Search

The rapid increase in the ageing population and health conditions are imposing a higher challenge to the health care system that requires multidisciplinary teamwork utilizing coordinated care approach. This study examined the effects of integrated care model on quality of care received by older hospitalized patients in West Bank. A quantitative interrupted time series design (pretest and posttest multiple time series, quasi-experiment design) was used. The study examined the effects of integrated care model on admitted older patients (n=32) in the West Bank measuring ten dimensions of quality of care and four health indicators. There was a significant improvement in the dimensions of quality of care: dimensions: nurses’ communications with patients, physicians’ communications with patients, staff response to patients’ needs, pain management, explanations on medications, amount of information given on discharge plan, patients' area cleanliness, patients' area quietness, rating of the hospital, and willingness to recommend the hospital. Incidence of falls and incidence of pressure ulcer improved after implementing the model, while readmission rate and average length of stay did not improve. This study contributed to the limited body of knowledge related to the effect of integrated care model on hospitalized older patients’ quality of care in Palestine/ West Bank. Integrated care has the potential to improve care outcomes among hospitalized older patients.

The use of computer assisted joint replacement has facilitated precise intraoperative measurement of knee kinematics. The changes in "screw home mechanism" (SHM) resulting from Total Knee Arthroplasty (TKA) with different prostheses and constraints has not yet been accurately described.A pilot study was first completed. Intraoperative kinematic data was collected two groups of 15 patients receiving different prostheses.On average, patients lost 5.3° of ER (SD = 6.1°). There was no significant difference between the prostheses or different prosthetic constraints.There significant loss of SHM after TKA. Further research is required to understand its impact on patient function.

Structural equation models (SEQM) can be used to model causal relationships between multiple variables in multivariate systems. Among the strengths of SEQM is its ability to consider causal links between latent variables. The use of latent variables allows modeling complex phenomena while reducing at the same time the dimensionality of the data. One relevant aspect in the quantitative genetics context is the possibility of correlated genetic effects influencing sets of variables under study. Under this scenario, if one aims at inferring causality among latent variables, genetic covariances act as confounders if ignored. Here we describe a methodology for assessing causal networks involving latent variables underlying complex phenotypic traits. The first step of the method consists of the construction of latent variables defined on the basis of prior knowledge and biological interest. These latent variables are jointly evaluated using confirmatory factor analysis. The estimated factor scores are then used as phenotypes for fitting a multivariate mixed model to obtain the covariance matrix of latent variables conditional on the genetic effects. Finally, causal relationships between the adjusted latent variables are evaluated using different SEQM with alternative causal specifications. We have applied this method to a data set with pigs for which several phenotypes were recorded over time. Five different latent variables were evaluated to explore causal links between growth, carcass, and meat quality traits. The measurement model, which included 5 latent variables capturing the information conveyed by 19 different phenotypic traits, showed an acceptable fit to data (e.g., χ/df = 1.3, root-mean-square error of approximation = 0.028, standardized root-mean-square residual = 0.041). Causal links between latent variables were explored after removing genetic confounders. Interestingly, we found that both growth (-0.160) and carcass traits (-0.500) have a significant negative causal effect on quality traits (-value ≤ 0.001). This result may have important implications for strategies for pig production improvement. More generally, the proposed method allows further learning regarding phenotypic causal structures underlying complex traits in farm species.

Maternal diet during pregnancy is a major determinant of the fetal developmental competence and may induce long-lasting epigenetic changes to the offspring. Imprinted genes have important roles in fetal programming, growth, and development. There are, however, limited data available on the influence of maternal diet on the expression of imprinted genes in beef cattle. Therefore, the objective of this study was to analyze the impact of maternal diet during pregnancy on the expression of 5 imprinted genes and 3 DNA methyltransferase genes in longissimus dorsi muscle from Angus calves. A total of 36 Angus-cross cows were inseminated to a single sire and on Day 135 of gestation they were randomly assigned to either low-starch (haylage) or high-starch (corn silage) diets. Diets were initially formulated to provide isocaloric and isonitrogenous intake. The H19, MEG8, IGF2R, and DNMT3a genes showed differential expression in longissimus dorsi muscle in calves between the diet groups. Given that high-starch diet is a source of energy for muscle growth and feed conversion efficiency in postnatal development, the mechanisms by which this diet affected expression of imprinted genes should be further explored.

In a previous study to locate the major coarse aggregate resources currently being exploited in the Lebanon, 20 major operating quarrying sites were located, described and sampled. This paper reports the evaluation of these samples, based on petrographic analysis and mechanical and chemical acceptance tests as well as the results of tests conducted on fresh and hardened concrete samples made with various types of coarse aggregate. In general, the samples were of good quality and suitable for use in concrete although the grading of the aggregates varied widely between quarries and some samples were found to be gap graded. Only the material from Berquayel failed the soundness test. Cherts were identified in some of the samples, leading to the conclusion that alkali-aggregate reactions might occur in these rocks. The results of the concrete tests showed that the measured concrete stiffness was in many cases slightly lower than the anticipated theoretical value. It is hoped that the results of the study will provide valuable assistance to all those involved in the construction industry, including engineers, contractors, ready-mix plant operators and government officials.

Developing countries have per capita electricity consumption of less than 1500 kWh per annum. The demand of these countries, which is presently only 28% of global demand, will equal half the world demand by the middle of the next century. Therefore it is the performance of developing countries that will affect the expansion of the electricity supply worldwide. This performance has to be improved by reforms, reorganisation and restructuring, also by privatisation in some cases and infusion of private sector finance. There is also need to introduce modern technologies, the foremost of which are clean fossil-fuel technologies.

Naturally occurring hydrolyzable (HT) and condensed (CT) tannins and their monomeric units were tested for their ability to inhibit the stimulation of DNA synthesis by UVB radiation. Hairless mice were irradiated with either single (200 mJ/cm2) or multiple (150 mJ/cm2) doses of UVB applied at 24 h intervals and epidermal DNA synthesis was measured at different times after the last of these treatments. The peak of DNA synthesis that is observed 48-56 h after a single UVB irradiation shifts to an earlier time of 16-24 h after multiple UVB treatments. Interestingly, the early inhibitory period of DNA synthesis observed 8 h after a single UVB treatment is not detected following multiple UVB treatments. Rather, DNA synthesis is stimulated six-fold 24 h after multiple UVB treatment, a response that is higher than the peak occurring 48-56 h after a single UVB irradiation. The disappearance of the early period of inhibition when the peak of DNA synthesis shifts to an earlier time may be linked to reactive oxygen species brought to the epidermis by infiltrating leukocytes, which, in turn, act as second messengers to stimulate growth signals in cells. Topical applications of HT or CT remarkably inhibit the DNA responses to single and multiple UVB treatments, an effect that is dependent on the dose and time of administration. Indeed, the peak stimulation of DNA synthesis is maximally inhibited when 17 mg of Tarapod tannic acid (TA), an HT, are applied topically 20 min before a single UVB treatment. The polymeric tannins inhibited DNA synthesis to a greater degree than equal doses of their monomeric units, gallic acid and catechin. These results suggest that various oligomeric HT and CT may be useful against tumor-promoting responses associated with the exposure of skin to physical carcinogens.

In a previous study, the results of extensive surveys and investigations covering 80 percent of the Lebanese territory to locate the major sand resources, were reported. Forty-one samples representing major operating sand quarries or sand excavation sites were located, described, and sampled. The research program reported in this paper was designed to evaluate the 41 sand samples based on petrographic analysis, mechanical and chemical acceptance tests, and results of tests conducted on fresh and hardened concrete samples identical except for the type of sand. Conclusions are presented concerning each sand source.

This tutorial is concerned with project evaluation and feasibility. It systematically works through the issues involved, referring whenever possible to the real world of the electrical power industry. However, the analysis can equally apply to all major engineering projects. The author considers the evaluation of costs and benefits, financial and economic returns calculation, sensitivity analysis and risk analysis.

Twelve sets of small scale fiber reinforced concrete (FRC) slab-column connections were tested to investigate the effect of fiber reinforcement on the punching shear resistance of flat slabs. The parameters studied included type, content and aspect ratio of fibers, and span-depth ratio of the slab. The results indicate that the use of hooked steel fibers improves substantially the ductility of shear failure of slab-column connections, modifies their failure mode, favorably, from pure punching to flexural, and leads to a significant increase in their ultimate shear capacity. The increase in ultimate shear resistance varied almost linearly with the steel fiber content. While polypropylene fibers increase the ductility of shear failure, they are not as effective as steel fibers in increasing the punching shear resistance. Based on evaluation of the current test results and other experimental data reported in the technical literature, a design equation is proposed to predict the ultimate punching shear strength of slab-column connections containing deformed steel fiber reinforcement.

For the mammalian embryo to successfully complete development, it must not only incur proper timing of internal machinery, but also protect itself from potentially harmful external stimuli. These stimuli, ranging from chemical to temperature flux, can result in defects in processes regulating gamete production and quality, as well as early embryonic development. To counterbalance these potential detriments, the mammalian cell has complex machinery consisting of heat shock factors and proteins that prevent protein misfolding and malfunction. Heat shock protein (HSP) genes have become a growing topic to understand the mechanisms of successful gamete formation and embryonic development, critical factors for livestock fertility. In addition, HSP have become a focus in understanding how external stimuli during the in vitro embryo production process may have a developmental impact. To further elucidate these mechanisms, it has become a necessity for more in-depth functional studies on HSP using technologies such as RNA interference and antibody use during embryo culture. Through these studies we can gain a more comprehensive perspective of HSP function and importance during early development. In addition, information from these studies may provide critical markers for improved fertility and development.

The decline in the reproductive efficiency of dairy cows, especially those with high producing potential, has become a challenging problem. In this study, a selective DNA pooling approach was applied to a cow population whose oocytes were fertilized and cultured to obtain phenotypic records of fertilization rate and blastocyst rate. Using a stringent 5% genome-wide significance level, 22 and five single nucleotide polymorphisms (SNPs) were found to be associated with fertilization rate and blastocyst rate, respectively. SNPs that showed significant association in selective DNA pooling were further evaluated by individual genotyping. Interestingly, the majority of the SNP associations were confirmed by individual genotyping, testifying to the effectiveness of selective DNA pooling using a high-density SNP genotyping array. This study is the first application of the selective DNA pooling approach using the BovineSNP50 array in cattle.

The objective of this study was to investigate the association of the fibroblast growth factor 2 (FGF2) gene with embryonic survival and fertilization rate in cattle. This gene was chosen because of its role in regulating trophectoderm expression of interferon-tau, the maternal pregnancy recognition factor in ruminants. To evaluate the effect of FGF2 on fertility traits, we produced in vitro-fertilized embryos from 281 Holstein cows and from 7 sires. A total of 4,542 in vitro fertilizations were performed, from which a total of 3,171 embryos were produced. Survival and fertilization rates were assessed at d 7 of embryonic development. Using the pooled DNA sequencing approach, we identified 2 SNP in FGF2, SNP11646 and SNP23. All sires and cows were genotyped for these SNP. For fertilization rate, no significant differences between genotypes were found for either SNP, whereas the effect on survival rate was significant for SNP11646. The survival rate of embryos produced from GG cows for this SNP was 37%, compared with 28 and 29% for embryos produced from AG and AA cows, respectively. Although the molecular mechanisms that cause embryonic mortality have not yet been identified, this study provides the first evidence of association between FGF2 and embryonic mortality in cattle. Thus, we propose that FGF2 can be used in animal breeding strategies to test for improved reproductive performance.

Imprinted genes are monoallelically expressed in a parent-of-origin-specific manner under epigenetic regulation. Although it is generally believed that genomic imprinting is conserved among mammalian species, there is accumulating evidence that suggests such an assumption is false. Identification of species-specific imprinted genes is necessary to understand the evolution of genomic imprinting and to elucidate mechanisms leading to allele-specific expression. In this study, we analyzed the imprinting status of the CD81, target of antiproliferation antibody 1 (TSSC4), and oxysterol-binding protein homologue 1 (OBPH1) genes clustered on bovine chromosome 29; the paternally expressed gene 10 and ankyrin repeat and suppressor of cytokine signaling box-containing protein 4 genes clustered on bovine chromosome 4; and the 5-hydroxytryptamine (serotonin) 2A receptor microdomain gene on bovine chromosome 12 using a sequencing-based approach. It was found that CD81 and OBPH1 showed biallelic expression in all cattle tissues examined, whereas TSSC4 showed monoallelic expression in placental tissues, like its mouse ortholog. Comparative expression analysis showed that the imprinting pattern of the CD81, TSSC4, and OBPH1 cluster was not conserved among mouse, human, and cattle. None of these genes were imprinted in all 3 species. The the paternally expressed gene 10 gene was imprinted in all 3 species, whereas ankyrin repeat and suppressor of cytokine signaling box-containing protein 4 gene, reported to be imprinted in mouse, was not imprinted in cattle. The the 5-hydroxytryptamine (serotonin) 2A receptor gene was not imprinted in cattle, and human imprinting data has shown conflicting results. It is more likely that imprinting in the genes examined in this study is species-specific. In addition, we studied the expression and tissue distribution of transcripts of these genes in 174 fetal and adult cattle tissues.

Sixty elderly patients scheduled for surgical hip fracture repair were given the choice of either general isoflurane anaesthesia (n = 30) or a nerve stimulator guided combined sciatic-paravertebral nerve block (n = 30). The incidence of intraoperative hypotension and the need for postoperative admission to the intensive care unit/high dependency unit (ICU/HDU) within 48 hours postoperatively were recorded. No differences in patient characteristics, ASA class or concomitant disease status were detected between the two study groups. Both the incidence of intraoperative hypotension (0/30 vs. 11/30, p0.001) and the postoperative need for ICU/HDU admission (0/30 vs. 11/30, p0.001) was significantly reduced in patients treated with a combined sciatic-paravertebral nerve block compared to patient receiving general anaesthesia. The length of hospital stay was also found to be shorter for patient in the regional anaesthesia group [mean 6.7 days (SD 2.3) vs. 13.6 days (SD 6.1)]. The described technique appears to be an attractive alternative method to handle proximal fractures of the femur in the elderly, especially in a situation with limited ICU/HDU availability.

Naturally occurring hydrolyzable (HT) and condensed (CT) tannins and their monomeric units were tested for their ability to inhibit the stimulation of DNA synthesis by UVB radiation. Hairless mice were irradiated with either single (200 mJ/cm2) or multiple (150 mJ/cm2) doses of UVB applied at 24 h intervals and epidermal DNA synthesis was measured at different times after the last of these treatments. The peak of DNA synthesis that is observed 48-56 h after a single UVB irradiation shifts to an earlier time of 16-24 h after multiple UVB treatments. Interestingly, the early inhibitory period of DNA synthesis observed 8 h after a single UVB treatment is not detected following multiple UVB treatments. Rather, DNA synthesis is stimulated six-fold 24 h after multiple UVB treatment, a response that is higher than the peak occurring 48-56 h after a single UVB irradiation. The disappearance of the early period of inhibition when the peak of DNA synthesis shifts to an earlier time may be linked to reactive oxygen species brought to the epidermis by infiltrating leukocytes, which, in turn, act as second messengers to stimulate growth signals in cells. Topical applications of HT or CT remarkably inhibit the DNA responses to single and multiple UVB treatments, an effect that is dependent on the dose and time of administration. Indeed, the peak stimulation of DNA synthesis is maximally inhibited when 17 mg of Tarapod tannic acid (TA), an HT, are applied topically 20 min before a single UVB treatment. The polymeric tannins inhibited DNA synthesis to a greater degree than equal doses of their monomeric units, gallic acid and catechin. These results suggest that various oligomeric HT and CT may be useful against tumor-promoting responses associated with the exposure of skin to physical carcinogens.

Naturally occurring hydrolyzable (HT) and condensed (CT) tannins and their monomeric units were tested for their ability to inhibit the induction of epidermal ODC activity and the formation of skin edema by UVB, two responses that are linked to the hyperplastic and inflammatory components of skin tumor promotion by this agent. Hairless mice were irradiated with either single (200 mJ/cm2/sec) or multiple (150 mJ/cm2/sec) doses of UVB and epidermal ODC activity was assayed at different times following irradiation. The peak of ODC induction which is observed 30-40 hours after a single UVB irradiation increases by 2.5 fold and shifts to a much earlier time of 5 hours after two UVB treatments repeated at 24-hour intervals. Topical applications of the various plant tannins, before or after irradiation, were found to inhibit, in a dose-dependent manner, epidermal ODC activity induced by single and multiple UVB treatments. Furthermore, the various HT and CT samples resulted in significant protection against UVB radiation-caused cutaneous edema. In general, the polymeric tannins inhibited ODC induction and edema to a greater degree than equal doses of their monomeric units, gallic acid and catechin. These results, in conjunction with our prior publications, suggest that various HTs and CTs may be useful against the hyperplastic and inflammatory responses associated with the exposure of skin to the tumor-promoting effects of both physical and chemical environmental carcinogens.

Electricity is versatile, clean to use, easy to distribute and supreme to control. As important, it is now established that electricity has better productivity in many applications than most other energy products. All this has led to the wider utilization of electricity and its replacement of other forms of energy in many uses. Demand for electricity is now growing globally at a rate higher than that of economic growth and at almost 1.5-2 times that of demand for primary energy sources. With the type of technologies and applications that already exist, there is nothing to handicap electricity's advancement and it assuming a higher share of the energy market. This paper describes the world electricity scene, its new trends and orientation and the effect of all this on the global electric power generating system.

Accurate quantification of relative allele frequencies in pooled DNA samples can be carried out for microsatellite markers having a dinucleotide repeat unit, conditional on the absence of overlapping "shadow" bands. This provides a basis for extending DNA pooling to this useful class of DNA marker. Expressions for the standard error of densitometric estimates of allele frequencies from pooled samples are presented, and their statistical application is illustrated in a variety of situations. This enables DNA pooling to be utilized in situations requiring the testing of statistical hypotheses concerning differences in allele frequencies between populations, or samples.

A synovial cyst of the hip was identified by CT scan in two cases of iliac and/or femoral vein compression. In one of these cases, incomplete resection required radical treatment of the underlying condition, osteoarthritis of the hip. The authors discuss the clinical signs, aetiopathogenesis and treatment of this disease which, although rare, has been frequently reported in the literature over the last decade.

Owing to the many advantages and versatility of electricity, its share in the global demand for energy in final use is increasing. In 1990, global electricity generation amounted to 11 700 TWH and fuels for electricity production consumed 36% of the total global primary energy needs; which is more than twice their share in the 1950s. More than half of the electricity consumption occurs in OECD countries, however prospects for future demand growth are in developing countries. With increasing populations, higher economic growth, and the present modest use of electricity and energy, these countries are likely to consume a larger share of the electricity market in the future. Their demand growth rate will most likely be moderated by an acute shortage of capital. Future electricity generation technologies will aim towards improving efficiency, clean emissions, low capital cost and short lead times. Therefore, gas turbines and combined cycle plants will gradually assume a larger share of the power generating equipment market. For many decades to come, coal, because of its abundance and cheapness, will remain the world's major fuel for electricity generation. Natural gas, owing to its cleanliness, will be more in demand. However, the shares of hydro- and nuclear fuel, owing to their highly capital intensive nature and other considerations, are not likely to increase.

This paper critically reviews the various techniques utilised for maintenance scheduling of generating facilities and points out their inaccuracies in minimising the risk of system shortages. The paper describes a new maintenance scheduling algorithm based on stochastic simulation which would provide a more reliable operation for the system, and better assessment of risk and system costs.

The virulence of 66 Escherichia coli strains was evaluated in 12-day-old chicken embryos inoculated by the allantoic route. The index of virulence used was the proportion of dead embryos within 3 days of inoculation. The strains were classified into "highly virulent," "moderately virulent," and "avirulent" groups. Although both virulent and avirulent strains grew equally well in vivo in the allantoic and yolk sacs, virulent E. coli invaded the whole embryo but avirulent ones failed to do so.

The history of structural growth of the Harmaliyah oil field in eastern Saudi Arabia was studied by means of a series of paleostructural maps to determine if early entrapment of hydrocarbons played an important role in preserving the high porosity of the Kimmeridgian (Upper Jurassic) Arab D reservoir. The Arab D has been affected by shallow or preburial diagenesis--a common feature in Arabian Upper Jurassic calcarenitic reservoirs. Closure forming the structural trap in the Arab D at Harmaliyah oil field developed principally during the late Turonian (Late Cretaceous). During Kimmeridgian (Late Jurassic)-early Turonian (Late Cretaceous) time, shallow or preburial diagenesis of the calcarenitic Arab D reservoir rocks seems to have played a major part in preservation of por sity before the porosity was filled with hydrocarbons.

The virulence of 66 Escherichia coli strains was evaluated in 12-day-old chicken embryos inoculated by the allantoic route. The index of virulence used was the proportion of dead embryos within 3 days of inoculation. The strains were classified into "highly virulent," "moderately virulent," and "avirulent" groups. Although both virulent and avirulent strains grew equally well in vivo in the allantoic and yolk sacs, virulent E. coli invaded the whole embryo but avirulent ones failed to do so.