Search results for: mortality improvement

Authors: Mehves Isiklar Ekici, Ceyda Tuna Kirsaclioglu, Zarife Kuloglu, Aydan Kansu

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Malnutrition is an important cause of morbidity and mortality as it accounts for 45% of child deaths under the age of 5 worldwide. Therefore, early recognition and effective treatment of failure to thrive and malnutrition are important. In this study, it was aimed to retrospectively evaluate the nutritional support treatment approaches (nutrition education and diet enrichment / use of enteral nutrition products) applied in children followed up with growth failure without underlying organic causes, and to compare the efficacy of nutritional support treatments. In this study, children aged 1 month to 18 years diagnosed with growth failure who were followed up for at least 12 months between January 2011 and February 2020, were included. Anthropometric measurements at baseline and during follow-up, type of nutritional support therapy and treatment compliance were evaluated based on the retrospective records. 119 children (median age:3.2, 69 girls) were included in the study. Nutrition education and dietary enrichment were provided to 28% of the patients (Group 1). In addition to dietary education and recommendations, enteral nutrition supplements was given in 78% of them (Group 2). Compliance to the treatment rates of the patients in Group 1 and Group 2 were not significantly different at both 6th and 12th month controls. At the end of the follow up children who comply with the treatment in Group 1 had significant increase in weight for age z scores (-1.74 vs 0.05, respectively, p=0.019) and body mass index z scores (-1.47 vs -0.53, respectively, p=0.034) compared with baseline measurements. Similar to Group 1, in Group 2 children with treatment compliance, had a significant increase in weight for age z scores (-2.24 vs. -0.54, respectively, p=0.00) and body mass index z scores (-2.27 vs. -1.06, respectively, p=0.00) compared with baseline measurements. The rate of patients with severe malnutrition decreased from 15% to 12%, for moderate malnutrition decreased from 54% to 33%. Moreover, it was observed that this decrease in the rate of patients with both severe and moderate malnutrition was more prominent in patients under 3 years of age. Although there was a significant increase in anthropometric measurements with treatment in both groups, there was no significant difference in between two groups terms of change in anthropometric measurements (p>0.05), therefore effectiveness. Failure to thrive and malnutrition in infancy and childhood cause health problems that can affect adult life. To conclude, nutritional education - dietary enrichment. recommendations and use of enteral nutrition supplements were both proven beneficial in this study. Researchers are willing to underline that the most important part of the treatment is to include the family to the process to ensure the treatment compliance.

Keywords: enteral nutrition supplements, failure to thrive, malnutrition, nutritional education

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Authors: Atitallah Sofien, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Bouyahia Olfa, Boukthir Samir

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Introduction: Acute bronchiolitis (AB) is a real public health problem on a global and national scale. Its treatment is most often outpatient. The use of audio-visual supports, such as educational videos, is an innovation in therapeutic education in outpatient treatment. The aim of our study was to evaluate the impact of an educational video on the knowledge, attitudes, and practices of mothers of infants with AB. Methodology: This was a descriptive, analytical, and cross-sectional study with prospective data collection, including mothers of infants with AB. We assessed mothers' knowledge, attitudes, and practices regarding AB, and we created an educational video. We used a questionnaire written in Tunisian Arabic concerning sociodemographic data, mothers' knowledge and attitudes regarding AB, and their opinions on the video, as well as an observation grid to evaluate their practices on the nasopharyngeal unblocking technique. We compared the different parameters before and after watching the video. Results: We noted a statistically significant improvement in mothers' knowledge scores on AB (7.46 in the pre-test versus 14.08 in the post-test; p≤0.05), practices (12.42 in the pre-test versus 18 in the post-test; p≤0.05) and attitudes (5.86 in pre-test versus 9.02 in post-test; p≤0.05). Conclusion: The use of an educational video has a positive impact on the knowledge, practices, and attitudes of mothers towards AB.

Keywords: acute bronchiolitis, therapeutic education, mothers, educational video

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Authors: Suppawan Lertpongpakpoom, Anongnat Boonrat, Kunya BoontummoSuppawan

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This descriptive cost analysis aimed to analyze the unit cost of patients in medical intensive care unit. Purposive sampling was used to select 20 nurses, 6 practical nurses, 5 nurses aid and select samples 30 patients. Data were collected from both primary source (activity and average time of nursing care) and secondary source Z bill of payment and patient record). Instruments were cost recording form, activity observation form, and service recording form. Content validity of all instruments were evaluated by three experts (CVI = 0.87). Descriptive statistics was employed for data analysis. The results of the Activity-Based Costing Analysis showed that total activity cost of 4 service types for the patients was 14,776.92 Bath. The highest cost was nursing record was 5,674.78 Bath, followed direct nursing activity was 5,176.18 Bath, medical treatment was 1,976.6 Bath. The lowest cost was management activity was 1,003.64 Bath per visit. The result suggested that Activity-Base Costing Analysis could be applied to give better understanding of cost structure, enabling better consideration wasted expense and non-value-added activity, and improvement of effective utilization.

Keywords: activity-based costing, medical intensive care, nursing care, cost analysis

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Authors: Zainab Elazab, Azhar Aziz

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Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Wiji Wijaya

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The aim of this research is to examine the effect of internal control weaknesses and audit opinion on the state’s loss findings of audit compliance to the regulation in public sector. The samples of this research consisted of 175 local government financial statements in the area of Central Java Province at 2009 until 2013. Area sampling design was used to select the financial statements. This study using quantitative descriptive statistical analysis and regression was run for data analysis and hypothesis examination. Result of this study indicated that internal control weaknesses and audit opinion contributes a positive influence which is significant to the state’s loss findings of audit compliance to the regulation. The internal control weaknesses that affect the state's loss finding are weakness control system of accounting and reporting with the value of the critical ratio 0.010 p 2.613 ; weakness budget execution control system with critical ratio value of 3.421 p 0.001 and weaknesses internal control structure with critical ratio value of 2.246 p 0.026 . While the audit opinion with a critical ratio value of 4.401 p 0.000. The implications of this research so that policy makers at the local government should give more attention to the implementation and improvement of internal control system.

Keywords: audit compliance findings, state’s loss, audit opinion, internal control, local government

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Authors: Phannarithisen Ong

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Children's independent mobility for school trips promotes physical and mental well-being, reduces parental chauffeuring and traffic congestion, and boosts children's public confidence. However, in Thailand, despite a decade of rail mass transit development in Bangkok City, cars still queue to drop students at schools near transit stations. This worsens congestion, urging better independent mobility among children in mass transit regions. The high reliance on the private vehicle will influence the private mode in the children's adulthood. This research emphasizes mass transit use among high school students near transit systems. Through a questionnaire survey, quantitative and qualitative methods reveal key factors impacting school trip mode choice. Preliminary findings highlight children's independence as crucial. The socioeconomic, demographic, trip, and transportation traits explain private car use, even schools near mass transit stations. The outcomes of this study will shed light on urban strategic policies for improvement, advocacy, and encouragement of students using mass transit for school trips, which will help normalize the use of mass transit for such trips.

Keywords: children's independence mobility, mode choice, school trips, TOD, extraneous variable, children's independency

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Authors: Xiaoyuan Chen

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Background: This study aimed to characterize the epidemiological and clinical features of five rare subtypes of hepatocellular carcinoma (HCC) and to create a competing risk nomogram for predicting cancer-specific survival. Methods: This study used the Surveillance, Epidemiology, and End Results database to analyze the clinicopathological data of 50,218 patients with classic HCC and five rare subtypes (ICD-O-3 Histology Code=8170/3-8175/3) between 2004 and 2018. The annual percent change (APC) was calculated using Joinpoint regression, and a nomogram was developed based on multivariable competing risk survival analyses. The prognostic performance of the nomogram was evaluated using the Akaike information criterion, Bayesian information criterion, C-index, calibration curve, and area under the receiver operating characteristic curve. Decision curve analysis was used to assess the clinical value of the models. Results: The incidence of scirrhous carcinoma showed a decreasing trend (APC=-6.8%, P=0.025), while the morbidity of other rare subtypes remained stable from 2004 to 2018. The incidence-based mortality plateau in all subtypes during the period. Clear cell carcinoma was the most common subtype (n=551, 1.1%), followed by fibrolamellar (n=241, 0.5%), scirrhous (n=82, 0.2%), spindle cell (n=61, 0.1%), and pleomorphic (n=17, ~0%) carcinomas. Patients with fibrolamellar carcinoma were younger and more likely to have non-cirrhotic liver and better prognoses. Scirrhous carcinoma shared almost the same macro clinical characteristics and outcomes as classic HCC. Clear cell carcinoma tended to occur in the Asia-Pacific elderly male population, and more than half of them were large HCC (Size>5cm). Sarcomatoid (including spindle cell and pleomorphic) carcinoma was associated with larger tumor size, poorer differentiation, and more dismal prognoses. The pathological subtype, T stage, M stage, surgery, alpha-fetoprotein, and cancer history were identified as independent predictors in patients with rare subtypes. The nomogram showed good calibration, discrimination, and net benefits in clinical practice. Conclusion: The rare subtypes of HCC had distinct clinicopathological features and biological behaviors compared with classic HCC. Our findings could provide a valuable reference for clinicians. The constructed nomogram could accurately predict prognoses, which is beneficial for individualized management.

Keywords: hepatocellular carcinoma, pathological subtype, fibrolamellar carcinoma, scirrhous carcinoma, clear cell carcinoma, spindle cell carcinoma, pleomorphic carcinoma

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Authors: G. Lancellotta, G. Di Salvo, A. Rigazio, A. Davout, V. Pastore, G. Tonoli, A. Martin, P. Jullien, R. Jagow-Klaff, R. Wernecke

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Artificial ground freezing (AGF) technique is a well-proven soil improvement approach used worldwide to construct shafts, tunnels and many other civil structures in difficult subsoil or ambient conditions. As part of the extension of Line 14 of the Paris subway, a passenger interchange tunnel between the new station at Porte de CI ichy and the new Tribunal the Grand Instance has been successfully constructed using this technique. The paper presents the successful application of AGF by Liquid Nitrogen and Brine implemented to provide structural stability and groundwater cut-off around the passenger interchange tunnel. The working conditions were considered to be rather challenging, due to the proximity of a hundred-year-old existing service tunnel of the Line 13, and subsoil conditions on site. Laboratory tests were carried out to determine the relevant soil parameters for hydro-thermal-mechanical aspects and to implement numerical analyses. Monitoring data were used in order to check and control the development and the efficiency of the freezing process as well as to back analyze the parameters assumed for the design, both during the freezing and thawing phases.

Keywords: artificial ground freezing, brine method, case history, liquid nitrogen

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Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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Authors: Esperanza Garcia-Uceda, Josefina L. Murillo-Luna, M. Pilar Latorre-Martinez, Marta Ferrer-Serrano

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Social entrepreneurship represents an innovation of traditional business models. During the last decade, its important role in contributing to rural and regional development has been widely recognized, due to its capacity to combat the problem of depopulation through the creation of employment. However, the success of this type of innovative business initiatives depends to a large extent on the existence of an adequate ecosystem of support resources. Based on the theoretical framework of the quadruple helix (QH), which highlights the need for collaboration between different interest groups -university, industry, government and civil society- for the development of regional innovations, in this work the network analysis is applied to study the ecosystem of resources to support social entrepreneurship in the rural area of the province of Zaragoza (Spain). It is a quantitative analysis that can be used to measure the interactions between the different actors that make up the quadruple helix, as well as the networks created between the different institutions and support organizations, through the study of the complex networks they form. The results show the importance of the involvement of local governments and the university, as key elements in the development process, but also allow identifying other issues that are susceptible to improvement.

Keywords: ecosystem of support resources, network analysis, quadruple helix, social entrepreneurship

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Authors: Lai Tzu-Hsuan, Lai Jung-Nien, Lin Jaung-Geng, Kao Shung-Te, Hsuan-Kuang Jung

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Background: Whether acupuncture therapy contributes to preserving residual renal function (RRF) remains largely unknown. This case series evidenced the potential beneficial effects of acupuncture for preserving RRF in five patients with the end-stage renal disease under hemodialysis (HD) treatment. Participants: Five patients on HD receiving eight sessions of weekly 30-min interdialytic acupuncture (Inter-A) with residual urine volume (rUV) and residual glomerular filtration rate (rGFR) recorded once every two weeks were included for analysis. Outcomes: Changes in rUV and rGFR calculated using 24-hour urine collection data were analyzed to assess RRF. Variations in hemoglobin, urea Kt/V and serum albumin levels measured monthly were analyzed to evaluate HD adequacy. Results: After eight Inter-A sessions, mean (standard deviation (SD)) rUV and rGFR increased from 612 (184) ml/day and 1.48 (.94) ml/min/1.73 m2 at baseline to 803(289) ml/day and 2.04(1.17) ml/min/1.73m2 at 2- and 4-week follow-up, respectively. The mean percentage difference increased by 31% in rUV and 38% in rGFR. Routine measurements on HD adequacy also showed improvement. Conclusions: Acupuncture might be an optional add-on treatment for HD population with poor control of water; however, further well-designed controlled trials are warranted.

Keywords: end-stage renal disease, hemodialysis, acupuncture, residual renal function, residual urine volume

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Authors: Elia Caldini, Cláudia N. Battlehner, Marcelo A. Ferreira, Rolf Gemperli, Nivaldo Alonso, Luiz P. Vana

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The advent of dermal regenerate templates has fostered major advances in the treatment of acute burns and their sequelae, in the last two decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are still lacking. The goal of this study was to prospectively analyze the outcome of patients treated with two of the existing templates, followed by thin skin autograft. They are both made of bovine collagen, one includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from burn sequelae (n = 12 per template). Negative pressure therapy was applied post-surgically; patients were monitored for 12 months. Data on scar skin quality (Vancouver and POSAS evaluation scales), rate of joint mobility recovery, and graft contraction were recorded. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The silicone-coupled template showed the best performance in all aspects.

Keywords: dermal regeneration template, artificial skin, skin quality, scar contracture

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Authors: Y. D. Lim, K. S. Yap, K. T. Ooi

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Cross Vane Expander Compressor (CVEC) is a newly invented expander-compressor combined unit, where it is introduced to replace the compressor and the expansion valve in traditional refrigeration system. The mathematical model of CVEC has been developed to examine its performance, and it was found that the energy consumption of a conventional refrigeration system was reduced by as much as 18%. It is believed that energy consumption can be further reduced by optimizing the device. In this study, the coefficient of performance (COP) of CVEC has been optimized under predetermined operational parameters and constrained main design parameters. Several main design parameters of CVEC were selected to be the variables, and the optimization was done with theoretical model in a simulation program. The theoretical model consists of geometrical model, dynamic model, heat transfer model and valve dynamics model. Complex optimization method, which is a constrained, direct search and multi-variables method was used in the study. As a result, the optimization study suggested that with an appropriate combination of design parameters, a 58% COP improvement in CVEC R134a refrigeration system is possible.

Keywords: COP, cross vane expander-compressor, CVEC, design, simulation, refrigeration system, air-conditioning, R134a, multi variables

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Authors: Gómez Romero Jacob, García Peña Elvia Inés

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The co-digestion process of crude cheese whey (CCW) with fruit vegetable waste (FVW) for biohydrogen production was investigated in batch and continuous systems, in stirred 1.8 L bioreactors at 37°C. Five different C/N ratios (7, 17, 21, 31, and 46) were tested in batch systems. While, in continuous system eight conditions were evaluated, hydraulic retention time (from 60 to 10 h) and organic load rate (from 21.96 to 155.87 g COD/L d). Data in batch tests showed a maximum specific biohydrogen production rate of 10.68 mmol H2/Lh and a biohydrogen yield of 449.84 mL H2/g COD at a C/N ratio of 21. In continuous co-digestion system, the optimum hydraulic retention time and organic loading rate were 17.5 h and 80.02 g COD/L d, respectively. Under these conditions, the highest volumetric production hydrogen rate (VPHR) and hydrogen yield were 11.02 mmol H2/L h, 800 mL H2/COD, respectively. A pyrosequencing analysis showed that the main acclimated microbial communities for co-digestion studies consisted of Bifidobacterium, with 85.4% of predominance. Hydrogen producing bacteria such as Klebsiella (9.1%), Lactobacillus (0.97%), Citrobacter (0.21%), Enterobacter (0.27%), and Clostridium (0.18%) were less abundant at this culture period. The microbial population structure was correlated with the lactate, acetate, and butyrate profiles obtained. Results demonstrated that the co-digestion of CCW with FVW improves biohydrogen production due to a better nutrient balance and improvement of the system’s buffering capacity.

Keywords: acclimatation, biohydrogen, co-digestion, microbial community

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Authors: Araba A. Z. Osei-Tutu, Ebenezer Odame, Joseph Bawa, Samuel Amponsah

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Education is recognized as a fundamental human right and a catalyst for development. Despite progress in the provision of higher education on the African continent, there persist challenges with the tripartite areas of access, equity and quality. Therefore, this systematic review aimed at providing a comprehensive overview of conversations and voices of scholars on these three concepts in HE in Africa. The systematic review employed a thematic analysis approach, synthesizing findings from 38 selected sources. After a critical analysis of the sources included in the systematic review, deficits in access, quality, and equity were outlined, focusing on infrastructure, regional disparities, and privatization challenges. The review also revealed the weak enforcement of quality assurance measures. Strategies for improvement, proffered by the study, include expanding public sector HE, deregulating the educational sector, promoting open and distance learning, implementing preferential admission policies, and enhancing financial aid. This research contributes valuable insights for policymakers, educators, and stakeholders, fostering a collaborative approach to address challenges and promote holistic development in African higher education.

Keywords: access, equity, quality, higher education, Africa, systematic review, strategies

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Authors: Kartika Marta Budiana

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Low competence in speaking for the students of Non English native speakers have been crucial so far for the teachers in language teaching in Indonesia. This study attempts to explore the effect of video using in teaching speaking onstudents of non-native English speakers at STIE Perbanas Surabaya. This includes investigate the students` attitudes toward the video used in classroom. This is a quantitative research that is an experimental one based on analyses derived the concepts of from teaching speaking and the use of video. There are two classes observed, the experimental and the control one. The experimental consist of 28 students and the control class consists of 25 students. Before the treatment given, both of the group is given the pre-test to check their ability level. Then, after the treatment is given, the post-test is given to the both groups. Then, the students were given treatment how to conduct a meeting that they learnt from a video of business English. The post test was held after they undergone a treatment. The instruments to get the data are the oral test and questionnaire. The data of this study is students` score and from the tests` score it can be seen there is a positive significant difference in the experimental group. The t-test to test hypothesize also shows that it is accepted which said that there is an improvement on the students` speaking competence achievement. In conclusion, the video effects on the significant difference on the students speaking competence achievement.

Keywords: video, teaching, speaking, Indonesia

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Authors: M. Kislu Noman, Syed Mohammed Shamsul Islam, Shahriar Hassan, Raihana Pervin

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With the increasing rate of wireless devices and high bandwidth operations, wireless networking and communications are becoming over crowded. To cope with such crowdy and messy situation, massive MIMO is designed to work with hundreds of low costs serving antennas at a time as well as improve the spectral efficiency at the same time. TDD has been used for gaining beamforming which is a major part of massive MIMO, to gain its best improvement to transmit and receive pilot sequences. All the benefits are only possible if the channel state information or channel estimation is gained properly. The common methods to estimate channel matrix used so far is LS, MMSE and a linear version of MMSE also proposed in many research works. We have optimized these methods using genetic algorithm to minimize the mean squared error and finding the best channel matrix from existing algorithms with less computational complexity. Our simulation result has shown that the use of GA worked beautifully on existing algorithms in a Rayleigh slow fading channel and existence of Additive White Gaussian Noise. We found that the GA optimized LS is better than existing algorithms as GA provides optimal result in some few iterations in terms of MSE with respect to SNR and computational complexity.

Keywords: channel estimation, LMMSE, LS, MIMO, MMSE

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Authors: Mohammed Mahmood, Walid Tizani, Carlo Sansour

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In this paper, experimental testing and numerical analysis were used to investigate the effect of tube thickness on the face bending for concrete filled hollow sections connected to other structural members using Extended Hollobolts. Six samples were tested experimentally by applying pull-out load on the bolts. These samples were designed to fail by column face bending. The main variable in all tests is the column face thickness. Finite element analyses were also performed using ABAQUS 6.11 to extend the experimental results and to quantify the effect of column face thickness. Results show that, the column face thickness has a clear impact on the connection strength and stiffness. However, the amount of improvement in the connection stiffness by changing the column face thickness from 5 mm to 6.3 mm seems to be higher than that when increasing it from 6.3 mm to 8 mm. The displacement at which the bolts start pulling-out from their holes increased with the use of thinner column face due to the high flexibility of the section. At the ultimate strength, the yielding of the column face propagated to the column corner and there was no yielding in its walls. After the ultimate resistance is reached, the propagation of the yielding was mainly in the column face with a miner yielding in the walls.

Keywords: anchored bolted connection, Extended Hollobolt, column faces bending, concrete filled hollow sections

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Authors: Shimaa A. Higazy, Mohamed S. Selim, Olfat E. El-Azabawy, Abeer A. Hassan

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We designed novel epoxy/graphitic carbon nitride (g-C₃N₄) nanocomposite materials as suitable surface coatings. g-C₃N₄ nanosheets were facilely prepared and dispersed in the epoxy resin via solution casting. This research focuses on the mechanical and anticorrosion properties of g-C₃N₄ nanofiller reinforced epoxy nanocomposites. The structures, sizes, and morphologies of designed polymeric nanocomposites and nanofillers were elucidated using various techniques such as FT-IR, NMR, FE-TEM, FE-SEM. The developed nanocomposite was applied as a surface coating by air-assisted spray method. The structure-property relationship was studied for different concentrations of nanofiller in the epoxy matrix. The anticorrosive properties were studied via electrochemical experiments, including potentiodynamic polarization, electrochemical impedance, and open-circuit potential analyses, as well as salt spray test. Mechanical durability was assessed by various methods, such as impact, T-bending, and crosscut tests. Surface heterogeneity, elasticity, and corrosion-resistance features are among the merits of developed composite. The highest improvement was achieved with well dispersion of g-C₃N₄ sheets fillers. This fascinating epoxy nanostructured coating provides a promising anticorrosive coatings for a sustainable future environment.

Keywords: epoxy, nanocomposite, surface coating, anticorrosive properties, mechanical durability

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Authors: Jaspreet Kaur, Parminder Nain, Vipin Saini, Sumitra Dahiya

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Elaeocarpus sphaericus has been traditionally used in the Indian traditional medicine system for the treatment of stress, anxiety, depression, palpitation, epilepsy, migraine and lack of concentration. The study was investigated to evaluate the neurological potential such as anxiolytic, muscle relaxant and sedative activity of methanolic extract of Elaeocarpus sphaericus stem bark (MEESSB) in mice. Preliminary phytochemical screening and acute oral toxicity of MEESSB was carried out by using standard methods. The anxiety was induced by employing Elevated Plus-Maze (EPM), Light and Dark Test (LDT), Open Field Test (OFT) and Social Interaction test (SIT). The motor coordination and sedative effect was also observed by using actophotometer, rota-rod apparatus and ketamine-induced sleeping time, respectively. Animals were treated with different doses of MEESSB (i.e.100, 200, 400 and 800 mg/kg orally) and diazepam (2 mg/kg i.p) for 21 days. Brain neurotransmitters like dopamine, serotonin and nor-epinephrine level were estimated by validated methods. Preliminary phytochemical analysis of the extract revealed the presence of tannins, phytosterols, steroids and alkaloids. In the acute toxicity studies, MEESSB was found to be non-toxic and with no mortality. In anxiolytic studies, the different doses of MEESSB showed a significant (p<0.05) effect on EPM and LDT. In OFT and SIT, a significant (p<0.05) increase in ambulation, rearing and social interaction time was observed. In the case of motor coordination activity, the MEESSB does not cause any significant effect on the latency to fall off from the rotarod bar as compared to the control group. Moreover, no significant effects on ketamine-induced sleep latency and total sleeping time induced by ketamine were observed. Results of neurotransmitter estimation revealed the increased concentration of dopamine, whereas the level of serotonin and nor-epinephrine was found to be decreased in the mice brain, with MEESSB at dose 800 mg/kg only. The study has validated the folkloric use of the plant as an anxiolytic in Indian traditional medicine while also suggesting potential usefulness in the treatment of stress and anxiety without causing sedation.

Keywords: anxiolytic, behavior experiments, brain neurotransmitters, elaeocarpus sphaericus

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Authors: Gobinda Gopal Khan, Ashutosh K. Singh, Debasish Sarkar

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This study reports the facile fabrication of 1D ZnO/α-Fe2O3 semiconductor nano-heterostructures (SNHs), and we investigate the strong interfacial interactions at the heterojunction, resulting in novel multifunctionality in the hybrid structure. ZnO-coated α-Fe2O3 nanowires (NWs) have been prepared by combining electrodeposition and wet chemical methods. Significant improvement in electrical conductivity, photoluminescence, and room temperature magnetic properties have been observed for the ZnO/α-Fe2O3 SNHs over the pristine α-Fe2O3 NWs because of the contribution of the ZnO nanolayer. The increase in electrical conductivity in ZnO/α-Fe2O3 SNHs is because of the increase in free electrons in the conduction band of the SNHs due to the formation of type-II n-n band configuration at the heterojunction. The SNHs are found to exhibit enhanced visible green photoluminescence along with the UV emission at room temperature. The band-gap emission of the α-Fe2O3 NWs coupled to the defect emissions of the ZnO in SNHs can be attributed to the profound enhancement of the visible green luminescence. Ferromagnetism of the SNHs is found to be increased nearly five times in magnitude over the primeval α-Fe2O3 NWs, which can be ascribed to the exchange coupling of the interfacial spin at ZnO/α-Fe2O3 interface, the surface spin of ZnO nanolayer, along with the structural defects like the cation vacancies (VZn) and the singly ionized oxygen vacancies (Vo•) present in SNHs.

Keywords: nano-heterostructures, photoluminescence, electrical property, magnetism

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Authors: Kathleen Moyer, Nora Ait Boucherbil, Murtaza Zohair, Janna Eaves-Rathert, Cary Pint

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This study demonstrates the significance of interface engineering in the field of structural energy by being the first case where the performance of the system with the structural battery is greater than the performance of the same system with a battery separate from the system. The benefits of improving the interface in the structural battery were tested by creating carbon fiber composite batteries (and independent graphite electrodes and lithium iron phosphate electrodes) with and without an improved interface. Mechanical data on the structural batteries were collected using tensile tests and electrochemical data was collected using scanning electron microscopy equipment. The full-cell lithium-ion structural batteries had capacity retention of over 80% exceeding 100 cycles with an average energy density of 52 W h kg−1 and a maximum energy density of 58 W h kg−1. Most scientific developments in the field of structural energy have been done with supercapacitors. Most scientific developments with structural batteries have been done where batteries are simply incorporated into the structural element. That method has limited advantages and can create mechanical disadvantages. This study aims to show that a large improvement in structure energy research can be made by improving the interface between the structural device and the battery.

Keywords: composite materials, electrochemical performance, mechanical properties, polymer interface, structural batteries

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Authors: Se-Hyuk Park, Hee-Jung Seo

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Previous studies have investigated effective coping strategies for excessive stress, positive adaptation, resilience, mental health, and personal growth. However, to the best of the authors' knowledge, little research has been conducted to investigate how Koreans with physical disabilities deal with the COVID-19 pandemic. The purpose of this study was to identify coping strategies and coping resources that Koreans with physical disabilities utilized during the COVID-19 crisis. This study used semi-structured, in-depth interviews with 15 participants. Data were qualitatively analyzed using the constant comparative method with content mapping and content mining questions. We identified three salient themes that were used by participants as coping strategies to deal with various COVID-related challenges: (a) engagement in meaningful activities, (b) improvement of social and emotional support, and (c) experience of resilience. The findings of the present study highlighted that Korean adults with SCI actively engaged in various leisure activities, maintained and developed closer social relationships, and experienced resilience to face COVID-19-related stressors. These coping strategies were noted as a catalyst for physical health as well as psychological well-being of individuals with SCI.

Keywords: spinal cord injury, covid-19 pandemic, coping strategies, coping resources, leisure

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Authors: J. Chow

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In laboratory settings, this study measured and reported the effects of undergraduate students watching animated videos on learning microeconomics as compared with the effectiveness of reading written texts. The study described an experiment on learning microeconomics in higher education using two different types of learning materials. It reported the effectiveness on microeconomics learning of watching animated videos and reading written texts. Undergraduate students in the university were randomly assigned to either a ‘video group’ or a ‘text group’ in the experiment. Previously-validated multiple-choice questions on fundamental concepts of microeconomics were administered. Both groups showed improvement between the pre-test and post-test. The experience of learning using text and video materials was also assessed. After controlling the student characteristics variables, the analyses showed that both types of materials showed comparable level of perceived learning experience. The effect size and statistical significance of these results supported the hypothesis that animated video is an effective alternative to text materials as a learning tool for students. The findings suggest that such animated videos may support teaching microeconomics in higher education.

Keywords: animated videos for education, laboratory experiment, microeconomics education, undergraduate economics education

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Authors: S. Alrekabi, A. Cundy, A. Lampropoulos, I. Savina

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Due to their remarkable mechanical properties, multi-wall carbon nanotubes (MWCNTs) are considered by many researchers to be a highly promising filler and reinforcement agent for enhanced performance cementitious materials. Currently, however, achieving an effective dispersion of MWCNTs remains a major challenge in developing high performance nano-cementitious composites, since carbon nanotubes tend to form large agglomerates and bundles as a consequence of Van der Waals forces. In this study, effective dispersion of low concentrations of MWCNTs at 0.01%, 0.025%, and 0.05% by weight of cement in the composite was achieved by applying different sonication conditions in combination with the use of polycarboxylate ether as a surfactant. UV-Visible spectroscopy and Transmission electron microscopy (TEM) were used to assess the dispersion of MWCNTs in water, while the dispersion states of MWCNTs within the cement composites and their surface interactions were examined by scanning electron microscopy (SEM). A high sonication intensity applied over a short time period significantly enhanced the dispersion of MWCNTs at initial mixing stages, and 0.025% of MWCNTs wt. of cement, caused 86% and 27% improvement in tensile strength and compressive strength respectively, compared with a plain cement mortar.

Keywords: dispersion, mechanical performance, multi wall carbon nanotubes, sonication conditions

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Authors: Jaleh Shoshtarian Malak, Niloofar Mohamadzadeh

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Managing pre-hospital emergency patients requires real-time practices and efficient resource utilization. Since we are facing a distributed Network of healthcare providers, services and applications choosing the right resources and treatment protocol considering patient situation is a critical task. Delivering care to emergency patients at right time and with the suitable treatment settings can save ones live and prevent further complication. In recent years Multi Agent Systems (MAS) introduced great solutions to deal with real-time, distributed and complicated problems. In this paper we propose a multi agent based pre-hospital emergency management architecture in order to manage coordination, collaboration, treatment protocol and healthcare provider selection between different parties in pre-hospital emergency in a self-organizing manner. We used AnyLogic Agent Based Modeling (ABM) tool in order to simulate our proposed architecture. We have analyzed and described the functionality of EMS center, Ambulance, Consultation Center, EHR Repository and Quality of Care Monitoring as main collaborating agents. Future work includes implementation of the proposed architecture and evaluation of its impact on patient quality of care improvement.

Keywords: multi agent systems, pre-hospital emergency, simulation, software architecture

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Authors: Kirsty Biggs, Peter Larsen-Disney

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Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

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Authors: Mehrnoosh Askarizadeh

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In an ever changeable and globalized world with new economic and global competitors competing for the same customers and resources, is increasing the pressure on organizations' competitiveness. In addition, organizations faces additional challenges due to an ever-growing amount of data and the ever-bigger challenge of analyzing that data and keeping the data secure. Successful companies are characterized by exploiting their intellectual capital in an efficient manner. Thus, the most valuable asset an organization has today has become its employees' knowledge. To enable this, there is a tool that supports easier handling and optimizes the use of knowledge, which is knowledge management. Based on the theoretical framework and careful review as well as analysis of interviews and observations resulted in six essential areas: structure, management, compensation, communication, trust and motivation. The analysis showed that the scientific articles and literature have different perspectives, different definitions and are based on different theories but the essence is that they all finally seems to arrive at the same result and conclusion, although with different viewpoints and perspectives. This is regardless of whether the focus is on management style, rewards or communication they all focus on the individual. The conclusion is that organizational culture affects knowledge management and dissemination of information, because of its direct impact on the individual. The largest and most important underlying factor why we choose to participate in improvement work or share knowledge is our motivation. Motivation is the reason for and the reason behind our actions.

Keywords: lean, lean production, knowledge management, information management, motivation

Procedia PDF Downloads 506