Comparing the quality of life in children with cancer in Tabriz Children Medical and Training Center reported by themselves and their parents, 2013

زمینه و هدف: با توجه به درمان های فعلی، حدود 75 درصد از کودکان مبتلا به سرطان به بقای بدون بیماری دست می-یابند. این درمان های پیچیده و تهاجمی می توانند بر روی کیفیت زندگی کودکان تاثیر بگذارند. پیشرفت های اخیرِ ابزارهای استاندارد کیفیت زندگی ما را قادر به داشتن دید دقیق تری از تاثیرِ بیماری برکیفیت زندگی کودکان می سازد. هدف از این مطالعه، توصیف و مقایسه کیفیت زندگی کودکان مبتلا به سرطان براساس گزارشات کودکان و والدینشان بوده است. روش بررسی: در این مطالعه توصیفی- مقایسه‌ای به روش نمونه گیری در دسترس، تعداد 150 خانواده ی واجد شرایط از بین مراجعه کنندگان مرکز آموزشی درمانی کودکان تبریز انتخاب و وارد مطالعه شدند. کودک و والدینش پرسشنامه های کیفیت زندگی کودکان Kid-KINDL را تکمیل نمودند و جنبه های مختلف کیفیت زندگی در این کودکان مقایسه شد. یافته ها: در بعد روانشناختی، خانوادگی و اجتماعی، کودکان و هر دو والد کیفیت زندگی را بیشتر از حد متوسط بیان نمودند (05/0

The effect of acrylamide on sperm oxidative stress, total antioxidant levels, tyrosine phosphorylation, and carboxymethyl-lysine expression: A laboratory study

Background: Acrylamide (AA) is a reactive molecule produced during food processing at temperatures above 120°C. Objective: To evaluate the impact of different concentrations of AA on human sperm parameters, oxidative stress and total antioxidant capacity (TAC). Materials and Methods: In this laboratory study, semen samples were obtained from healthy donors referred to the Taleghani Hospital, Tehran, Iran between June and July 2019. Samples were divided into four groups (n = 10/each): one control and three treatment groups (0.5, 1, and 2 mM of AA). After 2 hr of exposure to AA, the superoxide dismutase and malondialdehyde levels were measured based on colorimetric methods. The TAC was determined by the ferric-reducing antioxidant power assay. Flow cytometry was performed to measure the intracellular reactive oxygen species generation. Also, immunohistochemistry was done to determine the effect of AA on tyrosine phosphorylation and carboxymethyl-lysine expression. Results: Results of the study demonstrated that the motility and viability of spermatozoa were significantly decreased after AA exposure (p < 0.001). This decrease was also seen in the TAC and superoxide dismutase activity as well as in the phosphotyrosine percentage compared with the control (p < 0.01). However, the carboxymethyllysine and prooxidant activity including reactive oxygen species generation and lipid peroxidation level increased (p < 0.001). Conclusion: Overall, the results confirmed the detrimental effect of AA on human spermatozoa which may be due to oxidative stress and decreased total antioxidant levels. AA may reduce fertility by reducing sperm capacitation and motility. Key words: Acrylamide, Oxidative stress, Antioxidant, Spermatozoa, Infertility

Simulation numérique de l'écoulement du BAP dans des éléments de mur et de poutre en utilisant des modèles dynamiques d'écoulement

Abstract : Recently, there is a great interest to study the flow characteristics of suspensions in different environmental and industrial applications, such as snow avalanches, debris flows, hydrotransport systems, and material casting processes. Regarding rheological aspects, the majority of these suspensions, such as fresh concrete, behave mostly as non-Newtonian fluids. Concrete is the most widely used construction material in the world. Due to the limitations that exist in terms of workability and formwork filling abilities of normal concrete, a new class of concrete that is able to flow under its own weight, especially through narrow gaps in the congested areas of the formwork was developed. Accordingly, self-consolidating concrete (SCC) is a novel construction material that is gaining market acceptance in various applications. Higher fluidity characteristics of SCC enable it to be used in a number of special applications, such as densely reinforced sections. However, higher flowability of SCC makes it more sensitive to segregation of coarse particles during flow (i.e., dynamic segregation) and thereafter at rest (i.e., static segregation). Dynamic segregation can increase when SCC flows over a long distance or in the presence of obstacles. Therefore, there is always a need to establish a trade-off between the flowability, passing ability, and stability properties of SCC suspensions. This should be taken into consideration to design the casting process and the mixture proportioning of SCC. This is called “workability design” of SCC. An efficient and non-expensive workability design approach consists of the prediction and optimization of the workability of the concrete mixtures for the selected construction processes, such as transportation, pumping, casting, compaction, and finishing. Indeed, the mixture proportioning of SCC should ensure the construction quality demands, such as demanded levels of flowability, passing ability, filling ability, and stability (dynamic and static). This is necessary to develop some theoretical tools to assess under what conditions the construction quality demands are satisfied. Accordingly, this thesis is dedicated to carry out analytical and numerical simulations to predict flow performance of SCC under different casting processes, such as pumping and tremie applications, or casting using buckets. The L-Box and T-Box set-ups can evaluate flow performance properties of SCC (e.g., flowability, passing ability, filling ability, shear-induced and gravitational dynamic segregation) in casting process of wall and beam elements. The specific objective of the study consists of relating numerical results of flow simulation of SCC in L-Box and T-Box test set-ups, reported in this thesis, to the flow performance properties of SCC during casting. Accordingly, the SCC is modeled as a heterogeneous material. Furthermore, an analytical model is proposed to predict flow performance of SCC in L-Box set-up using the Dam Break Theory. On the other hand, results of the numerical simulation of SCC casting in a reinforced beam are verified by experimental free surface profiles. The results of numerical simulations of SCC casting (modeled as a single homogeneous fluid), are used to determine the critical zones corresponding to the higher risks of segregation and blocking. The effects of rheological parameters, density, particle contents, distribution of reinforcing bars, and particle-bar interactions on flow performance of SCC are evaluated using CFD simulations of SCC flow in L-Box and T-box test set-ups (modeled as a heterogeneous material). Two new approaches are proposed to classify the SCC mixtures based on filling ability and performability properties, as a contribution of flowability, passing ability, and dynamic stability of SCC.Résumé : Récemment, il y a un grand intérêt à étudier les caractéristiques d'écoulement des suspensions dans différentes applications environnementales et industrielles, telles que les avalanches des neiges, les coulées de débris, les systèmes de transport et les processus d’écoulement des matériaux. En ce qui concerne les aspects rhéologiques, la plupart des suspensions, comme le béton frais, se comportent comme un fluide non-Newtonien. Le béton est le matériau de construction le plus largement utilisé dans le monde. En raison de limites qui caractérisent le béton normal en termes de maniabilité et de capacité de remplissage de coffrage, il était nécessaire de développer une nouvelle classe de béton qui peut couler sous son propre poids, en particulier à travers les zones congestionnées du coffrage. Par conséquent, le béton autoplaçant (BAP) est un nouveau matériau de construction qui est de plus en plus utilisé dans les différentes applications. Étant donné sa fluidité élevée de BAP peut être utilisé dans certaines applications particulières, notamment dans la section densément renforcée. Cependant, la fluidité élevée rend le béton plus sensible à la ségrégation des gros granulats pendant l'écoulement (la ségrégation dynamique) et ensuite au repos (ségrégation statique). La ségrégation dynamique peut augmenter lorsque le BAP est coulé sur une longue distance ou en présence d'obstacles. Par conséquent, il est toujours nécessaire d'établir un compromis entre la fluidité, la capacité de passage, et la stabilité du BAP. Ceci doit être pris en considération afin de concevoir le processus de coulée et dosage des mélanges du BAP. Ceci est appelé la conception d'ouvrabilité du BAP. Une conception de maniabilité efficace et non coûteuse peut être achevée à travers la e prévision et l'optimisation de l'ouvrabilité des mélanges de béton pour les procédés de construction sélectionnés, notamment le transport, le pompage, la mise en place, le compactage, la finition, etc. En effet, les formulations de mélange doivent se confirmer à la qualité de la construction demandée, par exemple les niveaux exigés de fluidité, la capacité de passage, la capacité de remplissage, et la stabilité (statique et dynamique). Celui est nécessaire pour développer des outils théoriques afin d’évaluer dans quelles conditions les exigences de qualité de la construction sont satisfaites. Cette thèse est consacrée à la réaliser des simulations analytiques et numériques pour prédire la performance d'écoulement du BAP dans différents procédés de la mise en place du béton. L'objectif spécifique de cette étude consiste à simuler l'écoulement du BAP dans essais empiriques, notamment la boite en L et la boite en T pour évaluer la performance du BAP pendent la mise en place (la fluidité, la capacité de passage, la capacité de remplissage, et la ségrégation dynamique induite par cisaillement ou par gravité). Par conséquent, le BAP est modélisé comme matériau hétérogène. En outre, un modèle analytique est proposé pour prédire la performance à l'écoulement du BAP dans la boite en L en utilisant la théorie de Dam Break. D'autre part, les résultats des simulations numériques de l’écoulement du BAP dans une poutre renforcée sont comparés aux résultats expérimentaux par des profils de surface libres. Les résultats des simulations numériques de BAP coulée (modélisée comme un fluide homogène unique), sont utilisés pour déterminer les zones critiques correspondant à des risques plus élevés de ségrégation et de blocage. Les effets des paramètres rhéologiques, la masse volumique, le contenu des particules, la distribution de barres d'armature, et les interactions particule-barres sur les performances d'écoulement du BAP sont évaluées à l'aide de simulations MFN d’écoulement du BAP par les essais des L-Box et T-box (modélisée comme une matériau hétérogène). Deux nouvelles approches sont proposées pour classifier les mélanges du BAP sur la base de la capacité de remplissage, et les propriétés de performabilité, en fonction de la fluidité, la capacité de passage et de la stabilité dynamique du BAP

Homogenous Flow Performance of Steel Fiber-Reinforced Self-Consolidating Concrete for Repair Applications: Developing a New Empirical Set-Up

In this study, a new empirical Square-Box test was employed to evaluate the homogeneous flow performance of fiber-reinforced self-consolidating concrete (FR-SCC) under confined-flow conditions that are typical of repair applications. The Square-Box set-up consisted of a closed-circuit box, providing 2.4-m flow distance and a closed-surface cross section of 100-mm width and 200-mm height, equipped with 0 and 4 rows of reinforcing bar grids with 45-mm clear spacing. The flow performance was assessed in terms of dynamic stability and passing ability. The investigated mixtures were considered as diphasic suspensions of fiber-coarse aggregate (F-A \u3e 5 mm) in suspending mortars containing particles finer than 5 mm. According to the experimental results, the dynamic segregation and blocking indices of the investigated mixtures were found in good agreements with characteristics of F-A combination and rheology of mortar. The investigated mixtures exhibited significantly higher blocking indices through the Square-Box set-up compared to those obtained using the L-Box test. Furthermore, the characteristics of F-A and rheology of mortar showed opposite effects on dynamic segregation assessed using Square-Box and conventional T-Box set-ups. Under confined flow conditions, higher dynamic segregation led to more dissimilar compressive strength values at different flow distances through the proposed Square-Box set-up. A new filling ability classification was established based on the experimental dynamic stability and passing ability results of the proposed empirical test

Novel Tri-Viscous Model to Simulate Pumping of Flowable Concrete through Characterization of Lubrication Layer and Plug Zones

In this study, computational fluid dynamics (CFD) was employed to simulate the pipe flow of 18 self-consolidating and four highly workable concrete mixtures in a 30-m long pumping circuit. Pressure loss (ΔP) in 100- and 125-mm diameter (DP) pipelines was measured under low (1.2–6.2 l/s) and high (8.1–16.4 l/s) flow rates (Q). The numerical simulation was successfully carried out using a two-fluid model and a new variable-viscosity single-fluid approach, namely double-Bingham and tri-viscous models, respectively. The radial variation of rheological properties of the concrete across the pipe section, representing the plug flow, sheared concrete, and lubrication layer (LL) zones was successfully simulated based on a total of 404 pipe flow experiments. The relative LL viscous constant (ηLL) values obtained using numerical simulations-to-those obtained experimentally using a tribometer ranged between 30% and 200%. Moreover, the coupled effect of the characteristics of different flow zones, DP, and Q on ΔP was evaluated

Homogeneous Flow Performance of Steel-Fiber Reinforced Self-Consolidating Concrete for Repair Application: A Biphasic Approach

In this study, fiber-reinforced self-consolidating concrete (FR-SCC) was considered as a diphasic suspension of fiber and coarse aggregate (F-A ≥ 5 mm) skeleton in mortar suspension with solid particles finer than 5 mm. The coupled effect of the volumetric content of fibers, coarse aggregate particle-size distribution, and rheological properties of the mortar on the passing ability and dynamic stability of various FR-SCC mixtures was investigated. Nine high-strength and 10 conventional-strength FR-SCC mixtures for repair application were proportioned with water-to-binder ratios (W/B) of 0.35 and 0.42, respectively, and macro steel fibers of 0.1%–0.5% volumetric contents. The dosages of high-range water-reducer (HRWR) admixture were optimized to achieve a targeted slump flow of 680 ± 20 mm. The yield stress and plastic viscosity of the mortar mixtures varied between 4.6-17.7 Pa and 2.8–8.2 Pa s, respectively. Flow performance of the investigated mixtures were evaluated in terms of flowability (slump-flow test), passing ability (J-Ring and L-Box set-ups), and dynamic stability (T-Box test). According to the established correlations, the main influencing parameters on homogeneous performance of FR-SCC include W/B, paste volume, volumetric content-to-packing density of F-A (φ/φmax), HRWR dosage, fiber content, mortar rheology, and volume of excess mortar. The robustness analyses results revealed that homogeneous flow performance of FR-SCC is more sensitive due to variations of the φ/φmax and paste volume rather than mortar rheology, W/B, and HRWR dosage. The characteristics of the mixture constituents for FR-SCC mixtures with different strength levels were finally recommended to ensure acceptable homogeneous performance under restricted flow conditions of repair application

Coupled Effect of Fiber and Granular Skeleton Characteristics on Packing Density of Fiber-Aggregate Mixtures

The addition of fiber to cementitious materials enhances mechanical performance but can reduce workability of the fiber-reinforced concrete (FRC) mixtures. This can be due to the negative effect of fibers on packing density (PD) of the fiber-coarse aggregate (F-A) combination. The performance of FRC, as a diphasic suspension, is dependent on the characteristics of both F-A (suspended-solid skeleton) and mortar (suspending liquid) phases. PD can reflect the voids within the F-A skeleton to be filled with mortar. An adequate optimization of the characteristics of the F-A skeleton can modify the performance of FRC in fresh and hardened states. The F-A skeleton can be characterized in terms of particle-size distribution, volumetric content, and morphology of the coarse aggregate, as well as size, rigidity, and content of fibers. In this study, a comprehensive investigation was undertaken to identify the coupled effect of the characteristics of fibers and coarse aggregate on the PD of F-A combination used without any cement paste/mortar. The solid components play a key role in the overall performance of the concrete produced. This study was carried out to optimize the F-A combination and enhance the workability design of FRC. Various types of steel, polypropylene, and polyolefin fibers having different sizes and rigidities were investigated. Moreover, four combinations of three different classes of coarse aggregate were used to proportion F-A mixtures. Test results showed that shorter length, smaller diameter, and more flexible fibers can lead to higher PD of F-A systems. Moreover, the coarser aggregate skeleton with larger interparticle voids led to more available length for fibers to be deformed, hence improving the PD of F-A mixtures. New empirical models were proposed to predict the packing density of F-A combinations given the characteristics of coarse aggregate and fibers, as well as the level of compaction. The established models were employed to propose a new proportioning approach for fiber-reinforced self-consolidating concrete mixtures to achieve the targeted workability

Stakeholders' perceptions of rehabilitation services for individuals living with disability:A survey study

Background: The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes.   Methods: We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale.   Results: Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively).   Conclusion: The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their acceptability. The majority of stakeholders found 'Task shifting' as neither feasible nor acceptable

Customers' Satisfaction with primary health care: comparison of two district health centers with and without ISO certificate in Kerman University of Medical Sciences

Background and Aims: One of the principles of the quality management systems in organizations is attention to customer centered approach and one of the scales for evaluation of the efficacy of provided services is customer satisfaction. This research aimed to compare satisfaction levels of customers attending primary health care centers in Bardsir (with ISO certificate) and Zarand (without ISO certificate) districts affiliated to Kerman University of Medical Sciences. Material and Methods: This comparative and cross- sectional study was carried out in 2011 with 960 people (n= 480 in each district). The data gathering instrument was a validated self-construct questionnaire including two main parts of general and specialty services for evaluation of satisfaction rate. Data were analyzed through SPSS version 18.0 and using descriptive statistics, Chi-square, Pearson correlation and logistic regression model. Judgment criterion for desired satisfaction was attaining 75% of the score of each part. Results: The desired satisfaction level of customers of health centers affiliated to Zarand district was more than that of Bardsir district (83.3% vs. 70.2%, P <0.01). Moreover, there was a significant difference between two districts in regard to satisfaction levels of general services (P <0.05). Result of logistic regression model showed no significant relationship between total satisfaction and demographic variables. Discussion: As compared with Zarand district, implementation of ISO quality management system in the Bardsir district has not enriched total customers' satisfaction. Thus, the utilization of quality management approaches based on needs rather than organizational emotions and fashions are emphasized. Keywords: Satisfaction, Customer, ISO, Health centers, Health car

Discrete-Element Modeling of Shear-Induced Particle Migration during Concrete Pipe Flow: Effect of Size Distribution and Concentration of Aggregate on Formation of Lubrication Layer

The Paper Seeks to Better Understand the Particulate Mechanics Giving Rise to the Lubrication Layer (LL) in Flows with Wide Particle-Size Distributions (PSD) Typical of Concrete Pumping Applications. the Study Uses a Soft-Sphere Discrete Element Method (DEM) to Simulate the Shear-Induced Particle Migration (SIPM) Mechanism of Formation of the LL. to Provide Realistic Understanding of SIPM and Rheological Heterogeneity of Concrete, Three Wide PSDs (Fine, Medium, and Coarse) and Three Different Concentrations (10 %–40 %) of Five Spherical-Particle Subclasses (1–17 Mm Diameter) Were Investigated. the Radial Evolution of Concentration and Particle Distribution Was Simulated over Time and the LL Formation Was Successfully Simulated. the Predicted LL Thicknesses Compared Well with Experimental Values. the Coupled Effect of PSD, Concentration, and Mean Diameter of Particles on Wall Effect, SIPM, and Rheological Heterogeneities Across the Pipe Was Evaluated. Higher Rheological Heterogeneity Across the Pipe Was Obtained for Higher Concentration and Coarser Particle Size Distributions