Search results for: measures for improvement

Authors: Hamida Memon, Muhammad Sanan

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A 34-year-old male with no prior health issues presented with a wound in his left leg exhibiting active pus discharge, intense inflammation, pain radiating from the buttocks to the knee, foot drop, and skin darkening. Four years prior, he sustained an untreated dislocation of the hip joint and acetabulum from a road traffic accident. Initial nerve conduction studies (NCS) and electromyography (EMG) revealed severe axonotomesis of the left sciatic nerve and reduced compound muscle action potential in the left common peroneal nerve. Despite normal venous flow, edema and cellulitis were noted. Follow-up NCS/EMG in 2022 showed improvement, but in 2023, the patient experienced recurrent infection and underwent surgical intervention with tissue culture. Postoperative care included antibiotics and pain management. NCS/EMG in 2024 indicated decreased nerve amplitudes and conduction velocities, consistent with moderate axonotmesis and ongoing recovery, alongside incidental right S1 radiculopathy. General lab tests and abdominal imaging were normal. The patient was treated with Pregabalin and Neurobion for neuropathic pain and nerve support and is currently under observation by a tertiary sector hospital for treatment. This case underscores the critical importance of prompt treatment for hip dislocations to prevent long-term complications such as neuropathy and avascular necrosis. Delays in treatment significantly increase the risk of severe outcomes, highlighting the need for timely intervention. Overall, the case illustrates the challenges of managing complex nerve injuries and the importance of comprehensive care for optimal recovery.

Keywords: sciatic nerve neuropathy, hip dislocation, acetabular fracture, radiculopathy

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Authors: Charles Chikwendu Okpala, Christopher Chukwutoo Ihueze

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As a technique that reduces variation in a product by lessening the sensitivity of the design to sources of variation, rather than by controlling their sources, Taguchi Robust Design entails the designing of ideal goods, by developing a product that has minimal variance in its characteristics and also meets the desired exact performance. This paper examined the concept of the manufacturing approach and its application to brake pad product of an automotive parts manufacturing company. Although the firm claimed that only defects, excess inventory, and over-production were the few wastes that grossly affect their productivity and profitability, a careful study and analysis of their manufacturing processes with the application of Single Minute Exchange of Dies (SMED) tool showed that the waste of waiting is the fourth waste that bedevils the firm. The selection of the Taguchi L9 orthogonal array which is based on the four parameters and the three levels of variation for each parameter revealed that with a range of 2.17, that waiting is the major waste that the company must reduce in order to continue to be viable. Also, to enhance the company’s throughput and profitability, the wastes of over-production, excess inventory, and defects with ranges of 2.01, 1.46, and 0.82, ranking second, third, and fourth respectively must also be reduced to the barest minimum. After proposing -33.84 as the highest optimum Signal-to-Noise ratio to be maintained for the waste of waiting, the paper advocated for the adoption of all the tools and techniques of Lean Production System (LPS), and Continuous Improvement (CI), and concluded by recommending SMED in order to drastically reduce set up time which leads to unnecessary waiting.

Keywords: lean production system, single minute exchange of dies, signal to noise ratio, Taguchi robust design, waste

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Authors: A. Hira Masood, B. Umer Hameed, C. Ezza Nasir

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Contemporary studies support the strong co-relation between psychology and design. This study elaborates how different psychological personality test can help a fashion designer to judge the needs of their clients with respect to have products which will satisfy the client's request concerning costumised clothing. This study will also help the designer to improve the lacking in the personality and will enable him to put his effort in required areas for grooming the customer, control and direct organization regarding quality maintenance. The use of psychology test to support the choice of certain design strategies that how the right clothing can make client a better intellectual with enhanced self-esteem and confidence. Different projective personality test are being used to suggest to evaluate personality traits. The Rorschach Inkblot Test is projective mental comprising of 10 ink-blots synonymous with the clinical brain research. Lüsher Color Diagnostics measures a person’s psycho physical state, his or her ability to withstand stress to perform and communicate. HTP is a projective responsibility test measuring self-perception, attitudes. The TAT test intend to evaluate a person’s patterns of thoughts, attitudes, observation, capacity and emotional response to this ambiguous test materials. No doubt designers are already crucially redesigning the individuals by their attires, but to expose the behavioral mechanism of the customer, designers should be able to recognize the hidden complexity behind his client by using the above mentioned methods. The study positively finds the design and psychology need to become substantially contacted in order to create a new regime of norms to groom a personality under the concentration and services of a fashion designer in terms of clothing, This interactive activity altimately upgrade design team to help customers to find the suited way to satisfy their needs and wishes, offer client relible relationship and quality management services, and to become more disereable.

Keywords: projective personality tests, customized clothing, Rorschach Inkblot test, TAT, HTP, Lüsher color diagnostics, quality management services

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Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma

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Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p＜0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.

Keywords: resilience, clinical learning environment, career adaptability, nursing interns

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Authors: Mergim Gasia, Bojan Milovanovica, Sanjin Gumbarevic

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Better energy performance of the building envelope is one of the most important aspects of energy savings if the goals set by the European Union are to be achieved in the future. Dynamic heat transfer simulations are being used for the calculation of building energy consumption because they give more realistic energy demands compared to the stationary calculations that do not take the building’s thermal mass into account. Software used for these dynamic simulation use methods that are based on the analytical models since numerical models are insufficient for longer periods. The analytical models used in this research fall in the category of the conduction transfer functions (CTFs). Two methods for calculating the CTFs covered by this research are the Laplace method and the State-Space method. The literature review showed that the main disadvantage of these methods is that they are inadequate for heavyweight façade elements and shorter time periods used for the calculation. The algorithms for both the Laplace and State-Space methods are implemented in Mathematica, and the results are compared to the results from EnergyPlus and TRNSYS since these software use similar algorithms for the calculation of the building’s energy demand. This research aims to check the efficiency of the Laplace and the State-Space method for calculating the building’s energy demand for heavyweight building elements and shorter sampling time, and it also gives the means for the improvement of the algorithms used by these methods. As the reference point for the boundary heat flux density, the finite difference method (FDM) is used. Even though the dynamic heat transfer simulations are superior to the calculation based on the stationary boundary conditions, they have their limitations and will give unsatisfactory results if not properly used.

Keywords: Laplace method, state-space method, conduction transfer functions, finite difference method

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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Authors: Biraj Puri, Bikram Puri

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Arbitration is one of the prompt and efficient methods of alternative dispute resolution, especially of a commercial nature, by a neutral arbitrator outside the formal court structure. Due to the globalization of trade, privatization, and global investment, recognition and enforcement of foreign arbitral awards attract prime concern. Arbitral awards are generally based on arguments and evidence presented by disputing parties. The foreign investor wants to secure the investment by appropriate legal measures and an amicable way of dispute settlement if it arises. Now, arbitration as a mechanism of commercial dispute settlement has gained international recognition. It can take place in any State, in any language and with arbitrators of any nationality. There are various international institutions to conduct arbitral proceedings and render awards. Once an arbitral award is delivered, it can be enforced as a court judgment. However, it is really challenging to execute foreign arbitral awards in Nepal. Any party willing to execute an award made in a foreign country in Nepal should submit an application to the High Court along with essential documents prescribed by domestic law (The Arbitration Act 1999). Arbitrarily and public policy are also the requirements regarding the recognition and enforcement of foreign arbitral awards in Nepal. Nepal is a signatory State to the New York Convention on Recognition and Enforcement of Foreign Arbitral Awards, 1958. It is crucial to acknowledge that Nepal has liberalized its economy as well as opened the door for a liberal and market-oriented economy through the Constitution of Nepal, 2015. Nepal is trying to expand business from local to global level. Commercial trade is expanding day by day. So in this context, acceptance of arbitration as an alternative means to solve commercial disputes is a matter of prime importance. India ratified the New York Convention, and also being a neighborhood country of Nepal, in practice, does not enforce arbitral awards provided by Nepal in the name of reservation. India has published a gazette notice in which it lists the countries in which the award will be recognized in India, but it does not include Nepal. As the largest trade partner of Nepal, India should rethink this in order to make trade smooth.

Keywords: commercial arbitration, foreign arbitral awards, recognition and enforcement of foreign arbitral awards, requirements

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Authors: Protima Chakraborty

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The sustainability of conventional agriculture in Bangladesh is under threat from the continuous degradation of land and water resources, and from declining yields due to indiscriminate use of agrochemicals. NASL (Northern Agro Services Limited) is pursuing efforts to promote ecological agriculture with emphasis on better use of organic fertilizer resources and the reduction of external inputs. This paper examines the sustainability of two production systems in terms of their environmental soundness, economic viability and social acceptability based on empirical data collected through making demonstration land cultivation, a household survey, soil sample analysis, observations and discussions with key informants. Twelve indicators were selected to evaluate sustainability. Significant differences were found between the two systems in crop diversification, soil fertility management, pests and diseases management, and use of agrochemicals & Organic Compost. However, significant variations were found in other indicators such as land-use pattern, crop yield and stability, risk and uncertainties, and food security. Although crop yield and financial return were found to be slightly higher in the ecological system, the economic return and value addition per unit of land show the positive difference of using compost rather than chemical fertilizer. The findings suggest that ecological agriculture has a tendency towards becoming ecologically, economically and socially more sound than conventional agriculture, as it requires considerably fewer agro-chemicals, adds more organic matter to the soil, provides balanced food, and requires higher local inputs without markedly compromising output and financial benefits. Broad-policy measures, including the creation of mass awareness of adverse health effects of agrochemical-based products, are outlined for the promotion of ecological agriculture.

Keywords: Bangladesh, compost, conventional agriculture, organic fertilizer, environmental sustainability, economic viability, social acceptability

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Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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Authors: Naylya Djumaeva

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Since the end of 2019, the world has been shaken by an infection that has claimed the lives of more than six and a half million patients. Currently, SARS-CoV-2 not only causes acute damage but has long-term consequences affecting every organ and has brought a wave of a new chronic disabling condition called Long-Covid..This preliminary study describes an application of un-explored properties of low-level laser radiation with laser- light emitter in the field of which is placed Copegus (Ribavirin) with the aim of treatment of patients with Long-Covid syndrome. The difference from the traditional use of the drug is that Copegus was not prescribed to the patient by the traditional method - orally or intravenously, and the medicinal properties of the drug were introduced into the patient’s body using the un-explored properties of low-power laser radiation. Ninety eight patients with Long- Covid syndrome were observed. The obtained findings suggest that under the influence of the field formed into the laser- light emitter with a Copegus placed inside the field, the remote transfer of pharmacological properties of Сopegus occurs. Conclusions about the produced effect of exposure were made based on improvement in the condition of patients, the disappearance of complaints, and positive changes in various diagnostic tests performed by the patients. Biography: Djumaeva N completed her PhD from the Institute of Epidemiology, Microbiology and Infectious Diseases in 2000. In her dissertation work devoted to the treatment of patients with chronic hepatitis B virus infection, she presented data on the possible influence of Complex Homeopathic Preparations on the organization of bound intracellular water in the cells of the body. She is the Consultant (Neurologist) at the Scientific-Research Institute for Virology, Uzbekistan, and an expert in “medicament testing” method (30 years). She has published 43 papers, including 2 patents.

Keywords: long covid, low level laser, copegus, laser- light emmiter

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Authors: Manmeet Kaur, Madhu Vij

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The Board of Directors in a firm performs the primary role of an internal control mechanism. This Study seeks to understand the relationship between internal governance and performance of banks in India. The research paper investigates the effect of board structure (proportion of nonexecutive directors, gender diversity, board size and meetings per year) on the firm performance. This paper evaluates the impact of corporate governance mechanisms on bank’s financial performance using panel data for 28 listed banks in National Stock Exchange of India for the period of 2008-2014. Returns on Asset, Return on Equity, Tobin’s Q and Net Interest Margin were used as the financial performance indicators. To estimate the relationship among governance and bank performance initially the Study uses Pooled Ordinary Least Square (OLS) Estimation and Generalized Least Square (GLS) Estimation. Then a well-developed panel Generalized Method of Moments (GMM) Estimator is developed to investigate the dynamic nature of performance and governance relationship. The Study empirically confirms that two-step system GMM approach controls the problem of unobserved heterogeneity and endogeneity as compared to the OLS and GLS approach. The result suggests that banks with small board, boards with female members, and boards that meet more frequently tend to be more efficient and subsequently have a positive impact on performance of banks. The study offers insights to policy makers interested in enhancing the quality of governance of banks in India. Also, the findings suggest that board structure plays a vital role in the improvement of corporate governance mechanism for financial institutions. There is a need to have efficient boards in banks to improve the overall health of the financial institutions and the economic development of the country.

Keywords: board of directors, corporate governance, GMM estimation, Indian banking

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Authors: Michael Sinclair, Andrea Ghermandi, Sheela A. Moses, Joseph Sabu

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Passively crowdsourced data, such as geotagged photographs from social media, represent an opportunistic source of location-based and time-specific behavioral data for ecosystem services analysis. Such data have innovative applications for environmental management and protection, which are replicable at wide spatial scales and in the context of both developed and developing countries. Here we test one such innovation, based on the analysis of the metadata of online geotagged photographs, to investigate the provision of recreational services by the entire network of wetland ecosystems in the state of Kerala, India. We estimate visitation to individual wetlands state-wide and extend, for the first time to a developing region, the emerging application of cultural ecosystem services modelling using data from social media. The impacts of restoration of wetland areal extension and water quality improvement are explored as a means to inform more sustainable management strategies. Findings show that improving water quality to a level suitable for the preservation of wildlife and fisheries could increase annual visits by 350,000, an increase of 13% in wetland visits state-wide, while restoring previously encroached wetland area could result in a 7% increase in annual visits, corresponding to 49,000 visitors, in the Ashtamudi and Vembanad lakes alone, two large coastal Ramsar wetlands in Kerala. We discuss how passive crowdsourcing of social media data has the potential to improve current ecosystem service analyses and environmental management practices also in the context of developing countries.

Keywords: coastal wetlands, cultural ecosystem services, India, passive crowdsourcing, social media, wetland restoration

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Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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Authors: Nurcihan Kiris

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Restricted sleep is common in young adults and adolescents. The results of a few objective studies of sleep deprivation on cognitive performance were not clarified. In particular, the effect of sleep deprivation on the cognitive functions associated with frontal lobe such as attention, executive functions, working memory is not well known. The aim of this study is to investigate the effect of partial sleep deprivation experimentally in adolescents on the cognitive tasks of frontal lobe including working memory, strategic thinking, simple attention, continuous attention, executive functions, and cognitive flexibility. Subjects of the study were recruited from voluntary students of Cukurova University. Eighteen adolescents underwent four consecutive nights of monitored sleep restriction (6–6.5 hr/night) and four nights of sleep extension (10–10.5 hr/night), in counterbalanced order, and separated by a washout period. Following each sleep period, cognitive performance was assessed, at a fixed morning time, using a computerized neuropsychological battery based on frontal lobe functions task, a timed test providing both accuracy and reaction time outcome measures. Only the spatial working memory performance of cognitive tasks was found to be statistically lower in a restricted sleep condition than the extended sleep condition. On the other hand, there was no significant difference in the performance of cognitive tasks evaluating simple attention, constant attention, executive functions, and cognitive flexibility. It is thought that especially the spatial working memory and strategic thinking skills of adolescents may be susceptible to sleep deprivation. On the other hand, adolescents are predicted to be optimally successful in ideal sleep conditions, especially in the circumstances requiring for the short term storage of visual information, processing of stored information, and strategic thinking. The findings of this study may also be associated with possible negative functional effects on the processing of academic social and emotional inputs in adolescents for partial sleep deprivation. Acknowledgment: This research was supported by Cukurova University Scientific Research Projects Unit.

Keywords: attention, cognitive functions, sleep deprivation, working memory

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Authors: A. Sohouli, A. Suleman

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This study focuses on reliability analysis of variable stiffness composite laminate structures to investigate the potential structural improvement compared to conventional (straight fibers) composite laminate structures. A computational framework was developed which it consists of a deterministic design step and reliability analysis. The optimization part is Discrete Material Optimization (DMO) and the reliability of the structure is computed by Monte Carlo Simulation (MCS) after using Stochastic Response Surface Method (SRSM). The design driver in deterministic optimization is the maximum stiffness, while optimization method concerns certain manufacturing constraints to attain industrial relevance. These manufacturing constraints are the change of orientation between adjacent patches cannot be too large and the maximum number of successive plies of a particular fiber orientation should not be too high. Variable stiffness composites may be manufactured by Automated Fiber Machines (AFP) which provides consistent quality with good production rates. However, laps and gaps are the most important challenges to steer fibers that effect on the performance of the structures. In this study, the optimal curved fiber paths at each layer of composites are designed in the first step by DMO, and then the reliability analysis is applied to investigate the sensitivity of the structure with different standard deviations compared to the straight fiber angle composites. The random variables are material properties and loads on the structures. The results show that the variable stiffness composite laminate structures are much more reliable, even for high standard deviation of material properties, than the conventional composite laminate structures. The reason is that the variable stiffness composite laminates allow tailoring stiffness and provide the possibility of adjusting stress and strain distribution favorably in the structures.

Keywords: material optimization, Monte Carlo simulation, reliability analysis, response surface method, variable stiffness composite structures

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Authors: Ayesha Siddiqua

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Background: Hypertension is a silent killer disease and a common risk factor for considerable morbidity and mortality. Its effects can be seen on the organs like Heart; Brain; Kidneys. In Saudi Arabia, hypertension affects a sizeable enough proportion of the population, with a prevalence of 27.9% in urban and 22.4 in rural population. Despite these features, the magnitude and epidemiological characteristics of this disease have been rarely studied in Saudi Arabia. To fill this gap, we conducted a survey in Abha to study the KAP of hypertension. KAP study shows what people know about certain things, their feelings and behavior towards the disease management. An improvement in the Knowledge and Attitudes towards disease management can reform the kinds of practices which are followed. Objectives: To assess the level of Knowledge, Attitude and Practice of patients who suffer from Hypertension. To improve the Quality of life of patients. Methods: A prospective cross-sectional survey was conducted on a sample size of 130 Hypertensive patients of both the genders enrolled by simple random sampling technique admitted in the Aseer Central Hospital of Abha during the period from October 2016 to December 2016. Results: Altogether 130 hypertensive patients were enrolled in this study with equal no. of Males and Females. Most of the respondents were aged between 18-40 years (45%). On assessing the KAP of the patients, we found that the Knowledge and Attitude score was good but the Practice scores were moderate in both the genders. Conclusion: Our study concludes that a significant proportion of hypertensive patients show less Practice towards the disease management which can lead to severe complications in time being and also result in damage of other vital organs. So there is a need of intense educational intervention for the patients which can be done by Patient counselling by the clinical pharmacist. Strategies to modify lifestyle which help in control of hypertension can include providing leaflets as well as direct educational programs.

Keywords: Attitude, hypertension, Knowledge, practices

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Authors: Ganesh R. Bhand, N. B. Chaure

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Cadmium selenide (CdSe) quantum dots (QDs) were prepared by solvothermal route. Subsequently a inorganic QDs-organic semiconductor (copper phthalocyanine) nanocomposite (i.e CuPc:CdSe nanocomposites) were produced by different concentration of QDs varied in CuPc. The nanocomposite thin films have been prepared by means of spin coating technique. The optical, structural and morphological properties of nanocomposite films have been investigated. The transmission electron microscopy (TEM) confirmed the formation of QDs having average size of  4 nm. The X-ray diffraction pattern exhibits cubic crystal structure of CdSe with reflection to (111), (220) and (311) at 25.4ᵒ, 42.2ᵒ and 49.6ᵒ respectively. The additional peak observed at lower angle at 6.9ᵒ in nanocomposite thin films are associated to CuPc. The field emission scanning electron microscopy (FESEM) observed that surface morphology varied in increasing concentration of CdSe QDs. The obtained nanocomposite show significant improvement in the thermal stability as compared to the pure CuPc indicated by thermo-gravimetric analysis (TGA) in thermograph. The effect in the Raman spectra of composites samples gives a confirm evidence of homogenous dispersion of CdSe in the CuPc matrix and their strong interaction between them to promotes charge transfer property. The success of reaction between composite was confirmed by Fourier transform infrared spectroscopy (FTIR). The photo physical properties were studied using UV - visible spectroscopy. The enhancement of the optical absorption in visible region for nanocomposite layer was observed with increasing the concentration of CdSe in CuPc. This composite may obtain the maximized interface between QDs and polymer for efficient charge separation and enhance the charge transport. Such nanocomposite films for potential application in fabrication of hybrid solar cell with improved power conversion efficiency.

Keywords: CdSe QDs, cupper phthalocyanine, FTIR, optical absorption

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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: Guo Rui, Cao Xinhu

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In recent decades, the world has endured severe challenges in light of climate change, epidemics, geopolitics, terrorism, economic uncertainties, as well as regional conflicts and rivalries. The appropriate use of critical infrastructures (Cis) is confronted. Ports, as typical Cis cover more than 80% of the global freight movement. Within this context, even the minimal disruption of port operations could cause malfunction of the holistic supply chain network and substantial economic losses. Hence, it is crucial to evaluate port performance from the perspective of resilience. Research on resilience and risk/safety management has been increasing, however, it needs more attention, as it could prevent potential socio-economic losses and inspire decision-makers to make resilience-based decisions to answer the challenges, such as COVID-19. To facilitate better moves from decision-makers, ports need to identify proper factors influencing port resilience. Inappropriately influenced factor selection could have a cascading effect on undesirable port performances. Thus, a systematic evaluation of factors is essential to stimulate the improvement process of port resilience investigation. This study zooms into container ports considering their critical role in international trade and global supply chains. 440 articles are selected after relevance ranking, and consequently, 62 articles are scrutinized after the title and abstract screening. Forty-one articles are included for bibliographic analysis in the end. It is found that there is no standardized index system to measure port resilience. And most studies evaluate port resilience merely in the recovery phase. Only two articles cover absorption, adaption and recovery state. However, no literature involves the prevention state. Hence, a uniform resilience index system is expected with a clear resilience definition. And port safety and security should also be considered while evaluating port resilience.

Keywords: port resilience, port safety and security, literature review, index system, port performance

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Authors: Jaime Pizarro, Ximena Castillo

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The intensive use of water in agriculture, industry, human consumption and increasing pollution are factors that reduce the availability of water for future generations; the challenge is to advance in sustainable and low-cost solutions to reuse water and to facilitate the availability of the resource in quality and quantity. The use of new low-cost materials with sorbent capacity for pollutants is a solution that contributes to the improvement and expansion of water treatment and reuse systems. Fly ash, a residue from the combustion of coal in power plants that is produced in large quantities in newly industrialized countries, contains a high amount of silicon oxides and aluminum oxides, whose properties can be used for the synthesis of mesoporous materials. Properly functionalized, this material allows obtaining matrixes with high sorption capacity. The mesoporous materials have a large surface area, thermal and mechanical stability, uniform porous structure, and high sorption and functionalization capacities. The goal of this study was to develop hexagonal mesoporous siliceous material (HMS) for the adsorption of sulphate from industrial and mining waters. The silica was extracted from fly ash after calcination at 850 ° C, followed by the addition of water. The mesoporous structure has a surface area of 282 m2 g-1 and a size of 5.7 nm and was functionalized with ethylene diamine through of a self-assembly method. The material was characterized by Diffuse Reflectance Infrared Fourier Transform Spectroscopy (DRIFTS). The capacity of sulphate sorption was evaluated according to pH, maximum load capacity and contact time. The sulphate maximum adsorption capacity was 146.1 mg g-1, which is three times higher than commercial sorbents. The kinetic data were fitted according to a pseudo-second order model with a high coefficient of linear regression at different initial concentrations. The adsorption isotherm that best fitted the experimental data was the Freundlich model.

Keywords: fly ash, mesoporous siliceous, sorption, sulphate

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Authors: Stephanie Ducrot, Marie Vernet, Eve Meiss, Yves Chaix

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Learning to read is a key topic of debate today, both in terms of its implications on school failure and illiteracy and regarding what are the best teaching methods to develop. It is estimated today that four to six percent of school-age children suffer from specific developmental disorders that impair learning. The findings from people with dyslexia and typically developing readers suggest that the problems children experience in learning to read are related to the preliteracy skills that they bring with them from kindergarten. Most tools available to professionals are designed for the evaluation of child language problems. In comparison, there are very few tools for assessing the relations between visual skills and the process of learning to read. Recent literature reports that visual-motor skills and visual-spatial attention in preschoolers are important predictors of reading development — the main goal of this study aimed at improving screening for future reading difficulties in preschool children. We used a prospective, longitudinal approach where oculomotor processes (assessed with the DiagLECT test) were measured in pre-readers, and the impact of these skills on future reading development was explored. The dialect test specifically measures the online time taken to name numbers arranged irregularly in horizontal rows (horizontal time, HT), and the time taken to name numbers arranged in vertical columns (vertical time, VT). A total of 131 preschoolers took part in this study. At Time 0 (kindergarten), the mean VT, HT, errors were recorded. One year later, at Time 1, the reading level of the same children was evaluated. Firstly, this study allowed us to provide normative data for a standardized evaluation of the oculomotor skills in 5- and 6-year-old children. The data also revealed that 25% of our sample of preschoolers showed oculomotor impairments (without any clinical complaints). Finally, the results of this study assessed the validity of the DiagLECT test for predicting reading outcomes; the better a child's oculomotor skills are, the better his/her reading abilities will be.

Keywords: vision, attention, oculomotor processes, reading, preschoolers

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Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio

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Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.

Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression

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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: Alokananda Nath

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Land is an important issue anywhere in the world as it is one of the fundamental elements in human settlements. Since the urban areas are considered to be the drivers of economy for any country across the world and the phenomenon of ‘urbanization’ happening everywhere, there is always a greater pressure on urban land and its management. Many states in India have realized the importance of land as a valuable resource and have implemented certain framework for managing and developing land. But in West Bengal no such statutory framework has been formulated till now and a very out dated model of land acquisition for public purpose is practiced. Due to the lop-sided character of urban growth in the entire eastern region of India, the city of Kolkata continues to bear the burden of excessive growth of population and consequent urbanization of the adjoining areas at a rapid pace. This research tries to look into these conflicts with respect to the present pattern of development in the context of Kolkata and suggest a system for land management in order to implement the planning processes. For this purpose, five case study areas were taken up within the Kolkata Metropolitan Area and subsequent analysis of their present land management and development techniques was done. The findings reveal that there is a lack of political will as well as administrative inefficiency on part of both the development authority and the local bodies. Mostly the local bodies lack the financial resources and technical expertise to work out any kind of land management framework or work out any kind of model in order to manage the development that is happening. All these place undue strain on city infrastructure systems and reduce the potential of cities to contribute as engines of economic growth. The focus of reforms, therefore, ought to be on streamlining the urban planning process, judicious and optimal land use, efficient plan implementation mechanisms, improvement of titling and registration processes.

Keywords: urbanization, land management framework, land development, policy reforms, land-use planning processes

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Authors: Riaz A. Agha, Alexander J. Fowler, Seon-Young Lee, Buket Gundogan, Katharine Whitehurst, Harkiran K. Sagoo, Kyung Jin Lee Jeong, Douglas G. Altman, Dennis P. Orgill

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Introduction: Case Series are an important and common study type. Currently, no guideline exists for reporting case series and there is evidence of key data being missed from such reports. We propose to develop a reporting guideline for case series using a methodologically robust technique. The first step in this process is a systematic review of literature relevant to the reporting deficiencies of case series. Methods: A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, EMBASE, Cochrane Methods Register, Science Citation index and Conference Proceedings Citation index, from the start of indexing until 5th November 2014. Independent screening, eligibility assessments and data extraction was performed. Included articles were analyzed for five areas of deficiency: failure to use standardized definitions missing or selective data transparency or incomplete reporting whether alternate study designs were considered. Results: The database searching identified 2,205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequency of methodological and reporting issues identified was a failure to use standardized definitions (57%), missing or selective data (66%), transparency, or incomplete reporting (70%), whether alternate study designs were considered (11%) and other issues (52%). Conclusion: The methodological and reporting quality of surgical case series needs improvement. Our data shows that clear evidence-based guidelines for the conduct and reporting of a case series may be useful to those planning or conducting them.

Keywords: case series, reporting quality, surgery, systematic review

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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

Procedia PDF Downloads 190

Authors: Jeongwoo Lee

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Children are the most vulnerable travelers and they are at risk for pedestrian injury. Creating a safe route to school is important because walking to school is one of the main opportunities for promotion of needed physical exercise among children. This study examined how the built environmental attributes near an elementary school influence traffic accidents among school-aged children. The study used two complementary data sources including the locations of police-reported pedestrian crashes and the built environmental characteristics of school areas. The environmental attributes of road segments were collected through GIS measurements of local data and actual site audits using the inventory developed for measuring pedestrian-crash risk scores. The inventory data collected at 840 road segments near 32 elementary schools in the city of Ulsan. We observed all segments in a 300-meter-radius area from the entrance of an elementary school. Segments are street block faces. The inventory included 50 items, organized into four domains: accessibility (17items), pleasurability (11items), perceived safety from traffic (9items), and traffic and land-use measures (13items). Elementary schools were categorized into two groups based on the distribution of the pedestrian-crash hazard index scores. A high pedestrian-crash zone was defined as an school area within the eighth, ninth, and tenth deciles, while no pedestrian-crash zone was defined as a school zone with no pedestrian-crash accident among school-aged children between 2013 and 2016. No- and high pedestrian-crash zones were compared to determine whether different settings of the built environment near the school lead to a different rate of pedestrian-crash incidents. The results showed that a crash risk can be influenced by several environmental factors such as a shape of school-route, number of intersections, visibility and land-use in a street, and a type of sidewalk. The findings inform policy for creating safe routes to school to reduce the pedestrian-crash risk among children by focusing on school zones.

Keywords: active school travel, school zone, pedestrian crash, safety route to school

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Authors: Atiq Uz Zaman

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Sustainable waste management is one of the major global challenges that we face today. A poor waste management system not only symbolises the inefficiency of our society but also depletes valuable resources and emits pollutions to the environment. Presently, we extract more natural resources than ever before in order to meet the demand for constantly growing resource consumption. It is estimated that around 71 tonnes of ‘upstream’ materials are used for every tonne of MSW. Therefore, resource recovery from waste potentially offsets a significant amount of upstream resource being depleted. This study tries to measure the environmental benefits of global waste management systems by applying a tool called the Zero Waste Index (ZWI). The ZWI measures the waste management performance by accounting for the potential amount of virgin material that can be offset by recovering resources from waste. In addition, the ZWI tool also considers the energy, GHG and water savings by offsetting virgin materials and recovering energy from waste. This study analyses the municipal solid waste management system of 172 countries from all over the globe and the population covers in the study is 3.37 billion. This study indicates that we generated around 1.47 billion tonnes (436kg/cap/year) of municipal solid waste each year and the waste generation is increasing over time. This study also finds a strong and positive correlation (R2=0.29, p = < .001) between income (GDP/capita/year) and amount of waste generated (kg/capita/year). About 84% of the waste is collected globally and only 15% of the collected waste is recycled. The ZWI of the world is measured in this study of 0.12, which means that the current waste management system potentially offsets only 12% of the total virgin material substitution potential from waste. Annually, an average person saved around 219kWh of energy, emitted around 48kg of GHG and saved around 38l of water. Findings of this study are very important to measure the current waste management performance in a global context. In addition, the study also analysed countries waste management performance based on their income level.

Keywords: global performance, material substitution; municipal waste, resource recovery, waste management, zero waste index

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Authors: Narupon Kunbootsri, Patpiya Sirasaporn

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Low back pain is the most common of chief complaints in chronic pain. Low back pain directly affect to activities daily living and also has high socioeconomic costs. The prevalence of low back pain is high in both genders in all populations. The symptoms of low back pain including, pain at low back area, muscle spasm, tenderness points and stiff back. Trancutanous Electrical Nerve Stimulation (TENS) is one of modalities mainly use for control pain. There was indicated that TENS is wildly use in low back pain, but no scientific data about the flexibility of muscle after TENS in low back pain. Thus the aim of this study was to investigate immediate effect of TENS on flexibility and health status in patients with chronic nonspecific low back pain. Eight chronic nonspecific low back pain patients 1 male and 7 female employed in this study. Participants were diagnosed by a doctor based on history and physical examination. Each participant received treatment at physiotherapy unit. Participants completed Roland Morris Disability Questionnaire (RMDQ), numeric rating scale (NRS) and trunk flexibility before treatment. Each participant received low frequency TENS set at asymmetrical, 10 Hz, 20 minutes per point. Immediately after treatment, participants completed RNS, RMDQ and trunk flexibility again. All participants were treated by only one physiotherapist. There was a statistically significant increased in flexibility immediately after low frequency TENS [mean difference -6.37 with 95%CI were (-8.35)-(-4.39)]. There was a statistically significant decreased in numeric rating scale [mean difference 2.13 with 95%CI were 1.08-3.16]. Roland Morris Disability Questionnaire showed improvement of health status average 44.8% immediately after treatment. In conclusion, the results of the present study indicate that immediately effect after low frequency TENS can decrease pain and improve flexibility of back muscle in chronic nonspecific low back pain patients.

Keywords: low back pain, flexibility, TENS, chronic

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Authors: C. Sánchez de Rojas Candela, A. Riquelme, P. Rodrigo, M. D. Escalera-Rodríguez, B. Torres, J. Rams

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Selective laser melting is one of the most commonly used AM techniques. In it, a thin layer of metallic powder is deposited, and a laser is used to melt selected zones. The accumulation of layers, each one molten in the preselected zones, gives rise to the formation of a 3D sample with a nearly arbitrary design. To ensure that the properties of the final parts match those of the powder, all the process is carried out in an inert atmosphere, preferentially Ar, although this gas could be substituted. Ti6Al4V alloy is widely used in multiple industrial applications such as aerospace, maritime transport and biomedical, due to its properties. However, due to the demanding requirements of these applications, greater hardness and wear resistance are necessary, together with a better machining capacity, which currently limits its commercialization. To improve these properties, in this study, Selective Laser Melting (SLM) is used to manufacture Ti/TiN metal matrix composites with in-situ and ex-situ titanium nitride reinforcement where the scanning speed is modified (from 28.5 up to 65 mm/s) to study the influence of the processing parameters in SLM. A one-step method of nitriding the Ti6Al4V alloy is carried out to create in-situ TiN reinforcement in a reactive atmosphere and it is compared with ex-situ composites manufactured by previous mixture of both the titanium alloy powder and the ceramic reinforcement particles. The microstructure and mechanical properties of the different Ti/TiN composite materials have been analyzed. As a result, the existence of a similar matrix has been confirmed in in-situ and ex-situ fabrications and the growth mechanisms of the nitrides have been studied. An increase in the mechanical properties with respect to the initial alloy has been observed in both cases and related to changes in their microstructure. Specifically, a greater improvement (around 30.65%) has been identified in those manufactured by the in-situ method at low speeds although other properties such as porosity must be improved for their future industrial applicability.

Keywords: in-situ reinforcement, nitriding reaction, selective laser melting, titanium nitride

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