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Physicists are generally trained in the Standard Model of Physics (SMP). This implies that they perceive and account for only 3 dimensions of space in a moment in time (3S-1t) (a 4-dimensional [4D] model). However, applying the SMP, more than fifty significant conundrums have arisen that are unexplained or incomplete. Explaining these within the SMP 4D fabric led to hypothesizing a ‘fifth force’, most recently the hypothetical ‘X17 particle’. We propose this hypothetical X17 may better be explained by a 9-dimensional model (9D) with gimmel. Our model, the Neppe-Close Triadic Dimensional Vortical Paradigm (TDVP) has amplified the ‘physics’ from 4 dimensions to 9D, specifically first postulating and then further demonstrating mathematically—starting with derivations of the Cabibbo angle—that 9 dimensions must exist. Moreover, this data is empirically demonstrated because the neutron, proton and electron mass-energy-gimmel equivalence in the Triadic Rotational Units of Equivalence (TRUE) as part of the TDVP model, exactly corresponds with the normalized data for the mass-energy equivalence volumetric data for these particles in the CERN Large Hadron Collider. This data shows definitively that we exist in a 9-dimensional finite, quantized, volumetric, spinning reality. This is, furthermore, embedded in an infinite continuity (9D+). Mathematically, applying this 9D+ model definitively requires an extra third component that is massless and energyless (‘gimmel’). Without gimmel, no particle in the universe would be stable. TDVP unifies nature because the same laws apply across the quantum, macro-world and cosmological reality. Our 4D experience is simply the physical component of 9D+ existence. Summary Amplification: At all levels, there is the consistent application of a 9-Dimensional quantized finite reality embedded within an infinite continuity. The application of gimmel specifically requires applying the 9-dimensional model and is based on necessary mathematical calculations not only at the quantal level (where the fifty plus unsolved, unexplained or contradictory conundrums can be explained somewhat, and there is no longer ‘quantum weirdness’), but at the macroscale level with more gimmel in the life elements (which, additionally, are consistently all cubic multiples of 108 cubed), as well as cosmologically, where the correlations with proportionate Dark Matter and Dark Energy are overwhelming. Moreover, these 9-dimensional plus factors together with Triadic Rotational Units of Equivalence (TRUE) and gimmel, allow numerous solutions that couldn’t otherwise be solved. For example, importantly, applying the simple mathematics of TRUE, we can demonstrate why gluons, while adequate in 4D, are impossible applying 9D. These solutions are simpler because we have markedly adapted George Spencer-Brown’s ‘Laws of Form’ to applying a new method of mathematical calculation, Edward Close’s ‘Calculus of Distinctions’ (COD) which recognizes quantal limits and that the nature of finite reality is quantized and volumetric. The COD includes distinguishing between content, extent, and impact. We emphasize the pioneering works of Wolfgang Pauli with his multidimensional model and his ‘Pauli Exclusion Principle’, Alfred Whitehead with ‘Process Philosophy’ and his ‘Principia Mathematica’ (with Bertrand Russell), Georg Cantor with Set Theory, and Roger Penrose with spinors and twistors. TDVP is a prime example of our broad new specialty of ‘Dimensional Biopsychophysics’ (DBP). DBP extends physics, consciousness, and the biopsychosocial to extra dimensions and applies mathematics empirically. Like Max Tegmark, we recognize the key role of mathematics as fundamental in nature, not just for application in calculation and operations.

The Federal and State governments have declared the presence of an opioid addiction pandemic in the United States claiming the lives of more than 55,000 in 2015 (Rudd RA, Seth P, David F and Scholl L. 2016). The pharmaceutical manufacturers of the numerous FDA-approved opioid drugs are raking in more than $5 billion per year with about 2 million chronic pain sufferers addicted. The irony of this narcotic use and abuse conundrum is the existence of evidence-based technology for drug-free pain management which is not covered for reimbursement among public and private third-party payers. Therefore, this paper is presented to propose a pilot study to demonstrate the efficacy of resolving the chronic inflammation, edema and ischemia that causes non-malignant chronic pain with PEMF therapy, a non-invasive, non-thermal radio transmission of electrical impulses, thereby invalidating the legitimacy of prescribing opioid analgesics in such cases.

Circular Economy, Sustainability, Design for Environment are some of the keywords that identify new formidable challenges to be faced in the next years. Raw materials have a dominant role in reaching that goal. Green energy, electric vehicles, communication, etc. depends on raw materials labeled as critical because of their economic importance coupled with high supply risk. For this reason, mitigating actions need to be used in materials selection and design such as material substitution, improved materials efficiency and recycling. In this technical communication, a method to implement raw materials criticality issues in materials selection is described according to the recent literature. The strategy is based on Ashby’s approach and the definition of the alloy criticality index quantifying the criticality per unit of mass of the material.

Healthcare is realizing the importance of health information technology - its applications and devices in play today. Advancing healthcare best practices will rely on up to date data and analysis to provide the most effective forms of therapy. Healthcare is becoming more reliant on patients who are engaging in their own healthcare. With this we are seeing an increase in available health related apps for these devices. This summary reviews various connected health strategies using proven apps and devices to improving the quality of care, promoting patient engagement, and improving outcomes. Here we discuss several trends and the healthcare delivery implications.

A quantum mechanical model that considers tunneling and inelastic scattering has been applied to explain the hole transfer reaction from a G (Guanine) base to a GGG base cluster through a barrier of Adenine bases, (A)n (n = 1-16). For n = 1, the ratio of tunneling to inelastic scattering is about 6, which is sharply decreased to around 0.23 and 5.23 × 10-8 for n = 4 and 16 respectively, suggesting dominance of inelastic scattering for n ≥ 4. As in experiment, the calculated product yield ratios (PGGG) exhibit a strong distance dependence for n < 4, and a weak distance dependence for n ≥ 4. We also predict conditions under which oscillatory or non-oscillatory charge transfer (CT) yield are expected.

The purpose of this study was to differentiate between muscular activity of three different types of belt squats (SquatMax-MD, Pit Shark and Monster Rhino) and the muscle activation of the rectus femoris, vastus medialis oblique, gluteus maximus, and gluteus medius. Fourteen healthy, male athletes, over the age of 18 years, performed 2 sets of 5 repetitions on each of the three belt squat machines with a weight equivalent to each participant’s body weight. Athletes were given at least 2 minutes of rest between each set and condition. Electromyographic data were collected from four muscles: rectus femoris, vastus medialis oblique, gluteus maximus, and gluteus medius muscles. ANOVA revealed the SquatMax-MD belt squat resulted in the highest muscle activation in every muscle, with significantly higher activity in the rectus femoris, vastus medialis oblique, and gluteus medius muscles. The Monster Rhino belt squat produced the second highest muscle activation with the Pit Shark belt squat creating the lowest muscle activation. In totality, the SquatMax-MD produced 38.7% greater muscle activation than the Monster Rhino and 12.2% greater activation than the Pit Shark. The belt squat can be an advantageous exercise because it can effectively load the lower body while de-loading the spine and upper body. The difference in activation between the SquatMax-MD and other belt squats may be due, in part, to the design of the machines. The additional activation produced by the SquatMax-MD belt squat may be useful for individuals seeking hypertrophy, strength, or a reduction in injury risk.

Nurses play a vital role in acute care hospitals and health care delivery. The purpose of this research study is to identify the nurse’s perception of the Clinical Ladder Program at their hospital and the correlation it has on the nurse’s job satisfaction and their professional development. A quantitative study will be conducted using two convenience samples from Alexian Brothers Hospital and Saint Anthony’s hospital with a total of 52 nurses who are currently participating in the clinical ladder program.

Clinical physicians believe they are drowning . . . because they are! Between complying with an ever-changing landscape of time-wasting federal regulations, avoiding Health Insurance Portability and Accountability Act violations, plus the entire billing process, who can keep up with the literature, study a patient’s medical history, or even talk with a patient?!? 

The Uranium extraction and processing plant of INB (Brazilian Nuclear Industries) is in Caetité, a city located in a region hosting the largest Uranium reserve of the country. The degree of Uranium contamination in the Caetité population was investigated before using teeth as bioindicator, where a quite high Uranium concentration was measured in this region, about 160 times higher than the world-wide average. Radiobiological risks are here evaluated from Uranium burdens in organs as skeleton, kidneys, liver, tissues and blood, which were estimated from transfer coefficients and effective internal doses. This was accomplished by means of calculations with the use of the STATFLUX/ICRP approach, plus a set of Uranium transfer rate parameters as function of individual’s age assuming an uninterrupted exposure over a period of 60 years. It was found that U ingestion rates by residents of Caetité are three orders of magnitude higher than worldwide average, indicating that food and water would exhibit high levels of contamination. Calculated effective internal doses range from a minimum of one to a maximum of three orders of magnitude higher than background doses, for blood and bones respectively. The likelihood that this circumstance could lead to serious health problems as e.g. neoplasia is addressed. The methodology presented in this work offers subsidies for further studies on environmental pollution by radionuclides.

The effect of the intrinsic lutetium radioactivity on the detection performances of a LYSO based in-beam PET-like prototype used for quality control of hadrontherapy treatments is studied. This radioactivity leads to a background that degrades the measurement of the β+ signal. In particular, it prevents the measurement of faint signals originating from low activity β+ sources. This paper presents a method to estimate the minimum β+ activity that can be measured for any acquisition time taking into account the non-extensible dead time of the detector. This method is illustrated with experimental data collected with the in-beam PET-like prototype. The results presented in this paper are therefore specific to this detector. The method can however be applied in other contexts, either to other lutetium based PET detectors or even to non-PET detectors affected by lutetium radioactivity. The dead time correction formalism can also be used generally to scale signal and background yields in any non-paralizable detector, even those in which the background is not due to the presence of intrinsic radioactivity.

Introduction: A patient satisfaction is considered as one of the desire outcomes of health care and it is directly related with utilization of health services. However, its level is falls at the fundamental level in developing countries including Ethiopia. Objective: To assess the level of patients’ satisfaction and its associated factors at Dessie Referral Hospital, Northeast Ethiopia Methods and Materials: An institutional based cross-sectional study design was employed from May 1 to June 1 2019. A total of 374 patients were selected by using systematic sampling technique and interviewer administer structured questionnaire was used to collect data. After data collection, the data were checked for its completeness and entered into Epi data version 3.1. The data were presented in frequency distribution tables and graphs. Both bivariable and multivariable logistic regression were applied to identify factors at a p < 0.05. Result: Among total study participants, 220 (58.8%) patients were satisfied with nursing care service. Patients who had particular nurse for nursing care were more likely satisfied than those who didn’t have particular nurse for nursing care (AOR = 2.01, 95% CI: 1.212 - 3.334). Patients who had other diseases in addition to current health problem were more likely satisfied (AOR = 0.45 & 95% CI: 0.196 - 1.031) compared with patients who had not. Conclusion: In this finding, the level of patients’ satisfaction towards nursing care was low. Having specific or particular nurse and presence of comorbid disease were factors associated with patients’ satisfaction towards nursing care. Health institutions should assign particular nurses for patients to improve their satisfaction and quality of care. In addition, nurses should give great attention to their patients who have co-morbid illnesses.

Background: The argument on whether extracorporeal shock-wave therapy (ESWT) is beneficial in short- term intervention in adults with plantar fasciitis. It is important and necessary to conduct a meta-analysis to make a comparatively more reliable and overall assessment of the outcomes of ESWT in the less than 6 months. Methods: We conducted a systematic review and meta-analysis of randomized control trials from MEDLINE, EMBASE and CINAHL databases from 2000 to 2020. Randomized trials that evaluated extracorporeal shock wave therapy used to treat plantar heel pain were included. Trials comparing an extra corporeal shock wave therapy with control/placebo were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identified randomized controlled trial, extracted data and assessed the methodological quality of each trial. Results: Four studies involving 645 patients were included. 3 RCTs (n = 605) permitted a pooled estimate of effectiveness based on overall success rate and composite score of visual analogue scales for pain at follow-up 1 (12 weeks). The pooled data showed no significant heterogeneity at the three-month follow-up (p - value of chi-square = 0.61, p = 0.74 and I2 = 0%). The shock wave group had a better success rate than the control group at the three-month follow-up (OR = 2.26, 95% CI = 1.62-3.15, p - < 0.00001). For reduction of pain the pooled data showed no significant heterogeneity (p - value of chi-Square 0.28 and I2 22%). There were significant differences between the ESWT and control groups for all follow-up visits (random-effect model, three trials, MD = 15.14, 95% CI = 13.86 to 16.42, < 0.00001 at three-month). Conclusion: A meta-analysis of data from three randomized-controlled trials that included a total of 605 patients was statistically significant in favor of extracorporeal shock wave therapy at follow-up 1(12 weeks).

Introduction: Contact of health care workers and patient at health facility lead to the transmission of pathogenic organisms to each other. Hospital acquired infection prevention is standardized guide lines contain multitude protocols needed to be implemented by health care workers to reduce hospital acquired infections. Objective: To assess health care workers knowledge, attitude and practice towards hospital acquired infection prevention at Dessie referral hospital. Method: Institutional based cross sectional study was conducted among health care workers. The subjects were selected by proportional allocation in each respective department and simple random sampling method was employed. Statistical package for social sciences (SPSS) was used to analyze the data and presented in frequency tables and graph. Results: 191 study subjects were participated in the study which gives a response rate of 90.5% from 211 total sample sizes. The study subjects had given their response according to self-administered questioner. The result indicates that 86.4%, 76.4% and 77% of respondents had good knowledge and favorable attitude and poor practice towards hospital acquired infection prevention respectively. Conclusion: Even though the majority of the health care workers had good knowledge and favorable attitude, more than two third of them had poor practice towards hospital acquired infection prevention. Therefore health workers should strictly follow hospital acquired infection prevention guidelines. Improving sustainable supplies like personal protective equipment, water supply and hand washing facilities at patient care site is vital to correct the poor practice of infection prevention.

Objective: The importance of understanding the perceptions of medical students to their training environment cannot be overemphasized. The study evaluated the wet lab training organized for Senior Registrars in the Neurosurgery, Division of the University College Hospital, Ibadan. Aim: The purpose of this study is to assess the experiences of postgraduate students during wet-lab training with the aim of improving the course content and introducing evidence-based and student-centered changes. Methodology: The study made use of a cross-sectional design and data were collected using the qualitative research approach. Information was elicited from all the Senior Registrars who participated in the training through in-depth interviews. Result: All the postgraduate students who participated in the training were satisfied with the course content and the method of delivery appropriated during the training. They also found it relevant to their practice. However, certain shortcomings were observed such as high cost of training, poor standard of equipment/tools, tight work schedule and short training duration. Conclusion: Hands-on training plays an important role in enhancing the quality of care and high performance in health-care service delivery. The shortcomings and suggestions for improving future trainings as reported by the residents should be addressed in order to maximize the gains of the hands-on training experience

Introduction: Physical activity (PA) directly affects Health-related quality of life. The aim of the study was to establish the relationship between physical activity levels of physiotherapists and their physical activity promotion strategies. in Hebron/West Bank. Method: The study relied on cross-section, which included 150 PTs distributed over 42 centers of Hebron areas in Palestine country. The questionnaire is based on Likert scale items pentagonal level, which included several aspects of Health-related quality of life. Statistical analysis was used to test the associations between different categorical variables (p < 0.05). Results: of total 150 participants, most of them were male 56%, their ages ranged from 25-30 years (46%), and holding bachelor’s degrees 78%. About 60% of them are in good physical health. Most participants feel vitality, depression, quit, have energy, and are happy in the most of the time. In addition, most of them believe their health is similar to that of the members of the surrounding community. The study showed there is no relationship between general health and age except in the age group over 40 years, and females are the most exposed group. In addition, there is an influence relationship between physical and psychological with age, and this effect also includes females more than males. Conclusion: Physical functioning of most of the participants was good, while most of the participants had problems with their work and the major effect was on the female category.

Objective: This descriptive study was conducted in order to determine body image perception and life satisfaction of individuals undergoing hemodialysis treatment. Material and methods: The population of the study consisted of individuals who were treated in hemodialysis units in the city center of Kırşehir. Patients. The study was conducted with 135 patients. Questionnaire, multidimensional body-self relations questionnaire, and satisfaction with life scale were used as data collection tool. Results: According to study results, total mean scores of MBSRQ were significantly low in individuals who were older than 65, illiterate, had an extended family, were unemployed, had low income, suffered from disease and underwent hemodialysis treatment for 10 years and longer, had arteriovenous fistula in vascular insertion site, had body mass index within the class of morbid obese, and had no planned transplantation. SWLS mean scores of individuals, who were in the age group of 25-34 years, high school graduate, employed, described their income status as very high, had CRF for 6-12 months, underwent hemodialysis for 6-12 months, were waiting for renal transplantation, were significantly high. As a result of the correlation analysis made between body image and life satisfaction, it was determined that there was a positive, quite significant correlation Conclusion: As a result, it was determined that hemodialysis patients were affected by body image and life satisfaction negatively due to many factors and the total score of body image scale was very low.

In the beginning of 1973 in the USSR the study of possibility of LJE designing was conducted. The reflector, located in the tail of the rocket prototype, concentrated the obtained radiation in air and ensured micro-burst that the reactive thrust was created. The successful results of different models of the reflectors tests, which were at the same time the laser light receivers, had been obtained. One should note that all experiments pointed out above were conducted with the use of electric discharge CO2- lasers with power up to 10 kW, while for the injection into orbit of different highly and technologically effective equipment (global network connections, Internet, photo-monitoring of Earth surface, debris cleaning) the radiated power substantially higher is required. Thus, for example, for SC launching with the weight 1000 kg the laser with power not less than 15 MW is necessary [1,2].

This paper is a study of nuclear reactions involving 12c + 12c nuclei carried out with a heavy-ion nucleus-nucleus optical potential derived from a new M3Y-type effective interaction, called B3Y-Fetal, within the framework of optical model at the incident energies of 112, 126.7, 240, 300, 1016 MeV. Folding analyses of the differential cross sections associated with the elastic scattering of the nuclear system, determined at these incident energies with four B3Y-Fetal-based folded potentials constructed from double folding model, have shown the DDB3Y1- and BDB3Y1-Fetal potentials to be the best in excellent agreement with previous work done with the M3Y-Reid. The agreement of the B3Y-Fetal with the famous M3Y-Reid effective interaction, which is also used for folding analysis in this work, is further buttressed and well-established by the findings of this study Herein, the values of the renormalization factor, NR ranging from 1.1117 to 0.8121, obtained with the B3Y-Fetal have been found to be slightly higher, with lower reaction cross sections, aR = 1418 - 1047 millibarns, than NR = 0.9971 - 0.8108 obtained with the M3Y-Reid effective interaction whose accompanying reaction cross sections, being higher, range from 1431 to 1050 millibarns. This depicts the B3Y-Fetal as having a better performance. Additionally, results of folding analyses have shown the best-fit folded potentials, DDB3Y1- and BDB3Y1-Fetal potentials to be in agreement at all incident energies, implying that the cold nuclear matter has an underlying soft equation of state.

Introduction: There is increasing published evidence confirming the long-term adult mental and physical health impact of childhood exposure to adverse events including different forms of abuse and family dysfunction. Looked-after Children and young people (LACYP) living in public care are known to be a highly vulnerable group, who have often experienced several pre-care poor socio-economic and family circumstances with subsequent placement instability, as well as inadequate compensatory care within the social care system. We aimed to evaluate the relationship between the adverse socio-emotional risk factors experienced by a cohort of LACYP and their emotional, behavioural and physical health needs within a South-West England Local Authority between Jan and Dec 2018. Methods: We carried out a retrospective review of the medical records of all looked-after children and young people (LACYP) within one year (Jan to Dec 2018) at the North Somerset Local Authority (NSLA). This was an audit project of the LAC Health team completed as part of the Clinical Governance strategies of the NSLA. Results: 93% (89/96) of the LACYP experienced at least one or more socio-emotional adverse risk factors. The commonest socio-emotional risk factors recorded were parent-related including poor mental health (67%), neglectful parenting (59%), drugs/alcohol abuse (45%) and domestic violence (47%). Forty-six (48%) of the LACYP had at least one or more emotional problems, 48 (50%) had neurodevelopmental conditions, while 63 (66%) had at least one or more physical problems. The most common emotional needs were behavioural problems (35%), anxiety/ depression (17%), nicotine/substance misuse (10%) and self-harm (6%). Conclusion: High levels of physical, emotional, behavioral, developmental and neurodisability disorders are prevalent among LACYP due to their high vulnerabilities to adverse life experiences and trauma while living within their biological families. Present and future clinical implications of the socio-emotional risk factors and the need for more integrated multi-agency services for addressing the diverse health needs of the LACYP were discussed. What is known? • There is increasing awareness of the relationship between childhood exposure to adverse events and long-term adult mental and physical health • Looked after children and young people (LACYP) are highly vulnerable to early traumatic and poor socio-economic circumstances exposure What this study adds: • Over 90% of LACYP experienced at least one ACE which disproportionately affected the youngest age-group • Parental factors such as childhood abuse, alcohol/substance abuse and mental health problems were the most common adverse factors experienced by the LACYP

The paper is dedicated to the consideration of the metal-carbon mesocomposites application possibilities for the medicine magnetic transport. This trend is determined by correspondent peculiarities of content and structure of mesoscopic composites. The main peculiarities of these nanosized particles are the following: a) the presence of unpaired electrons on the carbon shell; b) the structure of carbon shell from poly acetylene and carbine fragments; c) the atomic magnetic moment of inner metal is equaled to more than 1–3 μB. The creation of reactive mesoscopic materials with regulated magnetic characteristics which can find application as medicine magnetic transport within an organism is very topical. The present investigation has fundamental character. It’s based on the ideas concerning to the change of metal-carbon mesocomposites reactivity. The use is possible as metal-carbon mesocomposites both and they are modified analogously.