Punching shear behavior of fiber reinforced polymers reinforced concrete flat slabs: experimental study

This paper presents the results of a two-phase experimental program investigating the punching shear behavior of fiber reinforced polymer reinforced concrete (FRP RC) flat slabs with and without carbon fiber reinforced polymer (CFRP) shear reinforcement. In the first phase, problems of bond slip and crack localization were identified. Decreasing the flexural bar spacing in the second phase successfully eliminated those problems and resulted in punching shear failure of the slabs. However, CFRP shear reinforcement was found to be inefficient in enhancing significantly the slab capacity due to its brittleness. A model, which accurately predicts the punching shear capacity of FRP RC slabs without shear reinforcement, is proposed and verified. For slabs with FRP shear reinforcement, it is proposed that the concrete shear resistance is reduced, but a strain limit of 0.0045 is recommended as maximum strain for the reinforcement. Comparisons of the slab capacities with ACI 318-95, ACI 440-98, and BS 8110 punching shear code equations, modified to incorporate FRP reinforcement, show either overestimated or conservative results

Current Status and Utilization of Oral and Dental Health Services in Gezira State (2005-2009)

 Objective:  This study aimed to assess the status of the present dental and oral health services   in the Gezira state.  Methods: The study areas comprise of three clusters: urban, suburban and rural. Five study sites in the urban area, four sites in suburban area around Wad Medani and 12 sites in the rural area were chosen from the six localities of Gezira State . The households study sample was as follows: 100 in the urban area, 108 in the rural area and 52 in the suburban area. The study tools were direct pre-coded questionnaires, household survey and observation checklist. The procedure involved household interview to evaluate dental  status of dental health professionals, equipment and materials in order to assess dental health services. Descriptive statistics was used to analyze and present the data. The SPSS Statistical Programme using Microsoft Windows was used. Results: This result revealed absolute lack of dental services in the rural and relative lack of services in suburban areas. The present unit is old and most of them were incomplete and not functioning. This was the reason that some of rural and suburban populations seek oral health services in Wad Medani health institutions. Most of the patients irrespective of their residence preferred treatment at private dental clinics because they expect better care due to good facilities Recommendation: Establishing new dental units with good facilities distributed in different localities and rehabilitation of dental units provided to Elhasaheisa and Elmanagil dental departments with equipments and dental specialties to become specialized dental hospitals to cover the population needs and demand dental services for the surrounding areas

Measuring organizational readiness for knowledge translation in chronic care

<p>Abstract</p> <p>Background</p> <p>Knowledge translation (KT) is an imperative in order to implement research-based and contextualized practices that can answer the numerous challenges of complex health problems. The Chronic Care Model (CCM) provides a conceptual framework to guide the implementation process in chronic care. Yet, organizations aiming to improve chronic care require an adequate level of organizational readiness (OR) for KT. Available instruments on organizational readiness for change (ORC) have shown limited validity, and are not tailored or adapted to specific phases of the knowledge-to-action (KTA) process. We aim to develop an evidence-based, comprehensive, and valid instrument to measure OR for KT in healthcare. The OR for KT instrument will be based on core concepts retrieved from existing literature and validated by a Delphi study. We will specifically test the instrument in chronic care that is of an increasing importance for the health system.</p> <p>Methods</p> <p>Phase one: We will conduct a systematic review of the theories and instruments assessing ORC in healthcare. The retained theoretical information will be synthesized in a conceptual map. A bibliography and database of ORC instruments will be prepared after appraisal of their psychometric properties according to the standards for educational and psychological testing. An online Delphi study will be carried out among decision makers and knowledge users across Canada to assess the importance of these concepts and measures at different steps in the KTA process in chronic care.</p> <p>Phase two: A final OR for KT instrument will be developed and validated both in French and in English and tested in chronic disease management to measure OR for KT regarding the adoption of comprehensive, patient-centered, and system-based CCMs.</p> <p>Discussion</p> <p>This study provides a comprehensive synthesis of current knowledge on explanatory models and instruments assessing OR for KT. Moreover, this project aims to create more consensus on the theoretical underpinnings and the instrumentation of OR for KT in chronic care. The final product--a comprehensive and valid OR for KT instrument--will provide the chronic care settings with an instrument to assess their readiness to implement evidence-based chronic care.</p

The plasma membrane carbonic anhydrase in murine hepatocytes identified as isozyme XIV

BACKGROUND: Biochemical and histochemical studies have both previously indicated plasma membrane-associated carbonic anhydrase (CA) activity in hepatocytes which has been assumed to be CA IV. However, immunohistochemical data did not support this assignment. Recent northern blotting results indicated the presence of mRNA for the most recently discovered membrane-bound CA isozyme, CA XIV, in the liver. The present study was designed to examine whether CA XIV could contribute to the CA activity described in the hepatocytes. METHODS: Tissue samples from mouse liver were subjected to immunohistochemical staining using the antibodies raised against recombinant mouse CA XIV and CA IV. RT-PCR and western blotting were also performed for CA XIV. RESULTS: A strong immunofluorescent signal was observed in the plasma membrane of mouse hepatocytes. Although CA XIV was expressed on both the apical and basolateral surfaces, the staining was more prominent at the apical (canalicular) membrane domain. The expression of CA XIV in the liver was confirmed by RT-PCR and western blotting. CONCLUSIONS: The presence of CA XIV in the hepatocyte plasma membrane places this novel enzyme at a strategic site to control pH regulation and ion transport between the hepatocytes, sinusoids and bile canaliculi

Letter: The Impact of the Coronavirus (COVID-19) Pandemic on Neurosurgeons Worldwide

This article is made available for unrestricted research re-use and secondary analysis in any form or be any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.The aim of our study was to explore the impact of this pandemic on neurosurgeons with the hope of improving preparedness for future crisis. We created a 20-question survey designed to explore demographics (nation, duration and scope of practice, and case-burden), knowledge (source of information), clinical impact (elective clinic/surgery cancellations), hospital preparedness (availability of personal protective equipment [PPE] and cost of the supplies), and personal factors (financial burden, workload, scientific and research activities). The survey was first piloted with 10 neurosurgeons and then revised. Surveys were distributed electronically in 7 languages (Chinese, English, French, German, Italian, Portuguese, and Spanish) between March 20 and April 3, 2020 using Google Forms, WeChat used to obtain responses, and Excel (Microsoft) and SPSS (IBM) used to analyze results. All responses were cross-verified by 2 members of our team. After obtaining results, we analyzed our data with histograms and standard statistical methods (Chi-square and Fisher's exact tests and logistic regression). Participants were first informed about the objectives of our survey and assured confidentiality after they agreed to participate (Helsinki declaration). We received 187 responses from 308 invitations (60.7%), and 474 additional responses were obtained from social media-based neurosurgery groups (total responses = 661). The respondents were from 96 countries representing 6 continents (Figure ​(Figure11A-​A-11C)

Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study.

Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice. Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value < 0.05 was considered to be statistically significant. Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, and 52 (46.4%) were residents. 39 (34.8%) had regular journal club sessions at their hospital, 100 (89.3%) did not have access to cadaver dissection labs, and 62 (55.4%) had never attended a WFNS-endorsed conference. 67.0% of respondents reported limited research opportunities and 58.9% reported limited education opportunities. Lack of mentorship (P = 0.023, Phi = 0.26), lack of access to journals (P = 0.002, Phi = 0.332), and limited access to conferences (P = 0.019, Phi = 0.369) were associated with the country income category. Conclusion: This survey identified barriers to education, research, and practice among African trainees and young neurosurgeons. The findings of this study should inform future initiatives aimed at reducing the barriers faced by this group