Search results for: College of Applied Medical Sciences

Authors: Julian Thrash, Douglas Folk, Michael Ciracy, Audrey C. Tseng, Kristen M. Stromsodt, Amber Younggren, Christopher Maciolek

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The cardiopulmonary system is comprised of the heart, lungs, and many dynamic feedback mechanisms that control its function based on a multitude of variables. The next generation of cardiopulmonary medical devices will involve adaptive control and smart pacing techniques. However, testing these smart devices on living systems may be unethical and exceedingly expensive. As a solution, a comprehensive computational model of the cardiopulmonary system was implemented in Simulink. The model contains over 240 state variables and over 100 equations previously described in a series of published articles. Simulink was chosen because of its ease of introducing machine learning elements. Initial results indicate that physiologically correct waveforms of pressures and volumes were obtained in the simulation. With the development of a comprehensive computational model, we hope to pioneer the future of predictive medicine by applying our research towards the initial stages of smart devices. After validation, we will introduce and train reinforcement learning agents using the cardiopulmonary model to assist in adaptive control system design. With our cardiopulmonary model, we will accelerate the design and testing of smart and adaptive medical devices to better serve those with cardiovascular disease.

Keywords: adaptive control, cardiopulmonary, computational model, machine learning, predictive medicine

Procedia PDF Downloads 186

Authors: A. Lubis, L. Setiawati, A. R. Setyoningrum, A. Suryawan, Irwanto

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Asthma is a condition that causing chronic health problems in children. In addition to basic therapy against disease, we must try to reduce the impact of chronic health problems and also optimize their medical aspect of growth and development. A boy with mild asthma attack frequent episode did not showed any improvement with medical treatment and his asthma control test was 11. From radiologic examination he got hyperaerated lung and billateral sinusitis maxillaris; skin test results were house dust, food and pet allergy; an overweight body; bad school grades; psychological and environmental problem. We followed and evaluated this boy in 6 months, treated holistically. Even we could not do much on environmental but no more psychological and school problems, his on a good bodyweight and his asthma control test was 22. A case of a child with mild asthma attack frequent episode was reported. Asthma clinical course show no significant improvement when other predisposing factor is not well-controlled and a child’s growth and development may be affected. Improving condition of the patient can be created with the help of loving and caring way of nurturing from the parents and supportive peer group. Therefore, continuous and consistent monitoring is required because prognosis of asthma is generally good when regularly and properly controlled.

Keywords: asthma, chronic health problems, growth, development

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Authors: Yulia A. Kononova, Znang X. Ning

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Nowadays, architectural development is getting faster and faster. Nevertheless, modern architecture often does not meet all the points, which could help our planet to get better. As we know, people are spending an enormous amount of energy every day of their lives. Because of the uncontrolled energy usage, people have to increase energy production. As energy production process demands a lot of fuel sources, it courses a lot of problems such as climate changes, environment pollution, animals’ distinction, and lack of energy sources also. Nevertheless, nowadays humanity has all the opportunities to change this situation. Architecture is one of the most popular fields where it is possible to apply new methods of saving energy or even creating it. Nowadays we have kinds of buildings, which can meet new willing. One of them is energy effective buildings, which can save or even produce energy, combining several energy-saving principles. The main aim of this research is to provide information that helps to apply energy-saving methods while designing an environment-friendly building. The research methodology requires gathering relevant information from literature, building guidelines documents and previous research works in order to analyze it and sum up into a material that can be applied to energy-efficient building design. To mark results it should be noted that the usage of all the energy-saving methods applied to a design project of building results in ultra-low energy buildings that require little energy for space heating or cooling. As a conclusion it can be stated that developing methods of passive house design can decrease the need of energy production, which is an important issue that has to be solved in order to save planet sources and decrease environment pollution.

Keywords: accumulation, energy-efficient building, storage, superinsulation, passive house

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Authors: Siamak Samani, Nadereh Sohrabi

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Psychological nano-therapy is a new method based on systems theory. According to the theory, systems with severe dysfunctions are resistant to changes. Psychological nano-therapy helps the therapists to break this ice. Two key concepts in psychological nano-therapy are nano-functions and nano-behaviors. The most important step in psychological nano-therapy in family therapy is selecting the most effective nano-function and nano-behavior. The aim of this study was to check the effectiveness of psychological nano-therapy for family therapy. One group pre-test-post-test design (quasi-experimental Design) was applied for research. The sample consisted of ten families with severe marital conflict. The important character of these families was resistance for participating in family therapy. In this study, sending respectful (nano-function) text massages (nano-behavior) with cell phone were applied as a treatment. Cohesion/respect sub scale from self-report family processes scale and family readiness for therapy scale were used to assess all family members in pre-test and post-test. In this study, one of family members was asked to send a respectful text massage to other family members every day for a week. The content of the text massages were selected and checked by therapist. To compare the scores of families in pre-test and post-test paired sample t-test was used. The results of the test showed significant differences in both cohesion/respect score and family readiness for therapy between per-test and post-test. The results revealed that these families have found a better atmosphere for participation in a complete family therapy program. Indeed, this study showed that psychological nano-therapy is an effective method to make family readiness for therapy.

Keywords: family therapy, family conflicts, nano-therapy, family readiness

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Authors: Radu Deju, Carmen Mustata

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The VVR-S nuclear research reactor owned by Horia Hubulei National Institute of Physics and Nuclear Engineering (IFIN-HH) was designed for research and radioisotope production, being permanently shut-down in 2002, after 40 years of operation. All amount of the nuclear spent fuel S-36 and EK-10 type was returned to Russian Federation (first in 2009 and last in 2012), and the radioactive waste resulted from the reprocessing of it will remain permanently in the Russian Federation. The decommissioning strategy chosen is immediate dismantling. At this moment, the radionuclides with half-life shorter than 1 year have a minor contribution to the contamination of materials and equipment used in reactor department. The decommissioning of the reactor has started in 2010 and is planned to be finalized in 2020, being the first nuclear research reactor that has started the decommissioning project from the South-East of Europe. The management system applied in the decommissioning of the VVR-S research reactor integrates all common elements of management: nuclear safety, occupational health and safety, environment, quality- compliance with the requirements for decommissioning activities, physical protection and economic elements. This paper presents the application of integrated management system in decommissioning of systems, structures, equipment and components (SSEC) from pumps room, including the management of the resulted radioactive waste. The primary cooling system of this type of reactor includes circulation pumps, heat exchangers, degasser, filter ion exchangers, piping connection, drainage system and radioactive leaks. All the decommissioning activities of primary circuit were performed in stage 2 (year 2014), and they were developed and recorded according to the applicable documents, within the requirements of the Regulatory Body Licenses. In the presentation there will be emphasized how the integrated management system provisions are applied in the dismantling of the primary cooling system, for elaboration, approval, application of necessary documentation, records keeping before, during and after the dismantling activities. Radiation protection and economics are the key factors for the selection of the proper technology. Dedicated and advanced technologies were chosen to perform specific tasks. Safety aspects have been taken into consideration. Resource constraints have also been an important issue considered in defining the decommissioning strategy. Important aspects like radiological monitoring of the personnel and areas, decontamination, waste management and final characterization of the released site are demonstrated and documented.

Keywords: decommissioning, integrated management system, nuclear reactor, waste management

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Authors: Shende Suraj Balu, A. B. Deoghare, K. M. Pandey

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The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.

Keywords: computed tomography (μCT), human middle ear (ME), harmonic response, pathologies, tympanic membrane (TM)

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Andreas Kunz, Ali Alavi

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In this paper, we present a simple active stylus for interactive IR-based tabletop systems. Such tables offer a set of tags for realizing tangible user interfaces, which can only be applied to objects having a relatively big contacting area with the interactive surface. The stylus has a unique address and thus can be clearly distinguished from other styli, objects or finger touches that might simultaneously occur on the interactive surface.

Keywords: interactive screens, pen, tangibles, user interfaces

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Authors: Hira Jabbar, Tanzeel-Ur Rehman

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Urban parks and open spaces play a significant role in improving physical and mental health of the citizens, strengthen the societies and make the cities more attractive places to live and work. As the world’s cities continue to grow, continuing to value green space in cities is vital but is also a challenge, particularly in developing countries where there is pressure for space, resources, and development. Offering equal opportunity of accessibility to parks is one of the important issues of park distribution. The distribution of parks should allow all inhabitants to have close proximity to their residence. Remote sensing and Geographic information systems (GIS) can provide decision makers with enormous opportunities to improve the planning and management of Park facilities. This study exhibits the capability of GIS and RS techniques to provide baseline knowledge about the distribution of parks, level of accessibility and to help in identification of potential areas for such facilities. For this purpose Landsat OLI imagery for year 2016 was acquired from USGS Earth Explorer. Preprocessing models were applied using Erdas Imagine 2014v for the atmospheric correction and NDVI model was developed and applied to quantify the land use/land cover classes including built up, barren land, water, and vegetation. The parks amongst total public green spaces were selected based on their signature in remote sensing image and distribution. Percentages of total green and parks green were calculated for each town of Lahore City and results were then synchronized with the recommended standards. ANGSt model was applied to calculate the accessibility from parks. Service area analysis was performed using Network Analyst tool. Serviceability of these parks has been evaluated by employing statistical indices like service area, service population and park area per capita. Findings of the study may contribute in helping the town planners for understanding the distribution of parks, demands for new parks and potential areas which are deprived of parks. The purpose of present study is to provide necessary information to planners, policy makers and scientific researchers in the process of decision making for the management and improvement of urban parks.

Keywords: accessible natural green space standards (ANGSt), geographic information systems (GIS), remote sensing (RS), United States geological survey (USGS)

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Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Main text: Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. Conclusions: The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments

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Authors: Pac Ordu

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The paper was conceived on the premise that employment of tertiary education graduates has become an endemic problem in Nigeria. Recognizing the objective of current education as schooling for paid employment, the paper identified that the basic objective of present-day education should be schooling to become self-employed. While schooling to become a successful employee was identified as the focus for the older generation, schooling to become self-employed was defined as the focus for 21st-century teaching and learning. Hence, the paper condemned the inability of curriculum implementers to teach creative trends to enable students to acquire practical skills and small business operation-oriented competencies. A review of some disciplines was made to show the new trend of education that would empower Nigerian students with small business enterprise operation skills for self-employment on graduation. This was further made to draw the attention of institutions and curriculum designers to the need for our curriculum to be functional in line with demands of the innovative economic environment. The paper also noted that at periods of recession with its attendant effects, was the best period for students of entrepreneurship to dream and create their small business enterprises. It highlighted the role of Federal College of Education (Technical) Omoku, Rivers State, Nigeria and the national recognition it has received for developing an innovative, practical model of teaching entrepreneurship education in Nigeria Colleges of Education system. In order to equip students for economic survival on graduation, the introduction of innovative teaching can only be successful if lecturers shift their focus away from the conventional emphasis on theory to students’ energy quotients. While the paper obviously recommended that lecturers should be creative and teach outside the curriculum box, it further recommended that students should use this period of their studentship to dream, create and operate their own small business enterprises.

Keywords: 21st century students, curriculum, entrepreneurship, hands-on-training, innovative

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Authors: Rafi Ullah, Shah Muhammad Emaduddin, Taha Jilani

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Vehicle Adhoc Networks (VANET) belongs to a special class of Mobile Adhoc Network (MANET) with high mobility. Network is created by road side vehicles equipped with communication devices like GPS and Wifi etc. Since the environment is highly dynamic due to difference in speed and high mobility of vehicles and weak stability of the network connection, it is a challenging task to design an efficient routing protocol for such an unstable environment. Our proposed algorithm uses heuristic for the calculation of optimal path for routing the packet efficiently in collaboration with several other parameters like geographical location, speed, priority, the distance among the vehicles, communication range, and networks congestion. We have incorporated probabilistic, heuristic and machine learning based approach inconsistency with the relay function of the memory buffer to keep the packet moving towards the destination. These parameters when used in collaboration provide us a very strong and admissible heuristics. We have mathematically proved that the proposed technique is efficient for the routing of packets, especially in a medical emergency situation. These networks can be used for medical emergency, security, entertainment and routing purposes.

Keywords: heuristics routing, intelligent routing, VANET, route optimization

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Authors: M. Zareh, H. Mohammadi, B. Naser

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Atherosclerotic plaque rupture is the main trigger of heart attack and brain stroke which are the leading cause of death in developed countries. Better understanding of rupture-prone plaque can help clinicians detect vulnerable plaques- rupture prone or instable plaques- and apply immediate medical treatment to prevent these life-threatening cardiovascular events. Therefore, there are plenty of studies addressing disclosure of vulnerable plaques properties. Necrotic core and fibrous tissue are two major tissues constituting atherosclerotic plaque; using histopathological and numerical approaches, many studies have demonstrated that plaque rupture is strongly associated with a large necrotic core and a thin fibrous cap, two morphological characteristic which can be acquired by two-dimensional imaging of atherosclerotic plaque present in coronary and carotid arteries. Plaque rupture is widely considered as a mechanical failure inside plaque tissue; this failure occurs when the stress within plaque excesses the strength of tissue material; hence, finite element method, a strong numerical approach, has been extensively applied to estimate stress distribution within plaques with different compositions which is then used for assessment of various vulnerability characteristics including plaque morphology, material properties and blood pressure. This study aims to evaluate significance of three-dimensional morphology on vulnerability degree of atherosclerotic plaque. To reach this end, different two-dimensional geometrical models of atherosclerotic plaques are considered based on available data and named Main 2D Models (M2M). Then, for each of these M2Ms, two three-dimensional idealistic models are created. These two 3D models represent two possible three-dimensional morphologies which might exist for a plaque with similar 2D morphology to one of M2Ms. Finite element method is employed to estimate stress, von-Mises stress, within each 3D models. Results indicate that for each M2Ms stress can significantly varies due to possible 3D morphological changes in that plaque. Also, our results show that an atherosclerotic plaque with thick cap may experience rupture if it has a critical 3D morphology. This study highlights the effect of 3D geometry of plaque on its instability degree and suggests that 3D morphology of plaque might be necessary to more effectively and accurately assess atherosclerotic plaque vulnerability.

Keywords: atherosclerotic plaque, plaque rupture, finite element method, 3D model

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Authors: Ramy Reda Morgan Kamel

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generation-greater education gear are being unexpectedly included into health packages globally. these gadget provide an interactive platform for students and may be used to deliver topics in various modes which include video games and simulations. Simulations are of particular hobby to healthcare education, wherein they are hired to enhance clinical know-how and help to bridge the distance among precept and exercise. Simulations will regularly test talents for practical responsibilities, but restrained research examines the effects of simulation on student perceptions of their getting to know. The aim of this observe become to determine the effects of an interactive virtual patient simulation for pharmacology schooling and clinical workout on scholar know-how, skills and confidence. Ethics popularity of the examine end up received from Griffith college studies Ethics Committee (PHM/eleven/14/HREC). The simulation became intended to duplicate the pharmacy surroundings and affected man or woman interaction. The content material material come to be designed to beautify know-how of proton-pump inhibitor pharmacology, role in therapeutics and secure deliver to sufferers. The tool changed into deployed into a 3rd-year scientific pharmacology and therapeutics course. a number of core exercise regions were examined along with the competency domains of wondering, counselling, referral and product provision. Baseline measures of pupil self-stated knowledge, capabilities and self warranty were taken preceding to the simulation using a especially designed questionnaire. A greater substantial questionnaire became deployed following the virtual affected character simulation, which moreover blanketed measures of scholar engagement with the hobby. A quiz assessing scholar proper and conceptual understanding of proton-pump inhibitor pharmacology and associated counselling statistics changed into also included in both questionnaires.

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Uditi Dhakad, Baldev Ram, Chaman K. Jadon, R. K. Yadav, D. L. Yadav, Pratap Singh, Shalini Meena

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A field experiment was conducted during Kharif 2021 at Agricultural Research Station, Kota, to evaluate the effect of different post-emergence herbicides applied to soybean [Glycine max (L.) Merrill] on soil enzymes activity viz. dehydrogenase, phosphatase, and urease. The soil of the experimental site was clay loam (vertisols) in texture and slightly alkaline in reaction with 7.7 pH. The soil was low in organic carbon (0.49%), medium in available nitrogen (210 kg/ha), phosphorus (23.5 P2O5 kg/ha), and high in potassium (400 K2O kg/ha) status. The results elucidated that no significant adverse effect on soil dehydrogenase, urease, and phosphatase activity was determined with the application of post-emergence herbicides over the untreated control. Two hands weeding at 20 and 40 DAS registered maximum dehydrogenase enzyme activity (0.329 μgTPF/g soil/d) closely followed by herbicides mixtures and sole herbicide while pre-emergence application of pendimethalin + imazethapyr 960 g a.i./ha and pendimethalin 1.0 kg a.i./ha significantly reduced dehydrogenase enzyme activity compared to control. Urease enzyme activity was not much affected under different weed control treatments and weedy checks. The treatments were found statistically non-significant, and values ranged between 1.16-1.25 μgNH4N/g soil/d. Phosphatase enzyme activity was also not influenced significantly due to various weed control treatments. Though maximum phosphatase enzyme activity (30.17 μgpnp/g soil/hr) was observed under two-hand weeding, followed by fomesafen + fluazifop-p-butyl 220 g a.i./ha. Herbicidal weed control measures did not influence the total bacteria, fungi, and actinomycetes population.

Keywords: dehydrogenase, phosphatase, post-emergence, soil enzymes, urease.

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Authors: Cristina Sanchez-Sanchez

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Although there seems to be a growing interest in the study of the citizen’s happiness as an alternative measure of a country’s progress to GDP, happiness as a public concern is still an ambiguous concept, hard to define. Moreover, different notions are used indiscriminately to talk about the same thing. This investigation aims to determine the conceptions of happiness, well-being and quality of life that originate from the indexes that different governments and public institutions around the world have created to study them. Through the Scoping Review method, this study identifies the recent academic research in this field (a total of 267 documents between 2006 and 2016) from some of the most popular social sciences databases around the world, Web of Science, Scopus, JSTOR, Sage, EBSCO, IBSS and Google Scholar, and in Spain, ISOC and Dialnet. These 267 documents referenced 53 different indexes and researches. The Grounded Theory method has been applied to a sample of 13 indexes in order to identify the main categories they use to determine these three concepts. The results show that these are multi-dimensional concepts and similar indicators are used indistinctly to measure happiness, well-being and quality of life.

Keywords: common good, grounded theory, happiness economics, happiness index, quality of life, scoping review, well-being

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Authors: Nalan Kaya, Elif Erdem, Mehmet Ali Kisacam, Gonca Ozan, Enver Ozan

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Tobacco smokers continuously inhale thousands of carcinogens and free radicals. It is estimated that about 1017 oxidant molecules are present in each puff of tobacco smoke. It is known that smoking has adverse effects on the structure and functions of the liver. Ellagic acid (EA) has antioxidant, antiapoptotic, anticarcinogenic, antibacterial and antiinflammatory effects. The aim of our study was to investigate the possible protective effect of ellagic acid against tobacco smoke-mediated oxidative stress in the rat liver. Twenty-four male adult (8 weeks old) Spraque-Dawley rats were divided randomly into 4 equal groups: group I (control), group II (tobacco smoke), group III (tobacco smoke + corn oil) and group IV (tobacco smoke + ellagic acid). The rats in group II, III and IV, were exposed to tobacco smoke 1 hour twice a day for 12 weeks. In addition to tobacco smoke exposure, 12 mg/kg ellagic acid (dissolved in corn oil), was applied to the rats in group IV by oral gavage. An equal amount of corn oil used in solving ellagic acid was applied to the rats by oral gavage in group III. At the end of the experimental period, rats were decapitated, and liver tissues were removed. Histological and biochemical analyzes were performed. Sinusoidal dilatation, inflammatory cell infiltration in portal area, increased Kuppfer cells were examined in tobacco smoke group and tobacco smoke+ corn oil groups. The results, observed in tobacco smoke and tobacco smoke+corn oil groups, were found significantly decreased in tobacco smoke+EA group. Group-II and group-III MDA levels were significantly higher, and GSH activities were not different than group-I. Compared to group-II, group-IV MDA level was decreased, and GSH activities was increased significantly. The results indicate that ellagic acid could protect the liver tissue from the tobacco smoke harmful effects.

Keywords: ellagic acid, liver, rat, tobacco smoke

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Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

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Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Karol Konaszewski

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Background: The article is an analysis of the results of the studies conducted among juveniles (boys and girls) in the case of whom the family court applied the educational means of placing them in the youth educational centers. The aim of the study was to find out the correlations between antisocial behaviors, personality traits and the environmental determinants (support factors and risk factors) among juveniles (boys and girls). Methods: The total of 481 juveniles staying in youth educational centers participated in the study. Applied research tools: The Antisocial Behaviors Scale by L. Pytka, NEO-FFI by P. T. Costa and R. R. McCrae was used to diagnose personality traits included in a popular five-factor model (it has been adapted into Polish by B. Zawadzki, J. Strelau, P. Szczepaniak, and M. Śliwińska) and a questionnaire concerning support factors and risk factors was constructed to measure environmental determinants. The data was analysed in a regression model. Findings: The analysis model showed that the significant predictors of antisocial behaviors were neuroticism, extraversion, conscientiousness and negative relations at school. In girls group, the significant predictors of antisocial behaviors were neuroticism, conscientiousness, family support and negative relations at school, while in boys group the significant predictors of antisocial behaviors were neuroticism, extraversion and negative relations at family. Discussion: The results of this study have important implications. They allow for a better understanding of the factors that contribute to antisocial behaviors among juveniles. Future interventions could be based on the creation of personality traits, strengthening of support factors and correction of risk factors.

Keywords: antisocial behaviours, juveniles, personality, youth

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Authors: Tri Murti Tugiman, Awalyya Fasha

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This research aims to analyze the magnitude of the economic losses incurred as a result of a person suffering from a particular disease of the ten highest in the productive age diseases in Hospitals Inche Abdul Moeis Samarinda. This research was a descriptive survey research and a secondary data analysis. For the analysis of economic losses populations used are all in patients who suffer from the 10 highest diseases in the productive age in hospitals IA Moeis Samarinda in 2011. Sampling was performed by using a stratified random sampling with samples of 77 people. Research results indicate that the direct cost community incurred to obtain medical services in hospitals IA Moeis is IDR 74437520. The amount of indirect costs incurred during service in a community hospital is IDR 10562000. The amount lost due to sickness fee is IDR 5377800. The amount of economic lost people to obtain medical services in hospitals IA Moeis is IDR 90377320. The number of days of hospitalization was as much as 171 respondents throughout the day. This study suggests the economic loss could be prevented by changes in the lifestyle of the people who clean and healthy along with the following insurance.

Keywords: hospitalized, economic lost, productive age diseases, secondary data analysis

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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: Aline Valverde Arroteia, Tatiana Gondim do Amaral, Silvio Burrattino Melhado

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During the last twenty years, the construction field in Brazil has evolved significantly in response to its market growing and competitiveness. However, this evolving path has faced many obstacles such as cultural barriers and the lack of efforts to achieve quality at the construction site. At the same time, the greatest amount of information generated on the designing or construction phases is lost due to the lack of an effective coordination of these activities. Face this problem, the aim of this research was to implement a French method named PEO which means preparation for building construction (in Portuguese) seeking to understand the design management process and its interface with the building construction phase. The research method applied was qualitative, and it was carried out through two case studies in the city of Goiania, in Goias, Brazil. The research was divided into two stages called pilot study at Company A and implementation of PEO at Company B. After the implementation; the results demonstrated the PEO method's effectiveness and feasibility while a booster on the quality improvement of design management. The analysis showed that the method has a purpose to improve the design and allow the reduction of failures, errors and rework commonly found in the production of buildings. Therefore, it can be concluded that the PEO is feasible to be applied to real estate and building companies. But, companies need to believe in the contribution they can make to the discovery of design failures in conjunction with other stakeholders forming a construction team. The result of PEO can be maximized when adopting the principles of simultaneous engineering and insertion of new computer technologies, which use a three-dimensional model of the building with BIM process.

Keywords: communication, design and construction interface management, preparation for building construction (PEO), proactive coordination (CPA)

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Authors: G. Alex Ambrose, Melissa Paulsen, Abrar Fitwi, Masud Akbari

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In 2016, a U.S. business college was awarded a sub grant to work with FHI360, a nonprofit human development organization, to support a university in Afghanistan funded by the State Department’s U.S. Agency for International Development (USAID). A newly designed Master’s Degree in Finance and Accounting is being implemented to support Afghanistan’s goal of 20% females in higher education and industry by 2020 and to use finance and accounting international standards to attract capital investment for economic development. This paper will present a case study to describe the co-construction of an approach to an International Flipped Faculty Development Model grounded in blended learning theory. Like education in general, faculty development is also evolving from the traditional face to face environment and interactions to the fully online and now to a best of both blends. Flipped faculty development is both a means and a model for careful integration of the strengths of the synchronous and asynchronous dynamics and technologies with the combination of intentional sequencing to pre-online interactions that prepares and enhances the face to face faculty development and mentorship residencies with follow-up post-online support. Initial benefits from this model include giving the Afghan faculty an opportunity to experience and apply modern teaching and learning strategies with technology in their own classroom. Furthermore, beyond the technological and pedagogical affordances, the reciprocal benefits gained from the mentor-mentee, face-to-face relationship will be explored. Evidence to support this model includes: empirical findings from pre- and post-Faculty Mentor/ Mentee survey results, Faculty Mentorship group debriefs, Faculty Mentorship contact logs, and student early/end of semester feedback. In addition to presenting and evaluating this model, practical challenges and recommendations for replicating international flipped faculty development partnerships will be provided.

Keywords: educational development, faculty development, international development, flipped learning

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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Authors: Faranak Omidian

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The aim of this research was to examine the quality of education service at master's level in the Islamic Azad University of Dezful. In terms of objective, this is an applied research and in regard to methodology, it is a descriptive analytical research. The statistical population included all students of master's degree in the Islamic Azad University of Dezful. The sample size was determined using stratified random sampling method in different fields of study. The research questionnaire is the translated version of standardized Abdullah's HEdPERF 41-item scale which is based on a 5-point Likert scale. In order to determine the validity, the translated questionnaire was given to the professors of educational sciences. The correlation among all questions has been regarded at a value of 0.644. The results showed that the quality of educational service at master's level in this university, based on chi-square goodness of fit test, was equal to 73.36 and its degree of freedom was 2 at a significant level of 0.001, indicating the low desirability of the services. According to Friedman test, academic responsiveness has been reported to be in a higher status than other dimensions with an average rank of 3.94 while accessibility, with an average rank of 2.15, has been in the lowest status from master's students' viewpoint.

Keywords: educational service quality, master's level, Iranian university

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Authors: Szilvia Várallyay, Béla Kovács, Éva Bódi, Farzeneh Garousi, Szilvia Veres

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Arsenic (As) is a naturally occurring substance that can be present in soil, water and air. Vegetables, fruits, and other plants that grow in contaminated soils which are able to accumulate arsenic. Arsenic when presents in plant cells, has various negative physiological effects and when presents in soil will be inorgaic form, namely arsenite (As(III)) and arsenate (As(V)). These two forms of arsenic disrupt plant metabolism by inhibiting its growth and these arsenic species has negative effect on nutrient uptake. A rhizobox experiment was conducted to investigate the effect of arsenite and arsenate on root growth of sunflower seedlings. Sunflower plants were grown in climatic room under irradiance of 300 µmol m-2 s-1, 16-h day and 8-h night photoperiod, day/night temperature of 25/20°C and relative humidity of 65-75%. We applied arsenic in form of arsenite (NaAsO2) and arsenate (KH2AsO4), respectively. The applied arsenic treatments was 0, 10, 30, 90 mg.kg-1. After disinfection, seeds were germinated between moist filter papers. Seedlings with 2-3 cm coleoptils were placed into rhizoboxes. In the rhizoboxes the growing and daily growing rhythm of roots of sunflower can be followed up, moreover possible phytotoxic symptoms of roots resulting from increasing arsenic can be seen. Weights of rhizoboxes were measured daily and also evaporated water added each day. The lengths of roots were measured daily until seedlings roots get at the end of the rhizoboxes. Negative correlation was observed between the higher concentration of arsenic in the soil and the growth of sunflower seedlings roots. The effect of arsenic toxicity was more considerable in 90 mg.kg-1 arsenic treatment than lower concentration. The same arsenite concentration causes slower growth in case of sunflower plant than the same arsenate concentration produced.

Keywords: arsenic, rhizobox experiment, sunflower, root growth

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Authors: Vittorio Astarita, Giuseppe Guido, Vincenzo Pasquale Giofre, Alessandro Vitale

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Traffic microsimulation has been used extensively to evaluate consequences of different traffic planning and control policies in terms of travel time delays, queues, pollutant emissions, and every other common measured performance while at the same time traffic safety has not been considered in common traffic microsimulation packages as a measure of performance for different traffic scenarios. Vehicle conflict techniques that were introduced at intersections in the early traffic researches carried out at the General Motor laboratory in the USA and in the Swedish traffic conflict manual have been applied to vehicles trajectories simulated in microscopic traffic simulators. The concept is that microsimulation can be used as a base for calculating the number of conflicts that will define the safety level of a traffic scenario. This allows engineers to identify unsafe road traffic maneuvers and helps in finding the right countermeasures that can improve safety. Unfortunately, most commonly used indicators do not consider conflicts between single vehicles and roadside obstacles and barriers. A great number of vehicle crashes take place with roadside objects or obstacles. Only some recent proposed indicators have been trying to address this issue. This paper introduces a new procedure based on the simulation of potential crash events for the evaluation of safety levels in microsimulation traffic scenarios, which takes into account also potential crashes with roadside objects and barriers. The procedure can be used to define new conflict indicators. The proposed simulation procedure generates with the random perturbation of vehicle trajectories a set of potential crashes which can be evaluated accurately in terms of DeltaV, the energy of the impact, and/or expected number of injuries or casualties. The procedure can also be applied to real trajectories giving birth to new surrogate safety performance indicators, which can be considered as “simulation-based”. The methodology and a specific safety performance indicator are described and applied to a simulated test traffic scenario. Results indicate that the procedure is able to evaluate safety levels both at the intersection level and in the presence of roadside obstacles. The procedure produces results that are expressed in the same unity of measure for both vehicle to vehicle and vehicle to roadside object conflicts. The total energy for a square meter of all generated crash can be used and is shown on the map, for the test network, after the application of a threshold to evidence the most dangerous points. Without any detailed calibration of the microsimulation model and without any calibration of the parameters of the procedure (standard values have been used), it is possible to identify dangerous points. A preliminary sensitivity analysis has shown that results are not dependent on the different energy thresholds and different parameters of the procedure. This paper introduces a specific new procedure and the implementation in the form of a software package that is able to assess road safety, also considering potential conflicts with roadside objects. Some of the principles that are at the base of this specific model are discussed. The procedure can be applied on common microsimulation packages once vehicle trajectories and the positions of roadside barriers and obstacles are known. The procedure has many calibration parameters and research efforts will have to be devoted to make confrontations with real crash data in order to obtain the best parameters that have the potential of giving an accurate evaluation of the risk of any traffic scenario.

Keywords: road safety, traffic, traffic safety, traffic simulation

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Authors: Nikita Valluri, Vatcharaporn Esichaikul

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With the popularity of data-driven decision making on the rise, this study focuses on providing an alternative outlook towards the process of decision-making. Combining quantitative and qualitative methods rooted in the social sciences, an integrated framework is presented with a focus on delivering a much more robust and efficient approach towards the concept of data-driven decision-making with respect to not only Big data but also 'Thick data', a new form of qualitative data. In support of this, an example from the retail sector has been illustrated where the framework is put into action to yield insights and leverage business intelligence. An interpretive approach to analyze findings from both kinds of quantitative and qualitative data has been used to glean insights. Using traditional Point-of-sale data as well as an understanding of customer psychographics and preferences, techniques of data mining along with qualitative methods (such as grounded theory, ethnomethodology, etc.) are applied. This study’s final goal is to establish the framework as a basis for providing a holistic solution encompassing both the Big and Thick aspects of any business need. The proposed framework is a modified enhancement in lieu of traditional data-driven decision-making approach, which is mainly dependent on quantitative data for decision-making.

Keywords: big data, customer behavior, customer experience, data mining, qualitative methods, quantitative methods, thick data

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Authors: Zita Fomukong Andam

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With a general objective of evaluating the importance and Performance attributes of Volunteer Tourism in Ethiopia and also specifically intending to rank out the importance to evaluate the competitive performance of Ethiopia to host volunteer tourists, laying them in a four quadrant grid and conduct the IPA Iso-Priority Line comparison of Volunteer Tourism in Ethiopia. From hosts and guests point of view, a deeper research discourse was conducted with a randomly selected 384 guests and 165 hosts in Ethiopia. Findings of the discourse through an exploratory research design on both the hosts and the guests confirm that attributes of volunteer tourism generally and marginally fall in the South East quadrant of the matrix where their importance is relatively higher than their performance counterpart, also referred as ‘Concentrate Here’ quadrant. The fact that there are more items in this particular place in both the host and guest study, where they are highly important, but their relative performance is low, strikes a message that the country has more to do. Another focus point of this study is mapping the scores of attributes regarding the guest and host importance and performance against the Iso-Priority Line. Results of Iso-Priority Line Analysis of the IPA of Volunteer Tourism in Ethiopia from the Host’s Perspective showed that there are no attributes where their importance is exactly the same as their performance. With this being found, the fact that this research design inhabits many characters of exploratory nature, it is not confirmed research output. This paper reserves from prescribing anything to the applied world before further confirmatory research is conducted on the issue and rather calls the scientific community to augment this study through comprehensive, exhaustive, extensive and extended works of inquiry in order to get a refined set of recommended items to the applied world.

Keywords: volunteer tourism, competitive performance importance-performance analysis, Ethiopian tourism

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