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Bridge specifications do not consider the effect of parapet stiffness in the analysis and design of reinforced concrete slab bridges. This paper performs a parametric investigation using finite element analysis (FEA) to study the effects of parapet stiffness on live load-carrying capacity of two-span, three-and four-lane concrete slab bridges. This study analyzed 96 highway bridge cases with varied parameters such as span-length, bridge width, and parapet stiffness within practical ranges. Reinforced concrete parapets or railings, built integrally with the bridge deck, were placed on one and/or both sides of bridge deck. The longitudinal bending moments calculated using the FEA results were compared with reference bridge cases without parapets, as well as AASHTO Standard and LRFD specifications. The FEA results presented in this paper showed that the presence of concrete parapets reduces the negative bending moments by 15% to 60% and the positive bending moments by 10% to 45%. The reduction in longitudinal bending moments can mean an increase in the load-carrying capacity of such bridges depending on the parapet stiffness. This investigation can assist engineers in modeling the actual bridge geometry more accurately for estimating the load-carrying capacity of existing concrete bridges. Hence, new bridges can be designed by considering the presence of concrete parapets. Parapets can be used as an alternative for strengthening existing one and two-span reinforced concrete slab bridges.

Background Laryngopharyngeal reflux disease (LPRD) is a condition with nonspecific symptoms and most of times patients present late with advanced disease which may predispose to malignancy. The magnitude and clinical characteristics of this condition are not well known among patients attending Otorhinolaryngology services in Tanzania. Materials and methods This was a hospital based descriptive cross sectional study, conducted in the wards and clinics of Otorhinolaryngology department of Muhimbili National Hospital. Patients with symptoms of Laryngopharyngeal reflux disease were included in the study. Data was collected using questionnaires and clinical examination forms, were processed and analysed by using SPSS. Results presented in frequency tables, cross tabulations and figures. Results This study recruited 256 participants among them males were 131(51.2%).The mean age was (41.38 ± 13.94) years. Prevalence of Laryngopharyngeal reflux disease was 18.4% without gender predilection. The commonest symptoms were globus sensation, hoarseness of voice and excessive urge to clear the throat with 95.7%, 88.1% and 83.0% respectively while the most observed signs were thick endolaryngeal mucus, Vocal cord oedema and partial ventricular obliteration with 90.9%, 88.6% and 72.7% respectively. Lying down less than two hours after meal and spices foods consumption were the leading risk factors. Hypertension and Diabetes Mellitus type 2 were the most prevalent co morbid conditions associated with Laryngopharyngeal reflux disease. Conclusion The prevalence of Laryngopharyngeal reflux disease is high among patients attending Otorhinolaryngology services at Muhimbili national hospital. All patients with Laryngopharyngeal reflux disease related symptoms should get thorough evaluation for early diagnosis and treatment.

This paper aims to assess trainees’ satisfaction with the process and assessment aspects of the Saudi Diploma of Family Medicine (SDFM). This cross-sectional study was conducted in February 2015 among trainees undertaking the SDFM. A questionnaire was distributed to all trainees in four examination centres in Saudi Arabia, under the supervision and guidance of the investigators (four members of the scientific committee of SDFM). There was a total of 97 participants in this study, the majority of whom were Saudis. More than 85% were satisfied with most elements of training including; an adequate number and variety of patients and cases, allocating time for training, giving regular written evaluation. Satisfaction with mentoring and giving constructive feedback scored less well and trainees were less satisfied with some hospital clinical rotations, which requires further exploration.

Small business entrepreneurships (SBEs) offer key contributions to economic growth and development, as well as to employment. However, SBEs are described as a high-risk sector. Relative risk measurement in SBEs is varied and diverse and involves genuine challenges, specifically in obtaining the necessary finance required. These types of businesses are usually constrained by restricted access to fair funding when compared to public and big enterprises. The financial institutions, which have ethical and social undertakings beside commercial objectives, confront two dilemmas: whether to support SBEs through facilitating the accessibility of SBEs’ entrepreneurs to financial services, or to be more cautious in dealing with them. This qualitative descriptive-theoretical analysis paper aims to examine the risks and challenges SBEs face in obtaining financial facilitation from banks, and factors that obstruct financial institutions to finance SBEs. This includes identifying SBEs’ financial-related risks, addressing initiatives that may improve the capability of SBEs to meet their financial obligations, access equity funds and proper financing.

—Despite the acceleration of intervention in advanced technologies, the human element is still considered as a cornerstone to efficient running and provision of business in organizations. It is this role, with the concept of human awareness, which is fundamental to the risk management process. Risk, as it is usually referred to, is an awareness-related issue, and depends, extremely, on those who deal with it and are responsible for controlling its adverse impact. Indeed, risk awareness is extensively responsible for the ways in which people interpret and systematize potential risks, and thus, the way they deal with these risks. Therefore, for an effective risk management system to be realized, organizations need to build and set up appropriate programs that help employees improve their management skills in dealing with potential risks. One way this can be done is through training. However, the main challenge of implementing effective training is to decide where and what training should actually focus on. This paper examines the role of training in improving risk management among employees. The focal point of the paper is to tackle where training should be allocated for the effective controlling of risk. The paper suggests that training is likely to be most effective in terms of managing risk if it, initially, targets the awareness of employees towards risk rather than focus on technical procedures of dealing with risk. 

Fifty patients with electrocardiographic (ECG) evidence of left Bundle Branch Block (LBBB) and fifty control group with no significant electrocardiographic findings were studied over the period from October 2004 to July 2005 for evidence of Coronary Artery Disease (CAD) and Left Ventricular (LV) dysfunction. Both groups underwent cardiac catheterization and CAD considered present if there was 70% and more lumen diameter stenosis except for Left Main Coronary Artery (LMCA) was 50% and more. LV function was assessed visually and the function was considered normal or abnormal. The CAD was found in 37/50 (74%) of patients with LBBB, it was significantly (P

Background: Lung cancer is the leading cause of cancer deaths and its incidence is rising. The determination of histopathology and stage of primary lung carcinoma is crucial to develop appropriate treatment approach that affects morbidity and mortality. Fiber optic bronchoscope techniques for early detection of lung cancer are a promising tool as they might allow visualizing changes of early lung cancer and also permitting sampling for histological confirmation.Objective: This study was intended to compare the fiber optic bronchoscopy findings and their anatomical locations with the histopathology types in patients with lung cancer.Patient and Methods: A cross section study was conducted during the period from 1st February 2012 to the 31th of July 2013, 49 patients with clinical and radiological findings suggesting primary lung cancer and diagnose later by bronchoscope samples as cases of primary lung cancer chosen for analysis of their bronchoscope findings, at Baghdad teaching hospital / respiratory clinic.Results: Patients with squamous carcinoma (31%) had (67%) visible mass and (13%) presented invisibly as external compression. Patients with adenocarcinoma (41%) had (40%) visible mass and (35%) presented invisibly as external compression while normal bronchoscope was seen in (30%) of those patients so that adenocarcinoma mostly invisible. Patients with small cell carcinoma (28%) had (50%) visible mass and (21%) presented invisibly as external compression.The location of finding in (27%) of the patients with squam. ous carcinoma was in the right main bronchus and (20%) in right upper lobe bronchus while the carina affected in (47%). Patients with adenocarcinoma have vocal cord affected in (25%) and left upper lobebronchus lesion in (25%).Conclusion: There was no relationship between the fiber optic bronchoscope findings and their anatomical locations with the histological types of lung.

Background: Chronic obstructive pulmonary disease (COPD) is a preventable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients.. The systemic manifestations of COPD include a number of endocrine disorders , such as those involving the pituitary, the thyroid , the gonads, the adrenals and the pancreas. The mechanisms by which COPD alters endocrine function are incompletely understood but likely involve hypoxemia , hypercapnia , systemic inflammation and glucocorticoid administration. Objective: To evaluate the relationship between pulmonary function tests and thyroid gland function in patient with chronic obstructive pulmonary disease (COPD). Subjects and Methods: Cross sectional study was done in Baghdad teaching hospital from April 2012 to October 2012 in respiratory outpatient. Thirty eight patients were included in the study (36 male and 2 females) who had stable COPD , thyroid function tests and FEV1% were done to all of them. Patients were classified into four groups according to GOLD criteria: mild COPD ( > 80) FEV1% , moderate (80 – 50)%, severe ( 50 – 30)% and very severe < 30%. Results: one patient has decreased level of TSH , one patient has decreased T3 hormone and one patient has increased free T3 hormone level, all other patient had normal thyroid hormones levels. The results of study showed no significant changes in thyroid hormones concentrations with COPD and its severity. Conclusion: We found no significant changes in thyroid hormones in patients with COPD, and any changes that occur in TFT in these patients are may be due to other causes than COPD.

The hybrid ink-sensitized solar cell (ISSC) was manufactured by thin film techniques using Ultrasonic spray pyrolysis. Transparent conductive glass was manufactured by doping Indium-Tin Oxide (ITO), the (ITO) colloidal solution sprayed on glass substrate at 250 °C, the sheet resistance of (ITO) film was about (10 Ω/π) by using (Jandal-TFC), the transparent of thin film is about (85%) by using (UV-Vis) and the high peak of thin film was measured (250 nm) by using Atomic Force Microscopic (AFM). The photoelectrode (the anode) was manufactured by nano-titanium dioxide colloidal solution at absorption maximum 1.55 in wavelength (lmax=345 nm), was sprayed on (ITO) glass and the ink sensitized solution with polymer was sprayed on TiO2 layer. The counter electrode (the cathode) was fabricated from the nano-carbon layer through its coating on (ITO) glass by electrodepositing method A small molecule based hole conductor, copper phthalocyanine, is used here to replace the liquid electrolyte in (DSSC) which putting between electrodes of cell when its assembling Photovoltaic parameters like short circuit current (ISC), open circuit voltage (VOC), fill factor (FF) and overall conversion efficiencies (η) for fabricated cell were 5.2 (mA/cm2), 500 mV, 26.92% and 1.88 under (100 mW/cm2) sunlight energy respectively and current-voltage curve (I-V).

This paper presents the results of an investigation of wheel load distribution in reinforced concrete slab bridges. The finite element method was used to investigate the effect of span length, slab width, and wheel load conditions on simply supported, one-span, reinforced concrete slab bridges. The concrete slab was modeled using rectangular SHELL elements. Element sizes of 1 It x 1 It (0.3m x 0.3m) were selected to model all the slab bridges. This paper presents the f'mite element results of one-, two-, three-, and four-lane bridges. The lane width considered in this research is 12 it (3.6m). Four typical span lengths were considered in this study: 24 It, 36 It, 46 It, and 54 ft (7.2, 10.8, 13.8, and 16.2m). Two possible loading conditions were investigated: (a) design trucks assumed to be traveling in the center of each lane and (b) the design trucks were placed close to one edge of the slab with a minimum spacing between the trucks. The FEA results for bridges subjected to wheel loading placed to one edge of the slab showed that the AASHTO procedure over-estimates the bending moment by 30% for one-lane and span length less than 25 It (7.5m). As the span length increases (30 ft to 55 ft) for one-lane bridges, the AASHTO bending moment correlates well with the FEA results. The AASHTO bending moment gave similar results to the FEA when considering two-lane slab bridges and span length less than 25 It (7.5m). However, as the span length increases for the twolane bridges, reduction factor is applied to the FEA moments for two-lanes in combination with span length greater than 30 It (9m). The results of this study ' Associate Professor and Graduate Student, Dept. of Civil and Environmental Engineering, American University of Beirut, Beirut, Lebanon 2 Associate Professor of Civil Engineering, Valparaiso University, Valparaiso, Indiana 46383 3 Professor of Civil Engineering, University of Nevada Las Vegas, Las Vegas, NV 89154

The development of refined finite element models for the analysis of a concrete slab on steel beam highway bridges is presented in this paper. This paper summarizes the process by which a refined finite element analysis was applied to bridge superstructures using ICES-STRUDL. This process will assist bridge engineers and researchers in predicting the actual stress distribution and evaluating the load transfer to beams from designed vehicle loads on highway bridges.