Search results for: total error rate

Authors: Pampita Chakraborty, Sukumar Mukherjee

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People with diabetes mellitus are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defences in diabetes. People who have minimally elevated blood sugar levels experience worse outcomes with infections. Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalisation and recovery times. A study was done in a tertiary care unit in eastern India. Patients with type 2 diabetes mellitus infection were recruited in the study. A total of 520 cases of Type 2 Diabetes Mellitus were recorded out of which 200 infectious cases was included in the study. All subjects underwent detailed history & clinical examination. Microbiological samples were collected from respective site of the infection for microbial culture and antibiotic sensitivity test. Out of the 200 infectious cases urinary tract infection(UTI) was found in majority of the cases followed by diabetic foot ulcer (DFU), respiratory tract infection(RTI) and sepsis. It was observed that Escherichia coli was the most commonest pathogen isolated from UTI cases and Staphylococcus aureus was predominant in foot ulcers followed by other organisms. Klebsiella pneumonia was the major organism isolated from RTI and Enterobacter aerogenes was commonly observed in patients with sepsis. Isolated bacteria showed differential sensitivity pattern against commonly used antibiotics. The majority of the isolates were resistant to several antibiotics that are usually prescribed on an empirical basis. These observations are important, especially for patient management and the development of antibiotic treatment guidelines. It is recommended that diabetic patients receive pneumococcal and influenza vaccine annually to reduce morbidity and mortality. Appropriate usage of antibiotics based on local antibiogram pattern can certainly help the clinician in reducing the burden of infections.

Keywords: antimicrobial resistance, diabetic foot ulcer, respiratory tract infection, urinary tract infection

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Authors: P. Amarnath, Albert Thomas

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Buildings qualify to be the major consumer of energy and resources thereby urging the designers, architects and policy makers to place a great deal of effort in achieving and implementing sustainable building strategies in construction. Green building rating systems help a great deal in this by measuring the effectiveness of these strategies along with the escalation of building performance in social, environmental and economic perspective, and construct new sustainable buildings. However, for a country like India, enormous population and its rapid rate of growth impose an increasing burden on the country's limited and continuously degrading natural resource base, which also includes the land available for construction. In general, the number of sustainable rated buildings in India is very minimal primarily due to the complexity and obstinate nature of the assessment systems/regulations that restrict the stakeholders and designers in proper implementation and utilization of these rating systems. This paper aims to introduce a data driven and user-friendly framework which cross compares the present prominent green building rating systems such as LEED, BREEAM, and GRIHA and subsequently help the users to rate their proposed building design as per the regulations of these assessment frameworks. This framework is validated using the input data collected from green buildings constructed globally. The proposed system has prospects to encourage the users to test the efficiency of various sustainable construction practices and thereby promote more sustainable buildings in the country.

Keywords: BREEAM, GRIHA, green building rating systems, LEED, sustainable buildings

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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Authors: D. Hephzibah, P. Kumaran, N. M. Saifuddin

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Anaerobic digestion is a well-known technique for sustainable energy recovery from sewage sludge. However, sewage sludge digestion is restricted due to certain factors. Pre-treatment methods have been established in various publications as a promising technique to improve the digestibility of the sewage sludge and to enhance the biogas generated which can be used for energy recovery. In this study, continuous flow microwave (MW) pre-treatment with different intensities were compared by using 5 L semi-continuous digesters at a hydraulic retention time of 27 days. We focused on the effects of MW at different intensities on the sludge solubilization, sludge digestibility, and biogas production of the untreated and MW pre-treated sludge. The MW pre-treatment demonstrated an increase in the ratio of soluble chemical oxygen demand to total chemical oxygen demand (sCOD/tCOD) and volatile fatty acid (VFA) concentration. Besides that, the total volatile solid (TVS) removal efficiency and tCOD removal efficiency also increased during the digestion of the MW pre-treated sewage sludge compared to the untreated sewage sludge. Furthermore, the biogas yield also subsequently increases due to the pre-treatment effect. A higher MW power level and irradiation time generally enhanced the biogas generation which has potential for sustainable energy recovery from sewage treatment plant. However, the net energy balance tabulation shows that the MW pre-treatment leads to negative net energy production.

Keywords: anaerobic digestion, biogas, microwave pre-treatment, sewage sludge

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Authors: Friday I. Joseph

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Background: Nigeria has an under-five mortality rate that is 128 per 1000 live birth which is higher than the rate for the African region. Optimal breastfeeding practice has the potential to reduce under-five mortality by 13% in developing countries. However, documented exclusive breastfeeding rate in Nigeria from birth to six months is just 17%. Aim: To explore perceptions of the sociocultural factors that influence exclusive breastfeeding for six months among rural mothers in Bindawa and Baure Local Government Area (LGA), Katsina state, North West Nigeria, to inform policies, intervention or strategies to improve exclusive breastfeeding practice in Nigeria. Methods: The social constructionism-interpretivist epistemological approach informed the use of an exploratory study to understand mothers’ experiences and views. Twenty mothers, all from rural areas between 19-35 years old were conveniently sampled from two LGA in Katsina state, north –west Nigeria for semi-structured interviews. Sample size had representation of both Hausa and Fulani ethnic group. Thematic content analysis was utilized for analysis. Results: Three major themes emerged from the study: (1) Breastfeeding initiation - Immediate traditional newborn care practices, birth attendant, place of delivery, the perception of about colostrum determines how soon a mother initiate breastfeeding. (2) Exclusive breastfeeding and introduction of food-Motivation to sustain exclusive breastfeeding relies on the interplay between the obligation to perform traditional rites; mother’s awareness and family support. (3) Decision making about infant feeding – It is not independent of the influence of key social figures like the father, mother-in-law, traditional birth attendant and the health workers. Overall, in spite of awareness of exclusive breastfeeding benefits, mothers expressed concerns that they may not win their family support if they shared contrary views. Conclusions: Health promotion intervention should be tailored, taking cognizant and addressing the sociocultural barriers to the practice of optimal breastfeeding by a focused community and family-based participatory approach. Implementers of interventions should employ culture-sensitive approaches in community-based intervention.

Keywords: exclusive breastfeeding, perception, qualitative, sociocultural determinants

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Authors: Ramesh Rajagopalan, Adam Dahlstrom

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Noise removal techniques play a vital role in the performance of electrocardiographic (ECG) signal processing systems. ECG signals can be corrupted by various kinds of noise such as baseline wander noise, electromyographic interference, and power-line interference. One of the significant challenges in ECG signal processing is the degradation caused by additive 50 or 60 Hz power-line interference. This work investigates the removal of power line interference and suppression of transient response for filtering noise corrupted ECG signals. We demonstrate the effectiveness of Infinite Impulse Response (IIR) notch filter with time varying pole radius for improving the transient behavior. The temporary change in the pole radius of the filter diminishes the transient behavior. Simulation results show that the proposed IIR filter with time varying pole radius outperforms traditional IIR notch filters in terms of mean square error and transient suppression.

Keywords: notch filter, ECG, transient, pole radius

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Authors: Saleh Alagla, Murya Habbash

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The paper investigates whether the board of directors plays a monitoring role or not in CEO compensation for the UK firms during the eve of the recent financial crisis, 2004-2008. The use of heteroscedastic and autocorrelated error consistent estimation of the panel data shows, surprisingly, that four board characteristics variables are found to play a significant role in increasing the level of CEO compensation. This insightful result would suggest evidence of the managerial power theory in general and the cronyism hypothesis in particular. Moreover, the interesting evidence supporting managerial power perspective is that CEO-Chair duality reduces long-term compensation while increasing short-term compensation, thus suggesting that CEOs are risk averse who prefer short-term compensation to long-term compensation. Finally, consistent with the agency perspective board size is found to increase all compensation variables as expected.

Keywords: corporate governance, CEO compensation, board of directors, internal governance mechanisms, agency theory, managerial power theory, cronyism hypothesis

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Authors: Prem K. Mony, Bharadwaj Amrutur, Prashanth Thankachan, Swarnarekha Bhat, Suman Rao, Maryann Washington, Annamma Thomas, N. Sheela, Hiteshwar Rao, Sumi Antony

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The disease burden among mothers and newborns is caused mostly by a handful of avoidable conditions occurring around the time of childbirth and within the first month following delivery. Real-time monitoring of vital parameters of mothers and neonates offers a potential opportunity to impact access as well as the quality of care in vulnerable populations. We describe the design, development and testing of an innovative wearable device for remote biomonitoring (RBM) of body temperatures in mothers and neonates in a hospital in southern India. The architecture consists of: [1] a low-cost, wearable sensor tag; [2] a gateway device for ‘real-time’ communication link; [3] piggy-backing on a commercial GSM communication network; and [4] an algorithm-based data analytics system. Requirements for the device were: long battery-life upto 28 days (with sampling frequency 5/hr); robustness; IP 68 hermetic sealing; and human-centric design. We undertook pre-clinical laboratory testing followed by clinical trial phases I & IIa for evaluation of safety and efficacy in the following sequence: seven healthy adult volunteers; 18 healthy mothers; and three sets of babies – 3 healthy babies; 10 stable babies in the Neonatal Intensive Care Unit (NICU) and 1 baby with hypoxic ischaemic encephalopathy (HIE). The 3-coin thickness, pebble-design sensor weighing about 8 gms was secured onto the abdomen for the baby and over the upper arm for adults. In the laboratory setting, the response-time of the sensor device to attain thermal equilibrium with the surroundings was 4 minutes vis-a-vis 3 minutes observed with a precision-grade digital thermometer used as a reference standard. The accuracy was ±0.1°C of the reference standard within the temperature range of 25-40°C. The adult volunteers, aged 20 to 45 years, contributed a total of 345 hours of readings over a 7-day period and the postnatal mothers provided a total of 403 paired readings. The mean skin temperatures measured in the adults by the sensor were about 2°C lower than the axillary temperature readings (sensor =34.1 vs digital = 36.1); this difference was statistically significant (t-test=13.8; p<0.001). The healthy neonates provided a total of 39 paired readings; the mean difference in temperature was 0.13°C (sensor =36.9 vs digital = 36.7; p=0.2). The neonates in the NICU provided a total of 130 paired readings. Their mean skin temperature measured by the sensor was 0.6°C lower than that measured by the radiant warmer probe (sensor =35.9 vs warmer probe = 36.5; p < 0.001). The neonate with HIE provided a total of 25 paired readings with the mean sensor reading being not different from the radian warmer probe reading (sensor =33.5 vs warmer probe = 33.5; p=0.8). No major adverse events were noted in both the adults and neonates; four adult volunteers reported mild sweating under the device/arm band and one volunteer developed mild skin allergy. This proof-of-concept study shows that real-time monitoring of temperatures is technically feasible and that this innovation appears to be promising in terms of both safety and accuracy (with appropriate calibration) for improved maternal and neonatal health.

Keywords: public health, remote biomonitoring, temperature surveillance, wearable sensors, mothers and newborns

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Authors: Lev Chernyshev, Ekaterina Lieshout, Natalia Kabaliuk

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Sit-skis enable individuals with limited lower limb or core movement to ski unassisted confidently. The rise in popularity of the Winter Paralympics has seen an influx of engineering innovation, especially for the Downhill and Super-Giant Slalom events, where the athletes achieve speeds as high as 160km/h. The growth in the sport has inspired recent research into sit-ski aerodynamics. Crosswinds are expected in mountain climates and, therefore, can greatly impact a skier's maneuverability and aerodynamics. This research investigates the impact of crosswinds on the drag force of a Paralympic sit-ski using Computational Fluid Dynamics (CFD). A Paralympic sit-ski with a model of a skier, a leg cover, a bucket seat, and a simplified suspension system was used for CFD analysis in ANSYS Fluent. The hybrid initialisation tool and the SST k–ω turbulence model were used with two tetrahedral mesh bodies of influence. The crosswinds (10, 30, and 50 km/h) acting perpendicular to the sit-ski's direction of travel were simulated, corresponding to the straight-line skiing speeds of 60, 80, and 100km/h. Following the initialisation, 150 iterations for both first and second order steady-state solvers were used, before switching to a transient solver with a computational time of 1.5s and a time step of 0.02s, to allow the solution to converge. CFD results were validated against wind tunnel data. The results suggested that for all crosswind and sit-ski speeds, on average, 64% of the total drag on the ski was due to the athlete's torso. The suspension was associated with the second largest overall sit-ski drag force contribution, averaging at 27%, followed by the leg cover at 10%. While the seat contributed a negligible 0.5% of the total drag force, averaging at 1.2N across the conditions studied. The effect of the crosswind increased the total drag force across all skiing speed studies, with the drag on the athlete's torso and suspension being the most sensitive to the changes in the crosswind magnitude. The effect of the crosswind on the ski drag reduced as the simulated skiing speed increased: for skiing at 60km/h, the drag force on the torso increased by 154% with the increase of the crosswind from 10km/h to 50km/h; whereas, at 100km/h the corresponding drag force increase was halved (75%). The analysis of the flow and pressure field characteristics for a sit-ski in crosswind conditions indicated the flow separation localisation and wake size correlated with the magnitude and directionality of the crosswind relative to straight-line skiing. The findings can inform aerodynamic improvements in sit-ski design and increase skiers' medalling chances.

Keywords: sit-ski, aerodynamics, CFD, crosswind effects

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Authors: Shymaa S. Zaher, Hesham M. Abd El-Fatah, Dina M. Ali

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Burullus Lagoon is the second largest lake, along the Mediterranean seashore. It exposed to over nutrient enrichment from fish farming and agricultural drainage wastes. This study assesses the present status phytoplankton response to different flow events, including domestic, agricultural, industrial, and fish farms discharge in the three main sectors of Burullus Lagoon, to focus on the influence of environmental variables on phytoplankton species composition inhabiting the Lagoon. Twelve sites representing the eastern, central, and western basin were selected during winter and summer 2018. Among the most abundant group, Chlorophyceae came in the first rank by 37.9% of the total phytoplankton densities, Bacillariophyceae (29.31%), Cyanophyceae (20.7%), Euglenophyceae (8.63%) and Dinophyceae (3.4%). Cyclotella menenghiana was the most abundant diatoms, while Scenedesmus quadricauda, S. acuminatus, and S. bijuga were highly recorded nearby the drains (in the middle sector). Phytoplankton in Burullus Lagoon attained the lowest values during the winter season and the highest ones during the summer season. The total count of phytoplankton in the middle and western basin of the lake was higher than that of the eastern part. Excessive use of chemical fertilizers, pesticides, and washing out of nutrients loaded to the drainage water, leading to a significant pronounced decrease in community composition and standing crop of phytoplankton in Burullus Lake from year to year, hold the danger of shifting the lagoon ecosystem.

Keywords: Burullus Lagoon, environmental variables, phytoplankton, water pollution

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Authors: Tamer El-Messery, Teresa Sanchez-Moya, Ruben Lopez-Nicolas, Gaspar Ros, Esmat Aly

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Olive leaves (OLs), the main by-product of the olive oil industry, have a considerable amount of phenolic compounds. The exploitation of these compounds represents the current trend in food processing. In this study, OLs polyphenols were microencapsulated with polycaprolactone (PCL) and utilized in formulating novel functional yoghurt. PCL-microcapsules were characterized by scanning electron microscopy, and Fourier transform infrared spectrometry analysis. Their total phenolic (TPC), total flavonoid (TFC) contents, and antioxidant activities (DPPH, FRAP, ABTS), and polyphenols bioaccessibility were measured after oral, gastric, and intestinal steps of in vitro digestion. The four yoghurt formulations (containing 0, 25, 50, and 75 mg of PCL-microsphere/100g yoghurt) were evaluated for their pH, acidity, syneresis viscosity, and color during storage. In vitro digestion significantly affected the phenolic composition in non-encapsulated extract while had a lower impact on encapsulated phenolics. Higher protection was provided for encapsulated OLs extract, and their higher release was observed at the intestinal phase. Yoghurt with PCL-microsphere had lower viscosity, syneresis, and color parameters, as compared to control yoghurt. Thus, OLs represent a valuable and cheap source of polyphenols which can be successfully applied, in microencapsulated form, to formulate functional yoghurt.

Keywords: yoghurt quality attributes, olive leaves, phenolic and flavonoids compounds, antioxidant activity, polycaprolactone as microencapsulant

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Authors: Lucky Dartsa Wakawa, Friday Nwabueze Ogana, Temitope Elizabeth Adeniyi

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Timely and reliable information on the status of a forest is essential for assessing the extent of regeneration and degradation. However, when such information is lacking effective forest management practices becomes impossible. Therefore, this study assessed the tree species composition, richness, diversity, structure of Oluwa forest reserve with the view of ascertaining it conservation status. A systematic line transect was used in the laying of eight (8) temporary sample plots (TSPs) of size 50m x 50m. Trees with Dbh ≥ 10cm in the selected plots were enumerated, identified and measured. The results indicate that 535 individual trees were enumerated cutting across 26 families and 58 species. The family Sterculiaceae recorded the highest number of species (10) and occurrence (112) representing 17.2% and 20.93% respectively. Celtis zenkeri is the species with the highest number of occurrence of tree per hectare and importance value index (IVI) of 59 and 53.81 respectively. The reserve has the Margalef's index of species richness, Shannon-Weiner diversity Index (H') and Pielou's Species Evenness Index (EH) of 9.07, 3.43 and 0.84 respectively. The forest has a mean Dbh (cm), mean height (m), total basal area/ha (m2) and total volume/ha (m3) of 24.7, 16.9, 36.63 and 602.09 respectively. The important tropical tree species identified includes Diospyros crassiflora Milicia excels, Mansonia altisima, Triplochiton scleroxylon. Despite the level of exploitation in the forest, the forest seems to be resilience. Given the right attention, it could regenerate and replenish to save some of the original species composition of the reserve.

Keywords: forest conservation, forest structure, Lowland tropical forest, South-west Nigeria

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Authors: Mina Hojat Ansari, Kamran Bagheri Lankarani, Mohammad Reza Fattahi, Ali Reza Safarpour

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Irritable bowel syndrome (IBS) is a common bowel disorder which is usually diagnosed through the abdominal pain, fecal irregularities and bloating. Alteration in the intestinal microbial composition is implicating to inflammatory and functional bowel disorders which is recently also noted as an IBS feature. Owing to the potential importance of microbiota implication in both efficiencies of the treatment and prevention of the diseases, we examined the association between the intestinal microbiota and different bowel patterns in a cohort of subjects with IBS and healthy controls. Fresh fecal samples were collected from a total of 50 subjects, 30 of whom met the Rome IV criteria for IBS and 20 Healthy control. Total DNA was extracted and library preparation was conducted following the standard protocol for small whole genome sequencing. The pooled libraries sequenced on an Illumina Nextseq platform with a 2 × 150 paired-end read length and obtained sequences were analyzed using several bioinformatics programs. The majority of sequences obtained in the current study assigned to bacteria. However, our finding highlighted the significant microbial taxa variation among the studied groups. The result, therefore, suggests a significant association of the microbiota with symptoms and bowel characteristics in patients with IBS. These alterations in fecal microbiota could be exploited as a biomarker for IBS or its subtypes and suggest the modification of the microbiota might be integrated into prevention and treatment strategies for IBS.

Keywords: irritable bowel syndrome, intestinal microbiota, small whole genome sequencing, fecal samples, Illumina

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Authors: Hany R. Ammar, Khalil A. Khalil, El-Sayed M. Sherif

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The as-received metal powders were used to synthesis bulk nanocrystalline Al; Al-10%Cu; and Al-10%Cu-5%Ti alloys using mechanical alloying and high frequency induction heat sintering (HFIHS). The current study investigated the influence of milling time and ball-to-powder (BPR) weight ratio on the microstructural constituents and mechanical properties of the processed materials. Powder consolidation was carried out using a high frequency induction heat sintering where the processed metal powders were sintered into a dense and strong bulk material. The sintering conditions applied in this process were as follow: heating rate of 350°C/min; sintering time of 4 minutes; sintering temperature of 400°C; applied pressure of 750 Kgf/cm2 (100 MPa); cooling rate of 400°C/min and the process was carried out under vacuum of 10-3 Torr. The powders and the bulk samples were characterized using XRD and FEGSEM techniques. The mechanical properties were evaluated at various temperatures of 25°C, 100°C, 200°C, 300°C and 400°C to study the thermal stability of the processed alloys. The bulk nanocrystalline Al; Al-10%Cu; and Al-10%Cu-5%Ti alloys displayed extremely high hardness values even at elevated temperatures. The Al-10%Cu-5%Ti alloy displayed the highest hardness values at room and elevated temperatures which are related to the presence of Ti-containing phases such as Al3Ti and AlCu2Ti, these phases are thermally stable and retain the high hardness values at elevated temperatures up to 400ºC.

Keywords: nanocrystalline aluminum alloys, mechanical alloying, hardness, elevated temperatures

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Authors: Muhammad Mohsin, Mir Md Abdus Salam, Pertti Pulkkinen, Ari Pappinen

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Soil polluted with elevated level of nickel (Ni) concentration may cause severe hazards to humans and forest ecosystems, for example, by polluting underground water reserves, affecting food quality and by reducing agricultural productivity. The present study investigated the phytoextraction ability of Salix schwerinii, enhanced with an application of the N100 (11-amino-1-hydroxyundecylidene) chelate. N100 has proved to be a non-toxic, low risk of leaching, environmentally friendly and easily biodegradable chelate that has a potential for metal chelation. The Salix were grown in garden soil that was also amended with nickel (Ni; 150 mg kg⁻¹). Multiple doses of N100 were applied to the treatments as follows: Ni + N100 1.2 g and Ni+ N100 2.4 g. Furthermore, N100 doses were also repeated with the control soil. The effect of N100 on height growth, biomass, and the accumulation of Ni in Salix in polluted soils was studied. In this study, N100 application was found to be effective in enhancing height and biomass growth under polluted treatments. Total reflection X-ray fluorescence (TXRF) spectrometry was used to determine the concentration of Ni in the Salix tissues. The total Ni concentrations in the soils amended with N100 increased substantially by up to 324% as compared to the control. The Ni translocation factor (TF) and bioconcentration factor (BF) values for S. schwerinii increased with the application of N100 as varied from 0.45–1.25 and 0.80‒1.50, respectively. This study revealed that S. schwerinii is suitable for the phytoextraction of Ni-contaminated soils.

Keywords: bisphosphonic acid, nickel, phytoextraction, Salix

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Authors: N. Boussoualim, H. Trabsa, I. Krache, S. Aouachria, S. Boumerfeg, L. Arrar, A. Baghiani

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The aim of this study consisted in evaluating the antioxidant in vivo properties, anti-hemolytic and XOR inhibitory effect of Globularia alypum L. (GA) extracts. GA was submitted to extraction and fractionation to give crude (CrE), chloroformique (ChE), ethyle acetate (EAE) and aqueos (AqE) extracts. Total polyphenols contents of GA extracts were determined; EAE is the most rich in polyphenols (157,74±5,27 mg GAE/mg of extract). GA Extracts inhibited XO in a concentration-dependent manner, the EAE showed the highest inhibitory properties on the XOR activity (IC50=0,083±0,001 mg/ml), followed by CrE and ChE. The antioxidant activities of the CrE, EAE, and AqE were tested by an in vivo assay in mice, the plasma ability to inhibit DPPH radical was measured, The CrE was found to exhibit the greatest scavenger activity with 48.41±2.763%, followed by AqE and EAE (40.54±7.51% and 41.79±1.654%, respectively). Total antioxidant capacity of red blood cells was measured, from the kinetics of hemolysis obtained. The calculated HT50 reveal an extension of time for half hemolysis in all treated groups compared with the control group. CrE increase significantly HT50 (112,8±2,427). The hemolysis is lagged, indicating that endogenous antioxidants in the erythrocytes can trap radicals to protect them against free-radical-induced hemolysis. Antimicrobial activities of the extracts were determined by the disc diffusion method. Test microorganisms were; 4 Gram positive, 7 gram negative bacteria, most active extracts were EAE and CrE. We deduce a great relationship between the effect on the extracts antibacterial effect and their contents in flavonoid.

Keywords: Globularia alypum, Xanthine oxidoreductase, in vivo-antioxidant activity, hemolysis, polyphenol

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Authors: Bahram Khan, Anderson Rocha Ramos, Rui R. Paulo, Fernando J. Velez

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With the growing demand for a new blend of applications, the users dependency on the internet is increasing day by day. Mobile internet users are giving more attention to their own experiences, especially in terms of communication reliability, high data rates and service stability on move. This increase in the demand is causing saturation of existing radio frequency bands. To address these challenges, researchers are investigating the best approaches, Carrier Aggregation (CA) is one of the newest innovations, which seems to fulfill the demands of the future spectrum, also CA is one the most important feature for Long Term Evolution - Advanced (LTE-Advanced). For this purpose to get the upcoming International Mobile Telecommunication Advanced (IMT-Advanced) mobile requirements (1 Gb/s peak data rate), the CA scheme is presented by 3GPP, which would sustain a high data rate using widespread frequency bandwidth up to 100 MHz. Technical issues such as aggregation structure, its implementations, deployment scenarios, control signal techniques, and challenges for CA technique in LTE-Advanced, with consideration of backward compatibility, are highlighted in this paper. Also, performance evaluation in macro-cellular scenarios through a simulation approach is presented, which shows the benefits of applying CA, low-complexity multi-band schedulers in service quality, system capacity enhancement and concluded that enhanced multi-band scheduler is less complex than the general multi-band scheduler, which performs better for a cell radius longer than 1800 m (and a PLR threshold of 2%).

Keywords: component carrier, carrier aggregation, LTE-advanced, scheduling

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Authors: G. R. Hashemi Tabar, G. R. Razmi, F. Mirshekar

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Echinococcus granulosus have ten strains from G1 to G9. Each strain is related to special intermediated host. The morphology, epidemiology, treatment and control in these strains are different. There are many morphological and molecular methods to differentiate of Echinococcus strains. However, using both methods were provided better information about identification of each strain. The aim of study was to identify Echinococcus granulosus strain of hydrated cysts in slaughtered sheep using morphological and molecular methods in Mashhad area. In the present study, the infected liver and lung with hydatid cysts were collected and transferred to laboratory. The hydatid cyst liquid was extracted and morphological characters of rostellar hook protosclocies were measured using micrometer ocular. The total length of large blade length of large hooks, total length of small and blade length of small hooks, and number of hooks per protoscolex were 23± 0.3μm, 11.7±0.5 μm, 19.3±1.1 μm,8±1.1 and 33.7±0.7 μm, respectively. In molecular section of the study, DNA each samples was extracted with MBST Kit and development of PCR using special primers (EgF, EgR) which amplify fragment of ITS1 gen. The PCR product was digested with Bsh1236I enzyme. Based on pattern of PCR-RLFP results (four band forming), G1, G2 and G3 strain of Echinococcus granulosus were obtained. Differentiation of three strains was done using sequencing analysis and G1 strain was diagnosed. The agreement between the molecular results with morphometric characters of rosetellar hook was confirmed the presence of G1 strain of Echinococcus in the slaughtered sheep of Mashhad area.

Keywords: Echinococcus granulosus, Hydatid cyst, PCR, sheep

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Authors: Gianella Franco, Karen Suarez, María Quijano, Patricia Manzano

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Agro-industries generate large amounts of waste, which are mostly untapped. This research was carried out to use cocoa, coffee and orange industrial by-products to develop a dairy drink. The product was prepared by making a 10% aqueous extract of the mixture of cocoa and coffee beans shells and orange peel. Extreme Vertices Mixture Design was applied to vary the proportions of the ingredients of the aqueous extract, getting 13 formulations. Each formulation was mixed with skim milk and pasteurized. The attributes of taste, smell, color and appearance were evaluated by a semi-trained panel by multiple comparisons test, comparing the formulations against a standard marked as "R", which consisted of a coffee commercial drink. The formulations with the highest scores were selected to maximize the Total Polyphenol Content (TPC) through a process of linear optimization resulting in the formulation 80.5%: 18.37%: 1.13% of cocoa bean shell, coffee bean shell and orange peel, respectively. The Total Polyphenol Content was 4.99 ± 0.34 mg GAE/g of drink, DPPH radical scavenging activity (%) was 80.14 ± 0.05 and caffeine concentration of 114.78 mg / L, while the coffee commercial drink presented 3.93 ± 0.84 mg GAE / g drink, 55.54 ± 0.03 % and 47.44 mg / L of TPC, DPPH radical scavenging activity and caffeine content, respectively. The results show that it is possible to prepare an antioxidant - rich drink with good sensorial attributes made of industrial by-products.

Keywords: DPPH, polyphenols, waste, food science

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Authors: Dhanuj M. Gandikota

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Sensor-derived three-dimensional (3D) point clouds of trees are invaluable in remote sensing analysis for the accurate measurement of key structural metrics, bio-inventory values, spatial planning/visualization, and ecological modeling. Machine learning (ML) holds the potential in addressing the restrictive tradeoffs in cost, spatial coverage, resolution, and information gain that exist in current point cloud sensing methods. Terrestrial laser scanning (TLS) remains the highest fidelity source of both canopy and below-canopy structural features, but usage is limited in both coverage and cost, requiring manual deployment to map out large, forested areas. While aerial laser scanning (ALS) remains a reliable avenue of LIDAR active remote sensing, ALS is also cost-restrictive in deployment methods. Space-borne photogrammetry from high-resolution satellite constellations is an avenue of passive remote sensing with promising viability in research for the accurate construction of vegetation 3-D point clouds. It provides both the lowest comparative cost and the largest spatial coverage across remote sensing methods. However, both space-borne photogrammetry and ALS demonstrate technical limitations in the capture of valuable below-canopy point cloud data. Looking to minimize these tradeoffs, we explored a class of powerful ML algorithms called Deep Learning (DL) that show promise in recent research on 3-D point cloud reconstruction and interpolation. Our research details the efficacy of applying these DL techniques to reconstruct accurate below-canopy point clouds from space-borne and aerial remote sensing through learned patterns of tree species fractal symmetry properties and the supplementation of locally sourced bio-inventory metrics. From our dataset, consisting of tree point clouds obtained from TLS, we deconstructed the point clouds of each tree into those that would be obtained through ALS and satellite photogrammetry of varying resolutions. We fed this ALS/satellite point cloud dataset, along with the simulated local bio-inventory metrics, into the DL point cloud reconstruction architectures to generate the full 3-D tree point clouds (the truth values are denoted by the full TLS tree point clouds containing the below-canopy information). Point cloud reconstruction accuracy was validated both through the measurement of error from the original TLS point clouds as well as the error of extraction of key structural metrics, such as crown base height, diameter above root crown, and leaf/wood volume. The results of this research additionally demonstrate the supplemental performance gain of using minimum locally sourced bio-inventory metric information as an input in ML systems to reach specified accuracy thresholds of tree point cloud reconstruction. This research provides insight into methods for the rapid, cost-effective, and accurate construction of below-canopy tree 3-D point clouds, as well as the supported potential of ML and DL to learn complex, unmodeled patterns of fractal tree growth symmetry.

Keywords: deep learning, machine learning, satellite, photogrammetry, aerial laser scanning, terrestrial laser scanning, point cloud, fractal symmetry

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Authors: Xiaohan Bookman, Xiaoyan Zhu

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Margin-Based Principle has been proposed for a long time, it has been proved that this principle could reduce the structural risk and improve the performance in both theoretical and practical aspects. Meanwhile, feed-forward neural network is a traditional classifier, which is very hot at present with a deeper architecture. However, the training algorithm of feed-forward neural network is developed and generated from Widrow-Hoff Principle that means to minimize the squared error. In this paper, we propose a new training algorithm for feed-forward neural networks based on Margin-Based Principle, which could effectively promote the accuracy and generalization ability of neural network classifiers with less labeled samples and flexible network. We have conducted experiments on four UCI open data sets and achieved good results as expected. In conclusion, our model could handle more sparse labeled and more high-dimension data set in a high accuracy while modification from old ANN method to our method is easy and almost free of work.

Keywords: Max-Margin Principle, Feed-Forward Neural Network, classifier, structural risk

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Authors: Ivory A. Rulona, Jarungchai Anton S. Vatanagul

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Background: Depression is common after stroke with quoted rates ranging from 18% to 61%. 8 Mood disturbance is common after stroke and may present as depression or anxiety. Psychological mood disturbance is associated with higher rates of mortality, long term disability, and hospital readmission. Objectives: To investigate the incidence of post-stroke depression in a tertiary hospital in Cebu City, Philippines and to determine its associated factors. The study is designed to be prospective, descriptive, cross-sectional survey. Participants: Adult patients seen and diagnosed to have stroke either infarct or hemorrhage within the period of January 1 to July 31, 2014. Results: A total of 100 patients with stroke were interviewed using the 17-item Hamilton Depression Rating Scale (HDRS) questionnaire. The average age of the respondents was 60.50 years old ±1.18, majority were males (55%), 83% were married, and 81% were employed. The most common co-morbidity was hypertension 78% followed by diabetes mellitus at 50%. Moreover, 39% of these patients had stroke in months, 26% in years, and 18% in weeks. The average functional capacity based on Modified Rankin Scale was 2.14+/-0.14. Among 100 patients, a total of 30 patients (30%) had depression: 2 (2%) very severe, 5 (5%) moderate and 23 (23%) had mild depression while 70 patients (70%) had no depression. Stroke located at the dominant hemisphere was not associated with severe depression (p=0.102). A similar trend was also noted among those with stroke at the right side (p=0.183), pons (p=0.634), bilateral (p=0.776), and midbrain (p=0.336). Conclusion: This study showed that majority of stroke patients were males with average age of 60.50 years. Hypertension was the most common co-morbidity. There was no association between stroke location and depression. The incidence of PSD was 30%.

Keywords: post-stroke depression, co-morbidity, disturbance, bilateral

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Authors: Cheng Shen, LaiHong Shen

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Ammonia is an important carrier of hydrogen energy, with the characteristics of high hydrogen content density and no carbon dioxide emission. Ammonia synthesis by the Haber process is the main method for industrial ammonia synthesis, but the conversion rate of ammonia per pass is only about 12%, while the conversion rate of biomass synthesis ammonia is as high as 56%. Therefore, safe and efficient ammonia capture for ammonia synthesis from biomass is an important way to alleviate the energy crisis and solve the energy problem. Metal chloride has a chemical adsorption effect on ammonia, and can be desorbed at high temperature to obtain high-concentration ammonia after combining with ammonia, which has a good development prospect in ammonia capture and separation technology. In this paper, the ammonia adsorption properties of CuCl₂ were measured, and the composite adsorbents were prepared by using silicon and multi-walled carbon nanotubes respectively to support CuCl₂, and the ammonia adsorption properties of the composite adsorbents were studied. The study found that the ammonia adsorption capacity of the three adsorbents decreased with the increase in temperature, so metal chlorides were more suitable for the low-temperature adsorption of ammonia. Silicon and multi-walled carbon nanotubes have an enhanced effect on the ammonia adsorption of CuCl₂. The reason is that the porous material itself has a physical adsorption effect on ammonia, and silicon can play the role of skeleton support in cupric chloride particles, which enhances the pore structure of the adsorbent, thereby alleviating sintering.

Keywords: ammonia, adsorption properties, metal chloride, silicon, MWCNTs

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Authors: K. Rasool

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Sulfate-reducing bacteria (SRBs) induced biofilm formation is a global industrial concern due to its role in the development of microbial-induced corrosion (MIC). Herein, we have developed a biodegradable chitosan/lignosulfonate nanocomposite (CS@LS) as an efficient green biocide for the inhibition of SRBs biofilms. We investigated in detail the inhibition mechanism of SRBs by CS@LS in seawater media. Stable CS@LS-1:1 with 150–200 nm average size and zeta potential of + 34.25 mV was synthesized. The biocidal performance of CS@LS was evaluated by sulfate reduction profiles coupled with analysis of extracted extracellular polymeric substances (EPS) and lactate dehydrogenase (LDH) release assays. As the nanocomposite concentration was increased from 50 to 500 µg/mL, the specific sulfate reduction rate (SSRR) decreased from 0.278 to 0.036 g-sulfate/g-VSS*day showing a relative sulfate reduction inhibition of 86.64% as compared to that of control. Similarly, the specific organic uptake rate (SOUR) decreased from 0.082 to 0.039 0.036 g-TOC/g-VSS*day giving a relative co-substrate oxidation inhibition of 52.19% as compared to that of control. The SRBs spiked with 500 µg/mL CS@LS showed a reduction in cell viability to 1.5 × 106 MPN/mL. To assess the biosafety of the nanocomposite on the marine biota, the 72-hours acute toxicity assays using the zebrafish embryo model revealed that the LC50 for the CS@LS was 103.3 µg/mL. Thus, CS@LS can be classified as environmentally friendly. The nanocomposite showed long-term stability and excellent antibacterial properties against SRBs growth and is thus potentially useful for combating the problems of biofilm growth in harsh marine and aquatic environments.

Keywords: green biocides, chitosan/lignosulfonate nanocomposite, SRBs, toxicity

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Authors: Nermin Isik, Ozlem Derinbay Ekici

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The cat is one of the potential hosts for parasitic zoonoses, such as Toxocara cati, Ancylostoma braziliense, A. tubaeforme, Uncinaria stenocephala, Cryptosporidium sp, Giardia sp. This study was performed to determine the prevalence and intensity of intestinal parasites in household cats in Konya, Turkey. In this study, a total of 100 stool samples with different ages and sex were used as a material. They were examined for infections with endoparasites by the use of native, Fulleborn flotation and Benedek sedimentation methods in University of Selcuk, Faculty of Veterinary Medicine, Department of Parasitology. The overall prevalence of intestinal parasites was 15%. A total of 6 parasite species was recorded: Giardia sp (6%), Toxocara cati (4%), Isospora sp (3%), Joyeuxiella pasqualei, Taenia sp (1%), Trichuris sp (1%). The most common intestinal parasites in cats were Giardia sp (6%) and Toxocara cati (4%). Younger cats up to 1 year of age were more frequently infected with endoparasites than animals over 1 year of age (p < 0.05). Giardia sp and Toxocara cati were detected significantly more often in younger than 1 year of age (p < 0.05). In fecal examination, Toxocara cati, Ancylostoma sp. Joyeuxiella pasqualei, Dipylidium caninum, Trichuris sp were found in cats in Turkey. In this study, based on microscopic and macroscopic fecal examinations, Giardia sp (6%), Toxocara cati (4%), Isospora sp (3%), Joyeuxiella pasqualei (%2), Taenia sp (1%), Trichuris sp (1%) was detected in cats. In conclusion, zoonotic intestinal parasites in household cats such as Giardia sp and Toxocara cati should be considered more seriously and it is necessary to take precautions against these infections. Cats should be routinely checked by faecal examination for endoparasite infections.

Keywords: cat, intestinal parasites, faecal, Turkey

Procedia PDF Downloads 397

Authors: Tagouelbe Tiho, Amissa Augustin Adima, Yao Casimir Brou, Nabayo Traore, Gouha Firmin Kouassi, Thierry Roland Kouame, Maryline Kouba

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The work aimed to study Borassus aethiopum Mart (B.a) dried pulp nutritional value for its incorporation in human and poultry diets. Firstly, the mature fruit macro-composition was assessed. Secondly, the pulp was dried at 40, 50, 60, 70, and 80ᵒC. Thereafter, the analysis was performed for fat, protein, total sugars, Ca, P, Mg, and fatty acid profile monitoring. As a result, the fruits weighed 1,591.35, delivered 516.73, and 677.82 grams of pulp and seeds, respectively. Mainly, increasing heat adversely affected the outputs. Consequently, the fat results were 14.12, 12.97, 8.93, 8.89ᶜ, and 5.56%; protein contents were 11.64, 10.15, 8.97, 8.84, and 8.42%; total sugar deliveries were 6.28, 6.05, 5.26, 5.02, and 4.76% (P < 0.01). Thereafter, the metabolizable energies were 3,785.22; 3,834.28; 3,616.62; 3,667.03; and 3,608.33 kcal/kg (DM). Additionally, Calcium (Ca) contents were 0.51, 0.55, 0.69, 0.77, and 0.81%, while phosphorus (P) mean was 0.17%, and the differences were not significant (P < 0.01). So, the Ca/P ratios were 2.79, 3.04, 4.10, 4.71, and 4.95. Finally, fatty acids (FA) assessments revealed 22.33 saturated (SFA), 77.67 unsaturated (UFA), within which 67.59% were monounsaturated (MUFA). Interestingly, the rising heat depressed n-6/n-3 ratios that were 1.1, 1.1, 0.45 and 0.38, respectively at 40, 50, 70 and 80ᵒC. In short, drying did not only enhance the product shelf life but it also improved the nutritional value. Thus, B.a mature fruit pulps dried at 70ᵒC are good functional foods, with more than 66% MUFA, and energy source for human and poultry nutrition.

Keywords: Borassus aethiopum Mart, fatty acids, metabolizable energy, minerals, protein

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Authors: S. Zouari, H. Ghorbel, H. Liao, R. Elleuch

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Research is increasingly moving towards the use of surface treatment processes to limit environmental effects. Electrolytic plating has traditionally been seen as a way to protect brass products, especially faucets, from mechanical and chemical damage. However, this method was not effective industrially, economically and ecologically. The aim of this work is to develop non-usual polymer coatings for brass faucets in order to improve the performance of brass and to replace electrolytic chromium coatings, thereby reducing environmental impact. Fluorinated-Ethylene-Propylene polymer (FEP) was chosen for its excellent mechanical and chemical properties and its good environmental performance. This coating was developed by spraying (painting) process onto brass substrates. The coatings obtained were characterized using a scanning electron microscope to evaluate the morphology of the deposits and their porosity rate. Grid adhesion, surface energy and corrosion tests (salt spray) were also performed to evaluate the mechanical and chemical behavior of these coatings properly. The results show that the deposits obtained have a homogeneous microstructure with a very low porosity rate. The results of the grid adhesion test prove the conformity of the test according to the NF077 standard. The coatings have a hydrophobic character following the low values of surface energy obtained and a very good resistance to corrosion. These results are interesting and may represent real technological issues in the industrial field.

Keywords: FEP coatings, spraying process, brass, adhesion, surface energy, corrosion resistance

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Authors: Luofu Liu, Fei Xiao Jr., Fei Xiao

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Through the analysis technology of gas chromatography-mass spectrometry (GC-MS), the composition and distribution characteristics of aromatic hydrocarbons in the Chepaizi area of the Junggar Basin were analyzed in detail. Based on that, the biological input, maturity of crude oils and sedimentary environment of the corresponding source rocks were determined and the origin types of crude oils were divided. The results show that there are three types of crude oils in the study area including Type I, Type II and Type III oils. The crude oils from the 1st member of the Neogene Shawan Formation are the Type I oils; the crude oils from the 2nd member of the Neogene Shawan Formation are the Type II oils; the crude oils from the Cretaceous Qingshuihe and Jurassic Badaowan Formations are the Type III oils. For the Type I oils, they show a single model in the late retention time of the chromatogram of total aromatic hydrocarbons. The content of triaromatic steroid series is high, and the content of dibenzofuran is low. Maturity parameters related to alkyl naphthalene, methylphenanthrene and alkyl dibenzothiophene all indicate low maturity for the Type I oils. For the Type II oils, they have also a single model in the early retention time of the chromatogram of total aromatic hydrocarbons. The content of naphthalene and phenanthrene series is high, and the content of dibenzofuran is medium. The content of polycyclic aromatic hydrocarbon representing the terrestrial organic matter is high. The aromatic maturity parameters indicate high maturity for the Type II oils. For the Type III oils, they have a bi-model in the chromatogram of total aromatic hydrocarbons. The contents of naphthalene series, phenanthrene series, and dibenzofuran series are high. The aromatic maturity parameters indicate medium maturity for the Type III oils. The correlation results of triaromatic steroid series fingerprint show that the Type I and Type III oils have similar source and are both from the Permian Wuerhe source rocks. Because of the strong biodegradation and mixing from other source, the Type I oils are very different from the Type III oils in aromatic hydrocarbon characteristics. The Type II oils have the typical characteristics of terrestrial organic matter input under oxidative environment, and are the coal oil mainly generated by the mature Jurassic coal measure source rocks. However, the overprinting effect from the low maturity Cretaceous source rocks changed the original distribution characteristics of aromatic hydrocarbons to some degree.

Keywords: oil source, geochemistry, aromatic hydrocarbons, crude oils, chepaizi area, Junggar Basin

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Authors: Farnaz Alaeimoghadam, Farzad Alaeimoghadam

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In low-lactose milk, due to lactose hydrolysis and its conversion to monosaccharides like glucose and galactose, the Maillard reaction (non-enzymatic browning) occurs more readily compared to non-hydrolyzed milk. This reaction incurs off-flavor and dark color, as well as a decrease in the nutritional value of milk. The target of this research was to evaluate the effect of natural antioxidants in diminishing the browning in low-lactose milk. In this research, three antioxidants, namely ascorbic acid, gallic acid, and pantothenic acid in the concentration range of 0-1 mM/L, either in combination with each other or separately, were added to low-lactose milk. After heat treatment (120 0C for 3 min.), milk samples incubated at 55 0C for one day and then stored at 4 0C for 9 days. Quality indices, including total phenol content, antioxidant activity, color indices, and sensory characters, were measured during intervals of 0, 2, 5, 7, and 9 days. Results of this research showed that the effect of storage time and adding antioxidants were significant on pH, antioxidant activity, total phenolic compounds either before or after heating, index L*, color change, and sensational characteristics (p < 0.05); however, acidity, a* and b* indices, chroma, and hue angle showed no significant changes (p > 0.05). The findings showed that the simultaneous application of gallic acid and ascorbic in the diminishing of non-enzymatic browning and color change, increasing pH, longevity, and antioxidant activity after heat treatment, and augmenting phenolic compounds before heat treatment was better than that of pantothenic acid.

Keywords: Maillard, low-lactose milk, non-enzymatic browning, natural antioxidant

Procedia PDF Downloads 126

Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

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