On the Newtonian Anisotropic Configurations

In this paper we are concerned with the effects of anisotropic pressure on the boundary conditions of anisotropic Lane-Emden equation and homology theorem. Some new exact solutions of this equation are derived. Then some of the theorems governing the Newtonian perfect fluid star are extended taking the anisotropic pressure into account

Epidural dexamethasone for postoperative analgesia in patients undergoing unilateral inguinal herniorrhaphy: A comparative study

Background. This study was designed to evaluate the effect of adding dexamethasone to epidural bupivacaine on postoperative analgesia in unilateral inguinal herniorrhaphy. Methods. Forty-four patients were enrolled in this double-blind, clinical trial study. Patients were randomly allocated into dexamethasone or control group. In the dexamethasone group, patients received 18ml of bupivacaine 0.5% and 2ml (8mg) of dexamethasone; in the control group, patients received 18ml of bupivacaine 0.5% and 2ml of normal saline. The onset of sensory block and its duration and incidence of nausea and vomiting were recorded. Results. The onset of epidural anesthesia was significantly more rapid in the dexamethasone group than in the control group (P < 0.001). Duration of analgesia was markedly prolonged in the dexamethasone group than in the control group (P < 0.001). Five patients (22.7%) in the control group had nausea in the first hour after the procedure (P = 0.048). None of the patients in the dexamethasone group had nausea. None of our patients had vomiting in the two groups. Conclusions. This study showed that adding dexamethasone to bupivacaine significantly prolongs the duration of postoperative analgesia

An approach to the diagnosis and management of multiple myeloma

Multiple myeloma (MM) is a plasma cell dyscrasia that accounts for ~10% of haematological malignancies. It is a disease of the elderly, with a slight male predominance. Almost all cases of MM are preceded by an asymptomatic, premalignant phase known as monoclonal gammopathy of undetermined significance (MGUS). The clinical presentation of MM may be nonspecific, with the most common presenting symptoms being fatigue, bone pain and anaemia. The diagnostic criteria for MM were revised in 2014 to include 3 specific biomarkers of malignancy that are associated with an increased risk of target organ damage. This has resulted in a paradigm shift in the management of MM. The introduction of immunomodulatory agents and proteasome inhibitors has significantly improved the survival of patients with MM. Autologous stem cell transplantation remains the standard of care in younger, fit patients, where there is also a clear role for maintenance chemotherapy. Transplant-ineligible patients benefit from a prolonged induction therapy, and the role of maintenance therapy in this setting is still unclear. Despite major advances in therapy, MM remains an incurable malignant condition and novel agents such as monoclonal antibodies play an important role, especially in the elderly and patients who have relapsed

Developing a Structural Equation Modeling of the Role of Academic Stressors on Resilience, Motivation and Academic Burnout Among Pre-University Female in Isfahan

The purpose of this study was to develop a structural equation model of the role of academic stressors on resiliency, motivation and academic burnout among female participants of entrance exam of University in Isfahan. The population was female participants of entrance exam. Two hundred pre-university females were selected by random multistage method as samples of this   study. The questionnaires: The Classroom and School Community (Rovai, 2002), Sarason Test Anxiety (1980), Frost Multidimensional Perfectionism (1990), Ego-Resiliency (Klohnen, 1996), Academic Motivation (Vallerand, 1992), Academic Burnout (Breso, 2007) were used. Confirmatory Factor Analysis (CFA) was used for studying structural equation and AMOS-1 was used for evaluating suggested model. According to proper fitting of final model, this model was verified and accepted. The results of research showed that the academic stressors were effective on academic burnout variables, academic motivation and resiliency variable. Also resiliency, as a mediator variable of academic stressors, led to educational inefficiency. The increase of academic stressors decreased academic motivation, especially internal motivation and resiliency, as a result the educational inefficiency increased. These pressures predicted academic burnout

Thalassaemia (part 2): Management

The management of thalassaemia with a severe phenotype includes blood transfusion, iron chelation, bone marrow transplantation, prenatal diagnosis and national programmes to co-ordinate these in countries with a high prevalence. If blood transfusion and iron chelation therapy are not administered regularly, as was the case historically and as is still the case in many poorer regions, progressive deterioration occurs, viz. impaired growth and development, hepatosplenomegaly, bony abnormalities, cardiac failure, increased susceptibility to infections and premature mortality. Remarkable progress has been made in the past few decades, which has led to much-improved survival rates. Transfusion therapy has evolved to a hyper-transfusion regimen designed to maintain a physiological haemoglobin level and achieve a post-transfusion haemoglobin of 14 g/dL, which, as a matter of course, necessitated intensification of iron chelation. The development of effective oral iron chelators has led to improved compliance. Exploration of novel therapeutic approaches continues, with several agents under study. The prospect of gene therapy is particularly exciting as it has potential to provide cure on a large scale. Currently, regular blood transfusion and iron chelation therapy remain the cornerstone of management of thalassaemia major

The crisis in ICT education: an academic perspective

A national Discipline-Based Initiative project for ICT, funded by the ALTC, has sought to identify the issues and challenges facing the sector. The crisis in ICT education spans high schools, universities and industry. The demand for skilled ICT graduates is increasing yet enrolments are declining. Several factors contribute to this decline including the perceived quality of teaching and a poor perception of the ICT profession amongst the general public. This paper reports on a consultation process with the academic community. Academic concerns include the capacity of the sector to survive the downturn, and improving relationships with industry which should benefit students, academics and industry. An outcome of the consultation process has been the formation of the Australian Council of Deans of ICT (ACDICT) which will have broad responsibility for addressing the issues affecting ICT higher education

A systematic review on randomized controlled trials : Coaching elements of digital services to support chronically ill adolescents during transition of care

Aims To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes. Design Systematic review without meta-analysis. Data sources MEDLINE (Ovid), Pub Med, Scopus and CINAHL on 28 May 2018. Review methods Peer-reviewed articles published between January 2008-May 2018 were reviewed following the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Results Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. Conclusion E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. Impact Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care.Peer reviewe

Comparing laboratory and field samples of lime-cement improved Norwegian clay

acceptedVersio

Validation and recalibration of OxMIV in predicting violent behaviour in patients with schizophrenia spectrum disorders

Oxford Mental Illness and Violence (OxMIV) addresses the need in mental health services for a scalable, transparent and valid tool to predict violent behaviour in patients with severe mental illness. However, external validations are lacking. Therefore, we have used a Dutch sample of general psychiatric patients with schizophrenia spectrum disorders (N = 637) to evaluate the performance of OxMIV in predicting interpersonal violence over 3 years. The predictors and outcome were measured with standardized instruments and multiple sources of information. Patients were mostly male (n = 493, 77%) and, on average, 27 (SD = 7) years old. The outcome rate was 9% (n = 59). Discrimination, as measured by the area under the curve, was moderate at 0.67 (95% confidence interval 0.61–0.73). Calibration-in-the-large was adequate, with a ratio between predicted and observed events of 1.2 and a Brier score of 0.09. At the individual level, risks were systematically underestimated in the original model, which was remedied by recalibrating the intercept and slope of the model. Probability scores generated by the recalibrated model can be used as an adjunct to clinical decision-making in Dutch mental health services