Search results for: internal medicine

Authors: Dada Durojaye Joshua

Abstract:

The study examined the combined effect of internal control system and whistle blowing policy while it pursues the following specific objectives, which are to: examine the relationship between monitoring activities and fraud’s detection and prevention; investigate the effect of control activities on fraud’s detection and prevention in Nigerian Deposit Money Banks (DMBs). The population of the study comprises the 89,275 members of staff in the 20 DMBs in Nigeria as at June 2019. Purposive and convenient sampling techniques were used in the selection of the 80 members of staff at the supervisory level of the Internal Audit Departments of the head offices of the sampled banks, that is, selecting 4 respondents (Audit Executive/Head, Internal Control; Manager, Operation Risk Management; Head, Financial Crime Control; the Chief Compliance Officer) from each of the 20 DMBs in Nigeria. A standard questionnaire was adapted from 2017/2018 Internal Control Questionnaire and Assessment, Bureau of Financial Monitoring and Accountability Florida Department of Economic Opportunity. It was modified to serve the purpose for which it was meant to serve. It was self-administered to gather data from the 80 respondents at the respective headquarters of the sampled banks at their respective locations across Nigeria. Two likert-scales was used in achieving the stated objectives. A logit regression was used in analysing the stated hypotheses. It was found that effect of monitoring activities using the construct of conduct of ongoing or separate evaluation (COSE), evaluation and communication of deficiencies (ECD) revealed that monitoring activities is significant and positively related to fraud’s detection and prevention in Nigerian DMBS. So also, it was found that control activities using selection and development of control activities (SDCA), selection and development of general controls over technology to prevent financial fraud (SDGCTF), development of control activities that gives room for transparency through procedures that put policies into actions (DCATPPA) contributed to influence fraud detection and prevention in the Nigerian DMBs. In addition, it was found that transparency, accountability, reliability, independence and value relevance have significant effect on fraud detection and prevention ibn Nigerian DMBs. The study concluded that the board of directors demonstrated independence from management and exercises oversight of the development and performance of internal control. Part of the conclusion was that there was accountability on the part of the owners and preparers of the financial reports and that the system gives room for the members of staff to account for their responsibilities. Among the recommendations was that the management of Nigerian DMBs should create and establish a standard Internal Control System strong enough to deter fraud in order to encourage continuity of operations by ensuring liquidity, solvency and going concern of the banks. It was also recommended that the banks create a structure that encourages whistleblowing to complement the internal control system.

Keywords: internal control, whistleblowing, deposit money banks, fraud prevention, fraud detection

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Authors: Dada Durojaye Joshua

Abstract:

The study examined the combined effect of internal control system and whistle blowing policy while it pursues the following specific objectives, which are to: examine the relationship between monitoring activities and fraud’s detection and prevention; investigate the effect of control activities on fraud’s detection and prevention in Nigerian Deposit Money Banks (DMBs). The population of the study comprises the 89,275 members of staff in the 20 DMBs in Nigeria as at June 2019. Purposive and convenient sampling techniques were used in the selection of the 80 members of staff at the supervisory level of the Internal Audit Departments of the head offices of the sampled banks, that is, selecting 4 respondents (Audit Executive/Head, Internal Control; Manager, Operation Risk Management; Head, Financial Crime Control; the Chief Compliance Officer) from each of the 20 DMBs in Nigeria. A standard questionnaire was adapted from 2017/2018 Internal Control Questionnaire and Assessment, Bureau of Financial Monitoring and Accountability Florida Department of Economic Opportunity. It was modified to serve the purpose for which it was meant to serve. It was self-administered to gather data from the 80 respondents at the respective headquarters of the sampled banks at their respective locations across Nigeria. Two likert-scales was used in achieving the stated objectives. A logit regression was used in analysing the stated hypotheses. It was found that effect of monitoring activities using the construct of conduct of ongoing or separate evaluation (COSE), evaluation and communication of deficiencies (ECD) revealed that monitoring activities is significant and positively related to fraud’s detection and prevention in Nigerian DMBS. So also, it was found that control activities using selection and development of control activities (SDCA), selection and development of general controls over technology to prevent financial fraud (SDGCTF), development of control activities that gives room for transparency through procedures that put policies into actions (DCATPPA) contributed to influence fraud detection and prevention in the Nigerian DMBs. In addition, it was found that transparency, accountability, reliability, independence and value relevance have significant effect on fraud detection and prevention ibn Nigerian DMBs. The study concluded that the board of directors demonstrated independence from management and exercises oversight of the development and performance of internal control. Part of the conclusion was that there was accountability on the part of the owners and preparers of the financial reports and that the system gives room for the members of staff to account for their responsibilities. Among the recommendations was that the management of Nigerian DMBs should create and establish a standard Internal Control System strong enough to deter fraud in order to encourage continuity of operations by ensuring liquidity, solvency and going concern of the banks. It was also recommended that the banks create a structure that encourages whistleblowing to complement the internal control system.

Keywords: internal control, whistleblowing, deposit money banks, fraud prevention, fraud detection

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Authors: Ali Alshahrani, Adel Almaai, Saad Garni

Abstract:

Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Emrah Caylak

Abstract:

The aim of this study is to investigate the effect of iron therapy on oxidative stress, ghrelin, and nesfatin-1 levels in patients with iron deficiency anemia (IDA). Thirty patients who applied to Internal Medicine Clinic and were diagnosed with IDA and also 30 healthy individuals as a control were included in the study. The samples were collected from IDA patients before and after treatment. Differences in serum MDA, TAC, and plasma ghrelin, nesfatin-1 were analyzed among the three groups. Serum MDA and TAC levels were found higher and lower in IDA patients before the treatment group compared to the controls (p < 0.05). After the iron therapy, plasma acylated ghrelin and nesfatin-1 levels in IDA patients were found higher in IDA patients before the treatment group and controls (p < 0.05). Plasma ghrelin and nesfatin-1 levels increase with iron treatment in IDA patients. The iron therapy induces the synthesis of ghrelin and nesfatin-1 in human body, thus causes increased appetite and food intake.

Keywords: anemia, oxidative stress, ghrelin, nesfatin-1

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Authors: Qianqian He, Naian Liu, Xiaodong Xie, Linhe Zhang, Yang Zhang, Weidong Yan

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In the wild, the vegetation layer with exceptionally complex fuel composition and heterogeneous spatial distribution strongly affects the rate of fire spread (ROS) and fire intensity. Clarifying the influence of fuel bed structure on fire spread behavior is of great significance to wildland fire management and prediction. The packing ratio is one of the key physical parameters describing the property of the fuel bed. There is a threshold value of the packing ratio for ROS, but little is known about the controlling mechanism. In this study, to address this deficiency, a series of fire spread experiments were performed across a discrete fuel bed composed of some regularly arranged laser-cut cardboards, with constant wind speed and different packing ratios (0.0125-0.0375). The experiment aims to explore the relative importance of the internal and surface heat transfer with packing ratio. The dependence of the measured ROS on the packing ratio was almost consistent with the previous researches. The data of the radiative and total heat fluxes show that the internal heat transfer and surface heat transfer are both enhanced with increasing packing ratio (referred to as ‘Stage 1’). The trend agrees well with the variation of the flame length. The results extracted from the video show that the flame length markedly increases with increasing packing ratio in Stage 1. Combustion intensity is suggested to be increased, which, in turn, enhances the heat radiation. The heat flux data shows that the surface heat transfer appears to be more important than the internal heat transfer (fuel preheating inside the fuel bed) in Stage 1. On the contrary, the internal heat transfer dominates the fuel preheating mechanism when the packing ratio further increases (referred to as ‘Stage 2’) because the surface heat flux keeps almost stable with the packing ratio in Stage 2. As for the heat convection, the flow velocity was measured using Pitot tubes both inside and on the upper surface of the fuel bed during the fire spread. Based on the gas velocity distribution ahead of the flame front, it is found that the airflow inside the fuel bed is restricted in Stage 2, which can reduce the internal heat convection in theory. However, the analysis indicates not the influence of inside flow on convection and combustion, but the decreased internal radiation of per unit fuel is responsible for the decrease of ROS.

Keywords: discrete fuel bed, fire spread, packing ratio, wildfire

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Authors: Keivan Saeb, Azade Kakouei, Razieh Jafari Hajati, Khalil Pourshamsian, Babak Babakhani

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Urtica Diocia L. from the Urticaceae family is a plant of herbal value and of a noticeable distribution in the north of Iran. The growth of different plants in various natural environments and ecosystems seems to be affected by factors such as the height (from sea surface).To investigate the effect of height on Urtica Diocia L. medicine compounds in its natural environment, three areas with the height of zero, 800 and 1800m were selected.The samples were randomly gathered three times and were dried; also, their compounds was extracted using the Clivenger with the water-distilling method. To determine the medicine compounds, the GC-MS as well as the GC machines were used. The analysis of variance was done in the form of the random-full-block design. The results indicated that there was a significant difference between the percent of EOs in the selected heights; however, such difference was not significant within each height. From among the eight flavors of the study, the phytol compound was more in terms of percentage. By increasing the height the percent of EOs would decrease. lower heights could be considered most appropriate for producing the studied effective materials despite of the moistened climate and soil there.

Keywords: Urtica diocia L., height, EOs, medicine

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Authors: Masoumeh Khailghi Sikaroudi, Mohsen Masoodi, Fazad Shidfar, Meghdad Sedaghat

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Background: The hypertonicity of internal anal sphincter resting pressure is one of the main reasons for chronic anal fissures. The aim of this study is to assess the effect of oral administration of L-arginine on anal fissure symptom improvement by relaxation of the internal anal sphincter. Method: Seventy-six chronic anal fissure patients (age: 18-65 years) took part in this randomized, double-blind, placebo-controlled trial study from February 2019 to October 2020 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were allocated into treatment (L-arginine) or placebo groups. They took a 1000 mg capsule three times a day for one month and were followed up at the end of the first and third months after receiving the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. Result: The analysis of data was shown significant improvement in bleeding, fissure size, and pain within each group; however, this effect was more seen in the arginine group compared to the control group at the end of the study (P-values<0.001). Following that, a significant increase in QoL was seen just in patients who were treated with arginine (P-value=0.006). Also, the comparison of anal pressures to baseline and between groups at the end of the study showed a significant reduction in sphincter pressure in treated patients (P-value<0.001, =0.049; respectively). Conclusion: Oral administration of 3000 mg L-arginine can heal chronic anal fissures by reducing anal internal sphincter pressure with fewer side effects. However, a long-term study with more follow-up is recommended.

Keywords: L-arginine, anal fissure, sphincter pressure, clinical symptoms, quality of life

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Authors: William Casto

Abstract:

Studies that consider the actual impact of international law upon foreign affairs crises are flawed by an unrealistic model of decision making. The common, unexamined assumption is that a nation has a unitary executive or ruler who considers a wide variety of considerations, including international law, in attempting to resolve a crisis. To the extent that negotiation theory is considered, the focus is on negotiations between or among nations. The unsettling result is a shallow focus that concentrates on each country’s public posturing about international law. The country-to-country model ignores governments’ internal negotiations that lead to their formal position in a crisis. The model for foreign policy crises needs to be supplemented to include a model of internal negotiations. Important foreign policy decisions come from groups within a government committee, advisers, etc. Within these groups, participants may have differing agendas and resort to international law to bolster their positions. To understand the influence of international law in international crises, these internal negotiations must be considered. These negotiations are crucial to creating a foreign policy agenda or recommendations. External negotiations between the two nations are significant, but the internal negotiations provide a better understanding of the actual influence of international law upon international crises. Discovering the details of specific internal negotiations is quite difficult but not necessarily impossible. The present proposal will use a specific crisis to illustrate the role of international law. In 1861 during the American Civil War, a United States navy captain stopped a British mail ship and removed two ambassadors of the rebelling southern states. The result was what is commonly called the Trent Affair. In the wake of the captain’s unauthorized and rash action, Great Britain seriously considered going to war against the United States. A detailed analysis of the Trent Affair is possible using the available and extensive internal British correspondence and memoranda to reach an understanding of the effect of international law upon decision making. The extensive trove of internal British documents is particularly valuable because in 1861, the only effective means of communication was face-to-face or through letters. Telephones did not exist, and travel by horse and carriage was tedious. The British documents tell us how individual participants viewed the process. We can approach an accurate understanding of what actually happened as the British government strove to resolve the crisis. For example, British law officers initially concluded that the American captain’s rash act was permissible under international law. Later, the law officers revised their opinion. A model of internal negotiation is particularly valuable because it strips away nations’ public posturing about disputed international law principles. In internal decision making, there is room for meaningful debate over the relevant principles. This fluid debate tells how international law is used to develop a hard, public bargaining position. The Trent Affair indicates that international law had an actual influence upon the crisis and that law was not mere window dressing for the government’s public position.

Keywords: foreign affairs crises, negotiation, international law, Trent affair

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Authors: Oluwole A. Solanke

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This article explores internal generation of revenues in higher education institutions. The research focuses on how polytechnic institutions in Nigeria generate other sources of revenues to augment government subventions and tuition fees. The study provides a qualitative case study and triangulation data on three polytechnics representing tertiary institution structure of federal, state and private ownership in Nigeria. The article argues that dependence on government subventions by the public polytechnics and tuition fees by private polytechnic would not provide funding adequacy for the activities of the institutions under study. Findings revealed that there are basically seven themes; guest houses; poly consult; part-time courses; tuition fees; capitation fees; ownership contribution; and printing and business centre by which the polytechnics generate additional sources of revenues in the management of the institutions. The research concludes that for the polytechnics to gain financial adequacy, entrepreneurial activities must be embarked upon vigorously by stakeholders of the polytechnics as this is the only way by which financial self-reliance can be achieved.

Keywords: entrepreneurial, government subventions, internal generation, polytechnics, revenues

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Authors: Veena Chaudhary, Rakesh P. Gakkhar

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In this study, energy and exergy analysis are applied to the experimental data of an internal combustion engine operating on conventional diesel cycle. The experimental data are collected using an engine unit which enables accurate measurements of fuel flow rate, combustion air flow rate, engine load, engine speed and all relevant temperatures. First and second law efficiencies are calculated for different engine speed and compared. Results indicate that the first law (energy) efficiency is maximum at 1700 rpm whereas exergy efficiency is maximum and exergy destruction is minimum at 1900 rpm.

Keywords: diesel engine, exergy destruction, exergy efficiency, second law of thermodynamics

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Authors: I. Kurashvili, G. Darsavelidze, T. Kimeridze, G. Chubinidze, I. Tabatadze

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At present, a number of modern semiconductor devices based on SiGe alloys have been created in which the latest achievements of high technologies are used. These devices might cause significant changes to networking, computing, and space technology. In the nearest future new materials based on SiGe will be able to restrict the A³B⁵ and Si technologies and firmly establish themselves in medium frequency electronics. Effective realization of these prospects requires the solution of prediction and controlling of structural state and dynamical physical –mechanical properties of new SiGe materials. Based on these circumstances, a complex investigation of structural defects and structural-sensitive dynamic mechanical characteristics of SiGe alloys under different external impacts (deformation, radiation, thermal cycling) acquires great importance. Internal friction (IF) and shear modulus temperature and amplitude dependences of the monocrystalline boron-doped Si_1-xGe_x(x≤0.05) alloys grown by Czochralski technique is studied in initial and ⁶⁰Co gamma-irradiated states. In the initial samples, a set of dislocation origin relaxation processes and accompanying modulus defects are revealed in a temperature interval of 400-800 ⁰C. It is shown that after gamma-irradiation intensity of relaxation internal friction in the vicinity of 280 ⁰C increases and simultaneously activation parameters of high temperature relaxation processes reveal clear rising. It is proposed that these changes of dynamical mechanical characteristics might be caused by a decrease of the dislocation mobility in the Cottrell atmosphere enriched by the radiation defects.

Keywords: internal friction, shear modulus, gamma-irradiation, SiGe alloys

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Prateek Rastogi

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Medical teaching in present era concentrates not only on teaching but on effective teaching. For effective teaching a combination of effective carefully designed curriculum, an educated educator, competent learner and fool proof evaluation system is required. Keeping these parameters in mind and study was undertaken at Kasturba Medical College, Mangalore among medical students. In this study, evaluation of Forensic Medicine syllabus along with its teaching and evaluation methodology was done using 20 different parameters. This questionnaire based study was done over a period of two years i.e. 2013 and 2014. Batch of students who just passed the forensic medicine subject was included for study. Carefully designed questionnaire contained questions related to course content, teaching methodology and evaluation system along with provisions to mention merits and demerits of subject. The feedbacks in first round were analyzed and suggestions were implemented before conducting the second round of study. Overall evaluation of course was done as well as it was compared with other subjects of second MBBS. It was noted that Scores improved in 2nd survey thus stressing the importance of course evaluation and student feedback in teaching improvement.

Keywords: teaching methodology, system of evaluation, course content, bioinformatics, biomedicine

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Authors: Razieh Arian, Hadi Adibi-Asl

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This paper investigates an efficient combustion modeling for cycle simulation of internal combustion engine (ICE) studies. The term “efficient model” means that the models must generate desired simulation results while having fast simulation time. In other words, the efficient model is defined based on the application of the model. The objective of this study is to develop math-based models for control applications or shortly control-oriented models. This study compares different modeling approaches used to model the ICEs such as mean-value models, zero dimensional, quasi-dimensional, and multi-dimensional models for control applications. Mean-value models have been widely used for model-based control applications, but recently by developing advanced simulation tools (e.g. Maple/MapleSim) the higher order models (more complex) could be considered as control-oriented models. This paper presents the enhanced zero-dimensional cycle-by-cycle modeling and simulation of a spark ignition engine with a two-zone combustion model. The simulation results are cross-validated against the simulation results from GT-Power package and show a good agreement in terms of trends and values.

Keywords: Two-zone combustion, control-oriented model, wiebe function, internal combustion engine

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Authors: Shahryar Eslamitabar

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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

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Authors: Jamil Khalil Izraqi

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This paper investigates the transition of a 1970 Volkswagen Beetle from an internal combustion engine (ICE) to an EV using Matlab/Simulink modeling and simulation. The performance of the EV drivetrain system was simulated under various operating conditions, including standard and custom driving cycles in Turkey and Jordan (Amman), respectively. The results of this paper indicate that the transition is viable and that modeling and simulation can help in understanding the performance and efficiency of the electric drivetrain system, including battery pack, power electronics, and brushless direct current (BLDC) Motor.

Keywords: BLDC, buck-boost, inverter, SOC, drive-cycle

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Authors: Gopal Lamichhane, Biswash Sapkota, Grinsun Sharma, Mahendra Adhikari

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Urolithiasis is a condition in which insoluble or less soluble salts like oxalate, phosphate etc. precipitate in urinary tract and causes obstruction in ureter resulting renal colic or sometimes haematuria. It is the third most common disorder of urinary tract affecting nearly 2% of world’s population. Poor urinary drainage, microbial infection, oxalate and calcium containing diet, calciferol, hyperparathyroidism, cysteine in urine, gout, dysfunction of intestine, drought environment, lifestyle, exercise, stress etc. are risk factors for urolithiasis. Wide ranges of treatments are available in allopathic system of medicine but reoccurrence is unpreventable even with the surgical removal of stone or lithotripsy. So, people prefer alternative medicinal systems such as Unani, homeopathic, ayurvedic etc. systems of medicine due to their fewer side effects over allopathic counterpart. Different plants based ethnomedicines are being well established by their continuous effective use in human since long time in treatment of urinary problem. Many studies have scientifically proved those ethnomedicines for antiurolithiatic effect in animal and in vitro model. Plant-based remedies were found to be therapeutically effective for both prevention as well as cure of calcium oxalate urolithiasis. Plants were known to show these effects through a combination of many effects such as antioxidant, diuretic, hypocalciuric, urine alkalinizing effect in them. Berberine, triterpenoids, lupeol are the phytochemicals established for antiurolithiatic effect. Hence, plant-based medicine can be the effective herbal alternative as well as means of discovery of novel drug molecule for curing urolithiatic disorder and should be focused on further research to discover their value in coming future.

Keywords: urolithiasis, herbal medicine, ethnomedicine, kidney stone, calcium oxalate

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Authors: A. Briseno, A, Zorrilla

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Firms are increasingly responding to social and environmental claims from society. Practices oriented to attend issues such as poverty, work equality, or renewable energy, are being implemented more frequently by firms to address impacts on sustainability. However, questions remain on how the responses of firms vary across industries and regions between the social and the economic objectives. Using concepts from organizational theory and social network theory, this paper aims to create a theoretical framework that explains the internal and external influences that make a firm establish its objective. The framework explains why firms might have a different objective orientation in terms of its economic and social prioritization.

Keywords: organizational identity, social network theory, firm objective, value maximization, social responsibility

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Authors: Eun-Seop Kim, Eun-Ha Jang, Rana R. Kim, Sae-Byul Jang

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Objective: Preterm labor is the most common antecedent of preterm birth(PTB), which is characterized by regular uterine contraction before 37 weeks of pregnancy and cervical change. In acute preterm labor, tocolytics are administered as the first-line medication to suppress uterine contractions but rarely delay pregnancy to 37 weeks of gestation. On the other hand, according to the Korean Traditional Medicine, PTB is caused by the deficiency of Qi and unnecessary energy in the body of the mother. The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of PTB. Methods: It is a case report of a 38-year-old woman (0-0-6-0) hospitalized for irregular uterine contractions and cervical change at 33+3/7 weeks of gestation. Past history includes chemical pregnancies achieved by Artificial Rroductive Technology(ART), one stillbirth (at 7 weeks) and a laparoscopic surgery for endometriosis. After seven trials of IVF and articificial insemination, she had succeeded in conception via in-vitro fertilization (IVF) with help of Traditional Korean Medicine (TKM) treatments. Due to irregular uterine contractions and cervical changes, 2 TKM were prescribed: Gami-Dangguisan, and Antae-eum, known to nourish blood and clear away heat. 120ml of Gami-Dangguisan was given twice a day monring and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: On admission, the cervix of 15mm in length and cervical os with 0.5cm-dilated were observed via ultrasonography. 50% cervical effacement was also detected in physical examination. Tocolysis had been temporarily maintained. As a supportive therapy, TKM herbal preparations(gami-dangguisan and Antae-eum) were concomitantly given. As of 34+2/7 weeks of gestation, however intermittent uterine contractions appeared (5-12min) on cardiotocography and vaginal bleeding was also smeared at 34+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39+3/7 gestational weeks. Conclusions: This is the first successful case report about a preter labor patient administered with conventional tocolytic agents as well as TKM herbal decoctions, delaying delivery to term. This case deserves attention considering it is rare to maintain gestation to term only with tocolytic intervention. Our report implies the potential of herbal medicine as an adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

Keywords: preterm labor, traditional Korean medicine, herbal medicine, integrative treatment, complementary and alternative medicine

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Authors: Hooman Dabirmanesh, Attila M. Zsaki

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Traditionally, rock slope stability is carried out using limit equilibrium analysis when investigating toppling failure. In these equilibrium methods, internal forces exerted between columns are not clearly defined, and to the authors’ best knowledge, there is no consensus in literature with respect to the results of analysis. A discrete element method-based numerical model was developed and applied to simulate the behavior of rock layers subjected to toppling failure. Based on this calibrated numerical model, a study of the location and distribution of internal forces that result in equilibrium was carried out. The sum of side forces was applied at a point on a block which properly represents the force to determine the inter-column force distribution. In terms of the side force distribution coefficient, the result was compared to those obtained from laboratory centrifuge tests. The results of the simulation show the suitable criteria to select the correct position for the internal exerted force between rock layers. In addition, the numerical method demonstrates how a theoretical method could be reliable by considering the interaction between the rock layers.

Keywords: contact bond, discrete element, force distribution, limit equilibrium, tensile stress

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Authors: Peyman Rezaei Hachesu, Vahideh Zareh Gavgani, Zahra Salahzadeh

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To survey the attitudes, awareness, and practice of Evidence Based Medicine (EBM), and to determine the barriers that influence apply’ EBM in therapeutic process among clinical residents in Iran.We conducted a cross sectional survey during September to December 2012 at the teaching hospitals of Tehran University of Medical Sciences among 79 clinical residents from different medical specialties. A valid and reliable questionnaire consisted of five sections and 27 statements were used in this research. We applied Spearman and Mann Whitney test for correlation between variables. Findings showed that the knowledge of residents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard with the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.138). Integration of training approaches like journal clubs or workshops with clinical practice is suggested.

Keywords: evidence-based medicine, clinical residents, decision-making, attitude, questionnaire

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Authors: Cemile Kütmeç Yilmaz, Güler Duru Asiret, Gulcan Bagcivan

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The aim of this study was to evaluate the reliability and validity of the Turkish version of the Carer’s Assessment of Satisfaction Index (CASI-TR). The study was conducted between the dates of June 2016 and September 2017 at the Training and Research Hospital of Aksaray University with the caregiving family members of the inpatients with chronic diseases. For this study, the sample size was calculated as at least 10 individuals for each item (item number (30)X10=300). The study sample included 300 caregiving family members, who provided primer care for at least three months for a patient (who had at least one chronic disease and received inpatient treatment in general internal medicine and palliative care units). Data were collected by using a demographic questionnaire and CASI-TR. Descriptive statistics, and psychometric tests were used for the data analysis. Of those caregivers, 76.7% were female, 86.3% were 65 years old and below, 43.7% were primary school graduates, 87% were married, 86% were not working, 66.3% were housewives, and 60.3% defined their income status as having an income covering one’s expenses. Care recipients often had problems in terms of walking, sleep, balance, feeding and urinary incontinence. The Cronbach Alpha value calculated for the CASI-TR (30 items) was 0,949. Internal consistency coefficients calculated for subscales were: 0.922 for the subscale of ‘caregiver satisfaction related to care recipient’, 0.875 for the subscale of ‘caregiver satisfaction related to themselves’, and 0.723 for the subscale of ‘dynamics of interpersonal relations’. Factor analysis revealed that three factors accounted for 57.67% of the total variance, with an eigenvalue of >1. assessed in terms of significance, we saw that the items came together in a significant manner. The factor load of the items were between 0.311 and 0.874. These results show that the CASI-TR is a valid and reliable scale. The adoption of the translated CASI in Turkey is found reliable and valid to assessing the satisfaction of caregivers. CASI-TR can be used easily in clinics or house visits by nurses and other health professionals for assessing caregiver satisfaction from caregiving.

Keywords: carer’s assessment of satisfaction index, caregiver, validity, reliability

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Authors: Omar Bouledroua, Djamel Zelmati, Zahreddine Hafsi, Milos B. Djukic

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Transporting hydrogen gas through the existing natural gas pipeline network offers an efficient solution for energy storage and conveyance. Hydrogen generated from excess renewable electricity can be conveyed through the API 5L steel-made pipelines that already exist. In recent years, there has been a growing demand for the transportation of hydrogen through existing gas pipelines. Therefore, numerical and experimental tests are required to verify and ensure the mechanical integrity of the API 5L steel pipelines that will be used for pressurized hydrogen transportation. Internal pressure loading is likely to accelerate hydrogen diffusion through the internal pipe wall and consequently accentuate the hydrogen embrittlement of steel pipelines. Furthermore, pre-cracked pipelines are susceptible to quick failure, mainly under a time-dependent cyclic pressure loading that drives fatigue crack propagation. Meanwhile, after several loading cycles, the initial cracks will propagate to a critical size. At this point, the remaining service life of the pipeline can be estimated, and inspection intervals can be determined. This paper focuses on the hydrogen embrittlement of API 5L steel-made pipeline under cyclic pressure loading. Pressurized hydrogen gas is transported through a network of pipelines where demands at consumption nodes vary periodically. The resulting pressure profile over time is considered a cyclic loading on the internal wall of a pre-cracked pipeline made of API 5L steel-grade material. Numerical modeling has allowed the prediction of fatigue crack evolution and estimation of the remaining service life of the pipeline. The developed methodology in this paper is based on the ASME B31.12 standard, which outlines the guidelines for hydrogen pipelines.

Keywords: hydrogen embrittlement, pipelines, transient flow, cyclic pressure, fatigue crack growth

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Authors: Janis E. Campbell

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Most of what is known about complementary, alternative or traditional medicine (CATM) in the United States today is known from either the National Health Interview Survey a cross-sectional survey with a few questions or from small cross-sectional or cohort studies with specific populations. The broad geographical distribution in CATM use or providers is not known. For this project, we used geospatial cluster analysis to determine if there were clusters of CATM provider by county in the US. In this analysis, we used the National Provider Index to determine the geographic distribution of providers in the US. Of the 215,769 CAMT providers 211,603 resided in the contiguous US: Acupuncturist (26,563); Art, Poetry, Music and Dance Therapist (2,752); Chiropractor (89,514); Doula/Midwife (3,535); Exercise (507); Homeopath (380); Massage Therapist (36,540); Mechanotherapist (1,888); Naprapath (146); Naturopath (4,782); Nutrition (42,036); Reflexologist (522); Religious (2,438). ESRI® spatial autocorrelation was used to determine if the geographic location of CATM providers were random or clustered. For global analysis, we used Getis-Ord General G and for Local Indicators of Spatial Associations with an Optimized Hot Spot Analysis using an alpha of 0.05. Overall, CATM providers were clustered with both low and high. With Chiropractors, focusing in the Midwest, religious providers having very small clusters in the central US, and other types of CAMT focused in the northwest and west coast, Colorado and New Mexico, the great lakes areas and Florida. We will discuss some of the implications of this study, including associations with health, economic, social, and political systems.

Keywords: complementary medicine, alternative medicine, geospatial, United States

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Authors: Gaurav Gupta, Jitendra Mahakud

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This study focuses on the significance of internal financing constraints on the determination of corporate fixed investments in the case of Indian manufacturing companies. Financing constraints companies which have less internal fund or retained earnings face more transaction and borrowing costs due to imperfections in the capital market. The period of study is 1999-2000 to 2013-2014 and we consider 618 manufacturing companies for which the continuous data is available throughout the study period. The data is collected from PROWESS data base maintained by Centre for Monitoring Indian Economy Pvt. Ltd. Panel data methods like fixed effect and random effect methods are used for the analysis. The Likelihood Ratio test, Lagrange Multiplier test, and Hausman test results conclude the suitability of the fixed effect model for the estimation. The cash flow and liquidity of the company have been used as the proxies for the internal financial constraints. In accordance with various theories of corporate investments, we consider other firm specific variable like firm age, firm size, profitability, sales and leverage as the control variables in the model. From the econometric analysis, we find internal cash flow and liquidity have the significant and positive impact on the corporate investments. The variables like cost of capital, sales growth and growth opportunities are found to be significantly determining the corporate investments in India, which is consistent with the neoclassical, accelerator and Tobin’s q theory of corporate investment. To check the robustness of results, we divided the sample on the basis of cash flow and liquidity. Firms having cash flow greater than zero are put under one group, and firms with cash flow less than zero are put under another group. Also, the firms are divided on the basis of liquidity following the same approach. We find that the results are robust to both types of companies having positive and negative cash flow and liquidity. The results for other variables are also in the same line as we find for the whole sample. These findings confirm that internal financing constraints play a significant role for determination of corporate investment in India. The findings of this study have the implications for the corporate managers to focus on the projects having higher expected cash inflows to avoid the financing constraints. Apart from that, they should also maintain adequate liquidity to minimize the external financing costs.

Keywords: cash flow, corporate investment, financing constraints, panel data method

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Authors: Mojtaba Ahmadabadi, Akbar Masoudi, Morteza Rezai

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In this paper, using the finite element method, the effect of soil and wall characteristics was investigated. Thirty and two different models were studied by different parameters. These studies could calculate displacement at any height of the wall for frictional-cohesive soils. The main purpose of this research is to determine the most effective soil characteristics in reducing the wall displacement. Comparing different models showed that the overall increase in internal friction angle, angle of friction between soil and wall and modulus of elasticity reduce the replacement of the wall. In addition, increase in special weight of soil will increase the wall displacement. Based on results, it can be said that all wall displacements were overturning and in the backfill, soil was bulging. Results show that the highest impact is seen in reducing wall displacement, internal friction angle, and the angle friction between soil and wall. One of the advantages of this study is taking into account all the parameters of the soil and walls replacement distribution in wall and backfill soil. In this paper, using the finite element method and considering all parameters of the soil, we investigated the impact of soil parameter in wall displacement. The aim of this study is to provide the best conditions in reducing the wall displacement and displacement wall and soil distribution.

Keywords: retaining wall, fem, soil and wall interaction, angle of internal friction of the soil, wall displacement

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Authors: S. Chandrakaran, G. Govind

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Stone columns are effectively used to improve bearing strength of soils and also for many geotechnical applications. In soft soils when stone columns are loaded they undergo large settlements due to insufficient lateral confinement. Use of geosynthetics encasement has proved to be a solution for this problem. In this paper, results of a laboratory experimental study carried out with model stone columns with and without encasement. Sand was used for making test beds, and grain size of soil varies from 0.075mm to 4.75mm. Woven geotextiles produced by Gareware ropes India with mass per unit area of 240gm/M2 and having tensile strength of 52KN/m is used for the present investigation. Tests were performed with large scale direct shear box and also using scaled laboratory plate load tests. Stone column of 50mm and 75mm is used for the present investigation. Diameter of stone column, size of stones used for making stone columns is varied in making stone column in the present study. Two types of stone were used namely small and bigger in size. Results indicate that there is an increase in angle of internal friction and also an increase in the shear strength of soil when stone columns are encased. With stone columns with 50mm dia, an average increase of 7% in shear strength and 4.6 % in angle of internal friction was achieved. When large stones were used increase in the shear strength was 12.2%, and angle of internal friction was increased to 5.4%. When the stone column diameter has increased to 75mm increase in shear strength and angle of internal friction was increased with smaller size of stones to 7.9 and 7.5%, and with large size stones, it was 7.7 and 5.48% respectively. Similar results are obtained in plate load tests, also.

Keywords: stone columns, encasement, shear strength, plate load test

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Authors: Renu Kumari

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State sovereignty refers to the ability and power of a state to be independent and not to have any interference of external actors in its internal affairs. This phenomenon has been accepted by International Law, which gives rights to the state to maintain its autonomy and territorial integrity without the interference of other actors. In of 1980’s and 1990’s the world has witnessed the worst case of human rights violence for instance, Rwanda genocide, the conflict in former Yugoslavia, Kosovo, Burundi, and Chad so and so forth. Though human rights violence is not a new phenomenon, it has been present all over the world in different time and space. But in 1990’s after the devastation of these conflicts and violence the world community came up with the notion of humanitarian intervention in which some states took the responsibility of protecting human rights violations and on the in order to protect they can intervene in the internal matters of a state specifically during civil war where state is unable to protect its people. Later on these so-called world community realized that intervention itself is a negative term that was criticized also therefore they came up with a different notion that sounded positive which known as responsibility to protect. In 2005 onwards, the notion of responsibility to protect accepted and recognized by the United Nations and states at a larger level. In the case of Syria on the name of responsibility to protect foreign interventions took place and due to the internal war Syrian people were already facing many problems, the government was not able to protect them. External invasion caused many devastating outcomes to the country. This paper is an attempt to analyze various dimensions of invasion of external affairs of a particular state and the status of sovereignty. Firstly, it lays out the notion of humanitarian intervention and then the responsibility to protect. Secondly, it looks in the case of Syria since 2011, the conflict of Syria. Thirdly it focuses on various efforts made by international organizations and other actors. Lastly, it looks why and how other actors intervene in the internal matter of Syria.

Keywords: state sovereignty, external actors, intervention, responsibility to protect

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Authors: Mohamed Mahmoud

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This paper has developed an effect-cause analysis technique for fault diagnosis in digital circuits. The main algorithm of our technique is based on the Enhanced Deduction Algorithm, which processes the real response of the CUT to the applied test T to deduce the values of the internal lines. An experimental version of the algorithm has been implemented in C++. The code takes about 7592 lines. The internal values are determined based on the logic values under the permanent stuck-fault model. Using a backtracking strategy guarantees that the actual values are covered by at least one solution, or no solution is found.

Keywords: enhanced deduction algorithm, backtracking strategy, automatic test equipment, verfication

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Authors: Mitsuhiro Okayasu, Lele Yang, Koji Shimotsu

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The effects of microstructural characteristics on the mechanical and hydrogen embrittlement properties of 1,800MPa grade hot stamping carbon steel were investigated experimentally. The tensile strength increased with increasing the hot stamping temperature until around 921°C, but that decreased with increasing the temperature in more than 921°C due to the increment of the size of lath martensite and prior austenite. With the hot stamping process, internal strain was slightly created in the sample, which led to the slight increment of the hardness value although no clear change of the microstructural formation was detected. Severity of hydrogen embrittlement was investigated using the hot stamped carbon steels after the immersion in a hydrogen gas, and that was directly attributed to the infiltration of the hydrogen into their grain boundaries. The high strength carbon steel with tiny lath martensite microstructure could make severe hydrogen brittleness as the hydrogen was strongly penetrated in the grain boundaries in the hydrogen gas for a month. Because of weak embrittlement for the as-received carbon (ferrite and pearlite), hydrogen embrittlement is caused by the high internal strain and high dislocation density. The hydrogen embrittlement for carbon steel is attributed to amount of the hydrogen immersed in-between grain boundaries, which is caused by the dislocation density and internal strain.

Keywords: hydrogen embrittlement, hot stamping process, carbon steel, mechanical property

Procedia PDF Downloads 201