IMPACT OF CONTAMINATED INTERIOR FINISHING MATERIALS ON THE EDUCATIONAL BUILDINGS

This paper focuses on the impact of indoor finishing material contaminations such as Formaldehyde (HCHO) and Volatile organic compounds (VOCS). These contaminations are reflected through harmful effects on the health of occupants in the indoor environment, reflecting negatively on the comfort, satisfaction, and productivity of inhabitants in the indoor environment. The research focuses particularly on educational buildings as a case study and the effect of contaminations in a design studio located in a faculty building of a university in Debbieh, Lebanon. During the first year of building use, the study checked the concentration of (HCHO) and (VOCS) through the use of an air quality meter in different periods of time. Following the tests, the study implemented a new method to discharge contaminations prior to occupants using the building. This document leads to the technical process to release contaminations, becoming a guideline for further professional practice. The research combines theoretical with the applicable methods to offer the best practices for releasing such contaminations

Pedunculated and obstructive Wilms\u27 tumor: A rare presentation in a 2 year- T old male

Wilms\u27 tumor manifesting as an obstructing ureteral mass is extremely rare. Herein, we report an unusual case in which a child presented with a clinical picture concerning for and suggestive of ureteropelvic junction ob- struction (UPJO), but was instead found to have an intrapelvic pedunculated Wilms\u27 tumor with extension into the proximal ureter. We discuss the patient\u27s diagnostic workup, radiographic, operative and pathologic findings, as well as important lessons learned from this unusual case

Pediatric testicular torsion: does patient transfer affect time to intervention or surgical outcomes at a rural tertiary care center?

Background: Testicular torsion (TT) is a urologic emergency that requires prompt surgical intervention. In rural Appalachia, patients are often transferred from surrounding communities due to lack of urologic care. We hypothesized that those transferred would have delayed intervention and higher rates of orchiectomy when compared to those who presented directly to our hospital. Methods: We performed a retrospective review of patient charts with an ICD-9 diagnosis of TT from 2008 to 2016. Patients met inclusion criteria if diagnosis was confirmed by operative exploration. We compared rate of testicular loss and time until surgical intervention between groups. Results: Twenty-three patients met inclusion criteria (12 transferred, 11 direct). Patient demographics did not significantly differ between groups. Transferred patients had a higher orchiectomy rate (33% v 22%,p = 0.41) although this was not statistically significant. Time to surgery from symptom onset was significantly longer in those transferred (12.9 h) compared to those not transferred (6.9 h, p = 0.02). Distance of transfer was not correlated with time of delay (r2 = 0.063). Conclusions: Transferred patients with TT have numerically higher rates of orchiectomy which may reach significance in an appropriately powered study, and relative delays in surgical intervention. This study highlights the need for improved access to urologic care in rural areas

Supply Chain Management and Organizational Performance: The Moderating Effect of Supply Chain Complexity

This study investigates the relationship between various factors in supply chain management (customer relationship, level of information, sharing postponement, sharing quality of information, and strategic supplier partnership) and their impact on organizational performance. This research relies on primary data collected through the use of questionnaires. The research will concentrate on Jordans tourist industry. Only 261 were approved and examined using SmartPLS.The results of the study indicate that sharing postponement, sharing quality of information, and strategic supplier partnership have a strong positive impact on organizational performance. However, the relationship between customer relationship and organizational performance is not statistically significant. The relationship between level of information and organizational performance is statistically significant. These findings suggest that organizations can improve their performance by implementing strategies to manage and optimize these factors in their supply chain. This study also evidenced that Supply Chain Complexity as moderator helps increase organiizational performance by interacting with Strategic Supplier Partnership, Level of Information, Sharing Quality of Information, Sharing Postponement. However, it should be noted that there is some inconsistency in the results compared to previous studies, and the relationship between these factors and organizational performance is still not fully understood. This highlights the need for further research in this area to gain a better understanding of how these factors impact organizational performance

Robotic-assisted Laparoscopic Surgery in Pediatric Urology: Capacity Building and Reflecting on Five Years’ Experience in West Virginia

Robotic surgery was born at the turn of the millennium as it was first approved by the US food and Drug Administration in 2000 with the introduction of the da Vinci (Intuitive Surgical, Inc., Mountain View, Ca) robotic surgical platform. However, its adoption by pediatric urologists did not occur until 2002, and even then it was used by only a select handful of surgeons. While the use of robotics in pediatric urology has grown steadily worldwide, its implementation in treating pediatric urology patients in West Virginia has been much slower. Reasons for this are twofold: historically, the lack of pediatric urology capability in the state, and comfort with the technology. The efforts in building a pediatric urologic robotics program at WVU are evident in the success of the program thus far. To date, 86 robotic urology cases have been performed in pediatric patients. Importantly, we report no significant complications (Clavien-Dindo Classification 2 or more) and no open conversions for our cohort. Demographically, the average age for our population at date of surgery was 8 years (range 1-19 years) with an average weight of 31.3 kg (10.3-74.7 kg). Intraoperatively, the average duration of surgery (cut-to-close) was 247.6 minutes with minimal blood loss and no patient requiring transfusion. Postoperatively, patients in our group did great, with an average length of hospitalization of 29.71 hours. We hope that our success may serve as an example of implementing robotics within other pediatric specialties where robotic implementation has been slow

Prevalence and factors associated with overweight and central obesity among adults in the Eastern Sudan

© 2020 Omar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background A global epidemic of obesity has been documented, particularly among African countries. While central obesity and overweight have been reported for many countries, very limited information exists about the prevalence of these health problems in Sudan, and these data are nonexistent for Eastern Sudan. The present study aimed to determine the prevalence of obesity and central obesity, as well as the factors associated with both, among adults in Gadarif, Eastern Sudan. Methods A cross-sectional study was conducted in Gadarif, Eastern Sudan, during the period of January through May 2018. Sociodemographic and health characteristics data were collected through a questionnaire. Body mass index (BMI) and waist circumference (WC) were measured using the standard methods. Both descriptive and inferential statics were applied to analyze the data. Results A total of 594 adults participated in the study; 70.4% of them were female. The mean (standard deviation) age was 44.98 (16.64) years. Of the 594 enrolled participants, 33.7%, 7.4%, 26.8%, and 32.2% were normal weight, underweight, overweight, and obese, respectively. The prevalence of central obesity was (67.8%). Approximately, one-third of the participants (29.29%) were obese and had central obesity. In the multinomial regression, being married was the main risk factor associated with overweight, and older age, female sex, being married and hypertension were significantly associated with obesity. In the binary regression, the main risk factors associated with central obesity were female sex and being married. Conclusion The prevalence rates of both obesity and central obesity among the study participants were high. Older age and hypertension were only associated with obesity. Obesity and central obesity were significantly associated with female sex and being married. This study provided valuable baseline information to develop appropriate strategies for the prevention and control of obesity in Eastern Sudan

COVID-19 vaccine acceptance among pregnant women: a hospital-based cross-sectional study in Sudan

IntroductionPregnancy increases the risk of developing a severe illness due to COVID-19 infection. To the best of our knowledge, no previous study has been conducted on COVID-19 vaccine acceptance among pregnant women in Sudan. Hence, this study aimed to determine COVID-19 vaccination acceptance and its predictors among pregnant women.MethodsA cross-sectional study was conducted among 623 pregnant women attending Gadarif maternity hospital in eastern Sudan through a structured questionnaire. Data were obtained on sociodemographic characteristics, obstetric and health-related characteristics, COVID-19 infection, and vaccination-related information, as well as beliefs about and acceptance of COVID-19 vaccination.ResultsCOVID-19 vaccine acceptance among the pregnant women was 2.7%. The vaccine acceptance was higher if their husband’s education was secondary school or higher [adjusted odds ratio [AOR] 4.30, 95% confidence interval (CI) 1.11–16.65, p = 0.035] and discussion of COVID-19 vaccine with the pregnant women by a health care professional in the hospital (AOR 5.46, 95% CI 1.94–15.35, p < 0.001). The most common reasons for resistance to the vaccine were concerns about the side effects of the vaccine for the mother and her baby.ConclusionAcceptance of the COVID-19 vaccination among the pregnant women was very low. Discussions with pregnant women and their husbands by health care professionals regarding the safety of COVID-19 vaccine for the mother and her baby are highly recommended

Dysfunctional Voiding: Does a validated urine color scale correlate with dysfunctional voiding severity score?

Introduction Dysfunctional voiding (DV), defined as abnormal coordination between the urinary sphincter and the detrusor muscle in a neurologically intact individual, affects approximately 40% of patients that populate pediatric urology clinics. Improper hydration affects the specific gravity and concentration of urinary irritants, resulting in symptoms similar to those seen in DV patients. Methods Herein, we administered a validated DV survey (the Dysfunctional Voiding Symptom Score [DVSS]) and a validated dehydration severity chart (the Urine Color Chart [UCC]) to toilet trained pediatric patients and compared DV patients to patients presenting with non-urologic concerns. Data was analyzed on an item-for-item basis and by the total DVSS and UCC between the two groups. A total of 29 DV pediatric patients and 21 non-urologic pediatric patients were recruited from 2016 to 2018. Results Both patient groups were equivalent with regards to age, sex, height, weight, and BMI. The DV population had significantly higher scores in 7 out of 10 individual items within the DVSS when compared to those presenting for non-urologic complaints (p \u3c 0.05). In addition, DV patients had significantly higher total scores on the DVSS than non-urologic patients (p = 0.0004). No significant difference was noted in UCC scores between patient groups (p = 0.753). Regression analysis showed that within the dysfunctional voiding group, there was a linear relationship between DVSS and UCC scores. Conclusion The present study suggests the DVSS results yield significantly different results for DV patients when compared to age, sex, and BMI matched children with no urologic complaints. The UCC does not reliably vary between DV and non-urologic patients; however, there appears to be a linear relationship between DVSS and UCC scores within the DV cohort. Further studies may elucidate a validated metric by which DV and non-urologic pediatric patients may be differentiated