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1
ENSERINK, R., L. MUGHINI-GRAS, E. DUIZER, T. KORTBEEK, and W. VAN PELT. "Risk factors for gastroenteritis in child day care." Epidemiology and Infection 143, no. 13 (January 16, 2015): 2707–20. http://dx.doi.org/10.1017/s0950268814003367.
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SUMMARYThe child day-care centre (DCC) is often considered as one risk factor for gastroenteritis (GE) rather than a complex setting in which the interplay of many factors may influence the epidemiology of GE. This study aimed to identify DCC-level risk factors for GE and major enteropathogen occurrence. A dynamic network of 100 and 43 DCCs participated in a syndromic and microbiological surveillance during 2010–2013. The weekly incidence of GE events and weekly prevalence of five major enteropathogens (rotavirus, norovirus, astrovirus,Giardia lamblia, Cryptosporidium hominis/parvum) were modelled per DCC using mixed-effects negative binomial/Poisson regression models. Sixteen hundred children were surveyed up to 3 years, during which 1829 GE episodes were reported and 5197 faecal samples were analysed. Identified risk factors were: large DCC capacity, crowding, having animals, nappy changing areas, sandpits, paddling pools, cleaning potties in normal sinks, cleaning vomit with paper towels (but without cleaner), mixing of staff between child groups, and staff members with multiple daily duties. Protective factors were: disinfecting fomites with chlorine, cleaning vomit with paper towels (and cleaner), daily cleaning of bed linen/toys, cohorting and exclusion policies for ill children and staff. Targeting these factors may reduce the burden of DCC-related GE.
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Verkulevičiūtė - Kriukienė, Daiva, and Angelija Bučienė. "International Academic Exchange of Students and Teaching Staff in Human Geography Study Field: The Case of Klaipėda University / Visuomeninės geografijos studijų krypties studentų ir dėstytojų tarptautiniai akademiniai mainai: Klaipėdos universiteto atvejis." Geografija ir edukacija mokslo almanachas / Geography and Education Science Almanac 5 (November 6, 2017): 91–103. http://dx.doi.org/10.15823/ge.2017.8.
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The participation in Erasmus and Erasmus+ programmes is the most popular form of mobility among the university teachers and other academic staff as well as students. The geographers of Klaipėda University can study in more than 20 universities of different regions of Europe, and the geography of studies expands from year to year. While studying in foreign countries, they not only deepen their knowledge, but also broaden the geographic scope, acquaint with new people and cultures, strengthen the knowledge of foreign language. From the other side, the students of foreign universities, having been chosen the geographic modules at Klaipėda University, have a possibility to see and learn about the nature of Western Lithuania, social and economic objects, the cultural environment. According to the foreign students, the studies are organized so, that academic staff is able to collaborate with each student immediately, and the atmosphere of studies is very good. Besides the foreign students, Klaipėda University receives also the foreign academic staff, organizes the international practices, develops the projects, and the academic staff of Klaipėda university has a possibility to visit the universities of foreign countries. Those visits give the invaluable benefit to the teachers, because one can receive more experience, and the newly adopted methods may be applied at Klaipėda University.
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Schwartz, Stefan, Maria Vergoulidou, Eckart Schreier, Christoph Loddenkemper, Mark Reinwald, Martin Schmidt-Hieber, Willy A. Flegel, Eckhard Thiel, and Thomas Schneider. "Norovirus gastroenteritis causes severe and lethal complications after chemotherapy and hematopoietic stem cell transplantation." Blood 117, no. 22 (June 2, 2011): 5850–56. http://dx.doi.org/10.1182/blood-2010-12-325886.
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Abstract Norovirus (NV) infections are a frequent cause of gastroenteritis (GE), but data on this disease in immunocompromised patients are limited. We analyzed an NV outbreak, which affected immunosuppressed patients in the context of chemotherapy or HSCT. On recognition, 7 days after admission of the index patient, preventive measures were implemented. Attack rates were only 3% (11/334) and 10% (11/105) among patients and staff members, respectively. The median duration of symptoms was 7 days in patients compared with only 3 days in staff members (P = .02). Three patients died of the NV infection. Commonly used clinical diagnostic criteria (Kaplan-criteria) were unsuitable because they applied to 11 patients with proven NV-GE but also to 15 patients without NV-GE. With respect to the therapeutic management, it is important to differentiate intestinal GVHD from NV-GE. Therefore, we analyzed the histopathologic patterns in duodenal biopsies, which were distinctive in both conditions. Stool specimens in patients remained positive for NV-RNA for a median of 30 days, but no transmission was observed beyond an asymptomatic interval of 48 hours. NV-GE is a major threat to patients with chemotherapy or HSCT, and meticulous measures are warranted to prevent transmission of NV to these patients.
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Baporikar, Neeta. "Turnaround Strategy Implementation for Service Efficacy and Citizenry Satisfaction in Government Organizations." International Journal of Project Management and Productivity Assessment 10, no. 1 (January 2022): 1–22. http://dx.doi.org/10.4018/ijpmpa.297085.
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The Government Enterprise (GE) implemented a turnaround strategy to enhance service efficacy and citizenry satisfaction in 2014. However, this GE takes too long like three months to issue any key documents such as birth, death, marriage certificates, passports, and work permits today. This reflects that the efficacy of services and the satisfaction of citizens is questionable. Hence, the main objective of the research was to investigate the turnaround strategy implementation in GE. Adopting the qualitative descriptive research design, questionnaires administered to the management and staff members, and interviews conducted with clients, thematic analysis has been undertaken. Findings reveal that the turnaround strategy did improve service efficacy and citizenry satisfaction for some time but there was a relapse. Recommendations include the adoption of customer service strategies along with the revival of the turnaround strategy and top management new team who can introduce with fresh ideas, staff training with constant monitoring, and control measures.
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Boxman, Ingeborg L. A., Linda Verhoef, Remco Dijkman, Geke Hägele, Nathalie A. J. M. te Loeke, and Marion Koopmans. "Year-Round Prevalence of Norovirus in the Environment of Catering Companies without a Recently Reported Outbreak of Gastroenteritis." Applied and Environmental Microbiology 77, no. 9 (March 4, 2011): 2968–74. http://dx.doi.org/10.1128/aem.02354-10.
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ABSTRACTFood handlers play an important role in the transmission of norovirus (NoV) in food-borne outbreaks of gastroenteritis (GE). In a year-round prevalence study, the prevalence of NoV in catering companies without recently reported outbreaks of GE was investigated and compared to the observed prevalence in catering companies with recently reported outbreaks. Swab samples were collected from surfaces in the kitchens and (staff) bathrooms in 832 randomly chosen companies and analyzed for the presence of NoV RNA. In total, 42 (1.7%) out of 2,496 environmental swabs from 35 (4.2%) catering companies tested positive. In contrast, NoV was detected in 147 (39.7%) of the 370 samples for 44 (61.1%) of the 72 establishments associated with outbreaks of gastroenteritis. NoV-positive swabs were more frequently found in winter, in specific types of companies (elderly homes and lunchrooms), and in establishments with separate bathrooms for staff. We found a borderline association with population density but no relation to the number of employees. Sequence analysis showed that environmental strains were interspersed with strains found in outbreaks of illness in humans. Thus, the presence of NoV in catering companies seemed to mirror the presence in the population but was strongly increased when associated with food-borne GE. Swabs may therefore serve as a valuable tool in outbreak investigations for the identification of the causative agent, although results should be interpreted with care, taking into account all other epidemiological data.
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ELSENBRUCH, Thomas. "GE ENERGY Jenbacher gas engine technology – preventive maintenance by means of highly sophisticated control systems." Combustion Engines 125, no. 2 (May 1, 2006): 82–86. http://dx.doi.org/10.19206/ce-117357.
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Data collection and control concept of Jenbacher gas engines has been presented in the paper. Internet data transmission allow on-line control of the engine operation, early detection of defects and optimal adjustment to engine actual operating conditions. The system offers both customers and GE Jenbacher maintenance staff a wide range of functionalities for commissioning, monitoring and maintaining installations and for diagnostic purposes.
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IMAKITA, Teppei, Kayo TAJIME, and Sanae IKENARI. "Sexual Harassment Toward Hospital Staff by Patients or Their Family Members in a Japanese General Hospital." Journal of Occupational Safety and Health 13, no. 1 (February 28, 2020): 11–22. http://dx.doi.org/10.2486/josh.josh-2019-0018-ge.
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Lam, E. G., N. B. Tajutdin, and C. K. K. Soh. "(P2-38) Operational Response to a Gastroenteritis Outbreak in the Emergency Department." Prehospital and Disaster Medicine 26, S1 (May 2011): s148. http://dx.doi.org/10.1017/s1049023x11004821.
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Mass gatherings can be disruptive to the daily operations of any emergency department (ED). These events usually are spontaneous and sudden. Therefore, operational processes must be effective and concise when dealing with a sudden surge. This study examines the Tan Tock Seng Hospital (TTSH) ED response process to a gastroenteritis (GE) outbreak. Prompt identification and establishment of a casualty holding and treatment area ensured smooth operational capacity, which allowed these patients to be segregated from the mainstream ED crowd and more specific care to be rendered. Entrance and exit points of the designated area were established with controlled access to prevent cross-contamination with the mainstream patient load. Patients with GE who presented with acute symptoms required immediate assessment and intervention, placing stress on existing personnel. Hence, adequate personnel was an important factor that could not be disregarded. Staff burnout was a plausible issue that was recognized from the start and attempts were made to prevent burnout by creating an encouraging work environment and allowing frequent relieving of duties. Communicating the event to relevant departments ensured that the ED was adequately supported during the GE outbreak, both administratively and logistically. This was a reflection of the established communication channels. Leadership also had an essential and crucial role to play as the nursing and medical leaders had to be decisive, delegate roles and give concise instructions during the chaotic situation. The availability and access to ample logistical supplies saves on precious time, which allowed more focus on patients. In summary, procedures and protocols, together with staff preparedness, enhances an ED operational capability of effectively responding to mass gatherings.
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Hill, N. Sharon, Marta A. Miller, and Reynold P. Stimart. "Demonstrating the Value of the User Interface Design Process Using Six Sigma Methodology." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 41, no. 1 (October 1997): 375–79. http://dx.doi.org/10.1177/107118139704100183.
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As part of an overall quality initiative at General Electric (GE), a study was undertaken to understand and reduce usability defects in the software development lifecycle at GE Information Services, Inc. Six Sigma methodology, which tries to increase quality through systematic process improvement, was applied to a sample of usability data. The results of this effort found that usability defects were highest in those products where there had been minimal involvement of the User Interface staff and usability defects were most dramatically reduced by using a systematic approach to usability (i.e., the user interface design process). When presented to upper management, the net effect of this study was a raised consciousness in the company that usability defects are very controllable, a policy statement issued that future development efforts would include the user interface design process, and a commitment for increased resources for the User Interface team.
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Vandervort, Christian, Todd Wetzel, and David Leach. "Engineering And Validating A World Record Gas Turbine." Mechanical Engineering 139, no. 12 (December 1, 2017): 48–50. http://dx.doi.org/10.1115/1.2017-dec-13.
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This article presents an overview of GE’s HA gas turbines that represent the most reliable and efficient machines in the world for converting natural gas into electricity. In a combined cycle arrangement, these turbines provide cost-effective and clean generation that offers reliable electricity to an expanding, global population. The 7/9HA turbine is based upon the original H-class 4-stage gas turbine with exception of simplification by eliminating steam cooling. Metals chosen for the 7/9HA are proven alloys with over 50 million hours of operation on F- and H-class gas turbines. The first 9HA.01 entered commercial operation on June 17, 2016 at the Électricité de France Bouchain plant, located in the Nord Pas-de-Calais region of France. GE followed the Guinness Book of World Records’ definition for a consistent and traceable operating condition for establishing efficiency in world records. Under the oversight of Guinness World Records staff, GE set the record for the world’s most efficient combined-cycle power plant with an efficiency of 62.22% while producing more than 605 MW of electricity.
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Smith, Lauren N. "School libraries, political information and information literacy provision: findings from a Scottish study." Journal of Information Literacy 10, no. 2 (December 1, 2016): 3. http://dx.doi.org/10.11645/10.2.2097.
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This paper presents the findings of research which explored Scottish school libraries’ information provision and information literacy (IL) support in the run-up to two major political events: the 2014 Scottish Independence Referendum (SIR) and the 2015 General UK Parliamentary Election (GE). To do this, the project identified, through an online survey, what political information seeking secondary school students engaged in through school libraries, what information provision and IL support was available to students relating to political issues and events, and what barriers school libraries faced in providing these aspects of political education. It also identified what information seeking students engaged in, what levels of information provision and IL support relating to politics are provided by school libraries, and to explore the perceptions and experiences of library staff relating to work in this area. Analysis of the results indicates that there are mixed levels of provision across school libraries in Scotland and that this variation may be influenced by inconsistent policies from local councils and individual schools themselves, as well as variations in the experience and views of library staff. Key activities to support young people’s political education are identified, and several reasons library staff do not engage in political work are discussed. The findings are linked to previous research, with a discussion of the need to encourage and support school library staff to contribute to the political education of students alongside teaching staff. Several recommendations for schools and library staff are made, relating to a consideration of the role of school libraries, how they can provide relevant political information, the importance of clear policies around political information provision and the support required for school library workers.
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Ge, Y., H. T. Nguyen, T. A. Arcury, A. J. Johnson, W. Hwang, H. D. Gage, T. Reynolds, J. J. Carr, and J. C. Sandberg. "Insight into the Sharing of Medical Images." Applied Clinical Informatics 03, no. 04 (2012): 475–87. http://dx.doi.org/10.4338/aci-2012-06-ra-0022.
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SummaryBackground: Scant knowledge exists describing health care providers’ and staffs’ experiences sharing imaging studies. Additional research is needed to determine the extent to which imaging studies are shared in diverse health care settings, and the extent to which provider or practice characteristics are associated with barriers to viewing external imaging studies on portable media.Objective: This analysis uses qualitative data to 1) examine how providers and their staff accessed outside medical imaging studies, 2) examine whether use or the desire to use imaging studies conducted at outside facilities varied by provider specialty or location (urban, suburban, and small town) and 3) delineate difficulties experienced by providers or staff as they attempted to view and use imaging studies available on portable media.Methods: Semi-structured interviews were conducted with 85 health care providers and medical facility staff from urban, suburban, and small town medical practices in North Carolina and Virginia. The interviews were audio recorded, transcribed, then systematically analyzed using ATLAS.ti.Results: Physicians at family and pediatric medicine practices rely primarily on written reports for medical studies other than X-rays; and thus do not report difficulties accessing outside imaging studies. Subspecialists in urban, suburban, and small towns view imaging studies through internal communication systems, internet portals, or portable media. Many subspecialists and their staff report experiencing difficulty and time delays in accessing and using imaging studies on portable media.Conclusion: Subspecialists have distinct needs for viewing imaging studies that are not shared by typical primary care providers. As development and implementation of technical strategies to share medical records continue, this variation in need and use should be noted. The sharing and viewing of medical imaging studies on portable media is often inefficient and fails to meet the needs of many subspeciality physicians, and can lead to repeated imaging studies.Citation: Sandberg JC, Ge Y, Nguyen HT, Arcury TA, Johnson AJ, Hwang W, Gage HD, Reynolds T, Carr JJ. Insight into the sharing of medical images. Physician, other health care providers, and staff experience in a variety of medical settings. Appl Clin Inf 2012; 3: 475–487http://dx.doi.org/10.4338/ACI-2012-06-RA-0022
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Husaj, Shqipe. "Diagnosing the Problems in Teaching Courses of English for Specific Purposes at the University of Prishtina and Private Colleges in Kosovo." European Journal of Social Science Education and Research 7, no. 1 (April 30, 2020): 124. http://dx.doi.org/10.26417/496blv89m.
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A number of academic units at the University of Prishtina (UP) offer English for specific purposes in order to address the needs of students to communicate effectively in their chosen field of study. Recent developments and the changing landscape of teaching and learning English for Specific Purposes around the world lead to the decision of analyzing a complex of factors that affect or hinder the effectiveness of the process of teaching and learning ESP courses at the University of Prishtina as well as at the private colleges in Kosovo. The research questions include: What are the problems faced by students learning ESP at the University of Prishtina and at the private colleges in Kosovo? What are the ways of solving these problems? etc. The data has been collected by conducting a survey in six academic units of the University of Prishtina including both teaching staff and student population. The selection of academic units is done on the bases of their specificity of the study field. That means the faculties that need a more specific vocabulary of English Language. There has also been conducted a survey in three private colleges considered as more successful colleges; “Dukagjini“ College, AAB College and the College “Biznesi”. Theoretical part is based on outstanding scholars and researchers of the English for Specific Purposes .Research findings have confirmed our research hypothesis displaying expected pattern of obstacles faced by the teaching staff and students in the process of teaching and learning ESP courses. Status of the course, large number of students in groups, lack of equipped laboratories and lack of qualified staff, present a hindrance in achieving the objectives of ESP courses at the University of Prishtina. While in private colleges it is students’ low knowledge of English language that prevents the teaching of English for Specific Purposes thus concentrating more on General English (GE).
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Al-Mohannadi, Abdulla Saeed, Abdulla M. Albuflasa, Suzan Sayegh, Ahmad Salman, and Abdulaziz Farooq. "A Cross-Sectional Study Exploring Motivators and Barriers to Physical Activity Participation Among Hospital Workers." Global Journal of Health Science 12, no. 9 (July 12, 2020): 76. http://dx.doi.org/10.5539/gjhs.v12n9p76.
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The workplace is an ideal setting to implement an effective health-promoting program. Insufficient information exists regarding the motivators and barriers to physical activity among working adults in Qatar. Therefore, this study aimed to identify the motivators and barriers to physical activity among adults in a healthcare setting. This cross-sectional study was conducted in an orthopaedic and sports medicine hospital. The participants were Qatari and non-Qatari adult staff (n = 100), who were recruited by word of mouth. They filled out self-administered questionnaires consisting of questions on age, gender, nationality, medical conditions, and the motivators (external, health/medical, and engagement) and barriers (personal, perceptual, and time constraint) to participating in physical activity. The characteristics of participants were: Age (<35 years, 50.5%; ≥35 years, 49.5%), Gender (men, 47.5%; women, 52.5%), Nationality (Qatari, 51%; non-Qatari, 49%), and health status (healthy, 53%; ≥1 medical condition, 47%). Common motivators particularly among workers <35 years, were the desire to maintain weight/shape (83.5%), participating in a sport (67.7%), and getting out of the house (64.2%). Common barriers to exercise were weather (84.9%) and family responsibilities (84.4%). Other barriers, particularly among women, were difficulty in maintaining a routine (82.1%) and finding physical activity uninteresting (52.7%). The most common motivator to physical activity was the desire to maintain weight/shape and the main perceived barrier was the usual hot weather conditions most part of the year). Employers may need to consider the influence of these and other factors to improve the success of a physical activity program implemented in a workplace.
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Satria, Fauzi Budi, Rahayu Lubis, Yi-Hsin Elsa Hsu, and Usman Iqbal. "Association of women’s literacy and children’s mortality rate among countries in southeast Asia 2015-2019: a cross-sectional study." F1000Research 11 (February 14, 2022): 178. http://dx.doi.org/10.12688/f1000research.109133.1.
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Background: Women’s literacy is often associated with the health status of family members, especially children. Unfortunately, in some regions of Southeast Asia, the rates of women’s literacy are still very low, and in these areas, children’s mortality rates are also very high. This study aims to identify the association of women's literacy and children’s mortality rates among countries in the Southeast Asian region from 2015 to 2019. Methods: In this cross-sectional study, children’s mortality rates were defined as mortality rates in newborns and under-fives. Besides women’s literacy (WL), we also assessed the Human Development Index (HDI), Freedom Status (FS), Government Effectiveness (GE), and the proportion of births assisted by skilled health staff (BASHS) as the independent variables in this study. First, we describe the profiles of WL as well as newborn and under-five mortality rates among 11 countries in Southeast Asia from 2015 to 2019, and then we assess the correlations. Results: Between 2015 to 2019, Myanmar, Lao, and Timor-Leste had the highest child mortality rates. In addition, these four countries were the countries with the lowest WL rates compared to other countries. Children’s mortality rates were significantly associated with WL, GE, HDI, and BASHS. Meanwhile, this study found that the FS of a country was not significantly associated with the children’s mortality rate of countries in the Southeast Asia region. Conclusion: This study found that there’s an indication that the better the WL rate, as well as the governance, the HDI, and maternity services in a country, the lower its children’s mortality rates. Therefore, improvement in multiple sectors such as governance, economy, health system, education, and gender equality is required to help countries in this region achieve the United Nations’ Sustainable Development Goals target by 2030.
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Omojola, Akintayo Daniel, Funmilayo Ruth Omojola, Michael Onoriode Akpochafor, and Samuel Olaolu Adeneye. "Shielding assessment in two computed tomography facilities in South-South Nigeria: How safe are the personnel and general public from ionizing radiation?" ASEAN Journal of Radiology 21, no. 2 (August 30, 2020): 5–27. http://dx.doi.org/10.46475/aseanjr.v21i2.89.
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Objective: The aims of this study were to estimate the instantaneous dose rate(IDR) and annual dose rate (ADR) to radiation staff and the general public withinthe controlled and supervised areas, respectively, to determine the shieldingdesign goals (P) of the 2 CT facilities and to determine the average annual dose(AD) to radiographer/operator in the control console during CT scans. Materials and Methods: The equipment used in this study consisted of twonewly installed General Electric (GE) Revolution ACTs CT machines. Technicalparameters used were a thoracic/dorsal spine scan, which was rarely done in both facilities. A calibrated Inspector USB (S.E. International, Inc.) survey meter was positioned < 50 cm from each barrier at various points to determine the average shielded air kerma Results: The average background radiation in the 2 facilities was 0.11 ?Sv/hr. The average ADR to the controlled and supervised areas in CT1 was 0.563±0.25 and 0.369±0.11 mSv/yr, respectively. Also, the average ADR to the controlled and supervised areas in CT2 were 0.410±0.28 and 0.354±0.04 mSv/yr, respectively. The average shielding design goal to the controlled and supervised areas for CT1 was 0.00898±0.0041 and 0.0059±0.0028 mSv/Week, respectively. Similarly, the average shielding design goal for the controlled and supervised areas for CT2 was 0.0066±0.0044 and 0.0057±0.0019 mSv/Week respectively. The estimated average AD to the operator in CT1 and CT2 was 2.5 and 1.3 ?Sv, respectively. Conclusion: The average ADR and shielding design goals in the controlled and supervised areas from both CTs were within acceptable limits for radiation staff and the public.
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Henao, César Augusto, Ana Batista, Andrés Felipe Porto, and Virginia I. González. "Multiskilled personnel assignment problem under uncertain demand: A benchmarking analysis." Mathematical Biosciences and Engineering 19, no. 5 (2022): 4946–75. http://dx.doi.org/10.3934/mbe.2022232.
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<abstract> <p>The personnel assignment problem in different service industries aims to minimize the staff surplus/shortage costs. However, uncertainty in the staff demand challenges the accomplishment of that objective. This research studies the personnel assignment problem considering uncertain demand and multiskilled workforce configured through a 2-chaining strategy. We develop a two-stage stochastic optimization (TSSO) approach to calculate the multiskilling requirements that minimize the training costs and the expected costs of staff surplus/shortage. Later, we evaluate and compare the performance of the TSSO approach solutions with the solutions of two alternative optimization approaches under uncertainty - robust optimization (RO) and closed-form equation (CF). These two alternative approaches were published in Henao et al. <sup>[<xref ref-type="bibr" rid="b1">1</xref>]</sup> and Henao et al. <sup>[<xref ref-type="bibr" rid="b2">2</xref>]</sup>, respectively. In addition, we compare the performance of the TSSO approach solutions with the solution of the deterministic (DT) approach and the solutions of myopic multiskilling approaches. To make performance comparisons between the different approaches, we used both real and simulated data derived from a retail store operating in Chile. The results show that, for different demand variability levels, TSSO, RO, and CF always belong to the set of approaches with the lowest average total cost. That is, in this group, there are no statistical differences from one approach to another, so these approaches are the most cost-effective. We also provide insights to retail decision-makers for addressing two key aspects. First, the methodology allows to address two fundamental multiskilling issues: how much multiskilling to add and how it should be added. Second, it is provided understanding on how to select the most suitable approach according to the balance between the conservatism and the reliability associated with the solutions delivered by each approach. Finally, we identify some methodological challenges for future research, such as the evaluation of k-chaining strategies with $ k\ge 2 $.</p> </abstract>
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Masadeh, Majed Abdel-Mohdi. "Role of Zarqa University in Improving the Quality of the Services Provided to the Local Community in Zarqa Governorate." Modern Applied Science 13, no. 1 (December 31, 2018): 192. http://dx.doi.org/10.5539/mas.v13n1p192.
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The study aimed to identify the role of Zarqa university in improving the quality of the services provided to the local community in Zarqa governorate. The study also sought to identify the degree of the university's interest in the quality of its services provided to the local community from the perspective of its employees, and have been using the scientific method, which combines the descriptive method and analytical method, so the researcher designed a questionnaire for this purpose, based on some previous studies related to the study, and the questionnaire included in its final form on (45) paragraph, and was test the sincerity of the instrument and its stability, and the stability coefficient of the total instrument is (0. 867). The study was conducted on the members of the faculty and administrative staff at the Zarqa University (580), due to the study population size is large, the researcher resorted to select a stratified random sample with percentage (25%) of the total study population, where the final sample is (98) member of faculty and administrative. The study found a number of results was the most important: that there were no statistically significant differences at the of significance level (≥ α 0.05), between the responses of the employees of Zarqa University about the role of Zarqa university in improving the quality of the services provided to the local community in Zarqa governorate attributed to some personal and functional characteristics represented by (gender, specialty of faculty, Scientific qualification, and experience years).
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Rohe, Duke, Cheryl Perego, Polly Williams, Cindy Zabka, Julie Foster, Lisa McLemore, and David Yao. "Increasing hand hygiene compliance using a solution session." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 147. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.147.
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147 Background: Few would argue that proper hand hygiene (HH) is vital for preventing nosocomial infection, yet compliance rates remain low and capturing its data is difficult. Methods: A homegrown "design" methodology called Solution Session which combines creative problem solving, GE WorkOut and an accountability maturity model was used to define problems, formulate ideas to increase HH compliance. From the session five subteams (addressing Compliance, Patient Education, Staff Education, Process and Automation) were enlisted to develop a holistic set of solutions to address HH compliance. Infection Control paid special attention to developing custom observation plans for each unit. One of the solutions, a homegrown web-based observation collection system, was created to collect and report compliance by individual and department level. The system of solutions were piloted on a unit that was already doing well (with a baseline compliance of 92%) and two struggling high acuity units (with baseline compliance at 54% and 50%). Results: The pilot unit that was doing well to begin with has averaged HH compliance rate 99% for over a 15 month period (n=105/month). The two struggling units have averaged 84% and 80% respectively (n= 60/month and n=24/month) over the same period. The operating room is the next candidate in line to employ this system. Conclusions: 1) Solutions are best designed by those affected. 2) People respond to data.Weekly reportsdisplay number of observations taken, compliance down to the department and individual level: powerful tools to start the self correction process. 3) Compliance is a marathon, not a sprint.
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Munir, Mehnaz, Hamza Nadeem Malik, Muhammad Jareer Alam, Ammara Arif, and Fiza Khalid. "Body Mass Index and its Relation with Socio-Demographic Factors among Healthcare Workers." BioMedica 37, no. 2 (June 30, 2021): 93–99. http://dx.doi.org/10.51441/biomedica/5-266.
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<p><strong>Background and Objective:</strong> Obesity leads to multiple complications that in turn increase mortality worldwide. There is a rapid rise in obesity in the last decade, especially among physicians. The objective of this study was to find out the frequency and relationship of obesity with socio-economic factors among faculty of a local medical college in Lahore, Pakistan.<br /><strong>Methods: </strong>A descriptive cross-sectional study was conducted on 162 medical and paramedical staff of Fatima Memorial College of Medicine and Dentistry, Lahore for a duration of 7 months from February 2019 to August 2019. Data were collected by filling the questionnaires and standard tools were used for height and weight measurement. Overweight/obesity was defined as a body mass index of ≥25 kg/m2.<br /><strong>Results:</strong> In this study, out of 86 males and 76 females, the majority of the respondents were between the ages of 21 and 35 years. Seventy three (45.1%) and thirty (18.5%) respondents were overweight and obese, respectively. Out of a total 162 subjects, 38 (24%) were hypertensive and 18 (11%) were suffering from diabetes. There was a statistically significant association of obesity with age (p < 0.05), marital status (p < 0.001), family history of obesity (p < 0.001), and smoking (p < 0.05).<br /><strong>Conclusion: </strong>Risk factors like age, marital status, family history of obesity, and smoking have a strong correlation with obesity in faculty members of a medical school.</p>
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Hassan, Ameer E., and Sophie Amelot. "Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience." Interventional Neurology 6, no. 3-4 (2017): 105–16. http://dx.doi.org/10.1159/000456622.
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Background and Purpose: Per the ALARA principle, reducing the dose delivered to both patients and staff must be a priority for endovascular therapists, who should monitor their own practice. We evaluated patient exposure to radiation during common neurointerventions performed with a recent flat-panel detector angiographic system and compared our results with those of recently published studies. Methods: All consecutive patients who underwent a diagnostic cerebral angiography or intervention on 2 modern flat-panel detector angiographic biplane systems (Innova IGS 630, GE Healthcare, Chalfont St Giles, UK) from February to November 2015 were retrospectively analyzed. Dose-area product (DAP), cumulative air kerma (CAK) per plane, fluoroscopy time (FT), and total number of digital subtraction angiography (DSA) frames were collected, reported as median (interquartile range), and compared with the previously published literature. Results: A total of 755 consecutive cases were assessed in our institution during the study period, including 398 diagnostic cerebral angiographies and 357 interventions. The DAP (Gy × cm2), fontal and lateral CAK (Gy), FT (min), and total number of DSA frames were as follows: 43 (33-60), 0.26 (0.19-0.33), 0.09 (0.07-0.13), 5.6 (4.2-7.5), and 245 (193-314) for diagnostic cerebral angiographies, and 66 (41-110), 0.46 (0.25-0.80), 0.18 (0.10-0.30), 18.3 (9.1-30.2), and 281 (184-427) for interventions. Conclusion: Our diagnostic cerebral angiography group had a lower median and was in the 75th percentile of DAP and FT when compared with the published literature. For interventions, both DAP and number of DSA frames were significantly lower than the values reported in the literature, despite a higher FT. Subgroup analysis by procedure type also revealed a lower or comparable DAP.
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Hsieh, Chen-Yu Chester. "Linguistic typology, language modality, and stuff like that." Studies in Language 43, no. 1 (June 12, 2019): 92–119. http://dx.doi.org/10.1075/sl.18009.hsi.
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Abstract Pragmatic particles termed general extenders (GE) have been examined across languages and are found to serve multiple functions. Despite the fruitful findings, few study the use of GEs in different language modalities and in typologically more different languages such as Chinese. This research aims to contribute to this literature by investigating the use of the GE zhilei(de) (zld), ‘of that kind,’ in spoken and written Chinese. Data from corpora of spoken and written Chinese suggest that zld displays some distinctive patterns in its form and function, partly due to the typological traits of Mandarin Chinese. The results also indicate that the language modality where zld is deployed may have impacts on its structural and functional distribution. The current article thus holds implications not only for the literature of GEs but also for the study of the interface between linguistic typology, language modality, and pragmatic expressions.
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Mackie, S., A. Barr, A. Cracknell, S. Farrell, J. Parvin, A. Patil, I. Simmons, et al. "AB1174 TRACKING THE EFFECTS ON A CLINICAL SERVICE OF INTRODUCING ULTRASOUND FOR DIAGNOSIS OF GIANT CELL ARTERITIS: DESIGN OF A SERVICE EVALUATION USING LEAN METHODOLOGY." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1877.2–1878. http://dx.doi.org/10.1136/annrheumdis-2020-eular.646.
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Background:In our large, multi-site hospital, patients with suspected GCA are started promptly on high-dose prednisolone but until 2019, patients waited for temporal artery biopsy (TAB) until the GCA diagnosis could be confirmed (“GCA”) or refuted (“not-GCA”). Reports of the impact of introducing temporal and axillary artery ultrasound (TAUS) have mainly come from smaller hospitals. Agreement between TAUS and TAB has been reported by others with a Cohen’s kappa of 0.35 [1] and 0.40 [2]. We used Lean methodology to identify metrics across 5 key domains: delivery, quality, service, morale and cost.Objectives:To design metrics for a service evaluation to measure impact of introducing TAUS, and to test their feasibility of measurement within routine care.Methods:Our primary driver was time from presenting to our service to diagnostic confirmation (lead time). Pathway mapping, value stream mapping and a driver diagram identified key ideas for improvement.We chose to measure: Delivery (mean lead time for each month), Quality (proportion of patients with GCA and positive TAB/TAUS; total (cumulative) prednisolone dose in patients with not-GCA, Service (patient feedback), Morale (staff feedback) and Cost (number of patients; cost of tests per patient; overall costs). We plotted these by month on run charts and defined a significant shift as 6 consecutive monthly values below baseline median. Cohen’s kappa was calculated using GraphPad QuickCalcs.Results:Routine TAUS for suspected GCA was introduced from January 2019, alongside a multidisciplinary team monthly meeting. TAUS was done a median of 2.5 days from referral. Agreement between TAB and TAUS results was good (Table 1). The run chart showed a significant shift in our Delivery (median lead time fell from 28.7 days to 21 days after introduction of ultrasound) and both Quality metrics (proportion of GCA with positive TAB/TAUS increased from 29% to 69%; total prednisolone dose for not-GCA fell from 1.335g to 0.846g).Table 1.Concordance between temporal and axillary artery ultrasound (TAUS) and temporal artery biopsy (TAB) in scans performed through 2019. Cohen’s weighted kappa 0.59 (including equivocal results as separate category).TAUS positiveTAUS negativeTAUS equivocalTAB positive1411TAB negative5275TAB equivocal030Within Costs, average per-patient costs of TAB/TAUS declined from £1004/patient to £792/patient, but total referrals for TAB/TAUS increased from 6/month to 10/month, increasing overall costs. Staff and patient feedback (Service, Morale) revealed that further improvements to the care pathway were needed to manage the additional complexity.Conclusion:Lean methodology identified multiple metrics for evaluating the impact of TAUS on our service. Introducing TAUS improved Delivery and Quality, but measuring Costs, Morale and Service helped identify unintended consequences. Concordance between TAUS and TAB was good. We plan to continue to improve and monitor the care pathway based on our multi-stakeholder feedback.References:[1]Luqmani et al., HTA 2016[2]Mukhtyar et al., Clin Rheum 2019Disclosure of Interests:Sarah Mackie Grant/research support from: Roche (attendance of EULAR 2019; co-applicant on research grant), Consultant of: Sanofi, Roche/Chugai (monies paid to my institution not to me), Andrew Barr: None declared, Alison Cracknell: None declared, Shannon Farrell: None declared, Jimmy Parvin: None declared, Ajay Patil: None declared, Ian Simmons: None declared, Kate Smith Grant/research support from: Medical education grants from Sanofi and Biogen, Speakers bureau: Novartis, Andrea Sweeting: None declared, Max Troxler: None declared, Tara Webster: None declared, Richard Wakefield Speakers bureau: Novartis, Janssen, GE
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Witt, Lucy, Jessica Howard-Anderson, Elizabeth Overton, and Jesse Jacob. "Impact of exposure to potentially contaminated hospital beds on risk of hospital-onset C. difficile infection." Antimicrobial Stewardship & Healthcare Epidemiology 2, S1 (May 16, 2022): s17—s18. http://dx.doi.org/10.1017/ash.2022.86.
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Background: Environmental contamination increases risk for Clostridioides difficile infection (CDI) given that spores can remain on a hospital bed, floor, sink, and light switch despite appropriate cleaning measures. Using real-time asset management software (AgileTrac, GE Healthcare) for beds we examined the risk of a patient developing hospital-onset CDI (HO-CDI) when staying in a hospital bed that had a previous occupant with CDI. Methods: We retrospectively identified all patients in tracked beds from April 2018 to August 2019 to identify hospital-onset CDI (HO-CDI), defined as a positive PCR test for C. difficile in a patient hospitalized for >3 days. A patient was defined as being exposed to a potentially “contaminated” bed if within the preceding 7 days from their HO-CDI diagnosis they resided in a hospital bed that, within the prior 90 days, had held an occupant with CDI (Fig. 1). We used multivariable logistic regression to evaluate the association between being exposed to a contaminated bed and HO-CDI. Model covariates were chosen a priori based on known risk factors for CDI. As a sensitivity analysis, we varied the length of time that a bed could stay contaminated from 90 to 60, 30, 14, and 7 days. Results: We analyzed 25,032 hospital encounters representing 18,860 unique patients; we identified 237 (0.9%) hospital encounters with HO-CDI (Table 1). The Elixhauser comorbidity score, being exposed to a contaminated bed, and receiving antibiotics or a proton pump inhibitor (PPI) during the hospital admission were all associated with HO-CDI in the univariable analysis (Table 2). In the adjusted multivariable model, being exposed to a contaminated bed remained a significant risk factor for HO-CDI (OR, 1.60; 95% CI, 1.22–2.08) even after controlling for known risk factors for CDI including age >65, elevated Elixhauser score, and recent antibiotic or PPI use (Table 2). In the sensitivity analysis in which we adjusted the time a bed was considered contaminated after CDI, being exposed to a contaminated bed remained a risk factor for HO-CDI, with a similar odds ratios as the original model (Table 2). Conclusions: Residing in a hospital bed that contained a previous occupant with CDI is a risk factor for developing HO-CDI. Hospital epidemiologists, infection control personnel, and environmental services staff should consider this association when developing CDI risk mitigation strategies.Funding: NoneDisclosures: None
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Liu, Tengfei. "SCIENTIFIC BASE OF CULTURAL AND EDUCATIONAL ACTIVITIES IN THE PALEONTOLOGICAL MUSEUM OF LIAONING IN CHINA." Vestnik Tomskogo gosudarstvennogo universiteta. Kul'turologiya i iskusstvovedenie, no. 40 (2020): 236–41. http://dx.doi.org/10.17223/22220836/40/21.
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The article covers the formation of the scientific base for working with visitors at the Paleontological Museum of Liaoning in China. The original reason for the creation of the museum is stated, it was connected with 1990s, when numerous fossils were discovered in Liaoning province. The first of them were Sinosauropteryx and the Liaoning ancient fruit (Archaefructus liaoningensis). Later large number of fossils were discovered, they represent the flora and fauna of China existed more than 3 billion years ago. It is important to say that the Liaoning Provincial Department of Land Resources and Shenyang University saw scientific value of the paleontological findings. They decided to build a paleontological museum on a parity basis. Construction of the museum building at Shenyang University began in 2006, and the Paleontological Museum of Liaoning was opened in 2011. The world-famous paleontologists contributed immensely to the formation of the Paleontological Museum of Liaoning. They are Sun Ge (Chinese researcher), M.A. Akhmetyev (Russian scientist), F. Mosbrugger (director of the Museum of Natural History of Germany), K. Johnson (director of the Smithsonian National Museum of Natural History, Washington, USA) and professor P. Godfroy (Royal Institute of Natural History of Belgium). The staff of the Liaoning Museum, part-time researchers, as well as student volunteers of the Shenyang University participated in the development of the museum resources. Thanks to joint hard work, the museum has collected more than 30 thousand paleontological fossils. At present, the collection of the Liaoning Museum includes all kinds of animals and plants of ancient China, they are subdivided into seven classification groups. The reliance on the rich resources of the museum ensured the creation of the exposition, which occupies eight exhibition halls. They exhibit genuine monuments of paleontology, as well as replicas and models. They acquaint visitors with the ancient world of China, communicate the geological history of the Liaoning province, and reveal the kingdom of dinosaurs. The author of article emphasizes that in 2011, when the museum was opened, a department for the popularization of science was formed along with other departments. The main task of the workers of this department was to carry out cultural and educational activities with specialists and ordinary visitors. The department organizes exhibitions in China and abroad, conducts seminars for workers of Chinese nature museums. The scientific and educational section within the department for popularization of science also work with schoolchildren. During the first nine years of the museum's creation, three million single visitors and twenty thousand social groups have visited Paleontological Museum of Liaoning. So the article reveals the importance of cultural and educational activities that ensures the cooperation of the Liaoning Museum with other schools and museums in China, brings the museum to the international level.
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Safonova, O. M., O. B. Dynnyk, G. L. Gumeniuk, V. A. Lukiianchuk, H. V. Linska, M. S. Brovchenko, V. V. Panasiuk, and S. O. Soliaryk. "Standardized protocol for ultrasound diagnosis of the lungs with COVID-19." Infusion & Chemotherapy, no. 2 (June 29, 2021): 19–30. http://dx.doi.org/10.32902/2663-0338-2021-2-19-30.
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BACKGROUND. The era of coronavirus disease (COVID-19) set the such task for lung ultrasound (LUS): to identify the presence of COVID-pneumonia, its differential diagnosis with other conditions which characterized by interstitial edema, determining the severity of lung damage and its location, the dynamics of pulmonary changes tissue, the development of complications, as well as to assess the effectiveness of personalized therapy.
OBJECTIVE. To develop a national LUS protocol for COVID-19 based on a balance of completeness of information with the optimal minimum of time and effort for medical staff, who often do not specialize in ultrasound using, with ultrasound equipment of basic and middle classes.
MATERIALS AND METHODS. A total of 1576 patients with COVID-19 were examined. There were 810 women (51.4 %) and 766 men (48.6 %). The age of the examined patients was in the range of 18-83 years, the average age was 52.3±14.6 years. 4710 LUS were performed, of which 1572 were repeated and 3144 – in the dynamics. Polysystemic ultrasound was performed in 275 patients. Ultrasound devices of both domestic and foreign production were used: Soneus P7 (Ultrasine, Ukraine), HandyUsound (Ukraine), Xario, USAP-770A (Toshiba, Japan), GE Venue (General Electric, USA) and TE7 COVID (Mindray, China) with ultrasound probes of convex, linear and microconvex formats.
RESULTS. Summarizing our own experience with patients with COVID-19 in 2020-2021, we have developed a version of the LUS-protocol, which has a convenient form of recording all stages of ultrasound with maximum coverage of the entire volume of both lungs according to a clear algorithm, a graphical form, clear ultrasound semiotics and diagnostic scoring criteria for the severity of lung damage.
CONCLUSIONS. 1. Clinical data indicate the feasibility and effectiveness of using LUS for dynamic monitoring of patients with pneumonia caused by SARS-CoV-2, especially in oxygen-dependent patients at their bedside (POCUS principle). 2. Optimization of the use of radiological diagnostic methods due to ultrasound makes it possible to reduce the radiation dose of the patient.3. The use of LUS allows more adequate decision-making on the need for intensive and interventional therapy, leads to faster diagnosis, improved medical care, reduced length of stay of patients in ICU, as well as reducing the total cost of treatment.4. Ability to reduce the impact of SARS-CoV-2 on healthcare professionals by limiting physical contact with the patient. 5. The standardized Ukrainian protocol of LUS provides availability, efficiency and clear interpretation of the received data at its use by different doctors in different medical institutions. The integration of the protocol in to the ultrasound machine provides optimization of the workflow process.
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Denis, Derek. "The Development of And Stuff in Canadian English: A Longitudinal Study of Apparent Grammaticalization." Journal of English Linguistics 45, no. 2 (April 30, 2017): 157–85. http://dx.doi.org/10.1177/0075424217701182.
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This paper examines the development of and stuff, a general extender (GE), in Canadian English in longitudinal perspective. Previous research (Cheshire 2007; Tagliamonte & Denis 2010; Pichler & Levey 2011) finds suggestive evidence that and stuff and other GEs have undergone grammaticalization over their development. However, when viewed in apparent time, there is little evidence of ongoing grammaticalization; rather only vestiges of apparent previous grammaticalization remain. This paper takes up Pichler and Levey’s (2011) call for an appropriate real-time benchmark of comparison to enable a more thorough understanding of the historical development of these features. A collection of oral histories recorded in the 1970s and 1980s with elderly residents of three communities in southern Ontario, Canada, is used as a proxy for comparison to Tagliamonte and Denis’s (2010) analysis of the Toronto English Archive. By tracking the development of and stuff over more than a century of apparent time, this paper finds three changes in progress: (1) a lexical replacement such that and stuff becomes the majority variant in the variable system; (2) a morphological clipping process such that longer GEs such as and stuff like that lose the comparative element like that; and (3) the semantic bleaching of the set-marking meaning of and stuff. While this last change is a necessary part of grammaticalization, in the absence of phonetic reduction, decategorialization, and pragmatic shift, it is not sufficient evidence according to grammaticalization theory (e.g., Heine 2003; Traugott 2003; Diewald 2010).
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Kovalchuk, I. I., R. S. Fedoruk, and M. M. Tsap. "Main directions of research and achievements of the Laboratory of ecological physiology and product quality in 2000–2020." Animal Biology 22, no. 3 (September 2020): 45–52. http://dx.doi.org/10.15407/animbiol22.03.045.
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The article presents the main directions of research and the most significant results of the laboratory of ecological physiology and product quality of the Institute of Animal Biology of NAAS for twenty years of its activity. The results of basic research and applied developments obtained during the implementation of tasks included in the scientific programs of NAAS and the Scientific and Methodological Center “Animal Physiology” are presented. The main characteristics of the physiological impact of new effective feed additives and BAS, tested in production and implemented on different species of animals — cattle, sheep, poultry, rabbits, bees, in pond fish, substantiated methods of their use. The relationship between the degree of man-made pollution and the intensity of physiological and biochemical processes in animals, their adaptive and reproductive capacity. The method of arterio-venous difference in the mammary gland revealed some mechanisms of physiological influence of Cd in the body of cows during lactation under conditions of experimental loading of its salts of different concentrations, the level of biotransformation into milk. The study of the biological action of new organic compounds Se in cows, calves and breeding bulls was started for the first time. The composition of the feed additive based on the drug “Sel-Pleks” was developed and tested, which increases the immunobiological, productive and reproductive ability of the body of cows in the conditions of intensive technogenic load. New scientific data on the biological action of the developed protein-mineral supplements in the body of rabbits with different methods of maintenance and feeding. Physiological and biochemical mechanisms of influence of terms of weaning of young rabbits on immunobiological reactivity of an organism are found out. A recipe for granular feed with high protein content has been developed and its effect on growth intensity and physiological and biochemical processes in rabbits has been studied. Possibilities of application of genetically modified feeds in animal feeding and their influence on physiological status, ecological safety and quality of production are substantiated. The influence of GMO soybeans and products of their processing on the formation of adaptive reactions and functioning of individual organs and systems in animals has been studied. The absence of a pronounced negative effect of transgenic soy on the growth and development of the organism and its reproductive ability in female animals has been proved. The effect of Ge in the form of germanium citrate, obtained by nanotechnological method and chemically synthesized, on the state of the immune, reproductive antioxidant and detoxification systems of the body in laboratory rats of two generations has been studied. The peculiarities of ontogenetic development of male F1 rats under the action of different doses of germanium citrate have been elucidated. The possibility of using small and medium doses of germanium citrate to stimulate the body’s immune and antioxidant systems, its reproductive capacity in females of multiple animals is substantiated. Changes in physiological and biochemical parameters of blood and detoxification ability of rats F0 and F1 under the action of different doses of germanium citrate were established. The effect of different doses of germanium citrate on the content of biotic mineral elements in tissues and organs of animals has been studied. Peculiarities of histological structure of tissues of immunocompetent organs of female F1 rats under the action of different doses of germanium citrate are noted. The role of the laboratory staff in the improvement of existing and development of new methods of physiological, biochemical and ecological research, State standards, the possibility of their adaptation and harmonization to modern conditions of science and production is shown.
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Streitparth, F., P. Schöttle, K. Schlichting, H. Schell, F. Fischbach, T. Denecke, G. N. Duda, and R. J. Schröder. "Osteochondral defect repair after implantation of biodegradable scaffolds: indirect magnetic resonance arthrography and histopathologic correlation." Acta Radiologica 50, no. 7 (September 2009): 765–74. http://dx.doi.org/10.1080/02841850902980272.
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Background: Biodegradable scaffolds have become an important option in the treatment of osteochondral defects. Therefore, accurate and reproducible monitoring of scaffold repair tissue is crucial. Purpose: To assess the feasibility of indirect magnetic resonance (MR) arthrography in determining the quality of osteochondral repair after scaffold implantation using an MR imaging (MRI) scoring and grading system with histology as reference. Material and Methods: Osteochondral defects created at ovine condylar facets were treated with either a commercial poly (DL-lactide-co-glycolide) (PLG) scaffold or a modified softer one ( n=6/group; 87% and 55% of the elastic modulus of ovine subchondral bone, respectively). Empty defects at the contralateral condyle served as control group. A 1.5T MRI scan was performed after 6 months with proton density (PD)-weighted (w) fat-saturated (fs) fast spin-echo (FSE), T1-w two-dimensional (2D), and 3D fs gradient echo (GE) sequences 30min after intravenous Gd-DTPA administration and passive joint movement. Two independent radiologists evaluated the repair tissue. The MR findings were correlated with histological findings. Results: MRI and histological grading correlated well (10/12 cases). The stiff-scaffold group showed significantly superior repair in comparison to the control group ( P<0.05). The 3D fs GE sequence proved to be most valuable in evaluating morphologic status. Complete defect filling and integration, intact surface and isointense signal to the adjacent native cartilage, subchondral incorporation with bone marrow edema, and graft plug enhancement were associated with a good histological outcome. Histologically, we found a smooth fibrocartilaginous layer and osseous replacement of the scaffold. Incomplete cartilage repair and irregular subchondral structures on the MRI correlated histologically with fibrocartilage-like repair and subchondral sclerosis, due to substantial degradation of the scaffold. Conclusion: Indirect MR arthrography is an accurate, noninvasive monitoring tool in the follow-up of scaffold implants. The MRI scoring and grading system allows reliable assessment of normal and pathological repair, with high correlation to histological findings.
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Sävborg, Daniel. "Painful Love and Desire in Skírnismál." Religionsvidenskabeligt Tidsskrift 74 (March 25, 2022): 490–512. http://dx.doi.org/10.7146/rt.v74i.132117.
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ABSTRACT: The Eddic poem Skírnismál depicts erotically associated suffering in several instances. The god Freyr is filled with pain and grief when he first lays eyes on the beautiful jǫtunn maiden Gerðr. Later in the poem, Gerðr is threatened with horrible punishments if she refuses to give herself to Freyr, and one of these punishments consists in unfulfilled desire. The present study examines the sorts of emotions that are in play in these instances and attempts to determine the origins of the ways in which these emotions are depicted. The study also focuses on whether, and if so in what way, the two cases of erotically associated suffering are related to one another.
SAMMANDRAG: I eddadikten Skírnismál skildras erotiskt anknutet lidande vid flera tillfällen. Guden Freyr uppfylls av smärta och sorg vid första anblicken av den sköna jättinnan Gerðr. Senare i dikten hotas Gerðr med gruvliga straff om hon nekar att ge sig åt Freyr, och ett av straffen består i ouppfylld åtrå. Denna studie undersöker vilka slags känslor det handlar om i dessa fall och försöker fastställa ursprunget för traditionen för skildringarna av dessa känslor. Studien undersöker också om och i så fall hur de två fallen av erotiskt anknutet lidande i dikten är relaterade till varandra.
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Abd Elaziz, Ahmed Yehia, and M. Hesham El Naggar. "Group behaviour of hollow-bar micropiles in cohesive soils." Canadian Geotechnical Journal 51, no. 10 (October 2014): 1139–50. http://dx.doi.org/10.1139/cgj-2013-0409.
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The use of hollow-core bars in micropiles has greatly increased over the past 10 years. In this study, the group behaviour of hollow-bar micropiles is investigated. The research methodology encompasses a full-scale field study on single hollow-bar micropiles and pairs of micropiles installed in cohesive soils and numerical investigations using three-dimensional (3D) finite element analysis. Four hollow-bar micropiles were installed in stiff silty clay deposit using large drilling carbide bits. Four axial monotonic tests on pairs of hollow-bar micropiles were conducted as part of the field study. The field test results were utilized to calibrate–verify a 3D finite element model (FEM). A parametric study was performed using the verified FEM to characterize capacity and performance of hollow-bar micropile groups. Group efficiency factors and interaction factors were established to evaluate the capacity and response of hollow-bar micropile groups under vertical loading. The results from the field tests and numerical investigations revealed that for hollow-bar micropiles, group efficiency factor, GE, can be taken equal to 1. A method for calculating the group settlement utilizing the interaction factors approach is proposed and a family of interaction factor diagrams is established to evaluate the group settlement.
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Kamp Felbo, S., L. Terslev, I. J. Sørensen, O. Hendricks, D. Kuettel, R. Lederballe Pedersen, S. Chrysidis, and M. Østergaard. "POS0131 CONCORDANCE BETWEEN LOCATION OF SELF-REPORTED SITE OF MUSCULOSKELETAL PAIN IN PSORIASIS AND FINDINGS OF INFLAMMATION BY ULTRASOUND." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 291.2–292. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2741.
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BackgroundPatients with psoriasis (PsO) often report muskuloskeletal (MSK) pain without clinical findings of inflammation. Ultrasound (US) is more sensitive than clinical evaluation in detecting synovitis and enthesitis, and we have previously found that patients with PsO and pain more often have US signs of inflammation in joints and entheses than patients without pain (1), indicating possible psoriatic arthritis (PsA). Whether the area of reported pain in these patients correspond to inflammation by US has not yet been investigated.ObjectivesIn patients with PsO with self-reported MSK pain, to investigate if the area of reported of pain corresponds to synovitis and/or enthesitis.MethodsPsO patients with self-reported MSK pain (n=79, Table 1), recruited from a Danish nationwide survey, were evaluated in one of four rheumatology departments with greyscale (GS) and color Doppler (CD) US of 48 joints and 12 entheses, applying the OMERACT scoring systems (2) for US synovitis (defined as GS score ≥2 or CD≥1) and enthesitis (defined as ≥1 GS inflammatory finding (hypoechogenicity/thickening) and CD score ≥1). Patients indicated the location of current pain in 21 areas on a homunculus, out of which shoulder (joint), elbow (joint and common extensor enthesis), hand (wrist and MCP, PIP, and DIP-joints 1-5), knees (joint and quadriceps- and patellar entheses), feet (ankle and MTP-joints 1-5) and heel (Achilles- and plantar fascia entheses) were evaluated by US, se Figure 1. Association between self-reported pain and US inflammation (synovitis/enthesitis) was explored using Fisher’s exact test and odds ratios (OR) for 2x2 tables. Agreement was calculated using Cohen’s kappa (κ).Table 1.Population characteristics (n=79)Sex (female)33 (42)Age (years)57 (47-66)Body Mass Index (kg/m2)28.4 (24.8-34.8)Disease duration PsO (years)25 (11-39)Swollen joint count (0-66)0 (0-1)Tender joint count (0-68)2 (0-5)Tender enthesis count (0-16)1 (0-2)Fibromyalgia tender point count (0-18)1 (0-5)Psoriasis Area and Severity Index (0-72)1.5 (0.2-4.2)Nail psoriasis (presence)26 (33)Physician VAS (0-100)3 (1-6)CRP (mmol/l)2.1 (0.5-4.1)Global VAS (0-100)16 (4-45)Pain VAS (0-100)20 (5-39)Health Assessment Questionnaire (0-3)0.25 (0.00-0.69)DAS28-CRP (0-10)1.6 (1.5-2.6)Disease Activity in Psoriatic Arthritis (0-164)5.2 (4.1-20.7)Numbers are median (IQR) or no. (%). CRP: C-reactive protein, DAS28: Disease Activity Score - 28 joints, VAS: Visual Analog ScaleFigure 1.Self-reported pain versus ultrasound (US) inflammation in different areas, and in all areas considered together, presented as 2x2 tables and corresponding odds ratios (OR, p-value) (Fisher’s exact test), and agreement (Cohens Kappa (κ (95% confidence interval)).ResultsOf the areas examined by US, pain was most frequent in the knees (41% of patients), while US inflammation was most frequent in the hand/wrist (55%). In total, US inflammation was found in of 72% patients (synovitis in 71%, enthesitis in 17%). In 47% of patients, US inflammation was found in one or more of the painful sites. Figure 1 shows 2x2 tables of pain versus US inflammation in different areas and corresponding ORs and κ-values. Self-reported pain was significantly related to US inflammation in that area, both overall (OR=3.1, p>0.001) and for the specific areas of the left hand (OR 3.1, p=0.03) and right elbow (OR 18.3, p=0.01). Agreement between self-reported pain and US inflammation, as measured by κ, was overall low, κ =0.18(95% confidence interval 0.10-0.27), with highest agreement found for the right elbow (κ = 0.30(-0.9-0.68)). Pain only in areas not examined by US (back/hips/breastbone/jaw) was indicated by 16% of patients.ConclusionWhile US signs of synovitis and enthesitis is frequent in patients with PsO and pain, concordance between US inflammation and the specific location of pain is only seen in half of the patients.References[1]Felbo SK et al., Rheumatology (Oxford), 2021.[2]Bruyn GA et al., The Journal of Rheumatology, 2019AcknowledgementsThe authors would like to thank all participating patients, physicians, laboratory staff, study nurses and secretaries who contributed to this study, Amgen/Celgene for financial study support and The Danish Rheumatism Association and The Danish Psoriasis Research Foundation for support of the work of SKF.Disclosure of InterestsSara Kamp Felbo Grant/research support from: Amgen/Celgene, Lene Terslev Speakers bureau: AbbVie, Janssen, Roche, Novartis, Pfizer, MSD, BMS and GE, Inge Juul Sørensen: None declared, Oliver Hendricks Speakers bureau: Abbvie, Pfizer and Novartis, Dorota Kuettel: None declared, Rasmus Lederballe Pedersen: None declared, stavros chrysidis: None declared, Mikkel Østergaard Speakers bureau: AbbVie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi and UCB, Grant/research support from: AbbVie, BMS, Celgene, Novartis
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Meehan, R., M. Gill, E. Hoffman, M. Wolf, I. Amigues, L. M. Kastsianok, E. Regan, et al. "POS1122 ULTRASOUND GUIDED INJECTIONS OF HYADD4 FOR KNEE OSTEOARTHRITIS IMPROVES PAIN AND FUNCTIONAL OUTCOMES AT 3 AND 6 MONTHS WITHOUT CHANGES IN SYNOVIAL FLUID VOLUMES." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 889.2–890. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2924.
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BackgroundPrior studies have demonstrated improved accuracy and efficacy when Intra-articular (IA) therapeutics are injected using ultrasound (US) guidance. There is also growing evidence that many patients with knee osteoarthritis (OA) exhibit a pro-inflammatory catabolic synovial fluid (SF) profile. However, it is not known if temporary clinical improvement in pain and function after IA Hyaluronic acid (HA) injections is associated with changes in SF volumes.ObjectivesThe purpose of this study was to determine if IA HA injections delivered using US directed needle visualization with an external pneumatic compression device would result in improved clinical outcomes for knee OA at 3 and 6 months, and if this was associated with a reduction in the amount of knee synovial fluid (SF) measured on US.Methods49 eligible subjects with symptomatic Knee OA, BMI < 40 and KL radiographic rating of II or III OA were consented for this open label prospective IRB approved Investigator Initiated SF OA biomarker study (HS 3179, NCT 04093232). All standing radiographs were reviewed by a fellowship-trained MSK radiologist. 36 subjects had adequate aspirated SF volumes of > 500 mcl for biomarker analysis and therefore were eligible to receive two IA injections of HYADD4, 24 mg/3ml (Fidia Farmaceutici S.p.A. Italy) 7 days apart by a MSK US certified Rheumatologist. An external pneumatic compression device and US visualized needle insertion ensured injections were delivered into the intra-synovial space. Despite COVID-19 restrictions, 34 patients (17 women and 17 men) between 35 and 78 years of age returned for 3 month evaluations and 30 had evaluations at 6 months. The following clinical variables were measured: Western Ontario and McMaster Universities Index (WOMAC) total scores, Visual Analog Pain Scale (VAS, 0-10), PCS scores on the SF-36 health survey questionnaires (physical function/bodily pain and general health), 6-minute walking distance in meters (6 MWD), and measured SF depth before and after an external pneumatic compression device was inflated to 100 mmHg to facilitate aspiration by increasing available SF volumes under positive presure. The SF depth was measured on the recorded US image (GE logiq e) as the largest anechoic region selected for aspiration on either the lateral (n= 30) or medial (n=4) compartment. SF and simultaneous peripheral blood samples were centrifuged and cryopreserved at -80 o C within 45 minutes of aspiration for future analysis. Statistical differences between baseline values compared to those levels at 3 and 6 months were determined using a paired ANOVA test with p <0.05 significance.ResultsImprovements over baseline values were observed at 3 and 6 months respectively, after IA HA injections in WOMAC (40%, 40%), VAS (45%, 51%) and PCS (15%, 18%) all p< 0.0001. The 6 WWD improved by 7 % at 3 months (p< 0.007) but was not statistically improved at 6 months. US measured SF depth at baseline was 3.2 ± 2.2 mm before inflation and 6.4 + 3.7 mm after inflation of the pneumatic external compressioin device but statistical differences in SF depth were not observed at 3 and 6 months.ConclusionDespite improvements in WOMAC, VAS scores, and PCS scores on the SF 36 at 3 and 6 months after US guided knee injections with an HA product, a statistically significant reduction in the amount of US measured SF was not observed. The 6 MWD improved at 3 months but was not statistically different from the baseline distance by 6 months. IA injections using US needle visualization confirmed that the product was delivered into the synovial space with 100 % accuracy which might have resulted in improved efficacy results in this study compared to prior IA HA studies injected without US or using different HA products. In the future, we hope SF biomarkers may identify which individual OA patients will likely achieve the greatest benefit with IA HA injections and to determine if this is associated with a reduction in catabolic pro-inflammatory proteins.Disclosure of Interestsrichard Meehan Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. I was the PI., Mary Gill Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As the study coordinator she received salary support, Eric Hoffman Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As a biomedical engineer consultant he received some compensation for his work., Molly Wolf Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As the Immunology laboratory supervisor she received support from this grant for sample processing and analysis., Isabelle Amigues Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As a Rheumatologist who performed some of the aspirations and injections she did receive some very small salary support from this grant., Liudmila (Mila) Kastsianok Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As a Rheumatologist who performed some of the aspirations and injections she did receive some very small salary support from this grant., Elizabeth Regan Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As a orthopedic surgeon and immunologists she did receive some very small salary support from this grant., James Crooks Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As our biostatistician for this project he did receive some support from this grant for statistical analysis and consultation., Gregory Czuczman: None declared, claire Coeshott Consultant of: She was ben an employee for pharmaceutical companies in the past unrelated to this project and has no relationship in the past with Fidia who funded the study., Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As the director of the ADx immunology labs where this samples are processed her staff received some compensation for sample handling and biomarker analysis. She did not receive any salary support., Vijaya Knight Grant/research support from: This grant was funded by Fidia Pharmaceutici and Fidia Pharma USA as an Investigator Initiated grant for synovial fluid based biomarker research in osteoarthritis. As an Immunologists and prior director of the ADx immunology labs when the project started in 2019 her staff performed sample processing and testing and they received support from this grant by Dr Knight did not receive and salary support or direct compensation for her consultation expertise.
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Lazarev, I. A., S. V. Bohdan, and L. M. Yuriychuk. "Рентгенденситометричні показники щільності кісткової тканини головки плечової кістки у хворих із контрактурою плечового суглоба та розривом сухожилка надостьового м’яза." TRAUMA 23, no. 4 (November 9, 2022): 17–23. http://dx.doi.org/10.22141/1608-1706.4.23.2022.905.
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Актуальність. Розриви сухожилків ротаторної манжети плеча часто супроводжуються обмеженням як активних, так і пасивних рухів у плечовому суглобі — контрактурою плечового суглоба (вторинним адгезивним капсулітом, або secondary stiff shoulder). Мета дослідження: визначити вплив вторинного адгезивного капсуліту у хворих із розривом сухожилка надостьового м’яза на стан мінеральної щільності кісткової тканини головки плечової кістки. Матеріали та методи. Обстеження хворих здійснено на рентгеностеоденситометрі Lunar iDXA ME+200082 фірми GE Healthcare, Сінгапур. Проведено рентгенденситометричне обстеження 126 плечових суглобів (63 — із розривом сухожилка надостьового м’яза та 63 — контра-латеральних — неушкоджених). Вік пацієнтів становив від 35 до 50 років (середній вік — 41,2 ± 15,1 року), чоловіків було 34 (54 %), жінок — 29 (46 %). Середній термін від травми до початку лікування — 64,9 ± 27,8 доби. Зони вимірювання BMD розміщували так: № 1 — великий горбок плечової кістки, № 2 — середина головки плечової кістки. Кожна зона мала квадратну форму і відповідала 0,90 ± 0,15 см2 площі стандартної рентгенограми. Результати. Ми виявили слабкий, проте вірогідний вплив кута відведення в плечовому суглобі у хворих із розривом сухожилка надостьового м’яза та вторинним адгезивним капсулітом на зміни мінеральної щільності кісткової тканини в ділянці головки плечової кістки (r = 0,44; р < 0,01). У ділянці великого горбка плечової кістки даний вплив був сильним (r = 0,68; р < 0,01). Висновки. Контрактура плечового суглоба (вторинний адгезивний капсуліт), що виникла в результаті розриву сухожилка надостьового м’яза, призводить до зменшення щільності кісткової тканини великого горбка плечової кістки (р = 0,034) та головки плечової кістки (р = 0,021) навіть у хворих із нормальними загальними показниками мінеральної щільності. Зі зменшенням кута пасивного відведення в плечовому суглобі знижується щільність кісткової тканини в ділянці великого горбка та головки плечової кістки у хворих із розривом сухожилка надостьового м’яза та вторинним адгезивним капсулітом.
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Bubnov, R., and O. Golubnitschaja. "AB0961 MYOFASCIAL TRIGGER POINTS ARE THE UNDEREVALUATED HYPOXIC NISCHES ALTERING POSTURE AND PHENOTYPE." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1777.1–1777. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1962.
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Objectives:Myofascial trigger point (MTrP) is a pillar pathophysiological unit in development of myofascial pain [1] and postural imbalance [2]. Dry needling (DN) of MTrP under ultrasound (US) guidance is prioritized method for treatment myofascial pain. Hypoxia-related signaling pathways play important role in development of rheumatic diseases and cancer [3,4].Hypothesis:MTrP are spastic hypovascularized hypoxic low energy areas that can produce organismic signaling, associated with niches in Flammer syndrome [3,4].Objectives:The aimwas to evaluate structure of MTrP in regard to stiffness and “ischemic pattern” before and after DN.Methods:We included 40 patients (26 females, aged 18–68 y.o.) with low back pain. Healthy 20 individuals (aged 18–52 y.o.) were controls. All patients underwent general exam, MRI, precise physical tests, extensive functional multiparameter neuromuscular US including M-mode, elastography (SWE), B-Flow (LOGIC E9 GE) of multifidus muscles. Then patients received DN of detected MTrP under US guidance.Results:We successfully detected MTrP as hypoechoic, stiff and hypovascular small areas with different patterns of decreasing motility, contractility (muscle contracted/rested thickness) in all patient and did precise DN. After DN muscle structure improved, motility, contractility restored, VAS scores changed from 7.4 to 2.3 (p <0.05). SWE was 11±6 kPa in MTrP (27 kPa in active, 5-8 kPa in latent MTrP) vs 3.8±0.3 kPa in controls and decreased to 4±0.4 kPa after treatment. Hypovascularity (“ischemic pattern”) size decreased from 3-4 mm to 0-1.5 mm, correlated with muscle function. Preliminary we found MTrP with more expressed hypovascular pattern, higher sensitivity and retaining levels of in individuals lower BMI and patient with Flammer phenotype [3,4] (13-15/15 positive responses to questionnaire).Conclusion:MTrP are stiff and most likely hypoxic areas, parameters improved after precise DN. US hunting for “ischemic pattern” markers can be important for patient stratification and targeted treatment and prevention. Metabolic profiling including HIF signaling, proteomic data collecting needed for further investigation for effective patients stratification. For the follow-up studies a correlation of the Flammer syndrome phenotype with individualised profiles of patients and diagnosed ischaemic patterns is recommended.References:[1]Bubnov RV: Evidence-based pain management: is the concept of integrative medicine applicable? EPMA J 2012; 3(1):13.[2]Bubnov R, Kalika L. EFFECTIVE RESTORING MOTION AND EFFECTIVE TREATMENT OF MYOFASCIAL AND NEUROPATHIC LOW BACK PAIN BY TARGETED DRY NEEDLING USING ULTRASOUND GUIDANCE. Annals of the Rheumatic Diseases 2019;78:1921-1922.http://dx.doi.org/10.1136/annrheumdis-2019-eular.5533[3]Flammer Syndrome: From Phenotype to Associated Pathologies, Prediction, Prevention and Personalisation. Ed. by Olga Golubnitschaja. Springer International Publishing, 2019: 340.4.Bubnov R, Polivka J, Zubor P, Konieczka K, Golubnitschaja O. “Pre-metastatic niches” in breast cancer: are they created by or prior to the tumour onset? “Flammer syndrome” relevance to address the question. EPMA J. 2017;8(2):141–57.Disclosure of Interests:None declared
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Shinde, Sachin Y., and Jaywant H. Arakeri. "Flexibility in flapping foil suppresses meandering of induced jet in absence of free stream." Journal of Fluid Mechanics 757 (September 19, 2014): 231–50. http://dx.doi.org/10.1017/jfm.2014.480.
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AbstractThrust-generating flapping foils are known to produce jets inclined to the free stream at high Strouhal numbers $\def \xmlpi #1{}\def \mathsfbi #1{\boldsymbol {\mathsf {#1}}}\let \le =\leqslant \let \leq =\leqslant \let \ge =\geqslant \let \geq =\geqslant \def \Pr {\mathit {Pr}}\def \Fr {\mathit {Fr}}\def \Rey {\mathit {Re}}\mathit{St} = fA/U_{\infty }$, where $f$ is the frequency and $A$ is the amplitude of flapping and $U_{\infty }$ is the free-stream velocity. Our experiments, in the limiting case of $\mathit{St} \rightarrow \infty $ (zero free-stream speed), show that a purely oscillatory pitching motion of a chordwise flexible foil produces a coherent jet composed of a reverse Bénard–Kármán vortex street along the centreline, albeit over a specific range of effective flap stiffnesses. We obtain flexibility by attaching a thin flap to the trailing edge of a rigid NACA0015 foil; length of flap is $0.79\, c$ where $c$ is rigid foil chord length. It is the time-varying deflections of the flexible flap that suppress the meandering found in the jets produced by a pitching rigid foil for zero free-stream condition. Recent experiments (Marais et al., J. Fluid Mech., vol. 710, 2012, p. 659) have also shown that the flexibility increases the $\mathit{St}$ at which non-deflected jets are obtained. Analysing the near-wake vortex dynamics from flow visualization and particle image velocimetry (PIV) measurements, we identify the mechanisms by which flexibility suppresses jet deflection and meandering. A convenient characterization of flap deformation, caused by fluid–flap interaction, is through a non-dimensional ‘effective stiffness’, $EI^{*} = 8 \, EI/(\rho \, V_{{{TE_{{max}}}}}^2 \, s_{{{f}}} \, c_{{{f}}}^3/2)$, representing the inverse of the flap deflection due to the fluid-dynamic loading; here, $EI$ is the bending stiffness of flap, $\rho $ is fluid density, $V_{{{TE_{{max}}}}}$ is the maximum velocity of rigid foil trailing edge, $s_{{{f}}}$ is span and $c_{{{f}}}$ is chord length of the flexible flap. By varying the amplitude and frequency of pitching, we obtain a variation in $EI^{*}$ over nearly two orders of magnitude and show that only moderate $EI^{*}\ (0.1 \lesssim EI^{*} \lesssim 1)$ generates a sustained, coherent, orderly jet. Relatively ‘stiff’ flaps ($EI^{*} \gtrsim 1$), including the extreme case of no flap, produce meandering jets, whereas highly ‘flexible’ flaps ($EI^{*} \lesssim 0.1$) produce spread-out jets. Obtained from the measured mean velocity fields, we present values of thrust coefficients for the cases for which orderly jets are observed.
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Farid, F. Mohd. "Makna Mobile Mammography Screening Unit." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 182s. http://dx.doi.org/10.1200/jgo.18.61800.
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Amount allocated in 2017 for this initiative RM 754,892.00 (US$ 195,353 or CHF 187,509.16) Background and context: Urbanization and its discontent have seen more urban poor in need of immediate medical intervention. Only a small percentage of women ever performed mammogram due to medical screening cost and poor knowledge pertaining to mammography screening for breast cancer. A massive health education campaign through multiple methods and agencies is necessary to upend this deep-seated perception. Aim: MAKNA's mobile mammography screening unit aims to improve lifesaving chances of people afflicted by cancer through early detection of presymptomatic cancer, using approved and fully equipped vehicle with the latest technology available. Focusing in early detection Garnering resources inter alia to help the financially-challenged cancer patients Many cases that come to MAKNA come in the late stages where help of a cure is usually less than 30% Enhancing knowledge and awareness among general public Economic-wise: cheaper to screen for diseases compared with treating patient Reducing death rate from breast cancer by conduct and deliver nationwide campaign all over Malaysia from districts to cities, rural to urban dwellings Strategy: Equipment overall specs Breast screenings with mammography using full fledge digital unit (GE SENOGRAPHE 2000D) Primary objectives: To conduct mammograms and clinical breast examinations (CBE) to public. To conduct general screening to public. Secondary objectives: To conduct cancer awareness and screening program to public. To educate staffs on early detection of cancer. To raise fund for financially challenged cancer patients via MAKNA various fundraising projects Key messages: Early detection saves lives - know the early warning signs and get screened. Care for yourself and others -help us to help the financially challenged cancer patient. (Cancer treatment is very expensive.) Get involved! -Participate in our activities Further targeted communities: Rural interior villages across Malaysia Costs and returns: A. Total 2007-2017: Total costs: RM 5,787,634 (US$ 1,497,398 or CHF 1,437,713) (RM 2,499,500 for fixed assets + RM 3,288,134 for services) Total ROI: Total screenings: 204 locations Results (by case): Normal: 20,027 Benign: 2434 Abnormal/referred: 383 Cancer diagnoses: 23 B. Year of 2017´s impacts: Costs: RM 753,109 (US$ 194,878 or CHF 187,083) ROI: 6378 screenings: 47 locations Result (by case) Normal: 5329 Benign: 956 Abnormal/referred: 93 Cancer diagnoses: 7 What was learned: Majority of cancers are the result of unhealthy lifestyle rather than inherited genetic faults. Breast cancer rate by ethnic: highest in Chinese > Malay > Indian > others. Early stage of breast cancer most detected. Patient navigation program to improve follow-up with positive cases. Overall, this is a scalable solution. Specifically in good prospect to operate in Borneo, East Malaysia with 2 more units.
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Tulloch, John S. P., Massimo Micocci, Peter Buckle, Karen Lawrenson, Patrick Kierkegaard, Anna McLister, Adam L. Gordon, et al. "Enhanced lateral flow testing strategies in care homes are associated with poor adherence and were insufficient to prevent COVID-19 outbreaks: results from a mixed methods implementation study." Age and Ageing, July 16, 2021. http://dx.doi.org/10.1093/ageing/afab162.
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Abstract Introduction Care homes have been severely affected by the SARS-CoV-2 pandemic. Rapid antigen testing could identify most SARS-CoV-2 infected staff and visitors before they enter homes. We explored implementation of staff and visitor testing protocols using lateral flow devices (LFDs). Methods An evaluation of a SARS-CoV-2 LFD-based testing protocol in 11 care homes in Liverpool, UK, including staff and visitor testing, plus a qualitative exploratory study in nine of these homes. The proportion of pilot homes with outbreaks, and outbreak size, were compared to non-pilot homes in Liverpool. Adherence to testing protocols was evaluated. Fifteen staff were interviewed, and transcript data were thematically coded using an iterative analysis to identify and categorize factors influencing testing implementation. Results In total, 1,638 LFD rapid tests were performed on 407 staff. Protocol adherence was poor with 8.6% of staff achieving >75% protocol adherence, and 25.3% achieving $\ge$50%. Six care homes had outbreaks during the study. Compared to non-pilot care homes, there was no evidence of significant difference in the proportion of homes with outbreaks, or the size of outbreaks. Qualitative data showed difficulty implementing testing strategies due to excessive work burden. Factors influencing adherence related to test integration and procedural factors, socio-economic factors, cognitive overload and the emotional value of testing. Conclusion Implementation of staff and visitor care home LFD testing protocols was poorly adhered to and consequently did not reduce the number or scale of COVID-19 outbreaks. More focus is needed on the contextual and behavioural factors that influence protocol adherence.
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Peresh, E. Yu, T. O. Malakhovska, I. E. Barchii, V. I. Sidey, O. V. Zubaka, and A. A. Kozma. "REGULARITIES OF CHANGES AND PREDICTION OF MELTING POINTS AND THERMOELECTRIC FIGURE OF MERIT FOR THE COMPOUNDS Tl4BIVC3 AND Tl9BVC6 (BIV – Si, Ge, Sn, Pb; BV – P, As, Sb, Bi; C – S, Se, Te)." Scientific Bulletin of the Uzhhorod University. Series «Chemistry» 45, no. 1 (June 30, 2021). http://dx.doi.org/10.24144/2414-0260.2021.1.16-20.
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The study is a continuation of the systematic investigation of the compounds which are the crystal chemical analogues of the Tl5Te3 structure, crystallizing in the tetragonal space groups I4/mcm or P4/ncc. The studies conducted by the staff of the Uzhhorod National University over the past decades have found that these compounds exhibit a number of physical properties that are promising for practical use in modern technology. The subject of this work was the relationship between some physicochemical properties of the ternary chalcogenide compounds, such as Tl4BIVC3 and Tl9BVC6 (where BIV = Si, Ge, Sn, Pb; BV = P, As, Sb, Bi; and C = S, Se, Te), and the average charge (Zave) of the compouns’ atomic nuclei. Some of the predicted values of the melting temperature presented in the work may correspond to the temperature of the peritectic (or other type) transformation, as the nature of the formation and properties of this type of compounds have not yet been studied.
For the first time, based on the results of collecting the literature data, detailed analysis and conclusions from them, the predicted melting temperature (Tm) values for 24 chalcogenide compounds of the Tl4BIVC3 (I) and Tl9BVC6 (II) compositions were established. There are five separate groups of the ternary chalcogenides of the both aforementioned types with a linear dependence of the changes in properties in the coordinates Tm – Zave, which include the analogues with both space groups, P4/ncc and I4/mcm. The limiting range of the Zave values of transformation of the above compounds from the space group P4/ncc to the I4/mcm one has been established; the defined range is within the Zave of ~60-62. The ternary compounds Tl9P(As,Sb,Bi)S6, Tl9P(As)Se6, Tl4Si(Ge,Sn,Pb)S3 and Tl4Si(Ge,Sn)Se3 belong to the space group P4/ncc, while the chalcogenides Tl9P(As,Sb,Bi)Te6, Tl9Sb(Bi)Se6, Tl4Si(Ge,Sn,Pb)S3 and Tl4PbSe3 belong to the space group I4/mcm. There is a clear tendency to increase the value of the thermoelectric figure of merit ZT for individual thio-, seleno- and tellurium-derived compounds at the substitution of the elements Si → Ge → Sn → Pb. Similar changes in the ZT values were also found for the vast majority of the type (II) compounds at the P → As → Sb → Bi transitions. The exceptions to this trend are thio-, selenium- and tellurium bismuth derivatives.
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Silva, Jonas Oliveira da, and Linda V. E. Caldas. "Assessment of dosimetric parameters in mammography employing a homemade ionization chamber." Scientia Plena 12, no. 12 (December 19, 2016). http://dx.doi.org/10.14808/sci.plena.2016.124101.
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X-ray mammography examination is the reference tool to discover breast cancer in an early stage. The mammography unit must follow an accurate quality control program that covers both patient and staff radiation protection. Plane parallel ionization chambers are the reference instrument for dosimetry in mammography beams, but they can represent higher cost for small clinics in countries as Brazil. In this work, it is presented a low cost ionization chamber for mammography X-rays energy range dosimetry developed at IPEN. The homemade ionization chamber has a sensitive volume of 6.0 cm3 and it was utilized to execute quality control tests in two distinct mammography systems: a GE Senographe DMR-plus and a Philips VMI Graph Mammo. The setups for the tests performed agreed with the IAEA HHS 2 and 17 recommendations. A breast phantom of various PMMA thicknesses was utilized in this work. The homemade ionization chamber performance was compared to that of a commercial one. The maximum difference between the incident air kerma measured with the reference ionization chamber and the developed one was only 5.62% for the GE equipment and only 4.42% for the Philips equipment. The homemade ionization chamber presented an excellent performance in incident air kerma and HVL measurements for the radiographic techniques utilized in the present work. All the results obtained were within IAEA specifications.
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Änggård, Eva. "Att skapa platser i naturmiljöer: Om hur vardagliga praktiker i en I Ur och Skur-förskola bidrar till att ge platser identitet." Tidsskrift for Nordisk barnehageforskning 5 (October 17, 2012). http://dx.doi.org/10.7577/nbf.414.
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Title: The construction of places in outdoor environments: About how every day practices in an outdoor preschool contribute to places identitiesAbstract: The purpose of this paper is to use data from an ethnographic study to analyse how places are given identities in an outdoor preschool. The preschool had 32 children between 1½ and 6 years divided in two groups. Each group had chosen their 'own' place that they generally visited three days a week. On the way to the places the same paths were used every day. Within the places different parts were used for normal preschool activities like eating, sleeping or playing. When the staff dramatized and the children played fantasy play the places were loaded with symbolic meanings. All these practices contributed to the process where the places were given identity.
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Marrón, Belén, Suzanne Pearce, Janusz Ostrowski, Dan Munteanu, Marietta Torok, Michael Roesch, Claudia Martín, et al. "P1853FIVE YEARS PROSPECTIVE, OBSERVATIONAL, INTERNATIONAL STUDY ON THE IMPACT OF DECISION-MAKING TOOLS FOR CHOICE OF RENAL REPLACEMENT THERAPY MODALITY." Nephrology Dialysis Transplantation 35, Supplement_3 (June 1, 2020). http://dx.doi.org/10.1093/ndt/gfaa142.p1853.
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Abstract Background and Aims Decision-Making Tools (DMTs) are still not widely used but are considered the Gold Standard to ensure patients are well informed to choose renal replacement therapy (RRT) modality. To analyze the impact of a structured modality information program (via DMTs) on RRT modality choice and start. Method All 2014-2017 predialysis patients (pts) with CKD G4-G5 and those starting unplanned dialysis without a prior information process underwent a DMTs process for RRT choice and were followed up to Dec.31st, 2018. DMTs included values evaluation, RRT information with different tools, staff deliberation support and patient modality choice. Results shown as percentage of pts who reached a certain stage over the total number of pts under evaluation. Results 2012 pts (mean age 61 y.) from 48 clinics (cl.) in Poland (PL, 19 cl., 980 pts), Romania (RO, 12 cl., 351 pts), Hungary (HU, 10 cl., 341 pts), Germany (DE, 6 cl., 292 pts) and Argentina (AR, 1 cl., 48 pts) underwent DMTs. Staff considered PD contraindicated in 29% of pts, hence optimal candidates for HD/PD were 1408 pts. (mean age 60y. and 46% prone for a home therapy). Early referral (≥3 m. in clinic before DMT started): 51%. Aids used included written information (97% of pts), DVD in 27% and HD/PD utility visits in 49%. Relatives’ participation in the process was 82%. Most pts (91%) considered the program useful whilst 64% of staff felt that this program was better than the prior one. PD choice (35%) varied among countries: 15% (RO), 30% (PL), 36% (HU), 62% (DE) and 98% (AR). For pts who had started dialysis by study closure (n=948), PD as chronic RRT was 31% (9% after an unplanned HD start); 13% (RO), 27% (PL), 34% (HU), 54% (GE) and 83% (AR). Conclusion Use of DMTs at the time of RRT modality choice complies with patient empowerment and decision sharing (patients-relatives-staff). PD choice and take-on varied among countries. Most patients who chose PD were chronically ascribed to PD representing at least one third of the suitable patients for both dialysis modalities.
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Omojola, Akintayo Daniel, Funmilayo Ruth Omojola, Michael Onoriode Akpochafor, and Samuel Olaolu Adeneye. "Shielding assessment in two computed tomography facilities in South-South Nigeria: How safe are the personnel and general public from ionizing radiation?" ASEAN Journal of Radiology, August 30, 2020, 5–27. http://dx.doi.org/10.46475/aseanjr.2020.06.
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Objective: The aims of this study were to estimate the instantaneous dose rate(IDR) and annual dose rate (ADR) to radiation staff and the general public withinthe controlled and supervised areas, respectively, to determine the shieldingdesign goals (P) of the 2 CT facilities and to determine the average annual dose(AD) to radiographer/operator in the control console during CT scans. Materials and Methods: The equipment used in this study consisted of twonewly installed General Electric (GE) Revolution ACTs CT machines. Technicalparameters used were a thoracic/dorsal spine scan, which was rarely done in both facilities. A calibrated Inspector USB (S.E. International, Inc.) survey meter was positioned < 50 cm from each barrier at various points to determine the average shielded air kerma Results: The average background radiation in the 2 facilities was 0.11 ?Sv/hr. The average ADR to the controlled and supervised areas in CT1 was 0.563±0.25 and 0.369±0.11 mSv/yr, respectively. Also, the average ADR to the controlled and supervised areas in CT2 were 0.410±0.28 and 0.354±0.04 mSv/yr, respectively. The average shielding design goal to the controlled and supervised areas for CT1 was 0.00898±0.0041 and 0.0059±0.0028 mSv/Week, respectively. Similarly, the average shielding design goal for the controlled and supervised areas for CT2 was 0.0066±0.0044 and 0.0057±0.0019 mSv/Week respectively. The estimated average AD to the operator in CT1 and CT2 was 2.5 and 1.3 ?Sv, respectively. Conclusion: The average ADR and shielding design goals in the controlled and supervised areas from both CTs were within acceptable limits for radiation staff and the public.
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Rajeswaran, Lakshmi, and Valerie J. Ehlers. "Audits of emergency trolleys’ contents in selected hospitals in Botswana." Health SA Gesondheid 17, no. 1 (July 17, 2012). http://dx.doi.org/10.4102/hsag.v17i1.621.
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Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment, as well as staff members skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana’s hospitals’ wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswana were audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley, some units failed to check their emergency trolleys’ contents daily. All 20 hospital wards or units that participated in this study, needed to improve the contents and maintenance of their emergency trolleys, otherwise in-hospital CPR efforts in Botswana might be doomed to failure, losing lives that could have been saved if emergency trolleys’ equipment and supplies had been up to standard.OpsommingHartarres is ‘n lewensbedreigende noodsituasie. Die uitkoms word bepaal deur tydige en effektiewe kardio-pulmonale resussitasie (KPR). Suksesvolle KPR pogings in hospitale vereis goed toegeruste noodtrollies en toerusting wat behoorlik funksioneer, asook personeellede wat bedrewe is in die uitvoering van KPR. Die studie het gepoog om te bepaal of die noodtrollies in Botswana se hospitaalsale of eenhede aan die verwagte standaarde voldoen. Die inhoud van die noodtrollies in 20 sale of enhede van twee van Botswana se hospitale is ge-ouditeer deur ‘n gestandardiseerde kontrolelys te benut. Geen hospitaalsaal of eenheid het al die verwagte toerusting of drogerye op sy noodtrollie gehad nie, sommige eenhede het nie hulle noodtrollies se inhoud gereeld gekontroleer nie. Al 20 hospitaalsale of eenhede wat aan die studie deelgeneem het, moet die inhoud en instandhouding van hulle noodtrollies verbeter, anders kan in-hospitaal KPR pogings in Botswana tot mislukkings gedoem wees, waardeur lewens verloor word wat gered kon gewees het, indien die noodtrollies se inhoud op standaard was.
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Macay Dueñas, Patricio, Daniela Vera Vélez, Aurora Barreiro Vera, and Cristian Mera Macías. "Gestión de las Tecnología de la Información y Comunicación en entidades educativas." Revista Científica Sinapsis 1, no. 12 (May 9, 2018). http://dx.doi.org/10.37117/s.v1i12.137.
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El objetivo de esta investigación fue determinar el estado actual de la gestión de las TIC en una institución de educación secundaria del Cantón Tosagua, ubicada en la provincia de Manabí, República del Ecuador. Como problema se identificó el desconocimiento de la gestión interna de las Tecnologías de la Información y comunicación, Esta investigación es de tipo cualitativo de cohorte transversal. Los métodos utilizados son los teóricos, como el histórico lógico, deductivo inductivo, analítico sintético y el descriptivo además se utilizaron los métodos empíricos como la encuesta misma que se aplicó a 25 usuarios donde se pudo conocer: a) el nivel de implementación de procedimientos internos para el uso de las TIC, b) el nivel de conocimientos que tienen los usuarios para operar las TIC, c) la frecuencia con la que se capacita al personal en el uso de las TIC, d) los niveles de resolución de problemas y otros aspectos de la gestión de TIC, tales como las normas y/o estándares para dicha gestión.
Los recursos tecnológicos también conocidos como Tecnologías de la Información y Comunicación (TIC) incluyen el hardware, software, infraestructura de telecomunicaciones y bases de datos, estos elementos deben ser gestionados de forma correcta para que las organizaciones puedan funcionar de manera eficiente, logrando con ello que tanto el usuario interno como el externo se empoderen en el uso de estas herramientas logrando un servicio de calidad.
Palabras clave: Gestión de TIC, Estándares de TIC, mejores prácticas de TIC
Abstract
The objective of this research was to determine the current state of ICT management in a secondary education institution of Cantón Tosagua, located in the province of Manabí, Republic of Ecuador. As a problem, the lack of knowledge of the internal management of Information and Communication Technologies was identified. This research is of a qualitative type of transversal cohort. The methods used are the theoretical ones, such as the logical historical, inductive deductive, synthetic analytical and descriptive. Empirical methods were also used, such as the survey itself applied to 25 users where it was possible to know: a) the level of implementation of internal procedures for the use of ICT, b) the level of knowledge that users have to operate ICT, c) the frequency with which staff is trained in the use of ICT, d) the levels of problem solving and other aspects of ICT management, such as standards and / or standards for such management. The technological resources also known as Information and Communication Technologies (ICT) include hardware, software, telecommunications infrastructure and databases, these elements must be managed correctly so that organizations can function efficiently, thereby achieving that both the internal and external users are empowered in the use of these tools, achieving a quality service.
Keyword: ICT management, ICT standards, ICT best practices
PARTICIPACIÓN EN LA PUBLICACIÓN: Autor: Patricio Macay Dueñas, Ing. Co – Autores: Daniela Vera Vélez, MSc. IE., Jenny Aurora Barreiro Vera, MSc. GE, Cristian Mera Macías, MSc. IE.
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Khatun, Sheela, Muhammad Minarul Islam, Md Tusher Mollah, Saykat Poddar, and Md Mahmud Alam. "EMHD radiating fluid flow along a vertical Riga plate with suction in a rotating system." SN Applied Sciences 3, no. 4 (March 12, 2021). http://dx.doi.org/10.1007/s42452-021-04444-4.
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AbstractThis study is performed on the numerical investigation of electro-magnetohydrodynamic (EMHD) radiating fluid flow nature along an infinitely long vertical Riga plate with suction in a rotating system. The prevailing equations are generated from the Navier–Stokes’ and energy equations. A uniform suction velocity is introduced to control the flow. The prevailing boundary layer (BL) equations are the stuff to delineate the mechanical features of the flowing nature along with the electromagnetic device (Riga plate). Accordingly, the use of usual transformations on the equations transformed those into a coupled dimensionless system of non-linear partial differential equations (PDEs). After conversion, the elucidation of the set of equations is conducted numerically by an explicit finite difference method (FDM). The criteria for stable and converging solutions are constructed to find restrictions on various non-dimensional parameters. The retrieved restrictions are $$P_{r} \ge 0.19,\,$$ P r ≥ 0.19 , $$R_{d} \ge 0.1,\,\,$$ R d ≥ 0.1 , $$S \ge 1,$$ S ≥ 1 , $$E_{c} = 0.01\,\,$$ E c = 0.01 and $$0 < R \le 0.1$$ 0 < R ≤ 0.1 . Furthermore, sensitivity tests on mesh and time as well as comparison within the literature have been demonstrated in graphical and tabular form. Finally, the important findings of the non-dimensional parameters influences have been portrayed in graphical manner by using the MATLAB R2015a tool. A substantial uprise is noted for both the velocities (secondary and primary) under the rising actions of the modified Hartmann number, whereas the suction parameter suppresses both the velocities.
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Oba, Ryoshun, and Shin-ichi Tanigawa. "Characterizing the universal rigidity of generic tensegrities." Mathematical Programming, November 29, 2021. http://dx.doi.org/10.1007/s10107-021-01730-2.
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AbstractA tensegrity is a structure made from cables, struts, and stiff bars. A d-dimensional tensegrity is universally rigid if it is rigid in any dimension $$d'$$ d ′ with $$d'\ge d$$ d ′ ≥ d . The celebrated super stability condition due to Connelly gives a sufficient condition for a tensegrity to be universally rigid. Gortler and Thurston showed that super stability characterizes universal rigidity when the point configuration is generic and every member is a stiff bar. We extend this result in two directions. We first show that a generic universally rigid tensegrity is super stable. We then extend it to tensegrities with point group symmetry, and show that this characterization still holds as long as a tensegrity is generic modulo symmetry. Our strategy is based on the block-diagonalization technique for symmetric semidefinite programming problems, and our proof relies on the theory of real irreducible representations of finite groups.
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Maset, S. "Relative error long-time behavior in matrix exponential approximations for numerical integration: the stiff situation." Calcolo 59, no. 2 (May 23, 2022). http://dx.doi.org/10.1007/s10092-022-00466-5.
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AbstractIn the stiff situation, we consider the long-time behavior of the relative error $$\gamma _n$$ γ n in the numerical integration of a linear ordinary differential equation $$y^{\prime }(t)=Ay(t),\quad t\ge 0$$ y ′ ( t ) = A y ( t ) , t ≥ 0 , where A is a normal matrix. The numerical solution is obtained by using at any step an approximation of the matrix exponential, e.g. a polynomial or a rational approximation. We study the long-time behavior of $$\gamma _n$$ γ n by comparing it to the relative error $$\gamma _n^{\mathrm{long}}$$ γ n long in the numerical integration of the long-time solution, i.e. the projection of the solution on the eigenspace of the rightmost eigenvalues. The error $$ \gamma _n^{\mathrm{long}}$$ γ n long grows linearly in time, it is small and it remains small in the long-time. We give a condition under which $$\gamma _n\approx \gamma _n^{\mathrm{long}}$$ γ n ≈ γ n long , i.e. $$\frac{\gamma _n}{\gamma _n^{\mathrm{long}}}\approx 1$$ γ n γ n long ≈ 1 , in the long-time. When this condition does not hold, the ratio $$\frac{\gamma _n}{\gamma _n^{\mathrm{long}}}$$ γ n γ n long is large for all time. These results describe the long-time behavior of the relative error $$\gamma _n$$ γ n in the stiff situation.
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Rajitha, B., Narendra R. R, and Beere Gowda Y. C. "CROSS SECTIONAL STUDY ON ASSESSMENT OF GESTATIONAL AGE OF NEONATES, BASED ON FOOT LENGTH." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, December 1, 2021, 10–12. http://dx.doi.org/10.36106/ijsr/9705302.
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Background: Birth weight is single most important criterion for determining neonatal and infant survival. LBW is a sensitive indicator of socioeconomic conditions and indirectly measures the health of the mother and child. Objective : To compare the accuracy of assessing gestational age using foot length by comparing with ultrasound ndings. Methods and Analysis: A cross sectional observational study was carried out in all live, newborn babies under 48 hours of life, admitted in RLJH, st was taken for the study at , Kolar from July 2021 to September 2021 Gestational a . ge of all the babies are determined by 1 trimester ultrasound report. Right foot gestational age measured from the heel to the tip of the great toe, using a plastic stiff ruler.Gestational range varied from 27 weeks to 42 weeks. Results: Gestational age and foot length also showed a positive correlation with a correlation coefcient , pearson coefcient of 0.677 and p value of <0.001. Conclusion : There was positive strong correlation between foot length and gestational age which was statistically signicant. Foot length can be taken as an ancillary to determine the gestational age of a neonate, when other parameters like rst trimester ultrasound or Ballard's scoring cannot be done. It is a quick method to estimate the gestational age to plan further management of the new born.
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Holland, Kristin, Francis Annor, Marissa Lynn Zwald, Jing Wang, Michael Coletta, Aaron Kite-Powell, Deborah M. Stone, Steven A. Sumner, Daniel Bowen, and Alana Marie Vivolo-Kantor. "Using Syndromic Surveillance Data to Study the Impact of Media Content on Self-harm." Online Journal of Public Health Informatics 11, no. 1 (May 30, 2019). http://dx.doi.org/10.5210/ojphi.v11i1.9936.
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ObjectiveTo describe national-level trends in nonfatal self-harm and suicidal ideation among 10-19 year old youth from January 2016 through December 2017 and examine the impact of popular entertainment on suicidal behavior.IntroductionIn 2016, a half million people were treated in U.S. emergency departments (EDs) as a result of self-harm. 1 Not only is self-harm a major cause of morbidity in the U.S., but it is also one of the best predictors of suicide. Given that approximately 40% of suicide decedents visited an ED in the year prior to their death and that the majority of medically-serious self-harm patients are treated in EDs2, EDs serve as a critical setting in which to monitor rates and trends of suicidal behavior.To date, the majority of ED data for self-harm are generally two to three years old and thereby can only be used to describe historical patterns in suicidal behavior. Thus, in 2018, a syndrome definition for suicide attempts and suicidal ideation (SA/SI) was developed by the International Society for Disease Surveillance (ISDS) Syndrome Definition Committee in conjunction with Centers for Disease Control and Prevention (CDC) staff, allowing researchers to better monitor recent trends in medically treated suicidal behavior using data from the CDC’s National Syndromic Surveillance Program (NSSP). These data serve as a valuable resource to help detect deviations from typical patterns of SA/SI and can help drive public health response if atypical activity, such as geospatial or temporal clusters of SA/SI, is observed. Such patterns may be indicative of suicide contagion (i.e., exposure to the suicide or suicidal behavior of a friend or loved one, or through media content, that may put individuals at increased risk of suicidal behavior).Research has demonstrated that suicide contagion is a real phenomenon. 3 13 Reasons Why is a Netflix series focused on social, school, and family-related challenges experienced by a high school sophomore; each episode in the 13-episode series describes a problem faced by the main character, which she indicates contributed to her decision to die by suicide. The series premiered March 31, 2017 and is rated TV-MA by TV Parental Guidelines4 (may be unsuitable for those under age 18 years due to graphic content). Nevertheless, the series has become popular among youth under 18 years of age. Of note, in the final episode, the main character’s suicide by wrist laceration is graphically depicted. Following the premiere of the series, researchers and psychologists across the U.S. expressed concern that this graphic depiction of suicide could result in a contagion effect, potentially exacerbating suicidal thoughts and behavior among vulnerable youth viewers. To date, the only empirical data demonstrating the potential iatrogenic effects of this graphic portrayal of suicide comes from a study of Google Trends data demonstrating an increase in online suicide queries in the weeks following the show, with most of the queries focusing on suicidal ideation (e.g., “how to commit suicide,” “how to kill yourself”).5 However, there has been no study to examine changes in nonfatal self-harm trends following the series debut.MethodsNSSP data were aggregated at the national level from January 2016 through December 2017 to examine weekly trends in the percentage of ED visits that involved SA/SI among all ED visits for youth aged 10-19. Google Trends data were also used to examine suicide-related online searches conducted during this period. Additional sensitivity analyses to explore these findings will be conducted by HHS region using NSSP data.ResultsPreliminary results suggest an increase in ED visits due to SA/SI among 10-19 year old youth across the U.S. beginning about two weeks after the premiere of 13 Reasons Why (April 16, 2017) and lasting a total of six weeks before weekly percentages of SA/SI ED visits returned to their endemic levels during the week of May 28-June 3, 2017. The peak of the increase represented a 26% increase in SA/SI compared to the highest weekly percentage of these visits in the previous 15 weeks in 2017. Additionally, this peak coincided with marked peaks in online searches for phrases including “13 Reasons Why” from March 26-June 3, 2017, “how to kill yourself” from April 16-June 3, 2017, and “how to slit wrists” from April 2-June 3, 2017 as demonstrated by Google Trends data.ConclusionsThis study demonstrates the utility of syndromic surveillance data for tracking SA/SI at the national level and for detecting atypical fluctuations in trends over time. Using syndromic surveillance data for this purpose could help spark public health response to emerging health threats. However, it is important to note that NSSP data are subject to some limitations; for instance, although about 60% of ED visits in the U.S. are captured in NSSP, the system is not nationally representative and thus, these findings are not generalizable to areas not participating in NSSP. Additionally, our definition may under- or over-estimate SA/SI based on differences in chief complaints or discharge diagnosis data between jurisdictions. Further, hospital participation in NSSP can vary across months–a factor that could contribute to trends observed in NSSP data. Finally, these analyses explored the concurrent trends in SA/SI among youth and the popularity of only one television series. Although these analyses point to an association between the increases in SA/SI and the time period in which the series reached its peak popularity as evidenced by Google Trends, there may have been other sociocultural factors that impacted SA/SI trends during the study period. Still, preliminary findings suggest that media content containing graphic depictions of suicide viewed by youth audiences may contribute to increases in ED visits for self-harm and suicidal ideation, as well as greater interest in searching for information about suicidal behavior online. While it is impossible to assess causation, these results are consistent with the phenomenon of suicide contagion. It is also possible that the series or related media coverage during this time increased help-seeking among some youth or their families that contributed to the increases observed. Regardless of the underlying mechanism, entertainment content creators may consider referring to the Recommendations for Reporting on Suicide (www.reportingonsuicide.org), which can help reduce the risk of suicide among vulnerable individuals and avoid contributing to suicide contagion while promoting suicide prevention messages. Finally, ongoing surveillance of suicidal behavior using NSSP data could help reduce the burden of nonfatal self-harm by catalyzing the implementation of prevention efforts.Results1. Center for Disease Control and Prevention, National Center for Injury Prevention and Control. (2018). Web-based Injury Statistics Query and Reporting System (WISQARS). Available from www.cdc.gov/ncipc/wisqars. Accessed 10-3-2018.2. Ahmedani BK, Simon GE, Stewart C et al. (2014) Health care contacts in the year before suicide death. J Gen Intern Med, 29, 870-877.3. Gould, M., Jamieson, P., & Romer, D. (2003). Media contagion and suicide among the young. American Behavioral Scientist, 46(9), 1269-1284.4. The TV Parental Guidelines. (2018). Available from http://tvguidelines.org/. Accessed 10-3-2018.5. Ayers, J. W., Althouse, B. M., Leas, E. C., Dredze, M., & Allem, J. P. (2017). Internet searches for suicide following the release of 13 Reasons Why. JAMA internal medicine, 177(10), 1527-1529.