Search results for: clinical laboratory persons

Authors: A. Pesin, D. Pustovoytov, A. Kolesnik, M. Sverdlik

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Rolling disturbances often arise which might lead to defects such as nonflatness, warpage, corrugation, etc. Numerous methods of compensation for such disturbances are well known. However, most of them preserve the initial form of transverse flow of the strip, such as convex, concave or asymmetric (for example, sphenoid). Sometimes, the form inherited (especially asymmetric) is undesirable. Technical solutions have been developed which include providing conditions for transverse metal flow in deformation zone. It should be noted that greater reduction is followed by transverse flow increase, while less reduction causes a corresponding decrease in metal flow for differently deformed metal lengths to remain approximately the same and in order to avoid the defects mentioned above. One of the solutions suggests sequential strip deforming from rectangular cross-section profile with periodical rectangular grooves back into rectangular profile again. The work was carried out in DEFORM 3D program complex. Experimental rolling was performed on laboratory mill 150. Comparison of experimental and theoretical results demonstrated good correlation.

Keywords: FEM, cross-section deformation, mechanical engineering, applied mechanics

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Authors: Seyed Abolhasan Naeini, M. Mortezaee

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Various factors such as the method of installation, the pile type, the pile material and the pile shape, can affect the final bearing capacity of a pile executed in the soil; among them, the method of installation is of special importance. The physical modeling is among the best options in the laboratory study of the piles behavior. Therefore, the current paper first presents and reviews the frustum confining vesel (FCV) as a suitable tool for physical modeling of deep foundations. Then, by describing the loading tests of two open-ended and closed-end steel piles, each of which has been performed in two methods, “with displacement" and "without displacement", the effect of end conditions and installation method on the final bearing capacity of the pile is investigated. The soil used in the current paper is silty sand of Firoozkooh. The results of the experiments show that in general the without displacement installation method has a larger bearing capacity in both piles, and in a specific method of installation the closed ended pile shows a slightly higher bearing capacity.

Keywords: physical modeling, frustum confining vessel, pile, bearing capacity, installation method

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Authors: Hocini Yousra, Medjnoun Amal, Khiatine Mohamed, Bahar Ramdane

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The development of the regions of southern Algeria require the construction of numerous road, rail, and airport infrastructures. However, this development is very expensive given the very severe climatic conditions, the difficulty of reusing local materials, and the unavailability of water on the project sites; these regions are characterized by an arid or semi-arid climate, which means that water sources are very limited. The climatic conditions and the scarcity of water make soil compaction work very difficult and excessively expensive. These constraints related to the supply of water for irrigation of these construction sites make it necessary to examine the solution of compaction with low water content. This work studies the possibility of improving the compaction with a low water content of the soils of southern Algeria and this by using natural or recycled ecological materials. Local soils are first subjected to a series of laboratory characterization tests, then mixed with varying amounts of natural additives. The new materials are, in turn, subjected to road tests.

Keywords: compaction, low water content, sand, natural materials

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Authors: Ravi Gujjula, Chinna Eranna, Narasimha Mangadoddy

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Hydrodynamic study of gas and solid flow in an internally circulating fluidized bed with draft tube is made in this paper using high speed camera and pressure probes for the laboratory ICFB test rig 3.0 m X 2.7 m column having a draft tube located in the center of ICFB. Experiments were conducted using different sized sand particles with varying particle size distribution. At each experimental run the standard pressure-flow curves for both draft tube and annular region beds measured and the same time downward particles velocity in the annular bed region were also measured. The effect of superficial gas velocity, static bed height (40, 50 & 60 cm) and the draft tube gap height (10.5 & 14.5 cm) on pressure drop profiles, solid circulation pattern, and gas bypassing dynamics for the ICFB investigated extensively. The mechanism of governing solid recirculation and the pressure losses in an ICFB has been eluded based on gas and solid dynamics obtained from the experimental data. 3D ICFB CFD simulation runs conducted and extracted data validated with ICFB experimental data.

Keywords: icfb, cfd, pressure drop, solids recirculation, bed height, draft tube

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Authors: Lucie Mrackova, Helena Kisvetrova

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Spirituality is an integral part of human life. In a secular environment, spiritual needs are often overlooked, especially in acute nursing care. Spiritual needs assessment for patients (SNAP), which also exists in the Czech version (SNAP-CZ), can be used for objective evaluation. The aim of this study was to measure the psychometric properties of SNAP-CZ and to find correlations between SNAP-CZ and sociodemographic and clinical variables. A cross-sectional study with tools assessing spiritual needs (SNAP-CZ), anxiety (Beck Anxiety Inventory; BAI), depression (Beck Depression Inventory; BDI), pain (Visual Analogue Scale; VAS), self-sufficiency (Barthel Index; BI); cognitive function (Montreal Cognitive Test; MoCa) and selected socio-demographic data was performed. The psychometric properties of SNAP-CZ were tested using factor analysis, reliability and validity tests, and correlations between the questionnaire and sociodemographic data and clinical variables. Internal consistency was established with Cronbach’s alfa for the overall score, respective domains, and individual items. Reliability was assessed by test-retest by Interclass correlation coefficient (ICC). Data for correlation analysis were processed according to Pearson's correlation coefficient. The study included 172 trauma patients (the mean age = 40.6 ± 12.1 years) who experienced polytrauma or severe monotrauma. There were a total of 106 (61.6%) male subjects, 140 (81.4%) respondents identified themselves as non-believers. The full-scale Cronbach's alpha was 0.907. The test-retest showed the reliability of the individual domains in the range of 0.924 to 0.960 ICC. Factor analysis resulted in a three-factor solution (psychosocial needs (alfa = 0.788), spiritual needs (alfa = 0.886) and religious needs (alfa = 0.841)). Correlation analysis using Pearson's correlation coefficient showed that the domain of psychosocial needs significantly correlated only with gender (r = 0.178, p = 0.020). Males had a statistically significant lower average value in this domain (mean = 12.5) compared to females (mean = 13.8). The domain of spiritual needs significantly correlated with gender (r = 0.199, p = 0.009), social status (r = 0.156, p = 0.043), faith (r = -0.250, p = 0.001), anxiety (r = 0.194, p = 0.011) and depression (r = 0.155, p = 0.044). The domain of religious needs significantly correlated with age (r = 0,208, p = 0,007), education (r = -0,161, p = 0,035), faith (r = -0,575, p < 0,0001) and depression (r = 0,179, p = 0,019). Overall, the whole SNAP scale significantly correlated with gender (r = 0.219, p = 0.004), social status (r = 0.175, p = 0.023), faith (r = -0.334, p <0.0001), anxiety (r = 0.177, p = 0.022) and depression (r = 0.173, p = 0.025). The results of this study corroborate the reliability of the SNAP-CZ and support its future use in the nursing care of trauma patients in a secular society. Acknowledgment: The study was supported by grant nr. IGA_FZV_2020_003.

Keywords: acute nursing care, assessment of spiritual needs, patient, psychometric validation, spirituality

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Authors: Nasrin Nejatbakhsh, Anita Kaiser, Sander Hitzig, Colleen McGillivray

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Following spinal cord injury (SCI), many individuals experience anxiety in adjusting to their lives, and its impacts on their sexuality. Research has demonstrated that regaining sexual function is a very high priority for individuals with SCI. Despite this, sexual health is one of the least likely areas of focus in rehabilitating individuals with SCI. There is currently a considerable gap in appropriate education and resources that address sexual health concerns and needs of people with spinal cord injury. Furthermore, the determinants of sexual health in individuals with SCI are poorly understood and thus poorly addressed. The purpose of this study was to improve current practices by informing a service delivery model that rehabilitation centers can adopt for appropriate delivery of their services. Methodology: We utilized qualitative methods in the form of a semi-structured interview containing open-ended questions to assess 1) sexual health concerns, 2) helpful strategies in current resources, 3) unhelpful strategies in current resources, and 4) Barriers to obtaining sexual health information. In addition to the interviews, participants completed surveys to identify socio-demographic factors. Data gathered was coded and evaluated for emerging themes and subthemes through a ‘code-recode’ technique. Results: We have identified several robust themes that are important for SCI sexual health resource development. Through analysis of these themes and their subthemes, several important concepts have emerged that could provide agencies with helpful strategies for providing sexual health resources. Some of the important considerations are that services be; anonymous, accessible, frequent, affordable, mandatory, casual and supported by peers. Implications: By incorporating the perspectives of individuals with SCI, the finding from this study can be used to develop appropriate sexual health services and improve access to information through tailored needs based program development.

Keywords: spinal cord injury, sexual health, determinants of health, resource development

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Authors: Namekong Fokeng Armand

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Background: Zoonoses are nowadays a serious public health problem in both developing and developed countries. They contribute to increase the economic burden. In case of emergence, rural populations are the most affected, hence the need to investigate risk practices in rural households of Penka-Michel (West Cameroon). Methods: This cross-sectional study was conducted from October to November 2021 among 200 heads of households living in the Penka-Michel health district (West Cameroon). It was done using a pre-tested and validated questionnaire, allowing to obtain socio-demographic, economic data, and data on zoonotic risk practices. Results: The participants [women (56%), men (44%)] worked mainly in the informal private sector (53%) and practiced agriculture secondarily (90%). Their highest level of education, for the most part, was a secondary school (50%); the average household size was 06 persons with a monthly income > 36270 FCFA (72%). 74% of household heads thought that animals can transmit diseases, and 17% had heard about zoonotic diseases through the media (65%). Rats caught in households (60%) were consumed there (74%), as was bush meat (61%) or dog meat (18%). For family food (90%), animals were slaughtered within the household (97%), rarely preceded by a veterinary inspection (6%). 87% of households practiced traditional rites with animal blood, 65% shared the same habitat as their animals, 41% did not systematically wash their hands after handling animals. More than 50% of households owned one or more dogs, usually strays (41%) and 48% of which were vaccinated (rabies). Many households had at least one: poultry (98%); pig (50%); dog (57%), cat (52%). 25% of households slaughtered sick animals for consumption, and 27% ate dead animals. Conclusion: This study identified numerous zoonotic risk practices in households in the Penka-Michel health district (West Cameroon). Concerted, multisectoral communication / awareness-raising actions are needed to break with these practices.

Keywords: zoonoses, risky practices, rural households, penka-michel, cameroon

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Authors: Virany Diana, Martono Tri Utomo, Risa Etika

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Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

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Authors: Manuel de Pazos-Liano, Manuel Cifuentes-Antonio, Juan Fisac-Gozalo, Sara Perales-Momparler, Carlos Martinez-Montero

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The first-ever game in the Wanda Metropolitano Stadium, the new home of the Club Atletico de Madrid, was played on September 16, 2017, thanks to the work of a multidisciplinary team that made it possible to combine urban development with sustainability goals. The new football ground sits on a 1.2 km² land owned by the city of Madrid. Its construction has dramatically increased the sealed area of the site (transforming the runoff coefficient from 0.35 to 0.9), and the surrounding sewer network has no capacity for that extra flow. As an alternative to enlarge the existing 2.5 m diameter pipes, it was decided to detain runoff on site by means of an integrated and durable infrastructure that would not blow up the construction cost nor represent a burden on the municipality’s maintenance tasks. Instead of the more conventional option of building a large concrete detention tank, the decision was taken on the use of pervious pavement on the 3013 car parking spaces for sub-surface water storage, a solution aligned with the city water ordinance and the Madrid + Natural project. Making the idea a reality, in only five months and during the summer season (which forced to pour the porous concrete only overnight), was a challenge never faced before in Spain, that required of innovation both at the material as well as the machinery side. The process consisted on: a) defining the characteristics required for the porous concrete (compressive strength of 15 N/mm2 and 20% voids); b) testing of different porous concrete dosages at the construction company laboratory; c) stablishing the cross section in order to provide structural strength and sufficient water detention capacity (20 cm porous concrete over a 5 cm 5/10 gravel, that sits on a 50 cm coarse 40/50 aggregate sub-base separated by a virgin fiber polypropylene geotextile fabric); d) hydraulic computer modelling (using the Full Hydrograph Method based on the Wallingford Procedure) to estimate design peak flows decrease (an average of 69% at the three car parking lots); e) use of a variety of machinery for the application of the porous concrete to achieve both structural strength and permeable surface (including an inverse rotating rolling imported from USA, and the so-called CMI, a sliding concrete paver used in the construction of motorways with rigid pavements); f) full-scale pilots and final construction testing by an accredited laboratory (pavement compressive strength average value of 15 N/mm2 and 0,0032 m/s permeability). The continuous testing and innovating construction process explained in detail within this article, allowed for a growing performance with time, finally proving the use of the CMI valid also for large porous car park applications. All this process resulted in a successful story that converts the Wanda Metropolitano Stadium into a great demonstration site that will help the application of the Spanish Royal Decree 638/2016 (it also counts with rainwater harvesting for grass irrigation).

Keywords: construction machinery, permeable carpark, porous concrete, SUDS, sustainable develpoment

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Authors: Adriane Amend, Leidiene Ferreira Santos, Daniella Pires Nunes

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The experience of assuming or caring for older persons dependents by relatives is a complex task that encompasses or affective involvement, the demand for technical activities and or psychological support. It would be necessary to understand the situations related to the caregiver, the person and the environment, which help the family difficulty, as a caregiver to lead this role. Objective: To identify the forces that drive and restrict the care process of family caregivers of the older adults. Method: Descriptive and exploratory research, with a qualitative approach, which has as a reference the Force Field Theory. Five family caregivers of older adult’s dependents residing in the city of Palmas, Tocantins, Brazil will participate. The data were collected from December 2021 to February 2022, through a semi-structured individual interview, and submitted to content analysis. Results: As forces that drive or process of caring for family caregivers were: the account of compassionate attitudes and patience of the caregiver (I); to the collaboration of the other person to the care and to the body structure of the same (Other); and the supports of other people not cared for and structural, such as adaptations in the room, read and bathroom, as in the presence of air conditioners (Environment). Among the restrictive forces of care we mention difficulties in delegating care to another person, or stress of care and other personal demands (I); imposition of the older person about care and e a transfer from bed to hip (Other); e lack of accessibility of the house and absence of air conditioning and hospital bed (Environment). Conclusion: The results show that there are driving forces with the caregiver's attitude and feelings, a bond as an idol and support for the caregiver and the environment. On the other hand, conflicting ties, absence of physical structure and daily and continuous care shifts, can significantly compromise well-being or the cycle of older adult, caregiver and care.

Keywords: caregivers, frail elderly, perception, geriatric nursing

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Authors: Mukhtarkhanova Ainagul Madievna, Imanbek Karakoz

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The development and implementation of active forms and methods of extracurricular work in biology are carried out, assistance to people in determining sustainable interests in a particular field of science, expanding pupil's knowledge and horizons during in–depth study of program issues that go beyond the curriculum where considered, but accessible to the understanding of people; the development of interest in the subject, independence, creative activity. The purpose of this study is to open interest through extracurricular activities for teaching biology. The purpose of the presented work is to arouse people's interest in biology lessons in the modern world through extracurricular activities. First, the level of people was determined in the traditional style of teaching lessons, for which special tests and evaluation criteria were compiled. The level of pupils' knowledge of biology was determined by a questionnaire. Samples of extracurricular work were presented, and practices were conducted in the educational process. At the next stage, the level of pupils after the experiment was compared. The results of the work were discussed, and recommendations were developed.

Keywords: extracurricular activities, modern world, teaching, method, excursions, laboratory experiments, science fairs

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Authors: Melikulov A. A., Toshpulotov Sh. G., Akhmedova M. F., Beshimov A. S., Rakhimov M. K. Zokirov N. K.

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Postinfarction ventricular septal defect (PVSD) is a rare but life-threatening complication of acute myocardial infarction. Currently, an alternative direction of minimally invasive treatment of postinfarction ventricular septal defect (PVSD) is being developed - transcatheter closure of the defect using an occluder, but surgical closure of the defect remains the <> correction of post-infarction VSD. Our article presents a case of successful surgical treatment of a patient with a large post-infarction rupture of the interventricular septum (IVS) and post-infarction LV aneurysm under cardiopulmonary bypass and parallel perfusion.

Keywords: echocardiography, myocardial infarction, ventricular septal defect, parallel perfusion

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Authors: B. V. Murlimanju, R. Abisshek Balaji, Apoorva Aggarwal, Mangala M. Pai

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Background: Since the literature is scarce from the South Indian population about the sesamoid bones of the thumb, the present study was undertaken. The objective of the present study was to figure out the muscle of the thumb which contain these sesamoid bones. Methods: The present study included 25 cadaveric thumbs, which were obtained from the anatomy laboratory of our institution. Thumbs were studied for the prevalence of sesamoid bones at the metacarpophalangeal and interphalangeal joints. The muscle which contain these sesamoid bones were identified. Results: The present study observed that, there were 2 sesamoid bones (92%) at the metacarpophalangeal joint of the thumb each at its medial and lateral aspect. The medial sesamoid bone was found inside the adductor pollicis muscle and lateral one was found either in the flexor pollicis brevis muscle or abductor pollicis brevis muscle. However, among the 25 thumbs being studied, 2 thumbs (8%) had solitary sesamoid bone. The interphalangeal joint of the thumb exhibited only one sesamoid bone at the median plane. Conclusion: The morphological data of the present study from the South Indians can be used as a database, which is enlightening to the operating hand surgeon and radiologist.

Keywords: morphology, muscles, sesamoid bones, thumb

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Authors: G. Bharath, K. S. Reddy, Vivek Tandon, M. Amaranatha Reddy

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This paper presents the details of a study conducted to evaluate the interaction between recycled binder and fresh binder in Recycled Asphalt Pavement (RAP) mixes. When RAP is mixed with virgin aggregates in the presence of fresh binder there will be partial blending in a hot mix asphalt mixture. A recent approach used by some researchers for studying the degree of blending of RAP binder with virgin binder has been adopted in this study. Dense Bituminous Macadam mix of Ministry of Road Transport of India with a nominal maximum aggregate size of 19 mm was studied. Two proportions of RAP-20% and 35% and two types of virgin binders – viscosity grade VG10 and VG30 were considered. Design binder contents were determined for all the four types of mixes (two RAP contents and two virgin binders) as per Marshall mix design procedure. The degree of blending of RAP and virgin binders was evaluated in terms of the complex modulus of the binder. Laboratory test results showed that with an increase in RAP content, the degree of blending decreases. Better blending was observed for softer grade binder (VG10).

Keywords: blending, complex modulus, recycled asphalt pavement, virgin binder

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Authors: M. D. Stelescu, E. Manaila, G. Pelin, M. Georgescu, M. Sonmez

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This paper presents studies on the development and characterization of nanocomposites based on ethylene-propylene terpolymer rubber (EPDM), chlorobutyl rubber (IIR-Cl) and organically modified montmorillonite (OMMT). Mixtures were made containing 0, 3 and 6 phr (parts per 100 parts rubber) OMMT, respectively. They were obtained by melt intercalation in an internal mixer - Plasti-Corder Brabender, in suitable blending parameters, at high temperature for 11 minutes. Curing agents were embedded on a laboratory roller at 70-100 ºC, friction 1:1.1, processing time 5 minutes. Rubber specimens were obtained by compression, using a hydraulic press at 165 ºC and a pressing force of 300 kN. Curing time, determined using the Monsanto rheometer, decreases with the increased amount of OMMT in the mixtures. At the same time, it was noticed that mixtures containing OMMT show improvement in physical-mechanical properties. These types of nanocomposites may be used to obtain rubber seals for the space application or for other areas of application.

Keywords: chlorobutyl rubber, ethylene-propylene-diene terpolymers, montmorillonite, rubber seals, space application

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Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

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Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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Authors: Y. Khulief, S. Bashmal, S. Said, D. Al-Otaibi, K. Mansour

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The prediction of flow rates at which the vibration-induced instability takes place in tubular heat exchangers due to cross-flow is of major importance to the performance and service life of such equipment. In this paper, the semi-analytical model for square tube arrays was extended and utilized to study the triangular tube patterns. A laboratory test rig with instrumented test section is used to measure the fluidelastic coefficients to be used for tuning the mathematical model. The test section can be made of any bundle pattern. In this study, two test sections were constructed for both the normal triangular and the rotated triangular tube arrays. The developed scheme is utilized in predicting the onset of flow-induced instability in the two triangular tube arrays. The results are compared to those obtained for two other bundle configurations. The results of the four different tube patterns are viewed in the light of TEMA predictions. The comparison demonstrated that TEMA guidelines are more conservative in all configurations considered

Keywords: fluid-structure interaction, cross-flow, heat exchangers,

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Authors: Mehdi Seifollahi, Ashkan Forootan, Sajjad Bahrami Reyhan

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Due to the complexity of olefinic plants, various environmental pollutants exist such as NO_x, CO₂, Tar Water, and most importantly Spent Caustic. In this paper, instead of investigating ways of treating this pollutant, we evaluated the production in relation to plant’s variable items. We primarily discussed the factors affecting the quality of the output spent caustic such as impurities in the feed of olefin plant, the amount of injected dimethyl disulfide (DMDS) in furnaces, variation in feed composition, differences among gas temperatures and the concentration of caustic solution at the bottom of the tower. The results of the laboratory proved that in the formation of Red Oil, 1,3butadiene and acetaldehyde followed free radical and aldol condensation mechanism respectively. By increasing the injection rate of DMDS, Mercaptide amount increases in the effluent. In addition, pyrolysis gasoline accumulation is directly related to caustic concentration in the tower. Increasing naphtenes in the liquid feed augments the amount of 1,3butadiene, as one of the sources of Red Oil formation. By increasing the oxygenated compound in the feed, the rate of acetaldehyde formation, as the main source of Red Oil formation, increases.

Keywords: olefin, spent caustic, red oil, caustic wash tower

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Authors: Markus Bredel, Sindhu Nair, Hoa Q. Trummell, Rajani Rajbhandari, Christopher D. Willey, Lewis Z. Shi, Zhuo Zhang, William J. Placzek, James A. Bonner

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Purpose: EGFR-targeted monoclonal antibodies (mAbs) provide clinical benefit in some patients with H&N squamous cell carcinoma (HNSCC), but others progress with minimal response. Missense mutations in the EGFR ectodomain (ECD) can be acquired under mAb therapy by mimicking the effect of large deletions on receptor untethering and activation. Little is known about the contribution of EGFR ECD mutations to EGFR activation and anti-EGFR response in HNSCC. Methods: We selected patient-derived HNSCC cells (UM-SCC-1) for resistance to mAb Cetuximab (CTX) by repeated, stepwise exposure to mimic what may occur clinically and identified two concurrent EGFR ECD mutations (UM-SCC-1R). We examined the competence of the mutants to bind EGF ligand or CTX. We assessed the potential impact of the mutations through visual analysis of space-filling models of the native sidechains in the original structures vs. their respective side-chain mutations. We performed CRISPR in combination with site-directed mutagenesis to test for the effect of the mutants on ligand-independent EGFR activation and sorting. We determined the effects on receptor internalization, endocytosis, downstream signaling, and radiation sensitivity. Results: UM-SCC-1R cells carried two non-synonymous missense mutations (G33S and N56K) mapping to domain I in or near the EGF binding pocket of the EGFR ECD. Structural modeling predicted that these mutants restrict the adoption of a tethered, inactive EGFR conformation while not permitting association of EGFR with the EGF ligand or CTX. Binding studies confirmed that the mutant, untethered receptor displayed a reduced affinity for both EGF and CTX but demonstrated sustained activation and presence at the cell surface with diminished internalization and sorting for endosomal degradation. Single and double-mutant models demonstrated that the G33S mutant is dominant over the N56K mutant in its effect on EGFR activation and EGF binding. CTX-resistant UM-SCC-1R cells demonstrated cross-resistance to mAb Panitumuab but, paradoxically, remained sensitive to the reversible receptor tyrosine kinase inhibitor Erlotinib. Conclusions: HNSCC cells can select for EGFR ECD mutations under EGFR mAb exposure that converge to trap the receptor in an open, constitutively activated state. These mutants impede the receptor’s competence to bind mAbs and EGF ligand and alter its endosomal trafficking, possibly explaining certain cases of clinical mAb and radiation resistance.

Keywords: head and neck cancer, EGFR mutation, resistance, cetuximab

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Authors: Khaled Benyounes

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Determination of the rock mechanical properties such as unconfined compressive strength UCS, Young’s modulus E, and tensile strength by the Brazilian test Rtb is considered to be the most important component in drilling and mining engineering project. Research related to establishing correlation between strength and physical parameters of rocks has always been of interest to mining and reservoir engineering. For this, many rock blocks of limestone were collected from the quarry located in Meftah(Algeria), the cores were crafted in the laboratory using a core drill. This work examines the relationships between mechanical properties and some physical properties of limestone. Many empirical equations are established between UCS and physical properties of limestone (such as dry bulk density, velocity of P-waves, dynamic Young’s modulus, alteration index, and total porosity). Others correlations UCS-tensile strength, dynamic Young’s modulus-static Young’s modulus have been find. Based on the Mohr-Coulomb failure criterion, we were able to establish mathematical relationships that will allow estimating the cohesion and internal friction angle from UCS and indirect tensile strength. Results from this study can be useful for mining industry for resolve range of geomechanical problems such as slope stability.

Keywords: limestone, mechanical strength, Young’s modulus, porosity

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Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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Authors: Sally Kafelghazal

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Introduction: Arab Americans, who include immigrants, refugees, or U.S. born persons of Middle Eastern or North African descent, may experience significant difficulties during acculturation to Western society. Influential stressors include relocation, loss of social support, language barriers, and economic factors, all of which can impact mental health. There is limited research investigating the effects of acculturation on the mental health of the Arab American population. Objectives: The purpose of this study is to identify ways in which acculturation impacts the mental health of Arab Americans, specifically the development of depression and anxiety. Method: A literature search was conducted using PubMed and PsycArticles (ProQuest), utilizing the following search terms: “Arab Americans,” “Arabs,” “mental health,” “depression,” “anxiety,” “acculturation.” Thirty-nine articles were identified and of those, nine specifically investigated the relationship between acculturation and mental health in Arab Americans. Three of the nine focused exclusively on depression. Results: Several risk factors were identified that contribute to poor mental health associated with acculturation, which include immigrant or refugee status, facing discrimination, and religious ideology. Protective factors include greater levels of acculturation, being U.S. born, and greater heritage identity. Greater mental health disorders were identified in Arab Americans compared to normative samples, perhaps particularly depression; none of the articles specifically addressed anxiety. Conclusion: The current research findings support the potential association between the process of acculturation and greater levels of mental health disorders in Arab Americans. However, the diversity of the Arab American population makes it difficult to draw consistent conclusions. Further research needs to be conducted in order to assess which subgroups in the Arab American population are at highest risk for developing new or exacerbating existing mental health disorders in order to devise more effective interventions.

Keywords: arab americans, arabs, mental health, anxiety, depression, acculturation

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Authors: L. K. Akila

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Art activities can fund as a clinical support tool (CST) between interventions in Art Therapy to direct the client back towards better outcome goals. In the present study, during free art sessions, researcher examined the possibilities of motivating the adolescent group to involve in art making process by reflecting upon art intervention administered. Results show that adolescents’ reflecting upon their art works generated during the intervention; could change their perceptions and cognitions to improve their positive approach by restructuring their art expressions. Consequently, such reflections triggered and improved their emotions, feelings and ideas, and produced secure attachment between family, peers and teachers. By the end of interference, transformations experienced were effective more upon depression, self-image, and self-efficacy, and to a certain extent on aggressive patterns represented.

Keywords: adolescent, adolescent psychology, aggression, art, art therapy, cognition, depression, emotion, self-image

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Authors: Abdulrahman M. Hamid

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Dynamic Cone Penetration Test (DCPT) is widely used for field quality assessment of soils. Its application to predict the engineering properties of soil is globally promoted by the fact that it is difficult to obtain undisturbed soil samples, especially when loose or submerged sandy soil is encountered. Detailed discussion will be presented on the current development of DCPT correlations with resilient modulus, relative density, California Bearing Ratio (CBR), unconfined compressive strength and shear strength that have been developed for different materials in both the laboratory and field, as well as on the usage of DCPT in quality control of compaction of earth fills and performance evaluation of pavement layers. In addition, the relationship of the DCPT with other instruments such as falling weight deflectometer, nuclear gauge, soil stiffens gauge, and plate load test will be reported. Lastely, the application of DCPT in Saudi Arabia in recent years will be addressed in this manuscript.

Keywords: dynamic cone penetration test, falling weight deflectometer, nuclear gauge, soil stiffens gauge, plate load test, automated dynamic cone penetration

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Authors: Catherine Bernard

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The maldistribution of clinicians within countries is well documented. It is a common theme throughout the world that rural areas often struggle to recruit and retain health workers resulting in inadequate healthcare for many. This paper will concentrate on the responsibilities that medical schools may have in addressing this shortage of rural health workers. Recommendations are made with regards to targeted rural student admissions, rurally-based medical schools, rural clinical rotations and a curriculum orientated towards rural health issues. The evidence gathered suggests that individual factors are positive in encouraging health workers to practice in rural locations. However, there is strength in numbers, and combining all the recommendations will likely result in a synergistic effect, thereby increasing numbers of rural health workers and achieving accessible healthcare for those living in rural populations.

Keywords: medical education, medical education design, public health, rural health

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Authors: I. Boroňová, J. Bernasovská, J. Kmec, E. Petrejčíková

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Dilated cardiomyopathy (DCM) is a primary myocardial disease, it is characterized by progressive systolic dysfunction due to cardiac chamber dilatation and inefficient myocardial contractility with estimated prevalence of 37 in 100 000 people. It is the most frequent cause of heart failure and cardiac transplantation in young adults. About one-third of all patients have a suspected familial disease indicating a genetic basis of DCM. Many candidate gene studies in humans have tested the association of single nucleotide polymorphisms (SNPs) in various genes coding for proteins with a known cardiovascular function. In our study we present the results of ZBTB17 gene rs10927875 polymorphism genotyping in relation to dilated cardiomyopathy in Slovak population. The study included 78 individuals, 39 patients with DCM and 39 healthy control persons. The mean age of patients with DCM was 50.7±11.5 years; the mean age of individuals in control group was 51.3±9.8 years. Risk factors detected at baseline in each group included age, sex, body mass index, smoking status, diabetes and blood pressure. Genomic DNA was extracted from leukocytes by a standard methodology and screened for rs10927875 polymorphism in intron of ZBTB17 gene using Real-time PCR method (Step One Applied Biosystems). The distribution of investigated genotypes for rs10927875 polymorphism in the group of patients with DCM was as follows: CC (89.74%), CT (10.26%), TT (0%), and the distribution in the control group: CC (92.31%), CT (5.13%), and TT (2.56%). Using the chi-square (χ2) test we compared genotype and allele frequencies between patients and controls. There was no difference in genotype or allele frequencies in ZBTB17 gene rs10927875 polymorphism between patients and control group (χ2=3.028, p=0.220; χ2=0.264, p=0.608). Our results represent an initial study, it can be considered as preliminary and first of its kind in Slovak population. Further studies of ZBTB17 gene polymorphisms of more numerous files and additional functional investigations are needed to fully understand the role of genetic associations.

Keywords: dilated cardiomyopathy, SNP polymorphism, ZBTB17 gene, bioscience

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Authors: Rosemary Saidu, Taiyelolu Martins Ogunjirin

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The study examines the teaching environment and instructional materials on the performance of students in the English Language in selected secondary schools in Ogun State and its implication for counselling. Two research questions guided the study were developed. The study adopted a descriptive survey design. A multi-stage sampling technique was employed for the study. Samples of 100 students of Senior Secondary School Two (SSS11) were drawn. Purposive sampling technique was to select the five schools. Additionally, the instruments known as Teaching Environment and Instructional Materials on Students Performance in English Inventory (TEIMEI) and Student Achievement Scores (SAS) were used to elicit information. Thereafter, inferential statistics and the non-parametric chi-square statistics at 0.05 alpha levels and 3 degree of freedom were adopted as analytical tools. From the study, it was discovered among others that teaching environment and instructional materials significantly contributed to the performance of students in the English language. From the findings, it was recommended that among others functional language laboratory in the schools, counselors to regularly give guidance talk on the importance of the subject.

Keywords: performance, English language, teaching environment, instructional materials

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Authors: Olu Ale, Olugbenga Aribisala, Sanmi Awopetu

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Groundwater (Wells) is obtained from several well-defined and different water-bearing geological layers or strata. The physical, chemical and bacteriological quality of the water contributed from each of these water-bearing formations and resultant effects of indiscriminate wastes disposal will be dependent on the dissolution of material within the formation. Therefore, water withdrawn from any ground water source will be a composite of these individual aquifers. The water quality was determined by actual sampling and analysis of the completed wells. This study attempted to examine the physicochemical and bacteriological water quality of twenty five selected wells comprising twenty boreholes (deep wells) and five hand dug wells (shallow wells). The twenty five wells cut across the entire Ado Ekiti Metropolitan area. The water samples collected using standard method was promptly taken to water laboratory at the Federal Polytechnic Ado-Ekiti for analysis, physical, chemical and bacteriological tests were carried out. Quality characteristics tested were found to meet WHO’s standard and generally acceptable, making it potable for drinking in most situations, thus encouraging the use of groundwater. Possible improvement strategies to groundwater exploitation were highlighted while remedies to poor quality water were suggested.

Keywords: bacteriological, physicochemical, quality, wells, Ado Ekiti

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Authors: Cristina Rodriguez, Abed Alaswad, Zaki El-Hassan, Abdul G. Olabi

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This study investigates the effect on methane production from the waste paper when co-digested with macroalgal biomass as a source of nitrogen. Both feedstocks were previously mechanically pretreated in order to reduce their particle size. Methane potential assays were carried out at laboratory scale in batch mode for 28 days. The study was planned according to two factors: the feedstock to inoculum (F/I) ratio and the waste paper to macroalgae (WP/MA) ratio. The F/I ratios checked were 0.2, 0.3 and 0.4 and the WP/MA ratios were 0:100, 25:75, 50:50, 75:25 and 100:0. The highest methane yield (608 ml/g of volatile solids (VS)) was achieved at an F/I ratio of 0.2 and a WP/MA ratio of 50:50. The methane yield at a ratio WP/MA of 50:50 is higher than for single compound, while for ratios WP/MA of 25:75 and 75:25 the methane yield decreases compared to biomass mono-digestion. This behavior is observed for the three levels of F/I ratio being more noticeable at F/I ratio of 0.3. A synergistic effect was found for the WP/MA ratio of 50:50 and all F/I ratios and for WP/MA=50:50 and F/I=0.2. A maximum increase of methane yield of 49.58% was found for a co-digestion ratio of 50:50 and an F/I ratio of 0.4. It was concluded that methane production from waste paper improves significantly when co-digested with macroalgae biomass. The methane yields from co-digestion were also found higher that from macroalgae mono-digestion.

Keywords: anaerobic co-digestion, biogas, macroalgae, waste paper

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Authors: A. Elsariti, T. Evans

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An understanding of the interaction between acoustic waves and cancellous bone is needed in order to realize the full clinical potential of ultrasonic bone measurements. Scattering is likely to be of central importance but has received little attention to date. Few theoretical approaches have been described to explain scattering of ultrasound from bone. In this study, a scattering model based on velocity and density fluctuations in a binary mixture (marrow fat and cortical matrix) was used to estimate the ultrasonic attenuation in cancellous bone as a function of volume fraction. Predicted attenuation and backscatter coefficient were obtained for a range of porosities and scatterer size. At 600 kHZ and for different scatterer size the effect of velocity and density fluctuations in the predicted attenuation was approximately 60% higher than velocity fluctuations.

Keywords: ultrasound scattering, sound speed, density fluctuations, attenuation coefficient

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