Search results for: audit quality control
Commenced in January 2007
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Edition: International
Paper Count: 18635

Search results for: audit quality control

13865 Physical Properties Characterization of Shallow Aquifer and Groundwater Quality Using Geophysical Method Based on Electrical Resistivity Tomography in Arid Region, Northeastern Area of Tunisia: A Study Case of Smar Aquifer

Authors: Nesrine Frifita

Abstract:

In recent years, serious interest in underground sources has led to more intensive studies of depth, thickness, geometry and properties of aquifers. Geophysical method is the common technique used in discovering the subsurface. However, determining the exact location of groundwater in subsurface layers is one of problems that needs to be resolved. While the biggest problem is the quality of the groundwater which suffers from pollution risk especially with water shortage in arid regions under a remarkable climate change. The present study was conducted using electrical resistivity tomography at Jeffara coastal area in Southeast Tunisia to image the potential shallow aquifer and studying their physical properties. The purpose of this study is to understand the characteristics and depth of the Smar aquifer. Therefore, it can be used as a reference in groundwater drilling in order to guide the farmers and to improve the living of the inhabitants of nearby cities. The use of the Winner-Schlumberger array for data acquisition is suitable to obtain a deeper profile in areas with homogeneous layers. For that, six electrical resistivity profiles were carried out in Smar watershed using 72 electrodes with 4 and 5 m spacing. The resistivity measurements were carefully interpreted by a least-square inversion technique using the RES2DINV program. Findings show that the Smar aquifer has about 31 m thickness and it extends to 36.5 m depth in the downstream area of Oued Smar. The defined depth and geometry of Smar aquifer indicate that the sedimentary cover thins toward the coast, and the Smar shallow aquifer becomes deeper toward the West. While the resistivity values show a significant contrast even reaching < 1 Ωm in ERT1, this resistivity value can be related to the saline water that foretells a risk of pollution and bad groundwater quality. The ERT1 geoelectrical model defines an unsaturated zone, while under ERT3 site, the geoelectrical model presents a saturated zone, which reflect a low resistivity values indicate the locally surface water coming from the nearby Office of the National Sanitation Utility (ONAS) that can be a source of recharge of the studied shallow aquifer and more deteriorate the groundwater quality in this region.

Keywords: electrical resistivity tomography, groundwater, recharge, smar aquifer, southeastern tunisia

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13864 Performance Evaluation of a Very High-Resolution Satellite Telescope

Authors: Walid A. Attia, Taher M. Bazan, Fawzy Eltohamy, Mahmoud Fathy

Abstract:

System performance evaluation is an essential stage in the design of high-resolution satellite telescopes prior to the development process. In this paper, a system performance evaluation of a very high-resolution satellite telescope is investigated. The evaluated system has a Korsch optical scheme design. This design has been discussed in another paper with respect to three-mirror anastigmat (TMA) scheme design and the former configuration showed better results. The investigated system is based on the Korsch optical design integrated with a time-delay and integration charge coupled device (TDI-CCD) sensor to achieve a ground sampling distance (GSD) of 25 cm. The key performance metrics considered are the spatial resolution, the signal to noise ratio (SNR) and the total modulation transfer function (MTF) of the system. In addition, the national image interpretability rating scale (NIIRS) metric is assessed to predict the image quality according to the modified general image quality equation (GIQE). Based on the orbital, optical and detector parameters, the estimated GSD is found to be 25 cm. The SNR has been analyzed at different illumination conditions of target albedos, sun and sensor angles. The system MTF has been computed including diffraction, aberration, optical manufacturing, smear and detector sampling as the main contributors for evaluation the MTF. Finally, the system performance evaluation results show that the computed MTF value is found to be around 0.08 at the Nyquist frequency, the SNR value was found to be 130 at albedo 0.2 with a nadir viewing angles and the predicted NIIRS is in the order of 6.5 which implies a very good system image quality.

Keywords: modulation transfer function, national image interpretability rating scale, signal to noise ratio, satellite telescope performance evaluation

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13863 Effect of Biostimulants to Control the Phelipanche ramosa L. Pomel in Processing Tomato Crop

Authors: G. Disciglio, G. Gatta, F. Lops, A. Libutti, A. Tarantino, E. Tarantino

Abstract:

The experimental trial was carried out in open field at Foggia district (Apulia Region, Southern Italy), during the spring-summer season 2014, in order to evaluate the effect of four biostimulant products (RadiconÒ, Viormon plusÒ, LysodinÒ and SiaptonÒ 10L), compared with a control (no biostimulant), on the infestation of processing tomato crop (cv Dres) by the chlorophyll-lacking root parasite Phelipanche ramosa. Biostimulants consist in different categories of products (microbial inoculants, humic and fulvic acids, hydrolyzed proteins and aminoacids, seaweed extracts) which play various roles in plant growing, including the improvement of crop resistance and quali-quantitative characteristics of yield. The experimental trial was arranged according to a complete randomized block design with five treatments, each of one replicated three times. The processing tomato seedlings were transplanted on 5 May 2014. Throughout the crop cycle, P. ramosa infestation was assessed according to the number of emerged shoots (branched plants) counted in each plot, at 66, 78 and 92 day after transplanting. The tomato fruits were harvested at full-stage of maturity on 8 August 2014. From each plot, the marketable yield was measured and the quali-quantitative yield parameters (mean weight, dry matter content, colour coordinate, colour index and soluble solids content of the fruits) were determined. The whole dataset was tested according to the basic assumptions for the analysis of variance (ANOVA) and the differences between the means were determined using Tukey’s tests at the 5% probability level. The results of the study showed that none of the applied biostimulants provided a whole control of Phelipanche, although some positive effects were obtained from their application. To this respect, the RadiconÒ appeared to be the most effective in reducing the infestation of this root-parasite in tomato crop. This treatment also gave the higher tomato yield.

Keywords: biostimulant, control methods, Phelipanche ramosa, tomato crop

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13862 Seawater Desalination for Production of Highly Pure Water Using a Hydrophobic PTFE Membrane and Direct Contact Membrane Distillation (DCMD)

Authors: Ahmad Kayvani Fard, Yehia Manawi

Abstract:

Qatar’s primary source of fresh water is through seawater desalination. Amongst the major processes that are commercially available on the market, the most common large scale techniques are Multi-Stage Flash distillation (MSF), Multi Effect distillation (MED), and Reverse Osmosis (RO). Although commonly used, these three processes are highly expensive down to high energy input requirements and high operating costs allied with maintenance and stress induced on the systems in harsh alkaline media. Beside that cost, environmental footprint of these desalination techniques are significant; from damaging marine eco-system, to huge land use, to discharge of tons of GHG and huge carbon footprint. Other less energy consuming techniques based on membrane separation are being sought to reduce both the carbon footprint and operating costs is membrane distillation (MD). Emerged in 1960s, MD is an alternative technology for water desalination attracting more attention since 1980s. MD process involves the evaporation of a hot feed, typically below boiling point of brine at standard conditions, by creating a water vapor pressure difference across the porous, hydrophobic membrane. Main advantages of MD compared to other commercially available technologies (MSF and MED) and specially RO are reduction of membrane and module stress due to absence of trans-membrane pressure, less impact of contaminant fouling on distillate due to transfer of only water vapor, utilization of low grade or waste heat from oil and gas industries to heat up the feed up to required temperature difference across the membrane, superior water quality, and relatively lower capital and operating cost. To achieve the objective of this study, state of the art flat-sheet cross-flow DCMD bench scale unit was designed, commissioned, and tested. The objective of this study is to analyze the characteristics and morphology of the membrane suitable for DCMD through SEM imaging and contact angle measurement and to study the water quality of distillate produced by DCMD bench scale unit. Comparison with available literature data is undertaken where appropriate and laboratory data is used to compare a DCMD distillate quality with that of other desalination techniques and standards. Membrane SEM analysis showed that the PTFE membrane used for the study has contact angle of 127º with highly porous surface supported with less porous and bigger pore size PP membrane. Study on the effect of feed solution (salinity) and temperature on water quality of distillate produced from ICP and IC analysis showed that with any salinity and different feed temperature (up to 70ºC) the electric conductivity of distillate is less than 5 μS/cm with 99.99% salt rejection and proved to be feasible and effective process capable of consistently producing high quality distillate from very high feed salinity solution (i.e. 100000 mg/L TDS) even with substantial quality difference compared to other desalination methods such as RO and MSF.

Keywords: membrane distillation, waste heat, seawater desalination, membrane, freshwater, direct contact membrane distillation

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13861 Effects of Aromatase Inhibitor on Morphology and Body Shape in Sex-Reversal Chicken: Gimmizah Strain

Authors: Hatem Ashur Masoud Shreha

Abstract:

Aromatase inhibitors administered before sexual differentiation of the gonads in chicken embryo can induce sex reversal in female layer chickens (phenotypic male). To analyze the process of sex reversal, we have followed for several months the changes induced by Fadrozole, a nonsteroidal aromatase inhibitor on morphology of female sex-reversed and female sex-reversed supplemented with L-tyrosine which was previously shown to stimulate release of Gn Rh. Fadrozole (1mg/egg) was injected into eggs on day four of incubation before sex differentiation. phenotypic males and phenotypic males treated with L-tyrosine and males hatched from eggs injected Fadrozole were sacrificed by slaughtering at 16 weeks old and the remaining chicks were sacrificed at 28 weeks old. Both sexes from control chickens were sacrificed at the same age (16 &28 weeks). Hatchability, behavior, body weight, shank length, comb weight, testes weight, blood cells count and wattle weight of sex reversal were tested at 16 and 28 weeks. The results showed that body weight, comb weight, wattles weight and shank length of sex-reversed females were significantly different from control female. Behavior of phenotypic males and phenotypic males fed on L-tyrosine showed aggressive sexual behavior like that of control males and absence of laying behavior. In conclusion our results confirm that Fadrazole injection in eggs before sex differentiation produce a male behavior and morphological index of male in female chicken.

Keywords: sex-reversal, fadrozole, phenotypic male, L-tyrosine

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13860 Difficulties in Providing Palliative Care in Rural India, West Bengal: Experience of an NGO

Authors: Aditya Manna

Abstract:

Introduction: As in any developing countries state of West Bengal in India has a huge burden of cancer patients in advanced stage coming from rural area where awareness regarding the usefulness of palliative care in rather poor. Objective: Our goal is to give a pain free good quality of life in these advanced stage cancer patients. Objective of this study is to identify the main difficulties in achieving the above goal in a rural village setting in India. Method: Advanced cancer patients in need of palliative care in various villages in of rural India were selected for this study. Their symptoms and managements in that rural surroundings were evaluated by an NGO (under the guidance of a senior palliative care specialist) working in that area. An attempt was made to identify the main obstacles in getting proper palliative care in a rural setting. Results: Pain, fatigue are the main symptoms effecting these patients. In most patients pain and other symptoms control were grossly inadequate due to lack of properly trained manpower in the rural India. However regular homecare visits by a group of social workers were of immense help in the last few months of life. NGO team was well guided by a palliative care specialist. Conclusion: There is a wide gap of trained manpower in this filled in rural areas of India. Dedicated groups from rural area itself need encouragement and proper training, so that difficult symptoms can be managed locally along with necessary social and psychological support to these patients.

Keywords: palliative care, NGO, rural India, home care

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13859 Evaluation of the Sterilization Practice in Liberal Dental Surgeons at Sidi Bel Abbes- Algeria

Authors: A. Chenafa, S. Boulenouar, M. Zitouni, M. Boukouria

Abstract:

The sterilization of medical devices constitutes for all the medical professions, an inescapable obligation. It has for objective to prevent the infectious risk, both for the patient and for the medical team. The Dental surgeon as every healthcare professional has to master perfectly this subject and to train his staff to the various techniques of sterilization. It is the only way to assure the patients all the security for which they are entitled to wait when they undergo a dental care. It’s for it, that we undertook to lead an investigation aiming at estimating the sterilization practice at the dental surgeon of Sidi bel Abbes. The survey result showed a youth marked with the profession with a majority use of autoclave with cycle B and an almost total absence of the sterilization controls (test of Bowie and Dick). However, the majority of the dentists control and validate their sterilizers. Finally, our survey allowed us to describe some practices which must be improved regarding control, regarding qualification and regarding staff training. And suggestions were made in this sense.

Keywords: dental surgeon, medical devices, sterilization, survey

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13858 Effect of Different Methods to Control the Parasitic Weed Phelipanche ramosa (L. Pomel) in Tomato Crop

Authors: Disciglio G., Lops F., Carlucci A., Gatta G., Tarantino A., Frabboni L, Tarantino E.

Abstract:

The Phelipanche ramosa is considered the most damaging obligate flowering parasitic weed on a wide species of cultivated plants. The semiarid regions of the world are considered the main center of this parasitic weed, where heavy infestation are due to the ability to produce high numbers of seeds (up to 200,000), that remain viable for extended period (more than 19 years). In this paper 13 treatments of parasitic weed control, as physical, chemical, biological and agronomic methods, including the use of the resistant plants, have been carried out. In 2014 a trial was performed on processing tomato (cv Docet), grown in pots filled with soil taken from a plot heavily infested by Phelipanche ramosa, at the Department of Agriculture, Food and Environment, University of Foggia (southern Italy). Tomato seedlings were transplanted on August 8, 2014 on a clay soil (USDA) 100 kg ha-1 of N; 60 kg ha-1 of P2O5 and 20 kg ha-1 of S. Afterwards, top dressing was performed with 70 kg ha-1 of N. The randomized block design with 3 replicates was adopted. During the growing cycle of the tomato, at 70-75-81 and 88 days after transplantation the number of parasitic shoots emerged in each pot was detected. Also values of leaf chlorophyll Meter SPAD of tomato plants were measured. All data were subjected to analysis of variance (ANOVA) using the JMP software (SAS Institute Inc., Cary, NC, USA), and for comparison of means was used Tukey's test. The results show lower values of the color index SPAD in tomato plants parasitized compared to those healthy. In addition, each treatment studied did not provide complete control against Phelipanche ramosa. However the virulence of the attacks was mitigated by some treatments: radicon product, compost activated with Fusarium, mineral fertilizer nitrogen, sulfur, enzone and resistant tomato genotype. It is assumed that these effects can be improved by combining some of these treatments each other, especially for a gradual and continuing reduction of the “seed bank” of the parasite in the soil.

Keywords: control methods, Phelipanche ramose, tomato crop

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13857 Bacteriological Screening and Antibiotic – Heavy Metal Resistance Profile of the Bacteria Isolated from Some Amphibian and Reptile Species of the Biga Stream in Turkey

Authors: Nurcihan Hacioglu, Cigdem Gul, Murat Tosunoglu

Abstract:

In this article, the antibiogram and heavy metal resistance profile of the bacteria isolated from total 34 studied animals (Pelophylax ridibundus = 12, Mauremys rivulata = 14, Natrix natrix = 8) captured around the Biga Stream, are described. There was no database information on antibiogram and heavy metal resistance profile of bacteria from these area’s amphibians and reptiles. In this study, a total of 200 bacteria were successfully isolated from cloaca and oral samples of the aquatic amphibians and reptiles as well as from the water sample. According to Jaccard’s similarity index, the degree of similarity in the bacterial flora was quite high among the amphibian and reptile species under examination, whereas it was different from the bacterial diversity in the water sample. The most frequent isolates were A. hydrophila (31.5%), B. pseudomallei (8.5%), and C. freundii (7%). The total numbers of bacteria obtained were as follows: 45 in P. ridibundus, 45 in N. natrix 30 in M. rivulata, and 80 in the water sample. The result showed that cefmetazole was the most effective antibiotic to control the bacteria isolated in this study and that approximately 93.33% of the bacterial isolates were sensitive to this antibiotic. The Multiple Antibiotic Resistances (MAR) index indicated that P. ridibundus (0.95) > N. natrix (0.89) > M. rivulata (0.39). Furthermore, all the tested heavy metals (Pb+2, Cu+2, Cr+3, and Mn+2) inhibit the growth of the bacterial isolates at different rates. Therefore, it indicated that the water source of the animals was contaminated with both antibiotic residues and heavy metals.

Keywords: bacteriological quality, amphibian, reptile, antibiotic, heavy metal resistance

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13856 Biodiesel Production from Yellow Oleander Seed Oil

Authors: S. Rashmi, Devashish Das, N. Spoorthi, H. V. Manasa

Abstract:

Energy is essential and plays an important role for overall development of a nation. The global economy literally runs on energy. The use of fossil fuels as energy is now widely accepted as unsustainable due to depleting resources and also due to the accumulation of greenhouse gases in the environment, renewable and carbon neutral biodiesel are necessary for environment and economic sustainability. Unfortunately biodiesel produced from oil crop, waste cooking oil and animal fats are not able to replace fossil fuel. Fossil fuels remain the dominant source of primary energy, accounting for 84% of the overall increase in demand. Today biodiesel has come to mean a very specific chemical modification of natural oils. Objectives: To produce biodiesel from yellow oleander seed oil, to test the yield of biodiesel using different types of catalyst (KOH & NaOH). Methodology: Oil is extracted from dried yellow oleander seeds using Soxhlet extractor and oil expeller (bulk). The FFA content of the oil is checked and depending on the FFA value either two steps or single step process is followed to produce biodiesel. Two step processes includes esterfication and transesterification, single step includes only transesterification. The properties of biodiesel are checked. Engine test is done for biodiesel produced. Result: It is concluded that biodiesel quality parameters such as yield(85% & 90%), flash point(1710C & 1760C),fire point(1950C & 1980C), viscosity(4.9991 and 5.21 mm2/s) for the biodiesel from seed oil of Thevetiaperuviana produced by using KOH & NaOH respectively. Thus the seed oil of Thevetiaperuviana is a viable feedstock for good quality fuel.The outcomes of our project are a substitute for conventional fuel, to reduce petro diesel requirement,improved performance in terms of emissions. Future prospects: Optimization of biodiesel production using response surface method.

Keywords: yellow oleander seeds, biodiesel, quality parameters, renewable sources

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13855 Effects of the Food Colour Erythrosine on Thyroid Gland Function in Experimental Rats

Authors: Maha M.Saber, Eitedal Daoud, Moetazza M. Alshafei, Lobna M. Abd El-Latif

Abstract:

Children in the third world consumes many food products colored red like sweets and soft drink without knowing its effect on health or the type of color used in these products Erythrosine (ER,FD & C Red No.3) is one of the most common coloring agent used in these products and in coloring cherry in compotes. The possible adverse effect of erythrosine ER on the thyroid gland function is investigated in albino rats. Forty-five adult male albino rats were divided to three groups two groups will receive ER orally in doses 68 and I36mg/kg respectively. Third group will receive distilled water for three months Sections of thyroid glands were examined for histopathological, morphometric analysis and MIB-I Ki67 (proliferative marker). Serum concentration of triiodothyronine (T3), Thyroxin (T4) and thyrotrophin (TSH) were determined, results showed histological changes in the two treatment groups versus control group in the group with 68mg/kg dose show vaculation of the cytoplasm of follicular cells and pleomorphism of their nuclei. While the other treated group {136mg /kg} showed congestion of blood vessels, hyperplasia of the interstitial cells and increased multilayer of the follicular cells. Highly significant increase in the mean area of the thyroid follicles in both treated groups compared to control group.Erythrosine treated groups showed a very highly significant decrease (P < 0.001) in serum concentration of T3 and T 4 while TSH showed a very highly significant increase versus control.

Keywords: erythrosine, thyroid, morphometrics, proliferative marker

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13854 Assessing the Disability-Free Life Expectancy and Decomposition of Its Difference: A Gender Perspective on India over the Decade 2001-2011

Authors: Kajori Banerjee, Laxmi Kant Dwivedi

Abstract:

“Health transition” is defined to be “a process through which high levels of mortality, morbidity and disability are reduced to low levels by influencing cultural, social and behavioural factors”. Life expectancy in India has been on the rise and parallel the burden of disease and disability has also risen noticeably. Borrowing data from Indian Census (2001, 2011), this study identifies the gender-wise burden of disability by calculating disability free life expectancy (DFLE) and life lived with disability (LWD). Sullivan’s method of calculating DFLE using proportion of disabled is used for this purpose. The change in person years lived with disability in the decade 2001-11 is further decomposed using Arriaga’s method into mortality and disability effects (ME and DE) to check the magnitude and direction of contribution of mortality and disability. Nationally, along with DFLE, LWD has amplified too. Despite having the highest life expectancy and DFLE, LWD in Kerala, was highest for both sexes in 2001. But in 2011, the LWD was highest among the males of Orissa and females of Rajasthan. For the overall population, DE is positive for the prime working age groups of 20-40years indicating that there has been an increase in the disability proportion holding mortality constant for 2001-2011. Females exhibit higher positive DE implying greater loss of healthy years due to disability than males. The findings call for an immediate attention to the causes of rising disability burden among the working population, especially females, as this might heavily effect the availability of quality labour force and its relative economic output in the Indian labour market. This also hints at the degrading quality of the elongated life and needs to be given the required attention to enhance the quality of life lead in the Nation.

Keywords: disability-free life expectancy, disability effect, life expectancy, mortality effect

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13853 Energy Efficiency Improvement of Excavator with Independent Metering Valve by Continuous Mode Changing Considering Engine Fuel Consumption

Authors: Sang-Wook Lee, So-Yeon Jeon, Min-Gi Cho, Dae-Young Shin, Sung-Ho Hwang

Abstract:

Hydraulic system of excavator gets working energy from hydraulic pump which is connected to output shaft of engine. Recently, main control valve (MCV) which is composed of several independent metering valve (IMV) has been introduced for better energy efficiency of the hydraulic system so that fuel efficiency of the excavator can be improved. Excavator with IMV has 5 operating modes depending on the quantity of regeneration flow. In this system, the hydraulic pump is controlled to supply demanded flow which is needed to operate each mode. Because the regenerated flow supply energy to actuators, the hydraulic pump consumes less energy to make same motion than one that does not regenerate flow. The horse power control is applied to the hydraulic pump of excavator for maintaining engine start under a heavy load and this control makes the flow of hydraulic pump reduced. When excavator is in complex operation such as loading or unloading soil, the hydraulic pump discharges small quantity of working fluid in high pressure. At this operation, the engine of excavator does not run at optimal operating line (OOL). The engine needs to be operated on OOL to improve fuel efficiency and by controlling hydraulic pump the engine can drive on OOL. By continuous mode changing of IMV, the hydraulic pump is controlled to make engine runs on OOL. The simulation result of this study shows that fuel efficiency of excavator with IMV can be improved by considering engine OOL and continuous mode changing algorithm.

Keywords: continuous mode changing, engine fuel consumption, excavator, fuel efficiency, IMV

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13852 Mentoring of Health Professionals to Ensure Better Child-Birth and Newborn Care in Bihar, India: An Intervention Study

Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

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AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

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13851 Integrated Risk Management in The Supply Chain of Essential Medicines in Zambia

Authors: Mario M. J. Musonda

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

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

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13850 Non Chemical-Based Natural Products in the Treatment and Control of Disease in Fish

Authors: Albert P. Ekanem, Austin I. Obiekezie, Elizabeth X. Ntia

Abstract:

Introduction: Some African plants and bile from animals have shown efficacies in the treatment and control of diseases in farmed fish. The background of the study is based on the fact the African rain forest is blessed with the abundance of medicinal plants that should be investigated for their use in the treatment of diseases. The significance of the study is informed by the fact that chemical-based substances accumulate in the tissues of food fish, thereby reducing the food values of such products and moreover, the continuous use of chemotherapeutics in the aquatic environments tends to degrade the affected environment. Methodology: Plants and animal products were extracted, purified and applied under in vitro and in vivo conditions to the affected organisms. Effective plants and bills were analyzed for biologically active substances responsible for the activities by both qualitative and HPLC methods. Results: Extracts of Carica papaya and Mucuna pruriens were effective in the treatment of Ichthyophthiriasis in goldfish (Carassius auratus auratus) with high host tolerance. Similarly, ectoparasitic monogeneans were effectively dislodged from the gills and skin of goldfish by the application of extracts of Piper guineense at therapeutic concentrations. Artemesia annua with known antimalarial activities in human was also effective against fish monogenean parasites of Clarias gariepinus in a concentration-related manner without detriments to the host. Effective antibacterial activities against Aeromonas and Pseudomonas diseases of the African catfish (Heterobranchus longifilis) were demonstrated in some plants such as Phylanthus amarus, Allium sativum, A. annua, and Citrus lemon. Bile from some animals (fish, goat, chicken, cow, and pig) showed great antibacterial activities against some gastrointestinal bacterial pathogens of fish. Conclusions: African plants and some animal bile have shown potential promise in the treatment of diseases in fish and other aquatic animals. The use of chemical-based substances for control of diseases in the aquatic environments should be restricted.

Keywords: control, diseases, fish, treatment

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13849 Non-Invasive Pre-Implantation Genetic Assessment Using NGS in IVF Clinical Routine

Authors: Katalin Gombos, Bence Gálik, Krisztina Ildikó Kalács, Krisztina Gödöny, Ákos Várnagy, József Bódis, Attila Gyenesei, Gábor L. Kovács

Abstract:

Although non-invasive pre-implantation genetic testing for aneuploidy (NIPGT-A) is potentially appropriate to assess chromosomal ploidy of the embryo, practical application of it in a routine IVF center has not been started in the absence of a recommendation. We developed a comprehensive workflow for a clinically applicable strategy for NIPGT-A based on next-generation sequencing (NGS) technology. We performed MALBAC whole genome amplification and NGS on spent blastocyst culture media of Day 3 embryos fertilized with intra-cytoplasmic sperm injection (ICSI). Spent embryonic culture media of morphologically good quality score embryos were enrolled in further analysis with the blank culture media as background control. Chromosomal abnormalities were identified by an optimized bioinformatics pipeline applying a copy number variation (CNV) detecting algorithm. We demonstrate a comprehensive workflow covering both wet- and dry-lab procedures supporting a clinically applicable strategy for NIPGT-A. It can be carried out within 48 h which is critical for the same-cycle blastocyst transfer, but also suitable for “freeze all” and “elective frozen embryo” strategies. The described integrated approach of non-invasive evaluation of embryonic DNA content of the culture media can potentially supplement existing pre-implantation genetic screening methods.

Keywords: next generation sequencing, in vitro fertilization, embryo assessment, non-invasive pre-implantation genetic testing

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13848 Knowledge of the Doctors Regarding International Patient Safety Goal

Authors: Fatima Saeed, Abdullah Mudassar

Abstract:

Introduction: Patient safety remains a global priority in the ever-evolving healthcare landscape. At the forefront of this endeavor are the International Patient Safety Goals (IPSGs), a standardized framework designed to mitigate risks and elevate the quality of care. Doctors, positioned as primary caregivers, wield a pivotal role in upholding and adhering to IPSGs, underscoring the critical significance of their knowledge and understanding of these goals. This research embarks on a comprehensive exploration into the depth of Doctors ' comprehension of IPSGs, aiming to unearth potential gaps and provide insights for targeted educational interventions. Established by influential healthcare bodies, including the World Health Organization (WHO), IPSGs represent a universally applicable set of objectives spanning crucial domains such as medication safety, infection control, surgical site safety, and patient identification. Adherence to these goals has exhibited substantial reductions in adverse events, fostering an overall enhancement in the quality of care. This study operates on the fundamental premise that an informed Doctors workforce is indispensable for effectively implementing IPSGs. A nuanced understanding of these goals empowers Doctors to identify potential risks, advocate for necessary changes, and actively contribute to a safety-centric culture within healthcare institutions. Despite the acknowledged importance of IPSGs, there is a growing concern that nurses may need more knowledge to integrate these goals into their practice seamlessly. Methodology: A Comprehensive research methodology covering study design, setting, duration, sample size determination, sampling technique, and data analysis. It introduces the philosophical framework guiding the research and details material, methods, and the analysis framework. The descriptive quantitative cross-sectional study in teaching care hospitals utilized convenient sampling over six months. Data collection involved written informed consent and questionnaires, analyzed with SPSS version 23, presenting results graphically and descriptively. The chapter ensures a clear understanding of the study's design, execution, and analytical processes. Result: The survey results reveal a substantial distribution across hospitals, with 34.52% in MTIKTH and 65.48% in HMC MTI. There is a notable prevalence of patient safety incidents, emphasizing the significance of adherence to IPSGs. Positive trends are observed, including 77.0% affirming the "time-out" procedure, 81.6% acknowledging effective healthcare provider communication, and high recognition (82.7%) of the purpose of IPSGs to improve patient safety. While the survey reflects a good understanding of IPSGs, areas for improvement are identified, suggesting opportunities for targeted interventions. Discussion: The study underscores the need for tailored care approaches and highlights the bio-socio-cultural context of 'contagion,' suggesting areas for further research amid antimicrobial resistance. Shifting the focus to patient safety practices, the survey chapter provides a detailed overview of results, emphasizing workplace distribution, patient safety incidents, and positive reflections on IPSGs. The findings indicate a positive trend in patient safety practices with areas for improvement, emphasizing the ongoing need for reinforcing safety protocols and cultivating a safety-centric culture in healthcare. Conclusion: In summary, the survey indicates a positive trend in patient safety practices with a good understanding of IPSGs among participants. However, identifying areas for potential improvement suggests opportunities for targeted interventions to enhance patient safety further. Ongoing efforts to reinforce adherence to safety protocols, address identified gaps, and foster a safety culture will contribute to continuous improvements in patient care and outcomes.

Keywords: infection control, international patient safety, patient safety practices, proper medication

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13847 Numerical Analysis of Passive Controlled Turbulent Flow around a Circular Cylinder

Authors: Mustafa Soyler, Mustafa M. Yavuz, Bulent Yaniktepe, Coskun Ozalp

Abstract:

In this study, unsteady two-dimensional turbulent flow around a circular cylinder and passive control of the flow with groove on the cylinder was examined. In the CFD analysis, solutions were made using turbulent flow conditions. Steady and unsteady solutions were used in turbulent flow analysis. Numerical analysis of the flow around the circular cylinder is difficult since flow is not in a stable regime when Reynold number is between 1000 and 10000. The analyses in this study were performed at a subcritical Re number of 5000 and the results were compared with available experimental results of the drag coefficient (Cd) and Strouhal (St) number values in the literature. The effect of different groove types and depths on the Cd coefficient has been analyzed and grooves increase the Cd coefficient compared to the smooth cylinder.

Keywords: CFD, drag coefficient, flow over cylinder, passive flow control

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13846 Assessing the Physical Conditions of Motorcycle Taxi Stands and Comfort Conditions of the Drivers in the Central Business District of Bangkok

Authors: Nissa Phloimontri

Abstract:

This research explores the current physical conditions of motorcycle taxi stands located near the BTS stations in the central business district (CBD) and the comfort conditions of motorcycle taxi drivers. The criteria set up for physical stand survey and assessment are the integration of multimodal access design guidelines. After the survey, stands that share similar characteristics are classified into a series of typologies. Based on the environmental comfort model, questionnaires and in-depth interviews are conducted to evaluate the comfort levels of drivers including physical, functional, and psychological comfort. The results indicate that there are a number of motorcycle taxi stands that are not up to standard and are not conducive to the work-related activities of drivers. The study concludes by recommending public policy for integrated paratransit stops that support the multimodal transportation and seamless mobility concepts within the specific context of Bangkok as well as promote the quality of work life of motorcycle taxi drivers.

Keywords: motorcycle taxi, paratransit stops, environmental comfort, quality of work life

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13845 Dimensions of Public Spaces: Feelings through Human Senses

Authors: Piyush Hajela

Abstract:

The significance of public spaces is on a rise in Indian cities as a strong interaction space across cultures and community. It is a pertinent gathering space for people across age and gender, where the face keeps changing with time. A public space is directly related to the social dimension, people, comfort, safety, and security, that, it proposes to provide, as inherent qualities. The presence of these and other dimensions of space, together with related equitable environments, impart certain quality to a public space. The higher the optimum contents of these dimensions, the better the quality of public space. Public is represented by PEOPLE through society and community, and space is created by dimensions. Society contains children, women and the elderly, community is composed of social, and religious groups. These behave differently in a different setting and call for varied quality of spaces, created and generated. Public spaces are spread across a city and have more or less established their existence and prominence in a social set up. While few of them are created others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The emergence of public space dates back to the times when people started forming communities, display cultures and traditions publicly, gathered for religious observations and celebrations, and address the society. Traditional cities and societies in India were feudal and orthodox in their nature and yet had public spaces. When the gathering of people at one point in a city became more frequent the point became more accessible and occupied. Baras (large courts, Chowks (public squares) and Maidans (large grounds) became well-known gathering spaces in the towns and cities. As the population grew such points grew in number, each becoming a public space in itself and with a different and definite social character. The author aims at studying the various dimensions of public spaces with which a public space has power to hold people for a significant period of time. The human senses here are note referred to as taste, sight, hearing, touch or smell, but how human senses collectively respond to when stationed in a given public space. The collectives may reflect in dimensions like comfort, safety, environment, freedom etc. Various levels of similar other responses would be studied through interviews, observations and other scientific methods for both qualitative and quantitative analysis.

Keywords: society, interaction, people, accessibility, comfort, enclosure

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13844 Application of Unmanned Aerial Vehicle in Urban Rail Transit Intelligent Inspection

Authors: Xinglu Nie, Feifei Tang, Chuntao Wei, Zhimin Ruan, Qianhong Zhu

Abstract:

Current method of manual-style inspection can not fully meet the requirement of the urban rail transit security in China. In this paper, an intelligent inspection method using unmanned aerial vehicle (UAV) is utilized. A series of orthophoto of rail transit monitored area was collected by UAV, image correction and registration were operated among multi-phase images, then the change detection was used to detect the changes, judging the engineering activities and human activities that may become potential threats to the security of urban rail. Not only qualitative judgment, but also quantitative judgment of changes in the security control area can be provided by this method, which improves the objectives and efficiency of the patrol results. The No.6 line of Chongqing Municipality was taken as an example to verify the validation of this method.

Keywords: rail transit, control of protected areas, intelligent inspection, UAV, change detection

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13843 Prediction of Compressive Strength of Concrete from Early Age Test Result Using Design of Experiments (Rsm)

Authors: Salem Alsanusi, Loubna Bentaher

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Response Surface Methods (RSM) provide statistically validated predictive models that can then be manipulated for finding optimal process configurations. Variation transmitted to responses from poorly controlled process factors can be accounted for by the mathematical technique of propagation of error (POE), which facilitates ‘finding the flats’ on the surfaces generated by RSM. The dual response approach to RSM captures the standard deviation of the output as well as the average. It accounts for unknown sources of variation. Dual response plus propagation of error (POE) provides a more useful model of overall response variation. In our case, we implemented this technique in predicting compressive strength of concrete of 28 days in age. Since 28 days is quite time consuming, while it is important to ensure the quality control process. This paper investigates the potential of using design of experiments (DOE-RSM) to predict the compressive strength of concrete at 28th day. Data used for this study was carried out from experiment schemes at university of Benghazi, civil engineering department. A total of 114 sets of data were implemented. ACI mix design method was utilized for the mix design. No admixtures were used, only the main concrete mix constituents such as cement, coarse-aggregate, fine aggregate and water were utilized in all mixes. Different mix proportions of the ingredients and different water cement ratio were used. The proposed mathematical models are capable of predicting the required concrete compressive strength of concrete from early ages.

Keywords: mix proportioning, response surface methodology, compressive strength, optimal design

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13842 Corporate Codes of Ethics and Earnings Discretion: International Evidence

Authors: Chu Chen, Giorgio Gotti, Tony Kang, Michael Wolfe

Abstract:

This study examines the role of codes of ethics in reducing the extent to which managers’ act opportunistically in reporting earnings. Corporate codes of ethics, by clarifying the boundaries of ethical corporate behaviors and making relevant social norms more salient, have the potential to deter managers from engaging in opportunistic financial reporting practices. In a sample of international companies, we find that the quality of corporate codes of ethics is associated with higher earnings quality, i.e., lower discretionary accruals. Our results are confirmed for a subsample of firms more likely to be engaging in opportunistic reporting behavior, i.e., firms that just meet or beat analysts’ forecasts. Further, codes of ethics play a greater role in reducing earnings management for firms in countries with weaker investor protection mechanisms. Our results suggest that corporate codes of ethics can be a viable alternative to country-level investor protection mechanisms in curbing aggressive reporting behaviors.

Keywords: corporate ethics policy, code of ethics, business ethics, earnings discretion, accruals

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13841 Postmortem Magnetic Resonance Imaging as an Objective Method for the Differential Diagnosis of a Stillborn and a Neonatal Death

Authors: Uliana N. Tumanova, Sergey M. Voevodin, Veronica A. Sinitsyna, Alexandr I. Shchegolev

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An important part of forensic and autopsy research in perinatology is the answer to the question of life and stillbirth. Postmortem magnetic resonance imaging (MRI) is an objective non-invasive research method that allows to store data for a long time and not to exhume the body to clarify the diagnosis. The purpose of the research is to study the possibilities of a postmortem MRI to determine the stillbirth and death of a newborn who had spontaneous breathing and died on the first day after birth. MRI and morphological data of a study of 23 stillborn bodies, prenatally dead at a gestational age of 22-39 weeks (Group I) and the bodies of 16 newborns who died from 2 to 24 hours after birth (Group II) were compared. Before the autopsy, postmortem MRI was performed on the Siemens Magnetom Verio 3T device in the supine position of the body. The control group for MRI studies consisted of 7 live newborns without lung disease (Group III). On T2WI in the sagittal projection was measured MR-signal intensity (SI) in the lung tissue (L) and shoulder muscle (M). During the autopsy, a pulmonary swimming test was evaluated, and macro- and microscopic studies were performed. According to the postmortem MRI, the highest values of mean SI of the lung (430 ± 27.99) and of the muscle (405.5 ± 38.62) on T2WI were detected in group I and exceeded the corresponding value of group II by 2.7 times. The lowest values were found in the control group - 77.9 ± 12.34 and 119.7 ± 6.3, respectively. In the group II, the lung SI was 1.6 times higher than the muscle SI, whereas in the group I and in the control group, the muscle SI was 2.1 times and 1.8 times larger than the lung. On the basis of clinical and morphological data, we calculated the formula for determining the breathing index (BI) during postmortem MRI: BI = SIL x SIM / 100. The mean value of BI in the group I (1801.14 ± 241.6) (values ranged from 756 to 3744) significantly higher than the corresponding average value of BI in the group II (455.89 ± 137.32, p < 0.05) (305-638.4). In the control group, the mean BI value was 91.75 ± 13.3 (values ranged from 53 to 154). The BI with the results of pulmonary swimming tests and microscopic examination of the lungs were compared. The boundary value of BI for the differential diagnosis of stillborn and newborn death was 700. Using the postmortem MRI allows to differentiate the stillborn with the death of the breathing newborn.

Keywords: lung, newborn, postmortem MRI, stillborn

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13840 Student Feedback and Its Impact on Fostering the Quality of Teaching at the Academia

Authors: S. Vanker, A. Aaver, A. Roio, L. Nuut

Abstract:

To be sure about the effective and less effective/ineffective approaches to course instruction, we hold the opinion that the faculty members need regular feedback from their students in order to be aware of how well or unwell their teaching styles have worked when instructing the courses. It can be confirmed without a slightest hesitation that undergraduate students’ motivated-ness can be sustained when continually improving the quality of teaching and properly sequencing the academic courses both, in the curricula and timetables. At Estonian Aviation Academy, four different forms of feedback are used: Lecture monitoring, questionnaires for all students, study information system subject monitoring and direct feedback received by the lecturer. Questionnaires for all students are arranged once during a study year and separately for the first year and senior students. The results are discussed in academic departments together with student representatives, analyzed with the teaching staff and, if needed, improvements are suggested. In addition, a monitoring system is planned where a lecturer acts in both roles – as an observer and as the lecturer. This will foster better exchange of experience and through this help to make the whole study process more interesting.

Keywords: learner motivation, feedback, student support, undergraduate education

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13839 Analysis of Total Acid in Arabica Coffee Beans after Fermentation with Ohmic Technology

Authors: Reta

Abstract:

Coffee is widely consumed not only because of its typical taste, but coffee has antioxidant properties because of its polyphenols, and it stimulates brain's performance. The main problem with the consumption of coffee is its content of caffeine. Caffeine, when consumed in excess, can increase muscle tension, stimulate the heart, and increase the secretion of gastric acid. In this research, we applied ohmic-based fermentation technology, which is specially designed to mimic the stomach. We used Arabica coffee, which although cheaper than Luwak coffee, has high acidity, which needs to be reduced. Hence, we applied the ohmic technology, varied the time and temperature of the process and measured the total acidity of the coffee to determine optimum fermentation conditions. Results revealed total acidity of the coffee varied with fermentation conditions; 0.32% at 400C and 12 hr, and 0.52% at 400C and 6 hr. The longer the fermentation, the lower was the acidity. The acidity of the mongoose-fermented (natural fermentation) beans was 2.34%, which is substantially higher than the acidity of the ohmic samples. Ohmic-based fermentation technology, therefore, offers improvements in coffee quality, and this is discussed to highlight the potential of ohmic technology in coffee processing.

Keywords: ohmic technology, fermentation, coffee quality, Arabica coffee

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13838 Haptic Robotic Glove for Tele-Exploration of Explosive Devices

Authors: Gizem Derya Demir, Ilayda Yankilic, Daglar Karamuftuoglu, Dante Dorantes

Abstract:

ABSTRACT HAPTIC ROBOTIC GLOVE FOR TELE-EXPLORATION OF EXPLOSIVE DEVICES Gizem Derya Demir, İlayda Yankılıç, Dağlar Karamüftüoğlu, Dante J. Dorantes-González Department of Mechanical Engineering, MEF University Ayazağa Cad. No.4, 34396 Maslak, Sarıyer, İstanbul, Turkey Nowadays, terror attacks are, unfortunately, a more common threat around the world. Therefore, safety measures have become much more essential. An alternative to providing safety and saving human lives is done by robots, such as disassembling and liquidation of bombs. In this article, remote exploration and manipulation of potential explosive devices from a safe-distance are addressed by designing a novel, simple and ergonomic haptic robotic glove. SolidWorks® Computer-Aided Design, computerized dynamic simulation, and MATLAB® kinematic and static analysis were used for the haptic robotic glove and finger design. Angle controls of servo motors were made using ARDUINO® IDE codes on a Makeblock® MegaPi control card. Simple grasping dexterity solutions for the fingers were obtained using one linear soft and one angle sensors for each finger, and six servo motors are used in total to remotely control a slave multi-tooled robotic hand. This project is still undergoing and presents current results. Future research steps are also presented.

Keywords: Dexterity, Exoskeleton, Haptics , Position Control, Robotic Hand , Teleoperation

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13837 Cable De-Commissioning of Legacy Accelerators at CERN

Authors: Adya Uluwita, Fernando Pedrosa, Georgi Georgiev, Christian Bernard, Raoul Masterson

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CERN is an international organisation founded by 23 countries that provide the particle physics community with excellence in particle accelerators and other related facilities. Founded in 1954, CERN has a wide range of accelerators that allow groundbreaking science to be conducted. Accelerators bring particles to high levels of energy and make them collide with each other or with fixed targets, creating specific conditions that are of high interest to physicists. A chain of accelerators is used to ramp up the energy of particles and eventually inject them into the largest and most recent one: the Large Hadron Collider (LHC). Among this chain of machines is, for instance the Proton Synchrotron, which was started in 1959 and is still in operation. These machines, called "injectors”, keep evolving over time, as well as the related infrastructure. Massive decommissioning of obsolete cables started in 2015 at CERN in the frame of the so-called "injectors de-cabling project phase 1". Its goal was to replace aging cables and remove unused ones, freeing space for new cables necessary for upgrades and consolidation campaigns. To proceed with the de-cabling, a project co-ordination team was assembled. The start of this project led to the investigation of legacy cables throughout the organisation. The identification of cables stacked over half a century proved to be arduous. Phase 1 of the injectors de-cabling was implemented for 3 years with success after overcoming some difficulties. Phase 2, started 3 years later, focused on improving safety and structure with the introduction of a quality assurance procedure. This paper discusses the implementation of this quality assurance procedure throughout phase 2 of the project and the transition between the two phases. Over hundreds of kilometres of cable were removed in the injectors complex at CERN from 2015 to 2023.

Keywords: CERN, de-cabling, injectors, quality assurance procedure

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13836 Relationship Between Behavioral Inhibition/Approach System, and Perceived Stress, Whit Control White Blood Cell In Multiple Sclerosis Patients

Authors: Amin Alvani

Abstract:

Multiple sclerosis (MS) is a chronic, often disabling disease in which the immune system attacks the myelin sheath of neurons in the central nervous system. The present study aimed to investigate the Relationship between behavioral inhibition/approach system (BIS-BAS) and perceived stress (PS) whit control white blood cell (WBC). 60 MS patients (male=36.7, female=63.3%; age range=15-65 participated in the study and completed the demographic questionnaire, the count blood cell (CBC) test, the behavioral Activation and behavioral inhibition scale (BIS-BAS), and the perceived stress Questionnaire (PSS-14). The results revealed that Between of BAS-reward responsiveness (BAS-DR) subscale and PS, in more than MS patient (BIS), there are increase WBC.

Keywords: behavioral inhibition/approach system, perceived stress, white blood cell, multiple sclerosis

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