Search results for: indication

Authors: Katherine Russell

Abstract:

Background: Over recent decades the number of caesarean sections performed in the UK has continued to rise. The cause of the rising caesarean rate (CSR) is not well understood. However, one of the most heavily cited reasons is an increase in maternal request for caesarean section. Maternal request for caesarean section (CDMR) refers to a caesarean section performed on maternal request with no medical indication. The true rate of caesarean delivery on maternal request in the UK and its contribution to the caesarean section rate is not known. Methods: To elucidate current understanding of the cause of the rising caesarean section rate and the role of CDMR we conducted a systematic review of the literature. To determine the role of CDMR in the CSR at the PRH we conducted a retrospective observational study of the caesarean section rates and CDMR from 2009-2015. Results: We demonstrated a negative correlation between rates of elective sections and CDMR over the study period (-0.123). On average, there were more elective sections performed after 2011 (15.10% of all deliveries) than before 2011 (12.41% of all deliveries); this difference was statistically significant (p = < 0.001). There were more cases of CDMR after 2011 (1.39% of all deliveries) than before 2011 (0.85% of all deliveries). The difference in average rates of CDMR before and after 2011 was statistically significant (p ≤ 0.001). Conclusions: CDMR is only a minor contributor to the CSR at the PRH. However, it remains an important factor because it represents a target for the reduction of the CSR that is more manageable than other, more complex and ubiquitous causes of the rising CSR.

Keywords: cesarean section, maternal request for cesarean section, obstetrics, pre-natal health

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Authors: Shu-Chuan Liao, Chia-Ti Chang, Ko-Shao Chen

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Titanium and its alloy are widely used in many fields such as dentistry or orthopaedics. Due to their high strength low elastic modulus that chemical inertness and bio inert. The micro-arc oxidation used to formation a micro porous ceramic oxide layer film on Titanium surface and also to improve the resistance corrosion. For improving the biocompatibility, micro-arc oxidation surfaces bio-inert need to introduce reactive group. We introduced boundary layer by used plasma enhanced chemical vapor deposition of hexamethyldisilazane (HMDS) and organic active layer by UV light graft reactive monomer acrylic acid (AAc) therefore we can immobilize Chondroitin sulphate on surface easily by crosslinking EDC/NHS. The surface properties and composition of the modified layer were measured by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD) and water contact angle. Water contact angle of the plasma-treated Ti surface decreases from 60° to 38°, which is an indication of hydrophilicity. The results of electrochemical polarization analysis showed that the sample plasma treated at micro-arc oxidation after plasma treatment has the best corrosion resistance. The result showed that we can immobilize chondroitin sulfate successful by a series of modification and MTT assay indicated the biocompatibility has been improved in this study.

Keywords: MAO, plasma, graft polymerization, biomedical application

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Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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Authors: Md Abdullah Al Faruque, Ram Balachandar

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Sudden change of bed condition is frequent in open channel flow. Change of bed condition affects the turbulence characteristics in both streamwise and wall-normal direction. Understanding the turbulence intensity in open channel flow is of vital importance to the modeling of sediment transport and resuspension, bed formation, entrainment, and the exchange of energy and momentum. A comprehensive study was carried out to understand the extent of the effect of Reynolds number and bed roughness on different turbulence characteristics in an open channel flow. Four different bed conditions (impervious smooth bed, impervious continuous rough bed, pervious rough sand bed, and impervious distributed roughness) and two different Reynolds numbers were adopted for this cause. The effect of bed roughness on different turbulence characteristics is seen to be prevalent for most of the flow depth. Effect of Reynolds number on different turbulence characteristics is also evident for flow over different bed, but the extent varies on bed condition. Although the same sand grain is used to create the different rough bed conditions, the difference in turbulence characteristics is an indication that specific geometry of the roughness has an influence on turbulence characteristics. Roughness increases the contribution of the extreme turbulent events which produces very large instantaneous Reynolds shear stress and can potentially influence the sediment transport, resuspension of pollutant from bed and alter the nutrient composition, which eventually affect the sustainability of benthic organisms.

Keywords: open channel flow, Reynolds Number, roughness, turbulence

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Authors: Wildan Syafitri

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The main purpose of the development is to embody public welfare. Its indication is shown by the increasing of the public prosperity in which it will be related to the consumption level as a consequence of the increasing of public income. One of the government’s efforts to increase public welfare is to create development equity in order to alleviate poor people. Poverty’s problem is not merely about the number and percentage of the poor people, but also it includes the gap and severity of poverty.the analysis method used is Benefit Incidence Analysis (BIA) that is an analysis method used to disclose the impact of government policy or individual access based on the income distribution in society. Further, the finding of the study revealed is that the highest number of the poor people in the village is those who are unemployed and have family members who are still in the Junior High School. The income distribution calculation shows a fairly good budget allocation applied with good mass ratio that is 0.31. In addition, the finding of this study also discloses that Indonesian Government policy to subsidize education cost for Elementary and Junior High School students has reached the right target. It is indicated by more benefits received by Elementary and Junior High School students who are poor and very poor than other income group.

Keywords: benefit incidence analysis, budget allocation, poverty, education

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Authors: Deok Hyun Han

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Objective: To explore outcomes of UventaTM metallic ureteral stent between malignant and benign ureteral obstruction. Methods: We reviewed the medical records of 90 consecutive patients who underwent Uventa stent placement for benign or malignant ureteral obstruction from December 2009 to June 2013. We evaluated the clinical outcomes, complications, and reasons and results for unexpected stent removals. Results: The median follow-up was 10.7 (0.9 – 41) months. From a total of 125 ureter units, there were 24 units with benign obstructions and 101 units with malignant obstructions. Initial technical successes were achieved in all patients. The overall success rate was 70.8% with benign obstructions and 84.2% with malignant obstructions. The major reasons for treatment failure were stent migration (12.5%) in benign and tumor progression (11.9%) in malignant obstructions. The overall complication rate was similar between benign and malignant obstructions (58.3% and 42.6%), but severe complications, which are Clavien grade 3 or more, occurred in 41.7% of benign and 6.9% of malignant obstructions. The most common complications were stent migration (25.0%) in benign obstructions and persistent pain (14.9%) in malignant obstructions. The stent removal was done in 16 units; nine units that were removed by endoscopy and seven units were by open surgery. Conclusions: In malignant ureteral obstructions, the Uventa stent showed favorable outcomes with high success rate and acceptable complication rate. However, in benign ureteral obstructions, overall success rate and complication rate were less favorable. Malignant ureteral obstruction seems to be appropriate indication of Uventa stent placement. However, in chronic diffuse benign ureteral obstructions the decision of placement of Uventa stent has to be careful.

Keywords: cause, complication, ureteral obstruction, metal stent

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Authors: Jake Tempo, Stephen Brough

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Introduction and Objectives: Urine cytology has a role in the diagnosis of urothelial cancer when used alongside cystoscopy and imaging, according to the European Association of Urology guidelines. It also has a role in the surveillance post-treatment of urothelial carcinoma. Collecting and analysing urine cytology is costly and time-consuming. We investigated the use of urine cytology in an Australian regional hospital to determine whether clinicians are following international guidelines. Materials and Methods: We analysed all urine cytology requests performed in an Australian regional hospital between 1st January 2017 and 31st December 2018. We reviewed the indication for urine cytology and the patients’ case notes to determine whether urine cytology changed management. Results: During the two-year study period, 153 patients had urine cytology analysed for a variety of indications. In no cases did cytology change the outcome of patient management significantly. In total, 69 of 153 (41%) urine cytology requests were not supported by urological society guidelines. Fifty requests were for haematuria, and twenty requests were for urothelial cancer surveillance. Seven were analysed for follow-up from previous urological investigations. Nine samples were sent for ureteric obstruction of unknown origin. Conclusion: Urine cytology, even when positive, did not significantly change management for the investigation of potential urothelial cancer, and therefore, its use as a diagnostic tool for this purpose should be reconsidered. Many cytology tests are expensive, unnecessary, and not supported by urological society guidelines.

Keywords: cytology, bladder cancer, urine, urothelial carcinoma

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Authors: Fahad Raj Khan, Suleman Khan

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There is a lack of consensus about the predictive value of raised blood glucose levels in terms of major adverse cardiac events (MACEs) in non-diabetic patients admitted for acute decompensated heart failure. The purpose of this research was to examine the long-term prognosis of acute decompensated heart failure (ADHF) in non-diabetic persons who had increased blood glucose levels, i.e., stress hyperglycemia, at the time of their ADHF hospitalization. The research involved 650 non-diabetic patients. Based on their admission stress hyperglycemia, they were divided into two groups.ie with and without (SHGL). The two groups' one-year outcomes for major adverse cardiac events (MACEs) were compared, and key predictors of MACEs were discovered. For statistical analysis, the two-tailed Mann-Whitney U test, Fisher's exact test, and binary logistic regression analysis were utilized. SHGL was found in 353 (54.3%) individuals. It was more frequent in men than in women. About 27% of patients with SHGL had previously been admitted for ADHF. Almost 62% were hypertensive, whereas 14 % had CKD. MACEs were significantly predicted by SHGL, HTN, prior hospitalization for ADHF, CKD, and cardiogenic shock upon admission. SHGL at the time of ADHF admission, independent of DM status, may be a predictive indication of MACEs.

Keywords: stress hyperglycemia, acute heart failure, major adverse cardiac events, MACEs

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Authors: Adel A. Ghobbar, Ahmad Bakkar

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Although special care is given to maintenance, aircraft systems fail, and these failures cause delays and cancellations. The occurrence of Delays and Cancellations affects operators and manufacturers negatively. To reduce technical delays and cancellations, one should be able to determine the important systems causing them. The goal of this research is to find a method to define the most expensive delays and cancellations systems for Airline operators. A predictive model was introduced to forecast the failure and their impact after carrying out research that identifies relevant information to tackle the problems faced while answering the questions of this paper. Data were obtained from the manufacturers’ services reliability team database. Subsequently, delays and cancellations evaluation methods were identified. No cost estimation methods were used due to their complexity. The model was developed, and it takes into account the frequency of delays and cancellations and uses weighting factors to give an indication of the severity of their duration. The weighting factors are based on customer experience. The data Analysis approach has shown that delays and cancellations events are not seasonal and do not follow any specific trends. The use of weighting factor does have an influence on the shortlist over short periods (Monthly) but not the analyzed period of three years. Landing gear and the navigation system are among the top 3 factors causing delays and cancellations for all three aircraft types. The results did confirm that the cooperation between certain operators and manufacture reduce the impact of delays and cancellations.

Keywords: reliability, availability, delays & cancellations, aircraft maintenance

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Authors: Sarah Hamdan Al-Jahdali, Khaled Alsaad, Abdullah Al-Sayyari

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Objectives: To study the prevalence, clinicopathological features, risk factors and outcome of biopsy proven polyoma (BK) virus infection among Saudi kidney transplant recipients and compare them to negative BK virus group. Methods: We retrospectively reviewed the charts of all the patients with biopsy-proven polyoma (BK) virus infection in King Abdulaziz Medical City in Riyadh between 2005 and 2011. The details of clinical presentation, the indication for kidney biopsy, the laboratory findings at presentation, the natural history of the disease, thepathological findings, the prognosis as well as the response to therapy were all recorded. Results: Kidney biopsy was performed in 37 cases of unexplained graft dysfunction. BK virus was found in 10 (27%). Out of those 10, 3 (30%) ended with graft failure. BK virus occurred in all patients who received ATG induction therapy 100% versus 59.3% in the non BK virus patients (p=0.06). Furthermore, the risk of BK virus was much less in those who received acyclovir as an anti-viral prophylaxis as compared to those who did not receive it (p=0.01). Also, patients with BK virus weighed much less (mean 46.7±20.6 Kgs) than those without BK virus at time of transplantation (mean 64.3±12.1). Graft survival was better among deceased donor kidneys compared to living ones (P=0.016) and with older age (P=0.005). Conclusion: Our findings suggest the involvement of ATG induction therapy, the lack of antiviral prophylaxis therapy and lower weight at transplant as significant risk factors for the development of BK virus infection.

Keywords: BKVAN, BKV, kidney transpant, Saudi Arabia

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Authors: Okupe Temitope Oluwaseun

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Purpose: The paper determines the existing position of attitudes to disability in a Nigerian organisation. It further assessed the progress that has been made in relation to employment matters as an indication of the Nigerian employment market. Design/methodology/approach: The paper discusses an investigative study which adopted survey research-based approach involving a Nigerian Management Agency. Findings: The paper finds that, although there have been some steps forward, not much has been done with regard to disability equality in the Nigerian employment market. Lack of education, lack of implementing and enforcing the law, inadequate awareness process and international culture have contributed to the current situation. International culture, in particular, is one of the major attributes to lack of disability equality. For example, in the rural areas, the majority of people believe that disability is a form of witchcraft. This paper argues that these traditions, attitudes, and beliefs make it difficult for an organisation to recruit people with disability. Practical Implications: This paper provides a deeper understanding of how organisations can address attitudes to disability within the workplace in Nigeria. The research findings give a fresher perspective on some of the issues associated with disability in this country. This increased understanding has potential to improve the education and training of staff in this area. Originality/value: A paper which human resources managers in Nigerian organisation and the rest of the world can reflect upon in order to assess their own organisation attitudes to the employment of staff with a disability.

Keywords: disability, international culture, Nigeria, attitudes

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Authors: Ifeyinwa Ijeoma Obianyo, Luqman Adedeji Taiwo, Olugbenga O. Amu, Azikiwe Peter Onwualu

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Improving the durability of building materials saves maintenance costs, construction time, and energy. In this study, titanium dioxide coated conventional and non-conventional composites were produced, and the effects of titanium dioxide coatings were investigated. Conventional composites were produced using river sand and Portland cement, whereas non-conventional composites were produced by partially replacing river sand and Portland cement with quarry dust and rice husk ash. Water absorption and thickness swelling tests were conducted on the produced coated and non-coated block samples. A reduction in water absorption was observed in the coated composite samples when compared to the non-coated composite samples, and this is an indication of the improved durability of the samples coated with titanium dioxide. However, there was an increase in the thickness swelling of coatings on the coated block samples, but this increase has a slight influence on the compressive strength of the coated samples. The outcome of this study indicates that coating composite building blocks with titanium dioxide will improve theirdurability. Also, the site exposure experiments revealed the self-cleansing properties of TiO2-coated composite block samples, while the Rhodamine B discolouration test confirmed the photocatalytic features of TiO2-coated composite block samples.

Keywords: titanium dioxide, water absorption, durability, mechanical properties, building composite

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Authors: Yina Donald Orga

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Osun Osogbo festival is one of the biggest art festivals in Nigeria with over 235, 518 tourist visits in 2014. The purpose of this study is to generate data on the tourists’ perception of Osun Osogbo Festival in Osogbo, Osun State Nigeria. Based on the population of 199, 860 tourist visits at Osun Osogbo festival in 2013, Krejcie and Morgan sample size table was used to select 768 tourists/respondents. Likert questionnaire were used to elicit data from the respondents. Descriptive statistic was used to describe the characteristics of respondents and analyse the tourists’ perception of the festival. The findings from data analysed suggest that the trend of domestic and international tourist visits in the past ten years for the festival had shown a consistent increase since 2004 except in 2007 and 2008 and continue to increase up to 2013. This is an indication that the tourists are satisfied with traditional, historical and authenticity features of the festival. Also, findings from the study revealed that the tourists are not satisfied with the number of toilets at Osun Sacred Grove, crowd control of visitors during the festival, medical personnel to cater for visitors during the festival, etc. In view of the findings of the study, the following recommendations are suggested; provision of more toilets at Osun Sacred grove, Osogbo Heritage Council to recruit festival guides to help control the huge crowd at the festival, the Government of State of Osun in conjunction with Red Cross Society should engage adequate medical personnel to cater for medical needs of visitors at the festival, etc.

Keywords: festival, perception, positive, tourists

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Authors: Ahmed Usman

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This paper attempts to examine the relevance of an Electoral Commission in the democratic process of governance in Nigeria. However, democratic system and governance present a clear indication of responsive and responsible governments. The idea of a government being responsive and responsible is based on the premise of conventional principles of democracy such as freedom of political, economic and social rights of and individual. More so, upholding of the Rule of Law based on the ground of constitutionalism is a clear manifestation of the democratic governance. The burdens of ascertaining theses democratic ethos rely solely on the constituted election management body known as Independent National Electoral Commission (INEC) for the case of Nigeria. This body is however, saddled with the responsibility of organizing and conducting periodic regular credible election known as free and fair election. The body also, is expected to be neutral, and independent to ensure fair treatment to all. It is on the basis of this fair treatment that credible leaders emerged. To this end, the paper examines the powers, functions and features of Independent National Electoral Commission. More so, the concepts of election and democracy have been operationalized. It is obvious that electoral process in Nigeria is marred with series of problems of which the paper identified and solutions were proffered towards credible, free and fair elections for sustainable democratic governance. In order to succinctly discuss and analyze the issues at stake, Structural Functional Analysis theory is adopted as a theoretical frame work for the paper.

Keywords: election, electoral commission, democracy, governance

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Authors: Chandra Mukherjee

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The prevalent knowledge of the biological systems is based on the standard scientific perception of natural equilibrium, determination and predictability. Recently, a rethinking of concepts was presented and a new scientific perspective emerged that involves complexity theory with deterministic chaos theory, nonlinear dynamics and theory of fractals. The unpredictability of the chaotic processes probably would change our understanding of diseases and their management. The mathematical definition of chaos is defined by deterministic behavior with irregular patterns that obey mathematical equations which are critically dependent on initial conditions. The chaos theory is the branch of sciences with an interest in nonlinear dynamics, fractals, bifurcations, periodic oscillations and complexity. Recently, the biomedical interest for this scientific field made these mathematical concepts available to medical researchers and practitioners. Any biological network system is considered to have a nominal state, which is recognized as a homeostatic state. In reality, the different physiological systems are not under normal conditions in a stable state of homeostatic balance, but they are in a dynamically stable state with a chaotic behavior and complexity. Biological systems like heart rhythm and brain electrical activity are dynamical systems that can be classified as chaotic systems with sensitive dependence on initial conditions. In biological systems, the state of a disease is characterized by a loss of the complexity and chaotic behavior, and by the presence of pathological periodicity and regulatory behavior. The failure or the collapse of nonlinear dynamics is an indication of disease rather than a characteristic of health.

Keywords: HRV, HRVI, LF, HF, DII

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Authors: Marcin Szlachetka, Konrad Pietrykowski

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Modeling of a combustion process in a 9-cylinder aircraft engine is presented. The simulations of the combustion process in the IC engine have provided the information on the spatial and time distributions of selected quantities within the combustion chamber of the engine. The numerical analysis results have been compared with the results of indication process of the engine on the test stand. Modeling of combustion process an auto-ignited IC engine in the AVL Fire was carried out within the study. For the calculations, a ECFM-3Z model was used. Verification of simulation results was carried out by comparison of the pressure in the cylinder. The courses of indicated pressure, obtained from the simulations and during the engine tests mounted on a test stand were compared. The engine was braked by the propeller, which results in an adequate external power characteristics. The test object is a modified ASz-62IR engine with the injection system. The engine was running at take-off power. To check the optimum ignition timing regarding power, calculations, tests were performed for 7 different moments of ignition. The analyses of temperature distribution in the cylinder depending on the moments of ignition were carried out. Additional the course of pressure in the cylinder at different angles of ignition delays of the second spark plug were examined. The swirling of the mixture in the combustion chamber was also analysed. It has been shown that the largest vortexes occur in the middle of the chamber, and gets smaller, closer to the combustion chamber walls. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: CFD, combustion, internal combustion engine, aircraft engine

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: Sarakorn Sukaviriya

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This paper describes the inspection procedure, root cause analysis, the rectification of crack, and how to apply the procedure with other similar plants. During the operation of the steam turbine (620MW), instruments such as speed sensor of steam turbine, the servo valve of main stop valve and electrical wires were malfunction caused by leakage steam from main steam governing valve. Therefore, the power plant decided to shutdown steam turbines for figuring out the cause of leakage steam. Inspection techniques to be applied in this problem were microstructure testing (SEM), pipe stress analysis (FEM) and non-destructive testing. The crack was initially found on main governing valve’s weldment by visual inspection. To analyze more precisely, pipe stress analysis and microstructure testing were applied and results indicated that the crack was intergranular and originated from the weld defect. This weld defect caused the notch with high-stress concentration which created crack and then propagated to steam leakage. The major root cause of this problem was an inappropriate welding process, which created a weld defect. To repair this joint from damage, we used a welding technique by producing refinement of coarse grain HAZ and eliminating stress concentration. After the weldment was completely repaired, other adjacent weldments still had risk. Hence, to prevent any future cracks, non-destructive testing (NDT) shall be applied to all joints in order to ensure that there will be no indication of crack.

Keywords: steam-pipe leakage, steam leakage, weld crack analysis, weld defect

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Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

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Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

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Authors: Abu Zafor Sadek

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Pharmaceuticals were one of the least impacted business sectors during the corona pandemic as they are the center point of Covid-19 fight. Emergency use authorization, unproven indication of some commonly used drugs, self-medication, research and production capacity of an individual country, capacity of producing vaccine by many countries, Active Pharmaceutical Ingredients (APIs) related uncertainty, information gap among manufacturer, practitioners and user, export restriction, duration of lock-down, lack of harmony in transportation, disruption in the regulatory approval process, sudden increased demand of hospital items and protective equipment, panic buying, difficulties in in-person product promotion, e-prescription, geo-politics and associated issues added a new dimension to this industry. Although the industry maintains a reasonable growth throughout Covid-19 days; however, it has been characterized by both long- and short-term effects. Short-term effects have already been visible to so many countries, especially those who are import-dependent and have limited research capacity. On the other hand, it will take a few more time to see the long-term effects. Nevertheless, supply chain disruption, changes in strategic planning, new communication model, squeezing of job opportunity, rapid digitalization are the major short-term effects, whereas long-term effects include a shift towards self-sufficiency, growth pattern changes of certain products, special attention towards clinical studies, automation in operations, the increased arena of ethical issues etc. Therefore, this qualitative and exploratory study identifies the post-covid-19 landscape of the global pharmaceutical industry.

Keywords: covid-19, pharmaceutical, businees, landscape

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Authors: Balimu Mwiya, Mundia Muya, Chabota Kaliba, Peter Mukalula

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Factors affecting construction unit cost vary depending on a country’s political, economic, social and technological inclinations. Factors affecting construction costs have been studied from various perspectives. Analysis of cost factors requires an appreciation of a country’s practices. Identified cost factors provide an indication of a country’s construction economic strata. The purpose of this paper is to identify the essential factors that affect unit cost estimation and their breakdown using artificial neural networks. Twenty-five (25) identified cost factors in road construction were subjected to a questionnaire survey and employing SPSS factor analysis the factors were reduced to eight. The 8 factors were analysed using the neural network (NN) to determine the proportionate breakdown of the cost factors in a given construction unit rate. NN predicted that political environment accounted 44% of the unit rate followed by contractor capacity at 22% and financial delays, project feasibility, overhead and profit each at 11%. Project location, material availability and corruption perception index had minimal impact on the unit cost from the training data provided. Quantified cost factors can be incorporated in unit cost estimation models (UCEM) to produce more accurate estimates. This can create improvements in the cost estimation of infrastructure projects and establish a benchmark standard to assist the process of alignment of work practises and training of new staff, permitting the on-going development of best practises in cost estimation to become more effective.

Keywords: construction cost factors, neural networks, roadworks, Zambian construction industry

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Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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Authors: Naqeeb Ahmad Jan, Rukhsana Bibi

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Extremism is once again pushing the globe towards ignorance and darkness. In the present day, the wave of extremist element (tendencies) has affected the people across the globe which led them to believe in manifestation of various ideologies. Likely, the Pakistan’s North-Western province (Khyber Pakhtunkhwa) served as a main prey. However, it also served as an equal partner to halt to and control the extremist activities. This current extremist element has also affected the poets herein, and thus they (poets) used their pen as a sword and depicted this havoc, the nature of extremism they witnessed, and also asked for and supported a positive and durable solution to this menace of extremism and terrorism. Their poetic works portrayed and exhibited various examples of the extremism and its possible solution to ensure peace and harmony. The researcher has taken the liberty to argue that a balanced behaviour and attitude play a key role in the fulfillment of desired actions. The imposition of any set of belief, value and attitude leads to the multiplication of extremism and it is so poisonous that it causes to the destruction of whole human society. This study has found that the present day extremism has led to the emergence of new words, similes, metaphor and other figures of speech to be a part of the language and literature to be survived. These words have been analyzed and discussed in a new getup and meanings; the similes and metaphors describing extremism used by poets and writers of this era. The methodology is based on quantitative, analytical and comparative research. Moreover, this research has discussed indication of new words and figures of speech used by the poets and which are in practice, and impacts of extremism on the modern Urdu poetry of Khyber Pakhtunkhwa.

Keywords: extremism, modern Urdu poetry, subcontinent, terrorism

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Authors: Ghoul Rachid Brahim

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Introduction: Back pain is a real public health problem with a significant socio-economic impact. It is the consequence of a degeneration of the lumbar intervertebral disc (IVD). This often asymptomatic pathology is compatible with an active life. As soon as it becomes symptomatic, conservative treatment is recommended in the majority of cases. The physical or functional disability is resistant to well-monitored conservative treatment, which justifies a surgical alternative which imposes a well-studied reflection on the objectives to be achieved. Objective: Evaluate the indication and short and medium term contribution of surgery in the management of painful degenerative lumbar disc disease. To prove the effectiveness of surgical treatment in the management of painful lumbar degenerative disc disease. Materials and methods: This is a prospective descriptive mono-centric study without comparison group, comprising a series of 104 patients suffering from lumbar painful degenerative disc disease treated surgically. Retrospective analysis of data collected prospectively. Comparison between pre and postoperative clinical status, by pain self-assessment scores and on the impact on pre and postoperative quality of life (3, 6 to 12 months). Results: This study showed that patients who received surgical treatment had great improvements in symptoms, function and several health-related quality of life in the first year after surgery. Conclusions: The surgery had a significantly positive impact on patients' pain, disability and quality of life. Overall, 97% of the patients were satisfied.

Keywords: degenerative disc disease, intervertebral disc, several health-related quality, lumbar painful

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Authors: Bongs Lainjo

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The evolution and escalation of bike-sharing programs (BSP) continue unabated. Since the sixties, many countries have introduced different models and strategies of BSP. These include variations ranging from dockless models to electronic real-time monitoring systems. Reasons for using this BSP include recreation, errands, work, etc. And there is all indication that complex, and more innovative rider-friendly systems are yet to be introduced. The objective of this paper is to analyze current variables established by different operators and streamline them identifying the most compelling ones using analytics. Given the contents of available databases, there is a lack of uniformity and common standard on what is required and what is not. Two factors appear to be common: user type (registered and unregistered, and duration of each trip). This article uses historical data provided by one operator based in the greater Washington, District of Columbia, USA area. Several variables including categorical and continuous data types were screened. Eight out of 18 were considered acceptable and significantly contribute to determining a useful and reliable predictive model. Bike-sharing systems have become popular in recent years all around the world. Although this trend has resulted in many studies on public cycling systems, there have been few previous studies on the factors influencing public bicycle travel behavior. A bike-sharing system is a computer-controlled system in which individuals can borrow bikes for a fee or free for a limited period. This study has identified unprecedented useful, and pragmatic parameters required in improving BSP ridership dynamics.

Keywords: sharing program, historical data, parameters, ridership dynamics, trip duration

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Authors: E. Soboleva, E. Sergachyova, S. G. Davydenko, T. V. Meledina

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Problem of food preservation is extremely important for mankind. Viscous damage ("illness") of bread results from development of Bacillus spp. bacteria. High temperature resistant spores of this microorganism are steady against 120°C) and remain in bread during pastries, potentially causing spoilage of the final product. Scientists are interested in further characterization of bread spoiling Bacillus spp. species. Our aim was to find weather yeast Saccharomyces cerevisiae strains that are able to produce natural antimicrobial killer factor can preserve bread illness. By diffusion method, we showed yeast antagonistic activity against spore-forming bacteria. Experimental technological parameters were the same as for bakers' yeasts production on the industrial scale. Risograph test during dough fermentation demonstrated gas production. The major finding of the study was a clear indication of the presence of killer yeast strain antagonistic activity against rope in bread causing bacteria. After demonstrating antagonistic effect of S. cerevisiae on bacteria using solid nutrient medium, we tested baked bread under provocative conditions. We also measured formation of carbon dioxide in the dough, dough-making duration and quality of the final products, when using different strains of S. cerevisiae. It is determined that the use of yeast S. cerevisiae RCAM 01730 killer strain inhibits appearance of rope in bread. Thus, natural yeast antimicrobial killer toxin, produced by some S. cerevisiae strains is an anti-rope in bread protector.

Keywords: bakers' yeasts, killer toxin, rope in bread, Saccharomyces cerevisiæ

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Authors: Jefri Draup, Antoine Ambard, Chi-Toan Nguyen

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Zirconium alloys exhibit solid-state phase transformations under thermal loading. These can lead to a significant evolution of the microstructure and associated mechanical properties of materials used in nuclear fuel cladding structures. Therefore, the ability to capture effects of phase transformation on the material constitutive behavior is of interest during conditions of severe transient thermal loading. Whilst typical Avrami, or Johnson-Mehl-Avrami-Kolmogorov (JMAK), type models for phase transformations have been shown to have a good correlation with the behavior of Zircaloy-4 under constant heating rates, the effects of variable and fast heating rates are not fully explored. The present study utilises the results of in-situ high energy synchrotron X-ray diffraction (SXRD) measurements in order to validate the phase transformation models for Zircaloy-4 under fast variable heating rates. These models are used to assess the performance of fuel cladding structures under loss of coolant accident (LOCA) scenarios. The results indicate that simple Avrami type models can provide a reasonable indication of the phase distribution in experimental test specimens under variable fast thermal loading. However, the accuracy of these models deteriorates under the faster heating regimes, i.e., 100Cs⁻¹. The studies highlight areas for improvement of simple Avrami type models, such as the inclusion of temperature rate dependence of the JMAK n-exponent.

Keywords: accident, fuel, modelling, zirconium

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Authors: Majid Samiee Zenoozian

Abstract:

The Persian Gulf is a bordering sea with an normal depth of 35 m and a supreme depth of 100 m near its narrow appearance. Its lengthen bathymetric axis divorces two main geological shires — the steady Arabian Foreland and the unbalanced Iranian Fold Belt — which are imitated in the conflicting shore and bathymetric morphologies of Arabia and Iran. The sediments were experimented with from 72 offshore positions through an oceanographic cruise in the winter of 2018. Throughout the observation era, several storms and river discharge actions happened, as well as the major flood on record since 1982. Suspended-sediment focus at all three sites varied in reaction to both wave resuspension and advection of river-derived sediments. We used hydrological models to evaluation and associate the wave height and inundation distance required to carriage the rocks inland. Our results establish that no known or possible storm happening on the Makran coast is accomplished of detaching and transporting the boulders. The fluid mud consequently is conveyed seaward due to gravitational forcing. The measured sediment focus and velocity profiles on the shelf provide a strong indication to provision this assumption. The sediment model is joined with a 3D hydrodynamic module in the Environmental Fluid Dynamics Code (EFDC) model that offers data on estuarine rotation and salinity transport under normal temperature conditions. 3-D sediment transport from model simulations specify dynamic sediment resuspension and transport near zones of highly industrious oyster beds.

Keywords: sediment transport, storm, coast, fluid dynamics

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Authors: Md. Ruhul Amin, Shakura Namni, Md. Ramiz Uddin Miah, Md. Giashuddin Miah, Mohammad Zakaria, Sang Jae Suh, Yong Jung Kwon

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Insect species abundance and diversity associated with meteorological factors during January to June 2013 at a mango-based agroforestry research field in Bangladesh, and the effects of pests and pollinator species on mango are presented in this study. Among the collected and identified insects, nine species belong to 3 orders were found as pollinator, 11 species in 5 orders as pest, and 13 species in 6 orders as predator. The mango hopper, fruit fly and stone weevil appeared as major pest because of their high levels of abundance and infestation. The hoppers caused 100% inflorescence damage followed by fruit fly (51.7% fruit) and stone weevil (31.0% mature fruit). The major pests exerted significantly higher abundance compared to pollinator, predator and minor pests. Hemipteroid insects were most abundant (60%) followed by Diptera (21%), Hymenoptera (10%), Lepidoptera (5%), and Coleoptera (4%). Insect population increased with increasing trend of temperature and humidity, and revealed peak abundance during April-May. The flower visiting insects differed in their landing duration and showed preference to forage with time of a day. Their foraging activity was found to be peaked between 11.00 am to 01.00 pm. The activity of the pollinators led to higher level of fruit set. This study provides baseline information about the phenological patterns of insect abundance in an agroforestry research field which could be an indication to incorporate some aspects of pest management.

Keywords: agroforestry, abundance, abiotic factors, insects, mango

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Authors: Hawbash Jalil

Abstract:

In this study, the effects of whey protein based films on various properties of kashar cheese were examined. In the study, edible film solutions based on whey protein isolate, whey protein isolate + transglutaminase enzyme and whey protein isolate + chitosan were produced and Kashar cheese samples were coated with these films by dipping method and stored at +4 ºC for 60 days. Chemical, microbiological and textural analyzes were carried out on samples at 0, 30 and 60 days of storage. As a result of the study, the highest dry matter and total nitrogen values were obtained from uncoated control samples This is an indication that the coatings limit water vapor permeability. The highest acidity and pH values obtained from the samples as storage results were 3.33% and 5.86%, respectively, in the control group samples. Both acidity and pH rise in these groups, is a consequence of the buffering of pH changes of hydrolsis products which are as a result of proteolysis occurring in the sample. Nitrogen changes and lipolysis values, which are indicative of the degree of hydrolysis of proteins and triglycerides in kashar cheese, were generally higher in the control group This result is due to limiting the micro organism reproduction by limiting the gas passage of the coatings. Hardness and chewiness values of the textural properties of the samples were significantly reduced in uncoated control samples compared to the coated samples due to maturation. The chitosan film coatings used in the study limited the development of mold yeast until the 30th day but after that did not yield successful results in this respect.

Keywords: chitosan, edible film, transglutaminase, whey protein

Procedia PDF Downloads 158