bluuebunny/crossref_metadata_2025 huggingface dataset:
Dapoxetine for the management of premature ejaculation
Authors: Sikdar Tushar Kanti , Chowdhury Moushumi , Ahsan Mohammad Shamsul , Ali Rubaiya
Published: February 2020

Premature ejaculation is the most prevalent male sexual disorder and is more common in South Asia. Bangladesh is no exception. Premature ejaculation causes dissatisfaction in the relationship, frustration for the patient and partner as well as reason of marital failure. Since 1970s sex therapy was the mode of treatment for premature ejaculation. Now treatment with drugs also seems effective. Now a days dapoxetine is used in Bangladesh for the treatment of premature ejaculation. The aim of the study was to determine the efficacy and tolerability of dapoxetine in patients with premature ejaculation. It was a prospective study conducted in private chamber of Dhaka city during the period of March 2016 to February 2017. A total of 60 patients within 21 to 75 years were enrolled in the study according to criteria of International Society for Sexual Medicine (ISSM). We determined the efficacy of dapoxetine 30 mg/day for 12 weeks. The primary endpoint was intra vaginal ejaculatory latency time (IELT) measured by stopwatch. Safety and tolerability were assessed. All analysis was done on an intention-to-treat basis. The results showed that, dapoxetine significantly prolonged IELT (p<0.001) after 12 weeks. After treatment of 1st, 4th ,8th week mean IELT were 1.71 (SD±0.50) minutes, 2.36 (±0.46) minutes and 2.98 (±0.66) minutes respectively. At the end of 12th week 3.89 (±0.87) minutes was evaluated. Common adverse effects were observed as nausea (11.0%), diarrhoea (3.5%), headache (5.6%), dizziness (5.8%), insomnia (2.1%) and backache (1.8%). So from this study it could be said that, dapoxetine was an effective and generally well tolerated treatment for men with premature ejaculation.

Bang J Psychiatry June 2017; 31(1): 15-19
Unusual presentation of patients with obsessive compulsive disorder
Authors: Hossain Mohammad Delowar , Ferdush Rubayet , Rahman Sajedar
Published: February 2020

Obsessive compulsive disorder (OCD) is a common psychiatric disorder in clinical practice. But few studies have been done in Bangladesh. The aim of the study was to find out the unusual presentation of OCD patients other than common presentation. This was a cross sectional study done at private chamber and clinic in Dhaka, Bangladesh during the period of February, 2018 to January, 2019. Hundred twenty five patients fulfilling the inclusion and exclusion criteria were selected consecutively. After taking written consent a predetermined questionnaire was filled for each patient through face-to-face interview. The results showed that, most of the patients were from 21-30 years of age group (34.4%) with female preponderance (60%). Majority of the patients were married (60%), completed up to HSC level (44.8%) and students (38.4%). Among the patients the unusual presentations of OCD were new experience headache (56%), decreased sexual desire (16%), cough (9.5%), pain (8%), vomiting (8%), fit like behaviour (4%), increased frequency of micturition (2.4%) and deliberate self harm (DSH) (1.6%). The research findings will help us for the assessment, diagnosis and treatment plan. Therefore misdiagnosis and patient sufferings will be reduced.

Bang J Psychiatry December 2017; 31(2): 48-50
Physical activity and menopausal symptoms
Authors: Khan Bushra E Zannat , Rahman Md Anisur , Begum Md Nadira , Halim Kazi Shafiqul , Muna Atiya Tasnim , Mostary Kazi Fardana , Islam Md Safikul
Published: February 2020

Menopause is an inevitable stage of every woman’s life. This cross sectional study was conducted to assess the relationship between physical activity and menopausal symptoms from January to December 2017. By convenient sampling total 213 post menopausal women were interviewed from Mirpur, situated at the northern part of Dhaka. Five most prevalent menopausal symptoms were joint and muscular pain (90.1%), anxiety and sleep disturbance (80.3%), chest discomfort as well as physical and mental exhaustion (78.9%). Most of the respondents were physically active (63.4%), few were inactive (1.9%) and 34.7% respondents were Health Enhancing Physical Activity (HEPA) active. The mean of total Metabolic Equivalent of Task (MET)-minute per week was 2713.46 ± 1152.24 minutes. Menopausal symptoms retrieved from Menopause Rating Scale were assessed according to physical activity level. Physical and mental exhaustion was found statistically significant (p=0.04) with the higher proportion reported in divorced and widowed (90.5%). Significant relationship between psychological subscale and educational status was seen (p=.03). There was significant association between dryness of vagina and educational status (p<0.01). Physical and mental exhaustion and heart problems were found to be significantly higher among working women (p<.05). The relationship between BMI (Body Mass Index) and hot flash was found statistically significant (p<0.001). Significant statistical difference also was found between irritability and increase in BMI (p <0.001). Hot flash (p=0.001) and depression (p=0.002) were found to be statistically significant in relation with tobacco use. Uro genital symptoms ( p=.03), hot flash (p=0.01) and depression (p=0.009) were found to be statistically significant in relation with history of chronic disease. Only urinary problems were found statistically significant with HRT use. (p >.05). Anxiety was found statistically significant (p=.04) with highest proportion found in HEPA active women (89.2%). Proportion of sleep problems (100%), physical and mental exhaustion (100%), bladder problems (urinary incontinence) (75%), joint and muscular discomfort (100%) were more in inactive than minimally active and HEPA active women but the relationships were not statistically significant (p>.05). The result indicates that physical activity may have some role in reducing menopausal symptoms.

Bangladesh Med J. 2018 Jan; 47 (1): 11-17
Unmet need of contraceptives amongst the married women of reproductive age group: a study in a coastal belt of Bangladesh
Authors: Dutta Palas , Debnath Sumon Chandra , Ghosh Kinkar
Published: February 2020

This cross-sectional study was conducted with an objective to assess the unmet need of contraceptives among married women of reproductive age at Assasuni Upazila (coastal area) in Satkhira District during the period from January to December 2016. A total of 222 participants (married women) were included in the study. The mean (± SD) age of the respondents was 27.9 ± 6.2 years and about half (45.9%) of the respondent’s marriage age were between 15 and 17 years. Most of the (85.6%) women were housewives and more than half (50.9%) belongs to a nuclear family. Most of the respondents (94.6%) were not currently pregnant and about one-fourth (25.7%) of them experienced with previous pregnancies. About ninety percent of the outcomes of last pregnancy were live-births. More than two-thirds (80.2%) were using contraceptives. More than two-fifth of the respondents was using the oral pill and 17.6% of their husband’s using condoms as a contraceptive. Among 222 respondents, 13.5% had the unmet need of contraceptives. Unmet need comprises who were not using any method of contraception due to husband’s opposition, did not know, opposition from other family members and no menstruation after last childbirth, (6.3%, 5.0%, 1.3% and 0.9%, respectively). Unmet need of contraceptive is high despite an extensive family planning program in Bangladesh. It is necessary for the governments to come up with strategies, which can reduce unmet needs of contraceptive, especially among coastal area.

Bangladesh Med J. 2018 Jan; 47 (1): 37-40
Depressive morbidity among female partner of infertile couple in a tertiary care setup in Bangladesh
Authors: Chowdury Tanzeem S , Chowdhury T A , Begum Shirin Akter , Begum Yasmin , Amatullah Mehriban
Published: February 2020

Background: There are 80 million infertile couples in the world which correspond to approximately 15% of all couples in their reproductive age. Negative attitude and behavior of family and acquaintances causes severe psychological stress resulting in social discrimination and stigmatization which may lead to anxiety, depression and even suicide. The study was aimed to estimate the prevalence and predictors of depressive morbidity among Bangladeshi infertile women.

Methods: This prospective, observational study was done on a total of 215 female partners of infertile couples who attended ‘Infertility Management Center’; a Dhaka based tertiary care setup for infertility management and assisted reproductive technologies from August - December 2016. Only those who were unable to conceive after one year of unprotected sexual intercourse and agreed to take part in the study were included in the study. Patients with history of mental illness prior to infertility diagnosis and on any anti-psychotic drugs were excluded from the study. Data collection was done using the validated Beck Depression Inventory (BDI) questionnaire.

Results: Among the study population 72.6% were suffering from primary infertility and 27.4% from secondary infertility. Of them, 52.6% had 5 to 10 years and 47.4% had various duration of infertility. Female cause of infertility was in 30.7% couples, male cause was in 16.3%, both were in 4.7% and finally unknown was 48.4%. Female partners of infertile couples showed different types of mode disorders such as 29.3% (n=63) having severe depression, 39.5% moderate, 20.5% mild and 10.7% having no depression. Association between educational status and depression score showed 53.02% graduate having severe depression, though statistically it was not significant. Depression was most common among patients suffering from primary infertility and among housewives as they probably had more time to think and feel the situation.

Conclusion: The high level of depression among female partners of infertile couples revealed in this study is quiet alarming and requires attention of the medical fraternity. This study proposes that clinicians should be more aware about anxiety-depression disorders among infertile groups and the necessity of identifying patients who require psychological assistance.

Bangladesh Med Res Counc Bull 2019; 45: 93-96
GeneXpert: A New Tool for Diagnosis of Tuberculosis
Authors: Razzak MA , Rahman MF
Published: February 2020

Abstract not available

Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 1-2
Re-evaluation of Smear Negative Suspected Tuberculosis Patients by GeneXpert
Authors: Rahman Md Fashiur , Alam Md Jahangir , Sarker Md Abu Sayeed , Alim Md Abdul , Matsumoto Yoshitsugu , Rahman Md Bahanur
Published: February 2020

Introduction: Tuberculosis (TB) is one of the major public health problems. Sputum microscopy even today is considered as most important laboratory diagnosis of TB though its negative result does not exclude tuberculosis.

Objective: To evaluate the smear negative suspected TB patients by GeneXpart.

Materials and Methods: This descriptive cross-sectional study was conducted in Surya Kanto Hospital, Mymensingh from September 2014 to September 2016.  Total 300 suspected TB patients were selected and sputum microscopy was performed then re-evaluation of the smear negative cases was carried out by GeneXpert.

Results: The mean age of the patients was 38.87 ± 13.78 years with a male to female ratio 2.1: 1 and 86% was in economically productive age of life. About 13.1% smear negative suspects were diagnosed as TB positive by GeneXpert.

Conclusion: GeneXpert played effective role to re-evaluate the smear negative TB cases. So, GeneXpert may be recommended routinely for TB detection.

Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 3-6
Aetiological Evaluation of Pleural Effusion in a Selected Hospital
Authors: Islam Saleh Mohammad Shahedul , Miah Md Abdul Ali , Rahman Shah Md Mahbubur , Roy Chandan Kumar
Published: February 2020

Introduction: Pleural effusion is a common clinical manifestation of varying aetiology. Its outcome varies according to underlying aetiology. The causes and prognosis vary between developed and developing countries.

Objectives: To find out the most common causes of pleural effusion in a tertiary care hospital of Bangladesh.

Materials and Methods: Total 50 patients were enrolled in the study during the period from January 2014 to November 2015 in combined military hospital, Dhaka. Informed written consent was obtained from all patients under the study, explaining the risk benefits and objectives of the study before sampling. Data were collected using a structured questionnaire containing all the key variables along with radiological, laboratory and pleural fluid analysis report. Data presented as frequency and percentage and Chai-square test was performed by using SPSS 23.0.

Results: Patients' mean age was 48.28 ± 12.53 years and ranged from 12 to 70 years where half of them were above 50. Male-female ratio was 1.63:1. Sixty five percent of the patients had positive smoking history. Persistent cough, fever and weight loss were the main presenting symptoms. Radiological findings revealed 50% had isolated right-sided pleural effusion and laboratory investigation found 28% cases ESR value 50-100 mm in 1st hour. Pleural fluid examination revealed 75% patient had straw coloured pleural fluid. Sputum for Acid-Fast Bacilli and other relevant investigations revealed 44% patients had tuberculosis, 16% had pneumonia, 8% had malignancy and 24% had other causes of pleural effusion.

Conclusion: This study revealed that the tuberculosis is the predominant cause of pleural effusion followed by pneumonia and malignancy.

Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 15-17
Patient’s Waiting Time at Emergency Department in a Selected Tertiary Level Hospital
Authors: Ali ASM Zulfiquer , Zafreen Farzana , Al Azad Md Abdus Samad , Hossain AKM Alamgir , Akter Jesmin
Published: February 2020

Introduction: Patient satisfaction is one of the principal aims of the healthcare delivery system. Waiting time is an important parameter for assessment of hospital management and influences patient satisfaction. Patient waiting time reflects the effectiveness of treatment and management of the hospital.

Objective: To find out the waiting time of patient attending the Emergency Department in a selected tertiary level hospital and to identify the factors related to waiting time, socio-demographic characteristics of the patient and patients satisfaction status about waiting time.

Materials and Methods: This descriptive cross-sectional study was conducted at emergency department of Dhaka Medical College Hospital from March 2011 to June 2011. A total of 115 cases were selected through systemic random sampling. Self-administered structured questionnaire was used for data collection.

Results: Mean waiting time was 10.17 ± 5.17 minutes. Patients waiting time was significantly (p < 0.001) associated with type of emergency. Out of 115 respondents, 30.4% received treatment within 5 minutes and only 17.4% waited more than 15 minutes. Patients waited more than 15 minutes at obstetric, medical, surgical and gynaecological emergency were 4.2%, 8.8%, 25.0% and 35.3% respectively. Most (72.1%) of the patients found satisfied with waiting time at emergency and only 27.8% expressed their dissatisfaction.

Conclusion: In this study patients’ waiting time was associated with type of emergency and most of the patients were satisfied with the waiting time at Emergency Department.

Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 32-34
Patterns of Neonatal Admission and Outcome in Neonatal Intensive Care Unit of a Tertiary Care Hospital
Authors: Sultana Jesmin , Nazme Nure Ishrat , Begum Nurun Nahar Fatema
Published: February 2020

Introduction: Analyzing the neonatal admission pattern helps the policymakers to make better strategies for healthcare provider to deliver better service.

Objective: To demonstrate the admission pattern and outcome of patients in the Neonatal Intensive Care Unit (NICU) in a tertiary care hospital of Bangladesh.

Materials and Methods: This retrospective descriptive study was conducted on all neonates admitted to the NICU of Combined Military Hospital (CMH), Dhaka from January to December 2015. Data were collected from file records of the patients regarding age, gender, mode of delivery, working diagnosis, length of stay in NICU and immediate outcome.

Results: A total of 502 neonates were admitted during the study period. Majority of the patients (77.3%) were admitted on the 1st day of life. There were 279(55.6%) males with a male to female ratio 1.2:1. The major cause of admission was prematurity (23.1%) and other leading causes were birth asphyxia (BA)14.9%, infant of a diabetic mother (IDM) 13.5%, neonatal sepsis 12.5%. Most of the neonates (82.7%) were delivered by caesarean section. About 84.1% were discharged after improvement, 65(12.94%) died and 15(3%) were referred to other specialties for further management. Within the first 24 hours of admission, 9.4% deaths occurred and two common causes of neonatal death were preterm (49.18%) and birth asphyxia (23%).

Conclusion: Good outcome of a neonate depends on adequate management, monitoring and good nursing care in an intensive care unit. By paying good attention to perinatal services and improving the facilities in the unit, morbidity and mortality in neonates can be reduced.

Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 49-53
Genetic Disorders and Consanguinity: Focus on Bangladesh
Authors: Yazdany Md Shameem
Published: February 2020

Genetic disorders are one of the major childhood health problems. Treatment and rehabilitation of children with genetic disorders are costly and complete recovery is usually impossible. Genetic disorders are far more common than is widely appreciated and represent only the tip of the iceberg. Consanguineous marriage increases the risk of mutated autosomal recessive gene expression and consequently increases the risk of inheriting genetic disorders among the offspring. The probability of inheriting genetic disorders depends on the closeness of the relationship between the parents. That’s why considerable attention has been attracted towards the consanguineous marriage as a causative factor of the genetic disorders. It was found that the rate of consanguinity is very high among the Muslim countries. Very limited data are available regarding the rate of consanguinity and prevalence of genetic disorders related to consanguinity in Bangladesh. Bangladesh has a lot of achievements in the health sector but still, sufficient initiative have not been taken to control the genetic disorders by informing, motivating and discouraging people in consanguineous marriage. Awareness of the people with premarital and prenatal screening is very important to reduce the incidence of genetic disorders.

Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 59-63
Treatment of Iatrogenic Subglottic Stenosis by Therapeutic Fibreoptic Bronchoscopy
Authors: Begum Nurun Nahar Fatema , Sultana Jesmin , Sarker Md Ferdousur Rahman , Yasmeen Sabina , Das Maj Bijoy Kumar , Jahan Isme
Published: February 2020

Endotracheal intubation is a common procedure in intensive care unit. It still qualifies as an invasive procedure. Prolonged endotracheal intubation or intubation with cuffed endotracheal tube in a newborn or young infant is a risk factor for the development of subglottic stenosis. It usually presents with stridor in childhood.  The most likely mechanism of subglottic stenosis is an injury of tracheal mucosa, with secondary scar healing that consequently leads to the development of some degree of subglottic stenosis. Depending on the degree of subglottic stenosis, patients may be asymptomatic for a long time or symptoms can occur within several weeks. The incidence of stenosis is very low if intubation lasts less than a week. Sometimes the patient may develop severe subglottic stenosis after short-term endotracheal intubation. Intubation with cuffed endotracheal tube in newborn results in pressure necrosis and sloughing followed by subglottic stenosis. This article presents a case of a patient (Baby A) who had intubation with cuffed tube which landed to airway problem and stenosis and was managed successfully by taking help from an expert pediatric pulmonologist of a neighbouring country.

Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 64-68
TEACHERS’ STAGE OF CONCERN IN IMPLEMENTING ELEMENTARY SCHOOL CURRICULUM INNOVATION
Authors: Wachidi Wachidi
Published: February 2020

The purpose of this study was to describe of teacher’ stages of concern in applicating curriculum innovation. The approach used in this study was a descriptive study. The number of population of this study were 500 primary school teachers. Meanwhile, the research sample were 50 teachers. A random sampling technique in the form of the lottery was used to get samples. Data were collected, classified, processed and analyzed by using the norms of the group in the calculation of percentile. The findings of this study were 42 % of teachers in a stage of concern called at the stage of awareness, 0 % of teachers have a stage of concern at the stage of I stage of information; 18 % of teachers have a stage of concern at the stage of personnel;10 % of teachers have a stage of concern at the stage of management); 16 % of teachers have a stage of concern at the stage of consequence; 6 % of teachers have a stage of concern at the stage of collaboration; and 12 % of teachers have a stage of concern at the stage of refocusing. The overall respondents have an average score of 2.06 (two point zero six). This means that their stage of concern for the implementation of the curriculum innovation is still low. They experience uncertainty in making decisions to adopt it. It was caused by (a) the lack of understanding of primary school teachers on information received, (b) lack of examples and evidence of the benefits of accepted curriculum innovation in school practices, (c) lack of training by trainers in applying new curriculum, (d) so complex in evaluating and (e) the curriculum is continuously changing.
MOTIVATION, LEARNING ACTIVITY, AND LEARNING OUTCOMES OF GRADE V ELEMENTARY SCHOOL
Authors: Alfian Yogi
Published: February 2020

The purpose of this study is to determine the effect of ice breaking on learning motivation, active learning and learning outcomes of fifth-grade elementary students, Bengkulu City. Non-Equivalent Control Group Design in the form of the quasi-experimental method was used in this study. The type of research is quantitative descriptive. The population were the public elementary students in Bengkulu City, while the sample of this study were two classes, those were VA and V B. Data collection techniques in this study were questionnaires and tests. Based on the description of the results of the research and discussion, it can be concluded that (1). There is an influence of ice breaking on the learning motivation of fifth-grade students of public elementary school 56 Bengkulu City. This is shown in the t-test that the value of t-test of 5.00> t table value at a significant level of 5% is 2.01 (2). There is an influence of ice breaking on the learning activeness of fifth-grade students of public elementary school 56 Bengkulu City. This is shown in the t-test that the value of t-test is 5.04> t table value at the 5% significance level of 2.01. (3). There is a significant effect of ice breaking on student learning outcomes on cognitive aspects of fifth-grade students of public elementary school 56 Bengkulu City. This is indicated by the calculation of the t-test that the value of t testis 2.71> the value of t table at a significant level of 5% of 2.03.
TEACHERS’ OBSTACLES IN UTILIZING INFORMATION AND COMMUNICATION TECHNOLOGY
Authors: Kristiawan Muhammad , Muhaimin Muhaimin
Published: February 2020

This study aims to study teacher barriers to utilizing information and communication media (ICT) for learning media. This research was carried out at Public Elementary School 24 Pulau Rimau located in Karang Manunggal village, Pulau Rimau sub-district, Banyuasin district. The subjects of this study were teachers at Public Elementary School 24 Pulau Rimau who tested 16 people. In conducting this research, data from certain sources are needed that are as expected in this study. The technique of collecting data is by observation and interview. Data were analyzed using percentages to see the percentage of respondents' answers. Furthermore, all data is processed by analyzing qualitative data, namely data reduction, data display, and data verification. The formulation of the problem in this study is what forms are questioned by the teacher in utilizing technology-based media in Public Elementary School 24 Pulau Rimau ? From the results of research on teacher barriers to using Information Technology (ICT) in Public Elementary School 24 Pulau Rimau, two aspects related to the ability of teachers and Information and Communication Technology (ICT) were inadequate. The obstacle of the teacher's ability to master ICT is that the teacher is not proficient in using computers, judging from the percentage of teacher answers, 75% say they are not proficient in using technology-based media, whereas using computers is one of the activities that support computer-based media. In addition, teachers do not have an advanced educational background in the use of ICT media. Another obstacle in terms of facilities, in Public Elementary School 24 Pulau Rimau there is no electricity network (PLN). In addition to not having a PLN, there is also the unavailability of computer facilities and laptops at the Public Elementary School 24 Pulau Rimau.
Study of Heavy Metals (Lead and Magnesium) Stress on Rosa indica
Authors: Azam Iqra , Sajjad Bakhtawar , Sarwar Hina , Javeed Aleeza , Riaz Anam , Yaseen Waheed , Ajaz Humayun
Published: February 2020

In the present study, concentration effects of different heavy metals (Pb and Mg) in Rosa indica are observed to detect the changes in growth response due to effect of metal’s toxicity. Both metals have different tolerance index. Lead is toxic metal and has small tolerance index, whereas Mg is a macronutrient having a high tolerance index which can move in a large scale to different parts of the plants. The least and highest accumulation values of Pb and Mg were observed as 0.608-25.897 mg/L and 20948-52291 mg/L, respectively. The toxicity order in rose plant is Pb>Mg. The bio concentration and translocation factor values of Pb and Mg were 0.97, 0.77, 0.93 and 0.9 respectively. In lead polluted soil, plants height shown is declined due to the concentration of lead (66.38 cm-56.48 cm) whereas plant height increased because of massive concentrations of Mg (63.93 cm-75.03 cm). Results `revealed that accumulation of both metals were excessive in the roots and least in the stem and leaves. It is concluded that rose plant is a good accumulator of lead and magnesium.
First record of Piscicapillaria bursata (Nematoda: Capillariidae), a parasite of hammerhead sharks Sphyrna spp., in the western Atlantic Ocean
Authors: Moravec F , Dalrymple KM , Galloway AS , Barker AM , de Buron I
Published: February 2020

Examination of 32 spiral valves from neonate specimens of hammerhead shark Sphyrna spp. (Carcharhiniformes: Sphyrnidae) captured between June and August 2018 off the Atlantic coast of South Carolina, USA, revealed the presence of the capillariid nematode Piscicapillaria bursata (Capillariidae) in the Carolina hammerhead S. gilberti, the scalloped hammerhead S. lewini, and their hybrids. This is the second find of this parasite originally described from hammerhead sharks off Australia, its first record from the western Atlantic Ocean, and its first record in a new host species and in hybrids.
Cardiovascular Outcomes of Diet Counseling
Authors: M Fleming Richard , R Fleming Matthew , K Chaudhuri Tapan , M Harrington Gordon
Published: February 2020

Context: The leading cause of death in the U.S. is heart disease with obesity as the major correlate and, some believe, Cause: Obesity is caused by eating behaviors. The U.S. Preventive Services Task Force notes the need for, yet absence of, randomized controlled trials of behavior modification interventions for cardiovascular disease endpoints. Objectives: To modify habitual dietary behaviors with counseling, to assess retention of the resulting habits, and to compare cardiovascular effects of such modifications under diets differing in fat content. Design: One-year randomized controlled trial of three diet behavior interventions for cardiovascular and behavioral end-points with intermediate surrogate end-points enabling intent-to-treat analysis. Setting: Prairie States private cardiology practice. Participants: One hundred and twenty referrals screened for: cardiovascular co-morbidity, heart medication, and informed agreement. Intervention: One hour of diet protocol initial individual instruction and one half-hour of individual self-efficacy counseling every six weeks thereafter for one year. Main outcome measures: The primary cardiovascular measure was SPECT device measured physiologic coronary blood flow. Retention of modified habits was assessed with four-month post-study measurement of changes in Respiratory Quotient as a menu selection index and in Body Mass Index as a portion control index. Surrogate endpoints were weight, BMI, lipids and other standard blood chemistry indices. Results: Participant attrition, zero. Changes in coronary blood flow were correlated with diet protocol, R (95%CI)=0.48 to 0.69, p=2.4 x 10-12. Ischemia improved significantly under a lowered fat protocol and worsened significantly under lowered carbohydrate conditions. Surrogate endpoints, weight and blood chemistry, showed similar correlations, p<10-11. Four months post-study, lowered fat dieters had retained their intervention modified behaviors while lowered carbohydrate and vegan dieters had changed, R (95%CI)=0.53 to 0.74, p=2.5 x 10-14 for portion control and R (95%CI)=0.76 to 0.88, p<2.2 x 10-16 for menu selection.
Usability of Mobile Health Application for Individuals with Type 2 Diabetes Mellitus and Clinicians
Authors: TİMURTAŞ Eren , POLAT Mine Gülden
Published: February 2020

Objective: Usability of technological devices is an important and relevant construct as mobile technologies are increasingly used to deliver healthcare products. Most accessible devices are smartphone and smartwatch but information on their usability is scarce. The aim of this study is to compare the usability of smartphone and smartwatch devices in delivering an exercise platform to individuals with Type 2 Diabetes Mellitus (T2DM) among two focus groups: individuals with T2DM and clinicians.Methods: A total of 40 individuals with T2DM (focus group 1) and 20 clinicians (focus group 2) were recruited to use the platforms one week. Each focus group was randomly divided into: smartphone and smartwatch groups. Each participant was provided with a practice trial for a week before data collection. Usability of both devices was measured with System Usability Scale (SUS). Student t-test was used to compare the total and subscale scores of SUS between two devices in each focus group.Results: In focus group 1 and 2, the mean total scores of SUS were slightly higher in smartphone group (88,75 9,34 and 86,75 8,68 ) than smartwatch group (87,87 7.56 and 82,35 6,59) respectively. When compared to individual items, three items were statistically significant in focus group 1 and one in focus group 2 (p 0.05).Conclusion:This study demonstrates a high usability (SUS score>80,8) for both smartphone and smartwatch devices in individuals with T2DM and clinicians. When compared between devices for two groups, exercise platform delivered through smartphone performed better on usability than smartwatch for both individuals with T2DM and clinicians.
Investigation of the Relationship Between Nurses’ Burnout and Psychological Resilience Levels
Authors: ERTEM Melike , CAPA Sevinc , KARAKAS Mehmet , ENSARI Hulya , KOC Aysegul
Published: February 2020

Objective: This descriptive and correlational study was performed to determine the relationship between resilience and burnout levels of nurses working in psychiatry clinics.Methods: The population of this correlational study comprised 70 nurses, 55 of which constituted the study sampling between February and May in 2018. Research data was collected by means of “Personal Information Form”, “Psychological Resilience Scale/PRS” and “Maslach Burnout Scale/MBS”.Results: “Devotion” subscale of PRS showed a strong statistically significant inverse relationship with “Emotional Burnout” subscale of MBS (r=-0.707; p=0.000) albeit a moderate statistically significant inverse relationship noted with both “Desensitization” and “Personal Success” subscales of MBS (p<0.05).Conclusion: The results of this study may help nurse managers and hospital administrators to have a better understanding of nurses’ burnout and resilience levels. Future studies on the determination of compassion fatigue, which is an expression of empathy fatigue against nurses in psychiatric clinics and particularly Community Mental Health Services, are highly recommended.
Optimal Design of the Vertical Earthing with Electrodes Arranged in Line
Authors: Pavel Sorin Gheorghe , Maier Virgil , Ciorca Claudiu , Beleiu Horia Gheorghe , Birou Iulian
Published: February 2020

The design methods of earthing from standards recommend the choice of electrode lengths and propose that the distances between electrodes to be 1–3 times larger than their length. The number of electrodes is determined from the condition of achieving the design earth resistance, while the design ends with the choice of one of the variants. This paper presents the methodology for calculating the earthing system with cylindrical, vertical electrodes arranged in a line. The main variables are the length and the number of earth electrodes, as well as the distance between adjacent ones. Firstly, a set of technologically advantageous values for the earth electrode length is established (e.g., 10 values). For each value of the electrode length and different numbers of electrodes (e.g., 11 values), the distance between adjacent electrodes is determined (e.g., for 110 cases), which leads to the design value resistance. Finally, optimal solutions are identified based on the five optimal applied criteria. The proposed optimal criteria for earthing design are the footprint area, the total earthing volume, the total dispersion surface, the total metal mass, and the investment costs. Comparing the optimal solutions with other technically possible solutions clearly highlights substantial savings concerning space, material, and cost.
Very-Short-Term Power Prediction for PV Power Plants Using a Simple and Effective RCC-LSTM Model Based on Short Term Multivariate Historical Datasets
Authors: Chen Biaowei , Lin Peijie , Lai Yunfeng , Cheng Shuying , Chen Zhicong , Wu Lijun
Published: February 2020

Improving the accuracy of very-short-term (VST) photovoltaic (PV) power generation prediction can effectively enhance the quality of operational scheduling of PV power plants, and provide a reference for PV maintenance and emergency response. In this paper, the effects of different meteorological factors on PV power generation as well as the degree of impact at different time periods are analyzed. Secondly, according to the characteristics of radiation coordinate, a simple radiation classification coordinate (RCC) method is proposed to classify and select similar time periods. Based on the characteristics of PV power time-series, the selected similar time period dataset (include power output and multivariate meteorological factors data) is reconstructed as the training dataset. Then, the long short-term memory (LSTM) recurrent neural network is applied as the learning network of the proposed model. The proposed model is tested on two independent PV systems from the Desert Knowledge Australia Solar Centre (DKASC) PV data. The proposed model achieving mean absolute percentage error of 2.74–7.25%, and according to four error metrics, the results show that the robustness and accuracy of the RCC-LSTM model are better than the other four comparison models.
Biogas from Anaerobic Digestion: Power Generation or Biomethane Production?
Authors: Caposciutti Gianluca , Baccioli Andrea , Ferrari Lorenzo , Desideri Umberto
Published: February 2020

Biogas is a fuel obtained from organic waste fermentation and can be an interesting solution for producing electric energy, heat and fuel. Recently, many European countries have incentivized the production of biomethane to be injected into natural gas grids or compressed and used as biofuel in vehicles. The introduction of an upgrading unit into an existing anaerobic digestion plant to convert biogas to biomethane may have a strong impact on the overall energy balance of the systems. The amount of biomethane produced may be optimized from several points of view (i.e., energy, environmental and economic). In this paper, the mass and energy fluxes of an anaerobic digestion plant were analyzed as a function of the biogas percentage sent to the upgrading system and the amount of biomethane produced. A numerical model of an anaerobic digestion plant was developed by considering an existing case study. The mass and energy balance of the digesters, cogeneration unit, upgrading system and auxiliary boiler were estimated when the amount of produced biomethane was varied. An internal combustion engine was adopted as the cogeneration unit and a CO2 absorption system was assumed for biogas upgrading. Results demonstrated that the energy balance of the plant is strictly dependent on the biomethane production and that an excess of biomethane production makes the plant totally dependent on external energy sources. As for the environmental impact, an optimal level of biomethane production exists that minimizes the emissions of equivalent CO2. However, high biomethane subsides can encourage plant managers to increase biomethane production and thus reduce CO2 savings.
Simulation Analysis on the Heat Performance of Deep Borehole Heat Exchangers in Medium-Depth Geothermal Heat Pump Systems
Authors: Deng Jiewen , Wei Qingpeng , He Shi , Liang Mei , Zhang Hui
Published: February 2020

Deep borehole heat exchangers (DBHEs) extract heat from the medium-depth geothermal energy with the depth of 2–3 km and provide high-temperature heat source for the medium-depth geothermal heat pump systems (MD-GHPs). This paper focuses on the heat transfer performance of DBHEs, where field tests and simulation are conducted to analyze the heat transfer process and the influence factors. Results identify that the heat transfer performance is greatly influenced by geothermal properties of the ground, thermal properties and depth of DBHEs and operation parameters, which could be classified into external factors, internal factors and synergic adjustment. In addition, the long-term operation effects are analyzed with the simulation, results show that with inlet water temperature setting at 20 °C and flow rate setting at 6.0 kg/s, the average outlet water temperature only drops 0.99 °C and the average heat extraction drops 9.5% after 20-years operation. Therefore, it demonstrates that the medium-depth geothermal energy can serve as the high-temperature heat source for heat pump systems stably and reliably. The results from this study can be potentially used to guide the system design and optimization of DBHEs.
Damage Evolution Mechanisms of Rock Induced by Blasting with the Aid of Empty-Hole Effect
Authors: Meng Ningkang , Bai Jianbiao , Chen Yong , Wang Xiangyu , Wu Wenda , Wu Bowen , Liu Shuaigang
Published: February 2020

Blasting has been widely used in coal mining as a method of reducing the integrity of rock mass. Its low controllability often leads to the unsatisfactory fragmentation effect of rock mass. The empty borehole effect has great significance in avoiding the excessive breakage of rock mass and guiding the directional propagation of blasting-induced fractures. Nevertheless, the rock mass damage type evolution induced by the empty borehole has been rarely studied. A tension–compression constitutive model of rock mass damage is established in this paper. The model is incorporated into the numerical modeling code LS-DYNA as a user-defined material model. Then, LS-DYNA is used to investigate the evolution mechanism of rock mass damage under the empty borehole effect. The damage types of rock mass caused by the empty borehole effect are also studied. The Fortran language is utilized to monitor the number variation of the tensile damaged elements and the compressive damaged elements in the rock mass around the empty borehole. The results indicate that existence of the empty borehole significantly enhances the tensile stress and the stress concentration factor in the rock mass nearby the empty borehole. Meanwhile, the rock mass nearby the empty borehole mainly damages in tension. Both the number of the tensile damaged elements and the tensile stresses in the elements increases as the empty borehole diameter increases. The number of the compressive damaged elements decreases with increasing empty borehole diameter.
Real-Time Control Strategy for Aggregated Electric Vehicles to Smooth the Fluctuation of Wind-Power Output
Authors: Yu Zicong , Gong Ping , Wang Zhi , Zhu Yongqiang , Xia Ruihua , Tian Yuan
Published: February 2020

Electric vehicles (EVs) are flexible demand-side response resources in a power distribution system. Reasonable and orderly control of charging/discharging processes of aggregated EVs can improve their coordination and interaction with the distribution system and ensure its efficient and stable operation. Aiming at the problem that the fluctuation of wind power output may affect the stable operation of distribution system, a real-time control strategy for aggregated EVs to smooth the fluctuation of wind power is proposed. Firstly, considering the dispatchability of EVs, the charging/discharging energy boundary model is established to determine the charging/discharging margin of an EV at each moment. Then, first-order low-pass filtering is used to determine the total dispatching power of aggregated EVs. Finally, the total charging power of aggregated EVs is determined and power allocation is carried out. Simulation results show that the proposed strategy can achieve real-time smoothing for the fluctuation of wind power output while meeting the charging requirements of EVs, and the proposed strategy can not only reduce the fluctuation rate of total load, but also realize peak shaving and valley filling for the distribution system.
Decarbonization of the Iron and Steel Industry with Direct Reduction of Iron Ore with Green Hydrogen
Authors: Bhaskar Abhinav , Assadi Mohsen , Nikpey Somehsaraei Homam
Published: February 2020

Production of iron and steel releases seven percent of the global greenhouse gas (GHG) emissions. Incremental changes in present primary steel production technologies would not be sufficient to meet the emission reduction targets. Replacing coke, used in the blast furnaces as a reducing agent, with hydrogen produced from water electrolysis has the potential to reduce emissions from iron and steel production substantially. Mass and energy flow model based on an open-source software (Python) has been developed in this work to explore the feasibility of using hydrogen direct reduction of iron ore (HDRI) coupled with electric arc furnace (EAF) for carbon-free steel production. Modeling results show that HDRI-EAF technology could reduce specific emissions from steel production in the EU by more than 35 % , at present grid emission levels (295 kgCO2/MWh). The energy consumption for 1 ton of liquid steel (tls) production through the HDRI-EAF route was found to be 3.72 MWh, which is slightly more than the 3.48 MWh required for steel production through the blast furnace (BF) basic oxygen furnace route (BOF). Pellet making and steel finishing processes have not been considered. Sensitivity analysis revealed that electrolyzer efficiency is the most important factor affecting the system energy consumption, while the grid emission factor is strongly correlated with the overall system emissions.
Numerical Simulations on the Application of a Closed-Loop Lake Water Heat Pump System in the Lake Soyang, Korea
Authors: Park Dong Kyu , Lee Youngmin
Published: February 2020

A lake is one of the geothermal energy sources to meet increasing demands for renewable energy use. In this study, a series of numerical modeling was performed to evaluate the applicability of a close-loop lake water heat pump (LWHP) system in Lake Soyang, Korea. A non-isothermal pipe flow model was used to simulate the flow and heat transfer processes occurring in the LWHP system with the main pipe and several helical tubes for heat exchange. Based on the temperature data measured in the Lake Soyang for 4 years, the installation depth and the number of helical tubes were determined sequentially, and the sensitivities of additional installation and operation factors on the system performance were analyzed. Assuming a mild current in the lake, the installation and operation conditions for the efficient operation of the system were suggested as follows: The installation of 16 helical tubes at 50 m deep, the circulation rates of heat-carrier fluid of 189.3 L/min, the inner diameter of tubes of 32 mm, and the wall thickness and thermal conductivity of 2.9 mm and 0.4 W/mK, respectively. Considering many lakes and reservoirs in Korea, the closed-loop LWHP system would be a viable renewable energy application.
Experimental, Numerical and Application Analysis of Hydrokinetic Turbine Performance with Fixed Rotating Blades
Authors: Guner Faruk , Zenk Hilmi
Published: February 2020

In this study, a hydrokinetic turbine is designed for the high-altitude regions where local electricity network lines are difficult to reach. If there was a stream flow around, electricity production could be possible and necessary because of environmental reasons. The performance of the hydrokinetic turbine was investigated experimentally and numerically. The numerical analyses of the turbine system were performed via MATLAB/Simulink version R2014a. Except power-based performance characteristics, efficiency of the system in terms of installation and necessary investment costs were also investigated. It is calculated that the system to be established on a river with a water flow rate of 30 m3/h will meet the investment cost in approximately 8 years.
Modulating Wine Pleasantness Throughout Wine-Yeast Co-Inoculation or Sequential Inoculation
Authors: Vilela Alice
Published: February 2020

Wine sensory experience includes flavor, aroma, color, and (for some) even acoustic traits, which impact consumer acceptance. The quality of the wine can be negatively impacted by the presence of off-flavors and aromas, or dubious colors, or sediments present in the bottle or glass, after pouring (coloring matter that precipitates or calcium bitartrate crystals). Flavor profiles of wines are the result of a vast number of variations in vineyard and winery production, including grape selection, winemaker’s knowledge and technique, and tools used to produce wines with a specific flavor. Wine color, besides being provided by the grape varieties, can also be manipulated during the winemaking. One of the most important “tools” for modulating flavor and color in wines is the choice of the yeasts. During alcoholic fermentation, the wine yeasts extract and metabolize compounds from the grape must by modifying grape-derived molecules, producing flavor-active compounds, and promoting the formation of stable pigments by the production and release of fermentative metabolites that affect the formation of vitisin A and B type pyranoanthocyanins. This review covers the role of Saccharomyces and non-Saccharomyces yeasts, as well as lactic acid bacteria, on the perceived flavor and color of wines and the choice that winemakers can make by choosing to perform co-inoculation or sequential inoculation, a choice that will help them to achieve the best performance in enhancing these wine sensory qualities, avoiding spoilage and the production of defective flavor or color compounds.