Search results for: first-attempt intubation success rate

Authors: Swati Bhasin, Ali Ahmed, Valence Xavier, Ben Liu

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Aims: Diarrhea is a problem that is a frequent clinic referral to the gastroenterology and surgical team from the General practitioner. To establish a diagnosis, these patients undergo colonoscopy. The current practice at our district general hospital is to perform random left and right colonic biopsies. National guidelines issued by the British Society of Gastroenterology advise all patients presenting with chronic diarrhea should have an Ileoscopy as an indicator for colonoscopy completion. Our primary aim was to check if Terminal ileum (TI) biopsy is required to establish a diagnosis of inflammatory bowel disease (IBD). Methods: Data was collected retrospectively from November 2018 to November 2019. The target population were patients who underwent colonoscopies for diarrhea. Demographic data, endoscopic and histology findings of TI were assessed and analyzed. Results: 140 patients with a mean age of 57 years (19-84) underwent a colonoscopy (M: F; 1:2.3). 92 patients had random colonic biopsies taken and based on the histological results of these, 15 patients (16%) were diagnosed with IBD. The TI was successfully intubated in 40 patients, of which 32 patients had colonic biopsies taken as well. 8 patients did not have a colonic biopsy taken. Macroscopic abnormality in the TI was detected in 5 patients, all of whom were biopsied. Based on histological results of the biopsy, 3 patients (12%) were diagnosed with IBD. These 3 patients (100%) also had colonic biopsies taken simultaneously and showed inflammation. None of the patients had a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were not done). None of the patients has a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were negative). Conclusion: TI intubation is a highly-skilled, time-consuming procedure with a higher risk of perforation, which as per our study, has little additional diagnostic value in finding IBD for symptoms of diarrhea if colonic biopsies are taken. We propose that diarrhea is a colonic symptom; therefore, colonic biopsies are positive for inflammation if the diarrhea is secondary to IBD. We conclude that all of the IBDs can be diagnosed simply with colonic biopsies.

Keywords: biopsy, colon, IBD, terminal ileum

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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Authors: Saadia Khalid

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This paper discusses the various leadership styles of project manager which lead to the success of a project since it is important for a project manager to understand and adopt the skills required to cope up with the modern challenges of any project. A project manager must be able to handle a project effectively and efficiently and be ready to assess the factors effecting success or failure of the project. A project manager must be capable of handling a project by managing, directing and leading the projects with requisite knowledge and skills. In this paper a project manager’s characteristics linkage to project success have been developed and analyzed for three different projects/industries. A web-based survey has also been carried out which revealed that specific leadership styles/traits can lead to better performance and success of organizations. Some basic factors like project complexity, the age, gender and nationality of the project manager and type of project also play a vital role in success of a project.

Keywords: leadership style, project success, project management, project manager

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Authors: Graziele Zwielewski, Suzana R. Tolfo

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The globalization of markets, the need to develop competitive advantages and core competencies, among other things, lead organizations to increasingly cross borders to operate in other countries. The expatriation of professionals who go to work in another country besides their own becomes increasingly common. In order to generate data about this issue, research was conducted concerning the perception of expatriate employees concerning expatriation success. The research method used was case study through a qualitative approach. This research was done through interviews with five India expatriates and five China expatriates, interview with expatriate department heads and analysis of company documents. It was found that there are differences between the organizational perception and perception of expatriates of what constitutes mission success. The paper also provides suggestions for further research and suggestions for future expatriates.

Keywords: expatriation success, international assignments, success factors, success for expatriates

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Authors: Dharamashi Rabari, Anand Patel

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n-Butanol can be regarded as a potential biofuel. Being resistive to corrosion and having high calorific value, butanol is a very attractive energy source as opposed to ethanol. By fermentation process called ABE (acetone, butanol, ethanol), bio-butanol can be produced. ABE carried out mostly by bacteria Clostridium acetobutylicum. The major drawback of the process is the butanol concentration higher than 10 g/L, delays the growth of microbes resulting in a low yield. It indicates the simultaneous separation of butanol from the fermentation broth. Two hydrophobic Ionic Liquids (ILs) 1-butyl-1-methylpiperidinium bis (trifluoromethylsulfonyl)imide [bmPIP][Tf₂N] and 1-hexyl-3-methylimidazolium bis (trifluoromethylsulfonyl)imide [hmim][Tf₂N] were chosen. The binary interaction parameters for both ternary systems i.e. [bmPIP][Tf₂N] + water + n-butanol and [hmim][Tf₂N] + water +n-butanol were taken from the literature that was generated by NRTL model. Particle swarm optimization (PSO) with the isothermal sum rate (ISR) method was used to optimize the cost of liquid-liquid extractor. For [hmim][Tf₂N] + water +n-butanol system, PSO shows 84% success rate with the number of stages equal to eight and solvent flow rate equal to 461 kmol/hr. The number of stages was three with 269.95 kmol/hr solvent flow rate for [bmPIP][Tf₂N] + water + n-butanol system. Moreover, both ILs were very efficient as the loss of ILs in raffinate phase was negligible.

Keywords: particle swarm optimization, isothermal sum rate method, success rate, extraction

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Authors: Novutry Siregar, Afdal, Emilzon Taslim

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Hyaline Membrane Disease (HMD) is the main cause of respiratory failure in preterm neonates caused by surfactant deficiency. Nasal Continuous Positive Airway Pressure (NCPAP) is the therapy for HMD. The success of therapy is determined by gestational age, birth weight, HMD grade, time of NCAP administration, and time of breathing frequency recovery. The aim of this research is to identify the predictive factor of NCPAP therapy success in preterm neonates with HMD. This study used a cross-sectional design by using medical records of patients who were treated in the Perinatology of the Pediatric Department of Dr. M. Djamil Padang Central Hospital from January 2015 to December 2017. The samples were eighty-two neonates that were selected by using the total sampling technique. Data analysis was done by using the Chi-Square Test and the Multiple Logistic Regression Prediction Model. The results showed the success rate of NCPAP therapy reached 53.7%. Birth weight (p = 0.048, OR = 3.34 95% CI 1.01-11.07), HMD grade I (p = 0.018, OR = 4.95 CI 95% 1.31-18.68), HMD grade II (p = 0.044, OR = 5.52 95% CI 1.04-29.15), and time of breathing frequency recovery (p = 0,000, OR = 13.50 95% CI 3.58-50, 83) are the predictive factors of NCPAP therapy success in preterm neonates with HMD. The most significant predictive factor is the time of breathing frequency recovery.

Keywords: predictive factors, the success of therapy, NCPAP, preterm neonates, HMD

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Authors: A. Elbaz, K. Spang

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Infrastructure projects are often subjected to delays and cost overruns and mistakenly described as unsuccessful projects. These projects have many peculiarities such as public attention, impact on the environment, subjected to special regulations, etc. They also deal with several stakeholders with different motivations and face unique risks. With this in mind we need to reconsider our approach to manage them, define their success factors and implement these success factors. Infrastructure projects are not only lacking a unified meaning of project success or a definition of success factors, but also a clear method to implement these factors. This paper investigates this gap and introduces a concept to implement success factors in an efficient way, taking into consideration the specific characteristics of infrastructure projects. This concept consists of six enablers such as project organization, project team, project management workflow, contract management, communication and knowledge transfer and project documentations. These enablers allow other success factors to be efficiently implemented in projects. In conclusion, this paper provides project managers as well as company managers with a tool to define and implement success factors efficiently in their projects, along with upgrading their assets for the coming projects. This tool consists of processes and validated checklists to ensure the best use of company resources and knowledge. Due to the special features of infrastructure projects this tool will be tested in the German infrastructure market. However, it is meant to be adaptable to other markets and industries.

Keywords: infrastructure projects, operative success factors, project success, success factors, transportation projects

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Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo

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Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.

Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation

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Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur

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Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.

Keywords: etomidate, intraocular pressure, thiopentone, traumatic

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Authors: Nipon Sasithornsaowapa

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This research aims to study the impact of personality and family status on women executives’ career success of the primary education department of Thailand. The independent variable includes three factors, namely family status, personality, and knowledge-skill-experience, while the dependent variable is the career success. The population of this study includes 2,179 female management officials in the department of primary education. A total of 400 female managers is interviewed and utilized as a sample group. A questionnaire is developed and used as a research tool for data collection. Content analysis is performed to get the quantitative data. Descriptive statistics in this research is conducted by SPSS program. The findings revealed that personality and family status of samples have an influence on the overall career success of women executives in terms of their objective career success. However, in terms of specific factors of personality or family status, it is found that there is no relevance of each factor on the women executives’ career success. It can be concluded that the factor affecting the women executives’ career success is subjective career success including the happiness and enjoyment with the job not factor concerning materials. Their success is the result of each individual working experience. However, their personal characteristics do not affect their success.

Keywords: career success, women executives, primary education, knowledge-skill-experience

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Authors: Julia Yalalova, Dilawar Khan Durrani

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Subjective and objective career success is one of the vital aims that the employees of any organization want to achieve. However, career success is affected by numerous factors. This study aims to identify few of such key factors that affect career success of individual employees. To achieve this objective, this study aims at empirically analyzing that weather or not self-efficacy of employees impacts their career success. Furthermore, this study also aims to analyze whether or not work effort mediates the relationship between self-efficacy and career success. The study will also test weather emotional intelligence moderate the relationship between self-efficacy and work effort. Furthermore, gender based differences related to all the variables are also the focus of this study. The data will be analyzed using SPSS software and the results, recommendations and future implications will be discussed.

Keywords: career success, emotional intelligence, self-efficacy, work effort

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Authors: Ankush Agrawal, Nadia Bhuiyan

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The new product development (NPD) literature emphasizes the importance of introducing new products on the market for continuing business success. New products are responsible for employment, economic growth, technological progress, and high standards of living. Therefore, the study of NPD and the processes through which they emerge is important. The goal of our research is to propose a framework of critical success factors, metrics, and tools and techniques for implementing metrics for each stage of the new product development (NPD) process. An extensive literature review was undertaken to investigate decades of studies on NPD success and how it can be achieved. These studies were scanned for common factors for firms that enjoyed success of new products on the market. The paper summarizes NPD success factors, suggests metrics that should be used to measure these factors, and proposes tools and techniques to make use of these metrics. This was done for each stage of the NPD process, and brought together in a framework that the authors propose should be followed for complex NPD projects. While many studies have been conducted on critical success factors for NPD, these studies tend to be fragmented and focus on one or a few phases of the NPD process.

Keywords: new product development, performance, critical success factors, framework

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Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Dóris F. Rabelo

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Some patients with COVID-19 disease and difficult airway characteristics undergo to endotracheal intubation (ETI) procedure. The tracheal introducer, known as the bougie guide, can aid ETI in patients with difficult airway pattern. Realistic simulation (RS) is a methodology utilized for healthcare professionals training. To improve skills in using the bougie guide of physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was carried out. Simulated scenario included the Nasco Lifeform realistic simulator for ETI and a bougie guide introducer. Training was a capacitation program organized by the Health Department of Bahia State. Objective: To report effects in participants´ self-confidence perception for using bougie guide after a RS based training. Methods: Descriptive study, secondary data extracted from questionnaires. Priority workplace and previous knowledge about bougie were reported on a preparticipation formulary. Participants also completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding to self-confidence in using bougie guide. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's exact test. Results: From May to June 2020 a total of 36 physicians participated of training, 25 (69%) from primary care setting, 32 (89%) with no previous knowledge about the bougie guide utilization. For those who had previous knowledge about bougie pre-training self-confidence median was 6,5, and 2 for participants who had not. In overall there was an increase in self-confidence median for bougie utilization. Median (variation) before and after training was 2.5 (1-7) vs. 8 (4-10) (p <0.0001). Among those who had no previous knowledge about bougie (n = 32) an increase in self-confidence greater than 3 points for bougie utilization was reported by 31 vs. 1 participants (p = 0.71). Conclusions: Most of participants had no previous knowledge about using the bougie guide. RS training contributed to self-confidence increase for using bougie for ETI procedure. RS methodology can contribute for training in using the bougie guide for ETI procedure during COVID-19 outbreak.

Keywords: bougie, confidence, COVID-19, endotracheal intubation, realistic simulation

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Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh

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Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.

Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture

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Authors: Hummaira Qudsia Yousaf, Sidra Munawar

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The study aims to examine in which way entrepreneurial education and attitude affect the entrepreneur’s success with the help of an entrepreneurial mindset, professional growth, and innovation. The target population was the entrepreneurs of successful startups in Pakistan. Data was gathered through an e-questionnaire, and 230 responses were analyzed using the partial least square structural equation modeling (PLS-SEM). Resultantly, entrepreneurial education is an essential component for the development of an entrepreneurial mindset. Also, an entrepreneurial attitude is responsible for the entrepreneurial mindset, which enhances professional growth. Moreover, the study highlighted that innovation is as necessary as mindset and education are for entrepreneurs. Furthermore, the findings confirmed that professional growth brings innovation to the success of entrepreneurs. This study provides proof of how entrepreneurial education and attitude influence pupils’ success in making entrepreneurs. This study extends the scope of education by incorporating predictors, such as professional growth, innovation, and entrepreneurial success. The study is unique due to the usage of innovative techniques for professional growth that ultimately bring career success.

Keywords: entrepreneurial education, entrepreneurial attitude, entrepreneurial mindset, professional growth, entrepreneurial success, innovation

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Authors: Nurazean Maarop, Noorjan Mohd Mustapha, Rasimah Yusoff, Roslina Ibrahim, Norziha Megat Mohd Zainuddin

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The goal of this study is to identify success factors that could influence the ISMS self-implementation in government sector from qualitative perspective. This study is based on a case study in one of the Malaysian government agency. Semi-structured interviews involving five key informants were conducted to examine factors addressed in the conceptual framework. Subsequently, thematic analysis was executed to describe the influence of each factor on the success implementation of ISMS. The result of this study indicates that management commitment, implementer commitment and implementer competency are part of the success factors for ISMS self-implementation in Malaysian Government Sector.

Keywords: ISMS success factors, IT project management, IS success, information security

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Susan Burkett-McKee, Bruce Knight, Michelle Vanderburg

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The wellbeing and educational success of high ability students are interrelated concepts with each potentially hindering or enhancing the other. A student’s well-being and educational success are also influenced by intrapersonal and interpersonal factors. This presentation begins with an exploration of the literature pertinent to the wellbeing and educational success of this cohort before an ecological perspective is taken to discuss research into the impact of interactions within the school context. While the literature consistently states that interactions exchanged between high ability students and school community members impact the students’ wellbeing or educational success, no consensus has been reached about whether the impact is positive or negative. Findings from the review shared in this presentation inform an interpretative phenomenological study involving senior secondary students enrolled in inclusive Australian schools to highlight, from the students’ perspective, the ways school-based interactions impact their wellbeing or educational success.

Keywords: educational success, interactions, literature review, wellbeing

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Authors: Shuqi Zhang

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Federated learning allows users to participate in collaborative model training without sending data to third-party servers, reducing the risk of user data privacy leakage, and is widely used in smart finance and smart healthcare. However, the distributed architecture design of federation learning itself and the existence of secure aggregation protocols make it inherently vulnerable to backdoor attacks. To solve this problem, the federated learning backdoor defense framework FLEX based on group aggregation, cluster analysis, and neuron pruning is proposed, and inter-compatibility with secure aggregation protocols is achieved. The good performance of FLEX is verified by building a horizontal federated learning framework on the CIFAR-10 dataset for experiments, which achieves 98% success rate of backdoor detection and reduces the success rate of backdoor tasks to 0% ~ 10%.

Keywords: federated learning, secure aggregation, backdoor attack, cluster analysis, neuron pruning

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

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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

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Authors: K. Hinde, R. Bookun, P. Tran

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Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

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Authors: Rianne Voet

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This paper uses a literature review to search for keys of success for entrepreneurial regional media collaborations in the Netherlands and elsewhere. It specifies keys on general aspects: a digital-first strategy, innovation, a particular journalistic mission and a new role for the public. It outlines keys in practicalities: competencies, revenue model, legal structure, communication structure and organization structure. The paper elaborates on a new public function and a new concept of citizenship which, according to several authors in the literature, are required in order to be successful. Finally, it offers a model of keys for success in regional entrepreneurial media collaboration.

Keywords: media collaboration, factors of success, keys of success, regional media cooperation

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Authors: Medya Fathi

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Today, success in the construction industry is not merely about project completion in a timely manner within an established budget and meeting required quality considerations. Management practices and partnerships need to be emphasized as well. In this regard, critical success factors (CSFs) cover necessary considerations for a successful project beyond the traditional success definition, which vary depending on project outcomes, delivery methods, project types, and partnering processes. Despite the extensive research on CSFs, there is a paucity of studies that examine CSFs for public-private partnership (PPP); the delivery method, which has gained increasing attention from researchers and practitioners over the last decade with a slow but growing adoption in the transportation infrastructure, particularly, highway industry. To fill this knowledge gap, data are collected through questionnaire surveys among private and public parties involved in PPP transportation projects in the United States. Then, the collected data are analyzed to explore the causality relationships between CSFs and PPP project success using structural equation model and provide a list of factors with the greatest influence. This study advocates adopting a critical success factor approach to enhance PPP success in the U.S. transportation industry and identify elements essential for public and private organizations to achieve this success.

Keywords: project success, critical success factors, public-private partnership, transportation

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Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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Authors: Sebnem Erismen, Ahmet Guneyli, Azize Ummanel

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The purpose of this study is to explore the relationship between the students' academic success and families' psychological nature. The study based upon the quantitative research, and descriptive model is used. Relational descriptive model is used while evaluating the relation between families’ psychological nature and the academic success level of the students. A total of 523 secondary school students have participated the study. Personal Information Form, Family Structure Evaluation Form (FSEF) and School Reports were employed as the primary methods of data gathering. ANOVA and LSD Scheffe Test were used for analysing the data. Results of the study indicate that there are differences between the FSEF scores according to the students’ and teachers’ gender; however, no differences between the class level and seniority of the teachers were seen. Regarding the academic success of the students, it was seen that majority of them have high points. It was also seen that the academic success level of the students differentiates regarding to the classroom teachers’ gender and seniority. In conclusion, it was seen that there is a relation between the families’ psychological nature and students' academic success.

Keywords: families’ perceived psychological nature, academic success, families effect on the academic success, education

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Authors: Prachi Abhishek Dave, Manisha Singh

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Purpose: The purpose is to study the microbiological profile, prognostic factors, and outcomes of surgery for microbial keratitis (MK) associated endophthalmitis. Methods: It is a retrospective analysis of 39 MK associated endophthalmitis cases which underwent combined PKP with VR surgery. Results: The majority (84.6%) of patients had a history of previous ocular surgery, cataract surgery being the most common (51.2%). Six patients had a history of trauma and 8 patients had corneal graft infection. The culture positivity rate was 92.3%. Organisms isolated were Streptococcal sp (20.5%), Pseudomonas (15.3%), Staphylococcal sp (12.8%) and Fungus (35.8%). Final visual acuities ranged from NPL to 20/120. Poor anatomic success was seen in 15(38.46%) eyes (9-phthisis, 6-eviscerated). Fungal cases had a poor success rate (P-0.02). Conclusion: MK associated endophthalmitis is a sight threatening ocular condition. Fungal etiology carries a poorer prognosis. Timely surgical intervention can achieve favourable anatomical and functional results.

Keywords: endophthalmitis, microbial keratitis, penetrating keratoplasty, vitreo retinal surgery

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Authors: Abdolreza Noroozi Chakoli

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This study aims to examine the impact of five effective factors on the success of the managers of distance knowledge sharing centers in Iran. To conduct it, 3 centers, including the National Library and Archives of Iran (NLAI), Scientific Information Database Center (SID), and Islamic World Science Citation Center (ISC), were selected to study the effect of five factors 'infrastructure of information technology', 'experienced staff', 'specialized staff', 'employee public relations' and 'the geographical location of the establishment' on the success of the centers. ANOVA test, Scheffe test, and Pearson's correlation test were used to analyze the data. The findings confirmed the effect of all 5 factors on the success of these centers. However, their effects are not the same on each factor. The results show each of these factors is not only individually but also together affect the success of centers for distance knowledge sharing. Moreover, it was demonstrated that there is a correlation between these factors. The results of this study show what factors determine the success of the centers and their efficiency in distance knowledge sharing in Iran.

Keywords: distance knowledge sharing centers, Iran’s knowledge centers, knowledge sharing centers, staff success

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Authors: Annette Joseph

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Background: The construction industry is dynamic in nature owing to the increasing uncertainties in technology, budgets, and development processes making projects more complex. Thus, predicting project performance and chances of its likely success has become difficult. The goal of all parties involved in construction projects is to successfully complete it on schedule, within planned budget and with the highest quality and in the safest manner. However, the concept of project success has remained ambiguously defined in the mind of the construction professionals. Purpose: This paper aims to study the analysis of a project in terms of its performance and measure the success. Methodology: The parameters for evaluating project success and the indices to measure success/performance of a project are identified through literature study. Through questionnaire surveys aimed at the stakeholders in the projects, data is collected from two live case studies (an ongoing and completed project) on the overall performance in terms of its success/failure. Finally, with the help of SPSS tool, the data collected from the surveys are analyzed and applied on the selected performance indices. Findings: The score calculated by using the indices and models helps in assessing the overall performance of the project and interpreting it to find out whether the project will be a success or failure. This study acts as a reference for firms to carry out performance evaluation and success measurement on a regular basis helping projects to identify the areas which are performing well and those that require improvement. Originality & Value: The study signifies that by measuring project performance; a project’s deviation towards success/failure can be assessed thus helping in suggesting early remedial measures to bring it on track ensuring that a project will be completed successfully.

Keywords: project, performance, indices, success

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Authors: Solomon Sisay, Belete Mengistu, Woldargay Erku, Desalegne Woldeyohannes

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Background: Tuberculosis is still the leading cause of illness in the world which accounted for 2.5% of the global burden of disease, and 25% of all avoidable deaths in developing countries. Objectives: The aim of study was to assess impact of DOTS strategy on tuberculosis case finding and treatment outcome in Gambella Regional State, Ethiopia from 2003 up to 2012 and from 2002 up to 2011, respectively. Methods: Health facility-based retrospective study was conducted. Data were collected and reported in quarterly basis using WHO reporting format for TB case finding and treatment outcome from all DOTS implementing health facilities in all zones of the region to Federal Ministry of Health. Results: A total of 10024 all form of TB cases had been registered between the periods from 2003 up to 2012. Of them, 4100 (40.9%) were smear-positive pulmonary TB, 3164 (31.6%) were smear-negative pulmonary TB and 2760 (27.5%) had extra-pulmonary TB. Case detection rate of smear-positive pulmonary TB had increased from 31.7% to 46.5% from the total TB cases and treatment success rate increased from 13% to 92% with average mean value of being 40.9% (SD= 0.1) and 55.7% (SD=0.28), respectively for the specified year periods. Moreover, the average values of treatment defaulter and treatment failure rates were 4.2% and 0.3%, respectively. Conclusion: It is possible to achieve the recommended WHO target which is 70% of CDR for smear-positive pulmonary TB, and 85% of TSR as it was already been fulfilled the targets for treatments more than 85% from 2009 up to 2011 in the region. However, it requires strong efforts to enhance case detection rate of 40.9% for smear-positive pulmonary TB through implementing alternative case finding strategies.

Keywords: Gambella Region, case detection rate, directly observed treatment short-course, treatment success rate, tuberculosis

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Authors: B. N. Asare, O. A. Ajigini

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Information systems (IS) are highly important in the operation of private and public organisations in developing and developed countries. Developing countries are saddled with many project failures during the implementation of information systems. However, successful information systems are greatly needed in developing countries in order to enhance their economies. This paper is highly important in view of the high failure rate of information systems in developing countries which needs to be reduced to minimum acceptable levels by means of recommended interventions. This paper centres on a review of IS development in developing countries. The paper presents evidences of the IS successes and failures in developing countries and posits a model to address the IS failures. The proposed model can then be utilised by developing countries to reduce their IS project implementation failure rate. A comparison is drawn between IS development in developing countries and developed countries. The paper provides valuable information to assist in reducing IS failure, and developing IS models and theories on IS development for developing countries.

Keywords: developing countries, information systems, IS development, information systems failure, information systems success, information systems success model

Procedia PDF Downloads 337