Search results for: fragility assessment

Authors: Magdi Kamil Shafik Zekry

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The variety of available virtual equipment, strategies and activities may confuse and disorient even an experienced marketer. this is applicable mainly to B2B organizations, which might be generally less flexible in uptaking of virtual era than B2C businesses. B2B groups are lacking a framework that corresponds to the specifics of the B2B enterprise, and which facilitates to assess a business enterprise’s talents and to select the precise course. A B2B digital marketing adulthood model facilitates to fill this gap. however, modern-day advertising gives no widely permitted digital marketing adulthood model, and consequently, some marketing establishments offer their personal tools. The cause of this paper is constructing an optimized B2B virtual advertising and marketing maturity version based totally on a SWOT (strengths, weaknesses, opportunities, and threats) analysis of present models. The contemporary have a look at gives an analytical assessment of the existing virtual advertising adulthood models with open get entry to. The effects of the studies are twofold. First, the furnished SWOT analysis outlines the principle blessings and disadvantages of current fashions. Secondly, the strengths of existing virtual advertising maturity models, enables to discover the primary traits and the structure of an optimized B2B virtual advertising adulthood version. The research findings imply that most effective one out of three analyzed fashions may be used as a separate tool. This look at is a number of the first inspecting the usage of maturity models in virtual marketing. It helps businesses to select among the present virtual advertising fashions, the best one. furthermore, it creates a base for destiny research on virtual advertising adulthood fashions. This study contributes to the emerging B2B virtual advertising and marketing literature by using offering a SWOT analysis of the present virtual marketing maturity fashions and suggesting a structure and fundamental characteristics of an optimized B2B digital advertising adulthood model.

Keywords: electronics engineering, marketing, sales, E-commercedigital marketing, digital maturity, innovation, SMEsB2B digital marketing strategy, digital marketing, digital marketing maturity model, SWOT analysis

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Authors: Sungsoo Na, Chanho Park

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Lung cancer is one of the most common severe diseases driving to the death of a human. Lung cancer can be divided into two cases of small-cell lung cancer (SCLC) and non-SCLC (NSCLC), and about 80% of lung cancers belong to the case of NSCLC. From several studies, the correlation between epidermal growth factor receptor (EGFR) and NSCLCs has been investigated. Therefore, EGFR inhibitor drugs such as gefitinib and erlotinib have been used as lung cancer treatments. However, the treatments result showed low response (10~20%) in clinical trials due to EGFR mutations that cause the drug resistance. Patients with resistance to EGFR inhibitor drugs usually are positive to KRAS mutation. Therefore, assessment of EGFR and KRAS mutation is essential for target therapies of NSCLC patient. In order to overcome the limitation of conventional therapies, overall EGFR and KRAS mutations have to be monitored. In this work, the only detection of EGFR will be presented. A variety of techniques has been presented for the detection of EGFR mutations. The standard detection method of EGFR mutation in ctDNA relies on real-time polymerase chain reaction (PCR). Real-time PCR method provides high sensitive detection performance. However, as the amplification step increases cost effect and complexity increase as well. Other types of technology such as BEAMing, next generation sequencing (NGS), an electrochemical sensor and silicon nanowire field-effect transistor have been presented. However, those technologies have limitations of low sensitivity, high cost and complexity of data analyzation. In this report, we propose a label-free and high-sensitive detection method of lung cancer using quartz crystal microbalance based platform. The proposed platform is able to sense lung cancer mutant DNA with a limit of detection of 1nM.

Keywords: cancer DNA, resonance frequency, quartz crystal microbalance, lung cancer

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Authors: Santram Lodhi, Alok Pal Jain, Awesh K. Yadav, Gopal Rai

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Rhodiola rosea L. (Crassulaceae) is commonly known as golden root or rose root. It is a perennial herbaceous plant and most investigated species of the genus Rhodiola. Rhodiola rosea contains flavonoids, terpenoids, phenylpropanoid glycosides and phenylethanol derivatives in the roots of the plant. The objective of present study was to investigate the protective effect of hydroalcoholic extract from Rhodiola rosea roots in DSS induced colitis in mice. The ulcerative colitis was induced by DSS (3%, w/v) in mice and estimated weight loss and stool consistency. Various parameters including Colon length, spleen weights and ulcer index were also measured. The histological observations were observed by H&E staining. Effect of hydroalcoholic extract on various antioxidant parameter of rat colon such as tissue myeloperoxidase (MPO), reduced GSH, SOD concentrations and lipid peroxidation were determined. Pro-inflammatory mediators, such as tumour necrosis factor-α (TNF-α) and nitric oxide (NO) were determined by ELISA. In DSS induced group, mice body weight decreased gradually as compared to the control group. Redness and edema were observed in the colons intensely and scores representing inflammation in this group. The extract treated showed with tissue levels of TNF-α, IL-6 and MPO activity were significantly (p<0.05) increased. The mice treated with higher doses of hydroalcoholic extract (300 mg/kg) significantly reduced the activity compared with standard drug sulfasalazine (100 mg/kg. B.wt). Conclusion: Results of this study were suggested that the efficacy of hydroalcoholic extract, especially at the higher dose, was similar to that of standard drug, which concerned its potential application as a natural medicine for the treatment of ulcerative colitis.

Keywords: phenylpropanoid, Rhodiola rosea, sulfasalazin, ulcerative colitis

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Authors: Choki, Supatchai Boonpratham, Suwannee Luppanapornlarp

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The objective of this study was to find a correlation between cephalometric measurements and visual perception of facial profile in skeletal type II patients. In this study, 250 lateral cephalograms of female patients from age, 20 to 22 years were analyzed. The profile outlines of all the samples were hand traced and transformed into silhouettes by the principal investigator. Profile ratings were done by 9 orthodontists on Visual Analogue Scale from score one to ten (increasing level of convexity). 37 hard issue and soft tissue cephalometric measurements were analyzed by the principal investigator. All the measurements were repeated after 2 weeks interval for error assessment. At last, the rankings of visual perceptions were correlated with cephalometric measurements using Spearman correlation coefficient (P < 0.05). The results show that the increase in facial convexity was correlated with higher values of ANB (A point, nasion and B point), AF-BF (distance from A point to B point in mm), L1-NB (distance from lower incisor to NB line in mm), anterior maxillary alveolar height, posterior maxillary alveolar height, overjet, H angle hard tissue, H angle soft tissue and lower lip to E plane (absolute correlation values from 0.277 to 0.711). In contrast, the increase in facial convexity was correlated with lower values of Pg. to N perpendicular and Pg. to NB (mm) (absolute correlation value -0.302 and -0.294 respectively). From the soft tissue measurements, H angles had a higher correlation with visual perception than facial contour angle, nasolabial angle, and lower lip to E plane. In conclusion, the findings of this study indicated that the correlation of cephalometric measurements with visual perception was less than expected. Only 29% of cephalometric measurements had a significant correlation with visual perception. Therefore, diagnosis based solely on cephalometric analysis can result in failure to meet the patient’s esthetic expectation.

Keywords: cephalometric measurements, facial profile, skeletal type II, visual perception

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Authors: Judith Klostermann, Miguel Segura, Wilma Jans, Dragana Bojovic, Isadora Christel Jimenez, Francisco Doblas-Reyees, Judit Snethlage

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The Climate Data Store (CDS), developed by the Copernicus Climate Change Service (C3S) implemented by the European Centre for Medium-Range Weather Forecasts (ECMWF) on behalf of the European Union, is intended to become a key instrument for exploring climate data. The CDS contains both raw and processed data to provide information to the users about the past, present and future climate of the earth. It allows for easy and free access to climate data and indicators, presenting an important asset for scientists and stakeholders on the path for achieving a more sustainable future. The C3S Evaluation and Quality Control (EQC) is assessing the quality of the CDS by undertaking a comprehensive user requirement assessment to measure the users’ satisfaction. Recommendations will be developed for the improvement and expansion of the CDS datasets and products. User requirements will be identified on the fitness of the datasets, the toolbox, and the overall CDS service. The EQC function of the CDS will help C3S to make the service more robust: integrated by validated data that follows high-quality standards while being user-friendly. This function will be closely developed with the users of the service. Through their feedback, suggestions, and contributions, the CDS can become more accessible and meet the requirements for a diverse range of users. Stakeholders and their active engagement are thus an important aspect of CDS development. This will be achieved with direct interactions with users such as meetings, interviews or workshops as well as different feedback mechanisms like surveys or helpdesk services at the CDS. The results provided by the users will be categorized as a function of CDS products so that their specific interests will be monitored and linked to the right product. Through this procedure, we will identify the requirements and criteria for data and products in order to build the correspondent recommendations for the improvement and expansion of the CDS datasets and products.

Keywords: climate data store, Copernicus, quality, user engagement

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Authors: Amit Kumar

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Accurate identification of deteriorated air quality regions is very helpful in devising better environmental practices and mitigation efforts. In the present study, an attempt has been made to identify the air pollutant dispersion patterns especially NOX due to vehicular and industrial sources over a rapidly developing urban city, Visakhapatnam (17°42’ N, 83°20’ E), India, during April 2009. Using the emission factors of different vehicles as well as the industry, a high resolution 1 km x 1 km gridded emission inventory has been developed for Visakhapatnam city. A dispersion model AERMOD with explicit representation of planetary boundary layer (PBL) dynamics and offline coupled through a developed coupler mechanism with a high resolution mesoscale model WRF-ARW resolution for simulating the dispersion patterns of NOX is used in the work. The meteorological as well as PBL parameters obtained by employing two PBL schemes viz., non-local Yonsei University (YSU) and local Mellor-Yamada-Janjic (MYJ) of WRF-ARW model, which are reasonably representing the boundary layer parameters are considered for integrating AERMOD. Significantly different dispersion patterns of NOX have been noticed between summer and winter months. The simulated NOX concentration is validated with available six monitoring stations of Central Pollution Control Board, India. Statistical analysis of model evaluated concentrations with the observations reveals that WRF-ARW of YSU scheme with AERMOD has shown better performance. The deteriorated air quality locations are identified over Visakhapatnam based on the validated model simulations of NOX concentrations. The present study advocates the utility of tNumerical Simulation of Air Pollutant Using Coupled AERMOD-WRF Modeling System over Visakhapatnam: A Case Studyhe developed gridded emission inventory of NOX with coupled WRF-AERMOD modeling system for air quality assessment over the study region.

Keywords: WRF-ARW, AERMOD, planetary boundary layer, air quality

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Authors: Mekni Sabrine, Nouira Mariem

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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.

Keywords: allogeneic, transplants, ferritin, survival

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Authors: Milad Mirzaei Aminiyan, Abdolreza Akhgar, Farzad Mirzaei Aminiyan

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Water quality is the critical factor that influence on human health and quantity and quality of grain production in semi-humid and semi-arid area. Pistachio is a main crop that accounts for a considerable portion of Iranian agricultural exports. Give that pistachio tree is a tolerant type of tree to saline and alkaline soil and water conditions, but groundwater and irrigation water quality play important roles in main production this crop. For this purpose, 94 well water samples were taken from 25 wells and samples were analyzed. The results showed give that region’s geological, climatic characteristics, statistical analysis, and based on dominant cations and anions in well water samples (piper diagram); four main types of water were found: Na-Cl, K-Cl, Na-SO4, and K-SO4. It seems that most wells in terms of water quality (salinity and alkalinity) and based on Wilcox diagram have critical status. The analysis suggested that more than eighty-seven percentage of the well water samples have high values of EC that these values are higher than into critical limit EC value for irrigation water, which may be due to the sandy soils in this area. Most groundwater were relatively unsuitable for irrigation but it could be used by application of correct management such as removing and reducing the ion concentrations of Cl‾, SO42‾, Na+ and total hardness in groundwater and also the concentrated deep groundwater was required treatment to reduce the salinity and sodium hazard. Given that irrigation water quality in this area was relatively unsuitable for most agriculture production but pistachio tree was adapted to this area conditions. The integrated management of groundwater for irrigation is the way to solve water quality issues not only in Rafsanjan area, but also in other arid and semi-arid areas.

Keywords: groundwater quality, irrigation water quality, salinity, alkalinity, Rafsanjan plain, pistachio

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Authors: Behzad Behnia, Noah LaRussa-Trott

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In recent years, fibers have been successfully used as an additive to reinforce asphalt concrete materials and to enhance the sustainability and resiliency of transportation infrastructure. Roads covered with fiber-reinforced asphalt concrete (FRAC) require less frequent maintenance and tend to have a longer lifespan. The present work investigates the application of sasobit-coated aramid fibers in asphalt pavements and employs machine learning to develop prediction models to evaluate the cracking performance of FRAC materials. For the experimental part of the study, the effects of several important parameters such as fiber content, fiber length, and testing temperature on fracture characteristics of FRAC mixtures were thoroughly investigated. Two mechanical performance tests, i.e., the disk-shaped compact tension [DC(T)] and indirect tensile [ID(T)] strength tests, as well as the non-destructive acoustic emission test, were utilized to experimentally measure the cracking behavior of the FRAC material in both macro and micro level, respectively. The experimental results were used to train the supervised machine learning approach in order to establish prediction models for fracture performance of the FRAC mixtures in the field. Experimental results demonstrated that adding fibers improved the overall fracture performance of asphalt concrete materials by increasing their fracture energy, tensile strength and lowering their 'embrittlement temperature'. FRAC mixtures containing long-size fibers exhibited better cracking performance than regular-size fiber mixtures. The developed prediction models of this study could be easily employed by pavement engineers in the assessment of the FRAC pavements.

Keywords: fiber reinforced asphalt concrete, machine learning, cracking performance tests, prediction model

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Authors: Islam Zeb

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The water of poor quality used for irrigation purposes has the potential to be the direct source of contamination and a vehicle for spreading contamination in the field. A number of wide-ranging review articles have been published that highlight irrigation water as a source of heavy metals toxicity which leads to chronic diseases in the human body. Here a study was planned to determine the microbial and heavy metals status of irrigation water collected from various locations of district Swat in various months. The analyses were carried out at the Environmental Horticulture Laboratory, Department of Horticulture, The University of Agriculture Peshawar, during the year 2018 – 19. The experiment was laid out in Randomized Complete Block Design (RCBD) with two factors and three replicates. Factor A consist of different locations and factor B represent various months. The result of heavy metals concentration in different regions, maximum Lead, Cadmium, Chromium, Nickel and Copper (4.27, 0.56, 0.81, 1.33 and 1.51 mg L-1 respectively) were noted for the irrigation water samples collected from Mingora while minimum Lead, Cadmium, Chromium, Nickel and Copper concentration (2.59, 0.30, 0.27, 0.40 and 0.54 mg L-1 respectively) were noted for the samples of matta. Whereas results of heavy metals content in irrigation water samples for various months maximum content of Lead, Cadmium, Chromium, Nickel and Copper (4.56, 0.63, 1.15, 1.31 and 1.48 mg L-1 respectively) were noted for the samples collected in Jan/Feb while lowest values for Lead, Cadmium, Chromium, Nickel and Copper (2.38, 0.24, 0.21, 0.41 and 0.52 mg L-1 respectively) were noted in the samples of July/August. A significant interaction was found for all the studied parameters. It was concluded that the concentration of heavy metal was maximum in irrigation water samples collected from the Mingora location during the month of Jan/Feb because Mingora is the most polluted area as compared to other studied regions, whereas the water content in winter goes to freeze and mostly contaminated water is used for irrigation purposes.

Keywords: irrigation water, various months, different regions, heavy metals contamination, Swat

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Authors: Caiwei Chen, Jianhao Li, Jiasong Zhu

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The reform and opening-up stimulated economic and technological take-off in China while resulting in massive urbanization and motorization. Wujiaochang area was set as a secondary business district in Shanghai to meet the growing demand, with the reconstruction of Wujiaochang Plaza in 2005 being a milestone of this intended urban renewal. Wujiaochang is now an economically dynamic area providing much larger traffic and transit capacity transportation-wise. However, this rebuilding has completely changed the face of the district. It is, therefore, appropriate to evaluate its impact on neighborhoods and communities while assessing the overall sustainability of such an operation. In this study, via an online questionnaire survey among local residents and daily visitors, we assess the perceptions and the estimated impact of Wujiaochang Plaza's reconstruction. We then confront these results to the 62 answers from local residents to a questionnaire collected on paper. The analysis of our data, along with observation and other forms of information -such as maps analysis or online applications (Dianping)- demonstrate major improvement in economic sustainability but also significant losses in environmental sustainability, especially in terms of active transportation. As for the social viewpoint, local residents' opinions tend to be rather positive, especially regarding traffic safety and access to consumption, despite the lack of connectivity and radical changes induced by Wujiaochang massive transformations. In general, our investigation exposes the overall positive outcomes of Wujiaochang Plaza reconstruction but also unveils major drawbacks, especially in terms of soft mobility and traffic fluidity. We gather that our approach could be of tremendous help for future major urban interventions, as such approaches in municipal regeneration are widely implemented in Chinese cities and yet still need to be thoroughly assessed in terms of sustainability.

Keywords: China's reform and opening-up, economical revitalization, neighborhood identity, sustainability assessment, urban renewal

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Authors: Imad Abdelhamid El-Haci, Wissame Mazari, Fayçal Hassani, Fawzia Atik Bekkara

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Much attention has been paid to the antioxidants, which are expected to prevent food and living systems from peroxidative damage. Incorporation of synthetic antioxidants in food products is under strict regulation due to the potential health hazards caused by such compounds. The use of plants as traditional health remedies is very popular and important for 80% of the world’s population in African, Asian, Latin America and Middle Eastern Countries. Their use is reported to have minimal side effects. In recent years, pharmaceutical companies have spent considerable time and money in developing therapeutics based upon natural products extracted from plants. In other part, due to the continuous emergence of antibiotic-resistant strains there is continual demand for new antibiotics. Chemical compounds from medicinal plant especially are targeted by many researches. In this light, genus Polygonum (Polygonaceae), comprising about 45 genera (300 species), is distributed worldwide, mostly in north temperate regions. They have been reported to have uses in traditional medicine, such as anti-inflammation, promoting blood circulation, dysentery, diuretic, haemorrhage and many other uses. In our study, Polygonum maritimum (from Algerian coast) was extracted with 80% methanol to obtain a crude extract. P. maritimum extract (PME) had a very high content of total phenol, which was 352.49 ± 18.03 mg/g dry weight, expressed as gallic acid equivalent. PME exhibited excellent antioxidant activity, as measured using DPPH and H2O2 scavenging assays. It also showed a high antibacterial activity against gram positive bacterial strains: Bacillus cereus, Bacillus subtilis and Staphylococcus aureus with an MIC 0,12 mg/mL.

Keywords: Polygonum maritimum, crude extract, antioxidant activity, antibacterial activity

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Authors: Ying-Yi Laio, Yea-Ru Yang, Yih-Ru Wu, Ray-Yau Wang

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Background: Virtual reality (VR) systems are proved to increase motor performance in stroke and elderly. However, the effects have not been established in patients with Parkinson’s disease (PD). Purpose: To examine the effects of VR based training in improving muscle strength, sensory integration ability and walking abilities in patients with PD by a randomized controlled trial. Method: Thirty six participants with diagnosis of PD were randomly assigned to one of the three groups (n=12 for each group). Participants received VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group received no structured exercise program but fall-prevention education. Outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment (FGA). All outcomes were assessed at baseline, after training and at 1-month follow-up. Results: Both VRWii and TE groups showed more improvement in level walking velocity, stride length, FGA, muscle strength and vestibular system integration than control group after training and at 1-month follow-up. The VRWii training, but not the TE training, resulted in more improvement in visual system integration than the control. Conclusions: VRWii training is as beneficial as traditional exercise in improving walking abilities, sensory integration ability and muscle strength in patients with PD, and such improvements persisted at least for 1 month. The VRWii training is then suggested to be implemented in patients with PD.

Keywords: virtual reality, walking, sensory integration, muscle strength, Parkinson’s disease

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Authors: Domenica Tambasco, Riina Bray, Sophia Jaworski, Gillian Grant, Celeste Corkery

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Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and reduced function. Management of symptoms include medications, physical treatments and mindfulness therapies. Myofascial Release is a modality that has been successfully applied in var-ious musculoskeletal conditions. However, to the author’s best knowledge, it is not yet recog-nized as a self-management therapy option in Fibromyalgia. In this study, we investigated whether Self-applied Myofascial Release (SMR) is associated with overall improved function and symptoms in Fibromyalgia. Methods: Eligible adult patients with a confirmed diagnosis of Fibromyalgia at Women’s College Hospital were recruited to SMR. Sessions ran for 1 hour once a week for 7 weeks, led by the same two Physiotherapists knowledgeable in this physical treat-ment modality. The main outcome measure was an overall impact score for function and symp-toms based on the validated assessment tool for Fibromyalgia, the Revised Fibromyalgia Impact Questionnaire (FIQR), measured pre and post-intervention. Both descriptive and analytical methods were applied and reported. Results: We analyzed results using a paired t-test to deter-mine if there was a statistically significant difference in mean FIQR scores between initial (pre-intervention) and final (post-intervention) scores. A clinically significant difference in FIQR was defined as a reduction in score by 10 or more points. Conclusions: Our pilot study showed that SMR appeared to be a safe and effective intervention for our Fibromyalgia participants and the overall impact on function and symptoms occurred in only 7 weeks. Further studies with larger sample sizes comparing SMR to other physical treatment modalities (such as stretching) in an RCT are recommended.

Keywords: fibromyalgia, myofascial release, physical therapy, FIQR

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Authors: D. Motlhanka, M. Mine, T. Bagaketse, T. Ngakane

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There is a plethora of evidence from numerous sources that highlights the triumph of naturally derived medicinal plant metabolites with antioxidant capability for repurposed therapeutics. As post-COVID-19 syndromes and non-communicable diseases are on the rise, there is an urgent need to come up with new therapeutic strategies to address the problem. Non-communicable diseases and Post COVID-19 syndromes are classified as socio-economic diseases and are ranked high among threats to health security due to the economic burden they pose to any government budget commitment. Research has shown a strong link between accumulation of free radicals and oxidative stress critical for pathogenesis of non-communicable diseases and COVID-19 syndromes. Botswana has embarked on a robust programme derived from ethno-pharmacognosy and drug repurposing to address these threats to health security. In the current approach, a number of medicinally active plant-derived polyphenolics are repurposed and combined into new medicinal tools to target diabetes, Hypertension, Prostate Cancer and oxidative stress induced Post COVID 19 syndromes such as “brain fog”. All four formulants demonstrated Free Radical scavenging capacities above 95% at 200µg/ml using the diphenylpicryalhydrazyl free radical scavenging assay and the total phenolic contents between 6899-15000GAE(g/L) using the folin-ciocalteau assay respectively. These repurposed medicinal tools offer new hope and potential in the fight against emerging health threats driven by hyper-inflammation and free radical-induced oxidative stress.

Keywords: drug repurposed plant polyphenolics, free radical damage, non-communicable diseases, post COVID 19 syndromes

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Authors: Jubril Olatunbosun Akinde

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Unplanned population growth are mostly attributed to a lack of infrastructural facilities and poor economic condition in the rural dwellings and the incidence of rural-urban migration, which has resulted in severe housing deficiency in the urban centre, with a resultant pressure on housing delivery in the cities. Affordable housing does not only encompass environmental factors that make living acceptable and comfortable, which include good access routes, ventilation, sanitation and access to other basic human needs, which include water and safety. The research assessed the housing affordability and safety measures in the varied residential area of lagos by examining the demographic and socioeconomic attributes of residents; examining the existing residential safety measures; by examining the residential quality in terms of safety; the researcher therefore examined if relationship between housing affordability and safety in the varied residential areas. The research adopted the bartlett, kotrlik and higgins (2001) method of t-test to determine the sample size which specifies different populations at different levels of significance (α). The researcher adopted primary data which was sourced from a field survey where the sample population was simply randomly selected to give a member of the population an equal chance of being selected, therefore, the sample size for the field survey was two hundred (200) respondents, and subjected to necessary testing. The research come to conclusion that housing safety and security is the responsibility of every resident, the landlords/landladies possess a better sense of security in their neighbourhood than renters in the community, therefore they need to be aware of their responsibility of ensuring the safety of lives and property.

Keywords: housing, housing affordability, housing security, residential, residential quality

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Authors: Chee Fei Chang, May Yee Ng

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As a result of its geographical location, flood is a natural disaster that happens regularly in Malaysia. Every year, heavy rainfall is brought by the cyclical monsoon to the East coast of Peninsular Malaysia. In recent years, the occurrence of unexpected heavy downpour somehow connected to climate-change phenomena is also on the increasing trend. Ironically, despite that Malaysians have suffered significant monetary losses as a result of the recurring floods in past many decades, little has been done by the government from the perspective of taxation. Perhaps due to political reason or as a populist measure, the federal and local government are more inclined to offer small cash handout then rolling out long-term tax policy or measure in relieving the financial and tax burden of the victims and affected business entities. Except for the one-off tax break granted to affected businesses in 2007, the authors have not found any income tax exemption or deduction order gazetted with regard to flood disaster. Hence, it is imperative for this study to explore the need and challenges of implementing flood inflicted disaster tax relief or credit in Malaysia. This research consists of two major parts. First, the assessment of relevant tax policies/ measures with regard to non-government organisations and other affected parties. Content and thematic analyses will be applied on current tax legislations and orders issued for this part. Second, a comparative analysis will be conducted benchmarking various disaster tax reliefs and credits implemented in developed countries. Resulting from the increasing climate change-related disasters in Malaysia, the findings of this study will shed light on the importance of introducing disaster tax relief measures to assist individual victims as well as the affected businesses.

Keywords: climate-changed related disaster, disaster tax credits, tax relief for victims, tax measures for disaster recovery

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Authors: Atma Sahu

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After 9/11, there will only be cyberwars. The cyberwars increase in intensity the country's cybersecurity workforce's hiring and retention issues. Currently, many organizations have unfilled cybersecurity positions, and to a lesser degree, their cybersecurity teams are understaffed. Therefore, there is a critical need to develop a new program to help meet the market demand for cybersecurity engineers (CYSE) and personnel. Coppin State University in the United States was responsible for developing a cybersecurity engineering BS degree program. The CYSE curriculum design methodology consisted of three parts. First, the ACM Cross-Cutting Concepts standard's pervasive framework helped curriculum designers and students explore connections among the core courses' knowledge areas and reinforce the security mindset conveyed in them. Second, the core course context was created to assist students in resolving security issues in authentic cyber situations involving cyber security systems in various aspects of industrial work while adhering to the NIST standards framework. The last part of the CYSE curriculum design aspect was the institutional student learning outcomes (SLOs) integrated and aligned in content courses, representing more detailed outcomes and emphasizing what learners can do over merely what they know. The CYSE program's core courses express competencies and learning outcomes using action verbs from Bloom's Revised Taxonomy. This aspect of the CYSE BS degree program's design is based on these three pillars: the ACM, NIST, and SLO standards, which all CYSE curriculum designers should know. This unique CYSE curriculum design methodology will address how students and the CYSE program will be assessed and evaluated. It is also critical that educators, program managers, and students understand the importance of staying current in this fast-paced CYSE field.

Keywords: cyber security, cybersecurity engineering, systems engineering, NIST standards, physical systems

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Authors: Asteria Nsamba

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Social networking applications and tools have become compelling platforms for generating and sharing knowledge across the world. Social networking applications and tools refer to a variety of social media platforms which include Facebook, Twitter WhatsApp, blogs and Wikis. The most popular of these platforms are Facebook, with 2.41 billion active users on a monthly basis, followed by WhatsApp with 1.6 billion users and Twitter with 330 million users. These communication platforms have not only impacted social lives but have also impacted students’ learning, across different delivery modes in higher education: distance, conventional and blended learning modes. With this amount of interest in these platforms, knowledge sharing has gained importance within the context in which it is required. In open distance learning (ODL) contexts, social networking platforms can offer students and teachers the platform on which to create and share knowledge, and form learning collaborations. Thus, they can serve as support mechanisms to increase interactions and reduce isolation and loneliness inherent in ODL. Despite this potential and opportunity, research indicates that many ODL teachers are not inclined to using social media tools in learning. Although it is unclear why these tools are uncommon in these environments, concerns raised in the literature have indicated that many teachers have not mastered the art of teaching with technology. Using technological, pedagogical content knowledge (TPCK) and product quality theory, and Bloom’s Taxonomy as lenses, this paper is aimed at; firstly, assessing the quality of three social media applications: Facebook, Twitter and WhatsApp, in order to determine the extent to which they are suitable platforms for teaching and learning, in terms of content generation, information sharing and learning collaborations. Secondly, the paper demonstrates the application of teaching, learning and assessment using Bloom’s Taxonomy.

Keywords: distance education, quality, social networking tools, TPACK

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Authors: Ainouna Bouziane

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The ability of Electron Tomography to recover the 3D structure of catalysts, with spatial resolution in the subnanometer scale, has been widely explored and reviewed in the last decades. A variety of experimental techniques, based either on Transmission Electron Microscopy (TEM) or Scanning Transmission Electron Microscopy (STEM) have been used to reveal different features of nanostructured catalysts in 3D, but High Angle Annular Dark Field imaging in STEM mode (HAADF-STEM) stands out as the most frequently used, given its chemical sensitivity and avoidance of imaging artifacts related to diffraction phenomena when dealing with crystalline materials. In this regard, our group has developed a methodology that combines image denoising by undecimated wavelet transforms (UWT) with automated, advanced segmentation procedures and parameter selection methods using CS-TVM (Compressed Sensing-total variation minimization) algorithms to reveal more reliable quantitative information out of the 3D characterization studies. However, evaluating the accuracy of the magnitudes estimated from the segmented volumes is also an important issue that has not been properly addressed yet, because a perfectly known reference is needed. The problem particularly complicates in the case of multicomponent material systems. To tackle this key question, we have developed a methodology that incorporates volume reconstruction/segmentation methods. In particular, we have established an approach to evaluate, in quantitative terms, the accuracy of TVM reconstructions, which considers the influence of relevant experimental parameters like the range of tilt angles, image noise level or object orientation. The approach is based on the analysis of material-realistic, 3D phantoms, which include the most relevant features of the system under analysis.

Keywords: electron tomography, supported catalysts, nanometrology, error assessment

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Authors: Peng Guo

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Objective To investigate the clinical characteristics and changes of video-polysomnography (v-PSG) in Parkinson disease (PD) patients accompanied with cognitive impairment. Methods Three hundred and ninety-four patients with PD were enrolled in Beijing Tiantan Hospital, according to CI level, the patients were divided into PD without cognitive impairment (PD-NCI), PD with mild cognitive impairment (PD-MCI), and PD with dementia (PDD) group. Collect patient's demographic data, including gender, onset age, education level and duration. The cognitive function of PD patients was evaluated by Montreal cognitive assessment (MoCA) scale, and the overall cognitive function and cognitive domains of the three groups were compared.Using v-PSG to assess the sleep status of patients. Correlation analysis of MoCA Scale and v-PSG results in PD-CI group. Results 1. In 394 cases of PD, 94 cases (23.86%) in PD-NCI group , 177 cases(44.92%) in PD-MCI group , 123 cases (31.22%) in PDD group. 2.There was no significant difference in gender, age of onset, education level and duration in PD-NCI group, PD-MCI group and PDD group （P＞0.05）. 3. The total score of MoCA scale in PD-NCI group, PD-MCI group and PDD group decreased one by one. In PD-NCI group, PD-MCI group and PDD group, the scores of each cognitive domain in MoCA scale decreased significantly（P<0.05）. 4.Compared with the PD-MCI group, PDD group had lower total sleep time, lower sleep efficiency （P<0.05）. Compared with PD-NCI group, PDD group had lower total sleep time and lower sleep efficiency （P<0.05）.5. The sleep efficiency of PD-CI patients is positively correlated with the total score of MoCA scale, visual spatial function, executive function, delayed recall and attention score（P<0.05). Conclusions The incidence of CI in PD patients was high; The cognitive function and cognitive domains of PD-CI patients were significantly impaired; In patients with PD-CI, total sleep time decreased, sleep efficiency decreased, and it was related to overall cognitive function and partial cognitive impairment.

Keywords: Parkinson disease, cognitive impairment, clinical characteristics, sleep disorders, video-polysomnography

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Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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Authors: B. I. Waziri, M. A. Yahaya

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Background: Practice of shisha smoking involves the use of a multi-stemmed instrument to smoke tobacco or non-tobacco herbal mixture where the smoke is designed to pass through water or other liquid before reaching the smoker. The presence of tobacco content and the use of charcoal when burning the ingredients in this popular practice necessitate for investigation of many physiological parameters of habitual shisha smokers in our environment. Methods: 103 young shisha smokers, regular in the practice for more than three years living in Nasarawa, Kano state, Nigeria, were recruited for the study. The controls were 100 university students (nonsmokers) match for age (18 - 30 years), sex and BMI (20 - 24) with the smokers. Participants with known history of cigarette smoking, cardiovascular or respiratory diseases were excluded. Ethical approval was obtained from the Ministry of Health, Kano Nigeria. Hear rate, blood pressure and percentage oxygen saturation (SPO₂) were measured using stethoscope, sphygmomanometer and pulse oximeter respectively. Data were analyzed using IBM SPSS version 20 and mean values of the measured parameters were compared between the smokers and controls using independent sample t-test. P-values < 0.05 were considered significant. Results: The mean Heart rate was found to be significantly higher (p = 0.01) in the shisha smokers (91.32 ± 0.84) compared to controls (79.19 ± 1.18). Systolic and diastolic blood pressure was also higher (p = 0.00) in the shisha smokers (128.75 ± 1.11 and 85.85 ± 0.78 respectively) compared to controls with the systolic and diastolic pressure of 116.64 ± 0.82 and 80.39 ± 0.83 respectively. SPO₂ was significantly lower (p = 0.00) in the shisha smokers (91.98% ± 0.42%) compared to the controls (97.98 ± 0.18). Conclusion: Habitual Shisha Smoking caused a significant increase in Heart rate, both systolic and diastolic blood pressure and a significant decrease in SPO2 among youth in Kano State, Nigeria.

Keywords: blood pressure, heart rate, shisha, youth

Procedia PDF Downloads 148

Authors: S. M. Mahdi Niktabara, K. Seshagiri Raob, Amit Kumar Shrivastavac, Jiří Ščučkaa

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The presence of the discontinuity in the form of joints is one of the most significant factors causing instability in the rock mass. On the other hand, dynamic loads, including earthquake and blasting induce cyclic shear loads along the joints in rock masses; therefore, failure of rock mass exacerbates along the joints due to changing shear resistance. Joints are under constant normal load (CNL) and constant normal stiffness (CNS) conditions. Normal stiffness increases on the joints with increasing depth, and it can affect shear resistance. For correct assessment of joint shear resistance under varying normal stiffness and number of cycles, advanced laboratory shear machine is essential for the shear test. Conventional direct shear equipment has limitations such as boundary conditions, working under monotonic movements only, or cyclic shear loads with constant frequency and amplitude of shear loads. Hence, a large-scale servo-controlled direct shear testing machine was designed and fabricated to perform shear test under the both CNL and CNS conditions with varying normal stiffness at different frequencies and amplitudes of shear loads. In this study, laboratory cyclic shear tests were conducted on non-planar joints under varying normal stiffness. In addition, the effects of different frequencies and amplitudes of shear loads were investigated. The test results indicate that shear resistance increases with increasing normal stiffness at the first cycle, but the influence of normal stiffness significantly decreases with an increase in the number of shear cycles. The frequency of shear load influences on shear resistance, i.e. shear resistance increases with increasing frequency. However, at low shear amplitude the number of cycles does not affect shear resistance on the joints, but it decreases with higher amplitude.

Keywords: cyclic shear load, frequency of load, amplitude of displacement, normal stiffness

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Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

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Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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Authors: Lubna M. Zakaryia Mahmoud, Mohammed A. Dawood, Doaa A. Heiba

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A prospective double-blind placebo controlled trial carried out on 60 children known to be asthmatic who presented to the emergency department at Alexandria University of Children’s Hospital at El-Shatby with acute asthma exacerbations to assess the efficacy of adding inhaled magnesium sulfate to β-agonist, compared with β-agonist in saline, in the management of acute asthma exacerbations in children. The participants in the study were divided in two groups; Group A (study group) received inhaled salbutamol solution (0.15 ml/kg) plus isotonic magnesium sulfate 2 ml in a nebulizer chamber. Group B (control group): received nebulized salbutamol solution (0.15 ml/kg) diluted with placebo (2 ml normal saline). Both groups received inhaled solution every 20 minutes that was repeated for three doses. They were evaluated using the Pediatric Asthma Severity Score (PASS), oxygen saturation using portable pulse oximetry and peak expiratory flow rate using a portable peak expiratory flow meter at initially recorded as zero-minute assessment and every 20 minutes from the end of each nebulization (nebulization lasts 5-10 minutes) recorded as 20, 40 and 60-minute assessments. Regarding PASS, comparison showed non-significant difference with p-value 0.463, 0.472, 0.0766 at 20, 40 and 60 minutes. Regarding oxygen saturation, improvement was more significant towards group A starting from 40 min with significant p-value=0.000. At 60 min p-value=0.000. Although mean PEFR significantly improved from zero-min in both groups; however, improvement was more significant in group A with significant p-value = 0.015, 0.001, 0.001 at 20 min, 40 min and 60 min, respectively. The conclusion this study suggests is that inhaled magnesium sulfate is an efficient add on drug to standard β- agonist inhalation used in the treatment of moderate to severe asthma exacerbations.

Keywords: nebulized, magnesium sulfate, acute asthma , pediatric

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Authors: Reza E. Sedgh, Rajesh P. Dhakal

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Shear walls have been used extensively as the main lateral force resisting systems in multi-storey buildings. The recent development in performance based design urges practicing engineers to conduct nonlinear static or dynamic analysis to evaluate seismic performance of multi-storey shear wall buildings by employing distinct analytical models suggested in the literature. For practical purpose, application of macroscopic models to simulate the global and local nonlinear behavior of structural walls outweighs the microscopic models. The skill level, computational time and limited access to RC specialized finite element packages prevents the general application of this method in performance based design or assessment of multi-storey shear wall buildings in design offices. Hence, this paper organized to verify capability of nonlinear shell element in commercially available package (Sap2000) in simulating results of some specimens under monotonic and cyclic loads with very oversimplified available cyclic material laws in the analytical tool. The selection of constitutive models, the determination of related parameters of the constituent material and appropriate nonlinear shear model are presented in detail. Adoption of proposed simple model demonstrated that the predicted results follow the overall trend of experimental force-displacement curve. Although, prediction of ultimate strength and the overall shape of hysteresis model agreed to some extent with experiment, the ultimate displacement(significant strength degradation point) prediction remains challenging in some cases.

Keywords: analytical model, nonlinear shell element, structural wall, shear behavior

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Authors: Behailu Shigute Habtemariam

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The aim of the study was to examine the effects of training load on some selected fitness performance variables of volleyball players in the case of U-17 female volleyball project players in the central Ethiopia region. Methods: In this study, quasi-experimental design was used. For the purpose of this study, twenty-three volleyball players were used as a subject from the two projects. The data collected through fitness performance assessment were analyzed and interpreted into a meaningful idea using manually as well as with computer in order to compare physical fitness variables and changes observed among participants. Those are taking part in the effects of training load on some selected physical fitness variables. The collected data were analyzed by means of the Statistical Package for Social Science version (SPSS V 20). The independent t-test was used to show the mean differences between the groups, and the paired T-test was used to compare the mean differences of the pre and post-training within each group. The level of significance will be set at Alfa 0.05. Results: The results are displayed using tables and figures. A significant difference was found in the mean differences of pre-test values (19.7 cm) and post-test values (37.5 cm) of the Durame city project on the flexibility test (MD =17.8 cm, P = 0.00). On the other hand, there was a significant difference in the mean difference of pre-test values of (18 cm) and post-test values (26.3 cm) of the Hosana city project on the flexibility test ( MD = 8.3 cm, P = 0.00). Conclusion: According to the results of the present studies, there were significant improvements from pre to post-test at Durame City and Hosana City projects on agility, flexibility, power, and speed fitness tests. On the other hand, a significant difference was not found before beginning the exercise between the two projects; however, a significant difference was found after 12 weeks of training.

Keywords: overload, performance, training, volleyball

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Authors: Waleed Aly Sayed Ahmed, Eman Kishk, Tahani Shams

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Aim: To study the effects of co-administration of phosphodiesterase-5 inhibitor (PDE-5) and sodium selenite against the damage induced by ovarian ischemia-reperfusion in rats. Materials and Methods: A total of forty-two sexually mature, virgin, female rats were divided randomly into six groups of seven each: sham group (C), ischemia group (I), ischemia/reperfusion group (I/R), ischemia/reperfusion plus 1.4mg/kg sildenafil (I/R+S) group, ischemia/reperfusion plus 0.2mg/kg selenium (I/R+Se) group and ischemia/reperfusion plus combination of sildenafil and selenium (I/R+S+Se) group. In ischemia group (I), rats were exposed to ischemia for 3 hours (h). In ischemia/reperfusion group (I/R), rats were exposed to ischemia for 3 h followed by 6 h of reperfusion. Treated groups received 1.4mg/kg sildenafil or 0.2 mg/kg selenium or both 30 min before reperfusion. Both ovaries were surgically removed carefully. One ovary was examined for histopathological changes and the other was subject to biochemical analysis including malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GPx). Results: Assessment of ovarian tissue damage using a scoring system showed marked vascular congestion, interstitial edema, leukocyte infiltration, hemorrhage, and follicular degeneration in ischemia and ischemia/reperfusion groups. Tissue damage score for I, IR and all treated groups were significantly higher than those of the sham group (p<0.001), while tissue damage score decreased significantly in I/R+S and I/R+Se groups compared to I/R group (p<0.05), and notably, the difference was highly significant in I/R+S+Se group (p<0.001). There was significant increase in MDA levels and reduction in activities of CAT and GPx in I/R group compared to the sham group (p < 0.05). In I/R+S and I/R+Se groups, MDA was significantly decreased compared to the I/R group (p<0.05) and the difference was highly significant with co-administration of sildenafil and selenium (p<0.001). CAT and GPx were higher in all treated groups compared to I/R group (p<0.05). Conclusion: The co-administration of sildenafil citrate and selenium are highly protective against damage induced by ovarian ischemia/reperfusion in rats.

Keywords: phosphodiesterase-5 inhibitor, sildenafil, antioxidant, selenium, ovarian ischemia

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Authors: Mario M. J. Musonda

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Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance, and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. Collected and analysed data of 35 returned and usable questionnaires from the 50 distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.

Keywords: essential medicine, risk assessment, risk management, supply chain, supply chain risk management

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