Search results for: background reduction

Authors: Rui Calejo Rodrigues

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Building Refurbishing and Maintenance is a major area of knowledge ultimately dispensed to user/occupant criteria. The optimization of the service life of a building needs a special background to be assessed as it is one of those concepts that needs proficiency to be implemented. ISO 15686-2 Buildings and constructed assets - Service life planning: Part 2, Service life prediction procedures, states a factorial method based on deterministic data for building components life span. Major consequences result on a deterministic approach because users/occupants are not sensible to understand the end of components life span and so simply act on deterministic periods and so costly and resources consuming solutions do not meet global targets of planet sustainability. The estimation of 2 thousand million conventional buildings in the world, if submitted to a probabilistic method for service life planning rather than a deterministic one provide an immense amount of resources savings. Since 1989 the research team nowadays stating for CEES–Center for Building in Service Studies developed a methodology based on Montecarlo method for probabilistic approach regarding life span of building components, cost and service life care time spans. The research question of this deals with the importance of probabilistic approach of buildings life planning compared with deterministic methods. It is presented the mathematic model developed for buildings probabilistic lifespan approach and experimental data is obtained to be compared with deterministic data. Assuming that buildings lifecycle depends a lot on component replacement this methodology allows to conclude on the global impact of fixed replacements methodologies such as those on result of deterministic models usage. Major conclusions based on conventional buildings estimate are presented and evaluated under a sustainable perspective.

Keywords: building components life cycle, building maintenance, building sustainability, Montecarlo Simulation

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Authors: Mohamed A. Eid, Sobhy M. Aly

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Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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Authors: Kopal Verma, Umesh C. Kulshrestha

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India is a rural major country and majority of rural population is dependent on burning of biomass as fuel for domestic cooking on traditional stoves (Chullahs) and heating purposes. This results into indoor air pollution and ultimately affects health of the residents. Still, a very small fraction of rural population has been benefitted by the facilities of Liquefied Petroleum Gas (LPG) cylinders. Different regions of country follow different methods and use different type of biomass for cooking. So in order to study the differences in cooking practices and resulting indoor air pollution, this study was carried out in two rural areas of India viz. Budhwada, Madhya Pradesh and Baggi, Himachal Pradesh. Both the regions have significant differences in terms of topography, culture and daily practices. Budhwada lies in plain area and Baggi belongs to hilly terrain. The study of carbonaceous aerosols was carried out in four different houses of each village. The residents were asked to bring slight change in their practices by cooking only with biomass (BB) then with a mix of biomass and LPG (BL) and then finally only with LPG (LP). It was found that in BB, average values of organic carbon (OC) and elemental carbon (EC) were 28% and 44% lower in Budhwada than in Baggi whereas a reverse trend was found where OC and EC was respectively more by 56% and 26% with BL and by 54% and 29% with LP in Budhwada than in Baggi. Although, a significant reduction was found both in Budhwada (OC by 49% and EC by 34%) as well as in Baggi (OC by 84% and EC by 73%) when cooking was shifted from BB to LP. The OC/EC ratio was much higher for Budhwada (BB=9.9; BL=2.5; LP=6.1) than for Baggi (BB=1.7; BL=1.6; LP=1.3). The correlation in OC and EC was found to be excellent in Baggi (r²=0.93) and relatively poor in Budhwada (r²=0.65). A questionnaire filled by the residents suggested that they agree to the health benefits of using LPG over biomass burning but the challenges of supply of LPG and changing the prevailing tradition of cooking on Chullah are making it difficult for them to make this shift.

Keywords: biomass burning, elemental carbon, liquefied petroluem gas, organic carbon

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Authors: Radka Obořilová, Hana Šimečková, Matěj Pastucha, Jan Přibyl, Petr Skládal, Ivana Mašlaňová, Zdeněk Farka

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Due to the spreading of antimicrobial resistance, alternative approaches to combat superinfections are being sought, both in the field of lysing agents and methods for studying bacterial lysis. A suitable alternative to antibiotics is phage therapy and enzybiotics, for which it is also necessary to study the mechanism of their action. Biosensor-based techniques allow rapid detection of pathogens in real time, verification of sensitivity to commonly used antimicrobial agents, and selection of suitable lysis agents. The detection of lysis takes place on the surface of the biosensor with immobilized bacteria, which has the potential to be used to study biofilms. An example of such a biosensor is surface plasmon resonance (SPR), which records the kinetics of bacterial lysis based on a change in the resonance angle. The bacteria are immobilized on the surface of the SPR chip, and the action of phage as the mass loss is monitored after a typical lytic cycle delay. Atomic force microscopy (AFM) is a technique for imaging of samples on the surface. In contrast to electron microscopy, it has the advantage of real-time imaging in the native conditions of the nutrient medium. In our case, Staphylococcus aureus was lysed using the enzyme lysostaphin and phage P68 from the familyPodoviridae at 37 ° C. In addition to visualization, AFM was used to study changes in mechanical properties during lysis, which resulted in a reduction of Young’s modulus (E) after disruption of the bacterial wall. Changes in E reflect the stiffness of the bacterium. These advanced methods provide deeper insight into bacterial lysis and can help to fight against bacterial diseases.

Keywords: biosensors, atomic force microscopy, surface plasmon resonance, bacterial lysis, staphylococcus aureus, phage P68

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Authors: Viveka Jackson, Erouscilla Joseph, Denise Beckles, Thomas Christopher

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Sulphur Dioxide (SO2) has been defined as a non-flammable, non-explosive, colourless gas, having a pungent, irritating odour, and is one of the main gases emitted from volcanoes. Sulphur dioxide has been recorded in concentrations hazardous to humans (0.25 – 0.5 ppm (~650 – 1300 μg/m3), downwind of many volcanoes and hence warrants constant air-quality monitoring around these sites. It has been linked to an increase in chronic respiratory disease attributed to long-term exposures and alteration in lung and other physiological functions attributed to short-term exposures. Sulphur Springs in Saint Lucia is a highly active geothermal area, located within the Soufrière Volcanic Centre, and is a park widely visited by tourists and locals. It is also a current source of continuous volcanic emissions via its many fumaroles and bubbling pools, warranting concern by residents and visitors to the park regarding the effects of exposure to these gases. In this study, we introduce a novel SO2 measurement system for the monitoring and quantification of ambient levels of airborne volcanic SO2 using low-cost technology. This work involves the extensive production of low-cost SO2 monitors/samplers, as well as field examination in tandem with standard commercial samplers (SO2 diffusion tubes). It also incorporates community involvement in the volcanic monitoring process as non-professional users of the instrument. We intend to present the preliminary monitoring results obtained from the low-cost samplers, to identify the areas in the Park exposed to high concentrations of ambient SO2, and to assess the feasibility of the instrument for non-professional use and application in volcanic settings

Keywords: ambient SO2, community-based monitoring, risk-reduction, sulphur springs, low-cost

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

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Soils contaminated with metals, e.g., copper (Cu), zinc (Zn) and nickel (Ni) are one of the main global environmental problems. Zn is an important element for plant growth, but excess levels may become a threat to plant survival. Soils polluted with metals may also pose risks and hazards to human health. Afforestation based on short rotation Salix crops may be a good solution for the reduction of metals toxicity levels in the soil and in ecosystem restoration of severely polluted sites. In a greenhouse experiment, plant growth and zinc (Zn) uptake by four Salix cultivars grown in Zn contaminated soils collected from a mining area in Finland were tested to assess their suitability for phytoextraction. The sequential extraction technique and inductively coupled plasma‒mass spectrometry (ICP–MS) were used to determine the extractable metals and evaluate the fraction of metals in the soil that could be potentially available for plant uptake. The cultivars displayed resistance to heavily polluted soils throughout the whole experiment. After uptake, the total mean Zn concentrations ranged from 776 to 1823 mg kg⁻¹. The average uptake percentage of Zn across all cultivars and treatments ranged from 97 to 223%. Lime and wood ash addition showed a significant effect on plant dry biomass growth and metal uptake percentage of Zn in most of the cultivars. The results revealed that Salix cultivars have the potential to accumulate and take up significant amounts of Zn. Ecological restoration of polluted soils could be environmentally favorable in conjunction with economically profitable practices, such as forestry and bioenergy production. As such, the utilization of Salix for phytoextraction and bioenergy purposes is of considerable interest.

Keywords: lime, phytoextraction, Salix, wood ash, zinc

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Authors: Bara M Yousef, Naresh B Raj, Nadiah W Arfah, Brightlin N Dhas

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Background: Executive function (EF) impairment is common in children with autism spectrum disorder (ASD). EF strategies are considered effective in improving the therapeutic outcomes of children with ASD. Aims: This study primarily aims to explore whether integrating EF strategies combined with regular occupational therapy intervention is more effective in improving daily life skills (DLS) and sensory integration/processing (SI/SP) skills than regular occupational therapy alone in children with ASD and secondarily aims to assess treatment outcomes on improving visual motor integration (VMI) skills. Procedures: A total of 92 children with ASD will be recruited and, following baseline assessments, randomly assigned to the treatment group (45-min once weekly individual occupational therapy plus EF strategies) and control group (45-min once weekly individual therapy sessions alone). Results and Outcomes: All children will be evaluated systematically by assessing SI/SP, DLS, and VMI, skills at baseline, 7 weeks, and 14 weeks of treatment. Data will be analyzed using ANCOVA and T-test. Conclusions and Implications: This single-blind, randomized controlled trial will provide empirical evidence for the effectiveness of EF strategies when combined with regular occupational therapy programs. Based on trial results, EF strategies could be recommended in multidisciplinary programs for children with ASD. Trial Registration: The trial has been registered in the clinicaltrail.gov for a registry, protocol ID: MRC-01-22-509 ClinicalTrials.gov Identifier: NCT05829577, registered 25th April 2023

Keywords: autism spectrum disorder, executive function strategies, daily life skills, sensory integration/processing, visual motor integration, occupational therapy, effectiveness

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Authors: S. Al-Fadala, J. Chakkamalayath, S. Al-Bahar, A. Al-Aibani, S. Ahmed

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Globally, the use of pozzolan in blended cement is gaining great interest due to the desirable effect of pozzolan from the environmental and energy conservation standpoint and the technical benefits they provide to the performance of cement. The deterioration of concrete structures in the marine environment and extreme climates demand the use of pozzolana cement in concrete construction in the Gulf region. Also, natural sources of cement clinker materials are limited in the Gulf region, and cement industry imports the raw materials for the production of Portland cement, resulting in an increase in the greenhouse gas effect due to the CO₂ emissions generated from transportation. Even though the Gulf region has vast deposits of natural pozzolana, it is not explored properly for the production of high performance concrete. Hence, an optimum use of regionally available natural pozzolana for the production of blended cement can result in sustainable construction. This paper investigates the effect of incorporating natural pozzolan sourced from the Gulf region on the performance of blended cement in terms of heat evolution and strength development. For this purpose, a locally produced Ordinary Portland Cement (OPC) and pozzolan-incorporated blended cements containing different amounts of natural pozzolan (volcanic ash) were prepared on laboratory scale. The strength development and heat evolution were measured and quantified. Promising results of strength development were obtained for blends with the percentages of Volcanic Ash (VA) replacement varying from 10 to 30%. Results showed that the heat of hydration decreased with increase in percentage of replacement of OPC with VA, indicating increased retardation in hydration due to the addition of VA. This property could be used in mass concreting in which a reduction in heat of hydration is required to reduce cracking in concrete, especially in hot weather concreting.

Keywords: blended cement, hot weather, hydration, volcanic ash

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Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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Authors: Hui-Yi Wang, Shu-Mei Chen, Mei-Fang Liu

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Background and purpose: Providing clinical experience in medical education is an important discipline method where students can gradually apply their academic knowledge to clinical situations. The purpose of this study was to establish self-assessment questionnaires for students to assess their learning outcomes for two fields of physical therapy, orthopedic physical therapy, and pediatric physical therapy, in a clinical fieldwork course. Methods: The questionnaires were developed based on the core competence dimensions of the course. The content validity of the questionnaires was evaluated and established by expert meetings. Among the third-year undergraduate students who took the clinical fieldwork course, there were 49 students participated in this study. Teachers arranged for the students to study two professional fields, and each professional field conducted a three-week clinical lesson. The students filled out the self-assessment questionnaires before and after each three-week lesson. Results: The self-assessment questionnaires were established by expert meetings that there were six core competency dimensions in each of the two fields, with 20 and 21 item-questions, respectively. After each three-week clinical fieldwork, the self-rating scores in each core competency dimension were higher when compared to those before the course, indicating having better clinical abilities after the lessons. The best self-rating scores were the dimension of attitude and humanistic literacy, and the two lower scores were the dimensions of professional knowledge and skills and problem-solving critical thinking. Conclusions: This study developed questionnaires for clinical fieldwork courses to reflect students' learning outcomes, including the performance of professional knowledge, practice skills, and professional attitudes. The use of self-assessment of learning performance can help students build up their reflective competencies. Teachers can guide students to pay attention to the performance of abilities in each core dimension to enhance the effectiveness of learning through self-reflection and improvement.

Keywords: physical therapy, clinical fieldwork course, learning outcomes assessment, medical education, self-reflection ability

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Authors: R. Al-Dujele, K. A. Cashell

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A tubular flange girder is an I-shaped steel girder with either one of both of the usual flat flange plates replaced with a hollow section. Typically, these hollow sections are either rectangular or circular in shape. Concrete filled tubular flange girders (CFTFGs) are unconventional I-shaped beams that use a hollow structural section as the top flange which is filled with concrete. The resulting section offers very high lateral torsional buckling strength and stiffness compared with conventional steel I-beams of similar depth, width and weight, typically leading to a reduction in lateral bracing requirements. This paper is focussed on investigating the ultimate capacity of concrete filled rectangular tubular flange girders (CFRTFGs). These are complex members and their behaviour is governed by a number of inter-related parameters. The FE model is developed using ABAQUS software, 3-D finite element (FE) model for simply supported CFRTFGs subjected to two point loads applied at the third-span points is built. An initial geometrical imperfection of (L/1000), as well as geometrical and material nonlinearities, are introduced into the model, where L denotes the span of the girder. In this numerical model, the concrete and steel materials are modelled using eight-node solid and four-node shell elements, respectively. In addition to the FE model, simplified analytical expressions for the flexural capacity are also proposed, and the results are compared to those from the FE analyses. The analytical expressions, which are suitable for design, are also shown to be capable of providing an accurate depiction of the bending moment capacity.

Keywords: concrete-filled rectangular tubular flange girders, ultimate capacity, confining effect, finite element analysis

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Authors: Zinhle Cindi, Collet Dandara, Mpiko Ntsekhe, Edson Makambwa, Miguel Larceda

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Background: Warfarin is the most commonly used drug in the management of thromboembolic disease. However, there is a huge variability in the time, number of doses or starting doses for patients to achieve the required international normalised ratio (INR) which is compounded by a narrow therapeutic index. Many genetic-association studies have reported on European and Asian populations which have led to the designing of specific algorithms that are now being used to assist in warfarin dosing. However, very few or no studies have looked at the pharmacogenetics of warfarin in African populations, yet, huge differences in dosage requirements to reach the same INR have been observed. Objective: We set out to investigate the distribution of 3 SNPs CYP4F2 c.1347C > T, VKORC1 g.-1639G > A and VKORC1 c.1173C > T among South African Mixed Ancestry (MA) and Black African patients. Methods: DNA was extracted from 383 participants and subsequently genotyped using PCR/RFLP for the CYP4F2 c.1347 (V433M) (rs2108622), VKORC1 g.-1639 (rs9923231) and VKORC1 c.1173 (rs9934438) SNPs. Results: Comparing the Black and MA groups, significant differences were observed in the distribution of the following genotypes; CYP4F2 c.1347C/T (23% vs. 39% p=0.03). All VKORC1 g.-1639G > A genotypes (p < 0.006) and all VKORC1 c.1173C > T genotypes (p < 0.007). Conclusion: CYP4F2 c.1347T (V433M) reduces CYP4F2 protein levels and therefore expected to affect the amount of warfarin needed to block vitamin k recycling. The VKORC1 g-1639A variant alters transcriptional regulation therefore affecting the function of vitamin k epoxide reductase in vitamin k production. The VKORC1 c.1173T variant reduces the enzyme activity of VKORC1 consequently enhancing the effectiveness of warfarin. These are preliminary results; more genetic characterization is required to understand all the genetic determinants affecting how patients respond to warfarin.

Keywords: algorithms, pharmacogenetics, thromboembolic disease, warfarin

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Authors: Kiomars Sefidi

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Dead and habitat tree such as fallen logs, snags, stumps and cracks and loos bark etc. is regarded as an important ecological component of forests on which many forest dwelling species depend, yet its relation to management history in Caspian forest has gone unreported. The aim of research was to compare the amounts of dead tree and habitat in the forests with historically different intensities of management, including: forests with the long term implication of management (PS), the short-term implication of management (NS) which were compared with semi virgin forest (GS). The number of 405 individual dead and habitat trees were recorded and measured at 109 sampling locations. ANOVA revealed volume of the dead tree in the form and decay classes significantly differ within sites and dead volume in the semi virgin forest significantly higher than managed sites. Comparing the amount of dead and habitat tree in three sites showed that dead tree volume related with management history and significantly differ in three study sites. Also, the numbers of habitat trees including cavities, Cracks and loose bark and Fork split trees significantly vary among sites. Reaching their highest in virgin site and their lowest in the site with the long term implication of management, it was concluded that forest management cause reduction of the amount of dead and habitat tree. Forest management history affect the forest's ability to generate dead tree especially in a large size, thus managing this forest according to ecological sustainable principles require a commitment to maintaining stand structure that allow, continued generation of dead tree in a full range of size.

Keywords: forest biodiversity, cracks trees, fork split trees, sustainable management, Fagus orientalis, Iran

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Authors: Pradeep Kulshrestha, Maulana Ayoub Ali

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The concept of financial inclusion has been tabled in the whole world where practitioners, academicians, policy makers and economists are working hard to look for the best possible opportunities in order to enable the whole society to be in the banking cycle. The Islamic banking system is considered to be one of the said opportunities. Countries like the United Kingdom, United States of America, Malaysia, Saudi Arabia, the whole of the United Arab Emirates and many African countries have accommodated the aspect of Islamic banking in the conventional banking system as one of the financial inclusion strategies. This paper tries to analyse the current state of affairs of the Islamic Banking system in Tanzania in order to understand the improvement of the provision of Islamic banking products and services in the said country. The paper discusses the historical background of the banking system in Tanzania, the level of penetration of banking products and services and the coming of the Islamic banking system in the country. Furthermore, the paper discusses banking regulatory bodies, legal instruments governing banking operations as well as number of legal challenges facing Islamic banking operations in the country. Following a critical literature review, the paper discovered that there is no legal instrument which talks about the introduction and provision of Islamic banking system in Tanzania. Furthermore, the Islamic banking system was considered as a banking product which is absolutely incorrect because Islamic banking is considered to be as a banking system of its own. In addition to that, it has been discovered that lack of a proper regulatory system and legal instruments to harmonize the conventional and Islamic banking systems has resulted in the closure of one Islamic window in the country, which in the end affects the credibility of the newly introduced banking system. In its conclusive remarks, the paper suggests that Tanzania should work on all legal challenges affecting the smooth operations of the Islamic banking system. This can be in a way of adopting various Islamic banking legal models which are used in countries like Malaysia and others, or a borrowing legal harmonization process which has been adopted by the UK, Uganda, Nigeria and Kenya.

Keywords: Islamic banking, Islamic windows, regulations, banks

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Authors: Y. Cochet, A. Achim, Tom Flatman, J-C. Domec, J. Ogée, L. Wingate, Ram Oren

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It is accepted that atmospheric CO2 concentration will increase in the future. For the past 30 years, researchers have used FACE (Free-Air Carbon Dioxide Enrichment) facilities to study the development of terrestrial ecosystems under elevated CO2 (eCO2). Forest responses to eCO2 are likely to impact timber industries with potential feedbacks towards the atmosphere. The main objectives of this study were to examine whether eCO2 alone or in combination with N-fertilization alter wood properties and to identify changes in wood anatomy related to water transport. Wood disks were sampled at breast height from mature loblolly pine trees (Pinus taeda L.) harvested at the Duke FACE site (NC, USA). By measuring ring width and intra-ring changes in density (X-ray densitometry) and tracheid size (lumen and cell wall thickness) from pith to bark, the following hypotheses were tested: 1) eCO2 and N-fertilization interact positively to increase significantly above-ground primary productivity; 2) eCO2 and N-fertilization lead to a decrease in density; 3) eCO2 and N-fertilization increase lumen diameter and decrease cell wall thickness, thus affecting water transport capacity. Our results revealed a boost in earlywood tracheid production induced by eCO2 lasting a few years. The following decrease seemed to be buffered by N-fertilization. X-ray profiles did not show a marked decrease in wood density under eCO2 or N-fertilization, although there were changes in cell anatomical properties such as a reduction in cell-wall thickness and an increase in lumen diameter. If such effects of eCO2 are confirmed, forest management strategies for example N-fertilization should be redesigned.

Keywords: wood density, Duke FACE (free-air carbon dioxide enrichment), N fertilization, tree ring

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Authors: Agodo Mugenyi Herbert

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Background: A high prevalence of both HIV infection and mental disorders exists in Sub-Saharan Africa, however there is little integration of care for mental health disorders among HIV-infected individuals. The study aimed at determining the management of common mental disorders among HIV/AIDS clients attending Antiretroviral clinic in Hoima regional referral hospital. Significancy of the study: The information generated by this study would help mental health advocates, ministry of health, Civil society organizations in HIV programming to advocate for enhanced mental health care for PLWHA. The result will be used in policy development and lobbying for integration of mental health care in HIV/AIDS care. Methods: This study applied a cross sectional design. It involved data collection from clients with HIV/AIDS attending ART clinic in Hoima regional referral hospital at one specific point in time. It aimed at providing data on the entire population under study. Data was collected from Hoima Regional Referral Hospital at the ART clinic. Data analysis was performed using SPSS version 24. Results: 66 HIV/AIDS clients and 10 health workers in the ART clinic who participated fully completed the study. The overall prevalence of at least one form of mental disorder was 83%. Majority of the health care practitioner do not use pharmacological, psychological, and social interventions to manage such disorders. Conclusion: These results are suggestive of a significant proportion of the HIV-infected patients experiencing psychological difficulty for which they do not receive treatment Recommendations: Current care practices applied to patients with HIV/AIDS should be integrated more generally to include treatment services to identify and manage common mental disorders.

Keywords: common mental disorders, mental health, mental illness, and severe mental illness

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Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

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Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

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Authors: Seyede Sanaz Seyedebrahimi, Shima Rahimi, Shohreh Fakhari, Ali Jalili

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Background: CXCR4, as a chemokine receptor, plays well-known roles in various types of cancers. Several studies have been conducted to overcome CXCR4 axis acts in multiple myeloma (MM) pathogenesis and progression. Dexamethasone, a standard treatment for multiple myeloma, has been shown to increase CXCR4 levels in multiple myeloma cell lines. Herein, we focused on the effects of metformin and dexamethasone on CXCR4 at the cellular level and the migration rate of cell lines after exposure to a combination compared to single-agent models. Materials and Method: Multiple myeloma cell lines (U266 and RPMI8226) were cultured with different metformin and dexamethasone concentrations in single-agent and combination models. The simultaneous combination doses were calculated by CompuSyn software. Cell surface and mRNA expression of CXCR4 were determined using flow cytometry and the quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay, respectively. The Transwell cell migration assay evaluated the migration ability. Results: In concurred with previous studies, our results showed a dexamethasone up-regulation effect on CXCR4 in a dose-dependent manner. Although, the metformin single-agent model could reduce CXCR4 expression of U266 and RPMI8226 in cell surface and mRNA expression level. Moreover, the administration of metformin and dexamethasone simultaneously exerted a higher suppression effect on CXCR4 expression than the metformin single-agent model. The migration rate through the combination model's matrigel membrane was remarkably lower than the metformin and dexamethasone single-agent model. Discussion: According to our findings, the combination of metformin and dexamethasone effectively inhibited dexamethasone-induced CXCR4 expression in multiple myeloma cell lines. As a result, metformin may be counted as an alternative medicine combined with other chemotherapies to combat multiple myeloma. However, more research is required.

Keywords: CXCR4, dexamethasone, metformin, migration, multiple myeloma

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Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

Abstract:

Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.

Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica

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Authors: Shivam Yadav, Neelam Atri

Abstract:

Cyanobacteria are photoautotrophic prokaryotes able to grow in diverse ecological habitats, originated 2.5 - 3.5 billion years ago and brought oxygenic photosynthesis. Since then superoxide dismutases (SODs) acquired great significance due to their ability to catalyze detoxification of byproducts of oxygenic photosynthesis, i.e. superoxide radicals. Sequence information from several cyanobacterial genomes offers a unique opportunity to conduct a comprehensive comparative analysis of the superoxide dismutases family. In the present study, we extracted information regarding SODs from species of sequenced cyanobacteria and investigated their diversity, conservation, domain structure, and evolution. 144 putative SOD homologues were identified. SODs are present in all cyanobacterial species reflecting their significant role in survival. However, their distribution varies, fewer in unicellular marine strains whereas abundant in filamentous nitrogen-fixing cyanobacteria. Motifs and invariant amino acids typical in eukaryotic SODs were conserved well in these proteins. These SODs were classified into three major families according to their domain structures. Interestingly, they lack additional domains as found in proteins of other family. Phylogenetic relationships correspond well with phylogenies based on 16S rRNA and clustering occurs on the basis of structural characteristics such as domain organization. Similar conserved motifs and amino acids indicate that cyanobacterial SODs make use of a similar catalytic mechanism as eukaryotic SODs. Gene gain-and-loss is insignificant during SOD evolution as evidenced by absence of additional domain. This study has not only examined an overall background of sequence-structure-function interactions for the SOD gene family but also revealed variation among SOD distribution based on ecophysiological and morphological characters.

Keywords: comparative genomics, cyanobacteria, phylogeny, superoxide dismutases

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Authors: Dada. O.Akinola, Uche. I. Ebele, Bamiro .A.Rafatu, Akinbami A. Akinsegun, Dada O. Adeyemi, Adeyemi. O. Ibukun, Okunowo O.Bolanle, Abdulateef O. Kareem, Ibrahim.N. Ismaila, Dosu Rihanat

Abstract:

Background: Hyperglycaemia alters qualitatively and quantitatively all the full blood count parameters. The alterations among other factors are responsible for the macrovascular and microvascular complications associated with diabetes mellitus (DM). This study is aimed at correlating haematological parameters in DM subjects with their fasting blood glucose (FBG) and anthropometric parameters. Materials and Methods: This was a cross-sectional study of participants attending DM clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja. The study recruited one hundred and two (102) DM subjects and one hundred (100) non-DM controls. Venous blood samples were collected for full blood count (FBC) assay while FBG was done, structured questionnaires were administered, and anthropometric measurements of all participants were done. Data were analyzed with Statistical Package for Social Science (SPSS) version 23. P was set at ≤0.05. Results: The mean age of DM patients was 64.32± 11.31 years. Using a haemoglobin concentration cut-off of 11g/dl, 39.2%, and 13% DM and control participants respectively had values lower than 11g/dl. A total of 22.5% and 3% of DM and controls respectively gave a history of previous blood transfusion.White blood cells count and platelet count means were (6.12±1.60 and 5.30±7.52,p=0.59) and (213.31±73.58 and 228.91±73.21,p = 0.26) *109/L in DM subjects and controls respectively. FBG and all the anthropometric data in DM subjects were significantly higher than in controls. Conclusions: The prevalence of anaemia in DM subjects was three times higher than in controls. The white blood cell count was higher but not statistically significant in DM compared with controls. But platelet count was higher but not statistically significant in controls compared with DM subjects.

Keywords: haematological profile, diabetes mellitus, anthropometric data, fasting blood glucose

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Authors: Ali Kassem, Mohamed Alsenbasy, Ahmed Nagaah

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Background: Diabetic foot is one of the often neglected complications of diabetes mellitus It was reported that patients of diabetic foot ulcer (DFU) have considerable morbidity and mortality. Due to arterial abnormalities, diabetic neuropathy, as well as the tendency to delayed wound healing, foot infection and or gangrene is relatively common in diabetic patients. Foot related problems are responsible for up to 50% of diabetic related hospital admissions. Aim of work: The aim of the present study is to assess the risk factors for DFU in diabetic patients attending Sohag University Hospitals (Upper Egypt) Material and methods: The present study includes 100 diabetic foot patients attending the diabetic outpatient clinic of Sohag University Hospitals. For all of the studied patients the following were done: Full medical history and clinical examination; thorough foot examination; Laboratory tests including: Blood glucose level, HBA1c, serum lipids and renal function tests, ECG and Echocardiography, Doppler study on the lower limbs. Results: Sixty eight percent of the affected patients were males versus 32 % female patients. All male patients and none of the female were smoker. Seventy nine percent of patients were living in rural areas versus 14 % in urban areas. Duration of diabetes was more than 12 years in 74%, less than 12 years in 26% of patients. Fifty percent of patients have associated hypertension, 46% have dyslipidemia, 18% have ischemic heart disease or old myocardial infarction and 8% have impaired renal function. History of previous foot ulcers was reported in 11 % and foot amputation in 2% of patients. Conclusion: Male gender, low socioeconomic status, smoking, long duration of diabetes, other cardiovascular risk factors particularly hypertension and previous history of foot ulceration are the major risk factors for diabetic foot in our locality.

Keywords: diabetic foot, diabetic neuropathy, foot gangrene, risk factors for diabetic complications

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Authors: Mulubrhan Berihu, Supratic Gupta, Zena Gebriel

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Due to the design versatility, availability, and cost efficiency, concrete is continuing to be the most used construction material on earth. However, the production of Portland cement, the primary component of concrete mix is causing to have a serious effect on environmental and economic impacts. This shows there is a need to study using of supplementary cementitious materials (SCMs). The most commonly used supplementary cementitious materials are wastes and the use of these industrial waste products has technical, economical and environmental benefits besides the reduction of CO2 emission from cement production. The study aims to document the effect on strength property of concrete due to use of low cement by maximizing supplementary cementitious materials like fly ash or marble powder. Based on the different mix proportion of pozzolana and marble powder a range of mix design was formulated. The first part of the project is to study the strength of low cement concrete using fly ash replacement experimentally. The test results showed that using up to 85 kg/m3 of cement is possible for plain concrete works like hollow block concrete to achieve 9.8 Mpa and the experimental results indicates that strength is a function of w/b. In the second part a new set of mix design has been carried out with fly ash and marble powder to study the strength of both binary and ternary mixes. In this experimental study, three groups of mix design (c+FA, c+FA+m and c+m), four sets of mixes for each group were taken up. Experimental results show that c+FA has maintained the best strength and impermeability whereas c+m obtained less compressive strength, poorer permeability and split tensile strength. c+FA shows a big difference in gaining of compressive strength from 7 days to 28 days compression strength compared to others and this obviously shows the slow rate of hydration of fly ash concrete. As the w/b ratio increases the strength decreases significantly. At the same time higher permeability has been seen in the specimens which were tested for three hours than one hour.

Keywords: efficiency factor, cement content, compressive strength, mix proportion, w/c ratio, water permeability, SCMs

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Authors: Maria I. Nuñez-Hernández, Maria L. Riesco

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Background: Exclusive breastfeeding (EBF) up to 6 months old infant have been considered one of the most important factors in the overall development of children. Nevertheless, as resources are scarce, it is essential to identify the most vulnerable groups that have major risk of EBF abandonment, in order to deliver the best strategies. Children of adolescent mothers are within these groups. Aims: To determine the EBF abandonment rate among adolescent mothers and to analyze the associated factors. Methods: Prospective cohort study of adolescent mothers in the southern area of Santiago, Chile, conducted in primary care services of public health system. The cohort was established from 2014 to 2015, with a sample of 105 adolescent mothers and their children at 2 months of life. The inclusion criteria were: adolescent mother from 14 to 19 years old; not twin babies; mother and baby leaving the hospital together after birthchild; correct attachment of the baby to the breast; no difficulty understanding the Spanish language or communicating. Follow-up was performed at 4 and 6 months old infant. Data were collected by interviews, considering EBF as breastfeeding only, without adding other milk, tea, juice, water or other product that not breast milk, except drugs. Data were analyzed by descriptive and inferential statistics, by Kaplan-Meier estimator and Log-Rank test, admitting the probability of occurrence of type I error of 5% (p-value = 0.05). Results: The cumulative EBF abandonment rate at 2, 4 and 6 months was 33.3%, 52.2% and 63.8%, respectively. Factors associated with EBF abandonment were maternal perception of the quality of milk as poor (p < 0.001), maternal perception that the child was not satisfied after breastfeeding (p < 0.001), use of pacifier (p < 0.001), maternal consumption of illicit drugs after delivery (p < 0.001), mother return to school (p = 0.040) and presence of nipple trauma (p = 0.045). Conclusion: EBF abandonment rate was higher in the first 4 months of life and is superior to the population of women who breastfeed. Among the EBF abandonment factors, one of them is related to the adolescent condition, and two are related to the maternal subjective perception.

Keywords: adolescent, breastfeeding, midwifery, nursing

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Authors: Adu Micheal Kwaku, Lamptey Shirley

Abstract:

Cowpea (Vigna unguiculata (L.) Walpis) is a major food grain legume in Ghana and plays a significant role in consumer diets. Drought in rain-fed crop production is known to cause substantial crop yield reduction due to their negative impacts on plant growth, physiology, and reproduction. There are various ways of reducing the effect of drought or addressing the problem of drought stress, including irrigation, breeding, and mulching. Among these three ways of reducing the effect of drought stress, the cheapest and quickest method is mulching. The broad objective of this project is to determine the influence of mulching on the performance of cowpea. The experiment was conducted at Planting for future garden located at Nyankpala Campus of the University for Development Studies (UDS), comprising five treatments (black plastic, rice hull, groundnut hull, dry grass mulch, and control). The treatments were evaluated in a Randomized Complete Block Design (RCBD) with three replications. The result shows that black plastic mulch increased soil moisture by 1, 8, 15, and 24% compared to rice hull, groundnut hull, dry grass, and control, respectively. Increased soil moisture translated into black plastic mulch increasing grain yield by 8, 25, 39, and 46% compared to groundnut hull, rice hull, dry grass and control, respectively. However, black plastic mulch increased the cost of production, resulting in decreased net returns compared to the other treatment. This study recommends the use of rice and groundnut hull as mulching material to improve soil moisture, grain yield, and profit of smallholder cowpea farmers and also because they are almost free and available.

Keywords: mulch, plastic mulch, cowpea, growth response

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Authors: Anton Grobler

Abstract:

Background: Psychological capital (PsyCap), consisting of Hope, Optimism, Resilience, and Self-efficacy, is a popular positive organisational behaviour construct utilised in the studying employee work and behavioral attitudes. Various scholars believe however that further validity research should be conducted on the PsyCap questionnaire (PCQ), outside of the founding research team and in more diverse settings, for the purpose of this paper, within the diverse South African (SA) context. Aim: The purpose of this study was to investigate the construct validity of the PCQ with specific reference to its psychometric properties within the diverse SA context. Setting: The sample includes a total of 1 749 respondents, ± 60 each from 30 organisations in South Africa. Method: This study utilised a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender) of the South African workforce. A multi-factorial model was statistically explored and confirmed (with exploratory factor analysis [EFA] and confirmatory factor analysis [CFA] respectively). Results: The study yielded a three-factor solution, with Hope and Optimism as a combined factor and Resilience and Self-efficacy made up of a reconfigured set of substantively justifiable items. Three items of the original 24 items were found not to be suitable. The three factors showed good psychometric properties, good fit (in support of construct validity) and acceptable levels of convergent and discriminant validity. Conclusion: The results support the original conceptualisation of PsyCap, although with a unique structural configuration. This resonates with the notion of scholars that further research should be conducted within diverse settings. This is necessary to ensure the valid measurement of the construct, which is considered to be one of the four criteria for a construct to be categorised as a positive organisational behaviour construct.

Keywords: positive organisational behaviour, psychological capital, hope, optimism, resilience, self-efficacy, construct validity

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Authors: Khaled M. Khader, Mamdouh I. Elimy

Abstract:

Reducing energy consumption became the major concern for all countries of the world during the recent decades. In general, power saving is currently the nominal goal of most industrial countries. It is well known that fossil fuels are the main pillar of development of world countries. Unfortunately, the increased rate of fossil fuel consumption will lead to serious problems caused by an expected depletion of fuels. Moreover, dangerous gases and vapors emission lead to severe environmental problems during fuel burning. Consequently, most engineering sectors especially the mechanical sectors are looking for improving any machine accompanied by reducing its energy consumption. Crank-Rocker planar mechanism is the most applied in mechanical systems. Besides, it is one of the most significant parts of the machines for obtaining the oscillatory motion. The transmission angle of this mechanism can be considered as an optimum value when its extreme values are equally varied around 90°. In addition, the transmission angle plays an important role in decreasing the required driving power and improving the dynamic properties of the mechanism. Hence, appropriate selection of mechanism links lengthens, which assures optimum transmission angle leads to decreasing the driving power. Moreover, mechanism's links manufactured from composite materials afford link's lightweight, which decreases the required driving torque. Furthermore, wear and corrosion problems can be treated through using composite links instead of using metal ones. This paper is dealing with improving the performance of crank-rocker mechanism using composite links due to their flexural elastic modulus values and stiffness in addition to high damping of composite materials.

Keywords: Composite Material, Crank-Rocker Mechanism, Transmission angle, Design techniques, Power Saving

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Authors: Annapurna Basavaraju, Andreas Marn, Franz Heitmeir

Abstract:

The Advisory Council for Aeronautics Research in Europe (ACARE) is cognizant for the overall reduction of NOx emissions by 80% in its vision 2020. Moreover small turbo engines have higher fuel specific emissions compared to large engines due to their limited combustion chamber size. In order to fulfill these requirements, novel combustion concepts are essential. This motivates to carry out the research on the current state of art, catalytic stabilized combustion chamber using hydrogen in small jet engines which are designed and investigated both numerically and experimentally during this project. Catalytic combustion concepts can also be adopted for low caloric fuels and are therefore not constrained to only hydrogen. However, hydrogen has high heating value and has the major advantage of producing only the nitrogen oxides as pollutants during the combustion, thus eliminating the interest on other emissions such as Carbon monoxides etc. In the present work, the combustion chamber is designed based on the ‘Rich catalytic Lean burn’ concept. The experiments are conducted for the characteristic operating range of an existing engine. This engine has been tested successfully at Institute of Thermal Turbomachinery and Machine Dynamics (ITTM), Technical University Graz. One of the facts that the efficient combustion is a result of proper mixing of fuel-air mixture, considerable significance is given to the selection of appropriate mixer. This led to the design of three diverse configurations of mixers and is investigated experimentally and numerically. Subsequently the best mixer would be equipped in the main combustion chamber and used throughout the experimentation. Furthermore, temperatures and pressures would be recorded at various locations inside the combustion chamber and the exhaust emissions will also be analyzed. The instrumented combustion chamber would be inspected at the engine relevant inlet conditions for nine different sets of catalysts at the Hot Flow Test Facility (HFTF) of the institute.

Keywords: catalytic combustion, gas turbine, hydrogen, mixer, NOx emissions

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Authors: Akram Rasheed

Abstract:

Background: Simulation in the health care field has been increasingly used over the last years in the training of resuscitation and life support practices. It has shown the advantage of improving the decision-making and technical skills through deliberate practice and return demonstration. Local Problem: This article reports on the integration of simulation-based training (SBT) in the training program about proper team dynamics and leadership skills during cardiopulmonary resuscitation (CPR) in the intensive care unit (ICU). Method and Intervention: Training of 180 critical care nurses was conducted using SBT between 1st January and 30th 2020. We had conducted 15 workshops, with the integration of SBT using high fidelity manikins and using demonstration and return-demonstration approach to train the nursing staff about proper team dynamics and leadership skills during CPR. Results: After completing the SBT session, all 180 nurses completed the evaluation form. The majority of evaluation items were rated over 95% for the effectiveness of the education; four items were less than 95% (88–94%). Lower rated items considered training and practice time, improved competency, and commitment to apply to learn. The team dynamics SBT was evaluated as an effective means to improve team dynamics and leadership skills during CPR in the intensive care unit (ICU). Conclusion: The use of simulation-based training to improve team dynamics and leadership skills is an effective method for better patient management during CPR. Besides skills competency, closed-loop communication, clear messages, clear roles, and assignments, knowing one’s limitations, knowledge sharing, constructive interventions, re-evaluating and summarizing, and mutual respect are all important concepts that should be considered during team dynamics training. However, participants reported the need for a repeated practice opportunity to build competency.

Keywords: cardiopulmonary resuscitation, high fidelity manikins, simulation-based training, team dynamics

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