Search results for: inpatient leave

Authors: Nadjib Melkemi, Salah Belaidi

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Quantitative Structure-Activity Relationship (QSAR) studies have been performed on nineteen molecules of 1,2-dithiole-3-thione analogues. The compounds used are the potent inducers of enzymes involved in the maintenance of reduced glutathione pools as well as phase-2 enzymes important to electrophile detoxication. A multiple linear regression (MLR) procedure was used to design the relationships between molecular descriptor and detoxication properties of the 1,2-dithiole-3-thione derivatives. The predictivity of the model was estimated by cross-validation with the leave-one-out method. Our results suggest a QSAR model based of the following descriptors: qS2, qC3, qC5, qS6, DM, Pol, log P, MV, SAG, HE and EHOMO for the specific activity of quinone reductase; qS1, qS2, qC3, qC4, qC5, qS6, DM, Pol, logP, MV, SAG, HE and EHOMO for the production of growth hormone. To confirm the predictive power of the models, an external set of molecules was used. High correlation between experimental and predicted activity values was observed, indicating the validation and the good quality of the derived QSAR models.

Keywords: QSAR, quinone reductase activity, production of growth hormone, MLR

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Authors: Bara M. Yousef

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Kingdome of Saudi Arabia (KSA). High numbers of traffic accidents with sever, moderate and mild level of impairments admits to Sultan bin Abdulaziz humanitarian city. Over a period of 4 months the city received 111 male and 79 female subjects with CP, who received 4-6 weeks of rehabilitation and using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings shed the light on the fact that nearly 85% of people at admission got better after rehabilitation program services at individual sever moderate and mild and has arrange of (59 out of 128 WeeFIM score) and by the time of discharge they leave the city with better FIM score close to (72 out of 128 WeeFIM score) for the entire study sample. WeeFIM score is providing fair evidence to rehabilitation specialists to assess their outcomes. However there is a need to implement other instruments and compare it to WeeFIM in order to reach better outcomes at discharge level.

Keywords: Cerepral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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Authors: B. Nageshwar Rao

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Urinary tract infection (UTI) represents the most commonly acquired bacterial infection worldwide, with substantial morbidity, mortality, and economic burden. The objective of the study is to characterize the microbial profiles of uropathogenic in the obstetric population by RTPCR. Study design: An observational cross-sectional study was performed at a single tertiary health care hospital among 50 pregnant women with UTIs, including asymptomatic and symptomatic patients attending the outpatient department and inpatient department of Obstetrics and Gynaecology.Methods: Serotyping and genes detection of various uropathogens were studied using RTPCR. Pulse filed gel electrophoresis methods were used to determine the various genetic profiles. Results: The present study shows that CsgD protein, involved in biofilm formation in Escherichia coli, VIM1, IMP1 genes for Klebsiella were identified by using the RTPCR method. Our results showed that the prevalence of VIM1 and IMP1 genes and CsgD protein in E.coli showed a significant relationship between strong biofilm formation, and this may be due to the prevalence of specific genes. Finally, the genetic identification of RTPCR results for both bacteria was correlated with each other and concluded that the above uropathogens were common isolates in producing Biofilm in the pregnant woman suffering from urinary tract infection in our hospital observational study.

Keywords: biofilms, Klebsiella, E.coli, urinary tract infection

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Authors: S. M. Gupta, Vanita Aggarwal, Som Nath Sachdeva

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The work reported through this paper is an experimental work conducted on High Performance Concrete (HPC) with super plasticizer with the aim to develop some models suitable for prediction of compressive strength of HPC mixes. In this study, the effect of varying proportions of fly ash (0% to 50% at 10% increment) on compressive strength of high performance concrete has been evaluated. The mix designs studied were M30, M40 and M50 to compare the effect of fly ash addition on the properties of these concrete mixes. In all eighteen concrete mixes have been designed, three as conventional concretes for three grades under discussion and fifteen as HPC with fly ash with varying percentages of fly ash. The concrete mix designing has been done in accordance with Indian standard recommended guidelines i.e. IS: 10262. All the concrete mixes have been studied in terms of compressive strength at 7 days, 28 days, 90 days and 365 days. All the materials used have been kept same throughout the study to get a perfect comparison of values of results. The models for compressive strength prediction have been developed using Linear Regression method (LR), Artificial Neural Network (ANN) and Leave One Out Validation (LOOV) methods.

Keywords: high performance concrete, fly ash, concrete mixes, compressive strength, strength prediction models, linear regression, ANN

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Authors: Danielle Sandler dos Passos, Helder Coelho, Flávia Mori Sarti

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Analysing the world banking sector, we realize that traditional risk measurement methodologies no longer reflect the actual scenario with uncertainty and leave out events that can change the dynamics of markets. Considering this, regulators and financial institutions began to search more realistic models. The aim is to include external influences and interdependencies between agents, to describe and measure the operationalization of these complex systems and their risks in a more coherent and credible way. Within this context, X-Events are more frequent than assumed and, with uncertainties and constant changes, the concept of antifragility starts to gain great prominence in comparison to others methodologies of risk management. It is very useful to analyse whether a system succumbs (fragile), resists (robust) or gets benefits (antifragile) from disorder and stress. Thus, this work proposes the creation of the Banking Antifragility Index (BAI), which is based on the calculation of a triangular fuzzy number – to "quantify" qualitative criteria linked to antifragility.

Keywords: adaptive complex systems, X-Events, risk management, antifragility, banking antifragility index, triangular fuzzy number

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Authors: Ana Mercedes Vernia Carrasco

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The objective of this work is to reflect through the theoretical framework on the access to the university for the formation of a degree in a teacher of primary education. The University Access Tests in Spain evaluate a series of skills and competencies in writing, which leave aside the sample of another set of skills and tools that this type of test cannot evaluate. In the last years, a very much diversified student body has arrived in the classrooms of the Universities. Nowadays, talking about special education means attending to the changes that are being experienced in this area. At present, the educational model focuses on the reinforcement by the educational institutions so that they form the students according to their personal characteristics and that it is not the students that must adapt to the system. A bibliographic review plus some years of experience in training for the future teacher allows us to make an initial assessment about the lack of rigor in the tests of access to the university. In conclusion, we can say that, although we are not a specialist in the type of Special Educational Needs that can manifest the students, therefore, we understand that teacher today needs training and support to develop their teaching with the best quality possible. These teacher and student needs also imply more institutional support.

Keywords: training, special needs, didactics, music

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Authors: Maya S. Rathod, Bahadur Singh Hathan

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Mustard leaves are rich in folates, vitamin A, K and B-complex. Mustard greens are low in calories and fats and rich in dietary fiber. They are rich in potassium, manganese, iron, copper, calcium, magnesium and low in sodium. It is very rich in antioxidants and Phytonutrients. For the optimization of process variables (moisture content and mustard leave powder), the experiments were conducted according to central composite Face Centered Composite design of RSM. The mustard leaves powder was replaced with composite flour (a combination of rice, chickpea and corn in the ratio of 70:15:15). The extrudate was extruded in a twin screw extruder at a barrel temperature of 120°C. The independent variables were mustard leaves powder (2-10 %) and moisture content (12-20 %). Responses analyzed were bulk density, water solubility index, water absorption index, lateral expansion, hardness, antioxidant activity, total phenolic content and overall acceptability. The optimum conditions obtained were 7.19 g mustard leaves powder in 100 g premix having 16.8 % moisture content (w.b).

Keywords: extrusion, mustard leaves powder, optimization, response surface methodology

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Authors: Pei Chin Lim

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School of Mathematics and Science of Singapore Polytechnic offers a Basic Mathematics module to students who did not pass GCE O-Level Additional Mathematics. These students are weaker in Mathematics. In particular, they struggle with word problems and tend to leave them blank in tests and examinations. In order to improve students’ problem-solving skills, the school redesigned the Basic Mathematics module to incorporate Polya’s problem-solving methodology. During tutorial lessons, students have to work through learning activities designed to raise their metacognitive awareness by following Polya’s problem-solving process. To assess the effectiveness of the redesign, students’ working for a challenging word problem in the mid-semester test were analyzed. Sixty-five percent of students attempted to understand the problem by making sketches. Twenty-eight percent of students went on to devise a plan and implement it. Only five percent of the students still left the question blank. These preliminary results suggest that with regular exposure to an explicit and systematic problem-solving approach, weak students’ problem-solving skills can potentially be improved.

Keywords: mathematics education, metacognition, problem solving, weak students

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Authors: Ashraf Shebl, Bassam Garah, Radah Youssef

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Sexual assault is usually a hidden crime where the only witnesses are the victim and the assailant. For a variety of reasons, even the victim may be unable to provide a detailed account of the assault or the identity of the perpetrator. Often the case history deteriorates into one person’s word against another. With such limited initial information, the physical and biological evidence collected from the victim, from the crime scene, and from the suspect will play a pivotal role in the objective and scientific reconstruction of the events in question. The aim of work is to examine whether DNA profiles could be recovered from repeated washed clothes after contaminated by semen stains. Fresh semen about 1ml. ( <1 h old) taken from donor was deposited on four types of clothes (cotton, silk, polyester, and jeans). Then leave to dry in room temperature and washed by washing machine at temperature (30°C-60°C) and by hand washing. Some items of clothing were washed once, some twice and others three times. DNA could be extracted from some of these samples even after multiple washing. This study demonstrates that complete DNA profiles can be obtained from washed semen stains on different types of clothes, even after many repeated washing. These results indicated that clothes of the victims must be examined even if they were washed many times.

Keywords: sexual assault, DNA, persistence, clothes

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Authors: Rejab Hajlaoui, Tarek Moulahi, Hervé Guyennet

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In a highway scenario, the vehicle speed can exceed 120 kmph. Therefore, any vehicle can enter or leave the network within a very short time. This mobility adversely affects the network connectivity and decreases the life time of all established links. To ensure an effective stability in vehicular ad hoc networks with minimum broadcasting storm, we have developed a weighted algorithm based on the k-medoids clustering algorithm (WKCA). Indeed, the number of clusters and the initial cluster heads will not be selected randomly as usual, but considering the available transmission range and the environment size. Then, to ensure optimal assignment of nodes to clusters in both k-medoids phases, the combined weight of any node will be computed according to additional metrics including direction, relative speed and proximity. Empirical results prove that in addition to the convergence speed that characterizes the k-medoids algorithm, our proposed model performs well both AODV-Clustering and OLSR-Clustering protocols under different densities and velocities in term of end-to-end delay, packet delivery ratio, and throughput.

Keywords: communication, clustering algorithm, k-medoids, sensor, vehicular ad hoc network

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Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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Over the past decade, the non-elective admissions in the UK have increased significantly. Taking into account limited resources (i.e. beds), the related service managers are obliged to manage their resources effectively due to the non-elective admissions which are mostly admitted to inpatient specialities via A&E departments. Geriatric medicine is one of specialities that have long length of stay for the non-elective admissions. This study aims to develop a discrete event simulation model to understand how possible increases on non-elective demand over the next 12 months affect the bed occupancy rate and to determine required number of beds in a geriatric medicine speciality in a UK hospital. In our validated simulation model, we take into account observed frequency distributions which are derived from a big data covering the period April, 2009 to January, 2013, for the non-elective admission and the length of stay. An experimental analysis, which consists of 16 experiments, is carried out to better understand possible effects of case studies and scenarios related to increase on demand and number of bed. As a result, the speciality does not achieve the target level in the base model although the bed occupancy rate decreases from 125.94% to 96.41% by increasing the number of beds by 30%. In addition, the number of required beds is more than the number of beds considered in the scenario analysis in order to meet the bed requirement. This paper sheds light on bed management for service managers in geriatric medicine specialities.

Keywords: bed management, bed occupancy rate, discrete event simulation, geriatric medicine, non-elective admission

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Authors: Santosh Kumar Sharma

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In view of management education with special reference to India, it has been noted that students have deviations between their career anchors and domain of specialization. As a consequence, they face problems in their summer internships and placements in the corporate sector. Eventually, they either change their career track or leave the management profession, which is a serious concern from the perspective of human capital. However, there is no substantial literature in the given context. Therefore, the present study contributes to the global discourse of management education and its spillover effect on human resource management. The objective of the present study is to analyze the deviation between career anchors and domain specialization with reference to management education in India. The present study is exploratory in nature, wherein data has been collected from a significant number of post-graduate students who are pursuing management education from a premium business school in India, followed by descriptive analysis. The present research contributes to the professional development of management students from the perspective of human capital, which is eventually related to various factors of the Indian economy.

Keywords: India, management education, domain specialization, placements

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Authors: Hansraj Riteesh Bookun, Emily Maree Stevens, Jarryd Leigh Solomon, Anthony Chan

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Objective: This was a retrospective cross-sectional study evaluating the safety and efficacy of femoral endarterectomy using the eversion technique with transection as opposed to the conventional endarterectomy technique with either vein or synthetic patch arterioplasty. Methods: Between 2010 to mid 2017, 19 patients with mean age of 75.4 years, underwent eversion femoral endarterectomy with transection by a single surgeon. There were 13 males (68.4%), and the comorbid burden was as follows: ischaemic heart disease (53.3%), diabetes (43.8%), stage 4 kidney impairment (13.3%) and current or ex-smoking (73.3%). The indications were claudication (45.5%), rest pain (18.2%) and tissue loss (36.3%). Results: The technical success rate was 100%. One patient required a blood transfusion following bleeding from intraoperative losses. Two patients required blood transfusions from low post operative haemogloblin concentrations – one of them in the context of myelodysplastic syndrome. There were no unexpected returns to theatre. The mean length of stay was 11.5 days with two patients having inpatient stays of 36 and 50 days respectively due to the need for rehabilitation. There was one death unrelated to the operation. Conclusion: The eversion technique with transection is safe and effective with low complication rates and a normally expected length of stay. It poses the advantage of not requiring a synthetic patch. This technique features minimal extraneous dissection as there is no need to harvest vein for a patch. Additionally, future endovascular interventions can be performed by puncturing the native vessel. There is no change to the femoral bifurcation anatomy after this technique. We posit that this is a useful adjunct to the surgeon’s panoply of vascular surgical techniques.

Keywords: endarterectomy, eversion, femoral, vascular

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Authors: Ibrahim Ahmed, Richard Amoateng, Akhil Jain, Mohamed Ahmed

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Alcoholic cardiomyopathy (ACM) is a type of acquired cardiomyopathy caused by chronic alcohol consumption. Frequently ACM is associated with arrhythmias such as atrial flutter. Our aim was to characterize the patient demographics and investigate the effect of atrial flutter (AF) on ACM. This was a retrospective cohort study using the Nationwide Inpatient Sample database to identify admissions in adults with principal and secondary diagnoses of alcoholic cardiomyopathy and atrial flutter from 2019. Multivariate linear and logistic regression models were adjusted for age, gender, race, household income, insurance status, Elixhauser comorbidity score, hospital location, bed size, and teaching status. The primary outcome was all-cause mortality, and secondary outcomes were the length of stay (LOS) and total charge in USD. There was a total of 21,855 admissions with alcoholic cardiomyopathy, of which 1,635 had atrial flutter (AF-ACM). Compared to Non-AF-ACM cohort, AF-ACM cohort had fewer females (4.89% vs 14.54%, p<0.001), were older (58.66 vs 56.13 years, p<0.001), fewer Native Americans (0.61% vs2.67%, p<0.01), had fewer smaller (19.27% vs 22.45%, p<0.01) & medium-sized hospitals (23.24% vs28.98%, p<0.01), but more large-sized hospitals (57.49% vs 48.57%, p<0.01), more Medicare (40.37% vs 34.08%, p<0.05) and fewer Medicaid insured (23.55% vs 33.70%, p=<0.001), fewer hypertension (10.7% vs 15.01%, p<0.05), and more obesity (24.77% vs 16.35%, p<0.001). Compared to Non-AF-ACM cohort, there was no difference in AF-ACM cohort mortality rate (6.13% vs 4.20%, p=0.0998), unadjusted mortality OR 1.49 (95% CI 0.92-2.40, p=0.102), adjusted mortality OR 1.36 (95% CI 0.83-2.24, p=0.221), but there was a difference in LOS 1.23 days (95% CI 0.34-2.13, p<0.01), total charge $28,860.30 (95% CI 11,883.96-45,836.60, p<0.01). In patients admitted with ACM, the presence of AF was not associated with a higher all-cause mortality rate or odds of all-cause mortality; however, it was associated with 1.23 days increase in LOS and a $28,860.30 increase in total hospitalization charge. Native Americans, older age and obesity were risk factors for the presence of AF in ACM.

Keywords: alcoholic cardiomyopathy, atrial flutter, cardiomyopathy, arrhythmia

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Authors: Feyza Gökce, Jochen Gensichen, Antonius Schneider, Karolina de Valerio, Gabriele Pitschel-Walz

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People with depressive symptoms often first consult a General Practitioner (GP) before making use of other treatment options. The present study shows the adaptation and evaluation of a psychoeducational program for patients with depressive symptoms that are treated by GPs in Bavaria, Germany. The adaptation of an existing psychoeducational program, that is used in inpatient psychiatric settings, was performed in exchange with experts (psychotherapists, general practitioners, and a patient representative). As a result, a program consisting of 4 psychoeducational sessions was developed, which is carried out in individual settings in GP practices by the practitioners themselves. This program will be compared to treatment as usual that patients with depression receive by GPs. Data is collected at 3 measurement points (baseline, 3-months-follow-up, 6-months-follow-up) using different questionnaires (BDI-II, D-Lit-R German, FERUS, PAM13-D, PHQ-9, GAD-7, PHQ-15, PC-PTSD-5). In addition to the change in depressive symptoms, changes in depression knowledge, self-efficacy, and patient activation will be analyzed, and the feasibility of the program and the subjective benefit for GPs and patients will be assessed. By now, 84 patients have been recruited by 20 cluster-randomized GP practices, with 73.5% of the participants being female and 26.5% being males. The average age was M= 50.1 (SD= 14.67) years. The change in depression symptoms over the 3-month period will be compared between the two study conditions by using a linear mixed model by the end of data collection (December 2023). The subjective benefit for the patients and GPs will be assessed via feedback questionnaires. Results will be presentable by the beginning of 2024 and will provide indications for further development and barriers to the implementation of such a program for GP practices.

Keywords: depression, general practice, psychoeducation, primary care

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Authors: M. Tahir Demirsel, Mustafa Atsan

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Many elements of the environment in which businesses operate today leave them faced with unexpected threats and opportunities. One of the major threats is business crisis. The crisis is a state of affairs in a business wherein the executives must take urgent and unprecedented action to try to save the business from failure. In order to survive in the business environment, organizations should be prepared for the potential crises. Technological developments, uncertainty in the market and the intense competition increase the probability of encountering a crisis for organizations. Therefore, by acting proactively to predict crisis, to detect signals of crisis and be prepared for a crisis by taking necessary precautions accordingly, is of great importance for businesses. In this context, the objective of this study is to reveal that how much organizations are proactive and can predict the future crises and investigate whether they are prepared for possible crises or not. The research was conducted on 222 business executives in one of the major industrial zones of Turkey, Konya Organized Industrial Zone (KOS). The findings are analyzed through descriptive statistics and multiple regression analysis. According to the results, it has been observed that organizations cannot predict the crisis signals and are not prepared for potential crises.

Keywords: crisis preparedness, crisis signals, industrial organizations, proactivity

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Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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Authors: Nancy Di Tunnariello, Jenna L. Currie-Mueller

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Totalistic organizations include organizations that operate by playing a prominent role in the life of its members through embedding values and practices. The Church of Scientology (CoS) is an example of a religious totalistic organization and has recently garnered attention because of the questionable treatment of members by those with authority, particularly when members try to leave the Church. The purpose of this study was to analyze exit communication and evaluate the task and relational messages discussed on online discussion boards for individuals with a previous or current connection to the totalistic CoS. Using organizational exit phases and interaction process analysis (IPA), researchers coded 30 boards consisting of 14,179 thought units from the Exscn.net website. Findings report all stages of exit were present, and post-exit surfaced most often. Posts indicated more tasks than relational messages, where individuals mainly provided orientation/information. After a discussion of the study’s contributions, limitations and directions for future research are explained.

Keywords: Bales' IPA, organizational exit, relational messages, scientology, task messages, totalistic organizations

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Authors: Chaluntorn Vichasilp, Sutee Wangtueai

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This study aims to develop a new method to detect active compounds in Thai herbs (1-deoxynojirimycin (DNJ) in mulberry leave, anthocyanin in Mao and curcumin in turmeric) using near infrared spectroscopy (NIRs). NIRs is non-destructive technique that rapid, non-chemical involved and low-cost determination. By NIRs and chemometrics technique, it was found that the DNJ prediction equation conducted with partial least square regression with cross-validation had low accuracy R2 (0.42) and SEP (31.87 mg/100g). On the other hand, the anthocyanin prediction equation showed moderate good results (R2 and SEP of 0.78 and 0.51 mg/g) with Multiplication scattering correction at wavelength of 2000-2200 nm. The high absorption could be observed at wavelength of 2047 nm and this model could be used as screening level. For curcumin prediction, the good result was obtained when applied original spectra with smoothing technique. The wavelength of 1400-2500 nm was created regression model with R2 (0.68) and SEP (0.17 mg/g). This model had high NIRs absorption at a wavelength of 1476, 1665, 1986 and 2395 nm, respectively. NIRs showed prospective technique for detection of some active compounds in Thai herbs.

Keywords: anthocyanin, curcumin, 1-deoxynojirimycin (DNJ), near infrared spectroscopy (NIRs)

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Authors: Meesun Sun, Yongmin Kim

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Estimating maintenance cost is crucial in defense management because it affects military budgets and availability of equipment. When it comes to estimating maintenance cost of the deployed equipment, time series forecasting can be applied with the actual historical cost data. It is more difficult issue to estimate maintenance cost of new equipment for which the actual costs are not provided. In this underlying context, this study proposes an analytical method for maintenance cost estimating relationships (CERs) development of helicopters using linear programming. The CERs can be applied to a new helicopter because they use non-cost independent variables such as the number of engines, the empty weight and so on. In the Republic of Korea, the maintenance cost of new equipment has been usually estimated by reflecting maintenance cost to unit price ratio of the legacy equipment. This study confirms that the CERs perform well for the 10 types of airmobile helicopters in terms of mean absolute percentage error by applying leave-one-out cross-validation. The suggested method is very useful to estimate the maintenance cost of new equipment and can help in the affordability assessment of acquisition program portfolios for total life cycle systems management.

Keywords: affordability analysis, cost estimating relationship, helicopter, linear programming, maintenance cost

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Authors: Yanhua Zhao, Chenli Rao, Dongdong Li, Chuanmin Tao

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The Chinese Centers for Disease Control and Prevention (CCDC) issued a new laboratory-based algorithm for HIV diagnosis on April 2016, which initially screens with a combination HIV-1/HIV-2 antigen/antibody fourth-generation immunoassay (IA) followed, when reactive, an HIV-1/HIV-2 undifferentiated antibody IA in duplicate. Reactive specimens with concordant results undergo supplemental tests with western blots, or HIV-1 nucleic acid tests (NATs) and non-reactive specimens with discordant results receive HIV-1 NATs or p24 antigen tests or 2-4 weeks follow-up tests. However, little data evaluating the application of the new algorithm have been reported to date. The study was to evaluate the performance of new laboratory-based HIV diagnostic algorithm in an inpatient population of Southwest China over the initial 6 months by compared with the old algorithm. Plasma specimens collected from inpatients from May 1, 2016, to October 31, 2016, are submitted to the laboratory for screening HIV infection performed by both the new HIV testing algorithm and the old version. The sensitivity and specificity of the algorithms and the difference of the categorized numbers of plasmas were calculated. Under the new algorithm for HIV diagnosis, 170 of the total 52 749 plasma specimens were confirmed as positively HIV-infected (0.32%). The sensitivity and specificity of the new algorithm were 100% (170/170) and 100% (52 579/52 579), respectively; while 167 HIV-1 positive specimens were identified by the old algorithm with sensitivity 98.24% (167/170) and 100% (52 579/52 579), respectively. Three acute HIV-1 infections (AHIs) and two early HIV-1 infections (EHIs) were identified by the new algorithm; the former was missed by old procedure. Compared with the old version, the new algorithm produced fewer WB-indeterminate results (2 vs. 16, p = 0.001), which led to fewer follow-up tests. Therefore, the new HIV testing algorithm is more sensitive for detecting acute HIV-1 infections with maintaining the ability to verify the established HIV-1 infections and can dramatically decrease the greater number of WB-indeterminate specimens.

Keywords: algorithm, diagnosis, HIV, laboratory

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Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This dissertation aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases.

Keywords: psychotraumatology, forensic psychology, PTSD, vietnam veterans

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Authors: Abdalla Mansour, Dan Brown, Adel Helmy, Rikin Trivedi, Mathew Guilfoyle

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Introduction: Diagnosing delayed cerebral ischaemia (DCI) following aneurysmal subarachnoid haemorrhage (SAH) can be challenging, particularly in poor-grade patients. Objectives: This study sought to assess the value of routine CTP in identifying (or excluding) DCI and in guiding management. Methods: Eight-year retrospective neuroimaging study at a large UK neurosurgical centre. Subjects included a random sample of adult patients with confirmed aneurysmal SAH that had a CTP scan during their inpatient stay, over a 8-year period (May 2014 - May 2022). Data collected through electronic patient record and PACS. Variables included age, WFNS scale, aneurysm site, treatment, the timing of CTP, radiologist report, and DCI management. Results: Over eight years, 916 patients were treated for aneurysmal SAH; this study focused on 466 patients that were randomly selected. Of this sample, 181 (38.84%) had one or more CTP scans following brain aneurysm treatment (Total 318). The first CTP scan in each patient was performed at 1-20 days following ictus (median 4 days). There was radiological evidence of DCI in 83, and no reversible ischaemia was found in 80. Findings were equivocal in the remaining 18. Of the 103 patients treated with clipping, 49 had DCI radiological evidence, in comparison to 31 of 69 patients treated with endovascular embolization. The remaining 9 patients are either unsecured aneurysms or non-aneurysmal SAH. Of the patients with radiological evidence of DCI, 65 had a treatment change following the CTP directed at improving cerebral perfusion. In contrast, treatment was not changed for (61) patients without radiological evidence of DCI. Conclusion: CTP is a useful adjunct to clinical assessment in the diagnosis of DCI and is helpful in identifying patients that may benefit from intensive therapy and those in whom it is unlikely to be effective.

Keywords: SAH, vasospasm, aneurysm, delayed cerebral ischemia

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Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Pseudomonas aeruginosa (P. aeruginosa) is an important nosocomial pathogen which causes serious hospital infections and is resistant to many commonly used antibiotics. P. aeruginosa can develop resistance during therapy and also it is very resistant to disinfectant chemicals. It may be found in respiratory support devices in hospitals. In this study, the antibiotic resistance of P. aeruginosa strains isolated from bronchial aspiration samples was evaluated retrospectively. Methods: Between October 2013 and September 2015, a total of 318 P. aeruginosa were isolated from clinical samples obtained from various intensive care units and inpatient patients hospitalized at Afyon Kocatepe University, ANS Practice and Research Hospital. Isolated bacteria identified by using both the conventional methods and automated identification system-VITEK 2 (bioMerieux, Marcy l’etoile France). Antibacterial resistance tests were performed by using Kirby-Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: Antibiotic resistance rates of identified 318 P. aeruginosa strains were found as follows for tested antibiotics; 32 % amikacin, 42% gentamicin, 43% imipenem, 43% meropenem, 50% ciprofloxacin, 57% levofloxacin, 38% cefepime, 63% ceftazidime, and 85% piperacillin/tazobactam. Conclusion: Resistance profiles change according to years and provinces for P. aeruginosa, so these findings should be considered empirical treatment choices. In this study, the highest and lowest resistance rates found against piperacillin/tazobactam % 85, and amikacin %32.

Keywords: Pseudomonas aeruginosa, antibiotic resistance rates, intensive care unit, Pseudomonas spp.

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Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

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Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

Procedia PDF Downloads 79

Authors: A. S. Lourens, B. Du Plooy

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Across the world, initiatives have been introduced to encourage women to enter into and remain in engineering fields. However, research has shown that many women leave engineering or suffer a loss of self-esteem and self-confidence compared to their male counterparts. To address this problem, a South African comprehensive university developed a self-leadership intervention pilot study in 2013, aimed at improving the self-efficacy of its female engineering students and increasing retention rates. This paper is a qualitative, descriptive and interpretive study of the rationale and operational aspects of the Women in Engineering Leadership Association’s (WELA) self-leadership workshop. The objectives of this paper are to provide a framework for the design of a self-leadership workshop and to provide insight into the process of developing such a workshop specifically for women engineering students at a South African university. Finally, the paper proposes an evaluation process for the pilot workshop, which also provides a framework to improve future workshops. It is anticipated that the self-leadership development framework will be applicable to other higher education institutions wishing to improve women engineering student’s feelings of self-efficacy and therefore retention rates of women in engineering.

Keywords: self-leadership, women in engineering, co-curricular interventions, self-efficacy

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Authors: J. Palán, M. Zemko

Abstract:

COMTES FHT has been active in a field of research and development of high-strength wires for quite some time. The main material was pure titanium. The primary goal of this effort is to develop a continuous production process for ultrafine and nanostructured materials with the aid of severe plastic deformation (SPD). This article outlines mechanical and microstructural properties of the materials and the options available for testing the components made of these materials. Ti Grade 2 and Grade 4 wires are the key products of interest. Ti Grade 2 with ultrafine to nano-sized grain shows ultimate strength of up to 1050 MPa. Ti Grade 4 reaches ultimate strengths of up to 1250 MPa. These values are twice or three times as higher as those found in the unprocessed material. For those fields of medicine where implantable metallic materials are used, bulk ultrafine to nanostructured titanium is available. It is manufactured by SPD techniques. These processes leave the chemical properties of the initial material unchanged but markedly improve its final mechanical properties, in particular, the strength. Ultrafine to nanostructured titanium retains all the significant and, from the biological viewpoint, desirable properties that are important for its use in medicine, i.e. those properties which made pure titanium the preferred material also for dental implants.

Keywords: CONFORM, ECAP, rotary swaging, titanium

Procedia PDF Downloads 217

Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal

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Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.

Keywords: urology, endourology, prostate, bladder outlet obstruction, laser

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Authors: Erin C. Rodenburg, Jennifer McWhirter, Andrew Papadopoulos

Abstract:

Support workers for adults with developmental disabilities promote the care and wellbeing of a historically underserved population. Poor employment training and low work satisfaction for these disability support workers are linked to low productivity, poor quality of care, turnover, and intention to leave employment. Therefore, to improve the lives of those within disability support homes, both client and caregiver, it is vital to determine where improvements to training and support for those providing direct care can be made. The current study aims to explore disability support worker’s perceptions of the training received in their employment at the residential homes, how it prepared them for their role, and where there is room for improvement with the aim of developing recommendations for an improved training experience. Responses were collected from 85 disability support workers across 40 Ontario group homes. Findings suggest most disability support workers within the 40 support homes feel adequately trained in their responsibilities of employment. For those who did not feel adequately trained, the main issues expressed were a lack of standardization in training, a need for more continuous training, and a move away from trial and error in performing tasks to support clients with developmental disabilities.

Keywords: developmental disabilities, disability workers, support homes, training

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Authors: Nizar Ahmad, Mushtaq Ahmad Jadoon, Farhat Ullah

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This study investigates the peace efforts made by Pakhtun’s traditional institution Jirga in conflict-affected communities of Khyber Pakhtunkhwa. Data were collected through a structured interview schedule from a sample of 278 household members in four selected villages of Dir Upper and Dir Lower Districts. A Chi square test was applied to ascertain relationships between Jirga related factors with the state of peace in the study area. It was found that factors such as Jirga regularly conducted meetings (P=. 000), it inflicted punishment upon local militants (P=. 001), ex-combatants were re-integrated through Jirga (P= .000) and Jirga ordered the local the defiant to leave the community had a significant association with state of peace in the area. It is concluded that Jirga system had played a vital role in the peacebuilding process of the area through provision of support to government in peace operation and mobilizing local people for peace in the area. It is suggested that Jirga shall to be the part of peace process and government needs to provide its possible support to members of the Jirga in order to enhance their capacity of peace work.

Keywords: Jirga, peacebuilding, terrorism, traditional mechanism, conflict affect areas

Procedia PDF Downloads 293