Perceptions, Experiences and Expectations of Physicians Regarding the Role of the Pharmacist in an Iraqi Hospital Setting

Purpose: To investigate the perceptions, expectations, and experiences of physicians regarding hospital-based pharmacists in some Iraqi government hospitals.Methods: A cross-sectional study was conducted at four government hospitals in Baghdad and Erbil, Iraq from March to July 2012. A validated, self-administered questionnaire was hand-delivered to a random sample of 200 physicians. The questionnaire comprised four sections that probed the physicians' demographic characteristics as well as their perceptions of, expectations of, and experiences with hospital pharmacists.Results: Most participants (69.4 %) reported rarely interacting with pharmacists and that enquiring about the availability of medications was the main purpose (74.9 %) of any interactions. Physicians reported being comfortable with pharmacists preventing prescription error, treating minor illness, and suggesting prescription medication to physicians of 74, 75 and 67 %, respectively, but only 47 % were comfortable with pharmacists providing patient education. The perspective of physicians in Erbil differed from that of physicians in Baghdad (p < 0.05).Conclusion: Interactions between Iraqi physicians and pharmacists are still not optimal. Physicians are much more comfortable with traditional pharmacist functions than with the extended, patient-oriented pharmacy services currently being promoted. Great efforts are needed to enhance the Iraqi physician's attitude regarding the clinical services provided by pharmacists which in turn would result in more collaboration among healthcare professionals.Keywords: Physician, Pharmacist, Perception, Experience, Expectation, Patient-oriented, Pharmacy servic

Comparative Analysis of Loss Functions in TD3 for Autonomous Parking

Autonomous parking is a revolutionary technology that has transformed the automotive industry with the rise of deep reinforcement learning, in particular, the Twin-Delayed Deep Deterministic Policy Gradient Algorithm (TD3). Nonetheless, the robustness of TD3 remains a significant challenge due to bias in Q-value estimates when determining how good an Action, A, taken at a particular state, S. To investigate this gap, this paper analyzes different loss functions in TD3 to better approximate the true Q-value, which is necessary for optimal decision making. Three loss functions are evaluated; Mean Squared Error (MSE), Mean Absolute Error (MAE) and Huber Loss via a simulation experiment for autonomous parking. The results showed that TD3 with Huber Loss has the highest convergence speed with the fastest Actor and Critic loss convergence. The Huber Loss function is found to be more robust and efficient than either loss function such MSE or MAE used in isolation, making it a suitable replacement for existing loss functions in the TD3 algorithm. In the future, TD3 with Huber Loss will be used as the base model to solve overestimation problem in TD3 when the estimated Q-values that represent the expected rewards of taking an action in a particular state, are higher than their true values

Modelling, Identification and Control of A" Magnetic Levitation CE152

43 unstable, it should be linearized at optional operating point and a digital PID controller with a fine tuned parameters is designed to track a small varying input signals. Finally the simulation’s model is validated with the real system, the results show the simulation’s model is adequately represents the real magnetic levitation system

Structural Behaviour and Fire Design of Duplex and Ferritic Stainless Steel CHS Stub Columns

This paper investigates the structural behaviour and design of duplex and ferritic stainless steel stub columns with a circular hollow cross-section (CHS) at elevated temperature. A numerical model is developed to supplement the limited test results on stainless steel CHS stub columns in the literature. Following validation, the numerical approach is employed to gain an understanding of the critical behavioural characteristics which have not previously been studied. In addition, the paper considers and extends the continuous strength method (CSM) to include duplex and ferritic stainless steel for CHS stub columns in fire. The CSM employs a base curve linking the cross-section resistance to its deformation capacity and implements an elastic, linear hardening material model. The cross-sectional resistances obtained from the proposed CSM are compared with those from the numerical analysis, as well as with the standardised procedures in the European, American and Australia/New Zealand design standards. It is demonstrated that CSM can lead to more accurate and less scattered strength predictions than current design codes

Cross‐sectional behaviour and design of ferritic and duplex stainless steel EHS in compression

This paper describes an investigation into the cross-sectional behaviour of elliptical hollow section (EHS) columns made from ferritic and duplex stainless steel. The EHS is a relatively new structural shape with a number of favourable attributes including aesthetic appeal, high strength-to-weight ratio, good torsional resistance and excellent flexural strength. In recent years there have been significant developments in the analysis and understanding of these shapes, although most studies have focused on carbon steel EHS. The work so far is taken a step further here by considering some of the newer grades of stainless steel that are used in structural applications. A numerical model is developed and validated against test data from the literature and is then employed to generate structural performance data. Subsequently, parametric studies are performed to investigate the influence of individual parameters such as the material properties, aspect ratio and local slenderness of cross-sectional elements. The accuracy of existing design procedures is assessed by comparing the numerical data with the resistances obtained using Eurocode 3. It is shown that the cross-sectional slenderness limits given in Eurocode 3 for EHS members made from carbon steel can also be safely used for sections made from ferritic and duplex stainless steel

Praziquantel coverage in schools and communities targeted for the elimination of urogenital schistosomiasis in Zanzibar: a cross-sectional survey

© 2015 Knopp et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The attached file is the published version of the article

Antimicrobial activity of microfungi from maritime Antarctic soil

The search for cold-adapted and cold-active fungi in extreme environments provides the potential for discovering new species and novel bioactive compounds. In this study, soil samples were collected from Deception Island, Wilhelmina Bay (north-west Antarctic Peninsula, Graham Land) and Yankee Bay (Greenwich Island), maritime Antarctica, for the isolation of soil fungi and determination of their antimicrobial activity. The soil-plate method, agar block, disc diffusion and broth micro-dilution assays were applied to characterize the thermal classes and antimicrobial activity of the isolated fungi. A total of 27 isolates of fungi were obtained from 14 soil samples, including 13 Ascomycota, 4 Zygomycota and 10 anamorphic fungi. Cold-active (psychrotolerant) fungi predominated over cold-adapted (psychrophilic) fungi. In the antimicrobial assay, 16 isolates showed substantial inhibitory activity against test bacterial pathogens. Ethyl acetate extracts of 10 competent isolates showed significant inhibition of bacterial pathogens. Antifungal activity was observed in the disc diffusion assay, but not in the agar block assay. Minimum inhibitory, bactericidal and fungicidal concentrations were determined using the broth micro-dilution method, with an average in the range of 0.78-25 mg ml-1 on the test microorganisms. Isolate WHB-sp. 7 showed the best broad spectrum antimicrobial activity, with the potential for biotechnological studies in antibiotic development

Building Information Modeling Strategy in Mitigating Variation Orders in Roads Projects

Most governmental projects in Jordan have cost overrun, it rises during the on-going stage to increase the cost and prolong the time of the project. Unfortunately, until this moment, there is no particular management system in Jordan construction industry to minimize cost overrun and variation order adopted by the government. In contrast, global construction industry has witnessed a huge transformation in terms of the use of digital technologies, particularly Building Information Modeling (BIM) which is a revolutionary digital technology and operation that is reshaping the Architecture, Engineering and Construction (AEC) industry. approach and objectives causes before of this paper are firstly to review the factors contributing to variation orders in governmental road projects in Jordan, secondly, to propose a BIM design applications strategy to minimize variation orders, to achieve the objectives a quantitative approach was followed by distributing a questionnaire, then the data was analyzed statistically using relative importance index, the results were as follow. Our findings suggests that the most important factors causing change orders were as follow: Inaccurate quantity take-off (0.66); Labours or material not meeting the specifications (0.63); Logistic delays (0.60); Internal politics (0.566); and the equipment and tools are not available (0.55). The results also indicate that Contract Parties, Consultant, Contractor and Other Variations had significant positive effects on V. O, whereas the effects of BIM Design Applications, Facility Operations Simulation, Exploration Design Scenarios, BIM Design Detection, (BIM Quantity Take-off and Cost Estimation) had a passive impact on V.O. Lastly, BIM has obtained a great reputability by enhancing the productivity in construction society, minimizing the total cost of the projects, and many other benefits

Immunoinformatic evaluation of multiple epitope ensembles as vaccine candidates:E coli 536

Epitope prediction is becoming a key tool for vaccine discovery. Prospective analysis of bacterial and viral genomes can identify antigenic epitopes encoded within individual genes that may act as effective vaccines against specific pathogens. Since B-cell epitope prediction remains unreliable, we concentrate on T-cell epitopes, peptides which bind with high affinity to Major Histacompatibility Complexes (MHC). In this report, we evaluate the veracity of identified T-cell epitope ensembles, as generated by a cascade of predictive algorithms (SignalP, Vaxijen, MHCPred, IDEB, EpiJen), as a candidate vaccine against the model pathogen uropathogenic gram negative bacteria Escherichia coli (E-coli) strain 536 (O6:K15:H31). An immunoinformatic approach was used to identify 23 epitopes within the E-coli proteome. These epitopes constitute the most promiscuous antigenic sequences that bind across more than one HLA allele with high affinity (IC50 <50nM). The reliability of software programmes used, polymorphic nature of genes encoding MHC and what this means for population coverage of this potential vaccine are discussed