Search results for: nursing assessment

Authors: Wameed Alghazali, Shawn Kenny, Paul J. Van Geel

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Settlement of municipal solid waste (MSW) in landfills can be represented by mechanical settlement, which is instantaneous and time-dependent creep components, and biodegradation-induced settlement. Mechanical settlement is governed by the physical characteristics of MSW and the applied overburden pressure. Several research studies used oedometers and different size compression cells to evaluate the primary and mechanical creep compression indices/ratios. However, MSW is known for its heterogeneity, which means data obtained from laboratory testing are not necessary to be a good representation of the mechanical response observed in the field. Furthermore, most of the laboratory tests found in the literature were conducted on shredded samples of MSW to obtain specimens that are suitable for the testing setup. It is believed that shredding MSW samples changes the physical and mechanical properties of the waste. In this study, settlement field data was collected during the filling stage of Ste. Sophie landfill was used to estimate the primary and mechanical creep compression ratios. The field results from Ste. Sophie landfill indicated that both the primary and mechanical creep compression ratios of MSW are not constants but decrease with the increase in the applied vertical stress.

Keywords: mechanical creep compression ratio, municipal solid waste, primary compression ratio, stress level

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Authors: L. Oufni, M. Amrane, R. Rabi

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Radon (and thoron) is a naturally occurring radioactive noble gas, having variable distribution in the geological environment. The exposure of human beings to ionizing radiation from natural sources is a continuing and inescapable feature of life on earth. Radon, thoron and their short-lived decay products in the atmosphere are the most important contributors to human exposure from natural sources. The aim of this study is to determine alpha-and beta-activities per unit volume of air due to radon (222Rn), thoron (220Rn) and their progenies in the air of ancient mine of Aouli in which there is no working activity is situated at approximately 25 km north of the city of Midelt (Morocco), by using LR-115 type II and CR-39 solid state nuclear track detectors (SSNTDs). Equilibrium factors between radon and its daughters and between thoron and its progeny were evaluated in the studied atmospheres. The committed equivalent doses due to the 218Po and 214Po radon short-lived progeny were evaluated in different tissues of the respiratory tract of the visitors of the considered ancient mine. The visitors in these mines spent a good amount of time. It was essential to let the staff know about these values and take the needed steps to prevent any health complications.

Keywords: radon, thoron, concentration, exposure dose, SSNTD, mine

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Authors: O. Vanijajiva, K. Oumaree, N. Ngampak

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This research aims to study the level of perception and participation of Phranakhon Rajabhat University staff and to study the relationship between the levels of perception and participation with the score of University evaluation of quality assurance in education. The respondents were composed of 479 staffs. The tool used in this research is perceived and participation questionnaire of quality assurance in education of Phranakhon Rajabhat University. The results found that the most staffs are female with undergraduate education. Most 2 respondents are revealing educational staffs without academic position. The fact of times to gain knowledge of quality assurance in education is 1-3 times. The perception of knowledge about quality assurance in education is moderate (3.74 ± 0.65) with most respondent are more focus on university activity than quality assurance in education activity. The participation of quality assurance in education activities involved in moderate (3.17 ± 0.88), with most respondents more involved in student affair than quality assurance in education motion. For assessment of the relationship of perception and participation of quality assurance in education are average score (4.31 ± 0.16) showed that the level of perception and participation was associated with university evaluation in very low level (r = -0.103 and -0.121, respectively), while perception and participation are correlated with the moderate level (r = 0.691).

Keywords: quality assurance education, awareness, participation, higher education, Thailand

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Authors: Saad A. Bakheet, Ashraf A. Younees, Abdalsamia M. Falah

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The main purpose of this study is to the occurrence of several failures in four-meter diameter pre-restressed concrete cylinder pipes, which transport a huge quantity of water from the Libyan Sahara Desert to the populated coastal area in the north. This study will help to address the problems related to corrosion of the pre-stressed concrete cylinder pipes and methods of controlling it. The methodologies used depended on reviewing the design and fabrication of pre-stressed concrete cylinder pipes and studying the cause of the corrosion, which resulted in the failure of the pre-stressed concrete cylinder pipe Man-Made River project in Libya. The chloride-induced corrosion penetrating through the mortar coat was the main reason for corrosion. The beginning of the occurrence of corrosion, its causes, and the mechanisms of its development in pre-stressed concrete pipes since 1937 have been reviewed and are continuing until now. Manufacturing technology control corrosion and all associated problems and technology to control it have been demonstrated, including variables during manufacture, the use of a modified coating, and cathodic protection systems. It has been revised and is still based on international standards. The development of these standards and the change in some of their technical contents reflect the world's interest in the problems of corrosion and the cost of maintenance and replacement.

Keywords: PCCP corrosion, international standard, coating system, failure assessment

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Authors: Parisa Golbayani, Dan Wang, Ionut¸ Florescu

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In this work we implement machine learning techniques to financial statement reports in order to asses company’s credit rating. Specifically, the work analyzes the performance of four neural network architectures (MLP, CNN, CNN2D, LSTM) in predicting corporate credit rating as issued by Standard and Poor’s. The paper focuses on companies from the energy, financial, and healthcare sectors in the US. The goal of this analysis is to improve application of machine learning algorithms to credit assessment. To accomplish this, the study investigates three questions. First, we investigate if the algorithms perform better when using a selected subset of important features or whether better performance is obtained by allowing the algorithms to select features themselves. Second, we address the temporal aspect inherent in financial data and study whether it is important for the results obtained by a machine learning algorithm. Third, we aim to answer if one of the four particular neural network architectures considered consistently outperforms the others, and if so under which conditions. This work frames the problem as several case studies to answer these questions and analyze the results using ANOVA and multiple comparison testing procedures.

Keywords: convolutional neural network, long short term memory, multilayer perceptron, credit rating

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Authors: Fathi Kallel, Ahmed Ben Hamida, Christian Berger-Vachon

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In this paper, a Speech Enhancement Algorithm based on Multi-Band Spectral Subtraction (MBSS) principle is evaluated for Bilateral Cochlear Implant (BCI) users. Specifically, dual-channel noise power spectral estimation algorithm using Power Spectral Densities (PSD) and Cross Power Spectral Densities (CPSD) of the observed signals is studied. The enhanced speech signal is obtained using Dual-Channel Multi-Band Spectral Subtraction ‘DC-MBSS’ algorithm. For performance evaluation, objective speech assessment test relying on Perceptual Evaluation of Speech Quality (PESQ) score is performed to fix the optimal number of frequency bands needed in DC-MBSS algorithm. In order to evaluate the speech intelligibility, subjective listening tests are assessed with 3 deafened BCI patients. Experimental results obtained using French Lafon database corrupted by an additive babble noise at different Signal-to-Noise Ratios (SNR) showed that DC-MBSS algorithm improves speech understanding for single and multiple interfering noise sources.

Keywords: speech enhancement, spectral substracion, noise estimation, cochlear impalnt

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Authors: Patrick T. Aquino, Jimwel B. Balunday, Cephas Olivier V. Cabatit, Mary Grace Q. Razonable

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In 2023, the Philippine Department of Energy (PDOE) published the National Energy Efficiency and Conservation Plan (NEECP) and Roadmap 2023-2050 to be the basis of a comprehensive program for the efficient supply and economical use of energy. The building sector, as one of the most energy-intensive sectors, shall conform to the energy-conserving design to reduce the use of energy. The concept of Net-Zero Energy Building (NZEB), and its definitions promote to improve energy efficiency of the buildings. The PDOE partnered with Meralco Power Academy to survey and conduct focus group discussions to establish the readiness into NZE-aspiring buildings of government entities. This paper outlines important NZEB principles, best practices from other countries, issues and gaps relating to energy management program, and the recommendations on the development of a framework for NZEB under government building in the Philippines. Results revealed the limitation on specific data to establish a baseline building energy efficiency performance index and significant energy uses; the need to update the Guidelines for Energy Conservation Design of Buildings, including NZEB definition and requirements; appropriate enabling infrastructures and programs to transition government buildings into NZE-aspiring buildings to Nearly Zero Energy Buildings by 2050.

Keywords: NZEB, energy efficiency, buildings, Philippines

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Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists (1). We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study of 1501 oncology patients using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction, including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP, were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 210 +/- 40 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 140 +/- 35 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for oncology patients (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 29 % compared with the prerobot era, and there was an ICU cost savings of KD2.2 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, icu management and care, cost and icu occupancy

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Authors: Belkacem Selma, Boumediene Selma, Tourkia Guerzou, Abbes Labdelli

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Natural disasters have occurred and will continue to cause human and material damage. Therefore, the idea of "preventing" natural disasters will never be possible. However, their prediction is possible with the advancement of technology. Even if natural disasters are effectively inevitable, their consequences may be partly controlled. The rapid growth and progress of artificial intelligence (AI) had a major impact on the prediction of natural disasters and risk assessment which are necessary for effective disaster reduction. The Earthquakes prediction to prevent the loss of human lives and even property damage is an important factor; that is why it is crucial to develop techniques for predicting this natural disaster. This present study aims to analyze the ability of artificial neural networks (ANNs) to predict earthquakes that occur in a given area. The used data describe the problem of high energy (higher than 10^4J) seismic bumps forecasting in a coal mine using two long walls as an example. For this purpose, seismic bumps data obtained from mines has been analyzed. The results obtained show that the ANN with high accuracy was able to predict earthquake parameters; the classification accuracy through neural networks is more than 94%, and that the models developed are efficient and robust and depend only weakly on the initial database.

Keywords: earthquake prediction, ANN, seismic bumps

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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Authors: Leah Ghebreberhan, Liya Abraham, John Issac, Atul Kaushik

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Medicinal plants are used for various indications in Eritrea according to traditional systems of medicine. Safety concerns, however, are dubious since some medicinal plants have toxic effects indeed. The medicinal plants under study (Commicarpus pedunculosis, Steganotaenia araliaceae, Boscia angustifolia, Solanum incanum, and Calpurnia aurea) are used in the treatment of various diseases. Thus, safety studies must be performed prior to usage since they are rich in phytoconstituents like saponins. Saponns are natural glycosides with several pharmacologic activities including hemolysis. The study was done to assess the level of saponin and toxic effects (hemolysis) of medicinal plants used in folk medicine. The plant extracts were subject to phytochemical analysis, foam test, and hemolytic assay. Regarding the Fh value, Solanam incanum consisted highest Fh value (20mm), whereas Boscia angustifolia showed the lowest Fh value (10mm). The level of hemolysis of all the plant extracts ranged between 9.0 to 20.2 %. All the plant extracts were suitable for treatment with respect to saponin level since they exhibited minimal hemolytic effect against erythrocytes.

Keywords: Boscia angustifolia, Calpurnia aurea, Commicarpus pedunculosis, hemolysis, saponin, Solanum incanum, Steganotaenia araliaceae

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Authors: Timothy J. Grebec

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This study investigated whether using a voice dictation software program (i.e., Google Voice Typing) has an impact on student writing quality. The research took place in a third-grade general education classroom in a suburban school setting. Because the study involved minors, all data was encrypted and deidentified before analysis. The students completed a series of writings prior to the beginning of the intervention to determine their thoughts and skill level with writing. During the intervention phase, the students were introduced to the voice dictation software, given an opportunity to practice using it, and then assigned writing prompts to be completed using the software. The prompts written by nineteen student participants and surveys of student opinions on writing established a baseline for the study. The data showed that using the dictation software resulted in a 34% increase in the response quality (compared to the Pennsylvania State Standardized Assessment [PSSA] writing guidelines). Of particular interest was the increase in students' proficiency in demonstrating mastery of the English language and conventions and elaborating on the content. Although this type of research is relatively no, it has the potential to reshape the strategies educators have at their disposal when instructing students on written language.

Keywords: educational technology, accommodations, students with disabilities, writing instruction, 21st century education

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Authors: Henok Metaferia Gebremariam

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Worldwide, considerable resources are spent implementing public health interventions that are interrupted soon after the initial funding ends. However, ambiguity remains as to how health programs can be effectively sustained over time because of the diversity of perspectives, definitions, study methods, outcomes measures and timeframes. From all the above-mentioned research challenges, standardized measures of sustainability should ultimately become a key research issue. To resolve this key challenge, the objective of the study was to adapt a tool for measuring the program’s capacity for sustainability and evaluating its reliability and validity. To adapt and validate the tool, a cross-sectional and cohort study design was conducted at 26 programs in Addis Ababa between September 2014 and May 2015. An adapted version of the tool after the pilot test was administered to 220 staff. The tool was analyzed for reliability and validity. Results show that a 40-item PSAT tool had been adapted into the Amharic version with good internal consistency (Cronbach’s alpha= 0.80), test-retest reliability(r=0.916) and construct validity. Factor analysis resulted in 7 components explaining 56.67 % of the variance. In conclusion, it was found that the Amharic version of PAST was a reliable and valid tool for measuring the program’s capacity for sustainability.

Keywords: program sustainability, public health interventions, reliability, validity

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Authors: Robert O'Mochain

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Over seven years have passed since the #MeToo movement first became prominent in Japan. Opinions vary on the degree of success of the movement along with its offshoot campaigns. This chapter suggests that a range of historical factors help to account for the relative lack of success of #MeToo in Japan, but that the gains achieved should also be highlighted. Our interviews with a range of activists provide insights into the nature of #MeToo in Japan and how it should be contextualized in the contemporary landscape of feminist movements here. In spite of the gains that have been made, it remains clear that levels of abuse and of non-reporting remain worryingly high and calls for well-resourced campaigns for ‘Awareness, Prevention, and Response’ are as timely as ever. Surprisingly, a case of sexual abuse involving boys and young men who were the victims of the sexual predator and entertainment mogul, Johnny Kitagawa, may be the clearest sign of change in Japanese society regarding victims of sexual abuse. In the post-#MeToo era, it was possible for these victims to come forward and attain some measure of justice. It was also possible for members of the public to strongly condemn the failures of the mass media journalists who ignored the evidence of sexual abuse for many years. Nevertheless, the case itself does not constitute reliable evidence that conditions have changed significantly for all victims of abuse or that media outlets will live up to their promises about reporting abuse.

Keywords: #MeToo, significance, Japan, prevention, response

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Authors: María Molinos-Senante, Giulia Romano

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This paper aims at investigating the effect of ownership in the efficiency assessment of municipal solid waste management. In doing so, the Data Envelopment Analysis meta-frontier approach integrating unsorted waste as undesirable output was applied. Three different clusters of municipalities have been created on the basis of the ownership type of municipal waste operators. In the second stage of analysis, the paper investigates factors affecting efficiency, in order to provide an outlook of levers to be used by policy and decision makers to improve efficiency, taking into account different management models in force. Results show that public waste management firms have better performance than mixed and private ones since their efficiency scores are significantly larger. Moreover, it has been demonstrated that the efficiency of waste management firms is statistically influenced by the age of population, population served, municipal size, population density and tourism rate. It evidences the importance of economies of scale on the cost efficiency of waste management. This issue is relevant for policymakers to define and implement policies aimed to improve the long-term sustainability of waste management in municipalities.

Keywords: data envelopment analysis, efficiency, municipal solid waste, ownership, undesirable output

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Authors: Seyedtaghi Mirmohammadi, Jamshid Yazdani, Syavash Etemadi Nejad

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One of the main indoor air parameters in classrooms is dust pollution and it depends on the particle size and exposure duration. However, there is a lake of data about the exposure level to PM2.5 concentrations in rural area classrooms. The objective of the current study was exposure assessment for PM2.5 for students in the classrooms. One year monitoring was carried out for fifteen schools by time-series sampling to evaluate the indoor air PM2.5 in the rural district of Sari city, Iran. A hygrometer and thermometer were used to measure some psychrometric parameters (temperature, relative humidity, and wind speed) and Real-Time Dust Monitor, (MicroDust Pro, Casella, UK) was used to monitor particulate matters (PM2.5) concentration. The results show the mean indoor PM2.5 concentration in the studied classrooms was 135µg/m3. The regression model indicated that a positive correlation between indoor PM2.5 concentration and relative humidity, also with distance from city center and classroom size. Meanwhile, the regression model revealed that the indoor PM2.5 concentration, the relative humidity, and dry bulb temperature was significant at 0.05, 0.035, and 0.05 levels, respectively. A statistical predictive model was obtained from multiple regressions modeling for indoor PM2.5 concentration and indoor psychrometric parameters conditions.

Keywords: classrooms, concentration, humidity, particulate matters, regression

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Authors: Diogo José Morgado Rebelo, Francisco António Carneiro Pacheco de Andrade, Paulo Jorge Freitas de Oliveira Novais

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Not everything in AI-power consumer credit scoring turns out to be a wonder. When using AI in Creditworthiness Assessment (CWA), opacity and unfairness ‘sins’ must be considered to the task be deemed Responsible. AI software is not always 100% accurate, which can lead to misclassification. Discrimination of some groups can be exponentiated. A hetero personalized identity can be imposed on the individual(s) affected. Also, autonomous CWA sometimes lacks transparency when using black box models. However, for this intended purpose, human analysts ‘on-the-loop’ might not be the best remedy consumers are looking for in credit. This study seeks to explore the legality of implementing a Multi-Agent System (MAS) framework in consumer CWA to ensure compliance with the regulation outlined in Article 14(4) of the Proposal for an Artificial Intelligence Act (AIA), dated 21 April 2021 (as per the last corrigendum by the European Parliament on 19 April 2024), Especially with the adoption of Art. 18(8)(9) of the EU Directive 2023/2225, of 18 October, which will go into effect on 20 November 2026, there should be more emphasis on the need for hybrid oversight in AI-driven scoring to ensure fairness and transparency. In fact, the range of EU regulations on AI-based consumer credit will soon impact the AI lending industry locally and globally, as shown by the broad territorial scope of AIA’s Art. 2. Consequently, engineering the law of consumer’s CWA is imperative. Generally, the proposed MAS framework consists of several layers arranged in a specific sequence, as follows: firstly, the Data Layer gathers legitimate predictor sets from traditional sources; then, the Decision Support System Layer, whose Neural Network model is trained using k-fold Cross Validation, provides recommendations based on the feeder data; the eXplainability (XAI) multi-structure comprises Three-Step-Agents; and, lastly, the Oversight Layer has a 'Bottom Stop' for analysts to intervene in a timely manner. From the analysis, one can assure a vital component of this software is the XAY layer. It appears as a transparent curtain covering the AI’s decision-making process, enabling comprehension, reflection, and further feasible oversight. Local Interpretable Model-agnostic Explanations (LIME) might act as a pillar by offering counterfactual insights. SHapley Additive exPlanation (SHAP), another agent in the XAI layer, could address potential discrimination issues, identifying the contribution of each feature to the prediction. Alternatively, for thin or no file consumers, the Suggestion Agent can promote financial inclusion. It uses lawful alternative sources such as the share of wallet, among others, to search for more advantageous solutions to incomplete evaluation appraisals based on genetic programming. Overall, this research aspires to bring the concept of Machine-Centered Anthropocentrism to the table of EU policymaking. It acknowledges that, when put into service, credit analysts no longer exert full control over the data-driven entities programmers have given ‘birth’ to. With similar explanatory agents under supervision, AI itself can become self-accountable, prioritizing human concerns and values. AI decisions should not be vilified inherently. The issue lies in how they are integrated into decision-making and whether they align with non-discrimination principles and transparency rules.

Keywords: creditworthiness assessment, hybrid oversight, machine-centered anthropocentrism, EU policymaking

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Authors: Saba Arif, Anam Nadeem, Roman Kalvin, Muzaffar Ali, Burhan Ali, Juntakan Taweekun

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Globally transportation sector accounts for around 25% of energy demand and nearly 62% of oil consumed. Therefore, new energy sources are required to introduce for this huge demand replenishment of depleting conventional energy sources. Currently, biofuels such as Jatropha trees as an energy carrier for transportation sector are being utilized effectively round the globe. However, climate conditions at low altitudes with an average annual temperature above 20 degrees Celsius and rainfall of 300-1000mm are considered the most suitable environment for the efficient growth of Jatropha trees. The current study is providing a theoretical survey-based analysis to investigate the effect of rate of cultivation of jatropha trees on the reduction of fuel prices and its environmental benefits. The resulted study shows that jatropha tree’s 100 kg seeds give 80kg oil and the conversion process cost is very small as 890 PKR. Moreover, the extraction of oil from Jatropha tree is tax-free compared to other fuels. The analysis proved very essential for potential assessment of Jatropha regarding future energy fuel for transportation sector at global level. Additionally, it can be very beneficial for increment in the total amount of transportation fuel in Pakistan.

Keywords: jatropha tree, environmental impact, energy contents, theoretical survey

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Authors: Nabil Saad, David Morgan, Manish Gupta

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Visibility has become a key component of air quality and is regulated in many areas by environmental laws such as the EPA Clean Air Act and Regional Haze Rule. Typically, visibility is calculated by estimating the optical absorption and scattering of both gases and aerosols. A major component of the aerosols’ climatic effect is due to their scattering and absorption of solar radiation, which are governed by their optical and physical properties. However, the accurate assessment of this effect on global warming, climate change, and air quality is made difficult due to uncertainties in the calculation of single scattering albedo (SSA). Experimental complications arise in the determination of the single scattering albedo of an aerosol particle since it requires the simultaneous measurement of both scattering and extinction. In fact, aerosol optical absorption, in particular, is a difficult measurement to perform, and it’s often associated with large uncertainties when using filter methods or difference methods. In this presentation, we demonstrate the use of a new open-path Optical Extinction Analyzer (OEA) in conjunction with a nephelometer and two particle sizers, emphasizing the benefits that co-employment of the OEA offers to derive the complex refractive index of aerosols and their single scattering albedo parameter. Various use cases, data reproducibility, and instrument calibration will also be presented to highlight the value proposition of this novel Open-Path OEA.

Keywords: aerosols, extinction, visibility, albedo

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Authors: Balogun Azeez Olawale, Azeez S. A.

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Post occupancy evaluation (POE) is a process of assessing building performance for its users and intended function during the occupation. User satisfaction impacts the performance of educational environments and their users: students, faculty, and staff. In addition, buildings are maintained and managed by teams that spend a large amount of time and capital on their long-term sustenance. By evaluating the feedback from users of higher education facilities, university planning departments are more prepared to understand the inputs for programming and future project planning. In addition, university buildings will be closer to meeting user and maintenance needs. This paper reports on a research team made up of academics, facility personnel, and users that have developed a plan to improve the quality of campus facilities through a POE exercise on a recently built project. This study utilized a process of focus group interviews representing the different users and subsequent surveys. The paper demonstrates both the theory and practice of POE in higher education and learning environment through the case example of four universities in Nigeria's POE exercise.

Keywords: post occupancy evaluation, building performance, building analysis, building evaluation, quality control, building assessment, facility management, design quality

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Jerome Dalphinis, Vishal Patel

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The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

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Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

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Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

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Authors: Armel Zacharie Ekoa Bessa, Annick Kwewouo Janpou

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Sediments collected along the beaches of the Atlantic Ocean in Africa were analyzed by geochemical proxies such as the ICP-MS technique to determine their heavy metal contamination and related ecological risks. Several metals were selected and show a decreasing trend: Fe > Mn > Ni > Cu > Co > Zn > Cr > Cd. Several pollution indices have been calculated, including the enrichment factor (EF), whose values are generally higher than 1. 5; the geo-accumulation index (I-geo), with values of some elements (Co, Ni and Cu) in the sediments of the study area being higher than 0, and other metals (Zn, Cr, Fe and Mn) being lower than 0; the contamination factor (CF), where the values of all the selected elements are between 1 and 3; and the pollution load index (PLI), where the values in almost all the study sites are higher than 1. These results show moderate contamination of the investigated sediments with heavy metals. The potential ecological risk assessment (Eri and RI) suggests that this part of the African coast is a low to a slight risk area. Statistical analyses indicate that heavy metals have shown fairly similar trends with anthropogenic and natural sources. This study shows that this coastal area is not highly concentrated in heavy metals and reveals that the Atlantic coast of Africa would be moderately polluted by the metals studied, with a low to moderate ecological risk.

Keywords: heavy metals, pollution, atlantic ocean, sediments

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Authors: PB Venkataraman

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Most of the real-life problems are ill-structured. They do not have a single solution but many competing solutions. The solution paths are non-linear and ambiguous, and the problem definition itself is many times a challenge. Students of professional education learn to solve such problems through internships. The current pandemic situation has constrained on-site internship opportunities; thus the students have no option but to pursue this learning online. This research assessed the learning gain of four undergraduate students in engineering as they undertook an online internship in an organisation over a period of eight weeks. A clinical interview at the end of the internship provided the primary data to assess the team’s problem-solving skills using a tested rubric. In addition to this, change in their learning attitudes were assessed through a pre-post study using a repurposed CLASS instrument for Electrical Engineering. Analysis of CLASS data indicated a shift in the sophistication of their learning attitude. A learning engagement survey adopting a 6-point Likert scale showed active participation and motivation in learning. We hope this new research will stimulate educators to exploit online internships even beyond the time of pandemic as more and more business operations are transforming into virtual.

Keywords: ill-structured problems, learning attitudes, internship, assessment, student engagement

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Authors: M. O. Eyankware, D. O. Ufomata

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Groundwater samples were collected from Otovwodo-Ughelli and Environ with the aim of assessing groundwater quality of the area. Twenty (20) water samples from Boreholes (BH) (six) and Hand Dug Wells (HDW) (fourteen) were randomly sampled and were analysed for different physiochemical and bacteriological parameters. The following 16 parameters have been considered viz: pH, electrical conductivity, temperature, total hardness, total dissolved solids, dissolved oxygen, biological oxygen demand, phosphate, sulphate, chloride, nitrate, calcium, sodium, chloride, magnesium, and total suspended solids. On comparing the results against drinking quality standards laid by World Health Organization and Nigeria industrial standard, it was found that the water quality parameters were not above the (WHO, 2011 and NIS, 2007) permissible limit. Microbial analysis reveals the presence of coliform and E.coli in two hand-dug well (HDW7 and 13) and one borehole well (BH20). These contaminations are perhaps traceable to have originated from human activities (septic tanks, latrines, dumpsites) and have affected the quality of groundwater in Otovwodo-Ughelli. From the piper trilinear diagram, the dominant ionic species is alkali bicarbonate water type, with bicarbonate as the predominant ion (Na+ + K+)-HCO3.

Keywords: groundwater, surface water, Ughelli, Nigeria industrial standard, who standard

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Authors: Stephen Adeniyi Adefegha, Vitor Mostardeiro, Vera Maria Morsch, Ademir F. Morel, Ivana Beatrice Manica Da Cruz, Sabrina Somacal Maria Rosa Chitolina Schetinger

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Moringa stenopetala is often consumed as food and used in folkloric medicine for the management of several diseases. Purpose: This study was set up in order to assess the effect of aqueous extract of Moringa stenopetala on cell viability and oxidative stress biomarkers in BV-2 microglial cells. Aqueous extracts of M. stenopetala were prepared, lyophilized and reconstituted in 0.5% dimethylsulphoxide (DMSO). Cells were treated with M. stenopetala extracts (0.1 - 100 µg/ml) for cell viability and nitric oxide (NO) production tests. However, M. stenopetala extract (50 µg/ml) was used in the treatment of cells for the determination of protein carbonyl content and reactive oxygen species (ROS) level. Incubation of BV-2 microglia cell with M. stenopetala extract maintained cell viability, diminished NO and ROS levels, and reduced protein carbonyl contents Chlorogenic acid, rutin, kaempferol and quercetin derivatives were the main phenolic compounds identified in M. stenopetala leaf extract. These phenolic compounds present in M. stenopetala may be responsible for the mitigation of oxidative stress in BV-2 microglial cells.

Keywords: oxidative stress, BV-2 microglial cell, Moringa stenopetala, cell viability, antioxidant

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Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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Authors: Danilsa Lorduy, Liliana Valle

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Assessment and evaluation are inextricable parts of the teaching learning process. Evaluation practices concerns are gaining popularity among curriculum developers an educational researchers, particularly in Colombian regions where English language is taught as a foreign language EFL. This study addressed one of those issues, which are the unbalanced in –services’ evaluation practices perceived in school classes. They present predominance on the written test among the procedures they use to evaluate; therefore, the purpose of this case study was to explore in-service teachers’ evaluation practices, their beliefs about evaluation and to establish an eventual connection between practices and beliefs. To this end, classroom observations, questionnaires, and a semi structured interview were applied to three in-service English teachers from different schools in a city in Colombia. The findings suggested that teachers’ beliefs indicate a formative inclination and they actually are using a variety of procedures different from test but they seem to have some issues regarding their appropriateness for application Moreover, it was found that teachers’ practices are being influenced by external factors such as school requirements and national policies. It could be concluded that the predominance in using tests is not only elicited by teachers’ beliefs but also by national test results 'Pruebas Saber' and law 115 demanding. It was also suggested that further quantitative research is needed to demonstrate connections between overuse of testing procedures and 'Pruebas Saber' national test.

Keywords: beliefs, evaluation, external factors, national test

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Authors: Pankaj Prashar, Bimlesh Kumar, Ankita Sood, Anamika Gautam

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Pharmacovigilance (PV) is a rapidly growing discipline in pharmaceutical industries as an integral part of clinical research and drug development over the past few decades. PV carries a breadth of scope from drug manufacturing to its regulation with safer utilization. The fundamental steps of PV not only includes data collection and verification, coding of drugs with adverse drug reactions, causality assessment and timely reporting to the authorities but also monitoring drug manufacturing, safety issues, product quality and conduction of due diligence. Standardization of adverse event information, collaboration of multiple departments in different companies, preparation of documents in accordance to both governmental as well as non-governmental organizations (FDA, EMA, GVP, ICH) are the advancements in discipline of PV. De-harmonization, lack of predictive drug safety models, improper funding by government, non-reporting, and non-acceptability of ADRs by developing countries and reports directly from patients to the monitoring centres respectively are the major road backs of PV. Mandatory pharmacovigilance reporting, frequent inspections, funding by government, educating and training medical students, pharmacists and nurses in this segment can bring about empowerment in PV. This area needs to be addressed with a sense of urgency for the safe utilization of pharmaceuticals.

Keywords: pharmacovigilance, regulatory, adverse event, drug safety

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