Physical Activity Levels in Total Hip Arthroplasty Comparing the Direct Anterior Approach to the Direct Lateral Approach: A Prospective Cohort Study

Total hip arthroplasty (THA) is a cost-effective surgical procedure to treat patients with end-stage hip arthritis with high patient satisfaction. Different surgical approaches to the hip have been used to successfully perform THA. However, the role of these surgical approaches on physical activity and early functional recovery in THA patients remains controversial. In this thesis, we prospectively evaluated physical activity levels in patients with end-stage hip OA whom are undergoing elective THA. The primary focus was to evaluate the impact of different surgical approaches on physical activity levels as a measure of functional recovery in the immediate postoperative period. Due to the muscle sparing nature, the DA approach demonstrated faster functional recovery in the early postoperative period compared to the DL approach. Further examination regarding the economic implications of the improved early function from the perspective of the patient, caregiver, and care payer may be indicated

Does Audit Quality in Libya Meet the International Standards Levels?

This study provide empirical evidence of the current situation and measure the perceptions of the level of audit quality in Libya by focusing on oil companies. It aims to examine the extent to which Libyan Accountants and Auditors Association (LAAA) and audit firms and play an essential role in enhancing the quality of audit and developing the audit profession. A questionnaire and interviews were used to collect data from audit firm that works in Libya and Libyan oil companies. The study finds that there is a lack of professionalism among auditors in Libya is pervasive and that weaknesses in the current regulatory framework are detrimental and have led to the ineffectiveness of the LAAA. In addition, the ignorance of audit firms in Libya in respect of new services, and the inability of Libya’s education system to produce competent graduates, all contribute to the low level of audit quality that the profession

Development of Empirical Method to Calculate Natural Gas Pipelines Rupture Exposure Radius

PresentationNatural Gas pipeline location classification are designed following an approach similar to ASME B31.8, which considers segmenting the pipeline length and count the population in each segment within a given distance from the pipeline (width of segment). ASMEB 31.8 utilizes fixed distance of 400m for the segment width, while other operators use the pipeline Rupture Exposure Radius (RER). This is a distance determined by the consequences modeling for pipeline full rupture. Since, the population density within the segment width affects the design factors of the pipeline, i.e. wall thickness requirements, over-predicting the distance can have significant cost implications. Some operators use default RER values on conservative estimates, while industrial best practices allow for detailed dispersion to calculate representative RER distances. Detailed dispersion modeling was performed for a large number of Natural Gas Pipeline scenarios, and an empirical formula was developed to estimate the RER for these pipelines as a function of the pipeline diameter and pressure. The dispersion calculations results show that the default RER values current used by some operators are very conservative, and that the cost of pipeline design/construction can be optimized by using the empirical formula developed in this work. The formula, which produces the RER value in terms of the distance from the pipeline to the point of 1⁄2 lower flammable limit is easy to use, and accurately represents the dispersion results. This eliminates the need to using sophisticated modeling software/tools to assess the RER values of Natural Gas pipelines. The formula also uses minimum number of data/information available about the pipelines (diameter and pressure only) increasing its effectiveness as a tool replacing the modeling software. In addition, for pipeline projects, lower RER distances result in more flexibility in route selection, lower pipeline location class and hence thinner wall thicknesses, less emergency isolation valves required and longer span between sectionalizing valves, which all translate to cost savings and reduces potential sources of leak (sectionalizing valves)

Hydrogeological Investigation and Groundwater Potential Assessment in Haromaya Watershed, Eastern Ethiopia

The paper assesses groundwater quality and productivity in Haromaya watershed, eastern Ethiopia. Continuous pumping test data, collected from seven boreholes was used to determine productivity of the aquifers. 14 water samples were tested for water quality. The aquifers on the basis of permeability, potential and extent of aquifers, are categorized into i) extended and shallow aquifers with intergranular porosity and permeability, and with moderate to high potential (alluvial and lacustrine sediments); ii) limited and shallow aquifers with fracture and/or karstic porosity and permeability, and with moderate potential (sandstone and limestone); and iii) limited and shallow aquifers with intergranular and fracture porosity and permeability, and with low potential (granite). On the basis of chemical data, the water is fresh except in lacustrine and swampy areas. HCO3-, Ca2+, Na+ and Mg2+ are the dominating ions in water from granite, sandstone and alluvium; and Cl and SO4 dominate in water from lacustrine sediments apart from HCO3-, Ca2+, Na+ and Mg2+. Areas suitable for groundwater development in the area are discussed. Keywords: Aquifer, Ethiopia, Groundwater potential, Haromaya, Hydrogeochemistry

Infectious diseases epidemic threats and mass gatherings: refocusing global attention on the continuing spread of the Middle East Respiratory syndrome coronavirus (MERS-CoV).

Media and World Health Organization (WHO) attention on Zika virus transmission at the 2016 Rio Olympic Games and the 2015 Ebola virus outbreak in West Africa diverted the attention of global public health authorities from other lethal infectious diseases with epidemic potential. Mass gatherings such as the annual Hajj pilgrimage hosted by Kingdom of Saudi Arabia attract huge crowds from all continents, creating high-risk conditions for the rapid global spread of infectious diseases. The highly lethal Middle Eastern respiratory syndrome coronavirus (MERS-CoV) remains in the WHO list of top emerging diseases likely to cause major epidemics. The 2015 MERS-CoV outbreak in South Korea, in which 184 MERS cases including 33 deaths occurred in 2 months, that was imported from the Middle East by a South Korean businessman was a wake-up call for the global community to refocus attention on MERS-CoV and other emerging and re-emerging infectious diseases with epidemic potential. The international donor community and Middle Eastern countries should make available resources for, and make a serious commitment to, taking forward a "One Health" global network for proactive surveillance, rapid detection, and prevention of MERS-CoV and other epidemic infectious diseases threats

A Biosensor-CMOS Platform and Integrated Readout Circuit in 0.18-μm CMOS Technology for Cancer Biomarker Detection

This paper presents a biosensor-CMOS platform for measuring the capacitive coupling of biorecognition elements. The biosensor is designed, fabricated, and tested for the detection and quantification of a protein that reveals the presence of early-stage cancer. For the first time, the spermidine/spermine N1 acetyltransferase (SSAT) enzyme has been screened and quantified on the surface of a capacitive sensor. The sensor surface is treated to immobilize antibodies, and the baseline capacitance of the biosensor is reduced by connecting an array of capacitors in series for fixed exposure area to the analyte. A large sensing area with small baseline capacitance is implemented to achieve a high sensitivity to SSAT enzyme concentrations. The sensed capacitance value is digitized by using a 12-bit highly digital successive-approximation capacitance-to-digital converter that is implemented in a 0.18 μm CMOS technology. The readout circuit operates in the near-subthreshold regime and provides power and area efficient operation. The capacitance range is 16.137 pF with a 4.5 fF absolute resolution, which adequately covers the concentrations of 10 mg/L, 5 mg/L, 2.5 mg/L, and 1.25 mg/L of the SSAT enzyme. The concentrations were selected as a pilot study, and the platform was shown to demonstrate high sensitivity for SSAT enzymes on the surface of the capacitive sensor. The tested prototype demonstrated 42.5 μS of measurement time and a total power consumption of 2.1 μW

Surgeon Burnout, Patient Safety and Quality of Care: Contributors, Consequences and Possible Solutions

Research has linked increased staff burnout to poorer patient safety in healthcare settings. Surgeons, in particular, are more inclined to suffer from burnout whereas surgeons often suffer silently when they are experiencing stress and burnout and do not ask for help which make the issue not clear. There needs to be more research on surgeon burnout, how it affects them and how to enhance their well-being. This thesis aimed to improve understanding of surgeon burnout and identify potential solutions. This thesis reports five studies. The first was a systematic review and meta�analysis which aimed to investigate the association between surgeon burnout and 1) patient safety and 2) surgical professionalism. The results of a systematic review provided important insights into the existing evidence base on surgeon’s burnout and identified gaps in knowledge, one of which is that there is not enough qualitative study to give a deep understanding of how surgeons experience and deal with burnout. Hence, the next two studies used semi-structured interviews to explore the main factors that lead to surgeon burnout and to examine how surgeons cope with burnout at work (Study 2) and to understand how burnout affects surgeons and the care they provide (Study 3). The systematic review also revealed that there is no evidence regarding the link between surgeon burnout and patient safety in the UK, to address this, the fourth study used questionnaire survey methods to investigate the association between surgeon burnout and patient safety outcomes. This study also tested whether surgeons' burnout levels varied over the first six months of the COVID-19 pandemic. The fifth study, ../ qualitative methods, investigated the effects of the COVID-19 pandemic on surgeons' mental health. Key findings This thesis found a significant link between surgeon burnout and patient care. The systematic review and meta-analysis (Study 1) results showed that burnout was associated with a 2.5-fold increased risk of medical error. Study 3 identified four themes about how burnout affects patient care: first, burnout weakens surgeon–patient relationships; second, burnout affects patient safety; third, burnout hurts staff relationships; and fourth, burnout makes vi surgeons less motivated to improve. Burnout was also associated with patient safety in the survey study (Study 4), and the longitudinal findings indicated a bi-directional connection between burnout and patient safety perceptions (Study 4). Regarding the main factors that can lead to burnout in surgeons, the thematic analysis identified several factors captured in the following themes: rising to the challenge of surgical work; interpersonal conflict at work; greater demands than resources; the challenge of work-life balance; and the devastating impact of errors and poor patient outcomes (Study 2). The analyses also revealed various strategies surgeons employed to cope with burnout: cognitive restructuring; seeking social support; stepping aside or down from the job; and prioritising personal health. Additionally, some surgeons also reported using maladaptive coping (Study 2). A second qualitative analysis also found three themes in surgeons' experiences of burnout: first, burnout is common but frequently not recognised nor understood; second, burnout is a personal crisis; and third, burnout creates vulnerability at work (Study 3). The impact of the COVID-19 pandemic on surgeons was also investigated in this thesis (Studies 4 and 5). Qualitative thematic analysis identified four major themes: a changing and challenging work environment due to the COVID-19 pandemic; professional development and life challenges; personal change and loss, and emotional and psychological repercussions (Study 5). Quantitative analyses found that burnout increased during the pandemic's first (June 2020) to second waves (January 2021) (Study 4). In conclusion, surgeons suffer from a high level of burnout, especially after the COVID-19 pandemic (Study 4). Without a defined retention plan, the problem affects not only surgeons through bad habits such as substance abuse, but also organisations through workforce loss due to surgeons leaving. It may also increase risks to patient safety

Thymoquinone attenuates diethylnitrosamine induction of hepatic carcinogenesis through antioxidant signaling

Hepatocellular carcinoma accounts for about 80–90% of all liver cancer and is the fourth most common cause of cancer mortality. Although there are many strategies for the treatment of liver cancer, chemoprevention seems to be the best strategy for lowering the incidence of this disease. Therefore, this study has been initiated to investigate whether thymoquinone (TQ), Nigella sativa derived-compound with strong antioxidant properties, supplementation could prevent initiation of hepatocarcinogenesis-induced by diethylnitrosamine (DENA), a potent initiator and hepatocarcinogen, in rats. Male Wistar albino rats were divided into four groups. Rats of Group 1 received a single intraperitoneal (I.P.) injection of normal saline. Animals in Group 2 were given TQ (4 mg/kg/day) in drinking water for 7 consecutive days. Rats of Group 3 were injected with a single dose of DENA (200 mg/kg, I.P.). Animals in Group 4 were received TQ and DENA. DENA significantly increased alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin, thiobarbituric acid reactive substances (TBARS) and total nitrate/nitrite (NOx) and decreased reduced glutathione (GSH), glutathione peroxidase (GSHPx), glutathione-s-transferase (GST) and catalase (CAT) activity in liver tissues. Moreover, DENA decreased gene expression of GSHPx, GST and CAT and caused severe histopathological lesions in liver tissue. Interestingly, TQ supplementation completely reversed the biochemical and histopathological changes induced by DENA to the control values. In conclusion, data from this study suggest that: (1) decreased mRNA expression of GSHPx, CAT and GST during DENA-induced initiation of hepatic carcinogenesis, (2) TQ supplementation prevents the development of DENA-induced initiation of liver cancer by decreasing oxidative stress and preserving both the activity and mRNA expression of antioxidant enzymes

Infectious diseases epidemic threats and mass gatherings: Refocusing global attention on the continuing spread of the Middle East Respiratory syndrome coronavirus (MERS-CoV)

Media and World Health Organization (WHO) attention on Zika virus transmission at the 2016 Rio Olympic Games and the 2015 Ebola virus outbreak in West Africa diverted the attention of global public health authorities from other lethal infectious diseases with epidemic potential. Mass gatherings such as the annual Hajj pilgrimage hosted by Kingdom of Saudi Arabia attract huge crowds from all continents, creating high-risk conditions for the rapid global spread of infectious diseases. The highly lethal Middle Eastern respiratory syndrome coronavirus (MERS-CoV) remains in the WHO list of top emerging diseases likely to cause major epidemics. The 2015 MERS-CoV outbreak in South Korea, in which 184 MERS cases including 33 deaths occurred in 2 months, that was imported from the Middle East by a South Korean businessman was a wake-up call for the global community to refocus attention on MERS-CoV and other emerging and re-emerging infectious diseases with epidemic potential. The international donor community and Middle Eastern countries should make available resources for, and make a serious commitment to, taking forward a "One Health" global network for proactive surveillance, rapid detection, and prevention of MERS-CoV and other epidemic infectious diseases threats

A Phytochemical Analysis, Microbial Evaluation and Molecular Interaction of Major Compounds of Centaurea bruguieriana Using HPLC-Spectrophotometric Analysis and Molecular Docking

Centaurea is one of the most important genera within the family Asteraceae. An investigation of the phytochemical composition of Centaurea bruguieriana using Gas-Chromatography coupled to Mass spectrometry (GC-MS) was performed. Antimicrobial activity was evaluated using the minimum inhibitory concentration method (MIC) and validated by molecular docking for the major compounds of the most active fraction (1,10-di-epi-cubenol and methyl 8-oxooctanoate) of C. bruguieriana against three bacterial receptors (TyrRS, DNA gyrase, and dihydrofolate reductase (DHFR)). Evaluation of antioxidant activity was conducted using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays. High-performance liquid chromatography (HPLC) was used to identify and quantify the contents of major compounds from ethyl acetate fraction (luteolin 7-O-glucoside, chlorogenic acid, kaempferol and isorhamnetin). The antimicrobial activity test showed that the chloroform fraction was more active against all microbial strains. The results of the molecular docking of two major compounds from chloroform fraction showed that good affinities were made between 1,10-di-epi-cubenol and the three selected receptors (TyrRs: −6.0 Kcal/mol against −8.2 Kcal/mol obtained with clorobiocin (standard); DNA gyrase: −6.6 Kcal/mol against −9.1 Kcal/mole obtained with clorobiocin; DHFR: −7.4 Kcal/mol against −6.3 Kcal/mol obtained with SCHEMBL2181345 Standard). Antioxidant evaluation showed that the ethyl acetate fraction was the most active fraction in DPPH (IC50 49.4 µg/mL) and ABTS (IC50 52.8 µg/mL) models. HPLC results showed the contents of luteolin 7-O-glucoside (7.4 µg/mg), and chlorogenic acid (3.2 µg/mg). Our study demonstrated that C. bruguierana is a promising source of bioactive compounds