Way-finding strategy for Healthcare Environments

Healthcare environments need to make it easier to way-finding as the most difficult problem a patient faces after illness is how to reach his intended destination in order to receive treat-ment, and the problem is more difficult if the design of the building is complicated, and health care buildings are often complex and complex buildings. Weak way-finding systems affect users, which leads to confusion, tension, and frustration, where the process of understanding the environment built of important issues and the process of cognition is the problem of way-finding because despite its basic role, it is often ignored when designing health care buildings, and instead of exacerbating the levels of stress and confusion of the users of the building and especially the patients, can work a strategy to way-finding properly designed free of stress and ensure Users reach their destination on time without stress. Therefore, the research aims to deduce an effective and successful strategy for way-finding to be a database of the planning and design of healthcare buildings and to make users aware of the environment in a way that helps them meet their different needs and enable them to move successfully within the healthcare environment in the least time and least effort possible by providing the necessary information or evidence, thereby transforming the complex and con-fusing healthcare environment into an easy-to-use and manageable environment.In order to reach the goal of the research, the research relied on the scientific-analytical approach in the study through the study of the theoretical framework of the research problem based on the study of the concept of cognition and the concept of the system of way-finding and its importance, the process of way-finding and the factors affecting it and the use of the senses in that process, and the components of a good and effective way-finding system, as well as an analytical study complementary to the theoretical study of the emergency hospital at Mansoura University as a sample of the study, and analysis of the current situation through field visits to reach the results of the study of the current situation, and proposed work to improve the system of way-finding in it, the study recommended the need to pay attention to providing the elements and components of way-finding system in an orderly and integrated manner commensurate with the needs of all users of healthcare buildings

Fault Location Effect on Short-Circuit Calculations of a TCVR Compensated Line in Algeria

This research work investigated the effect of fault location on short-circuit calculations for a high voltage transmission line equipped with a novel FACTS device, namely Thyristor Controlled Voltage Regulator (TCVR). This main function of this device was to control the voltage and active power of the line. The paper considered a study case for a 220 kV transmission line, in the Algerian transmission power network, which was subjected to a phase to earth fault in the presence of a fixed fault resistance. The paper presented theoretical analysis of the short-circuit calculations which was confirmed by the illustrated simulation results. Simulation results showed the impact of the fault location on the symmetrical current and voltage components of the line, and transmission line phase currents and voltages; before using TCVR and in the presence of TCVR for both cases of positive and negative TCVR controlled voltage

Non-dominated sorting gravitational search algorithm for multi-objective optimization of power transformer design

Transformers are crucial components in power systems. Due to market globalization, power transformer manufacturers are facing an increasingly competitive environment that mandates the adoption of design strategies yielding better performance at lower mass and losses. Multi-objective Optimization Problems (MOPs) consist of several competing and incommensurable objective functions. Recently, as a search optimization technique inspired by nature, evolutionary algorithms have been broadly applied to solve MOPs. In this paper, a power Transformer Design (TD) methodology using Non-dominated Sorting Gravitational Search Algorithm (NSGSA) is proposed. Results are obtained and presented for NSGSA approach. The obtained results for the study case are compared with those results obtained when using other multi objective optimization algorithms which are Novel Gamma Differential Evolution (NGDE) Algorithm, Chaotic Multi-Objective Algorithm (CMOA), and Multi- Objective Harmony Search (MOHS) algorithm. From the analysis of the obtained results, it has been concluded that NSGSA algorithm provides the most optimum solution and the best results in terms of normalized arithmetic mean value of two objective functions using NSGSA to the TD optimization

Assessment of external apical root resorption following En-masse and two steps retraction in maxillary protrusion cases: A randomized controlled clinical trial

Aim: The aim of this study was to investigate the degree of external apical root resorption (EARR) following En-masse retraction (EM) and compared it to two steps retraction technique (TS) using friction mechanics. Materials and Methods: Thirty adult female with maxillary protrusion were randomly allocated by a computer sequence generator with 1:1 allocation ratio. EM group (mean age = 17.7 ± 1.89 years) and TS group (mean age = 17.7 ± 1.77 years). Mini-screws were inserted followed by first premolars extraction then randomization was accomplished. Patients received treatment with either EM procedure or TS to close the extraction spaces after alignment and leveling with the same pre-adjusted fixed appliances. Pre- and post treatment CBCT images of both groups was used to evaluate the EARR from (T0) start of retraction till end of space closure (T1). Results: The data of 20 patients (10 in EM group and 10 in TS group) were analyzed. EARR was detected in both groups with more root resorption in EM group by total average decrease in root length by -1.14 mm while in TS group by -0.66 mm as an average decrease in root length. Conclusion: The difference in EARR between the study groups was statistically significant. The highest RR values were found in TS group to be -1.01 mm in upper left central (UL1), while the greatest RR in EM group to be -1.5 mm in upper left canine (UL3)

Impact of Total Salpingectomy Versus Tubal Conservation During Abdominal Hysterectomy on Ovarian Function

Background: Hysterectomy is one of the most common surgeries in women worldwide. It is applied for the treatment of various problems, such as pelvic pain, menstrual problems, tumors, and other related diseases. Objective: The aim of this work was to preservation of ovarian function as long as possible to decrease manifestation of menopause in hysterectomized patients. Patients and Methods: The study was case control study included 58 patients attendant in outpatient clinic of Obstetrics and Gynecology department, Zagazig University Hospital, and Banha Teaching Hospital during the period from April 2017 to October 2018. All patients were scheduled to total abdominal hysterectomy without oophorectomy due to benign uterine disease. Patients was classified into two groups randomly: Group 1: included odd number of patients 29 was subjected to total abdominal hysterectomy with bilateral complete excision of the tubes. Group II: included an even numbers of patients (n =29) for whom the classical approach of hysterectomy was performed. Results: There was no significant difference between groups regarding Operation, time Hospital stay and Bleeding. Also regarding number of antral follicle post operatively. While these are significant differences between Ovary size distributions between studied groups at different times. Conclusions: It could be concluded that salpingostomy with abdominal hysterectomy is a safe and convenient treatment that does not have a deleterious effect on ovarian reserve

Optimized Adaptive Frangi-based Coronary Artery Segmentation using Genetic Algorithm

Diseases of coronary artery are deliberated as one of the most common heart diseases leading to death worldwide. For early detection of such disease, the X-ray angiography is a benchmark imaging modality for diagnosing such illness. The acquired X-ray angiography images usually suffer from low quality and the presence of noise. Therefore, for developing a computer-aided diagnosis (CAD) system, vessel enhancement and segmentation play significant role. In this paper, an optimized adapter filter based on Frangi filter was proposed for superior segmentation of the angiography images using genetic algorithm (GA). The original angiography image is initially preprocessed to enhance its contrast followed by generating the vesselness map using the proposed optimized Frangi filter. Then, a segmentation technique is applied to extract only the artery vessels, where the proposed system for extracting only the main vessel was evaluated. The experimental results on angiography images established the superiority of the vessel regions extraction showing 98.58% accuracy compared to the state-of-the-art

C-Reactive Protein to Albumin Ratio and Albumin to Fibrinogen Ratio in Rheumatoid Arthritis Patients

Objective: the albumin to fibrinogen ratio (AFR) and the C-reactive protein (CRP) to albumin ratio (CAR) have been proposed as markers of systemic inflammation. The goal of this study was to differentiate rheumatoid arthritis (RA) patients from healthy people and to study the association between AFR/CAR and DAS28 in RA.Patients and methods. A case control study including 30 RA patients and 30 healthy controls was performed. Fibrinogen, albumin, CRP and erythrocyte sedimentation rate (ESR) were measured. We calculated CAR and AFR in each group and compared them. Correlations of AFR, and CAR with disease activity were examined. Receiver operation characteristic (ROC) curves of AFR and CAR were also used to detect cutoffs for disease activity assessment.Results and discussion. CAR was higher while AFR was lower in RA patients than in control group. ROC curve analyses showed that CAR can be used to detect disease activity of RA at cut off 2.66 with sensitivity 81.3% and specificity 64.3% with an area under the curve (AUC) 0.78. So, CAR was a fair parameter to discriminate disease activity among RA patients. AFR has AUC 0.62, sensitivity 87.5% and specificity 42.9% at cutoff value 5.96. So, in our group AFR was a poor indicator to discriminate disease activity among RA patients.Conclusion. AFR and CAR have been recently proposed as inflammatory markers for assessment of disease activity in RA. AFR and CAR are simple, and inexpensive biomarkers, they also can be rapidly evaluated. CAR was found to be a fair parameter to depict disease activity in RA patients. AFR poorly depicted RA activity.Objective: the albumin to fibrinogen ratio (AFR) and the C-reactive protein (CRP) to albumin ratio (CAR) have been proposed as markers of systemic inflammation. The goal of this study was to differentiate rheumatoid arthritis (RA) patients from healthy people and to study the association between AFR/CAR and DAS28 in RA.Patients and methods. A case control study including 30 RA patients and 30 healthy controls was performed. Fibrinogen, albumin, CRP and erythrocyte sedimentation rate (ESR) were measured. We calculated CAR and AFR in each group and compared them. Correlations of AFR, and CAR with disease activity were examined. Receiver operation characteristic (ROC) curves of AFR and CAR were also used to detect cutoffs for disease activity assessment.Results and discussion. CAR was higher while AFR was lower in RA patients than in control group. ROC curve analyses showed that CAR can be used to detect disease activity of RA at cut off 2.66 with sensitivity 81.3% and specificity 64.3% with an area under the curve (AUC) 0.78. So, CAR was a fair parameter to discriminate disease activity among RA patients. AFR has AUC 0.62, sensitivity 87.5% and specificity 42.9% at cutoff value 5.96. So, in our group AFR was a poor indicator to discriminate disease activity among RA patients.Conclusion. AFR and CAR have been recently proposed as inflammatory markers for assessment of disease activity in RA. AFR and CAR are simple, and inexpensive biomarkers, they also can be rapidly evaluated. CAR was found to be a fair parameter to depict disease activity in RA patients. AFR poorly depicted RA activity

Assessment of Serum Level of Paraoxonase-1 in Patients with Psoriasis Vulgaris

Background: Psoriasis is a chronic inflammatory dermatological disease with a strong genetic predisposition and autoimmune pathogenic traits. The hallmark of psoriasis is sustained inflammation that leads to uncontrolled keratinocyte proliferation and dysfunctional differentiation. Objective: The aim of this study was to evaluate serum level of paraoxonase-1 in psoriasis patients compared to control group. Patients and methods: This research included 50 psoriasis patients and 40 healthy controls that were comparable in age and sex to the cases category. They were chosen at random from the Outpatient Clinic of Dermatology Department, Mansoura University Hospitals. Results: Psoriasis group showed significantly lower level of paraoxonase-1 when compared to control group (median=35.6 versus 54.5; p < 0.001). Additionally, median paraoxonase-1 level decreased gradually with increased psoriasis grades (p < 0.001). No significant associations were found regarding paraoxonase-1 level according to gender, smoking, and FH in psoriasis group (p > 0.05 for each). Paraoxonase-1 level showed significant negative correlation with PASI score (p < 0.001), but not with age, onset, or duration (p > 0.05 for each). Lower paraoxonase-1 level was considered as independent predictor of psoriasis development. Lower paraoxonase-1 level was considered as independent predictor of psoriasis severity (p < 0.001). Conclusion: Paraoxonase-1 level in psoriasis patients had substantially lower levels than healthy controls. Paraoxonase1 level showed significant negative correlations with PASI score. Lower baseline paraoxonase-1 level was suggested to be independent risk predictor for psoriasis occurrence and severity

Detection of A2142G, A2142C and A2143G clarithromycin mutations in Helicobacter pylori in Alexandria University Pediatric Hospital

Background: Helicobacter pylori (H. pylori)colonizes the stomach and affect almost 50% of the world’s population. Clarithromycin is considered a cornerstone for H. pylori treatment. Emergence of clarithromycin resistance (CLR-R) has played a major role in failure of H. pylori eradication both in adults and children.  Clarithromycin resistance is mostly due to mutations in 23S rRNA gene: A2142G, A2142C, and A2143G. The aim of the current study is to determine the prevalence of CLR-R among H. pylori infected children with prior clarithromycin treatment. Materials and Methods: Multiple endoscopic gastric biopsies were collected from 50 H. pylori infected children after cessation of clarithromycin-based treatment. Samples were subjected to histopathological examinations, rapid urease test (RUT) and simultaneous molecular detection of H. pylori infection as well as CLR-R by multiplex Real-Time polymerase chain reaction (PCR). Results: Histopathological examinations and RUT revealed H. pylori in 74% and 92% of samples respectively. Molecular detection of CLR-R showed that 62.5% positive H. pylori cases were not harboring any of the tested mutations, while 25% harbored 2143A-G single mutation. Double mutations (2142A-C and 2143A-G) were detected in only 4 cases. Statistical significant correlation existed between both RUT and PCR results as well as between histopathological findings and PCR test results. Conclusions: A combination of histopathogy, RUT and multiplex PCR procedures offers a real benefit in the simultaneous diagnosis of H. pylori infection along with clarithromycin resistance status. Other mechanisms of clarithromycin resistance need to be investigated to explain treatment failure in absence of the previously detected mutations