Search results for: healthcare evaluation

Authors: Anna Claudia Pellicelli, Silvia Procacci

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The study aims to demonstrate how different locations, where the same product is unveiled and tested, can provide a different result in terms of perception by the same kind of people. The experiment was done in occasion of the presentation of a new bike. A group of dealers has been invited in Lloret de Mar, two persons from the headquarter were present to run the presentation, together with an outsourced trainer. Half day dedicated to the theoretical presentation and half day to the test of the new bike on the road, including the test of its direct competitors. The same presentation, organized in the same way, has been delivered in Italy, in 4 locations often used to run business meetings with dealers. In the end of all days of the presentation, dealers had to fill a questionnaire regarding the evaluation of the different bikes tested. The result of the questionnaire showed how the group invited in Spain rated much higher the new bike compared with the dealers testing the bike in locations already known and close to their home. So, in terms of business strategy, it is important to take into account how the location and the way of presenting any product or service can have a favourable impact on the people we want to convince. The next step of the experiment will be to cross check the sales of that bike with the dealers and measure if there is a relation between the top sellers and the one that appreciated the bike the most, in Spain. It would mean that they were able to transfer to customers the same good feelings and impressions they had in Spain.

Keywords: product presentation, locations, emotional effect, business strategy

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Authors: Paulo José Sigaúque, Paulo Rosman

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The Itajurú channel, located in the Eastern side of the Araruama lagoon, Rio de Janeiro state, is the one who makes the connection between Araruama lagoon and the sea. It is important to understand the hydrodynamic circulation of the location and effects of the sedimentological processes, and also estimate of the hydrodynamic and sedimentological processes in the future after the sea level change due to effects of climate change. This work presents results of a study about sediments dynamics in the Araruama lagoon focusing on the Itajurú channel region considering the present mean sea level and a foreseen sea level rise of 0.5 meters due to climate changes. The study was conducted with the aid of computer modeling for hydrodynamic and morphodynamic in SisBaHiA®. The results indicate that Araruama lagoon is composed by two hydrodynamics compartments; one is dominated by the action of the tide between the entrance of the channel and the strait of Perynas, and another one by the action of wind in narrow region between strait of Perynas and western extreme of the lagoon. With sea level rise, the magnitude of current velocities and flow rates is increased and consequently flow of sediment transport from upstream to downstream of Itajurú channel is increased and has more effect in the bridge Feliciano Sodré.

Keywords: hydrodinamic, superelevation, sea level, climate change

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Authors: Waraporn Boonchieng, Ekkarat Boonchieng, Wilawan Senaratana, Jaras Singkaew

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Geographical information system (GIS) is a designated system widely used for collecting and analyzing geographical data. Since the introduction of ultra-mobile, 'smart' devices, investigators, clinicians, and even the general public have had powerful new tools for collecting, uploading and accessing information in the field. Epidemiology paired with GIS will increase the efficacy of preventive health care services. The objective of this study is to apply GPS location services that are available on the common mobile device with district health systems, storing data on our private cloud system. The mobile application has been developed for use on iOS, Android, and web-based platforms. The system consists of two parts of district health information, including recorded resident data forms and individual health recorded data forms, which were developed and approved by opinion sharing and public hearing. The application's graphical user interface was developed using HTML5 and PHP with MySQL as a database management system (DBMS). The reporting module of the developed software displays data in a variety of views, from traditional tables to various types of high-resolution, layered graphics, incorporating map location information with street views from Google Maps. Multi-extension exporting is also supported, utilizing standard platforms such as PDF, PNG, JPG, and XLS. The data were collected in the database beginning in March 2013, by district health volunteers and district youth volunteers who had completed the application training program. District health information consisted of patients’ household coordinates, individual health data, social and economic information. This was combined with Google Street View data, collected in March 2014. Studied groups consisted of 16,085 (67.87%) and 47,811 (59.87%) of the total 23,701 households and 79,855 people were collected by the system respectively, in Saraphi district, Chiang Mai Province. The report generated from the system has had a major benefit directly to the Saraphi District Hospital. Healthcare providers are able to use the basic health data to provide a specific home health care service and also to create health promotion activities according to medical needs of the people in the community.

Keywords: health, public health, GIS, geographic information system

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Mahnoor Khan, Bashir Ahmad, Khizar Hayat, Saad Ahmad Khan, Laiba Ahmad, Shumaila Bashir, Abid Ali Khan

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The objective of this study was to synthesize the smallest possible size of ZnO NPs using a modified wet chemical synthesis method and to prepare core shell using polyethylene glycol (PEG) as shell material. Advanced and sophisticated techniques were used to confirm the synthesis, size, and shape of these NPs. Rounded, clustered NPs of size 5.343 nm were formed. Both the plain and core shell NPs were tested against MDR bacteria (E. cloacae, E. amnigenus, Shigella, S. odorifacae, Citrobacter, and E. coli). Both of the NPs showed excellent antibacterial properties, whereas E. cloacae showed maximum zone of inhibition of 16 mm, 27 mm, and 32 mm for 500 μg/ml, 1000 μg/ml, and 1500 μg/ml, respectively for plain ZnO NPs and 18 mm, 28 mm and 35 mm for 500 μg/ml, 1000 μg/ml and 1500 μg/ml for core shell NPs. These NPs were also biocompatible on human red blood cells showing little hemolysis of only 4% for 70 μg/ml for plain NPs and 1.5% for 70 μg/ml for core shell NPs. Core shell NPs were highly biocompatible because of the PEG. Their therapeutic effect as photosensitizers in photodynamic therapy (PDT) for cancer treatment was also monitored. The cytotoxicity of ZnO and PEG-ZnO was evaluated using MTT assay. Our results demonstrated that these NPs could generate ROS inside tumor cells after irradiation which in turn initiates an apoptotic pathway leading to cell death hence proving to be an effective candidate for PDT.

Keywords: ZnO, hemolysis, cytotoxiciy assay, photodynamic therapy, antibacterial

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Authors: Faiza Mnasri, Kamilia Abahri, Mohammed El Ganaoui, Slimane Gabsi

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Most of the building materials are considered porous, and composed of solid matrix and pores. In the pores, the moisture can be existed in two phases: liquid and vapor. Thus, the mass balance equation is comprised of various moisture driving potentials that translate the movement of the different existing phases occupying pores and the hygroscopic behavior of a porous construction material. This study suggests to resolve a hygrothermal mathematical model of heat and mass transfers in different porous building materials by a numerical investigation. Thereby, the evolution of temperature and moisture content fields has been processed. So, numerous series of hygrothermal calculation on several cases of wall are exposed. Firstly, a case of monolayer wall of massive wood has been treated. In this part, we have compared the numerical solution of the model on one and two dimensions and the effect of dimensional space has been evaluated. In the second case, three building materials (concrete, wood fiberboard and wooden insulation) are tested separately with the same boundary conditions and their hygrothermal behavior are compared. The evaluation of the exchange of heat and air at the interface between the wall and the interior ambiance is carried.

Keywords: building materials, heat transfer, moisture diffusion, numerical solution

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Authors: Sajeeha Ansar, Asad Ali Safi, Sheikh Ziauddin, Ahmad R. Shahid, Faraz Ahsan

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Gliomas are most challenging and aggressive type of tumors which appear in different sizes, locations, and scattered boundaries. CNN is most efficient deep learning approach with outstanding capability of solving image analysis problems. A fully automatic deep learning based 2D-CNN model for brain tumor segmentation is presented in this paper. We used small convolution filters (3 x 3) to make architecture deeper. We increased convolutional layers for efficient learning of complex features from large dataset. We achieved better results by pushing convolutional layers up to 16 layers for HGG model. We achieved reliable and accurate results through fine-tuning among dataset and hyper-parameters. Pre-processing of this model includes generation of brain pipeline, intensity normalization, bias correction and data augmentation. We used the BRATS-2015, and Dice Similarity Coefficient (DSC) is used as performance measure for the evaluation of the proposed method. Our method achieved DSC score of 0.81 for complete, 0.79 for core, 0.80 for enhanced tumor regions. However, these results are comparable with methods already implemented 2D CNN architecture.

Keywords: brain tumor segmentation, convolutional neural networks, deep learning, HGG

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Authors: Karam Ignaim, Joao M. Fernandes, Andre L. Ferreira

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Mapping the artifacts coming from a set of similar products family developed in an ad-hoc manner to make up the resulting software product line (SPL) plays a key role to maintain the consistency between requirements and code. This paper presents a feature mapping approach that focuses on tracing the artifact coming from the migration process, the current feature model (FM), to the other artifacts of the resulting SPL, the reference architecture, and code. Thus, our approach relates each feature of the current FM to its locations in the implementation code, using the reference architecture as an intermediate artifact (as a centric point) to preserve consistency among them during an SPL evolution. The approach uses a particular artifact (i.e., traceability tree) as a solution for managing the mapping process. Tool support is provided using friendlyMapper. We have evaluated the feature mapping approach and tool support by putting the approach into practice (i.e., conducting a case study) of the automotive domain for Classical Sensor Variants Family at Bosch Car Multimedia S.A. The evaluation reveals that the mapping approach presented by this paper fits the automotive domain.

Keywords: feature location, feature models, mapping, software product lines, traceability

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Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Nur Allisha Othman, Rosnah Shamsudin, Zaulia Othman, Siti Hajar Othman

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Mitigating short storage life of fruit like banana uses minimally process or known as fresh cut can contribute to the growing demand especially in South East Asian countries. The effect of different types of packaging material on fresh-cut Nipah (Musa acuminata balbisiana) were studied. Fresh cut banana cultivar (cv) Nipah are packed in polypropylene plastic (PP), low density polypropylene plastic (LDPE), polymer plastic film (shrink wrap) and polypropylene container as control for 12 days at low temperature (4ᵒC). Quality of physical and chemical evaluation such as colour, texture, pH, TA, TSS, and vitamin C were examined every 2 days interval for 12 days at 4ᵒC. Result shows that the PP is the most suitable packaging for banana cv Nipah because it can reduce respiration and physicochemical quality changes of banana cv Nipah. Different types of packaging significantly affected quality of fresh-cut banana cv Nipah. PP bag was the most suitable packaging to maintain quality and prolong storage life of fresh-cut banana cv Nipah for 12 days at 4ᵒC.

Keywords: physicochemical, PP, LDPE, shrink wrap, browning, respiration

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Authors: Li Yongyi

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In order to explore the distribution of geological disasters within the expressway area of Shaanxi Province, the Analytic Hierarchy Process theory is applied based on the geographic information system technology platform, and the ground elevation, rainfall, vegetation coverage and other indicators are selected for analysis, and the expressway area is sensitive Sexual evaluation. The results show that the highway area disasters in Shaanxi Province are mainly distributed in the southern mountainous areas and are dominated by landslides; the disaster area ratio basically increases with the increase in ground elevation, surface slope, surface undulation, rainfall, and vegetation coverage. The increase in the distance from the river shows a decreasing trend; after grading the disaster sensitivity within 5km of the expressway, the extremely sensitive area, the highly sensitive area, the medium sensitive area, the low sensitive area, and the extremely low sensitive area respectively account for 8.17%、15.80%、22.99%、26.22%、26.82%. Highly sensitive road areas are mainly distributed in southern Shaanxi.

Keywords: highway engineering, sensitivity, analytic hierarchy process, geological hazard, road area

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Authors: Thorsten Herrmann, Alexander Laukemann, Hansgeorg Binz, Daniel Roth

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For the analysis of already identified and existing problems, the pertinent literature provides a comprehensive collection of approaches as well as methods in order to analyze the problems in detail. But coming up with problems, which are assets worth pursuing further, is often challenging. However, the importance of well-formulated problem ideas and their influence of subsequent creative processes are incontestable and proven. In order to meet the covered challenges, the Institute for Engineering Design and Industrial Design (IKTD) developed the Emoji Method. This paper presents the Emoji Method, which support designers to generate problem ideas in a structured way. Considering research findings from knowledge management and innovation management, research into emojis and emoticons reveal insights by means of identifying and formulating problem ideas within the early design phase. The simple application and the huge supporting potential of the Emoji Method within the early design phase are only few of the many successful results of the conducted evaluation. The Emoji Method encourages designers to identify problem ideas and describe them in a structured way in order to start focused with generating solution ideas for the revealed problem ideas.

Keywords: emojis, problem ideas, innovation management, knowledge management

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Authors: Ravinder Singh, Ankita Gurao, Saroj Bandhan, Sudhir Kumar Kashyap

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The Bos taurus Beta defensin 3 is a defensin peptide secreted by neutrophils and epithelial that exhibits anti-microbial activity. It is one of the crucial components forming an innate defense against intra mammary infections in livestock. The beta defensin 3 by virtue of its anti-microbial activity inhibits major mastitis pathogens including Staphylococcus aureus and Pseudomonas aeruginosa etc, which are also responsible for biofilm formation leading to antibiotic resistance phenomenon. Therefore, the defensin may prove as a non-conventional option to treat mastitis. In this study, computational analysis has been performed including sequence comparison among species and homology modeling of Bos taurus beta defensin 3 protein. The assessments of protein structure were done using the protein structure and model assessment tools integrated in Swiss Model server, which employs various local and global quality evaluation parameters. Further, molecular docking was also carried out between the defensin peptide and the components of biofilm to gain insight into various interactions and structural differences crucial for functionality of this protein.

Keywords: beta defensin 3, bos taurus, docking, homology modeling

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Authors: Pratap Sriram Sundar, Chandan Chowdhury, Sagar Kamarthi

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Nature has perfected her designs over 3.5 billion years of evolution. Research fields such as biomimicry, biomimetics, bionics, bio-inspired computing, and nature-inspired designs have explored nature-made artifacts and systems to understand nature’s mechanisms and intelligence. Learning from nature, the researchers have generated sustainable designs and innovation in a variety of fields such as energy, architecture, agriculture, transportation, communication, and medicine. Axiomatic design offers a method to judge if a design is good. This paper analyzes design aspects of one of the nature’s amazing object: chicken egg. The functional requirements (FRs) of components of the object are tabulated and mapped on to nature-chosen design parameters (DPs). The ‘independence axiom’ of the axiomatic design methodology is applied to analyze couplings and to evaluate if eggs’ design is good (i.e., uncoupled design) or bad (i.e., coupled design). The analysis revealed that eggs design is a good design, i.e., uncoupled design. This approach can be applied to any nature’s artifacts to judge whether their design is a good or a bad. This methodology is valuable for biomimicry studies. This approach can also be a very useful teaching design consideration of biology and bio-inspired innovation.

Keywords: uncoupled design, axiomatic design, nature design, design evaluation

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Authors: Hsu-Hui Cheng, Peng-Chian Chen, Shu-Yuan Chang, Jie-Ying Zhang

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Activities in the music practice rooms range from playing, listening, rehearsing to music performing. The good room acoustics in a music practice room enables a music teacher to teach more effectively subtle concepts such as intonation, articulation, balance, dynamics and tone production. A poor acoustical environment would deeply affect the development of basic musical skills of music students. Practicing in the music practice room is an essential daily activity for music students; consequently, music practice rooms are very important facilities in a music school or department. The purpose of this survey is to measure and analyze the acoustic condition of piano practice rooms at the department of music in Zhaoqing University and accordingly apply a more effective teaching method to music students. The volume of the music practice room is approximately 25 m³, and it has existing curtains and some wood hole sound-absorbing panels. When all small music practice rooms are in constant use for teaching, it was found that the values of the background noise at 45, 46, 42, 46, 45 dB(A) in the small music practice room ( the doors and windows were close), respectively. The noise levels in the small music practice room to higher than standard levels (35dB(A)).

Keywords: acoustical performance, music practice room, noise level, piano room

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Authors: J. Vyas, R. Kazys, J. Sestoke

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Air-coupled ultrasonic is the contactless ultrasonic measurement approach which has become widespread for material characterization in Aerospace industry. It is always essential for the requirement of lightest weight, without compromising the durability. To archive the requirements, composite materials are widely used. This paper yields analysis of the air-coupled ultrasonics for composite materials such as CFRP (Carbon Fibre Reinforced Polymer) and GLARE (Glass Fiber Metal Laminate) and honeycombs for the design of modern aircrafts. Laser vibrometry could be the key source of characterization for the aerospace components. The air-coupled ultrasonics fundamentals, including principles, working modes and transducer arrangements used for this purpose is also recounted in brief. The emphasis of this paper is to approach the developed NDT techniques based on the ultrasonic guided waves applications and the possibilities of use of laser vibrometry in different materials with non-contact measurement of guided waves. 3D assessment technique which employs the single point laser head using, automatic scanning relocation of the material to assess the mechanical displacement including pros and cons of the composite materials for aerospace applications with defects and delaminations.

Keywords: air-coupled ultrasonics, contactless measurement, laser interferometry, NDT, ultrasonic guided waves

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Authors: A. K. Areamu, J. C. Igbeka

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The performance of box-type solar cookers has been reported by several researchers but little attention was paid to the effect of the type of insulation material on the energy and exergy efficiency of these cookers. This research aimed at evaluating the energy and exergy efficiencies of the box-type cookers containing different insulation materials. Energy and exergy efficiencies of five box-type solar cookers insulated with maize cob, air (control), maize husk, coconut coir and polyurethane foam respectively were obtained over a period of three years. The cookers were evaluated using water heating test procedures in determining the energy and exergy analysis. The results were subjected to statistical analysis using ANOVA. The result shows that the average energy input for the five solar cookers were: 245.5, 252.2, 248.7, 241.5 and 245.5J respectively while their respective average energy losses were: 201.2, 212.7, 208.4, 189.1 and 199.8J. The average exergy input for five cookers were: 228.2, 234.4, 231.1, 224.4 and 228.2J respectively while their respective average exergy losses were: 223.4, 230.6, 226.9, 218.9 and 223.0J. The energy and exergy efficiency was highest in the cooker with coconut coir (37.35 and 3.90% respectively) in the first year but was lowest for air (11 and 1.07% respectively) in the third year. Statistical analysis showed significant difference between the energy and exergy efficiencies over the years. These results reiterate the importance of a good insulating material for a box-type solar cooker.

Keywords: efficiency, energy, exergy, heating insolation

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Authors: Mimoza Canga, Irene Malagnino, Vergjini Mulo, Alketa Qafmolla, Vito Antonio Malagnino

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Background: Dental caries is the most common dental disease and pregnancy represents a special process of physical, hormonal and metabolic changes in pregnant women, which is accompanied by an imbalance in the oral cavity. Objective: The objective of this study is to evaluate caries reduction after dental visits, the scaling of teeth, fluoridated water, brushing of the teeth and using fluoride toothpaste before and during pregnancy. Materials and methods: This study was conducted in the time period March 2018- September 2021, the age range of the participants was: 18-41 years old. The sample taken under observation was composed of 84 pregnant women. The questionnaire included the demographic characteristics of the sample, such as age, women's education level was primary, secondary, and higher education. Based on women's education level, our analysis found that 25.9% of pregnant women had completed primary education, 35.2% of them had secondary education and 38.9% of pregnant women had higher education. The descriptive and analytical research analysis is formulated as a longitudinal study. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: In the present study, it was observed that there is a strong relationship between dental visits and the scaling of the teeth with the value of P˂ .0001. While the number of teeth with caries before pregnancy and fluoridated water have a P-value=0.002. If we compare the same factor with the number of teeth with dental caries during pregnancy, the correlation is P-value = 0.0001. The number of teeth with caries before pregnancy and carbohydrates consumption has a strong relation with P-value=0.05. According to the present research, the number of teeth with dental caries before pregnancy in relation to brushing the teeth has a P-value ˂ 0.05. Furthermore, in the actual research, it was established that using fluoride toothpaste doesn’t affect the number of teeth with caries before pregnancy with a P-value= .314. Conclusion: According to the results of the present study performed in Albania, it was found out that the periodical dental visits, scaling of the teeth, fluoridated water, brushing of the teeth influenced caries reduction before and during pregnancy. In comparison, the usage of fluoride toothpaste did not have any effect on dental caries reduction in the same time period. The recommendations are as follows: maintaining oral hygiene, using fluoridated water and brushing the teeth regularly. Healthcare providers should inform pregnant women about the importance of oral health and the implementation of measures to manage dental caries.

Keywords: brushing of the teeth, dental visits, dental scaling, fluoridated water, pregnancy

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Authors: Amir Jalalian-Khakshour, T. N. Croft

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Vertical Axis Wind Turbine (VAWT) systems are becoming increasingly popular as they have a number of advantages over traditional wind turbines. The advantages are reliability, ease of transportation and manufacturing. These attributes could make these technologies useful in developing economies. The performance characteristics of a VAWT are different from a horizontal axis wind turbine, which can be attributed to the low tip speed ratio operation. To unlock the potential of these VAWT systems, the operational behaviour in a number of system topologies and environmental conditions needs to be understood. In this study, a non-linear dynamic simulation method was developed in Matlab and validated against in field data of a large scale, 8-meter rotor diameter prototype. This simulation method has been utilised to determine the performance characteristics of a number of control methods and system topologies. The motivation for this research was to develop a simulation method which accurately captures the operating behaviour and is computationally inexpensive. The model was used to evaluate the performance through parametric studies and optimisation techniques. The study gave useful insights into the applications and energy generation potential of this technology.

Keywords: power generation, renewable energy, rotordynamics, wind energy

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Authors: Ali Amiri, Arash Esfandiari, Elham Zarenezhad

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We report here an efficient and rapid method for the preparation of 3,4-dihydro-1H-quinoxalin-2-ones and 1H‑quinolin-2-ones that involves grinding of o-, m-, or p‑phenylenediamine and three dialkyl acetylenedicarboxylates using a pestle and mortar. This solvent-free approach requires only a few minutes of reaction time. This type of reaction is expected to be the most economical method since neither catalyst nor solvent is used. Finally, all synthesised compounds were screened for antimicrobial activity against two Gram-positive bacteria (Pseudomonas aeruginosa PTCC 1077, Escherichia coli PTCC1330) and two Gram-negative bacteria (Staphylococcus aureus PTCC 1133, Bacillus cereus PTCC 1015) and their activity. Compared with gentamycin and ampicillin as reference drugs for Gram-negative and Gram-positive bacteria, respectively. The minimum inhibitory concentration (MIC) of the synthesised compounds and reference drugs were determined by the microdilution method. Good antibacterial activity was observed for 3,4-dihydro-1H-quinoxalin-2-ones against all species of Gram-positive and Gram-negative bacteria, and1H‑quinolin-2-ones showed good antibacterial activity against two Gram-positive bacteria.

Keywords: quinolin, quinoxalin, anti-bacterial activity, minimum inhibitory concentration (MIC)

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Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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Authors: Jun-ya Nagase

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There are many pipes such as a water pipe and a gas pipe in a chemical plant and house. It is possible to prevent accidents by these inspections. However, many pipes are very narrow and it is difficult for people to inspect directly. Therefore, development of a robot that can move in narrow pipe is necessary. A wheel movement type robot, a snake-like robot and a multi-leg robot are all described in the relevant literature as pipe inspection robots that are currently studied. Among them, the tracked crawler robot can travel by traversing uneven ground flexibly with a crawler belt attached firmly to the ground surface. Although conventional crawler robots have high efficiency and/or high ground-covering ability, they require a comparatively large space to move. In this study, a cylindrical crawler robot based on worm-rack mechanism, which does not need large space to move and which has high ground-covering ability, is proposed. Experiments have demonstrated smooth operation and a forward movement of the robot by application of voltage to the motor. In addition, performance tests show that it can propel itself in confined spaces. This paper reports the structure, drive mechanism, prototype, and experimental evaluation.

Keywords: tracked-crawler, pipe inspection robot, worm-rack mechanism, amoeba locomotion

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Authors: Imdat Taymaz, Erman Aslan, Kemal Cakir

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The Lattice Boltzmann Method (LBM) is performed to computationally investigate the laminar flow and heat transfer of an incompressible fluid with constant material properties in a 2D channel with a built-in triangular prism. Both momentum and energy transport is modelled by the LBM. A uniform lattice structure with a single time relaxation rule is used. Interpolation methods are applied for obtaining a higher flexibility on the computational grid, where the information is transferred from the lattice structure to the computational grid by Lagrange interpolation. The flow is researched on for different Reynolds number, while Prandtl number is keeping constant as a 0.7. The results show how the presence of a triangular prism effects the flow and heat transfer patterns for the steady-state and unsteady-periodic flow regimes. As an evaluation of the accuracy of the developed LBM code, the results are compared with those obtained by a commercial CFD code. It is observed that the present LBM code produces results that have similar accuracy with the well-established CFD code, as an additionally, LBM needs much smaller CPU time for the prediction of the unsteady phonema.

Keywords: laminar forced convection, lbm, triangular prism

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Authors: Vahid Nademi

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In response to widely used wearable medical devices equipped with a continuous glucose monitor (CGM) and insulin pump, the advanced control methods are still demanding to get the full benefit of these devices. Unlike costly clinical trials, implementing effective insulin-glucose control strategies can provide significant contributions to the patients suffering from chronic diseases such as diabetes. This study deals with a key role of two-layer insulin-glucose regulator based on model-predictive-control (MPC) scheme so that the patient’s predicted glucose profile is in compliance with the insulin level injected through insulin pump automatically. It is achieved by iterative optimization algorithm which is called an integrated perturbation analysis and sequential quadratic programming (IPA-SQP) solver for handling uncertainties due to unexpected variations in glucose-insulin values and body’s characteristics. The feasibility evaluation of the discussed control approach is also studied by means of numerical simulations of two case scenarios via measured data. The obtained results are presented to verify the superior and reliable performance of the proposed control scheme with no negative impact on patient safety.

Keywords: blood glucose monitoring, insulin pump, predictive control, optimization

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Authors: Janet Joy, Shri Shailesh Amarkhed, Pradeep M. Kulkarni

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Introduction: Ureteral stent-related symptoms significantly impact patients' quality of life. This study compared the efficacy of Mirabegron, Tolterodine, and Fesoterodine in managing these symptoms. Methodology: In this prospective, randomized, placebo-controlled trial, two hundred patients undergoing ureteral stenting were randomly assigned to receive Mirabegron, Tolterodine, Fesoterodine, or placebo for two weeks. Symptoms were assessed using the Ureteral Stent Symptom Questionnaire (USSQ) at stent removal. Results: 200 patients completed the study. Mirabegron demonstrated the lowest mean USSQ score (31.6 ± 6.4), followed by Fesoterodine (34.0 ± 6.9) and Tolterodine (35.0 ± 7.2), all significantly lower than placebo (48.6 ± 8.7, p<0.001). Mirabegron showed superior efficacy in reducing urinary symptoms (score: 16.5 ± 3.9) compared to Fesoterodine (17.8 ± 4.1) and Tolterodine (18.2 ± 4.3). Side effects, such as parched mouth, were less frequent with Mirabegron (6%) than with Tolterodine (28%) and Fesoterodine (24%). Conclusion: All three medications significantly improved stent-related symptoms compared to placebo. Mirabegron demonstrated a trend toward superior efficacy and fewer side effects, suggesting its potential as a first-line treatment for stent-related discomfort.

Keywords: ureteral stent, mirabegron, tolterodine, fesoterodine, USSQ, stent-related symptoms

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Authors: Alvaro Valera Sosa

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Background: In recent years, childhood overweight and obesity have become an increasing and challenging phenomenon in Berlin and Germany in general. The highest shares of childhood overweight in Berlin are district localities within the inner city ring with lowest socio-economic levels and the highest number of migration background populations. Most factors explaining overweight and obesity are linked to individual dispositions and nutrition balances. Among various strategies, to target drinking behaviors of children and adolescents has been proven to be effective. On the one hand, encouraging the intake of water – which does not contain energy and thus may support a healthy weight status – on the other hand, reducing the consumption of sugar-containing beverages – which are linked to weight gain and obesity. Anyhow, these preventive approaches have mostly developed into individual or educational interventions widely neglecting environmental modifications. Therefore, little is known on how urban physical environment patterns and features can act as influence factors for childhood overweight. Aiming the development of a physical environment intervention tackling children overweight, this study evaluated urban situations surrounding public playgrounds in Berlin where the issue is evident. It verified the presence and state of physical environmental conditions that can be conducive for children to engage physical activity and water intake. Methods: The study included public playgrounds for children from 0-12 y/o within district localities with the highest prevalence of childhood overweight, highest population density, and highest mixed uses. A systematic observation was realized to describe physical environment patterns and features that may affect children health behavior leading to overweight. Neighborhood walkability for all age groups was assessed using the Walkability for Health framework (TU-Berlin). Playground physical environment conditions were evaluated using Active Living Research assessment sheets. Finally, the food environment in the playground’s pedestrian catchment areas was reviewed focusing on: proximity to suppliers offering sugar-containing beverages, and physical access for 5 y/o children and up to drinking water following the Drinking Fountains and Public Health guidelines of the Pacific Institute. Findings: Out of 114 locations, only 7 had a child population over 3.000. Three with the lowest socio-economic index and highest percentage of migration background were selected. All three urban situations presented similar walkability: large trafficked avenues without buffer bordering at least one side of the playground, and important block to block disconnections for active travel. All three playgrounds rated equipment conditions from good to very good. None had water fountains at the reach of a 5 y/o. and all presented convenience stores and/or fast food outlets selling sugar-containing beverages nearby the perimeter. Conclusion: The three playground situations selected are representative of Berlin locations where most factors that influence children overweight are found. The results delivered urban and architectural design directives for an environmental intervention, used to study children health-related behavior. A post-intervention evaluation could prove associations between designed spaces and children overweight rate reduction creating a precedent in public health interventions and providing novel strategies for the health sector.

Keywords: children overweight, evaluation research, public playgrounds, urban design, urban health

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Authors: Maryam Beiranvand

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Multi-drug resistance in various microorganisms has increased globally in many healthcare facilities. Less effective antimicrobial activity of drug therapies for infection control becomes trouble. Since 1980, no new type of antimicrobial drug has been identified, even though combinations of antibiotic drugs have been discovered almost every decade. Between 1981 and 2006, over 70% of novel pharmaceuticals and chemical agents came from natural sources. Microorganisms have yielded almost 22,000 natural compounds. The identification of antimicrobial components from endophytes bacteria could help overcome the threat posed by multi-drug resistant strains. The project aims to analyze and identify antimicrobial peptides isolated from entophytic bacteria and their activity against multidrug-resistant Gram-negative bacteria in South Korea. Endophytic Paenibacillus polymyxa. 4G3 isolated from the plant, Gynura procumbery exhibited considerable antimicrobial activity against Methicillin-resistant Staphylococcus aureus, and Escherichia coli. The Rapid Annotations using Subsystems Technology showed that the total size of the draft genome was 5,739,603bp, containing 5178 genes with 45.8% G+C content. Genome annotation using antiSMASH version 6.0.0 was performed, which predicted the most common types of non-ribosomal peptide synthetase (NRPS) and polyketide synthase (PKS). In this study, diethyl aminoethyl cellulose (DEAEC) resin was used as the first step in purifying for unknown peptides, and then the target protein was identified using hydrophilic and hydrophobic solutions, optimal pH, and step-by-step tests for antimicrobial activity. This crude was subjected to C18 chromatography and elution with 0, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100% methanol, respectively. Only the fraction eluted with 20% -60% methanol demonstrated good antimicrobial activity against MDR E. coli. The concentration of the active fragment was measured by the Brad-ford test, and Protein A280 - Thermo Fisher Scientific at the end by examining the SDS PAGE Resolving Gel, 10% Acrylamide and purity were confirmed. Our study showed that, based on the combined results of the analysis and purification. P polymyxa. 4G3 has a high potential exists for producing novel functions of polymyxin E and bacitracin against bacterial pathogens.

Keywords: endophytic bacteria, antimicrobial activity, antimicrobial peptide, whole genome sequencing analysis, multi -drug resistance gram negative bacteria

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Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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Authors: Abebe Mulugojam Negash, Yongbin Yu, Ekong Favour, Bekalu Nigus Dawit, Molla Woretaw Teshome, Aynalem Birtukan Yirga

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Breast cancer remains a significant health concern, necessitating advancements in diagnostic methodologies. Addressing this, our paper confronts the notable challenges in breast cancer classification, particularly the imbalance in datasets and the constraints in the accuracy and interpretability of prevailing deep learning approaches. We proposed an attention-based residual neural network (ResNet), which effectively combines the robust features of ResNet with an advanced attention mechanism. Enhanced through strategic data augmentation and positive weight adjustments, this approach specifically targets the issue of data imbalance. The proposed model is tested on the BreakHis dataset and achieved accuracies of 99.00%, 99.04%, 98.67%, and 98.08% in different magnifications (40X, 100X, 200X, and 400X), respectively. We evaluated the performance by using different evaluation metrics such as precision, recall, and F1-Score and made comparisons with other state-of-the-art methods. Our experiments demonstrate that the proposed model outperforms existing approaches, achieving higher accuracy in breast cancer classification.

Keywords: residual neural network, attention mechanism, positive weight, data augmentation

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Authors: Jin A Ryu, Hee Sun Kim

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As the number of fire accidents is gradually raising, many studies have been reported on evacuation. Previous studies have mostly focused on evaluating the safety of evacuation and the risk of fire in particular buildings. However, studies on effects of various parameters on evacuation have not been nearly done. Therefore, this paper aims at observing evacuation time under the effect of fire initiated location. In this study, evacuation simulations are performed on a 5-floor building located in Seoul, South Korea using the commercial program, Fire Dynamics Simulator with Evacuation (FDS+EVAC). Only the fourth and fifth floors are modeled with an assumption that fire starts in a room located on the fourth floor. The parameter for evacuation simulations is location of fire initiation to observe the evacuation time and safety. Results show that the location of fire initiation is closer to exit, the more time is taken to evacuate. The case having the nearest location of fire initiation to exit has the lowest ratio of successful occupants to the total occupants. In addition, for safety evaluation, the evacuation time calculated from computer simulation model is compared with the tolerable evacuation time according to code in Japan. As a result, all cases are completed within the tolerable evacuation time. This study allows predicting evacuation time under various conditions of fire and can be used to evaluate evacuation appropriateness and fire safety of building.

Keywords: fire simulation, evacuation simulation, temperature, evacuation safety

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