Search results for: cross section shape

Authors: Carlos Gonzales, Zaida Quiroz, Marcos Prates

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Several spatial variables collected at the same location that share a common spatial distribution can be modeled simultaneously through a multivariate geostatistical model that takes into account the correlation between these variables and the spatial autocorrelation. The main goal of this model is to perform spatial prediction of these variables in the region of study. Here we focus on a geostatistical multivariate formulation that relies on sharing common spatial random effect terms. In particular, the first response variable can be modeled by a mean that incorporates a shared random spatial effect, while the other response variables depend on this shared spatial term, in addition to specific random spatial effects. Each spatial random effect is defined through a Gaussian process with a valid covariance function, but in order to improve the computational efficiency when the data are large, each Gaussian process is approximated to a Gaussian random Markov field (GRMF), specifically to the block nearest neighbor Gaussian process (Block-NNGP). This approach involves dividing the spatial domain into several dependent blocks under certain constraints, where the cross blocks allow capturing the spatial dependence on a large scale, while each individual block captures the spatial dependence on a smaller scale. The multivariate geostatistical model belongs to the class of Latent Gaussian Models; thus, to achieve fast Bayesian inference, it is used the integrated nested Laplace approximation (INLA) method. The good performance of the proposed model is shown through simulations and applications for massive data.

Keywords: Block-NNGP, geostatistics, gaussian process, GRMF, INLA, multivariate models.

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Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

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Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

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Authors: Omar Ali, Adesh Ramsubhag, Jayaraj Jayaraman

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Seaweed extracts have been reported as plant biostimulants which could be a safer, organic alternative to harsh pesticides. The incentive to use seaweed-based biostimulants is becoming paramount in sustainable agriculture. The current study, therefore, screened a commercial extract of A. nodosum in tomatoes, cultivated in Trinidad to showcase the multiple beneficial effects. Foliar treatment with an A. nodosum commercial extract led to significant increases in fruit yield and a significant reduction of incidence of bacterial spots and early blight diseases under both greenhouse and field conditions. Investigations were carried out to reveal the possible mechanisms of action of this biostimulant through defense enzyme assays and transcriptome profiling via RNA sequencing of tomato. Studies into disease control mechanisms by A. nodosum showed that the extract stimulated the activity of enzymes such as peroxidase, phenylalanine ammonia-lyase, chitinase, polyphenol oxidase, and β-1,3-glucanase. Additionally, the transcriptome survey revealed the upregulation and enrichment of genes responsible for the biosynthesis of growth hormones, defense enzymes, PR proteins and defense-related secondary metabolites, as well as genes involved in the nutrient mobilization, photosynthesis and primary and secondary metabolic pathways. The results of the transcriptome study also demonstrated the cross-talks between growth and defense responses, confirming the bioelicitor and biostimulant value of seaweed extracts in plants. These effects could potentially implicate the benefits of seaweed extract and validate its usage in sustainable crop production.

Keywords: A. nodosum, biostimulants, elicitor, enzymes, growth responses, seaweeds, tomato, transcriptome analysis

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Authors: Gamaliel Salazar, Adriana Chazaro, Oscar Madrigal

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The evolution of Unmanned Aerial Systems (UAS) has made it possible to develop new vehicles capable to perform microgravity experiments which due its cost and complexity were beyond the reach for many institutions. In this study, the aerodynamic behavior of an UAS is studied through its deceleration stage after an initial free fall phase (where the microgravity effect is generated) using Computational Fluid Dynamics (CFD). Due to the fact that the payload would be analyzed under a microgravity environment and the nature of the payload itself, the speed of the UAS must be reduced in a smoothly way. Moreover, the terminal speed of the vehicle should be low enough to preserve the integrity of the payload and vehicle during the landing stage. The UAS model is made by a study pod, control surfaces with fixed and mobile sections, landing gear and two semicircular wing sections. The speed of the vehicle is decreased by increasing the angle of attack (AoA) of each wing section from 2° (where the airfoil S1091 has its greatest aerodynamic efficiency) to 80°, creating a circular wing geometry. Drag coefficients (Cd) and forces (Fd) are obtained employing CFD analysis. A simplified 3D model of the vehicle is analyzed using Ansys Workbench 16. The distance between the object of study and the walls of the control volume is eight times the length of the vehicle. The domain is discretized using an unstructured mesh based on tetrahedral elements. The refinement of the mesh is made by defining an element size of 0.004 m in the wing and control surfaces in order to figure out the fluid behavior in the most important zones, as well as accurate approximations of the Cd. The turbulent model k-epsilon is selected to solve the governing equations of the fluids while a couple of monitors are placed in both wing and all-body vehicle to visualize the variation of the coefficients along the simulation process. Employing a statistical approximation response surface methodology the case of study is parametrized considering the AoA of the wing as the input parameter and Cd and Fd as output parameters. Based on a Central Composite Design (CCD), the Design Points (DP) are generated so the Cd and Fd for each DP could be estimated. Applying a 2nd degree polynomial approximation the drag coefficients for every AoA were determined. Using this values, the terminal speed at each position is calculated considering a specific Cd. Additionally, the distance required to reach the terminal velocity at each AoA is calculated, so the minimum distance for the entire deceleration stage without comprising the payload could be determine. The Cd max of the vehicle is 1.18, so its maximum drag will be almost like the drag generated by a parachute. This guarantees that aerodynamically the vehicle can be braked, so it could be utilized for several missions allowing repeatability of microgravity experiments.

Keywords: microgravity effect, response surface, terminal speed, unmanned system

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Authors: Zerubabel Mihret

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Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.

Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia

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Authors: Laura A. Rodriguez-Villamizar, Alvaro Osornio-Vargas, Brian H. Rowe, Rhonda J. Rosychuk

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Introduction/Objectives: The Census Metropolitan Area of Edmonton (CMAE) has important industrial emissions to the air from the Industrial Heartland Alberta (IHA) at the Northeast and the coal-fired power plants (CFPP) at the West. The objective of the study was to explore the presence of clusters of children asthma ED visits in the areas around the IHA and the CFPP. Methods: Retrospective data on children asthma ED visits was collected at the dissemination area (DA) level for children between 2 and 14 years of age, living in the CMAE between April 1, 2004, and March 31, 2010. We conducted a spatial analysis of disease clusters around putative sources with count (ecological) data using descriptive, hypothesis testing, and multivariable modeling analysis. Results: The mean crude rate of asthma ED visits was 9.3/1,000 children population per year during the study period. Circular spatial scan test for cases and events identified a cluster of children asthma ED visits in the DA where the CFPP are located in the Wabamum area. No clusters were identified around the IHA area. The multivariable models suggest that there is a significant decline in risk for children asthma ED visits as distance increases around the CFPP area this effect is modified at the SE direction with mean angle 125.58 degrees, where the risk increases with distance. In contrast, the regression models for IHA suggest that there is a significant increase in risk for children asthma ED visits as distance increases around the IHA area and this effect is modified at SW direction with mean angle 216.52 degrees, where the risk increases at shorter distances. Conclusions: Different methods for detecting clusters of disease consistently suggested the existence of a cluster of children asthma ED visits around the CFPP but not around the IHA within the CMAE. These results are probably explained by the direction of the air pollutants dispersion caused by the predominant and subdominant wind direction at each point. The use of different approaches to detect clusters of disease is valuable to have a better understanding of the presence, shape, direction and size of clusters of disease around pollution sources.

Keywords: air pollution, asthma, disease cluster, industry

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Authors: Xu Yifei, Le Yining, Yang Qingluan, Tu Yanjie

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Objective: This study aims to investigate the distribution features of Traditional Chinese Medicine (TCM) syndromes and syndrome elements in Epstein-Barr virus-associated diseases and then explores the relations between TCM syndromes or syndrome elements and laboratory indicators of Epstein-Barr virus-associated diseases. Methods: A cross-sectional study of 70 patients with EBV infection was described. We assessed the diagnostic information and laboratory indicators of these patients from Huashan Hospital Affiliated to Fudan University between November 2017 and July 2019. The disease diagnosis and syndrome differentiation were based on the diagnostic criteria of EBV-associated diseases and the theory of TCM respectively. Confidence correlation analysis, logistic regression analysis, cluster analysis, and the Sankey diagram were used to analyze the correlation between the data. Results: The differentiation of the 4 primary TCM syndromes in the collected patients was correlated with the indexes of immune function, liver function, inflammation, and anemia, especially the relationship between Qifen syndrome and high lactic acid dehydrogenase level. The common 11 TCM syndrome elements were associated with the increased CD3+ T cell rate, low hemoglobin level, high procalcitonin level, high lactic acid dehydrogenase level, and low albumin level. Conclusion: The changes in immune function indexes, procalcitonin, and liver function-related indexes in patients with EBV-associated diseases were consistent with the evolution law of TCM syndromes. This study provides a reference for judging the pathological stages of these kinds of diseases, predicting their prognosis, and guiding subsequent treatment strategies based on TCM syndrome type.

Keywords: EBV-associated diseases, traditional Chinese medicine syndrome, syndrome element, diagnostics

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Authors: Azza H. El-Medany, Hanan H. Hagar, Omnia A. Nayel, Jamila H. El-Medany

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In search for drugs that can target cancer cell micro-environment in as much as being able to halt malignant cellular transformation, the natural dietary phytochemical curcumin was currently assessed in DMH-induced colorectal cancer rat model. The study enrolled 50 animals divided into a control group (n=10) and DMH-induced colorectal cancer control group (n=20) (20mg/kg-body weight for 28 weeks) versus curcumin-treated group (n=20) (160 mg/kg suspension daily oral for further 8 weeks). Treatment by curcumin succeeded to significantly decrease the percent of ACF and tended to normalize back the histological changes retrieved in adenomatous and stromal cells induced by DMH. The drug also significantly elevated GSH and significantly reduced most of the accompanying biochemical elevations (namely MDA, TNF-α, TGF-β and COX2) observed in colonic carcinomatous tissue, induced by DMH, thus succeeding to revert that of MDA, COX2 and TGF-β back to near normal as justified by being non-significantly altered as compared to normal controls. The only exception was PAF that was insignificantly altered by the drug. When taken together, it could be concluded that curcumin possess the potentiality to halt some of the orchestrated cross-talk between cancerous transformation and its micro-environmental niche that contributes to cancer initiation, progression and metastasis in this experimental cancer colon model. Envisioning these merits to a drug with already known safety preferentiality, awaits final results of current ongoing clinical trials, before curcumin can be added to the new therapeutic armamentarium of anticancer therapy.

Keywords: curcumin, dimethyl hydralazine, aberrant crypt foci, malondialdehyde, reduced glutathione, cyclooxygenase-2, tumour necrosis factor-alpha, transforming growth factor-beta, platelet activating factor

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Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

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For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

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Authors: Pauline Blanchet

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In a world where images are a prominent part of our daily lives and a way of absorbing information, the analysis of the representation of migration narratives is vital. This thesis raises questions concerning the power of illustrations, drawings and visual culture in order to represent the migration narratives in the age of Instagram. The rise of graphic novels and comics has come about in the last fifteen years, specifically regarding contemporary authors engaging with complex social issues such as migration and refugeehood. Due to this, refugee subjects are often in these narratives, whether they are autobiographical stories or whether the subject is included in the creative process. Growth in discourse around migration has been present in other art forms; in 2018, there has been dedicated exhibitions around migration such as Tania Bruguera at the TATE (2018-2019), ‘Journeys Drawn’ at the House of Illustration (2018-2019) and dedicated film festivals (2018; the Migration Film Festival), which have shown the recent considerations of using the arts as a medium of expression regarding themes of refugeehood and migration. Graphic visuals are fast becoming a key instrument when representing migration, and the central thesis of this paper is to show the strength and limitations of this form as well the methodology used by the actors in the production process. Recent works which have been released in the last ten years have not being analysed in the same context as previous graphic novels such as Palestine and Persepolis. While a lot of research has been done on the mass media portrayals of refugees in photography and journalism, there is a lack of literature on the representation with illustrations. There is little research about the accessibility of graphic novels such as where they can be found and what the intentions are when writing the novels. It is interesting to see why these authors, NGOs, and curators have decided to highlight these migrant narratives in a time when the mainstream media has done extensive coverage on the ‘refugee crisis’. Using primary data by doing one on one interviews with artists, curators, and NGOs, this paper investigates the efficiency of graphic novels for depicting refugee stories as a viable alternative to other mass medium forms. The paper has been divided into two distinct sections. The first part is concerned with the form of the comic itself and how it either limits or strengthens the representation of migrant narratives. This will involve analysing the layered and complex forms that comics allow such as multimedia pieces, use of photography and forms of symbolism. It will also show how the illustration allows for anonymity of refugees, the empathetic aspect of the form and how the history of the graphic novel form has allowed space for positive representations of women in the last decade. The second section will analyse the creative and methodological process which takes place by the actors and their involvement with the production of the works.

Keywords: graphic novel, refugee, communication, media, migration

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Authors: Hetvi Trivedi

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Technological escalation cannot be negated. The same is true for the benefits of technology. However, such escalation has interfered with the traditional theories of protection under Intellectual Property Rights. Out of the many trends that have disrupted the old-school understanding of Intellectual Property Rights, one is hashtags. What began modestly in the year 2007 has now earned a remarkable status, and coupled with the unprecedented rise in social media the hashtag culture has witnessed a monstrous growth. A tiny symbol on the keypad of phones or computers is now a major trend which also serves companies as a critical investment measure in establishing their brand in the market. Due to this a section of the Intellectual Property Rights- Trademarks is undergoing a humungous transformation with hashtags like #icebucket, #tbt or #smilewithacoke, getting trademark protection. So, as the traditional theories of IP take on the modern trends, it is necessary to understand the change and challenge at a theoretical and proportional level and where need be, question the change. Traditionally, Intellectual Property Rights serves the societal need for intellectual productions that ensure its holistic development as well as cultural, economic, social and technological progress. In a two-pronged effort at ensuring continuity of creativity, IPRs recognize the investment of individual efforts that go into creation by way of offering protection. Commonly placed under two major theories- Utilitarian and Natural, IPRs aim to accord protection and recognition to an individual’s creation or invention which serve as an incentive for further creations or inventions, thus fully protecting the creative, inventive or commercial labour invested in the same. In return, the creator by lending the public the access to the creation reaps various benefits. This way Intellectual Property Rights form a ‘social contract’ between the author and society. IPRs are similarly attached to a social function, whereby individual rights must be weighed against competing rights and to the farthest limit possible, both sets of rights must be treated in a balanced manner. To put it differently, both the society and the creator must be put on an equal footing with neither party’s rights subservient to the other. A close look through doctrinal research, at the recent trend of trademark protection, makes the social function of IPRs seem to be moving far from the basic philosophy. Thus, where technology interferes with the philosophies of law, it is important to check and allow such growth only in moderation, for none is superior than the other. The human expansionist nature may need everything under the sky that can be tweaked slightly to be counted and protected as Intellectual Property- like a common parlance word transformed into a hashtag, however IP in order to survive on its philosophies needs to strike a balance. A unanimous global decision on the judicious use of IPR recognition and protection is the need of the hour.

Keywords: hashtag trademarks, intellectual property, social function, technology

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Authors: Ionela-Daniela Carja, Diana Serbezeanu, Tachita Vlad-Bubulac, Corneliu Hamciuc

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Nowadays, epoxy materials are extensively used in ever more areas and under ever more demanding environmental conditions due to their remarkable combination of properties, light weight and ease of processing. However, these materials greatly increase the fire risk due to their flammability and possible release of toxic by-products as a result of their chemical composition which consists mainly from carbon and hydrogen atoms. Therefore, improving the fire retardant behaviour to prevent the loss of life and property is of particular concern among government regulatory bodies, consumers and manufacturers alike. Modification of epoxy resins with organophosphorus compounds, as reactive flame retardants or additives, is the key to achieving non-flammable advanced epoxy materials. Herein, a detailed characterization of fire behaviour for a series of phosphorus-containing epoxy thermosets is reported. A carefully designed phosphorus flame retardant additive was simply blended with a bifunctional bisphenol-A based epoxy resin. Further thermal cross-linking in the presence of various aminic hardeners led to eco-friendly flame retardant epoxy resins. The type of hardener, concentration of flame retardant additive, compatibility between the components of the mixture, char formation and morphology, thermal stability, flame retardant mechanisms were investigated. It was found that even a very low content of phosphorus introduced into the epoxy matrix increased the limiting oxygen index value to about 30%. In addition, the peak of the heat release rate value decreased up to 45% as compared to the one of the neat epoxy system. The main flame retardant mechanism was the condensed-phase one as revealed by SEM and XPS measurements.

Keywords: condensed-phase mechanism, eco-friendly phosphorus flame retardant, epoxy resin, thermal stability

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Authors: Skander Ben Mami

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Despite its particular patterns and historical importance, the remote region of the Pamir Hindu Kush still lacks public recognition, as well as scientific substance, because of the abundance of classical state-centred geopolitical studies, the resilience of (inter)national narratives, and the political utility of the concepts of 'Central Asia' and 'South Asia'. However, this specific region of about 100 million inhabitants and located at the criss-cross of four geopolitical areas (Indian, Iranian, Chinese and Russian) over a territory of half a million square kilometres features a string of patterns that set it apart from the neighbouring areas of the Fergana, the Gansu and Punjab. Moreover, the Pamir Hindu Kush undergoes a series of parallel social and economic transformations that deserve scrutiny for their strong effect on the people’s lifestyle, particularly in three major urban centres (Aksu in China, Bukhara in Uzbekistan and Islamabad in Pakistan) and their immediate rural surroundings. While the involvement of various public and private stakeholders (States, NGOs, civil movements, private firms…) has undeniably resulted in positive elements (economic growth, connectivity, higher school attendance), it has in the same time generated a collection of negative effects (radicalizing, inequalities, pollution, territorial divide) that need to be addressed to strengthen regional and international security. This paper underscores the region’s strategical importance as the major hotbed and engine of insecurity and violence in Asia, notably in the context of Afghanistan’s enduring violence. It introduces the inner structures of the region, the different sources of violence as well as the governments’ responses to address it.

Keywords: geography, security, terrorism, urbanisation

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Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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Authors: Lakshmi Chebolu

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'War’, the word itself, is so vibrant and handcuffs the entire society. Since the beginning of manhood, the world has been evident in constant struggles. However, along with the growth of communities, relations, on the one hand, and disputes, on the other hand, infinitely increased. When states cannot or will not settle their disputes or differences by means of peaceful agreements, weapons are suddenly made to speak. It does not mean states can engage in war whenever they desire. At an international level, there has been a vast development of the law of war in the 20th century. War, it may be internal or international, in all situations, belligerent actors should follow the principles of warfare. With the advent of technology, the shape of war has changed, and it violates fundamental principles without observing basic norms. Conversely, states' attitudes towards international relationships are also undermined to some extent as state parties are not prioritized the communal interest rather than political or individual interest. In spite of the persistent development of communities, still many people are innocent victims of modern wars. It costs a toll on many lives, liberties, and properties and remains a major obstacle to nations' development. Recent incidents in Afghan are a live example to World Nations. We know that the principles of international law cannot be implemented very strictly on perpetrators due to the lacuna in the international legal system. However, the rules of war are universal in nature. The Geneva Convention, 1949 which are the core element of IHL, has been ratified by all 196 States. In fact, very few international treaties received this much of big support from nations. State’s approach towards Modern International Law, places a heavy burden on States practice towards in implementation of law. Although United Nations Security Council possesses certain powers under ‘Pacific Settlement of Disputes’, (Chapter VI) of the United Nations Charter to prevent disputes in a peaceful manner, conversely, this practice has been overlooked for many years due to political interests, favor, etc. Despite international consensus on the prohibition of war and protection of fundamental freedoms and human dignity, still, often, law has been misused by states’. The recent tendencies trigger questions about states’ willingness towards the implementation of the law. In view of the existing practices of nations, this paper aims to elevate the legal obligations of the international community to save the succeeding generations from the scourge of modern war practices.

Keywords: modern wars, weapons, prohibition and suspension of war activities, states’ obligations

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Authors: Demiraw Bikila, Tadesse Lejisa, Yosef Tolcha, Chala Bashea, Mehari Meles Tigist Getahun Genet Ashebir, Wossene Habtu, Feyissa Challa, Ousman Mohammed, Melkitu Kassaw, Adisu Kebede, Letebrhan G. Egzeabher, Endalkachew Befekadu, Mistire Wolde, Aster Tsegaye

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Background: Even though several factors affect reference intervals (RIs), the company-derived values are currently in use in many laboratories worldwide. However, little or no data is available regarding serum protein RIs, mainly in resource-limited setting countries like Ethiopia. Objective: To establish a reference interval for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted on a total of 297 apparently healthy adults from April-October 2019 in four selected sub-cities (Akaki, Kirkos, Arada, Yeka) of Addis Ababa, Ethiopia. Laboratory analysis of collected samples was performed using Capillarys 2 Flex Piercing analyzer, while statistical analysis was done using SPSS version 23 and med-cal software. Mann-Whitney test was used to check Partitions. Non-parametric method of reference range establishment was performed as per CLSI guideline EP28A3C. Result: The established RIs were: Albumin 53.83-64.59%, 52.24-63.55%; Alpha-1 globulin 3.04-5.40%, 3.44-5.60%; Alpha-2 globulin 8.0-12.67%, 8.44-12.87%; and Beta-1 globulin 5.01-7.38%, 5.14-7.86%. Moreover, Albumin to globulin ratio was 1.16-1.8, 1.09-1.74 for males and females, respectively. The combined RIs for Beta-2 globulin and Gamma globulin were 2.54-4.90% and 12.40-21.66%, respectively. Conclusion: The established reference interval for serum protein fractions revealed gender-specific differences except for Beta-2 globulin and Gamma globulin.

Keywords: serum protein electrophoresis, reference interval, Addis Ababa, Ethiopia

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Authors: M. Keršič, M. Lužnik, J. Lužnik

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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

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Authors: Thananyada Buapian

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Overnutrition is emerging as a morbid disease in developing and Westernized countries. Because of its comorbidity diseases, it is cost-effective to prevent and manage this disease earlier. In Thailand, this alarming disease has long been studied, but the prevalence is still higher than that in the past. Physicians should recognize it well and have a definite direction to face and combat this dangerous disease. Rapid changes in the tremendous figure of overnutrition students indicate that genetic factors are not the primary determinants since human genes have remained unchanged for a century. This study aims to assess the prevalence of overnutrition students and to investigate the non-genetic factors affecting over nutrition students. A cross-sectional school-based survey was conducted. A two-stage sampling was adopted. Respondents included 1,850 students in grades 4 to 6 in Ayutthaya Province. An anthropometric measurement and questionnaire were developed. Childhood over nutrition was defined as a weight-for-height Z-score above +2SD of NCHS/WHO references. About thirty three percent of the children were over nutrition in Ayutthaya province. Stepwise multiple logistic regression analysis showed that 8 statistically significant non genetic factors explain the variation of childhood over nutrition by 18 percent. Sex is the prime factor to explain the variation of childhood over nutrition, followed by duration of light physical activities, duration of moderate physical activities, having been breastfed, the presence of a healthy role model of the caregiver, number of siblings, birth order, and occupation of the caregiver, respectively. Non genetic factors, especially the subjects’ demographic and physical activities, as well as the caregivers’ background and family environment, should be considered in viable approach to remedy this health imbalance in children.

Keywords: non genetic factors, non-genetic, over nutrition, over nutrition students

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Authors: Jeroen Vinkx, Jan A. Delcour, Bart Goderis

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Complete aqueous dissolution of starch is notoriously difficult. A high-temperature autoclaving process is necessary, followed by cooling the solution below its boiling point. The cooled solution is inherently unstable over time. Gelation and retrogradation processes, along with aggregation-induced by undissolved starch remnants, result in starch precipitation. We recently observed the spontaneous gelatinization of native maize starch (MS) in aqueous sodium salicylate (NaSal) solutions at room temperature. A hydrotropic mode of solubilization is hypothesized. Differential scanning calorimetry (DSC) and polarized optical microscopy (POM) of starch dispersions in NaSal solution were used to demonstrate the room temperature gelatinization of MS at different concentrations of MS and NaSal. The DSC gelatinization peak shifts to lower temperatures, and the gelatinization enthalpy decreases with increasing NaSal concentration. POM images confirm the same trend through the disappearance of the ‘Maltese cross’ interference pattern of starch granules. The minimal NaSal concentration to induce complete room temperature dissolution of MS was found to be around 15-20 wt%. The MS content of the dispersion has little influence on the amount of NaSal needed to dissolve it. The effect of the NaSal solution on the MS molecular weight was checked with HPSEC. It is speculated that, because of its amphiphilic character, NaSal enhances the solubility of MS in water by association with the more hydrophobic MS moieties, much like urea, which has also been used to enhance starch dissolution in alkaline aqueous media. As such small molecules do not tend to form micelles in water, they are called hydrotropes rather than surfactants. A minimal hydrotrope concentration (MHC) is necessary for the hydrotropes to structure themselves in water, resulting in a higher solubility of MS. This is the case for the system MS/NaSal/H₂O. Further investigations into the putative hydrotropic dissolution mechanism are necessary.

Keywords: hydrotrope, dissolution, maize starch, sodium salicylate, gelatinization

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Authors: Yusuf Yilmaz, Gamze Gediz Ilis

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Gas Nitrogen where has a boiling point of -189.52oC at atmospheric pressure widely used in the industry. Nitrogen that used in the industry should be transported in liquid form to the plant area. Ambient air vaporizer (AAV) generally used for vaporization of cryogenic gases such as liquid nitrogen (LN2), liquid oxygen (LOX), liquid natural gas (LNG), and liquid argon (LAR) etc. AAV is a group of star-shaped fin vaporizer. The design and the effect of the shape of fins of the vaporizer is one of the most important criteria for the performance of the vaporizer. In this study, the performance of AAV working with liquid nitrogen was analyzed numerically in a star-shaped aluminum finned pipe. The numerical analysis is performed in order to investigate the heat capacity of the vaporizer per meter pipe length. By this way, the vaporizer capacity can be predicted for the industrial applications. In order to achieve the validation of the numerical solution, the experimental setup is constructed. The setup includes a liquid nitrogen tank with a pressure of 9 bar. The star-shaped aluminum finned tube vaporizer is connected to the LN2 tank. The inlet and the outlet pressure and temperatures of the LN2 of the vaporizer are measured. The mass flow rate of the LN2 is also measured and collected. The comparison of the numerical solution is performed by these measured data. The ambient conditions of the experiment are given as boundary conditions to the numerical model. The surface tension and contact angle have a significant effect on the boiling of liquid nitrogen. Average heat transfer coefficient including convective and nucleated boiling components should be obtained for liquid nitrogen saturated flow boiling in the finned tube. Fluent CFD module is used to simulate the numerical solution. The turbulent k-ε model is taken to simulate the liquid nitrogen flow. The phase change is simulated by using the evaporation-condensation approach used with user-defined functions (UDF). The comparison of the numerical and experimental results will be shared in this study. Besides, the performance capacity of the star-shaped finned pipe vaporizer will be calculated in this study. Based on this numerical analysis, the performance of the vaporizer per unit length can be predicted for the industrial applications and the suitable pipe length of the vaporizer can be found for the special cases.

Keywords: liquid nitrogen, numerical modeling, two-phase flow, cryogenics

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Authors: Lapatrada Numkham, Saowaluk Khakhong, Jeeraporn Kummabutr

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Non-communicable diseases (NCDs) are the leading cause of death in worldwide. Thailand also concerns and focuses on reduction a new case of these diseases. Community Health Volunteers (CHV) is important health personnel in primary health care and performs as a health leader in the community. If the health of CHV changes, it would impact on the performance to promote health of families and community. This cross-sectional study aimed to 1) describe the health status of community health volunteers and 2) examine the factors associated with health status among community health volunteers. The sample included 360 community health volunteers in a province in central Thailand during September-December 2014. Data were collected using questionnaires on health information, knowledge of health behaviors, and health behaviors. Body weight, height, waist circumference (WC), blood pressure (BP), and blood glucose (BS) (fingertip) were assessed. Data were analyzed using descriptive statistics and chi-square test. There were three hundred and sixty participants with 82.5% being women. The mean age was 54 + 8.9 years. Forty-seven percent of the participants had co-morbidities. Hypertension was the most common co-morbidity (26.7%). The results revealed that the health status of the volunteers included: no underlying disease, having risk of hypertension (HT) & diabetes mellitus (DM), and having HT&DM at 38.3%, 30.0%, and 31.7% respectively. The chi-square test revealed that the factors associated with health status among the volunteers were gender, age, WC and body mass index (BMI). The results suggested that community health nurses should; 1) implement interventions to decrease waist circumference and lose weight through education programs, especially females; 2) monitor people that have a risk of HT&DM and that have HT&DM by meeting and recording BP level, BS level, WC and BMI; and 3) collaborate with a district public health officer to initiate a campaign to raise awareness of the risks of chronic diseases among community health volunteers.

Keywords: community health volunteers, health status, risk of non-communicable disease, Thailand

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Authors: Morlu Stevens, Bareki Batlokwa

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The use of treated wastewater is widely employed to compensate for the scarcity of safe and uncontaminated freshwater. However, the existence of toxic heavy metal ions in the wastewater pose a health hazard to animals and the environment, hence, the importance for an effective technique to tackle the challenge. A multi-templated ion imprinted sorbent (Fe,Ni,Cu-IIP) for the simultaneous removal of heavy metal ions from waste water was synthesised employing molecular imprinting technology (MIT) via thermal free radical bulk polymerization technique. Methacrylic acid (MAA) was employed as the functional monomer, and ethylene glycol dimethylacrylate (EGDMA) as cross-linking agent, azobisisobutyronitrile (AIBN) as the initiator, Fe, Ni, Cu ions as template ions, and 1,10-phenanthroline as the complexing agent. The template ions were exhaustively washed off the synthesized polymer by solvent extraction in several washing steps, while periodically increasing solvent (HCl) concentration from 1.0 M to 10.0 M. The physical and chemical properties of the sorbents were investigated using Fourier Transform Infrared Spectroscopy (FT-IR), X-ray Diffraction (XRD) and Atomic Force Microscopy (AFM) were employed. Optimization of operational parameters such as time, pH and sorbent dosage to evaluate the effectiveness of sorbents were investigated and found to be 15 min, 7.5 and 666.7 mg/L respectively. Selectivity of ion-imprinted polymers and competitive sorption studies between the template and similar ions were carried out and showed good selectivity towards the targeted metal ion by removing 90% - 98% of the templated ions as compared to 58% - 62% of similar ions. The sorbents were further applied for the selective removal of Fe, Ni and Cu from real wastewater samples and recoveries of 92.14 ± 0.16% - 106.09 ± 0.17% and linearities of R2 = 0.9993 - R2 = 0.9997 were achieved.

Keywords: ion imprinting, ion imprinted polymers, heavy metals, wastewater

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Authors: Linta Koka

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Aim: The way people with severe mental disorders deal with self-stigma and how it affects their self-esteem is a problem that has gained much attention in recent years. The primary aim of this study was to empirically explore the link between self-stigma and self-esteem of individuals with the presence of a mental illness, offering a novel perspective by exploring the same variables amongst a sample without a mental illness. Methods: This study utilized a cross-sectional study. Participants with (N=85) and without (N=75) a mental health issue were included from Darlingdon's Mind organization. Participants completed two scales, one of Self-Stigma of Mental Illness Scale and one of Self-Esteem, following some demographics questions. Results: According to the primary hypothesis, self-stigma significantly correlates with self-esteem in the clinical population. Furthermore, gender and ethnicity, above all the demographics, positively correlates to the relationship of self-stigma with self-esteem in people who endure a mental health issue. Limitations: A significant limitation is that of the size of the sample of participants conducted in this study. The clinical population was limited to 85 participants, and the control group consisted of 76 participants. Since the sample was not representative. The small size used did not allow any comparisons between the group with mental illness and the control group. There was a restricted time to approach the participants since the online survey was released by the end of May. Conclusions: Individuals suffering from mental illnesses may internalize stigmatizing stereotypes on an explicit level. Efforts should be made to lessen the harmful impact stigma may have on mentally ill people, such as worsening symptoms or delays in receiving care. Further study is needed within this small research topic to improve awareness and regulate mental health among the general population. Undoubtedly, people with mental disorders are stigmatized; therefore, more research is required to explore all factors contributing to mentally ill patients' devaluation.

Keywords: self-stigma, mental illness, self-esteem, clinical population, non-clinical population

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Authors: Arjun G. Koppad

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The study was conducted in Joida taluk of Uttara Kannada district, Karnataka, India, to assess the land use land cover (LULC) and forest aboveground biomass using L band SAR data. The study area covered has dense, moderately dense, and sparse forests. The sampled area was 0.01 percent of the forest area with 30 sampling plots which were selected randomly. The point center quadrate (PCQ) method was used to select the tree and collected the tree growth parameters viz., tree height, diameter at breast height (DBH), and diameter at the tree base. The tree crown density was measured with a densitometer. Each sample plot biomass was estimated using the standard formula. In this study, the LULC classification was done using Freeman-Durden, Yamaghuchi and Pauli polarimetric decompositions. It was observed that the Freeman-Durden decomposition showed better LULC classification with an accuracy of 88 percent. An attempt was made to estimate the aboveground biomass using SAR backscatter. The ALOS-2 PALSAR-2 L-band data (HH, HV, VV &VH) fully polarimetric quad-pol SAR data was used. SAR backscatter-based regression model was implemented to retrieve forest aboveground biomass of the study area. Cross-polarization (HV) has shown a good correlation with forest above-ground biomass. The Multi Linear Regression analysis was done to estimate aboveground biomass of the natural forest areas of the Joida taluk. The different polarizations (HH &HV, VV &HH, HV & VH, VV&VH) combination of HH and HV polarization shows a good correlation with field and predicted biomass. The RMSE and value for HH & HV and HH & VV were 78 t/ha and 0.861, 81 t/ha and 0.853, respectively. Hence the model can be recommended for estimating AGB for the dense, moderately dense, and sparse forest.

Keywords: forest, biomass, LULC, back scatter, SAR, regression

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Authors: Ethan James

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Over one billion people worldwide suffer from some level of vision loss or blindness as a result of progressive retinal diseases. Many patients, particularly in developing areas, are incorrectly diagnosed or undiagnosed whatsoever due to unconventional diagnostic tools and screening methods. Artificial intelligence (AI) based on deep learning (DL) convolutional neural networks (CNN) have recently gained a high interest in ophthalmology for its computer-imaging diagnosis, disease prognosis, and risk assessment. Optical coherence tomography (OCT) is a popular imaging technique used to capture high-resolution cross-sections of retinas. In ophthalmology, DL has been applied to fundus photographs, optical coherence tomography, and visual fields, achieving robust classification performance in the detection of various retinal diseases including macular degeneration, diabetic retinopathy, and retinitis pigmentosa. However, there is no complete diagnostic model to analyze these retinal images that provide a diagnostic accuracy above 90%. Thus, the purpose of this project was to develop an AI model that utilizes machine learning techniques to automatically diagnose specific retinal diseases from OCT scans. The algorithm consists of neural network architecture that was trained from a dataset of over 20,000 real-world OCT images to train the robust model to utilize residual neural networks with cyclic pooling. This DL model can ultimately aid ophthalmologists in diagnosing patients with these retinal diseases more quickly and more accurately, therefore facilitating earlier treatment, which results in improved post-treatment outcomes.

Keywords: artificial intelligence, deep learning, imaging, medical devices, ophthalmic devices, ophthalmology, retina

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Authors: Clara Oliver, Oibar Martinez, Jose Miguel Miranda

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This paper is devoted to the study of the most suitable protocols to verify the lightning protection and ground resistance quality in a large-scale scientific facility located in a harsh environment. We illustrate this work by reviewing a case study: the largest telescopes of the Northern Hemisphere Cherenkov Telescope Array, CTA-N. This array hosts sensitive and high-speed optoelectronics instrumentation and sits on a clear, free from obstacle terrain at around 2400 m above sea level. The site offers a top-quality sky but also features challenging conditions for a lightning protection system: the terrain is volcanic and has resistivities well above 1 kOhm·m. In addition, the environment often exhibits humidities well below 5%. On the other hand, the high complexity of a Cherenkov telescope structure does not allow a straightforward application of lightning protection standards. CTA-N has been conceived as an array of fourteen Cherenkov Telescopes of two different sizes, which will be constructed in La Palma Island, Spain. Cherenkov Telescopes can provide valuable information on different astrophysical sources from the gamma rays reaching the Earth’s atmosphere. The largest telescopes of CTA are called LST’s, and the construction of the first one was finished in October 2018. The LST has a shape which resembles a large parabolic antenna, with a 23-meter reflective surface supported by a tubular structure made of carbon fibers and steel tubes. The reflective surface has 400 square meters and is made of an array of segmented mirrors that can be controlled individually by a subsystem of actuators. This surface collects and focuses the Cherenkov photons into the camera, where 1855 photo-sensors convert the light in electrical signals that can be processed by dedicated electronics. We describe here how the risk assessment of direct strike impacts was made and how down conductors and ground system were both tested. The verification protocols which should be applied for the commissioning and operation phases are then explained. We stress our attention on the ground resistance quality assessment.

Keywords: grounding, large scale scientific instrument, lightning risk assessment, lightning standards and safety

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Authors: Alan Walsh, Peter Walker, Michael Ellis

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There is a real danger that both practitioners and researchers considering risks associated with megaprojects ignore or underestimate the impacts of cultural risk. The paper investigates the potential impacts of a failure to achieve cultural unity between the principal actors executing a megaproject. The principle relationships include the relationships between the principle Contractors and the project stakeholders or the project stakeholders and their principle advisors, Western Consultants. This study confirms that cultural dissonance between these parties can delay or disrupt the megaproject execution and examines why cultural issues should be prioritized as a significant risk factor in megaproject delivery. This paper addresses the practical impacts and potential mitigation measures, which may reduce cultural dissonance for a megaproject's delivery. This information is retrieved from on-going case studies in live infrastructure megaprojects in Europe and the Middle East's GCC states, from Western Consultants' perspective. The collaborating researchers each have at least 30 years of construction experience and are engaged in architecture, project management and contracts management, dealing with megaprojects in Europe or the GCC. After examining the cultural interfaces they have observed during the execution of megaprojects, they conclude that globally, culture significantly influences their efficient delivery. The study finds that cultural risk is ever-present, where different nationalities co-manage megaprojects and that cultural conflict poses a real threat to the timely delivery of megaprojects. The study indicates that the higher the cultural distance between the principal actors, the more pronounced the risk, with the risk of cultural dissonance more prominent in GCC megaprojects. The findings support a more culturally aware and cohesive team approach and recommend cross-cultural training to mitigate the effects of cultural disparity.

Keywords: cultural risk underestimation, cultural distance, megaproject characteristics, megaproject execution

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Authors: William Cheng, Rini Sekartini

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Background: Sleep is essential for children because it provides enhancement for the neural system activities that give physiologic effects for the body to support growth and development. One of the modifiable factors that relates with sleep is nutrition, which includes nutritional status, iron intake, and magnesium intake. Nutritional status represents the balance between nutritional intake and expenditure, while iron and magnesium are micronutrients that are related to sleep regulation. The aim of this study is to identify prevalence of sleep disturbance among Indonesian children and to evaluate its relation with aspect to nutrition. Methods : A cross-sectional study involving children aged 5 to 7-years-old in an urban primary health care between 2012 and 2013 was carried out. Related data includes anthropometric status, iron intake, and magnesium intake. Iron and magnesium intake was obtained by 24-hours food recall procedure. Sleep Disturbance Scale for Children (SDSC) was used as the diagnostic tool for sleep disturbance, with score under 39 indicating presence of problem. Results: Out of 128 school-aged children included in this study, 28 (23,1%) of them were found to have sleep disturbance. The majority of children had good nutritional status, with only 15,7% that were severely underweight or underweight, and 12,4% that were identified as stunted. On the contrary, 99 children (81,8%) were identified to have inadequate magnesium intake and 56 children (46,3%) with inadequate iron intake. Our analysis showed there was no significant relation between all of the nutritional status indicators and sleep disturbance (p>0,05%). Moreover, inadequate iron and magnesium intake also failed to prove significant relation with sleep disturbance in this population. Conclusion: Almost fourth of school-aged children in Indonesia were found to have sleep disturbance and further study are needed to overcome this problem. According to our finding, there is no correlation between nutritional status, iron intake, magnesium intake, and sleep disturbance.

Keywords: iron intake, magnesium intake, nutritional status, school-aged children, sleep disturbance

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Authors: Marcelus U. Ajonina, Deodata B. Ngonga, Kenric B. Ware, Carine K. Nfor

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Background: Lack of knowledge of rational use of antimalarial drugs among dispensers is a serious problem, especially in areas of intense transmission, thus increasing the risk of resistance and adverse drug reactions. This study was aimed at assessing the knowledge of malaria as well as perception and dispensing practices of antimalarials among vendors in Buea community. Methods: A community-based cross-sectional survey of a random sample of 140 drug vendors living within the Buea community was conducted between March and June 2017. A questionnaire was designed to obtain information from drug vendors on the general knowledge of malaria as well as dispensing practices. Data were analyzed using SPSS Statistics 20.0 and were considered significant at p ≤ 0.05. Results: Knowledge of malaria symptoms, transmission, and prevention was reasonable among 55.8% (77) of the respondents. Only 33.6% (47) of the respondents could attribute the cause of malaria to protozoan of genus Plasmodium species. Of the 140 vendors, 115 (82.7%) prescribe antimalarial drugs. The knowledge of the national protocol was malaria case management among dispensers was 35.0%. Vendors in hospital/community pharmacies were 2.4 times (OR = 3.14, 95% CI: 4.14 - 8.74, p < 0.001) more knowledgeable about malaria treatment protocol than those of in drugstores. The prevalence of self-prescription of antimalarials was 39.3%. Self-prescription was significantly higher in drugstores than hospital/community pharmacies (p=0.004). In all, 56 (40.6%) of vendors showed good practices regarding antimalarial drug dispensing with the majority (51.7%) from community pharmacies (OR=2.27,95% CI: 1.13-4.56). Conclusion: Findings reveal moderate knowledge of malaria but poor prescription and dispensing practices of antimalarial drugs among vendors, thus indicating a need for routine monitoring and evaluation to prevent the emergence of resistant strains to current efficacious antimalarials.

Keywords: antimalarials, drug retail outlets, dispensing, drug resistance, prescription

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Authors: Rosy Chaudhary, Pushpa Parajuli

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Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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