Search results for: standardized mortality ratio (SMR)

Authors: Vesile Unver, Tulay Basak, Hatice Ayhan, Ilknur Cinar, Emine Iyigun, Nuran Tosun

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The aim of this study is to analyze the effects of the hybrid simulation. In this simulation, types standardized patients and task trainers are employed simultaneously. For instance, in order to teach the IV activities standardized patients and IV arm models are used. The study was designed as a quasi-experimental research. Before the implementation an ethical permission was taken from the local ethical commission and administrative permission was granted from the nursing school. The universe of the study included second-grade nursing students (n=77). The participants were selected through simple random sample technique and total of 39 nursing students were included. The views of the participants were collected through a feedback form with 12 items. The form was developed by the authors and “Patient intervention self-confidence/competence scale”. Participants reported advantages of the hybrid simulation practice. Such advantages include the following: developing connections between the simulated scenario and real life situations in clinical conditions; recognition of the need for learning more about clinical practice. They all stated that the implementation was very useful for them. They also added three major gains; improvement of critical thinking skills (94.7%) and the skill of making decisions (97.3%); and feeling as if a nurse (92.1%). In regard to the mean scores of the participants in the patient intervention self-confidence/competence scale, it was found that the total mean score for the scale was 75.23±7.76. The findings obtained in the study suggest that the hybrid simulation has positive effects on the integration of theoretical and practical activities before clinical activities for the nursing students.

Keywords: hybrid simulation, clinical practice, nursing education, nursing students

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Authors: Naik Nithesh, Andre Rozek

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The heat transfer and friction loss performances of a single rib-roughened rectangular cooling channel having four novel rib shapes were evaluated through numerical investigation using Ansys CFX. The investigation was conducted on a rectangular channel of aspect ratio (AR) = 4:1 with rib height to hydraulic diameter ratio (e/Dh) of 0.1 and rib pitch to height ratio (e/P) of 10 at Re = 30,000. The computations were performed by solving the RANS equation using k-ε turbulence model. Fluid flow simulation results of stationery case for different configuration are presented in terms of thermal performance parameter, Nusselt number and friction factor. These parameters indicate that a particular configuration of novel shaped ribs provides better heat transfer characteristics over the conventional 45° ribs. The numerical investigation undertaken in this study indicates an increase in overall efficiency of gas turbine due to increased thermal performance parameter, heat transfer co-efficient and less pumping pressure.

Keywords: gas turbine, rib shapes, nusselt number, thermal performance parameter

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Authors: Mustapha Bouhoun Ali, Ahmed Yacine Badjah Hadj Ahmed, Mouloud Attou, Abdel Hamid Elias, Mohamed Amine Didi

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The extraction of uranium(VI) from aqueous solutions has been investigated using 1-hydroxyhexadecylidene-1,1-diphosphonic acid (HHDPA) and 1-hydroxydodecylidene-1,1-diphosphonic acid (HDDPA), which were synthesized and characterized by elemental analysis and by FT-IR, 1H NMR, 31P NMR spectroscopy. In this paper, we propose a tentative assignment for the shifts of those two ligands and their specific complexes with uranium(VI). We carried out the extraction of uranium(VI) by HHDPA and HDDPA from [carbon tetrachloride + 2-octanol (v/v: 90%/10%)] solutions. Various factors such as contact time, pH, organic/aqueous phase ratio and extractant concentration were considered. The optimum conditions obtained were: contact time = 20 min, organic/aqueous phase ratio = 1, pH value = 3.0 and extractant concentration = 0.3M. The extraction yields are more significant in the case of the HHDPA which is equipped with a hydrocarbon chain, longer than that of the HDDPA. Logarithmic plots of the uranium(VI) distribution ratio vs. pHeq and the extractant concentration showed that the ratio of extractant to extracted uranium(VI) (ligand/metal) is 2:1. The formula of the complex of uranium(VI) with the HHDPA and the DHDPA is UO2(H3L)2 (HHDPA and DHDPA are denoted as H4L). A spectroscopic analysis has showed that coordination of uranium(VI) takes place via oxygen atoms.

Keywords: liquid-liquid extraction, uranium(VI), 1-hydroxyalkylidene-1, 1-diphosphonic acids, HHDPA, HDDPA, aqueous solution

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Authors: Dipak Sen, Rajdeep Ghosh

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This paper presents a computational study of steady state three dimensional very high turbulent flow and heat transfer characteristics in a constant temperature-surfaced circular duct fitted with 900 hemispherical inline baffles. The computations are based on realizable k-ɛ model with standard wall function considering the finite volume method, and the SIMPLE algorithm has been implemented. Computational Study are carried out for Reynolds number, Re ranging from 80000 to 120000, Prandtl Number, Pr of 0.73, Pitch Ratios, PR of 1,2,3,4,5 based on the hydraulic diameter of the channel, hydrodynamic entry length, thermal entry length and the test section. Ansys Fluent 15.0 software has been used to solve the flow field. Study reveals that circular pipe having baffles has a higher Nusselt number and friction factor compared to the smooth circular pipe without baffles. Maximum Nusselt number and friction factor are obtained for the PR=5 and PR=1 respectively. Nusselt number increases while pitch ratio increases in the range of study; however, friction factor also decreases up to PR 3 and after which it becomes almost constant up to PR 5. Thermal enhancement factor increases with increasing pitch ratio but with slightly decreasing Reynolds number in the range of study and becomes almost constant at higher Reynolds number. The computational results reveal that optimum thermal enhancement factor of 900 inline hemispherical baffle is about 1.23 for pitch ratio 5 at Reynolds number 120000.It also shows that the optimum pitch ratio for which the baffles can be installed in such very high turbulent flows should be 5. Results show that pitch ratio and Reynolds number play an important role on both fluid flow and heat transfer characteristics.

Keywords: friction factor, heat transfer, turbulent flow, circular duct, baffle, pitch ratio

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Authors: Mustafa M. Donma, Orkide Donma

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Obesity is defined as a severe chronic disease characterized by a low-grade inflammatory state. Therefore, inflammatory markers gained utmost importance during the evaluation of obesity and metabolic syndrome (MetS), a disease characterized by central obesity, elevated blood pressure, increased fasting blood glucose and elevated triglycerides or reduced high density lipoprotein cholesterol (HDL-C) values. Some inflammatory markers based upon complete blood cell count (CBC) are available. In this study, it was questioned which inflammatory marker was the best to evaluate the differences between various obesity groups. 514 pediatric individuals were recruited. 132 children with MetS, 155 morbid obese (MO), 90 obese (OB), 38 overweight (OW) and 99 children with normal BMI (N-BMI) were included into the scope of this study. Obesity groups were constituted using age- and sex-dependent body mass index (BMI) percentiles tabulated by World Health Organization. MetS components were determined to be able to specify children with MetS. CBC were determined using automated hematology analyzer. HDL-C analysis was performed. Using CBC parameters and HDL-C values, ratio markers of inflammation, which cover neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-HDL-C ratio (MHR) were calculated. Statistical analyses were performed. The statistical significance degree was considered as p < 0.05. There was no statistically significant difference among the groups in terms of platelet count, neutrophil count, lymphocyte count, monocyte count, and NLR. PLR differed significantly between OW and N-BMI as well as MetS. Monocyte-to HDL-C value exhibited statistical significance between MetS and N-BMI, OB, and MO groups. HDL-C value differed between MetS and N-BMI, OW, OB, MO groups. MHR was the ratio, which exhibits the best performance among the other CBC-based inflammatory markers. On the other hand, when MHR was compared to HDL-C only, it was suggested that HDL-C has given much more valuable information. Therefore, this parameter still keeps its value from the diagnostic point of view. Our results suggest that MHR can be an inflammatory marker during the evaluation of pediatric MetS, but the predictive value of this parameter was not superior to HDL-C during the evaluation of obesity.

Keywords: children, complete blood cell count, high density lipoprotein cholesterol, metabolic syndrome, obesity

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Authors: I. A. Ibrahim, T. A. Elbarbary, N. Abdelaty, A. T. Kandil, H. K. Farhan

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The present work aims to study the leaching of Abu Ghalaga ilmenite ore by hydrochloric acid and simultaneous reduction by iron powder method to dissolve its titanium and iron contents. Iron content in the produced liquor is separated by solvent extraction using TBP as a solvent. All parameters affecting the efficiency of the dissolution process were separately studied including the acid concentration, solid/liquid ratio which controls the ilmenite/acid molar ratio, temperature, time and grain size. The optimum conditions at which maximum leaching occur are 30% HCl acid with a solid/liquid ratio of 1/30 at 80 °C for 4 h using ore ground to -350 mesh size. At the same time, all parameters affecting on solvent extraction and stripping of iron content from the produced liquor were studied. Results show that the best extraction is at solvent/solution 1/1 by shaking at 240 RPM for 45 minutes at 30 °C whereas best striping of iron at H₂O/solvent 2/1.

Keywords: ilmenite ore, leaching, titanium solvent extraction, Abu Ghalaga ilmenite ore

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Authors: Ashish Dhamaniya, Satish Chandra

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Speed and traffic volume data are collected on different sections of four lane and six lane roads in three metropolitan cities in India. Speed data are analyzed to fit the statistical distribution to individual vehicle speed data and all vehicles speed data. It is noted that speed data of individual vehicle generally follows a normal distribution but speed data of all vehicle combined at a section of urban road may or may not follow the normal distribution depending upon the composition of traffic stream. A new term Speed Spread Ratio (SSR) is introduced in this paper which is the ratio of difference in 85^th and 50^th percentile speed to the difference in 50^th and 15^th percentile speed. If SSR is unity then speed data are truly normally distributed. It is noted that on six lane urban roads, speed data follow a normal distribution only when SSR is in the range of 0.86 – 1.11. The range of SSR is validated on four lane roads also.

Keywords: normal distribution, percentile speed, speed spread ratio, traffic volume

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Authors: Michael Ricardo Lang, AdriéLle Costa, Ivana Iesbik, Karine Haag, Leonardo Trindade Buffara, Oscar Reimann Junior, Chelin Auswaldt Steclan

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Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with SAH being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyspilipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: biomarkers, sex, stroke, stroke unit, population

Procedia PDF Downloads 245

Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

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Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

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Authors: Rapelang E. Simon, Thebeetsile A. Olebetse, Joseph R. Maritinkole, Ruth O. Moleleke

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The P and S wave seismic velocity ratios (Vp/Vs) of some aftershocks are investigated using the method ofWadati diagrams. These aftershocks occurred after the 3rdApril 2017 Botswana’s Mw 6.5 earthquake and were recorded by the Network of Autonomously Recording Seismographs (NARS)-Botswana temporary network deployed from 2013 to 2018. In this paper, P and S wave data with good signal-to-noise ratiofrom twenty events of local magnitude greater or equal to 4.0are analysed with the Seisan software and used to infer properties of the upper crust in Botswana. The Vp/Vsratiosare determined from the travel-times of body waves and then converted to Poisson’s ratio, which is useful in determining the physical state of the subsurface materials. The Vp/Vs ratios of the upper crust in Botswana show regional variations from 1.70 to 1.77, with an average of 1.73. The Poisson’s ratios range from 0.24to 0.27 with an average of 0.25 and correlate well with the geological structures in Botswana.

Keywords: Botswana, earthquake, poisson's ratio, seismic velocity, Vp/Vs ratio

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Authors: Charles Horace Ampong

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Non-linear models have been found to be useful in modeling the elasticity (measure of degree of responsiveness) of a dependent variable with respect to a set of independent variables ceteris paribus. This constant elasticity principle was applied to the dependent variable (Compressive Strength of Concrete in MPa) which was found to be non-linearly related to the independent variable (Water-Cement ratio in kg/m3) for given Ages of Concrete in days (3, 7, 28) at different levels of admixtures Superplasticizer (in kg/m3), Blast Furnace Slag (in kg/m3) and Fly Ash (in kg/m3). The levels of the admixtures were categorized as: S1=Some Plasticizer added & S0=No Plasticizer added; B1=some Blast Furnace Slag added & B0=No Blast Furnace Slag added; F1=Some Fly Ash added & F0=No Fly Ash added. The number of observations (samples) used for the research was one-hundred and thirty-two (132) in all. For Superplasticizer, it was found that Compressive Strength of Concrete was more elastic with regards to Water-Cement ratio at S1 level than at S0 level for the given ages of concrete 3, 7and 28 days. For Blast Furnace Slag, Compressive Strength with regards to Water-Cement ratio was more elastic at B0 level than at B1 level for concrete ages 3, 7 and 28 days. For Fly Ash, Compressive Strength with regards to Water-Cement ratio was more elastic at B0 level than at B1 level for Ages 3, 7 and 28 days. The research also tested for different combinations of the levels of Superplasticizer, Blast Furnace Slag and Fly Ash. It was found that Compressive Strength elasticity with regards to Water-Cement ratio was lowest (Elasticity=-1.746) with a combination of S0, B0 and F0 for concrete age of 3 days. This was followed by Elasticity of -1.611 with a combination of S0, B0 and F0 for a concrete of age 7 days. Next, the highest was an Elasticity of -1.414 with combination of S0, B0 and F0 for a concrete age of 28 days. Based on preceding outcomes, three (3) non-linear model equations for predicting the output elasticity of Compressive Strength of Concrete (in %) or the value of Compressive Strength of Concrete (in MPa) with regards to Water to Cement was formulated. The model equations were based on the three different ages of concrete namely 3, 7 and 28 days under investigation. The three models showed that higher elasticity translates into higher compressive strength. And the models revealed a trend of increasing concrete strength from 3 to 28 days for a given amount of water to cement ratio. Using the models, an increasing modulus of elasticity from 3 to 28 days was deduced.

Keywords: concrete, compressive strength, elasticity, water-cement

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Authors: Malek Ali

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Composites materials of Poly (vinyl alcohol) (PVA)/Chitosan (CS) have been synthesized and characterized successfully. HNTs have been added to composites to enhance the mechanical and degradation properties by hydrogen bonding interactions, compatibility, and chemical crosslink between HNTs and PVA. PVA/CS/HNTs composites prepared with different concentration ratio. SEM micrographs of composites surface showed that more agglomeration with more chitosan ratio. Mechanical and degradation properties were characterized and the result indicates that Mechanical and degradation of 80%PVA/5%Chitosan/15%HNTs higher than the others PVA/CS/HNTs composites.

Keywords: PVA/chitosan, composites, PVA/CS/HNTs, HNTs

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Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

Procedia PDF Downloads 143

Authors: Mubita Namuyamba

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Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.

Keywords: case study, enquiry, psychological and psycho social aspects, Zambia

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Authors: Chung Yan Natalia Yeung, Man Kit Indy Ho, Kin Yu Stan Chan, Ho Pui Kipper Lam, Man Wah Genie Tong, Tze Chung Jim Luk

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Excessive foot pronation is a well-known risk factor of knee and foot injuries such as patellofemoral pain, patellar and Achilles tendinopathy, and plantar fasciitis. Low-Dye taping (LDT) application is not uncommon for basketball players to control excessive foot pronation for pain control and injury prevention. The primary potential benefits of using LDT include providing additional supports to medial longitudinal arch and restricting the excessive midfoot and subtalar motion in weight-bearing activities such as running and landing. Meanwhile, restrictions provided by the rigid tape may also potentially limit functional joint movements and sports performance. Coaches and athletes need to weigh the potential benefits and harmful effects before making a decision if applying LDT technique is worthwhile or not. However, the influence of using LDT on basketball-related performance such as explosive and reactive strength is not well understood. Therefore, the purpose of this study was to investigate the change of drop jump (DJ) and countermovement jump (CMJ) performance before and after LDT application for collegiate male basketball players. In this within-subject crossover study, 12 healthy male basketball players (age: 21.7 ± 2.5 years) with at least 3-year regular basketball training experience were recruited. Navicular drop (ND) test was adopted as the screening and only those with excessive pronation (ND ≥ 10mm) were included. Participants with recent lower limb injury history were excluded. Recruited subjects were required to perform both ND, DJ (on a platform of 40cm height) and CMJ (without arms swing) tests in series during taped and non-taped conditions in the counterbalanced order. Reactive strength index (RSI) was calculated by using the flight time divided by the ground contact time measured. For DJ and CMJ tests, the best of three trials was used for analysis. The difference between taped and non-taped conditions for each test was further calculated through standardized effect ± 90% confidence intervals (CI) with clinical magnitude-based inference (MBI). Paired samples T-test showed significant decrease in ND (-4.68 ± 1.44mm; 95% CI: -3.77, -5.60; p < 0.05) while MBI demonstrated most likely beneficial and large effect (standardize effect: -1.59 ± 0.27) in LDT condition. For DJ test, significant increase in both flight time (25.25 ± 29.96ms; 95% CI: 6.22, 44.28; p < 0.05) and RSI (0.22 ± 0.22; 95% CI: 0.08, 0.36; p < 0.05) were observed. In taped condition, MBI showed very likely beneficial and moderate effect (standardized effect: 0.77 ± 0.49) in flight time, possibly beneficial and small effect (standardized effect: -0.26 ± 0.29) in ground contact time and very likely beneficial and moderate effect (standardized effect: 0.77 ± 0.42) in RSI. No significant difference in CMJ was observed (95% CI: -2.73, 2.08; p > 0.05). For basketball players with pes planus, applying LDT could substantially support the foot by elevating the navicular height and potentially provide acute beneficial effects in reactive strength performance. Meanwhile, no significant harmful effect on CMJ was observed. Basketball players may consider applying LDT before the game or training to enhance the reactive strength performance. However since the observed effects in this study could not generalize to other players without excessive foot pronation, further studies on players with normal foot arch or navicular height are recommended.

Keywords: flight time, pes planus, pronated foot, reactive strength index

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Authors: Andrea Parisi, Samantha Vilkins, Luis Furuya-Kanamori, John A. Crump, Benjamin P. Howden, Darren Gray, Kathryn Glass, Martyn Kirk

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Objectives: Salmonella is a leading cause of foodborne enterocolitis worldwide. Nontyphoidal Salmonella (NTS) infections that are Multi-Drug Resistant (MDR) (non-susceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on health in high-income settings. Methods: We systematically reviewed the literature from scientific databases, including PubMed, Scopus and grey literature sources, using PRISMA guidelines. We searched for data from case-control studies, cohorts, outbreaks, reports and theses, imposing no language restriction. We included only publications from January 1990 to September 2016 from high income countries as classified by World Bank. We extracted data from papers on duration of illness, hospitalisation rates, morbidity and mortality for MDR and non-MDR NTS strains. Results: After removing duplicates, the initial search revealed 4258 articles. After further screening, we identified 16 eligible studies for the systematic review, and 9 of these were included in meta-analysis. NTS serotypes differed among the reported studies but serotype Typhimurium, Enteritidis, Newport and Heidelberg were among the most often reported as MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (OR 1.63; 95%CI 1.18-2.26), excess hospitalisations (OR 2.77; 95%CI 1.47-5.21) and higher mortality (OR 3.54; 95%CI 1.10-11.40). Conclusions: MDR NTS infections are a serious public health concern. With the emergence of MDR Salmonella strains in the high-income countries, it is crucial to restrict the use of antimicrobials both in animals and humans, and intervene to prevent foodborne infections.

Keywords: Antimicrobial Resistance, Bloodstream Infection, Health Outcomes, Hospitalisation, Invasive Disease, Multi-Drug Resistance (MDR), Mortality, Nontyphoidal Salmonella

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Authors: Maedeh Gharazi

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Adults with age 50 and older will include more than 70% of the diabetic populace by the year 2025. More established patients with diabetes are more inclined to have concurrent ceaseless conditions like hypertension, dyslipidemia, and cardiovascular sickness that may affect their nutritious necessities. The issue of achievement and support of an ideal body weight in elderly diabetic persons may not be as direct as in other age gatherings, and the risk-benefit ratio may be diverse too. Albeit expanded predominance of overweight and weight in the elderly adds to insulin resistance and hyperglycemia, more seasoned tenants of long haul care offices who experience the ill effects of diabetes have a tendency to be underweight. Both may mean insufficient nutritional status and lead to expanded grimness and mortality. The attendant problems of appetite changes, palatability of food, dietary restrictions, loneliness, and depression may influence the sort and amount of food devoured by elderly persons. Organized screening devices may recognize nutrition related issues that warrant proof based mediations. Despite the fact that glucose control and health concerns are essential calculates diet change in the more established populace, different contemplations incorporate personal satisfaction and individual inclinations. Redoing of nutritious rules to the needs of the more seasoned diabetic patient bodes well.

Keywords: diabetes, nutritious necessities, insulin resistance, glucose control

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Authors: Pooria Pasbakhsh, Rangika T. De Silva, Vahdat Vahedi, Hanafi Ismail

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The influence of three different types of halloysite nanotubes (HNTs) with different dimensions, namely as camel lake (CLA), Jarrahdale (JA) and Matauri Bay (MB), on their reinforcing ability of ethylene propylene dine monomer (EPDM) were investigated by varying the HNTs loading (from 0-15 phr). Mechanical properties of the nanocomposites improved with addition of all three HNTs, but CLA based nanocomposites exhibited a significant enhancement compared to the other HNTs. For instance, tensile properties of EPDM nanocomposites increased by 120%, 256% and 340% for MB, JA, and CLA, respectively with addition of 15 phr of HNTs. This could be due to the higher aspect ratio and higher surface area of CLA compared to others. Scanning electron microscopy (SEM) of nanocomposites at 15 phr of HNT loadings showed low amounts of pulled-out nanotubes which confirmed the presence of more embedded nanotubes inside the EPDM matrix, as well as aggregates within the fracture surface of EPDM/HNT nanocomposites.

Keywords: aspect ratio, halloysite nanotubes (HNTs), mechanical properties, rubber/clay nanocomposites

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Authors: Md, MCS, MPH Munyangi Wa Nkola Jerome

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The pandemic of COVID-19, a recently discovered contagious respiratory disease called SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus 2 Majority of people infected with SARS-CoV-2: Asymptomatic or mildly ill 14% of patients will develop severe illness requiring hospitalization and oxygen support, and 5% of these will be transferred to an intensive care unit, Urgent need for new treatments that can be used quickly to avoid transfer of patients to intensive care and death. Objective: To evaluate the clinical activity (efficacy) of ArtiCovid Hypothesis: Administration of 3 times a teaspoon per day by COVID patients (symptomatic, mild, or moderate forms) results in the disappearance of symptoms and improvement of biological parameters (including viral suppression). Clinical efficacy: the disappearance of clinical signs after seven days of treatment; reduction in the rate of patients transferred to intensive care units for mechanical ventilation and a decrease in mortality related to this infection Paraclinical efficacy: improvement of biological parameters (mainly d-dimer, CRP) Virological efficacy: suppression of the viral load after seven days of treatment (control test on the seventh day is negative) Pilot study using a standardized solution based on Artemisia annua (ARTICOVID) Obtaining authorization from the health authorities of the province of Central Kongo Recruitment of volunteer patients, mainly in the Kinkanda HospitalCarrying out tests before and after treatment as well as analyses before and after treatment. The protocol obtained the approval of the ethics committee 50 patients who completed the treatment were aged between 2 and 70 years, with an average age of 36 yearsMore half were male (56%). One in four patients was a health professional (25%) Of the 12 health professionals, 4 were physicians. For those who reported the date of onset of the disease, the average duration between the appearance of the first symptoms and the medical consultation was 5 days. The 50 patients put on ARTICOVID were discharged alive with CRP levels substantially normalizedAfter seven to eight days, the control test came back negative. This pilot study suggests that ARTICOVID may be effective against COVID-19 infection.

Keywords: artiCovid, DRC, Covid-19, SARS_COV_2

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Authors: Michel Wakim, Rodrigo Rivera Tinoco

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Supersonic ejector is an economical device that use high pressure vapor to compress a low pressure vapor without any rotating parts or external power sources. Entrainment ratio is a major characteristic of the ejector performance, so the ejector performance is highly dependent on its geometry. The aim of this paper is to design ejector geometry, based on pre-specified operating conditions, and to study the flow behavior inside the ejector by using computational fluid dynamics ‘CFD’ by using ‘ANSYS FLUENT 15.0’ software. In the first section; 1-D mathematical model is carried out to predict the ejector geometry. The second part describes the flow behavior inside the designed model. CFD is the most reliable tool to reveal the mixing process at different parts of the supersonic turbulent flow and to study the effect of the geometry on the effective ejector area. Finally, the results show the effect of the geometry on the entrainment ratio.

Keywords: computational fluids dynamics, ejector, entrainment ratio, geometry optimization, performance

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Authors: Mahmoud M. Tash

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The present study was carried out to investigate the effect of alloying elements and thermo-mechanical treatment (TMT) i.e. hot rolling and forging with different reduction ratios on the hardness (HV) and impact toughness (J) of heat-treated low alloy steels. An understanding of the combined effect of TMT and alloying elements and by measuring hardness, impact toughness, resulting from different heat treatment following TMT of the low alloy steels, it is possible to determine which conditions yielded optimum mechanical properties and high strength to weight ratio. Experimental Correlations between hot work reduction ratio, hardness and impact toughness for thermo-mechanically heat treated low alloy steels are analyzed quantitatively, and both regression and mathematical hardness and impact toughness models are developed.

Keywords: hot forging, hot rolling, heat treatment, hardness (HV), impact toughness (J), microstructure, low alloy steels

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Authors: F. Gökgöz, M. E. Atmaca

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Electricity plays an indispensable role in human life and the economy. It is a unique product or service that must be balanced instantaneously, as electricity is not stored, generation and consumption should be proportional. Effective and efficient use of electricity is very important not only for society, but also for the environment. A competitive electricity market is one of the best ways to provide a suitable platform for effective and efficient use of electricity. On the other hand, it carries some risks that should be carefully managed by the market players. Risk management is an essential part in market players’ decision making. In this paper, risk management through diversification is applied with the help of Markowitz’s Mean-variance, Down-side and Semi-variance methods for a case study. Performance of optimal electricity sale solutions are measured and evaluated via Sharpe-Ratio, and the optimal portfolio solutions are improved. Two years of historical weekdays’ price data of the Turkish Day Ahead Market are used to demonstrate the approach.

Keywords: electricity market, portfolio optimization, risk management in electricity market, sharpe ratio

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Authors: Inayatullah Khan, Afzal Khan, Hamzullah Khan, Afzal Khan

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Objectives: The objective of this study was to compare different statistical variables for vaccinated and unvaccinated children in measles cases. Material and Methods: This cross sectional comparative study was conducted at Isolation ward, Department of Paediatrics, Lady Reading Hospital (LRH), Peshawar, from April 2012 to March 2013. A total of 566 admitted cases of measles were enrolled. Data regarding age, sex, address, vaccination status, measles contact, hospital stay and outcome was collected and recorded on a proforma. History of measles vaccination was ascertained either by checking the vaccination cards or on parental recall. Result: In 566 cases of measles, 211(39%) were vaccinated and 345 (61%) were unvaccinated. Three hundred and ten (54.80%) patients were males and 256 (45.20%) were females with a male to female ratio of 1.2:1.The age range was from 1 year to 14 years with mean age with SD of 3.2 +2 years. Majority (371, 65.5%) of the patients were 1-3 years old. Mean hospital stay was 3.08 days with a range of 1-10 days and a standard deviation of ± 1.15. History of measles contact was present in 393 (69.4%) cases. Fourty eight patients were expired with a mortality rate of 8.5%. Conclusion: Majority of the children in Khyber Pukhtunkhwa are unvaccinated and unprotected against measles. Among vaccinated children, 39% of children attracted measles which indicate measles vaccine failure. This figure is clearly higher than that accepted for measles vaccine (2-10%).

Keywords: measles, vaccination, immunity, population

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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Authors: Barenten Suciu, Yoshiki Tsuji

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In this paper, a theoretical investigation on the dynamic characteristics of one degree of freedom vibration system equipped with inerter of variable inertance, is presented. Differential equation of movement was solved under proper initial conditions in the case of free undamped/damped vibration, considered in the absence/presence of the inerter in the mechanical system. Influence of inertance on the amplitude of vibration, phase angle, natural frequency, damping ratio, and logarithmic decrement was clarified. It was mainly found that the inerter decreases the natural frequency of the undamped system and also of the damped system if the damping ratio is below 0.707. On the other hand, the inerter increases the natural frequency of the damped system if the damping ratio exceeds 0.707. Results obtained in this work are useful for the adequate design of inerters.

Keywords: damping, frequency control, inerter, one degree of freedom vibration system, parallel connection, variable inertance

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Authors: L. Al-Mulla, B. M. Thomas, N. R. Bhat, M. K. Suleiman, P. George

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Mangroves are halophytic shrubs habituated in the intertidal zones in the tropics and subtropics, forming a complex and highly dynamic coastal ecosystem. Historical evidence indicating the existence followed by the extinction of mangrove in Kuwait; hence, continuous projects have been established to reintroduce this plant to the marine ecosystem. One of the major challenges in establishing large-scale mangrove plantations in Kuwait is the very high rate of seedling mortality, which should ideally be less than 20%. This study was conducted at three selected locations in the Kuwait bay during 2016-2017, to evaluate the effect of four planting techniques on mangrove seedling establishment. Coir-pillow planting technique, comp-mat planting technique, and anchored container planting technique were compared with the conventional planting method. The study revealed that the planting techniques significantly affected the establishment of mangrove seedlings in the initial stages of growth. Location-specific difference in seedling establishment was also observed during the course of the study. However, irrespective of the planting techniques employed, high seedling mortality was observed in all the planting locations towards the end of the study; which may be attributed to the physicochemical characteristics of the mudflats selected.

Keywords: Avicennia marina (Forsk.) Vierh, coastal pollution, heavy metal accumulation, marine ecosystem, sedimentation, tidal inundation

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Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla

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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.

Keywords: AKI, dialysis, hypertension, sepsis, renal parameters

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Authors: Zhang Haiyan, Su Zujun, Zhao Fengqi

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Lepidolite after extraction of Lithium by sulfate produced many jarosite slag which contains a lot of Rb and Cs.The separation and recovery of Rubidium(Rb) and Cesium(Cs) can make full of use of Lithium mica. XRF analysis showed that the slag mainly including K Rb Cs Al and etc. Fractional solvent extraction tests were carried out; the results show that using20% t-BAMBP plus 80% sulfonated kerosene, the separation of Rb and Cs can be achieved by adjusting the alkalinity. Extraction is the order of Cs Rb, ratio of Cs to Rb and ratio of Rb to K can reach above 1500 and 2500 respectively.

Keywords: cesium, jarosite slag, rubidium, solvent extraction, t-BAMBP

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Authors: Dewan Ahsan

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Denmark is well ahead in generating electricity from renewable sources. The offshore wind sector is playing the pivotal role to achieve this target. Though there is a rapid growth of offshore wind sector in Denmark, still there is a dearth of synchronization in OHS (occupational health and safety) regulation and standards. Therefore, this paper attempts to ascertain: i) what are the major challenges of the company specific OHS standards? ii) why does the offshore wind industry need a standardized OHS management system? and iii) who can play the key role in this process? To achieve these objectives, this research applies the interview and survey techniques. This study has identified several key challenges in OHS management system which are; gaps in coordination and communication among the stakeholders, gaps in incident reporting systems, absence of a harmonized OHS standard and blame culture. Furthermore, this research has identified eleven key stakeholders who are actively involve with the offshore wind business in Denmark. As noticed, the relationships among these stakeholders are very complex specially between operators and sub-contractors. The respondent technicians are concerned with the compliance of various third-party OHS standards (e.g. ISO 31000, ISO 29400, Good practice guidelines by G+) which are applying by various offshore companies. On top of these standards, operators also impose their own OHS standards. From the technicians point of angle, many of these standards are not even specific for the offshore wind sector. So, it is a big challenge for the technicians and sub-contractors to comply with different company specific standards which also elevate the price of their services offer to the operators. For instance, when a sub-contractor is competing for a bidding, it must fulfill a number of OHS requirements (which demands many extra documantions) set by the individual operator and/the turbine supplier. According to sub-contractors’ point of view these extra works consume too much time to prepare the bidding documents and they also need to train their employees to pass the specific OHS certification courses to accomplish the demand for individual clients and individual project. The sub-contractors argued that in many cases these extra documentations and OHS certificates are inessential to ensure the quality service. So, a standardized OHS management procedure (which could be applicable for all the clients) can easily solve this problem. In conclusion, this study highlights that i) development of a harmonized OHS standard applicable for all the operators and turbine suppliers, ii) encouragement of technicians’ active participation in the OHS management, iii) development of a good safety leadership, and, iv) sharing of experiences among the stakeholders (specially operators-operators-sub contractors) are the most vital strategies to overcome the existing challenges and to achieve the goal of 'zero accident/harm' in the offshore wind industry.

Keywords: green energy, offshore, safety, Denmark

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Authors: Hyuk-Hoon Kim, Young Gi Min

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Background: Acute poisoning is the common cause of morbidity and mortality. Characteristics of acute poisoning differ between countries. While other countries operate the database system for poisoning, Korea has not collected the database for acute poisoning. Distribution of incidence of acute poisoning depending on the types of materials have also not studied in Korea. Our aims are to evaluate the etiologic and demographic characteristics of acute poisoning cases and to obtain up-to-date information on acute poisonings. Method: We retrospectively recorded cases of acute poisoning from eight emergency departments of second level or university hospitals from different cities in Gyeonggi province in Korea from April 2006 and March 2015. The distributions of incidence of acute poisoning depending on the types of materials are mapped by geographic information system. Result: A total of 3,449 poisoned cases were analyzed. Mean estimated age of patients was 39.56 ± 22.40 years. Mean male to female ratio of patients was 1:1.4. Mean proportion of intentional poisoning was 57.9%. Common materials are benzodiazepine (16.6%), carbon monoxide (10.5%), pesticide (8.1%) and zolpidem (7.1%) Common route of exposure is ingestion (79.5%) and followed by inhalation (16.5%). Common treatment methods are gastric lavage (20%) and activated charcoal (30%). Most cases had uneventful recovery; 61.4% were treated as outpatients and 0.1% of the poisoning resulted in death in ER. Conclusion: Even though the cases enrolled in our study is not the overall cases of acute poisoning in Korea, our study could be the basis of countermeasures for analysis and prevention of acute poisoning in Korea.

Keywords: acute poisoning, emergency department, epidemiology, Korea

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