The higher content of hot metal Si is mainly due to inferior raw material quality than those used in benchmark blast furnaces. With minimum control over raw material quality, the only option left to control hot metal Si is via optimizing the furnace parameters. Therefore, in order to identify the levers to reduce hot metal Si, Data mining was carried out, and multiple regression models were developed. The statistical analysis revealed that Slag B3{(CaO+MgO)/SiO2}, Slag Alumina and Hot metal temperature are key controllable parameters affecting hot metal silicon. Contour Plots were used to determine the optimum range of levels identified through statistical analysis. A trial plan was formulated to operate relevant parameters, at G blast furnace, in the identified range to reduce hot metal silicon. This paper details out the process followed and subsequent reduction in hot metal silicon by 15% at G blast furnace.

Keywords: blast furnace, optimization, silicon, statistical tools

Procedia PDF Downloads 223

Authors: Parveen Kundu, Zile Singh, Kunika Kundu, Swaran Kaur

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Context: Tuberculous osteomyelitis is a relatively uncommon condition that can present with various clinical and radiological features, often mimicking bone tumors or tumor-like lesions. In endemic countries like India, tuberculosis should be considered as a potential differential diagnosis for lytic bone lesions. This study aimed to highlight the different presentations of tuberculosis that can mimic tumors or tumor-like lesions in bone and emphasize the successful outcome of antitubercular therapy (ATT) in treating these cases. Research Aim: The main objective of this research was to explore the varied presentations of tuberculosis that mimic bone tumors or tumor-like lesions both clinically and radiologically, focusing on different bones. The study aimed to raise awareness among clinicians about this possibility and highlight the importance of histopathological confirmation before initiating treatment for lytic bone lesions. Methodology: This study utilized a retrospective review of 22 patients with suspected lytic bone lesions, who were subsequently diagnosed with tuberculous osteomyelitis through histopathological examination. The cases were collected over a period of ten years. Eleven cases required curettage for extensive lesions with sequestrations, while all 22 patients received 12 months of antitubercular therapy. Findings: The study included 14 male and 8 female patients, ranging in age from 3 to 61 years, with an average age of 22.05. The clinical and radiological presentations varied, with examples including bone cysts in the metaphyseal area of long bones, lesions resembling chondroblastomas, giant cell tumors, and osteoid osteoma, as well as multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had lesions in both the clavicle and hand. Lesions mimicking chondromas were also observed in the phalanges of the hand and foot metatarsal. All patients showed resolution of the lesions and no residual disability following ATT. Theoretical Importance: This study highlights the importance of considering tuberculosis as a potential differential diagnosis for lytic bone lesions, particularly in endemic regions. It emphasizes the need for histopathological confirmation to accurately diagnose tuberculous osteomyelitis, as this is considered the gold standard. Data Collection and Analysis Procedures: Data for this study were collected retrospectively from medical records and radiological images of the 22 patients. The cases were analyzed based on clinical presentation, radiological findings, and histopathological confirmation. The outcomes of antitubercular therapy were also assessed. The data were summarized and presented descriptively. Question Addressed: This study aimed to address the question of how tuberculosis can mimic different bone tumors and tumor-like lesions clinically and radiologically. It also aimed to assess the successful outcome of antitubercular therapy in treating these cases. Conclusion: Tuberculous osteomyelitis can present with varied clinical and radiological features, often mimicking bone tumors or tumor-like lesions. Clinicians should consider tuberculosis as a potential diagnosis for lytic bone lesions, especially in endemic areas. Histopathological confirmation is essential for accurate diagnosis. Antitubercular therapy is an effective treatment for tuberculous osteomyelitis, leading to the resolution of the lesions with no residual disability.

Keywords: tuberculosis, tumor, curettage, bone

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Authors: Mohammed A. Almomani, Dina W. Al-Qudah

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Product performance depends on the type and quality of its building material. Successful product must be made using high quality material, and using the right methods. Many foot problems took place as a result of using poor insole material. Therefore, selecting a proper insole material is crucial to eliminate these problems. In this study, the analytical hierarchy process (AHP) is used to provide a systematic procedure for choosing the best material adequate for this application among three material alternatives (polyurethane, poron, and plastzote). Several comparison criteria are used to build the AHP model including: density, stiffness, durability, energy absorption, and ease of fabrication. Poron was selected as the best choice. Inconsistency testing indicates that the model is reasonable, and the materials alternative ranking is effective.

Keywords: AHP, footwear insole, insole material, materials selection

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Authors: Recep Kesli, Cengiz Demir, Onur Turkyilmaz, Hayriye Tokay

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Objective: Gram-negative rods are a large group of bacteria, and include many families, genera, and species. Most clinical isolates belong to the family Enterobacteriaceae. Resistance due to the production of extended-spectrum β-lactamases (ESBLs) is a difficulty in the handling of Enterobacteriaceae infections, but other mechanisms of resistance are also emerging, leading to multidrug resistance and threatening to create panresistant species. We aimed in this study to evaluate resistance rates of Gram-negative rods bacteria isolated from clinical specimens in Microbiology Laboratory, Afyon Kocatepe University, ANS Research and Practice Hospital, between October 2012 and September 2015. Methods: The Gram-negative rods strains were identified by conventional methods and VITEK 2 automated identification system (bio-Mérieux, Marcy l’etoile, France). Antibiotic resistance tests were performed by both the Kirby-Bauer disk-diffusion and automated Antimicrobial Susceptibility Testing (AST, bio-Mérieux, Marcy l’etoile, France) methods. Disk diffusion results were evaluated according to the standards of Clinical and Laboratory Standards Institute (CLSI). Results: Of the totally isolated 1.701 Enterobacteriaceae strains 1434 (84,3%) were Klebsiella pneumoniae, 171 (10%) were Enterobacter spp., 96 (5.6%) were Proteus spp., and 639 Nonfermenting gram negatives, 477 (74.6%) were identified as Pseudomonas aeruginosa, 135 (21.1%) were Acinetobacter baumannii and 27 (4.3%) were Stenotrophomonas maltophilia. The ESBL positivity rate of the totally studied Enterobacteriaceae group were 30.4%. Antibiotic resistance rates for Klebsiella pneumoniae were as follows: amikacin 30.4%, gentamicin 40.1%, ampicillin-sulbactam 64.5%, cefepime 56.7%, cefoxitin 35.3%, ceftazidime 66.8%, ciprofloxacin 65.2%, ertapenem 22.8%, imipenem 20.5%, meropenem 20.5 %, and trimethoprim-sulfamethoxazole 50.1%, and for 114 Enterobacter spp were detected as; amikacin 26.3%, gentamicin 31.5%, cefepime 26.3%, ceftazidime 61.4%, ciprofloxacin 8.7%, ertapenem 8.7%, imipenem 12.2%, meropenem 12.2%, and trimethoprim-sulfamethoxazole 19.2 %. Resistance rates for Proteus spp. were: 24,3% meropenem, 26.2% imipenem, 20.2% amikacin 10.5% cefepim, 33.3% ciprofloxacin and levofloxacine, 31.6% ceftazidime, 20% ceftriaxone, 15.2% gentamicin, 26.6% amoxicillin-clavulanate, and 26.2% trimethoprim-sulfamethoxale. Resistance rates of P. aeruginosa was found as follows: Amikacin 32%, gentamicin 42 %, imipenem 43%, merpenem 43%, ciprofloxacin 50%, levofloxacin 52%, cefepim 38%, ceftazidim 63%, piperacillin/tacobactam 85%, for Acinetobacter baumannii; Amikacin 53.3%, gentamicin 56.6 %, imipenem 83%, merpenem 86%, ciprofloxacin 100%, ceftazidim 100%, piperacillin/tacobactam 85 %, colisitn 0 %, and for S. malthophilia; levofloxacin 66.6 % and trimethoprim/sulfamethoxozole 0 %. Conclusions: This study showed that resistance in Gram-negative rods was a serious clinical problem in our hospital and suggested the need to perform typification of the isolated bacteria with susceptibility testing regularly in the routine laboratory procedures. This application guided to empirical antibiotic treatment choices truly, as a consequence of the reality that each hospital shows different resistance profiles.

Keywords: antibiotic resistance, gram negative rods, ESBL, VITEK 2

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Authors: Adrian Kong, William Chang, Rolando Valdes, Alec Rodriguez, Roberto Miki

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The Pneumask consists of a custom snorkel-specific adapter that attaches a snorkel-port of the mask to a 3D-printed filter. This full-face snorkel mask was designed for use as personal protective equipment (PPE) during the COVID-19 pandemic when there was a widespread shortage of PPE for medical personnel. Various clinical validation tests have been conducted, including the sealing capability of the mask, filter performance, CO2 buildup, and clinical usability. However, data regarding the filter efficiencies of Pneumask and multiple filter types have not been determined. Using an experimental system, we evaluated the filtration efficiency across various masks and filters during inhalation. Eighteen combinations of respirator models (5 P100 FFRs, 4 Dolfino Masks) and filters (2091, 7093, 7093CN, BB50T) were evaluated for their exposure to airborne particles sized 0.3 - 10.0 microns using an electronic airborne particle counter. All respirator model combinations provided similar performance levels for 1.0-micron, 3.0-micron, 5.0-micron, 10.0-microns, with the greatest differences in the 0.3-micron and 0.5-micron range. All models provided expected performances against all particle sizes, with Class P100 respirators providing the highest performance levels across all particle size ranges. In conclusion, the modified snorkel mask has the potential to protect providers who care for patients with COVID-19 from increased airborne particle exposure.

Keywords: COVID-19, PPE, mask, filtration, efficiency

Procedia PDF Downloads 168