Assessment of Readiness of Newly Graduated Health Professionals to Communicate with Patients in Duhok, Kurdistan Region, Iraq

Communication Skills (CS) are essential to health workforce to conduct effective professional-patient interaction. In Iraq, majority of newly graduated health professionals are engaged in provision of direct health services. However, undergraduate curricula preparing these professionals include no distinct component to train them on CS. This study aims at assessing the status of CS among Health Professions Education (HPE) graduates of University of Duhok (UoD) and estimating the perception of their patients toward those skills. This cross-sectional study was conducted in 2014. Data on communication skills was obtained, from samples of different health professionals which included: medical doctors (junior residents, nurses, dentists and pharmacists) who recently graduated from different colleges at the UoD. Also, data from was obtained, their patients, to assess their satisfaction of the professionals’ CS. For assessing core CS, a specially designed checklist was adopted from Calgary-Cambridge Guide. Also, senior clinicians were asked on CS performed by their junior residents. Results show that 88% of the senior academic staff regarded CS as “highly essential” and 66% of them were not satisfied with interns’ conduct and suggested that CS should clearly be included in the medical curricula. The basic CS were perceived by patients as either not practiced or wrongly practiced. Patients were unsatisfied with the CS of their attending HPs during observed consultation sessions. The study shows obvious lack of CS among HPE graduates of UoD with patients’ dissatisfaction of their CSs. It seems legitimate to propose that relevant training elements to be designed and incorporated within training modules are needed to realize as a core element of the curriculum of all HPE colleges at the UoD. Keywords: Communication, skills, perception, graduates, Kurdistan-Iraq. DOI: 10.7176/JHMN/73-02 Publication date: April 30th 202

Расчет электромагнитного поля в электронных модулях с использованием интеграла Зоммерфельда

Излагается подход с использованием интеграла Зоммерфельда. Метод позволяет избежать интегрирования в комплексной области и снизить объем вычислений по сравнению с известными методами

Molecular Mechanisms of Light Harvesting in the Minor Antenna {CP}29 in Near-Native Membrane Lipidic Environment

CP29, a chlorophyll a/b-xanthophyll binding protein, bridges energy transfer between the major LHCII antenna complexes and photosystem II reaction centers. It hosts one of the two identified quenching sites, making it crucial for regulated photoprotection mechanisms. Until now, the photophysics of CP29 has been studied on the purified protein in detergent solutions since spectrally overlapping signals affect in vivo measurements. However, the protein in detergent assumes non-native conformations compared to its physiological state in the thylakoid membrane. Here, we report a detailed photophysical study on CP29 inserted in discoidal lipid bilayers, known as nanodiscs, which mimic the native membrane environment. Using picosecond time-resolved fluorescence and femtosecond transient absorption (TA), we observed shortening of the Chl fluorescence lifetime with a decrease of the carotenoid triplet formation yield for CP29 in nanodiscs as compared to the protein in detergent. Global analysis of TA data suggests a (1)Chl* quenching mechanism dependent on excitation energy transfer to a carotenoid dark state, likely the proposed S*, which is believed to be formed due to a carotenoid conformational change affecting the S-1 state. We suggest that the accessibility of the S* state in different local environments plays a key role in determining the quenching of Chl excited states. In vivo, non-photochemical quenching is activated by de-epoxidation of violaxanthin into zeaxanthin. CP29-zeaxanthin in nanodiscs further shortens the Chl lifetime, which underlines the critical role of zeaxanthin in modulating photoprotection activity.Published under an exclusive license by AIP Publishing

Dual Amplified Spontaneous Emission and Lasing from Nanographene Films

Chemically synthesized zigzag-edged nanographenes (NG) have recently demonstrated great success as the active laser units in solution-processed organic distributed feedback (DFB) lasers. Here, we report the first observation of dual amplified spontaneous emission (ASE) from a large-size NG derivative (with 12 benzenoid rings) dispersed in a polystyrene film. ASE is observed simultaneously at the 685 and 739 nm wavelengths, which correspond to different transitions of the photoluminescence spectrum. Ultrafast pump-probe spectroscopy has been used to ascertain the underlying photophysical processes taking place in the films. DFB lasers, based on these materials and top-layer nanostructured polymeric resonators (i.e., one or two-dimensional surface relief gratings), have been fabricated and characterized. Lasers emitting close to either one of the two possible ASE wavelengths, or simultaneously at both of them, have been prepared by proper selection of the resonator parameters.The Alicante team was funded by Spanish Government (MINECO) and European Community (FEDER), grant number MAT2015-66586-R. The researcher R.M-M was funded by a MINECO FPI fellowship (No. BES-2016-077681). The Singapore team was funded by the NRF Investigatorship programme (NRF-NRFI05-2019-0005). The Milan team has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No. 816313). G.M.P. acknowledges funding from Fondazione Cariplo, grant No. 2018-0979. C.D. and S.S. acknowledge funding from ERC Starting Grant SOLENALGAE (No. 679814)

CMS DAQ event builder based on Gigabit Ethernet

The CMS Data Acquisition System is designed to build and filter events originating from 476 detector data sources at a maximum trigger rate of 100 KHz. Different architectures and switch technologies have been evaluated to accomplish this purpose. Events will be built in two stages: the first stage will be a set of event builders called FED Builders. These will be based on Myrinet technology and will pre-assemble groups of about 8 data sources. The second stage will be a set of event builders called Readout Builders. These will perform the building of full events. A single Readout Builder will build events from 72 sources of 16 KB fragments at a rate of 12.5 KHz. In this paper we present the design of a Readout Builder based on TCP/IP over Gigabit Ethernet and the optimization that was required to achieve the design throughput. This optimization includes architecture of the Readout Builder, the setup of TCP/IP, and hardware selection

Frequency and characteristics of pulmonary nodules in children at computed tomography

Detail viewDemolished ; site on Q Street where Embassy Suites now stand

Hyperglycaemia-linked diabetic foot complications and their management using conventional and alternative therapies

Diabetes mellitus, a major cause of mortality around the globe, can result in several secondary complications, including diabetic foot syndrome, which is brought on by diabetic neuropathy and ischemia. Approximately 15% of diabetic patients suffer from diabetic foot complications, and among them 25% are at risk of lower limb amputations. Diabetic foot ulcers are characterized as skin lesions, gangrene, or necrosis, and may develop due to several reasons, including hyperglycemia and slower wound healing in diabetic patients. A management protocol involving wound cleaning, oral antibiotics, skin ointments, and removing dead tissue is currently followed to treat diabetic foot ulcers. In severe cases, amputation is performed to prevent the infection from spreading further. The existing therapy can be costly and present adverse side effects. Combined with a lack of vascular surgeons, this ultimately results in disability, especially in developing nations. There is a growing interest in the use of alternative therapies, such as medicinal plants, to discover more efficient and affordable treatments for diabetic foot syndrome. It has been observed that treatment with numerous plants, including Carica papaya, Annona squamosa, Catharanthus roseus, and Centella asiatica, promotes wound healing, reduces inflammation, and may decrease the number of amputations. However, little information is currently available on the prevention and management of diabetic foot ulcers, and additional research is necessary to completely understand the role of alternative therapies in the treatment of diabetic foot complications

Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq

BACKGROUND: The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. METHODS: An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999–2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. RESULTS: The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. CONCLUSION: A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established

L’année 2020 mise en perspective par les internistes hospitaliers [The Internal medicine articles that struck us the most in 2020]

2020 has continued to bring important progress in all areas of internal medicine, impacting our daily practice. From a shift to oral stepdown antibiotics in infectious endocarditis, to new indications for apixaban, SLGT-2 inhibitors and macrolide antibiotics, passing by the catheter-based renal denervation in hypertension, early paracentesis in cirrhosis and new diagnostic criteria in pulmonary embolism, internal medicine journals are full of novelties. Every year, the chief residents of internal medicine at the Swiss University Hospital of Lausanne meet up to share their readings: here is their selection of eleven articles, summarized and commented for you

Pediatric body composition based on automatic segmentation of computed tomography scans: a pilot study

Background: Body composition during childhood may predispose to negative health outcomes later in life. Automatic segmentation may assist in quantifying pediatric body composition in children. Objective: To evaluate automatic segmentation for body composition on pediatric computed tomography (CT) scans and to provide normative data on muscle and fat areas throughout childhood using automatic segmentation. Materials and methods: In this pilot study, 537 children (ages 1–17 years) who underwent abdominal CT after high-energy trauma at a Dutch tertiary center (2002–2019) were retrospectively identified. Of these, the CT images of 493 children (66% boys) were used to establish normative data. Muscle (psoas, paraspinal and abdominal wall) and fat (subcutaneous and visceral) areas were measured at the third lumbar vertebral (L3) level by automatic segmentation. A representative subset of 52 scans was also manually segmented to evaluate the performance of automatic segmentation. Results: For manually-segmented versus automatically-segmented areas (52 scans), mean Dice coefficients were high for muscle (0.87–0.90) and subcutaneous fat (0.88), but lower for visceral fat (0.60). In the control group, muscle area was comparable for both sexes until the age of 13 years, whereafter, boys developed relatively more muscle. From a young age, boys were more prone to visceral fat storage than girls. Overall, boys had significantly higher visceral-to-subcutaneous fat ratios (median 1.1 vs. 0.6, P<0.01) and girls higher fat-to-muscle ratios (median 1.0 vs. 0.7, P<0.01). Conclusion: Automatic segmentation of L3-level muscle and fat areas allows for accurate quantification of pediatric body composition. Using automatic segmentation, the development in muscle and fat distribution during childhood (in otherwise healthy) Dutch children was demonstrated