Search results for: acute liver failure

Authors: Thomas Schalow

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It is commonly recognized that our present curriculum is not preparing students to function in the 21st century. This is particularly true in regard to communication needs across cultures - both human and non-human. In this paper, a comprehensive theory of communication-based on communication with non-human cultures and intelligences is presented to meet the following three imminent contingencies: communicating with sentient biological intelligences, communicating with extraterrestrial intelligences, and communicating with artificial super-intelligences. The paper begins with the argument that we need to become much more serious about communicating with the non-human, intelligent life forms that already exists around us here on Earth. We need to broaden our definition of communication and reach out to other sentient life forms in order to provide humanity with a better perspective of its place within our ecosystem. The paper next examines the science and philosophy behind CETI (communication with extraterrestrial intelligences) and how it could prove useful even in the absence of contact with alien life. However, CETI’s assumptions and methodology need to be revised in accordance with the communication theory being proposed in this paper if we are truly serious about finding and communicating with life beyond Earth. The final theme explored in this paper is communication with non-biological super-intelligences. Humanity has never been truly compelled to converse with other species, and our failure to seriously consider such intercourse has left us largely unprepared to deal with communication in a future that will be mediated and controlled by computer algorithms. Fortunately, our experience dealing with other cultures can provide us with a framework for this communication. The basic concepts behind intercultural communication can be applied to the three types of communication envisioned in this paper if we are willing to recognize that we are in fact dealing with other cultures when we interact with other species, alien life, and artificial super-intelligence. The ideas considered in this paper will require a new mindset for humanity, but a new disposition will yield substantial gains. A curriculum that is truly ready for the 21st century needs to be aligned with this new theory of communication.

Keywords: artificial intelligence, CETI, communication, language

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Authors: Y. H. Mugahed Amran, Raizal S. M. Rashid, Farzad Hejazi, Nor Azizi Safiee, A. A. Abang Ali

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Experimental and analytical studies were accomplished to examine the structural behavior of precast foamed concrete sandwich panel (PFCSP) under vertical in-plane shear load. PFCSP full-scale specimens with total number of six were developed with varying heights to study an important parameter slenderness ratio (H/t). The production technique of PFCSP and the procedure of test setup were described. The results obtained from the experimental tests were analysed in the context of in-plane shear strength capacity, load-deflection profile, load-strain relationship, slenderness ratio, shear cracking patterns and mode of failure. Analytical study of finite element analysis was implemented and the theoretical calculations of the ultimate in-plane shear strengths using the adopted ACI318 equation for reinforced concrete wall were determined aimed at predicting the in-plane shear strength of PFCSP. The decrease in slenderness ratio from 24 to 14 showed an increase of 26.51% and 21.91% on the ultimate in-plane shear strength capacity as obtained experimentally and in FEA models, respectively. The experimental test results, FEA models data and theoretical calculation values were compared and provided a significant agreement with high degree of accuracy. Therefore, on the basis of the results obtained, PFCSP wall has the potential use as an alternative to the conventional load-bearing wall system.

Keywords: deflection curves, foamed concrete (FC), load-strain relationships, precast foamed concrete sandwich panel (PFCSP), slenderness ratio, vertical in-plane shear strength capacity

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Authors: Ernest Nweke

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The work of Professional Accountants and Corporate governance are synonymous and cannot be divorced from each other. Organizations, profit and non-profit alike cannot implement sound corporate practices without inputs from Professional Accountants. In today’s dynamic corporate world, good corporate governance practice is a sine qua non. More so, following the corporate failures of the past decades like Enron and WorldCom, governments around the world, including Mongolia are becoming more proactive in ensuring sound corporate governance mechanisms. In the past fifteen years, the Mongolian government has taken several measures to establish and strengthen internal corporate governance structures in firms. This paper highlights the role of professional accountants and auditors play in ensuring that good corporate governance mechanisms are entrenched in listed companies in Mongolia. Both primary and secondary data are utilized in this research. In collection of primary data, Delphi method was used, securing responses from only knowledgeable senior employees, top managers, and some CEOs. Using this method, a total of 107 top-level company employees and executives randomly selected from 22 companies were surveyed; maximum of 5 and minimum of 4 from each company. These companies cut across several sectors. It was concluded that Professional Accountants play key roles in setting and maintaining firm governance. They do this by ensuring full compliance with all the requirements of good and sound corporate governance, establishing reporting, monitoring and evaluating standards, assisting in the setting up of proper controls, efficient and effective audit systems, sound fraud risk management and putting in place an overall vision for the enterprise. Companies with effective corporate governance mechanisms are usually strong and fraud-resilient. It was also discovered that companies with big 4 audit firms tend to have better governance structures in Mongolia.

Keywords: accountants, corporate disclosure, corporate failure, corporate governance

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Authors: Leonard Tiong, Sonit Singh, Kevin Ho Shon, Sarah Lewis

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Investigation into the use of artificial intelligence in radiology continues to develop at a rapid rate. During the coronavirus pandemic, the combination of an exponential increase in chest x-rays and unpredictable staff shortages resulted in a huge strain on the department's workload. There is a World Health Organisation estimate that two-thirds of the global population does not have access to diagnostic radiology. Therefore, there could be demand for a program that could detect acute changes in imaging compatible with infection to assist with screening. We generated a conventional neural network and tested its efficacy in recognizing changes compatible with coronavirus infection. Following ethics approval, a deidentified set of 77 normal and 77 abnormal chest x-rays in patients with confirmed coronavirus infection were used to generate an algorithm that could train, validate and then test itself. DICOM and PNG image formats were selected due to their lossless file format. The model was trained with 100 images (50 positive, 50 negative), validated against 28 samples (14 positive, 14 negative), and tested against 26 samples (13 positive, 13 negative). The initial training of the model involved training a conventional neural network in what constituted a normal study and changes on the x-rays compatible with coronavirus infection. The weightings were then modified, and the model was executed again. The training samples were in batch sizes of 8 and underwent 25 epochs of training. The results trended towards an 85.71% true positive/true negative detection rate and an area under the curve trending towards 0.95, indicating approximately 95% accuracy in detecting changes on chest X-rays compatible with coronavirus infection. Study limitations include access to only a small dataset and no specificity in the diagnosis. Following a discussion with our programmer, there are areas where modifications in the weighting of the algorithm can be made in order to improve the detection rates. Given the high detection rate of the program, and the potential ease of implementation, this would be effective in assisting staff that is not trained in radiology in detecting otherwise subtle changes that might not be appreciated on imaging. Limitations include the lack of a differential diagnosis and application of the appropriate clinical history, although this may be less of a problem in day-to-day clinical practice. It is nonetheless our belief that implementing this program and widening its scope to detecting multiple pathologies such as lung masses will greatly assist both the radiology department and our colleagues in increasing workflow and detection rate.

Keywords: artificial intelligence, COVID, neural network, machine learning

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Authors: Liman Zhao, Jianlong Zhang, Mingman Ren, Chuang Wang, Jian Liu

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Rural migrant children have become a fast-growing population in China as a consequence of the large-scale population flow from rural to urban areas in the context of urbanization. In China, the socioeconomic status of migrant children is relatively low in comparison to non-migrant children. Parents of migrant children often work in occupations with long working hours, high labor intensity, and low pay due to their poor academic qualifications. Most migrant children's parents have not received higher education and have no time to read with their children. The family of migrant children usually does not have a good collection of books either, which leads to these children’s insufficient reading and low reading levels. Moreover, migrant children frequently relocate with their parents, and their needs for knowledge and reading are often neglected by schools, which puts migrant children at risk of academic failure in China. Therefore, the academic achievement of rural migrant children has become a focus of education in China. This study explores the relationship between the educational expectation of rural migrant children and their critical reading competence in general and the moderating effect of the difference between parental educational expectation to their children and the children’s own educational expectation. The responses to a survey from 5113 seventh-grade children in a district of the capital city in China revealed that children who moved to cities in grades 4-6 of primary school performed the best in critical reading, and children who moved to cities after middle school showed the worst performance in critical reading. In addition, parents’ educational expectations of their children and their own educational expectations were both significant predictors of rural migrant children’s reading competence. The higher a child's expectations of a degree and the smaller the gap between parents' expectations of a child's education and the child's own education expectations, the better the child's performance in critical reading.

Keywords: educational expectation, critical reading competence, rural migrant children, moderating effect

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Authors: T. M. Clark, S. J. Coggins, R. Malik, J. King, R. Korman

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Objectives: This observational study investigated the use of molnupiravir for treatment of cats with naturally occurring feline infectious peritonitis. Methods: From September 2022 to February 2024, 66 cats diagnosed with FIP across 32 veterinary practices, mainly in Australia, were enrolled. Of these, 54 cats met the inclusion criteria. Complete remission was defined by the resolution of clinical signs and normalisation of A:G ratio (to ≥0.6). Presumptive remission was defined as sustained resolution of FIP-related clinical signs for at least 100 days post cessation of antiviral therapy. Results: In Cohort 1, 18 cats were treated with molnupiravir monotherapy. Thirteen achieved complete remission and three attained presumptive remission, resulting in an overall remission rate of 89% and a provisional cure rate of 72%, with three relapses. Cohort 2 included 29 cats treated with a short induction course of GS-441524 and/or remdesivir before switching to molnupiravir; 23 attained complete remission, and two achieved presumptive remission. The overall cure rate was 86% with no relapses. Seven cats in cohort 3 were initially treated with extended courses of GS-441524, remdesivir, and/or mefloquine and experienced treatment failure or relapse. Molnupiravir was introduced as a rescue therapy; 6 achieved complete remission and 1 achieved presumed remission, resulting in a 100% cure rate with no relapses. Few adverse effects were reported, with the most notable including neutropenia, transient elevations in hepatic enzymes, and polydipsia/polyuria. Conclusion and Relevance: Molnupiravir as a monotherapy, or in combination with other antivirals, represents an accessible, effective treatment for FIP when given at a dosage of 10-15 mg/kg BID. Success occurred across various presentations of FIP, including cases with ocular and neurological involvement.

Keywords: feline infectious peritonitis, FIP, molnupiravir, nucleoside analogue, antiviral

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Authors: Elena Maria Scalisi, Roberta Pecoraro, Martina Contino, Sara Ignoto, Carmelo Iaria, Santi Concetto Pavone, Gino Sorbello, Loreto Di Donato, Maria Violetta Brundo

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5G Technology is evolving to satisfy a variety of service requirements that may allow high data-rate connections (1Gbps) and lower latency times than current (<1ms). In order to support a high data transmission speed and a high traffic service for eMBB (enhanced mobile broadband) use cases, 5G systems have the characteristic of using different frequency bands of the radio wave spectrum (700 MHz, 3.6-3.8 GHz and 26.5-27.5 GHz), thus taking advantage of higher frequencies than previous mobile radio generations (1G-4G). However, waves at higher frequencies have a lower capacity to propagate in free space and therefore, in order to guarantee the capillary coverage of the territory for high reliability applications, it will be necessary to install a large number of repeaters. Following the introduction of this new technology, there has been growing concern over the past few months about possible harmful effects on human health. The aim of this preliminary study is to evaluate possible short term effects induced by 5G-millimeter waves on embryonic development and early life stages of Danio rerio by Z-FET. We exposed developing zebrafish at frequency of 27 GHz, with a standard pyramidal horn antenna placed at 15 cm far from the samples holder ensuring an incident power density of 10 mW/cm2. During the exposure cycle, from 6 h post fertilization (hpf) to 96 hpf, we measured a different morphological endpoints every 24 hours. Zebrafish embryo toxicity test (Z-FET) is a short term test, carried out on fertilized eggs of zebrafish and it represents an effective alternative to acute test with adult fish (OECD, 2013). We have observed that 5G did not reveal significant impacts on mortality nor on morphology because exposed larvae showed a normal detachment of the tail, presence of heartbeat, well-organized somites, therefore hatching rate was lower than untreated larvae even at 48 h of exposure. Moreover, the immunohistochemical analysis performed on larvae showed a negativity to the HSP-70 expression used as a biomarkers. This is a preliminary study on evaluation of potential toxicity induced by 5G and it seems appropriate to underline the importance that further studies would take, aimed at clarifying the probable real risk of exposure to electromagnetic fields.

Keywords: Biomarker of exposure, embryonic development, 5G waves, zebrafish embryo toxicity test

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Authors: Serges Mendomo Meye, Li Guowei, Shen Zhenzhong

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Earthquake is one of the main loads threatening dam safety. Once the dam is damaged, it will bring huge losses of life and property to the country and people. Therefore, it is very important to research the seismic safety of the dam. Due to the complex foundation conditions, high fortification intensity, and high scientific and technological content, it is necessary to adopt reasonable methods to evaluate the seismic safety performance of concrete arch dams built and under construction in strong earthquake areas. Structural seismic vulnerability analysis can predict the probability of structural failure at all levels under different intensity earthquakes, which can provide a scientific basis for reasonable seismic safety evaluation and decision-making. In this paper, the response surface method (RSM) is applied to the seismic vulnerability analysis of arch dams, which improves the efficiency of vulnerability analysis. Based on the central composite test design method, the material-seismic intensity samples are established. The response surface model (RSM) with arch crown displacement as performance index is obtained by finite element (FE) calculation of the samples, and then the accuracy of the response surface model (RSM) is verified. To obtain the seismic vulnerability curves, the seismic intensity measure ??(?1) is chosen to be 0.1~1.2g, with an interval of 0.1g and a total of 12 intensity levels. For each seismic intensity level, the arch crown displacement corresponding to 100 sets of different material samples can be calculated by algebraic operation of the response surface model (RSM), which avoids 1200 times of nonlinear dynamic calculation of arch dam; thus, the efficiency of vulnerability analysis is improved greatly.

Keywords: high concrete arch dam, performance index, response surface method, seismic vulnerability analysis, vector-valued intensity measure

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Authors: Z. Abdollahi Biron, P. Pisu

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Connected vehicles are one of the promising technologies for future Intelligent Transportation Systems (ITS). A connected vehicle system is essentially a set of vehicles communicating through a network to exchange their information with each other and the infrastructure. Although this interconnection of the vehicles can be potentially beneficial in creating an efficient, sustainable, and green transportation system, a set of safety and reliability challenges come out with this technology. The first challenge arises from the information loss due to unreliable communication network which affects the control/management system of the individual vehicles and the overall system. Such scenario may lead to degraded or even unsafe operation which could be potentially catastrophic. Secondly, faulty sensors and actuators can affect the individual vehicle’s safe operation and in turn will create a potentially unsafe node in the vehicular network. Further, sending that faulty sensor information to other vehicles and failure in actuators may significantly affect the safe operation of the overall vehicular network. Therefore, it is of utmost importance to take these issues into consideration while designing the control/management algorithms of the individual vehicles as a part of connected vehicle system. In this paper, we consider a connected vehicle system under Co-operative Adaptive Cruise Control (CACC) and propose a fault diagnosis scheme that deals with these aforementioned challenges. Specifically, the conventional CACC algorithm is modified by adding a Kalman filter-based estimation algorithm to suppress the effect of lost information under unreliable network. Further, a sliding mode observer-based algorithm is used to improve the sensor reliability under faults. The effectiveness of the overall diagnostic scheme is verified via simulation studies.

Keywords: fault diagnostics, communication network, connected vehicles, packet drop out, platoon

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Authors: Williams A. Adu, Cynthia A. Danquah, Paul P. S. Ossei, Selase Ativui, Michael Ofori, James Asenso, George Owusu

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Background Silicosis is an occupational disease of the lung that is caused by chronic exposure to silica dust. There is a higher frequency of co-existence of silicosis with tuberculosis (TB), ultimately resulting in lung fibrosis and respiratory failure. Chronic intake of synthetic drugs has resulted in undesirable side effects. Diosgenin is a steroidal saponin that has been shown to exert a therapeutic effect on lung injury. Therefore, we investigated the ability of diosgenin to reduce the susceptibility of silica-induced TB in rats. Method Silicosis was induced by intratracheal instillation of 50 mg/kg crystalline silica in Sprague Dawley rats. Different doses of diosgenin (1, 10, and 100 mg/kg), Mycobacterium smegmatis and saline were administered for 30 days. Afterwards, 5 of the rats from each group were sacrificed, and the 5 remaining rats in each group, except the control, received Mycobacterium smegmatis. Treatment of diosgenin continued until the 50th day, and the rats were sacrificed at the end of the experiment. The result was analysed using a one-way analysis of variance (ANOVA) with a Graph-pad prism Result At a half-maximal inhibition concentration of 48.27 µM, diosgenin inhibited the growth of Mycobacterium smegmatis. There was a marked decline in the levels of immune cell infiltration and cytokines production. Lactate dehydrogenase and total protein levels were significantly reduced compared to control. There was an increase in the survival rate of the treatment group compared to the control. Conclusion Diosgenin ameliorated silica-induced pulmonary tuberculosis by declining the levels of inflammatory and pro-inflammatory cytokines and, in effect, significantly reduced the susceptibility of rats to pulmonary TB.

Keywords: silicosis, tuberculosis, diosgenin, fibrosis, crystalline silica

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Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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Authors: Ali Kassem, Ehab Fawzy, Mahmoud Sef el-eslam, Fatma Salah- Eldeen, El zahraa Mohamed

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Introduction: The combination of interferon (INF) and ribavirin is the preferred treatment for chronic hepatitis C viral (HCV) infection. However, nonresponse to this therapy remains common and is associated with several factors such as HCV genotype and HCV viral load in addition to host factors such as sex, HLA type and cytokine polymorphisms. Aim of the work: The aim of this study was to determine predictors of response to (INF) therapy in chronic HCV infected patients treated with INF alpha and ribavirin combination therapy. Patients and Methods: The present study included 110 patients (62 males, 48 females) with chronic HCV infection. Their ages ranged from 20-59 years. Inclusion criteria were organized according to the protocol of the Egyptian National Committee for control of viral hepatitis. Patients included in this study were recruited to receive INF ribavirin combination therapy; 54 patients received pegylated NF α-2a (180 μg) and weight based ribavirin therapy (1000 mg if < 75 kg, 1200 mg if > 75 kg) for 48 weeks and 53 patients received pegylated INF α-2b (1.5 ug/kg/week) and weight based ribavirin therapy (800 mg if < 65 kg, 1000 mg if 65-75 kg and 1200 mg if > 75kg). One hundred and seven liver biopsies were included in the study and submitted to histopathological examination. Hematoxylin and eosin (H&E) stained sections were done to assess both the grade and the stage of chronic viral hepatitis, in addition to the degree of steatosis. Modified hepatic activity index (HAI) grading, modified Ishak staging and Metavir grading and staging systems were used. Laboratory follow up including: HCV PCR at the 12th week to assess the early virologic response (EVR) and at the 24th week were done. At the end of the course: HCV PCR was done at the end of the course and tested 6 months later to document end virologic response (ETR) and sustained virologic response (SVR) respectively. Results One hundred seven patients; 62 males (57.9 %) and 45 females (42.1%) completed the course and included in this study. The age of patients ranged from 20-59 years with a mean of 40.39±10.03 years. Six months after the end of treatment patients were categorized into two groups: Group (1): patients who achieved sustained virological response (SVR). Group (2): patients who didn't achieve sustained virological response (non SVR) including non-responders, breakthrough and relapsers. In our study, 58 (54.2%) patients showed SVR, 18 (16.8%) patients were non-responders, 15 (14%) patients showed break-through and 16 (15 %) patients were relapsers. Univariate binary regression analysis of the possible risk factors of non SVR showed that the significant factors were higher age, higher fasting insulin level, higher Metavir stage and higher grade of hepatic steatosis. Multivariate binary regression analysis showed that the only independent risk factor for non SVR was high fasting insulin level. Conclusion: Younger age, lower Metavir stage, lower steatosis grade and lower fasting insulin level are good predictors of SVR and could be used in predicting the treatment response of pegylated interferon/ribavirin therapy.

Keywords: chronic HCV infection, interferon ribavirin combination therapy, predictors to antiviral therapy, treatment response

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Authors: E. Rama Devi Jothilingam

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Diabetes mellitus is now one of the most common non communicable diseases globally. India leads the world with largest number of diabetic subjects earning the title "diabetes capital of the world". In order to reduce the mortality rate, a fuzzy expert system is designed to predict the severity of cardiac and renal problems of diabetic patients using fuzzy logic. Since uncertainty is inherent in medicine, fuzzy logic is used in this research work to remove the inherent fuzziness of linguistic concepts and uncertain status in diabetes mellitus which is the prime cause for the cardiac arrest and renal failure. In this work, the controllable risk factors "blood sugar, insulin, ketones, lipids, obesity, blood pressure and protein/creatinine ratio" are considered as input parameters and the "the stages of cardiac" (SOC)" and the stages of renal" (SORD) are considered as the output parameters. The triangular membership functions are used to model the input and output parameters. The rule base is constructed for the proposed expert system based on the knowledge from the medical experts. Mamdani inference engine is used to infer the information based on the rule base to take major decision in diagnosis. Mean of maximum is used to get a non fuzzy control action that best represent possibility distribution of an inferred fuzzy control action. The proposed system also classifies the patients with high risk and low risk using fuzzy c means clustering techniques so that the patients with high risk are treated immediately. The system is validated with Matlab and is used as a tracking system with accuracy and robustness.

Keywords: Diabetes mellitus, fuzzy expert system, Mamdani, MATLAB

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Authors: Javed Iqbal

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Filling of Xiangjiaba Reservoir Lake in Southwest China triggered and re-activated numerous landslides due to water fluctuation. In order to understand the relationship between reservoirs and slope instability, a typical reservoir landslide (Dasha landslide) at right bank of Jinsha River was selected as a case study for in-depth investigations. The detailed field investigations were carried out in order to identify the landslide with respect to its surroundings and to find out the slip-surface. Boreholes were drilled in order to find out the subsurface lithology and the depth of failure of Dasha landslide. The in-situ geotechnical tests were performed, and the soil samples from exposed slip surface were retrieved for geotechnical laboratory analysis. Finally, stability analysis was done using 3D strength reduction method under different conditions of reservoir water level fluctuations and rainfall conditions. The in-depth investigations show that the Dasha landslide is a bedding rockslide which was once activated in 1986. The topography of Dasha landslide is relatively flat, while the back scarp and local terrain are relatively steep. The landslide area is about 29 × 104 m², and the maximum thickness of the landslide deposits revealed by drilling is about 40 m with the average thickness being about 20 m, and the volume is thus estimated being about 580 × 10⁴ m³. Bedrock in the landslide area is composed of Suining Formation of Jurassic age. The main rock type is silty mudstone with sandstone, and bedding orientation is 300~310° ∠ 7~22°. The factor of safety (FOS) of Dasha landslide obtained by 3D strength reduction cannot meet the minimum safety requirement under the working condition of reservoir level fluctuation as designed, with effect of rainfall and rapid drawdown.

Keywords: Dasha landslide, Xiangjiaba reservoir, strength reduction method, bedding rockslide

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Authors: S. Gupta, R. Sarkar, S. Pathak, D. H. Kela, A. Pramanick, P. Talukdar

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Low alloy quenched and tempered steels are typically used in cast railway components such as knuckles, yokes, and couplers. Since these components experience extensive impact loading during their service life, adequate impact toughness of these grades need to be ensured to avoid catastrophic failure of parts in service. Because of the general availability of Charpy V Test equipment, Charpy test is the most common and economical means to evaluate the impact toughness of materials and is generally used in quality control applications. With this backdrop, an experiment was designed to evaluate the effect of austenitizing temperature, soaking time and resultant grain size on the Charpy impact toughness and the related fracture mechanisms in a quenched and tempered low alloy steel, with the aim of optimizing the heat treatment parameters (i.e. austenitizing temperature and soaking time) with respect to impact toughness. In the first phase, samples were austenitized at different temperatures viz. 760, 800, 840, 880, 920 and 960°C, followed by quenching and tempering at 600°C for 4 hours. In the next phase, samples were subjected to different soaking times (0, 2, 4 and 6 hours) at a fixed austenitizing temperature (980°C), followed by quenching and tempering at 600°C for 4 hours. The samples corresponding to different test conditions were then subjected to instrumented Charpy tests at -40°C and energy absorbed were recorded. Subsequently, microstructure and fracture surface of samples corresponding to different test conditions were observed under scanning electron microscope, and the corresponding grain sizes were measured. In the final stage, austenitizing temperature, soaking time and measured grain sizes were correlated with impact toughness and the fracture morphology and mechanism.

Keywords: heat treatment, grain size, microstructure, retained austenite and impact toughness

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Authors: Igor Pejic

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The main focus of this research will be on analyzing correlative links between terrorism as an asymmetrical threat and the consequences it leaves on conventional security forces. The methodology behind the research will include qualitative research methods focusing on comparative analysis of books, scientific papers, documents and other sources, in order to deduce, explore and formulate the results of the research. With the coming of the 21^st century and the rising multi-polar, new world threats quickly emerged. The realistic approach in international relations deems that relations among nations are in a constant state of anarchy since there are no definitive rules and the distribution of power varies widely. International relations are further characterized by egoistic and self-orientated human nature, anarchy or absence of a higher government, security and lack of morality. The asymmetry of power is also reflected on countries' security capabilities and its abilities to project power. With the coming of the new millennia and the rising multi-polar world order, the asymmetry of power can be also added as an important trait of the global society which consequently brought new threats. Among various others, terrorism is probably the most well-known, well-based and well-spread asymmetric threat. In today's global political arena, terrorism is used by state and non-state actors to fulfill their political agendas. Terrorism is used as an all-inclusive tool for regime change, subversion or a revolution. Although the nature of terrorist groups is somewhat inconsistent, terrorism as a security and social phenomenon has a one constant which is reflected in its political dimension. The state's security apparatus, which was embodied in the form of conventional armed forces, is now becoming fragile, unable to tackle new threats and to a certain extent outdated. Conventional security forces were designed to defend or engage an exterior threat which is more or less symmetric and visible. On the other hand, terrorism as an asymmetrical threat is a part of hybrid, special or asymmetric warfare in which specialized units, institutions or facilities represent the primary pillars of security. In today's global society, terrorism is probably the most acute problem which can paralyze entire countries and their political systems. This problem, however, cannot be engaged on an open field of battle, but rather it requires a different approach in which conventional armed forces cannot be used traditionally and their role must be adjusted. The research will try to shed light on the phenomena of modern day terrorism and to prove its correlation with the state conventional armed forces. States are obliged to adjust their security apparatus to the new realism of global society and terrorism as an asymmetrical threat which is a side-product of the unbalanced world.

Keywords: asymmetrical warfare, conventional forces, security, terrorism

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Authors: Mostafa Firoozabadi, Alireza Foroughi Nematollahi

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Semi autogenous mills are designed for grinding or primary crushed ore, and are the most widely used in concentrators globally. Any defect occurrence in semi autogenous mills can stop the production line. A Gearbox is a significant part of a rotating machine or a mill, so, the gearbox monitoring is a necessary process to prevent the unwanted defects. When a defect happens in a gearbox bearing, this defect can be transferred to the other parts of the equipment like inner ring, outer ring, balls, and the bearing cage. Vibration analysis is one of the most effective and common ways to detect the bearing defects in the mills. Vibration signal in a mill can be made by different parts of the mill including electromotor, pinion girth gear, different rolling bearings, and tire. When a vibration signal, made by the aforementioned parts, is added to the gearbox vibration spectrum, an accurate and on time defect detection in the gearbox will be difficult. In this paper, a new method is proposed to detect the gearbox bearing defects in the semi autogenous mill on time and accurately, using the vibration signal analysis method. In this method, if the vibration values are increased in the vibration curve, the probability of defect occurrence is investigated by comparing the equipment vibration values and the standard ones. Then, all vibration frequencies are extracted from the vibration signal and the equipment defect is detected using the vibration spectrum curve. This method is implemented on the semi autogenous mills in the Golgohar mining and industrial company in Iran. The results show that the proposed method can detect the bearing looseness on time and accurately. After defect detection, the bearing is opened before the equipment failure and the predictive maintenance actions are implemented on it.

Keywords: condition monitoring, gearbox defects, predictive maintenance, vibration analysis

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Authors: M. C. Teng, M. C. Ke, C. Y. Yang, S. S. Ke

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There are more than one thousand times a year of felt earthquakes in Taiwan. Because earthquakes are disaster threats to urban infrastructure, they often disrupt infrastructure services. For example, the highway system is very important to transportation infrastructure; however, it is vulnerable to earthquakes and typhoons in Taiwan. When a highway system is damaged by disaster, it will create a major impact on post-disaster communications and emergency relief and affect disaster relief works. In a study case on September 18th, 2022, the Taitung Chihshang earthquake, with a magnitude of 6.8 on the Richter scale with a depth of 7 km, caused one death; 171 people were injured and had a significant urban infrastructure impact. Hualien and Taitung areas have a large number of surface ruptures, road disruptions due to the collapses, over ten cases of bridges failure or closed, partial railroad section service shutdown, building collapses, and casualties. Taitung Chihshang earthquake, the peak ground acceleration is 585 gal (cm/s²), and the seismic intensity is Level 6 Upper(6+)in Chishang, Taitung County. After the earthquakes, we conducted on-site disaster investigation works in the disaster area; the disaster investigation works included a public and private building survey, a transportation facility survey, a total of ten damaged bridges, and one railroad station damaged were investigated in this investigation. The results showed that the affected locations were mainly concentrated along the Chihshang fault and the Yuli fault in the Huatung Longitudinal Valley. We recorded and described the impact and assessed its influence region in terms of its susceptibility to and the consequences of earthquake attacks. In addition, a lesson is learned from this study regarding the key issues after the Taitung Chihshang earthquake.

Keywords: earthquake, infrastructure, disaster investigation, lesson learned

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Authors: Vishnu A., Ashesh Saha

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The operation of high-speed rotating machinery in industries is accompanied by rotor vibrations due to many factors. One of the primary instability mechanisms in a rotor system is the centrifugal force induced due to the eccentricity of the center of mass away from the center of rotation. These unwanted vibrations may lead to catastrophic fatigue failure. So, there is a need to control these rotor vibrations. In this work, control of rotor vibrations by using a 4-pole Radial Active Magnetic Bearing (RAMB) as an actuator is analysed. A continuous rotor system model is considered for the analysis. Several important factors, like the gyroscopic effect and rotary inertia of the shaft and disc, are incorporated into this model. The large deflection of the shaft and the restriction to axial motion of the shaft at the bearings result in nonlinearities in the system governing equation. The rotor system is modeled in such a way that the system dynamics can be related to the geometric and material properties of the shaft and disc. The mathematical model of the rotor system is developed by incorporating the control forces generated by the RAMB. A simple PD controller is used for the attenuation of system vibrations. An analytical expression for the amplitude and phase equations is derived using the Method of Multiple Scales (MMS). Analytical results are verified with the numerical results obtained using an ‘ode’ solver in-built into MATLAB Software. The control force is found to be effective in attenuating the system vibrations. The multi-valued solutions leading to the jump phenomenon are also eliminated with a proper choice of control gains. Most interestingly, the shape of the backbone curves can also be altered for certain values of control parameters.

Keywords: rotor dynamics, continuous rotor system model, active magnetic bearing, PD controller, method of multiple scales, backbone curve

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Authors: A.Chayaporn Kaoropthai, B. Onjaree Natakuatoong, C. Nagul Cooharojananone

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The first year is usually the most critical year for university students. Generally, a considerable number of first-year students worldwide drop out of university every year. One of the major reasons for dropping out is failing. Although they are supposed to have mastered sufficient English proficiency upon completing their high school education, most first-year students are still novices in academic reading. Due to their lack of experience in academic reading, first-year students need significant support from teachers to help develop their academic reading skills. Reading strategies training is thus a necessity and plays a crucial role in classroom instruction. However, individual differences in both students, as well as teachers, are the main factors contributing to the failure in not responding to each individual student’s needs. For this reason, reading strategies training inevitably needs a diagnosis of students’ academic reading skills levels before, during, and after learning, in order to respond to their different needs. To further support reading strategies training, scaffolding is proposed to facilitate students in understanding and practicing using reading strategies under the teachers’ guidance. The use of the Intelligent Tutoring Systems (ITSs) as a tool for diagnosing students’ reading problems will be very beneficial to both students and their teachers. The ITSs consist of four major modules: the Expert module, the Student module, the Diagnostic module, and the User Interface module. The application of Artificial Intelligence (AI) enables the systems to perform diagnosis consistently and appropriately for each individual student. Thus, it is essential to develop the Intelligent Scaffolding Diagnostic Reading Strategies Tutoring Systems to enhance first-year students’ academic reading skills. The systems proposed will contribute to resolving classroom reading strategies training problems, developing students’ academic reading skills, and facilitating teachers.

Keywords: academic reading, intelligent tutoring systems, scaffolding, university students

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Authors: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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Authors: Seung-Min Ko, Seung-Jai Choi, Gun Jung, Jang-Ho Jay Kim

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Although extensive explosion-related research has been performed in the past several decades, almost no research has focused on internal blasts. However, internal blast research is needed to understand about the behavior of a containment structure or building under internal blast loading, as in the case of the Chornobyl and Fukushima nuclear accidents. Therefore, the internal blast study concentrated on RC and PSC structures is performed. The test data obtained from reinforced concrete (RC) and prestressed concrete (PSC) tubular structures applied with an internal explosion using ammonium nitrate/fuel oil (ANFO) charge are used to assess their deformation resistance and ultimate failure load based on the structural stiffness change under various charge weight. For the internal blast charge weight, ANFO explosive charge weights of 15.88, 20.41, 22.68 and 24.95 kg were selected for the RC tubular structures, and 22.68, 24.95, 27.22, 29.48, and 31.75 kg were selected for PSC tubular structures, which were detonated at the center of cross section at the mid-span with a standoff distance of 1,000mm to the inner wall surface. Then, the test data were used to predict the internal charge weight required to fail a real scale reinforced concrete containment vessels (RCCV) and prestressed concrete containment vessel (PCCV). Then, the analytical results based on the experimental data were derived using the simple assumptions of the models, and another approach using the stiffness, deformation and explosion weight relationship was used to formulate a general method for analyzing internal blasted tubular structures. A model of the internal explosion of a steel tube was used as an example for validation. The proposed method can be used generically, using factors according to the material characteristics of the target structures. The results of the study are discussed in detail in the paper.

Keywords: internal blast, reinforced concrete, RCCV, PCCV, stiffness, blast safety

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Authors: Farhat Jabeen, Muhammad Asad

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The study assessed the curative potential of Moringa olifera seeds against copper oxide nanoparticles induced toxicity in Oreochromis mossambicus. In order to investigate the curative potential of M. olifera seeds, firstly we examine its chemical composition, secondary metabolites, and bioactive compounds including hydroxyl-cinnamic acids, flavanols and hydroxybenzoic acids through standard methods and high performance liquid chromatography. In current study, the potential sub-lethal toxic dose of CuO-NPs (0.12 mg/l) was investigated through pilot experiment and three non-lethal doses (low=32, medium=48 and high=96 mg/l) of M. olifera were selected on the basis of its LC50 value for O. mossambicus. The experimental fish, O. mossambicus (n=100 of approximately 20 g each) were procured from Manawan Fisheries Complex, Lahore, and acclimatized for two weeks in glass aquaria. Experiment was conducted in accordance with the guidelines of Institutional Animal Ethics Committee, Government College University Faisalabad, Pakistan. During acclimatization and experimental period, fish received the commercial fish feed at 2.5% body weight daily. In order to assess the curative effect of M. olifera against CuO NPs induced toxicity, O. mossambicus were randomly divided into five groups and were designated as control (C) without any treatment, positive control (G*) exposed to potential toxic dose of CuO-NPs at 0.12 mg/l, and three treated groups namely G1, G2, and G3 co-treated with 0.12 mg/l of CuO-NPs plus different doses of M. olifera seed extract at 32, 48, and 96 mg/l, respectively for 56 days. Fish were exposed to waterborne CuO NPs and M. olifera seed extract. CuO-NPs treatment was ceased after 28 days but the doses of M. olifera were continued for 56 days. Blood was taken after 28 and 56 days through caudal venipuncture. Liver and intestine were taken for oxidative stress and histological studies after 56 days. In M. olifera seeds, moisture contents, crude protein, lipids, carbohydrates and ash were recorded as 3.8, 37.83, 32.52, 46.12, and 7.75%, respectively on dry weight basis. Total energy was recorded as 627.36 kcal/100g. Qualitative analysis of M. olifera seeds showed the presence of terpenoids, saponins, flavonoids, alkaloids and phenolics, while its quantitative analysis showed the considerable amount of total phenolics, flavonoids, saponins, and alkaloids as 134.75, 170.15, 1.57, and 0.4 µg/mg, respectively. Analysis of bioactive compounds in M. olifera seeds showed the presence of hydroxy-cinnamic acids (6.07 µg/ml), flavanols (71.72 µg/ml), and hydroxyl benzoic acids (97.82 µg/ml). The results showed that M. oliefera seed extract at 48 and 56 mg/l was able to cure against the toxic effects of CuO-NPs. The significant changes were observed in G* and G1 for sero-hepatic enzymes, anti-oxidants and histological profile. The investigations of this study showed that M. olifera is a good curative agent against potential induced toxicity of CuO-NPs in O. mossambicus. The curative effect of M. olifera is attributed to the presence of higher amount of secondary metabolites and bioactive compounds. This study suggested the use of M. olifera to curate different ailments in fish and other organisms.

Keywords: CuO nanoparticles, curative, Moringa olifera, Oreochromis mossambicus

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Authors: Masoud Ghahvechi Pour

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Risk management is a systematic and regular process of identifying, analyzing and responding to risks throughout the project's life cycle in order to achieve the optimal level of elimination, reduction or control of risk. The purpose of project risk management is to increase the probability and effect of positive events and reduce the probability and effect of unpleasant events on the project. Risk management is one of the most fundamental parts of project management, so that unmanaged or untransmitted risks can be one of the primary factors of failure in a project. Effective risk management does not apply to risk regression, which is apparently the cheapest option of the activity. However, the main problem with this option is the economic sensitivity, because what is potentially profitable is by definition risky, and what does not pose a risk is economically interesting and does not bring tangible benefits. Therefore, in relation to the implemented project, effective risk management is finding a "middle ground" in its management, which includes, on the one hand, protection against risk from a negative direction by means of accurate identification and classification of risk, which leads to analysis And it becomes a comprehensive analysis. On the other hand, management using all mathematical and analytical tools should be based on checking the maximum benefits of these decisions. Detailed analysis, taking into account all aspects of the company, including stakeholder analysis, will allow us to add what will become tangible benefits for our project in the future to effective risk management. Identifying the risk of the project is based on the theory that which type of risk may affect the project, and also refers to specific parameters and estimating the probability of their occurrence in the project. These conditions can be divided into three groups: certainty, uncertainty, and risk, which in turn support three types of investment: risk preference, risk neutrality, specific risk deviation, and its measurement. The result of risk identification and project analysis is a list of events that indicate the cause and probability of an event, and a final assessment of its impact on the environment.

Keywords: risk, management, knowledge, risk management

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Authors: Nazish Badar

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In early 2009, Pandemic type A (H1N1) Influenza virus emerged globally. Since then, it has continued circulation causing considerable morbidity and mortality. The purpose of this study was to evaluate the evolutionary changes in Influenza A (H1N1) pdm09 viruses from 2009-15 and their relevance with the current vaccine viruses. Methods: Respiratory specimens were collected with influenza-like illness and Severe Acute Respiratory Illness. Samples were processed according to CDC protocol. Sequencing and phylogenetic analysis of Haemagglutinin (HA) and neuraminidase (NA) genes was carried out comparing representative isolates from Pakistan viruses. Results: Between Jan2009 - Feb 2016, 1870 (13.2%) samples were positive for influenza A out of 14086. During the pandemic period (2009–10), Influenza A/ H1N1pdm 09 was the dominant strain with 366 (45%) of total influenza positives. In the post-pandemic period (2011–2016), a total of 1066 (59.6%) cases were positive Influenza A/ H1N1pdm 09 with co-circulation of different Influenza A subtypes. Overall, the Pakistan A(H1N1) pdm09 viruses grouped in two genetic clades. Influenza A(H1N1)pdm09 viruses only ascribed to Clade 7 during the pandemic period whereas viruses belong to clade 7 (2011) and clade 6B (2015) during the post-pandemic years. Amino acid analysis of the HA gene revealed mutations at positions S220T, I338V and P100S specially associated with outbreaks in all the analyzed strains. Sequence analyses of post-pandemic A(H1N1)pdm09 viruses showed additional substitutions at antigenic sites; S179N,K180Q (SA), D185N, D239G (CA), S202A (SB) and at receptor binding sites; A13T, S200P when compared with pandemic period. Substitution at Genetic markers; A273T (69%), S200P/T (15%) and D239G (7.6%) associated with severity and E391K (69%) associated with virulence was identified in viruses isolated during 2015. Analysis of NA gene revealed outbreak markers; V106I (23%) among pandemic and N248D (100%) during post-pandemic Pakistan viruses. Additional N-Glycosylation site; HA S179N (23%), NA I23T(7.6%) and N44S (77%) in place of N386K(77%) were only found in post-pandemic viruses. All isolates showed histidine (H) at position 275 in NA indicating sensitivity to neuraminidase inhibitors. Conclusion: This study shows that the Influenza A(H1N1)pdm09 viruses from Pakistan clustered into two genetic clades, with co-circulation of some variants. Certain key substitutions in the receptor binding site and few changes indicative of virulence were also detected in post-pandemic strains. Therefore, it is imperative to continue monitoring of the viruses for early identification of potential variants of high virulence or emergence of drug-resistant variants.

Keywords: Influenza A (H1N1) pdm09, evolutionary analysis, post pandemic period, Pakistan

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Authors: Ali Al-Ghalib, Fouad Mohammad

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The identification of damage in reinforced concrete structures subjected to incremental cracking performance exploiting vibration data is recognized as a challenging topic in the published and heavily cited literature. Therefore, this paper attempts to shine light on the extent of dynamic methods when applied to reinforced concrete beams simulated with various scenarios of defects. For this purpose, three different reinforced concrete beams are tested through the course of the study. The three beams are loaded statically to failure in incremental successive load cycles and later rehabilitated. After each static load stage, the beams are tested under free-free support condition using experimental modal analysis. The beams were all of the same length and cross-sectional area (2.0x0.14x0.09)m, but they were different in concrete compressive strength and the type of damage presented. The experimental modal parameters as damage identification parameters were showed computationally expensive, time consuming and require substantial inputs and considerable expertise. Nonetheless, they were proved plausible for the condition monitoring of the current case study as well as structural changes in the course of progressive loads. It was accentuated that a satisfactory localization and quantification for structural changes (Level 2 and Level 3 of damage identification problem) can only be achieved reasonably through considering frequencies and mode shapes of a system in a proper analytical model. A convenient post analysis process for various datasets of vibration measurements for the three beams is conducted in order to extract, check and correlate the basic modal parameters; namely, natural frequency, modal damping and mode shapes. The results of the extracted modal parameters and their combination are utilized and discussed in this research as quantification parameters.

Keywords: experimental modal analysis, damage identification, structural health monitoring, reinforced concrete beam

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Authors: Nandini Mohan, Thiruvengadam R. B.

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Mahatma Gandhi advocated that the true indicator of modern India lay in the development of its villages. This has been proven with the recent outbreak of the Coronavirus pandemic and the surfacing predicament of our urban centers. Developed on the Industrialization model, the current state of the metropolis is of rampant overcrowding, high rates of unemployment, inadequate infrastructure, and resources to cater to the growing population. A majority of each city’s strength composes of the migrant population, demonstrated through the migrant crisis, a direct repercussion of COVID-19. This paper explores the ideology of how rural development can act as a tactic to counter the high rates of rural-urban migration. It establishes the need for a rural push, as India is predominantly an agrarian economy, with a vast disparity between the urban and rural centers due to its urban bias. It seeks to define development in holistic terms. It studies the models of ‘cluster’ as conceptualized by V.K.R.V. Rao, and detailed by Architect Charles Correa in his book, The New Landscape. The paper reexamines the theory of cluster development through existing models proposed by the government of India. Namely, PURA (Provision of Urban Amenities in Rural Areas), DRI (Deendayal Research Institute), and Rurban under Shyama Prasad Mukharjee Rurban Mission. It analyses the models, their strengths, weaknesses, and reasons for their failure and success to derive parameters for the ideation of an archetype model. A model of rural development that talks of the simultaneous development of existing adjacent villages, by the introduction of set unique functions, that may turn into self-sustaining clusters or agglomerations in the future, which could serve as the next step for Indian village development based on the cluster ideology.

Keywords: counter migration, models of rural development, cluster development theory, India

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Authors: Mohd Ritzman Abdul Karim, Zhaohui Huang

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A current focus in seismic engineering practice is the development of seismic design approach that focuses on the performance-based design. Performance-based design aims to design the structures to achieve specified performance based on the damage limit states. This damage limit is more restrictive limit than life safety and needs to be carefully estimated to avoid damage in piers due to failure in transverse reinforcement. In this paper, a different perspective of damage limit states has been explored by integrating two damage control material limit state, concrete and reinforcement by introduced parameters such as expected yield stress of transverse reinforcement where peak tension strain prior to bar buckling is introduced in a recent study. The different perspective of damage limit states with modified yield displacement and the modified plastic-hinge length is used in order to predict damage-control target displacement for reinforced concreate (RC) bridge pier. Three-dimensional (3D) finite element (FE) model has been developed for estimating damage target displacement to validate proposed damage limit states. The result from 3D FE analysis was validated with experimental study found in the literature. The validated model then was applied to predict the damage target displacement for RC bridge pier and to validate the proposed study. The tensile strain on reinforcement and compression on concrete were used to determine the predicted damage target displacement and compared with the proposed study. The result shows that the proposed damage limit states were efficient in predicting damage-control target displacement consistent with FE simulations.

Keywords: damage-control target displacement, damage limit states, reinforced concrete bridge pier, yield displacement

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Authors: ATM Emdadul Haque

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Phosphorus is an essential nutrient which is regularly consumed with food and exists in the body as phosphate. Phosphate is an important component of cellular structures and needed for bone mineralization. Excessive accumulation of phosphate is an important driving factor of mortality in chronic renal failure patients; of relevance, these patients are usually provided health care by doctors, nurses, and pharmacists. Hence, this study was planned to determine the level of awareness of the future healthcare providers about the phosphate-containing foods and beverages and to access their knowledge on the harmful effects of excess phosphate consumption. A questionnaire was developed and distributed among the year-1 medical, nursing and pharmacy students. 432 medical, nursing and pharmacy students responded with age ranging from 18-24 years. About 70% of the respondents were female with a majority (90.7%) from Malay ethnicity. Among the respondents, 29.9% were medical, 35.4% were the pharmacy and 34.7% were nursing students. 79.2% students knew that phosphate was an important component of the body, but only 61.8% knew that consuming too much phosphate could be harmful to the body. Despite 97% of the students knew that carbonated soda contained high sugar, surprisingly 77% of them did not know the presence of high phosphate in the same soda drinks; in the similar line of observation, 67% did not know the presence of it in the fast food. However, it was encouraging that 94% of the students wanted to know more about the effects of phosphate consumption, 74.3% were willing to give up drinking soda and eating fast food, and 52% considered taking green coconut water instead of soda drinks. It is, therefore, central to take an educational initiative to increase the awareness of the future healthcare providers about phosphate-containing food and its harmful effects in excessive consumptions.

Keywords: high phosphate containing foods and beverages, excessive consumption, future health care providers, phosphorus

Procedia PDF Downloads 365

Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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