Search results for: guideline adherence

Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Abdelkarim Mahdhi, Fdhila Kais, Faouzi Lamari, Zeineb Hmila, Fathi Kamoun, Maria Ángeles Esteban, Amina Bakhrouf

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Aquaculture is the world’s fastest growing food-production sector. However, one of the most serious problems regarding the culture of marine fishes is the mortality associated with pathogenic bacteria that occurs in the critical phases of larval development. Conventional approaches, such as the use of antimicrobial drugs to control diseases, have had limited success in the prevention or cure of aquatic diseases. Promising alternatives to antibiotics are probiotics, which are food supplements consisting of live microorganisms that benefit the host organism. In the search for more effective and environmentally friendly treatments with probionts against pathogenic species in shrimp larval culture, the probiotic properties of Bacillus strains isolated from Artemia culture such as antibacterial activity, adhesion, pathogenicity, toxicity and the effect of marine stress on viability and survival were investigated, as well as the changes occurring in their properties. Analyses showed that these bacteria corresponded to the genus Bacillus sp. Antagonism and adherence assays revealed that these strains have an inhibitory effect against pathogenic bacteria in vitro and in vivo conditions and are fairly adherent. Challenge tests performed with Artemia larvae provided evidence that the tested Bacillus strains were neither pathogenic nor toxic to the host. The tested strains maintained their viability and their probiotic properties during the period of study. The results suggest that the tested strains have suffered changes allowing them to survive in seawater in the absence of nutrients and outside their natural host, identifying them as potential probiotic candidates for Artemia culture.

Keywords: bacillus, probiotic, cell viability, stress response

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Authors: U. Waqas, M. F. Ahmed, A. Mehmood, M. A. Rashid

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In geophysical exploration surveys, the quality of acquired data holds significant importance before executing the data processing and interpretation phases. In this study, 2D seismic reflection survey data of Fort Abbas area, Cholistan Desert, Pakistan was taken as test case in order to assess its quality on statistical bases by using normalized root mean square error (NRMSE), Cronbach’s alpha test (α) and null hypothesis tests (t-test and F-test). The analysis challenged the quality of the acquired data and highlighted the significant errors in the acquired database. It is proven that the study area is plain, tectonically least affected and rich in oil and gas reserves. However, subsurface 3D modeling and contouring by using acquired database revealed high degrees of structural complexities and intense folding. The NRMSE had highest percentage of residuals between the estimated and predicted cases. The outcomes of hypothesis testing also proved the biasness and erraticness of the acquired database. Low estimated value of alpha (α) in Cronbach’s alpha test confirmed poor reliability of acquired database. A very low quality of acquired database needs excessive static correction or in some cases, reacquisition of data is also suggested which is most of the time not feasible on economic grounds. The outcomes of this study could be used to assess the quality of large databases and to further utilize as a guideline to establish database quality assessment models to make much more informed decisions in hydrocarbon exploration field.

Keywords: Data quality, Null hypothesis, Seismic lines, Seismic reflection survey

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Authors: Afshan Saad, Muhammad Saad, Shah Muhammad Emaduddin

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Nowadays the business condition is so quick paced that enhancing ourselves consistently has turned into a huge factor for the presence of an undertaking. We can check this for structural building and significantly more so in the quick-paced universe of data innovation and programming designing. The lithe philosophies, similar to Scrum, have a devoted advance in the process that objectives the enhancement of the improvement procedure and programming items. Pivotal to process enhancement is to pick up data that grants you to assess the condition of the procedure and its items. From the status data, you can design activities for the upgrade and furthermore assess the accomplishment of those activities. This investigation builds a model that measures the product nature of the improvement procedure. The product quality is dependent on the useful and auxiliary nature of the product items, besides the nature of the advancement procedure is likewise vital to enhance programming quality. Utilitarian quality covers the adherence to client prerequisites, while the auxiliary quality tends to the structure of the product item's source code with reference to its practicality. The procedure quality is identified with the consistency and expectedness of the improvement procedure. The product quality model is connected in a business setting by social occasion the information for the product measurements in the model. To assess the product quality model, we investigate the information and present it to the general population engaged with the light-footed programming improvement process. The outcomes from the application and the client input recommend that the model empowers a reasonable evaluation of the product quality and that it very well may be utilized to help the persistent enhancement of the advancement procedure and programming items.

Keywords: Agile SDLC Tools, Agile Software development, business value, enterprise applications, IBM, IBM Rational Team Concert, RTC, software quality, software metrics

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Authors: Maryam Ghavam Sadri, Kimia Moiniafshari

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Objectives: Autism is a neuro-developmental disorder that has negative effects on verbal, mental and behavioral development. Studies have shown the role of a maternal dietary pattern before and during pregnancy. The relation of exerting of nutritional management programs in prevention of Autism has been approved. This review article has been made to investigate the role of nutritional management strategies before and during pregnancy in the prevention of Autism. Methods: This review study was accomplished by using the keywords related to the topic, 67 articles were found (2000-2015) and finally 20 article with criteria such as including maternal lifestyle, nutritional deficiencies and Autism prevention were selected. Results: Maternal dietary pattern and health before and during pregnancy have important roles in the incidence of Autism. Studies have suggested that high dietary fat intake and obesity can increase the risk of Autism in offspring. Maternal metabolic condition specially gestational diabetes (GDM) (p-value < 0.04) and folate deficiency (p-value = 0.04) is associated with risk of Autism. Studies have shown that folate intake in mothers with autistic children is less than mothers who have typically developing children (TYP) (p-value<0.01). As folate is an essential micronutrient for fetus mental development, consumption of average 600 mcg/day especially in P1 phase of pregnancy results in significant reduction in incidence of Autism (OR:1.53, 95%CI=0.42-0.92, p-value = 0.02). furthermore, essential fatty acid deficiency especially omega-3 fatty acid increases the rate of Autism and consumption of supplements and food sources of omega-3 can decrease the risk of Autism up to 34% (RR=1.53, 95%CI=1-2.32). Conclusion: regards to nutritional deficiency and maternal metabolic condition before and during pregnancy in prevalence of Autism, carrying out the appropriate nutritional strategies such as well-timed folate supplementation before pregnancy and healthy lifestyle adherence for prevention of metabolic syndrome (GDM) seems to help Autism prevention.

Keywords: autism, autism prevention, dietary inadequacy, maternal lifestyle

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Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

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Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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Authors: Miseri Roeslan Afany, Nur Ainun Pulungan

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The unique characteristics of Andisol differentiate them from other soils. These characteristics become a guideline in determining management and usage with regards to agriculture. Especially in the tropical area, Andisols may have fast mineral alteration due to intensive water movement in the soils. Four soil chemical tests were conducted for evaluating soils in the study area. Al/Fe humus, allophane, pH, and P retention were used to differentiate Andisols under different practices. Non-cultivation practice (e.g. natural forest) and cultivation practices (e.g. horticulture systems and intensive farming systems) are compared in this study. We applied Blackmore method for P retention analysis. The aims of this study are: (i) to analyze the specific behavior of Al/Fe humus, pH, and allophane towards P retention in order (ii) to evaluate the effect of cultivation practices on their behavior changes among Andisols, and (iii) to gain the sustainable agriculture through proposing an appropriate soil managements in the study area. 5 observation sites were selected, and 75 soil sampling were analyzed in this study. The results show that the cultivation decreases P retention in all sampling sites. There is a declining from ±90% to ±50% of P retention in the natural forest where shifts into cultivated land. The average of P retention under 15 years of cultivation down into 63%, whereas, the average of P retention more than 15 years of cultivation down into 54%. Many factors affect the retention of P in the soil such as: (1) type and amount of clay, (2) allophone and/or imogolit, (3) Al/Fe humus, (4) soil pH, (5) type and amount of organic material, (6) Exchangeable bases (Ca, Mg, Na, K), (7) forms and solubility of Al/Fe. To achieve the sustainable agriculture in the study area, conventional agriculture practices should be preserved and intensive fertilizing practices should be applied in order to increase the soil pH, to maintain the organic matter of andisols, to maintain microba activities, and to release Al/Fe humus complex, and thus increase available P in the soils.

Keywords: Andisols, cultivation, P retention, sustainable agriculture

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Authors: Dishari Rakshit, Mitchell Gallagher

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The global landscape is witnessing a disconcerting surge in democratic backsliding, engendering concerns over the rise of autocratisation. This research demonstrates the intricate relationship between a nation's domestic propensity for autocratic governance and its trade relations with China. Giving prominence to Belt and Road Initiative (BRI) investments, this study adopts a rigorous neorealist framework to discern the complexities of nations' economic interests amidst an anarchic milieu and how these interests may transcend steadfast adherence to democratic principles. The burgeoning bipolarity in the international political setting serves as a backdrop to our inquiry. To operationalise our hypothesis, we conduct a large-scale 'N' study, encompassing a comprehensive global dataset comprising countries' democracy indicators, total trade volume with China, and cumulative Chinese BRI investments over a substantial temporal expanse. By meticulously examining BRI signatories’, we aim to ascertain the potential accentuation of democratic backsliding among these nations. To test our empirical underpinning, we will validate our findings through cogent case studies. Our analysis adds to the scholarship on multifaceted interactions between trade dynamics and democratic governance within the fabric of the international political landscape. In its culmination, the paper addresses the question- has the erstwhile grandeur of bipolarity resurfaced in the contemporary global panorama? Concurrently, we explore the nexus between the ascendant wave of autocratisation as a by-product of the Beijing Consensus? Pertinent to policymakers, our discoveries stand poised to furnish a comprehensive grasp of the manifold implications arising from the deepening entanglements with China under the auspices of the BRI.

Keywords: democracy, autocracy, china, belt road initiative, international political economy

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Authors: Nana Gorgiladze, Tamar Gaprindashvili, Mikheil Shavdia, Zurab Pagava

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Introduction/Purpose Chemotherapy is a common treatment for breast cancer, but it can also cause damage to the heart and blood vessels. This damage, known as cancer therapy-related cardiovascular toxicity (CTR-CVT), can increase the risk of heart failure and death in breast cancer patients. The left ventricle is often affected by CTR-CVT, but the right ventricle (RV) may also be vulnerable to CTR-CVT and may show signs of dysfunction before the left ventricle. The study aims to investigate how the RV function changes during chemotherapy for breast cancer by using conventional echocardiographic and global longitudinal strain (GLS) techniques. By measuring the GLS strain of the RV, researchers tend to detect early signs of CTR-CVT and improve the management of breast cancer patients. Methods The study was conducted on 28 women with low cardiovascular risk who received anthracycline chemotherapy for breast cancer. Conventional 2D echocardiography (LVEF, RVS’, TAPSE) and speckle-tracking echocardiography (STE) measurements of the left and right ventricles (LVGLS, RVGLS) were used to assess cardiac function before and after chemotherapy. All patients had normal LVEF at the beginning of the study. Cardiotoxicity was defined as a new LVEF reduction of 10 percentage points to an LVEF of 40-49% and/or a new decline in GLS of 15% from baseline, as proposed by the most recent cardio-oncology guideline. ResultsThe research found that the LVGLS decreased from -21.2%2.1% to -18.6%2.6% (t-test = -4.116; df = 54, p=0.001). The change in value LV-GLS was 2.6%3.0%. The mean percentage change of the LVGLS was 11,6%13,3%; p=0.001. Similarly, the right ventricular global longitudinal strain (RVGLS) decreased from -25.2%2.9% to -21.4%4.4% (t-test = -3.82; df = 54, p=0.001). The RV-GLS value of change was 3.8%3.6%. Likewise, the percentage decrease of the RVGLS was 15,0%14,3%, p=0.001.However, the measurements of the right ventricular systolic function (RVS) and tricuspid annular plane systolic excursion (TAPSE) were insignificant, and the left ventricular ejection fraction ( LVEF) remained unchanged.

Keywords: cardiotoxicity, chemotherapy, GLS, right ventricle

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Authors: Michael D. Vinod, Hadi Khabbaz

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Construction of infrastructure above or adjacent to landfills is becoming more common to capitalize on the limited space available within urban areas. However, development above landfills is a challenging task due to large voids, the presence of organic matter, heterogeneous nature of waste and ambiguity surrounding landfill settlement prediction. Prior to construction of infrastructure above landfills, ground improvement techniques are being employed to improve the geotechnical properties of landfill material. Although the ground improvement techniques have little impact on long term biodegradation and creep related landfill settlement, they have shown some notable short term success with a variety of techniques, including methods for verifying the level of effectiveness of ground improvement techniques. This paper provides geotechnical and landfill engineers a guideline for selection of landfill ground improvement techniques and their suitability to project-specific sites. Ground improvement methods assessed and compared in this paper include concrete injected columns (CIC), dynamic compaction, rapid impact compaction (RIC), preloading, high energy impact compaction (HEIC), vibro compaction, vibro replacement, chemical stabilization and the inclusion of geosynthetics such as geocells. For each ground improvement technique a summary of the existing theory, benefits, limitations, suitable modern ground improvement monitoring methods, the applicability of ground improvement techniques for landfills and supporting case studies are provided. The authors highlight the importance of implementing cost-effective monitoring techniques to allow observation and necessary remediation of the subsidence effects associated with long term landfill settlement. These ground improvement techniques are primarily for the purpose of construction above closed landfills to cater for transport infrastructure loading.

Keywords: closed landfills, ground improvement, monitoring, settlement, transport infrastructure

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Authors: Rachael Ojima Agarry, Raheemat Opeyemi Omosidi

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Over-schooling children is an abuse of the fundamental provisions of the National Policy on Education in Nigeria. The practice overburdens or places unwarranted academic demands on children, particularly preschoolers. This study was carried out to ascertain the prevalence of over-schooling preschoolers as perceived by teachers in the Kwara Central Senatorial District. One research question and two null hypotheses were formulated to guide the study. A descriptive survey design was employed. The population of the study consists of all preschool teachers in both private and public schools in Kwara Central. A validated instrument tagged “Questionnaire on Prevalence of Over-schooling of Preschoolers (QPOP)” with a reliability index of 0.76 was used for data collection. The questionnaire consists of sections A and B. Section A solicited the respondents’ demographic information, and Section B sought the prevalence of over-schooling as perceived by teachers. Data collected were analyzed using descriptive statistics of frequency and percentage. Mean and standard deviation were used to analyze the demographic information and the research question. The two research hypotheses were analyzed using a t-test and Analysis of Variance (ANCOVA) at a 0.05 level of significance. The results revealed that there is a high level of prevalence of over-schooling of preschoolers in Kwara Central. Also, there is a significant difference in teachers' perception of the prevalence of over-schooling preschoolers based on school type and school location. It was concluded that both private and public schools in Kwara Central practice over-schooling of preschoolers at a high level. Hence, it was recommended that the government, through the State and/or Federal Ministry of Education, should enact and enforce a law that would ensure children in this category spend only the stipulated time in school as well as strict adherence to the recommended curriculum contents by proprietors and teachers.

Keywords: over-schooling, preschoolers, school type, school location

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Authors: Leila Asadollahi

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Dry powder inhalers (DPIs) have come a long way since their creation, starting with the Spinhaler Fisons in 1967. For optimal performance, it is important to consider the interplay between formulation, device, and patient. DPIs have shown great potential in treating systemic disorders, as evidenced by their success in clinical practices. Ongoing clinical trials and market availability of DPI products for systemic disease treatment are also examined. Furthermore, the current COVID-19 pandemic has sparked increased interest in dry powder inhalation as a potential avenue for vaccines and antiviral drugs, prompting further exploration of its applications. To achieve optimal treatment outcomes for respiratory diseases, a thorough understanding of the various types of DPIs currently available is crucial. These include single-dose, multiple-unit dose, and multi-dose DPIs. This informative article delves into the administration of drugs via inhalation, examining its diverse routes of administration. Additionally, it illuminates the exciting advancements in inhalation delivery systems and investigates the latest therapeutic approaches for the treatment of respiratory ailments. Additionally, the article discusses the historical development of DPIs and the need for improved designs to enhance efficacy and patient adherence. The potential of DPIs in treating systemic diseases is also examined. Overall, this review provides valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders. The review aims to provide valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders.

Keywords: dry powder inhalers (DPIs), respiratory diseases, systemic disorders, pulmonary drug delivery

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Authors: Hsi-Chuan Wang, Hongxi Yin

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Compactness has been proposed as a type of sustainable urban form globally. However, the meanings and the measurements might diverse in regarding to the varying interpretation; moreover, since compactness was proposed to eliminate auto culture and urban sprawl in the developed countries, voices have emerged asking to rethink the suitability of compactness in the developing countries – based upon such understanding, Quality of Life (QOL) has been suggested as a good way to show the overall benefit of compactness. In regarding to such background, two subjects were targeted for discussion in this paper: (I) the meaning and feasibility of compactness between the developing and developed countries, and (II) the interaction between compactness and QOL. This paper argues that compactness should not be considered a universal principle for cities of all kind, but rather an ideal concept for urban designer and planner to consider throughout local practices. It firstly reviewed the benefits of both compactness and sprawl to uncover the features behind these urban forms, and later addressed the meaning and difficulty of adopting compactness in both the developing and developed countries. Secondly, arguing compactness to be positioned as a ‘process’ along the transition from the developing countries to the developed ones, this paper applied both cross-sectional and longitudinal analysis to uncover (I) the relationship between compactness and QOL in regarding to 30 American cities and (II) the impact of ‘becoming compact’ on QOL in regarding to 8 identified American Urbanized Areas (UZAs). The findings indicated that higher compactness could link to lower QOL among the compact cities, but with higher QOL among the sprawl cities. In addition, based upon the comparison between 2000 and 2010 on 8 UZAs, their QOL have escalated during the transition from the sprawl areas into the compact ones, but the extent of improvement in QOL could differ greatly among areas. In regarding to our findings, compact development should be proposed as a general guideline leading the contemporary sprawl cities in transition with sustainable urbanism; however, to prevent the externalities from damaging QOL with over-compactness, the compact policy should be flexible to adjust a long-term roadmap for sustainable development.

Keywords: compactness, quality of life, sprawl, sustainable urbanism

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Authors: Simone Huber, Bianca Schnalzer, Baptiste Alcalde, Sten Hanke, Lampros Mpaltadoros, Thanos G. Stavropoulos, Spiros Nikolopoulos, Ioannis Kompatsiaris, Lina Pérez- Breva, Vallivana Rodrigo-Casares, Jaime Fons-Martínez, Jeroen de Bruin

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Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depend on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.

Keywords: architectures and frameworks for health informatics systems, clinical trials, information and communications technology, remote decentralized clinical trials, technology availability

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Authors: Seon-Young Lee, Harkiran Sagoo, Reem Farwana, Katharine Whitehurst, Alex Fowler, Riaz Agha

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Background/Aims: Systematic reviews and meta-analysis are becoming increasingly important way of summarizing research evidence. Researches in ophthalmology may represent further challenges, due to their potential complexity in study design. The aim of our study was to determine the reporting quality of systematic reviews and meta-analysis in ophthalmology with the PRISMA statement, by assessing the articles published between 2010 and 2015 from five major journals with the highest impact factor. Methods: MEDLINE and EMBASE were used to search systematic reviews published between January 2010 and December 2015, in 5 major ophthalmology journals: Progress in Retinal and Eye Research, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology, Journal of the American Optometric Association. Screening, identification, and scoring of articles were performed independently by two teams, followed by statistical analysis including the median, range, and 95% CIs. Results: 115 articles were involved. The median PRISMA score was 15 of 27 items (56%), with a range of 5-26 (19-96%) and 95% CI 13.9-16.1 (51-60%). Compliance was highest in items related to the description of rationale (item 3,100%) and inclusion of a structured summary in the abstract (item 2, 90%), while poorest in indication of review protocol and registration (item 5, 9%), specification of risk of bias affecting the cumulative evidence (item 15, 24%) and description of clear objectives in introduction (item 4, 26%). Conclusion: The reporting quality of systematic reviews and meta-analysis in ophthalmology need significant improvement. While the use of PRISMA criteria as a guideline before journal submission is recommended, additional research identifying potential barriers may be required to improve the compliance to the PRISMA guidelines.

Keywords: systematic reviews, meta-analysis, research methodology, reporting quality, PRISMA, ophthalmology

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Authors: Sin Ying Tan, Mohammed Alloghani, A. J. Aljaaf, Abir Hussain, Jamila Mustafina

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Industry 4.0 is a term frequently used to describe the new upcoming industry era. Higher education institutions aim to prepare students to fulfil the future industry needs. Advancement of digital technology has paved the way for the evolution of education and technology. Evolution of education has proven its conservative nature and a high level of resistance to changes and transformation. The gap between the industry's needs and competencies offered generally by education is revealing the increasing need to find new educational models to face the future. The aim of this study was to identify the main issues faced by both universities and students in preparing the future workforce. From December 2018 to April 2019, a regional qualitative study was undertaken in Liverpool, United Kingdom (UK). Interviews were conducted with employers, faculty members and undergraduate students, and the results were analyzed using the open coding method. Four main issues had been identified, which are the characteristics of the future workforce, student's readiness to work, expectations on different roles played at the tertiary education level and awareness of the latest trends. The finding of this paper concluded that the employers and academic practitioners agree that their expectations on each other’s roles are different and in order to face the rapidly changing technology era, students should not only have the right skills, but they should also have the right attitude in learning. Therefore, the authors address this issue by proposing a learning framework known as 'ASK SUMA' framework as a guideline to support the students, academicians and employers in meeting the needs of 'Industry 4.0'. Furthermore, this technology era requires the employers, academic practitioners and students to work together in order to face the upcoming challenges and fast-changing technologies. It is also suggested that an interactive system should be provided as a platform to support the three different parties to play their roles.

Keywords: attitude, expectations, industry needs, knowledge, skills

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Authors: Nayak Amar, Turner Naomi, Gobina Edward

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The Scottish Higher Education Institutes must report their scope 1 & 2 emissions, whereas reporting scope 3 is optional. Scope 3 is indirect emissions which embodies a significant component of total carbon footprint and therefore it is important to record, measure and report it accurately. Robert Gordon University (RGU) reported only business travel, grid transmission and distribution, water supply and transport, and recycling scope 3 emissions. This study estimates the RGUs total scope 3 emissions by comparing it with a similar HEI in scale. The scope 3 emission reporting of sixteen Scottish HEI was studied. Glasgow Caledonian University was identified as the nearest neighbour by comparing its students' full time equivalent, staff full time equivalent, research-teaching split, budget, and foundation year. Apart from the peer, data was also collected from the Higher Education Statistics Agency database. RGU reported emissions from business travel, grid transmission and distribution, water supply, and transport and recycling. This study estimated RGUs scope 3 emissions from procurement, student-staff commute, and international student trip. The result showed that RGU covered only 11% of the scope 3 emissions. The major contributor to scope 3 emissions were procurement (48%), student commute (21%), international student trip (16%), and staff commute (4%). The estimated scope 3 emission was more than 14 times the reported emissions. This study has shown the relative importance of each scope 3 emissions source, which gives a guideline for the HEIs, on where to focus their attention to capture maximum scope 3 emissions. Moreover, it has demonstrated that it is possible to estimate the scope 3 emissions with limited data.

Keywords: HEI, university, emission calculations, scope 3 emissions, emissions reporting

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Authors: Rafid Doulab

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Elemental Impurities in the Pharmaceuticals industryis are indispensable to ensure pharmaceuticalssafety for 24 elements. Although atomic absorption and inductively coupled plasma are used in the U.S Pharmacopeia and the European Pharmacopoeia, FESEM with energy dispersive spectrometers can be applied as an alternative analysis method for quantitative and qualitative results for a variety of elements without chemical pretreatment, unlike other techniques. This technique characterizes by shortest time, with more less contamination, no reagent consumption, and generation of minimal residue or waste, as well as sample preparations time limiting, with minimal analysis error. Simple dilution for powder or direct analysis for liquid, we analyzed the usefulness of EDS method in testing with field emission scanning electron microscopy (FESEM, SUPRA 55 Carl Zeiss Germany) with an X-ray energy dispersion (XFlash6l10 Bruker Germany). The samples analyzed directly without coating by applied 5µ of known concentrated diluted sample on carbon stub with accelerated voltage according to sample thickness, the result for this spot was in atomic percentage, and by Avogadro converted factor, the final result will be in microgram. Conclusion and recommendation: The conclusion of this study is application of FESEM-EDS in US pharmacopeia and ICH /Q3D guideline to reach a high-precision and accurate method in element impurities analysis of drugs or bulk materials to determine the permitted daily exposure PDE in liquid or solid specimens, and to obtain better results than other techniques, by the way it does not require complex methods or chemicals for digestion, which interfere with the final results with the possibility of to keep the sample at any time for re analysis. The recommendation is to use this technique in pharmacopeia as standard methods like inductively coupled plasma both ICP-AES, ICP-OES, and ICP-MS.

Keywords: pharmacopoeia, FESEM-EDS, element impurities, atomic concentration

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Authors: Taiebe Shokri, Shahram Yazdani, Leila Afshar, Soleiman Ahmadi

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Introduction: The importance of professionalism in higher education not only determines the appropriate and inappropriate behaviors and guides faculty members in the implementation of professional responsibilities, but also guarantees faculty members' adherence to professional principles and values, ensures the quality of teaching and facilitator will be the teaching-learning process in universities and will increase the commitment to meet the needs of students as well as the development of an ethical culture based on ethics. Therefore, considering the important role of medical education teachers to prepare teachers and students in the future, the need to determine the concept of professional teacher and teacher, and the characteristics of teacher professionalism, we have explained the concept of professionalism in teachers in this study. Methods: The concept analysis method used in this study was Walker and Avant method which has eight steps. Walker and Avant state the purpose of concept analysis as follows: The process of distinguishing between the defining features of a concept and its unrelated features. The process of concept analysis includes selecting a concept, determining the purpose of the analysis, identifying the uses of the concept, determining the defining features of the concept, identifying a model, identifying boundary and adversarial items, identifying the precedents and consequences of the concept, and defining empirical references. is. Results: Professionalism in its general sense, requires deep knowledge, insight, creating a healthy and safe environment, honesty and trust, impartiality, commitment to the profession and continuous improvement, punctuality, criticism, professional competence, responsibility, and Individual accountability, especially in social interactions, is an effort for continuous improvement, the acquisition of these characteristics is not easily possible and requires education, especially continuous learning. Professionalism is a set of values, behaviors, and relationships that underpin public trust in teachers.

Keywords: concept analysis, medical education, professionalism, faculty members

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Authors: Max Butler

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Melanoma accounts for 80% of skin cancer-related deaths globally. The poor prognosis and increasing incidence of melanoma impose a significant burden on global healthcare systems. Early detection, precise diagnosis, and preventative strategies are critical to improving patient outcomes. Dermoscopy is the gold standard for specialist assessments of pigmented skin lesions, as it can differentiate between benign and malignant growths with greater accuracy than visual inspection. In the United Kingdom, guidelines from the National Institute of Clinical Excellence (NICE) state dermoscopy should be used in all specialist assessments of pigmented skin lesions. Compliance with this guideline is low, resulting in missed and delayed melanoma diagnoses. To address this problem, a quality improvement project was initiated at Buckinghamshire Healthcare Trust (BHT) within the plastic surgery department. The target group was a trainee and consultant plastic surgeons conducting outpatient skin cancer clinics. Analysis of clinic documentation over a one-month period found that only 62% (38/61) of patients referred with pigmented skin lesions were examined using dermoscopy. To increase dermoscopy rates, teaching was delivered to the department highlighting national guidelines and the evidence base for dermoscopic examination. In addition, clinic paperwork was redesigned to include a text box for dermoscopic examination. Reauditing after the intervention found a significant increase in dermoscopy rates (52/61, p = 0.014). In conclusion, implementing a quality improvement project with targeted teaching and documentation template templates successfully increased dermoscopy rates. This is a promising step toward improving early melanoma detection and patient outcomes.

Keywords: melanoma, dermoscopy, plastic surgery, quality improvement

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Authors: Sareh Rajabi, Taha Anjamrooz, Salwa Bheiry

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Sustainability of construction projects is an important issue to be addressed since the sector will continue to be developed in the coming years, especially in developing countries. Thus, it is significant to discover approaches and solutions for improving sustainability. Currently, the construction industry is the largest consumer of natural resources. This is the same in other countries in the Gulf region, and the United Arab Emirates (UAE) has limited natural resources such as water, electricity, etc. Recently, the UAE has taken several actions in order to implement sustainable initiatives within its construction industry. Within the industry, the contractors’ role is significant in promoting sustainable development by taking the responsibility to minimize their negative impacts on the environment and society, and maximize their economic distribution. In this research, sustainability will be studied as an important key to bring competitive advantages to contracting organizations. The contractors should understand the need to improve their sustainable performance in order to expand their business competitiveness. Competitiveness at the construction project level refers to a contractor’s ability to compete for a project. There is less focus on how to improve contractors’ competitiveness by implementing sustainable construction practices. Based on an inclusive literature review on the relationship between sustainability performance and business competitiveness, this research will conduct a study of sustainable practice in the construction industry and the relationship between sustainability performance and business competitiveness in order to develop a framework for evaluating how contractors can improve their competitiveness in terms of more efficient processes, enhancements in productivity, and lower costs of compliance in order to reduce the initial project cost and obtain market opportunities in the UAE. The research findings will provide a framework that can be a useful guideline for contractors to develop their sustainability policy, strategy and practice for meeting the increased requirements for sustainable development in construction.

Keywords: sustainable construction practice, sustainability, competitiveness, construction industry, contractors

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Authors: Sajjad Shukur Ullah, Syed Shujaa Safdar Gardezi

Abstract:

Road infrastructure plays a vital role in the economic activities of any economy. Besides derived benefits from these facilities, the utilization of extensive energy resources, fuels, and materials results in a negative impact on the environment in terms of carbon footprint; carbon footprint is the overall amount of greenhouse gas (GHG) generated from any action. However, this aspect of environmental impact from road structure is not seriously considered during such developments, thus undermining a critical factor of sustainable development, which usually remains unaddressed, especially in developing countries. The current work investigates the carbon footprint impact of a small road project (0.8 km, dual carriageway) initiated for traffic management in an urban centre. Life cycle assessment (LCA) with boundary conditions of cradle to the site has been adopted. The only construction phase of the life cycle has been assessed at this stage. An impact of 10 ktons-CO2 (6260 ton-CO2/km) has been assessed. The rigid pavement dominated the contributions as compared to a flexible component. Among the structural elements, the underpass works shared the major portion. Among the materials, the concrete and steel utilized for various structural elements resulted in more than 90% of the impact. The earth-moving equipment was dominant in operational carbon. The results have highlighted that road infrastructure projects pose serious threats to the environment during their construction and which need to be considered during the approval stages. This work provides a guideline for supporting sustainable development that could only be ensured when such endeavours are properly assessed by industry professionals and decide various alternative environmental conscious solutions for the future.

Keywords: construction waste management, kiloton, life cycle assessment, rigid pavement

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Authors: Eman Helal, Ahmed M. Esmat

Abstract:

Statement of problem: The development of computer-aided design/computer-aided manufacturing (CAD/CAM) resin dentures has simplified complete denture production. Most of the studies evaluated the mechanical properties of the material, but the hygienic performance of the CAD /CAM denture and their ability to maintain clean surfaces and minimize bacterial accumulation is still lacking. Purpose evaluation of the antibacterial characteristics of the 3D printed CAD/CAM denture and to compare it with the conventional heat polymerized acrylic denture base material. Methodology a total of thirty completely edentulous patients grouped randomly into two groups (Group I: Control group) received conventional heat polymerized acrylic resin complete dentures, (Group II: Test group) received 3D printed (CAD/CAM) dentures (stereolithographic PMMA), Samples of Candida albicans culture swabs were taken after 1 month and 3 months of dentures` insertion. A culture swab was obtained by scrubbing the fitting surface of the upper denture. At each time interval, three swab samples were collected from each patient and were inoculated in three individual culture media. Results: there was a significant difference in the colonization of Candida albicans to the fitting surface of the dentures between both groups (Group I: Conventional denture cases) exhibited more adhesion of Candida Albicans to the fitting surface than did (Group II: CAD/CAM cases) (P<0.05). Conclusion: 3D printed CAD/CAM complete denture showed minimal Candida adherence upon upper denture fitting compared to conventional heat-polymerized acrylic resin, which contributes to decreasing the incidence of denture stomatitis which is considered one of the most common problems among complete denture wearers.

Keywords: CAD/CAM denture, completely edentulous, elderly patients, 3D printing, antimicrobial efficiency, conventional denture, PMMA, Candida Albicans, denture stomatitis

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Authors: Cholpassorn Sitthiwarongchai, Chutikarn Sriviboon

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The two primary objectives of this research were (1) to examine the current knowledge and actual circumstance of agricultural workers about mangosteen product processing; and (2) to analyze and evaluate ways to develop capacity of mangosteen product processing. The population of this study was 15,125 people who work in the agricultural sector, in this context, mangosteen production, in the eastern part of Thailand that included Chantaburi Province, Rayong Province, Trad Province and Pracheenburi Province. The sample size based on Yamane’s calculation with 95% reliability was therefore 392 samples. Mixed method was employed included questionnaire and focus group discussion with Connoisseurship Model used in order to collect quantitative and qualitative data. Key informants were used in the focus group including agricultural business owners, academic people in agro food processing, local academics, local community development staff, OTOP subcommittee, and representatives of agro processing industry professional organizations. The study found that the majority of the respondents agreed with a high level (in five-rating scale) towards most of variables of knowledge management in agro food processing. The result of the current knowledge and actual circumstance of agricultural human resource in an arena of mangosteen product processing revealed that mostly, the respondents agreed at a high level to establish 7 variables. The guideline to developing the body of knowledge in order to enhance the capacity of the agricultural workers in mangosteen product processing was delivered in the focus group discussion. The discussion finally contributed to an idea to produce manuals for mangosteen product processing methods, with 4 products chosen: (1) mangosteen soap, (2) mangosteen juice, (3) mangosteen toffee, and (4) mangosteen preserves or jam.

Keywords: capacity enhancement, agricultural workers, mangosteen product processing, marketing management

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Authors: Mohammed Ahmed Alghamdi, Hazem Mahmoud Ali Darwish, Mostafa Mohamed Abdelraheem

Abstract:

Transparent conducting oxides (TCOs) possess low resistivity, exhibit good adherence to many substrates, and have good transmission characteristics from the visible to near-infrared wavelengths, which make it useful for various applications. Thin films of transparent conducting oxide (TCO’s) have received much attention because of their wide applications in the field of optoelectronic devices. Advancement of transparent conducting oxides TCO’s may not only lie within the improvement of existing materials in use, but also the development of novel materials. Solar cells are devices, which convert solar energy into electricity, either directly via the photovoltaic effect, or indirectly by first converting the solar energy to heat or chemical energy. Solar power has attracted attention of late as the most advanced of the alternative energy resources. The project aims to access the solar energy in Al-Baha region by search for materials (transparent-conductive oxides (TCO's)) to use in solar cells with highly transparent to the solar spectrum, have low electrical resistivity, be stable under H-plasma, and have a suitable structure in particular for a-Si solar cells. As the PV surface is exposed to the sunlight, the module temperature increases. High ambient temperatures along with long sunlight exposure time increases the temperature impact on PV cells efficiency. Since Al-Baha area is characterized by an atmosphere and pressure different from their counterparts in Saudi Arabia due to the height above sea level, hence it is appropriate to do studies to improve the efficiency of solar cells under these conditions. In this work, some ion change materials will be deposited using either sputtering/ or electron beam evaporation techniques. The optical properties of the synthesized materials will be studied in details for solar cell application. As we will study the effect of some dyes on the optical properties of the prepared films. The efficiency and other parameters of solar cell will be determined.

Keywords: thin films, solar cell, optical properties, electrical properties

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Authors: Hiroko Komatsu, Kaori Yagasaki

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Background: Cancer-related cognitive impairment is a common problem seen in cancer patients undergoing chemotherapy. Physical activity may show beneficial effects on the cognitive function in such patients. Therefore, we have developed a self-directed home yoga program for cancer patients with cognitive symptoms during chemotherapy. This program involves a DVD presenting a combination of yoga courses based on patient preferences to be practiced at home. This study was performed to examine the feasibility of this program. In addition, we also examined changes in cognitive function and quality of life (QOL) in these patients participating in the program. Methods: This prospective feasibility study was conducted in a 500-bed general hospital in Tokyo, Japan. The study population consisted of breast cancer patients undergoing chemotherapy as the initial therapy. This feasibility study used a convenience sample with estimation of recruitment rate in a single facility with the availability of trained nurses and physicians to ensure safe yoga intervention. The aim of the intervention program was to improve cognitive function by means of both physical and mental activation via yoga, consisting of physical practice, breathing exercises, and meditation. Information on the yoga program was provided as a booklet, with an instructor-guided group yoga class during the orientation, and a self-directed home yoga program on DVD with yoga logs. Results: The recruitment rate was 44.7%, and the study population consisted of 18 women with a mean age of 43.9 years. This study showed high rates of retention, adherence, and acceptability of the yoga program. Improvements were only observed in the cognitive aspects of fatigue, and there were serious adverse events during the program. Conclusion: The self-directed home yoga program discussed here was both feasible and safe for breast cancer patients showing cognitive symptoms during chemotherapy. The patients also rated the program as useful, interesting, and satisfactory. Participation in the program was associated with improvements in cognitive fatigue but not cognitive function.

Keywords: yoga, cognition, breast cancer, chemotherapy, quality of life

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Authors: Fredrick Etyang

Abstract:

This paper presents a Rapid Industrialization Model (RIM) designed to support existing industrialization policies, strategies and industrial development plans at National, Regional and Constituent level in Africa. The model will reinforce efforts to attainment of inclusive and sustainable industrialization of Africa by state and non-state actors. The overall objective of this model is to serve as a framework for rapid industrialization in developing economies and the specific objectives range from supporting rapid industrialization development to promoting a structural change in the economy, a balanced regional industrial growth, achievement of local, regional and international competitiveness in areas of clear comparative advantage in industrial exports and ultimately, the RIM will serve as a step-by-step guideline for the industrialization of African Economies. This model is a product of a scientific research process underpinned by desk research through the review of African countries development plans, strategies, datasets, industrialization efforts and consultation with key informants. The rigorous research process unearthed multi-directional and renewed efforts towards industrialization of Africa premised on collective commitment of individual states, regional economic communities and the African union commission among other strategic stakeholders. It was further, established that the inputs into industrialization of Africa outshine the levels of industrial development on the continent. The RIM comes in handy to serve as step-by-step framework for African countries to follow in their industrial development efforts of transforming inputs into tangible outputs and outcomes in the short, intermediate and long-run. This model postulates three stages of industrialization and three phases toward rapid industrialization of African economies, the model is simple to understand, easily implementable and contextualizable with high return on investment for each unit invested into industrialization supported by the model. Therefore, effective implementation of the model will result into inclusive and sustainable rapid industrialization of Africa.

Keywords: economic development, industrialization, economic efficiency, exports and imports

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Authors: Hadeer E. Eliwa, Naglaa S. Bazan, Ebtissam A. Darweesh, Nagwa A. Sabri

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Background: Generic substitution of brand ivabradine prescriptions can reduce drug expenditures and improve adherence. However, the distrust of generic medicines by practitioners and patients due to doubts regarding their quality and fear of counterfeiting compromise the acceptance of this practice. Aim: The goal of this study is to compare the therapeutic equivalence of brand product versus the generic product of ivabradine in adult patients with chronic heart failure with reduced ejection fraction (≤ 40%) (HFrEF). Methodology: Thirty-two Egyptian patients with chronic heart failure with reduced ejection fraction (HFrEF) were treated with branded ivabradine (Procrolan ©) and generic (Bradipect ©) during 24 (2x12) weeks. Primary outcomes were resting heart rate (HR), NYHA FC, Quality of life (QoL) using Minnesota Living with Heart Failure (MLWHF) and EF. Secondary outcomes were the number of hospitalizations for worsening HFrEF and adverse effects. The washout period was not allowed. Findings: At the 12th week, the reduction in HR was comparable in the two groups (90.13±7.11 to 69±11.41 vs 96.13±17.58 to 67.31±8.68 bpm in brand and generic groups, respectively). Also, the increase in EF was comparable in the two groups (27.44 ±4.59 to 33.38±5.62 vs 32±5.96 to 39.31±8.95 in brand and generic groups, respectively). The improvement in NYHA FC was comparable in both groups (87.5% in brand group vs 93.8% in the generic group). The mean value of the QOL improved from 31.63±15.8 to 19.6±14.7 vs 35.68±17.63 to 22.9±15.1 for the brand and generic groups, respectively. Similarly, at end of 24 weeks, no significant changes were observed from data observed at 12th week regarding HR, EF, QoL and NYHA FC. Only minor side effects, mainly phosphenes, and a comparable number of hospitalizations were observed in both groups. Conclusion: The study revealed no statistically significant differences in the therapeutic effect and safety between generic and branded ivabradine. We assume that practitioners can safely interchange between them for economic reasons.

Keywords: bradipect©, heart failure, ivabradine, Procrolan ©, therapeutic equivalence

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Authors: S. Jeyarajan

Abstract:

Concept of knowledge is discovered from conducted study for successive Competition in Sri Lankan Non-State Higher Educational Institutes. The Concept discovered out of collected Knowledge Management Practices from Emerald inside likewise reputed literatures and of Non-State Higher Educational sector. A test is conducted to reveal existences and its reason behind of these collected practices in Sri Lankan Non-State Higher Education Institutes. Further, unavailability of such study and uncertain on number of participants for data collection in the Sri Lankan context contributed selection of research method as qualitative method, which used attributes of Delphi Method to manage those likewise uncertainty. Data are collected under Dramaturgical Method, which contributes efficient usage of the Delphi method. Grounded theory is selected as data analysis techniques, which is conducted in intermixed discourse to manage different perspectives of data that are collected systematically through perspective and modified snowball sampling techniques. Data are then analysed using Grounded Theory Development Techniques in Intermix discourses to manage differences in Data. Consequently, Agreement in the results of Grounded theories and of finding in the Foreign Study is discovered in the analysis whereas present study conducted as Qualitative Research and The Foreign Study conducted as Quantitative Research. As such, the Present study widens the discovery in the Foreign Study. Further, having discovered reason behind of the existences, the Present result shows Concept for Knowledge from Sri Lankan Non-State sector to manage higher educational Institutes in successful manner.

Keywords: adherence of snowball sampling into perspective sampling, Delphi method in qualitative method, grounded theory development in intermix discourses of analysis, knowledge management for success of higher educational institutes

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

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