Need of providing additional training facilities in the east and southern African sub region

Substantial increase in the cost of maritime training for countries in Eastern and Southern Africa calls for an Inter-regional approach both in policy and educational institutions. This paper discusses the implication of manpower needs for shipborn services, lake services and other associated shipping activities. It looks at MET with a broader view over the whole region and recommends concerted efforts among the member regional states to work together. It also looks at the changes in MET during the last 10 years and other relatd activities that are necessary to ensure the future needs of these countries to produce efficient and safe personnel. Finally, the guidelines for a plan of action recommended by the author, will be set out based on interviews, work experience in this field, literature research, passed activities and also studies undertaken by IMO, NORAD, ILO and UNCTAD. The main objective of this study is to show the need of providing an additional maritime Training Facilities that will carter for the whole region at a minimum coast and high efficiency

Preemptive Dose Adjustment Effect on the Quality of Anticoagulation Management in Warfarin Patients With Drug Interactions: A Retrospective Cohort Study

One strategy to manage patients on warfarin starting an interacting drug is to increase the frequency of monitoring. Another strategy is to adjust warfarin dose around the time patient is started on an interacting medication, which is known as preemptive warfarin dose adjustment. The main objective of this study is to compare preemptive to nonpreemptive strategy and their impact on the quality of anticoagulation management. This is a retrospective cohort study performed at the pharmacist-managed anticoagulation clinic in a tertiary hospital in the State of Qatar. Over a 4-year period, 340 patients were evaluated, and 58 warfarin drug interaction encounters were identified. Mean age of the patients was (57.7 n 13.7), and 50% of them were females. Preemptive dose adjustment was used in 17 (29.3%) cases. Incidence of out-of-target international normalized ratio (INR) was statistically lower in the preemptive arm compared to the control group (41.2% [7/17] vs 69.2% [27/39], P =.048). Incidence of extreme out-of-target INR was numerically lower in the preemptive arm compared to the control but did not reach statistical significance (11.8% [2/17] vs 29.3% [12/41], P =.139). Change in frequency of INR monitoring was not different between the 2 groups. However, overall frequency of INR monitoring after onset/discontinuation of interacting medication increased compared to baseline (7 [9] vs 21 [16] days, P <.001). Preemptive strategy was shown in our study to decrease incidence of the out-of-target INR visits, although patients remained in need for close monitoring.This work is supported by Medical Research Center, Hamad Medical Corporation. RP#17226/17. ORCID iD Hazem Elewa https://orcid.org/0000-0003-1594-1199Scopu

Total ear reconstruction: The role of bilateral triangular post-auricular flaps for creation of the cephaloauricular sulcus

Introduction: Auricular reconstruction of congenital or acquired ear defects can provide a realistic good-looking ear and functional cephaloauricular sulcus especially for those who wear eyeglasses. Over the past few years, refinements in the techniques of elevating the buried ear framework in the second stage of ear reconstruction have shifted from simple skin grafting to the use of flaps and cartilage blocks for creation of the cephaloauricular sulcus. Objective: The aim of the study was to describe useful simple modification using bilateral triangular flaps and full thickness skin graft to create adequately functional cephalo-auricular sulcus especially for patients wearing eyeglasses during the second stage ear reconstruction.The study design: The described technique was carried out between June 2010 and January 2014, for 37 patients (24 patients with congenital microtia grade III, 7 patients with post-burn ear deformity, and 6 patients with post-traumatic ear defects). During the second stage of total ear reconstruction, the ear framework is separated substantially from the side of the head and positioned at the desired angle by means of a block of cartilage covered with a fascial flap. Then, two local triangular flaps from the adjacent non-hairy skin are created (one is superiorly based and the other is inferiorly based) and inset into the created cephaloauricular sulcus. The rest of the post-auricular defect is covered with a full thickness graft.Results: The technique was simple and effective with no post-operative complication regarding flaps viability. Patients requiring glasses have worn frames soon after the tie-over was removed and no sulcus problems have resulted

Approximated fixed points via completion

In this paper, using the concept of completion, we establish the existence&nbsp;of approximate fixed points for contracting set-valued mappings&nbsp;defined in a metric space not necessarily assumed to be complete. As a&nbsp;consequence, we obtain approximate versions of the famous results of the&nbsp;global Contraction Mapping Principle and Nadler Fixed Point Theorem&nbsp;without completeness

Flexural Fatigue Behaviour of Corroded Pretensioned Beams and Their Repair Using Carbon Fibre Reinforced Polymer Sheets

The study presented in this thesis investigated the flexural fatigue behaviour of non-corroded and corroded pretensioned beams and examined the use of externally bonded Carbon Fibre Reinforcement Polymer (CFRP) sheets as a repair technique aimed at restoring the loss in capacity due to corrosion. This was accomplished through an extensive experimental and analytical program. The experimental program was comprised of a material testing phase and a beam testing phase. The material testing phase consisted of testing seventy-two (72) material samples under monotonic and cyclic axial loading, full strand testing, and corrosion measurements of prestressing strands corroded while embedded in concrete prism. Material testing achieved multiple objectives: (a) it identified the rate of accelerated corrosion of the prestressing strands, (b) it quantified the distribution of the applied nominal tensile force among the seven wires within a single 7-wire strand in a prestressed strand, (c) it determined the material fatigue properties, and the stress-strain behaviour of the strand wires, and (d) it quantified the stress concentration factor in the prestressing strand due to corrosion. The beam testing involved constructing thirty-seven (37) 3.6 m long pretensioned T-beams and testing them in a four-point bending configuration. Twelve (12) beams were tested under monotonic loading, and twenty-five (25) beams were tested under cyclic loading. The main testing variables included: the corrosion level, the applied stress range, and a repair or the lack of it. Corrosion resulted in a significant deterioration of the monotonic and fatigue resistance of the beams in comparison to non-corroded beams, and repair using externally bonded CFRP sheet restored all or most of the monotonic and fatigue resistance lost due to corrosion. All beams failed by rupture of the prestressing strand. Inspection of the strand’s fracture surface showed signs of surface fretting. In addition, the fracture profile was similar to that reported by Toribio and Ovejero (2005) for hydrogen induced stress cracking of heavily cold drawn prestressing wires. Strands having corrosion levels of 5% and 10% by mass loss exhibited an overall section loss together with distinct deep corrosion pits. In the analysis phase, fatigue data measured from smooth axial samples taken from the centre wire of a prestrssing strand was used to model the fatigue behaviour of the outer wires of the 7-wire prestressing strand for corroded and non-corroded pretensioned beams. Strain-based fracture mechanics was employed in all the analyses, which included the flexure fatigue behaviour of: non-corroded and corroded single prestressing wires-in-air, a full 7-wire prestressing strand-in-air, and a non-corroded and corroded 7-wire prestressing strand in a beam. The mode results correlated well with the observed experimental results. This thesis presents extensive experimental work, along with an in depth fatigue analysis that is based on material fatigue properties obtained from simple single wire cyclic testing. The resulting modelling approach offers a mechanistic explanation of 7-wire prestressing strand failure under various conditions

Creep Behaviour of Post-Installed Adhesive Anchors under Various Sustained Load Levels and Environmental Exposures

This thesis describes an experimental study on the long-term creep behaviour of adhesive anchors under sustained tensile loads in combination with different environmental exposures. A comprehensive background and literature review is presented, focusing on various bond stress models for adhesive anchors, factors affecting their bond behavior, and an overview of available testing standards and evaluation criteria. The experimental program comprises of 82 test specimens. The specimens consist of a cylindrical shaped concrete block of 300 mm (12 inch) in diameter and 200mm (8 inch) in depth, with 15M (No. 5) deformed steel bar post-installed to an embedment depth of six times the bar diameter or 125mm (5 inch). Three types of adhesives were used for anchor installation: Type-A a fast setting two component methyl methacrylate adhesive, Type-B a fast setting two part epoxy adhesive, and Type-C a standard set two part epoxy adhesive. The study is divided into four phases. Phase I consists of 27 static pullout tests to determine the yield strength (fy) and the maximum tensile capacity of each anchor system under three exposure conditions. Phase II and Phase III consist of 36 specimens tested under sustained load levels of 40%fy (32kN) and 60%fy (48kN)under normal laboratory conditions (room temperature) and moisture exposure, respectively. Phase IV consists of 9 specimens tested under sustained load with a load level of 40%fy (32kN) with exposure to freeze/thaw cycling. All sustained load tests lasted for a period of at least 90 days. The results of the static pullout testing showed that specimens with epoxy based adhesive exhibited stronger bond strength, forcing the anchor to fail by rupture prior to bond failure. Under sustained load testing, specimens with standard set epoxy based adhesive showed insignificant creep displacement under room conditions, however, when exposed to moisture noticeable creep displacements were recorded. Specimens with both fast setting epoxy and methyl methacrylate based adhesives showed higher creep displacements under environmental exposure (moisture, freeze/thaw) versus those kept at room temperature. Displacement data from creep testing were analysed and projected over a service life span of 50 years for room temperature exposure, and for 10 years for moisture and freeze/thaw exposures. Based on the analysis results, the service life of different anchor systems was estimated. An integrated qualification and testing protocol is proposed for the creep behavior of adhesive anchors under various environmental exposures

Design and technological support for the manufacture of “Shaft Bearing Housing”

Design of work piece structure of shaft bearing housing deals economic calculation of new manufacturing part is already produce and the idea is to save money and increase production technological process implementation and to make manufacturing process better to reduce machining rejection, all mechanical work and design process standard operation to be done on it during the production process and all design activities covering this process

Predictors For TESE Outcomes and Fertility Potentials Among Infertile Adult Men

Background: Spermatogenesis is an essential process for human reproduction.&nbsp;&nbsp; Gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone play vital roles in the development and maturation of sperm. Growth hormone (GH) is thought to play a role in the reproductive system of both males and females. Growth Hormone deficiency can lead to reproductive problems. Aim: to assess predictors of fertility potentials and TESE outcomes among adult males. Methods: we enrolled 162 males and assessed FSH, LH, basal GH, clonidine (GH) stimulation test one time and insulin stimulation test in another time. We designed a predictive model to identify the fertility potentials, Fertility Score= 4.442 + (Basal GH*0.074) + (GH_CLON*0.035) - (FSH*0.021) (BMI*0.062)- (Smoker*0.429). The net result of this equation should be approximated to the nearest integer to predict the fertility status where, 1=TESE Negative, 2= TESE Positive, 3=Oligozoospermia, and 4= Fertile control. Results: multivariate analysis showed smoking status, testicular volume, BMI, Serum FSH, basal GH are not predictors for fertility potentials. GH after clonidine and after insulin stimulation GH after clonidine stimulation correlates positively with total motile count. Other semen parameters do not correlate with basal GH or GH after insulin or clonidine stimulation. Receiver Operator Characteristic (ROC) curve analysis is used to detect the cut off levels at which sperm recovery yield change. For the GH assessment only, the basal GH could be applied to predict the SRR in men with azoospermia, AUC=0.672 (95% CI: 0.499 to 0.844). Growth hormone after clonidine (AUC= 0.510) or Insulin stimulation (AUC=0.556) and therefore, cannot differentiate between TESE positive and TESE negative cases. Conclusion: Basal, post clonidine GH levels, has BMI and smoking are predictive factors for fertility potentials, our model have high sensitivity in predicting fertility potentials among positive TESE males. Basal GH can significantly predict TESE negative males

Facial rejuvenation: Serial fat graft transfer

Autologous fat transfer is a century-old method for both aesthetic and reconstructive purposes. It is considered by many plastic surgeons the ideal body filler. The only disadvantage is its variable degree of resorption, which ranged from 45% to 80%. Various groups have studied the effects of cryo-preservation for fat storage, the advantage being that fat harvesting need only be performed once, and thereafter fat injections can be performed using stored fat as an outpatient service. This a clinical study carried out to test the aesthetic outcome of serial injection of the cryo-preserved fat cells for both aesthetic and reconstructive purposes.Methods: Clinical evaluation was performed under standardized condition for serial lipofilling between October 2003 and May 2012, and 364 autologous fat transfers were performed in 104 patients ranging in age from 18 to 69 years (mean age 34 years).Results: The postoperative clinical results favored the use of serial fat transfer because the aesthetic and structural results were stable up to 90% of the initial volume more than a year after initial transfer.Conclusion: Our data suggest that serial transfer of the cryo-preserved fat leads to better cosmetic results on the basis of outpatient service without increasing the financial burden for our patients

Comparative study between fisher anatomical subunit approximation technique and millard rotation- advancement technique in unilateral cleft lip repair

Introduction: The ideal lip repair is characterized by; the symmetrical shape of nasolabial folds and both alae of the nose with a natural-looking philtrum and Cupid’s bow in both static and dynamic states, in addition to a hidden scar.Objective: to compare between Fisher anatomical subunit approximation technique and Millard rotational advancement technique in unilateral cleft lip repair.Methods: Prospective study for 40 patients presented to Alexandria Main University hospital with unilateral cleft lip deformity between March 2019 and October 2020. Twenty patients with unilateral cleft lip deformity were repaired by Fisher anatomical subunit approximation technique, while the other twenty were repaired by Millard rotational-advancement technique. The postoperative photographs of the patients were captured and processed in computer photogrammetry software through which anthropometric parameters including (lip height, lip width, vermilion height, and alar base width) were compared between the normal side and the repaired side. In this software, each anthropometric parameter length on the normal side is taken as a control with a fixed value of (1) then the same parameter on the repaired side was measured as a ratio of this value to avoid bias. Comparison between both groups for assessment of the quality of cleft lip repair was also done based on Steffensen grading criteria.Results: Comparison between both techniques in unilateral cleft lip repair showed that there was no significant difference between them in the anthropometric measurements. While the comparison between the two groups using Steffensen grading criteria showed that Fisher’s technique surpassed Millard’s technique.Conclusion: We recommend the use of the Fisher anatomical subunit approximation technique in unilateral cleft lip repair for its superior results over the Millard rotational advancement technique