Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial

Background and aim: It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FT versus fentanyl-midazolam (FM) in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods: In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccessful rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P

Statistical Description of Counterpoise Effective Length Based On Regressive Formulas

This paper presents a novel statistical description of the counterpoise effective length due to lightning surges, where the (impulse) effective length had been obtained by means of regressive formulas applied to the transient simulation results. The effective length is described in terms of a statistical distribution function, from which median, mean, variance, and other parameters of interest could be readily obtained. The influence of lightning current amplitude, lightning front duration, and soil resistivity on the effective length has been accounted for, assuming statistical nature of these parameters. A method for determining the optimal counterpoise length, in terms of the statistical impulse effective length, is also presented. It is based on estimating the number of dangerous events associated with lightning strikes. Proposed statistical description and the associated method provide valuable information which could aid the design engineer in optimising physical lengths of counterpoises in different grounding arrangements and soil resistivity situations.

CPT Pore Water Pressure Correlations with PDA to Identify Pile Drivability Problem

At certain depths during large diameter displacement pile driving, rebound well over 0.25 inches was experienced, followed by a small permanent-set during each hammer blow. High pile rebound (HPR) soils may stop the pile driving and results in a limited pile capacity. In some cases, rebound leads to pile damage, delaying the construction project, and the requiring foundations redesign. HPR was evaluated at seven Florida sites, during driving of square precast, prestressed concrete piles driven into saturated, fine silty to clayey sands and sandy clays. Pile Driving Analyzer (PDA) deflection versus time data recorded during installation, was used to develop correlations between cone penetrometer (CPT) pore-water pressures, pile displacements and rebound. At five sites where piles experienced excessive HPR with minimal set, the pore pressure yielded very high positive values of greater than 20 tsf. However, at the site where the pile rebounded, followed by an acceptable permanent-set, the measured pore pressure ranged between 5 and 20 tsf. The pore pressure exhibited values of less than 5 tsf at the site where no rebound was noticed. In summary, direct correlations between CPTu pore pressure and rebound were produced, allowing identification of soils that produce HPR.

Fetal and Infant Mortality in Botucatu City, São Paulo State, Brazil: Evaluation of Maternal - Infant Health Care

In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Assessing Chemo-Radiotherapy Induced Toxicity and Quality of Life of Cancer Patients

Chemotherapy and radiotherapy are one of the major treatment modalities that play important role in the management of a number of different cancers. This study for the first time evaluates the toxicity of these treatment modalities and its impact on quality of life of cancer patients in Pakistan. The study also for the first time determines what cancer patients of different ages and cancer stages believe would be an effective intervention to manage their psychosocial needs and treatment induced toxicity. The article also provides evidence based approach for the use of variety of interventions to mange cancer treatment induced morbidity and toxicity. In light of the present study and reviewed research data, evidence based recommendations are also made for selection of appropriate interventions to manage Pain, Nausea and Vomiting, Anxiety and Depression, Fatigue and Overall QOL of cancer survivors.

Negative Pressure Waves in Hydraulic Systems

Negative pressure phenomenon appears in many thermodynamic, geophysical and biophysical processes in the Nature and technological systems. For more than 100 years of the laboratory researches beginning from F. M. Donny’s tests, the great values of negative pressure have been achieved. But this phenomenon has not been practically applied, being only a nice lab toy due to the special demands for the purity and homogeneity of the liquids for its appearance. The possibility of creation of direct wave of negative pressure in real heterogeneous liquid systems was confirmed experimentally under the certain kinetic and hydraulic conditions. The negative pressure can be considered as the factor of both useful and destroying energies. The new approach to generation of the negative pressure waves in impure, unclean fluids has allowed the creation of principally new energy saving technologies and installations to increase the effectiveness and efficiency of different production processes. It was proved that the negative pressure is one of the main factors causing hard troubles in some technological and natural processes. Received results emphasize the necessity to take into account the role of the negative pressure as an energy factor in evaluation of many transient thermohydrodynamic processes in the Nature and production systems.

Unsupervised Segmentation Technique for Acute Leukemia Cells Using Clustering Algorithms

Leukaemia is a blood cancer disease that contributes to the increment of mortality rate in Malaysia each year. There are two main categories for leukaemia, which are acute and chronic leukaemia. The production and development of acute leukaemia cells occurs rapidly and uncontrollable. Therefore, if the identification of acute leukaemia cells could be done fast and effectively, proper treatment and medicine could be delivered. Due to the requirement of prompt and accurate diagnosis of leukaemia, the current study has proposed unsupervised pixel segmentation based on clustering algorithm in order to obtain a fully segmented abnormal white blood cell (blast) in acute leukaemia image. In order to obtain the segmented blast, the current study proposed three clustering algorithms which are k-means, fuzzy c-means and moving k-means algorithms have been applied on the saturation component image. Then, median filter and seeded region growing area extraction algorithms have been applied, to smooth the region of segmented blast and to remove the large unwanted regions from the image, respectively. Comparisons among the three clustering algorithms are made in order to measure the performance of each clustering algorithm on segmenting the blast area. Based on the good sensitivity value that has been obtained, the results indicate that moving kmeans clustering algorithm has successfully produced the fully segmented blast region in acute leukaemia image. Hence, indicating that the resultant images could be helpful to haematologists for further analysis of acute leukaemia.

Training Isolated Respiratory in Rehabilitation

A game for training of breath (TRABR) for continuous monitoring of pulmonary ventilation during the patients’ therapy focuses especially on monitoring of their ventilation processes. It is necessary to detect, monitor and differentiate abdominal and thoracic breathing during the therapy. It is a fun form of rehabilitation where the patient plays and also practicing isolated breathing. Finally the game to practice breath was designed to evaluate whether the patient uses two types of breathing or not.

Stereo Motion Tracking

Motion Tracking and Stereo Vision are complicated, albeit well-understood problems in computer vision. Existing softwares that combine the two approaches to perform stereo motion tracking typically employ complicated and computationally expensive procedures. The purpose of this study is to create a simple and effective solution capable of combining the two approaches. The study aims to explore a strategy to combine the two techniques of two-dimensional motion tracking using Kalman Filter; and depth detection of object using Stereo Vision. In conventional approaches objects in the scene of interest are observed using a single camera. However for Stereo Motion Tracking; the scene of interest is observed using video feeds from two calibrated cameras. Using two simultaneous measurements from the two cameras a calculation for the depth of the object from the plane containing the cameras is made. The approach attempts to capture the entire three-dimensional spatial information of each object at the scene and represent it through a software estimator object. In discrete intervals, the estimator tracks object motion in the plane parallel to plane containing cameras and updates the perpendicular distance value of the object from the plane containing the cameras as depth. The ability to efficiently track the motion of objects in three-dimensional space using a simplified approach could prove to be an indispensable tool in a variety of surveillance scenarios. The approach may find application from high security surveillance scenes such as premises of bank vaults, prisons or other detention facilities; to low cost applications in supermarkets and car parking lots.

Enhancement of Mechanical Properties for Al-Mg-Si Alloy Using Equal Channel Angular Pressing

Equal channel angular pressing (ECAP) of commercial Al-Mg-Si alloy was conducted using two strain rates. The ECAP processing was conducted at room temperature and at 250°C. Route A was adopted up to a total number of four passes in the present work. Structural evolution of the aluminum alloy discs was investigated before and after ECAP processing using optical microscopy (OM). Following ECAP, simple compression tests and Vicker’s hardness were performed. OM micrographs showed that, the average grain size of the as-received Al-Mg-Si disc tends to be larger than the size of the ECAP processed discs. Moreover, significant difference in the grain morphologies of the as-received and processed discs was observed. Intensity of deformation was observed via the alignment of the Al-Mg-Si consolidated particles (grains) in the direction of shear, which increased with increasing the number of passes via ECAP. Increasing the number of passes up to 4 resulted in increasing the grains aspect ratio up to ~5. It was found that the pressing temperature has a significant influence on the microstructure, Hv-values, and compressive strength of the processed discs. Hardness measurements demonstrated that 1-pass resulted in increase of Hv-value by 42% compared to that of the as-received alloy. 4-passes of ECAP processing resulted in additional increase in the Hv-value. A similar trend was observed for the yield and compressive strength. Experimental data of the Hv-values demonstrated that there is a lack of any significant dependence on the processing strain rate.

Formulation and ex vivo Evaluation of Solid Lipid Nanoparticles (SLNS) Based Hydrogel for Intranasal Drug Delivery

Risperidone (RISP) is an antipsychotic agent and has low water solubility and nontargeted delivery results in numerous side effects. Hence, an attempt was made to develop SLNs hydrogel for intranasal delivery of RISP to achieve maximum bioavailability and reduction of side effects. RISP loaded SLNs composed of 1.65% (w/v) lipid mass were produced by high shear homogenization (HSH) coupled ultrasound (US) method using glycerylmonostearate (GMS) or Imwitor 900K (solid lipid). The particles were loaded with 0.2% (w/v) of the RISP & surface-tailored with a 2.02% (w/v) non-ionic surfactant Tween® 80. Optimization was done using 32 factorial design using Design Expert® software. The prepared SLNs dispersion incorporated into Polycarbophil AA1 hydrogel (0.5% w/v). The final gel formulation was evaluated for entrapment efficiency, particle size, rheological properties, X ray diffraction, in vitro diffusion, ex vivo permeation using sheep nasal mucosa and histopathological studies for nasocilliary toxicity. The entrapment efficiency of optimized SLNs was found to be 76 ± 2%, polydispersity index

Testing the Validity of Maturity Model for E-Government Implementation in Indonesia

The research was conducted to empirically validate the proposed maturity model of e-Government implementation, composed of four dimensions, further specified by 54 success factors as attributes. To do so, there are two steps were performed. First, expert’s judgment was conducted to test its content validity. The second, reliability study was performed to evaluate inter-rater agreement by using Fleiss Kappa approach. The kappa statistic (kappa coefficient) is the most commonly used method for testing the consistency among raters. Fleiss Kappa was a generalization of Kappa in extensions to the case of more than two raters (multiple raters) with multi-categorical ratings. Our findings show that most attributes of the proposed model were related to their corresponding dimensions. According to our results, The percentage of agree answers given by the experts was 73.69% in dimension A, 89.76% in B, 81.5% in C and 60.37% in D. This means that more than half of the attributes of each dimensions were appropriate or relevant to the dimensions they were supposed to measure, while 85% of attributes were relevant enough to their corresponding dimensions. Inter-rater reliability coefficient also showed satisfactory result and interpreted as substantial agreement among raters. Therefore, the proposed model in this paper was valid and reliable to measure the maturity of e-Government implementation.

Evaluation of Prevalence of the Types of Thyroid Disorders Using Ultrasound and Pathology of One Humped Camel in Iran (Camelus dromedarius)

The thyroid gland is the largest classic endocrine organ that effects many organs of the body and plays a significant role in the process of Metabolism in animals. The aim of this study was to investigate the prevalence of thyroid disorders diagnosed by ultrasound and microscopic Lesions of the thyroid during the slaughter of apparently healthy One Humped Camels (Camelus dromedarius) in Iran. Randomly, 520 male camels (With an age range of 4 to 8 years), were studied in 2012 to 2013. The Camels’ thyroid glands were evaluated by sonographic examination. In both longitudinal and transverse view and then tissue sections were provide and stained with H & E and finally examined by light microscopy. The results obtained indicated the following: hyperplastic goiter (21%), degenerative changes (12%), follicular cysts (8%), follicular atrophy (4%), nodular hyperplasia (3%), adenoma (1%), carcinoma (1%) and simple goiter colloid (1%). Ultrasound evaluation of thyroid gland in adenoma and carcinoma showed enlargement and irregular of the gland, decreased echogenicity, and the heterogeneous thyroid parenchyma. Also, in follicular cysts were observed in the enlarged gland with no echo structures of different sizes and decreased echogenicity as a local or general. In nodular hyperplasia, increase echogenicity and heterogeneous parenchymal were seen. These findings suggest the use of sonography and pathology as a screening test in the diagnosis of complications of thyroid disorders.

Burnishing of Aluminum-Magnesium-Graphite Composites

Burnishing is increasingly used as a finishing operation to improve surface roughness and surface hardness. This can be achieved by applying a hard ball or roller onto metallic surfaces under pressure, in order to achieve many advantages in the metallic surface. In the present work, the feed rate, speed and force have been considered as the basic burnishing parameters to study the surface roughness and surface hardness of metallic matrix composites. The considered metal matrix composites were made from Aluminum-Magnesium-Graphite with five different weight percentage of graphite. Both effects of burnishing parameters mentioned above and the graphite percentage on the surface hardness and surface roughness of the metallic matrix composites were studied. The results of this investigation showed that the surface hardness of the metallic composites increases with the increase of the burnishing force and decreases with the increase in the burnishing feed rate and burnishing speed. The surface roughness of the metallic composites decreases with the increasing of the burnishing force, feed rate, and speed to certain values, then it starts to increase. On the other hand, the increase in the weight percentage of the graphite in the considered composites causes a decrease in the surface hardness and an increase in the surface roughness.

Seismic Assessment of Old Existing RC Buildings with Masonry Infill in Madinah as per ASCE

An existing RC building in Madinah is seismically evaluated with and without infill wall. Four model systems have been considered i.e. model I (no infill), model IIA (strut infill-update from field test), model IIB (strut infill- ASCE/SEI 41) and model IIC (strut infill-Soft storey- ASCE/SEI 41). Three dimensional pushover analyses have been carried out using SAP2000 software incorporating inelastic material behavior for concrete, steel and infill walls. Infill wall has been modeled as equivalent strut according to suggested equation matching field test measurements and to the ASCE/SEI 41 equation. The effect of building modeling on the performance point as well as capacity and demand spectra due to EQ design spectrum function in Madinah area has been investigated. The response modification factor (R) for the 5 story RC building is evaluated from capacity and demand spectra (ATC-40) for the studied models. The results are summarized and discussed.

Seismic Assessment of Old Existing RC Buildings on Madinah with Masonry Infilled Using Ambient Vibration Measurements

Early pre-code reinforced concrete structures present undetermined resistance to earthquakes. This situation is particularly unacceptable in the case of essential structures, such as healthcare structures and pilgrims' houses. Amongst these, an existing old RC building in Madinah city (KSA) is seismically evaluated with and without infill wall and their dynamic characteristics are compared with measured values in the field using ambient vibration measurements (AVM). After updating the mathematical models for this building with the experimental results, three dimensional pushover analysis (Nonlinear static analysis) was carried out using commercial structural analysis software incorporating inelastic material properties for concrete, infill and steel. The purpose of this analysis is to evaluate the expected performance of structural systems by estimating, strength and deformation demands in design, and comparing these demands to available capacities at the performance levels of interest. The results summarized and discussed.

Performance Evaluation of an Efficient Asynchronous Protocol for WDM Ring MANs

The idea of the asynchronous transmission in wavelength division multiplexing (WDM) ring MANs is studied in this paper. Especially, we present an efficient access technique to coordinate the collisions-free transmission of the variable sizes of IP traffic in WDM ring core networks. Each node is equipped with a tunable transmitter and a tunable receiver. In this way, all the wavelengths are exploited for both transmission and reception. In order to evaluate the performance measures of average throughput, queuing delay and packet dropping probability at the buffers, a simulation model that assumes symmetric access rights among the nodes is developed based on Poisson statistics. Extensive numerical results show that the proposed protocol achieves apart from high bandwidth exploitation for a wide range of offered load, fairness of queuing delay and dropping events among the different packets size categories.

Evaluation and Selection of Construction Contractors by Polish Public Clients

Contracting authorities in the public sector are obligated to apply the principles provided for in the Polish law for the evaluation and selection of contractors. In order to analyse the methods of contractors selecting applied in practice by public clients, the notices of contract award results for construction works were analysed. The analysis shows that the procedure selected more and more often is open competitive bidding, where the assessment of the competence of contractors is not very precise, as well as noncompetitive bidding, i.e. single source procurement. The share of procurement procedures, where the only criterion is price, is increasing. The solution to the problems existing here might be the introduction of one of the forms of pre-selection of contractors. The article also briefly discusses verification systems for companies applying for public contracts used in EU countries.

Protective Effect of Saponin Extract from the Root of Garcinia kola (Bitter kola) against Paracetamol- Induced Hepatotoxicity in Albino Rats

Liver disorders are one of the major problems of the world. Despite its frequent occurrence, high morbidity and high mortality, its medical management is currently inadequate. This study was designed to evaluate the hepatoprotective effect of saponin extract of the root of Garcinia kola on the integrity of the liver of paracetamol induced wistar albino rats. Twenty five (25) male adult wistar albino rats were divided into five (5) groups. Group I was the Control group that received distilled water only, group II was the negative control that received 2 g/kg of paracetamol on the 13th day, and group III, IV and V were pre-treated with 100, 200 and 400mg/kg of the saponin extract before inducing the liver damage on the 13th day with 2 g/kg of paracetamol. Twenty four (24) h after administration, the rats were sacrificed and blood samples were collected. The serum Alanine Transaminase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP) activities, Bilirubin and conjugated bilirubin, glucose and protein concentrations were evaluated. The liver was fixed immediately in Formalin and was processed and stained in Haematoxylin and Eosin (H&E). Administration of saponin extract from the root of Garcinia kola significantly decreased paracetamol induced elevated enzymes in the test group. Also histological observations showed that saponin extract of the root of Garcinia kola exhibited a significant liver protection against the toxicant as evident by the cells trying to return to normal. Saponin extract from the root of Garcinia kola indicated a protection of structural integrity of the hepatocytic cell membrane and regeneration of the damaged liver.

Detection of Tetracycline Resistance Genes in Lactococcus garvieae Strains Isolated from Rainbow Trout

The present study was done to evaluate the presence of tetracycline resistance genes in Lactococcus garvieae isolated from cultured rainbow trout, West Iran. The isolates were examined for antimicrobial resistance using disc diffusion method. Of the 49 strains tested, 19 were resistant to tetracycline (38.7%), 32 to enrofloxacin (65.3%), 21 to erythromycin (42.8%), 20 to chloramphenicol and trimetoprim-sulfamethoxazole (40.8%). The strains were then characterized for their genotypic resistance profiles. The results revealed that all 49 isolates contained at least one of the tetracycline resistance genes. Tet (A) was found in 89.4% of tetracycline resistant isolates and the frequency of other gene were as follows: tet (E) 42.1%, tet (B) 47.3%, tet (D) 15.7%, tet (L) 26.3%, tet (K) 52.6%, tet (G) 36.8%, tet (34) 21%, tet (S) 63.1%, tet (C) 57.8%, tet (M) 73.6%, tet (O) 42.1%. The results revealed high levels of antibiotic resistance in L. garvieae strains which is a potential danger for trout culture as well as for public health.