Search results for: initial trust

Authors: Paul Dankers, Juliet Stoltenkamp, Carolynne Kies

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In May 2005, the University of the Western Cape (UWC) established an eLearning Division (ED) that, over the past 18 years, accelerated into the institutionalization of an efficient eLearning Centre. The initial objective of the ED was to incessantly align itself with emerging technologies caused by digital transformation, which progressively impacted Higher Education Institutions (HEIs) globally. In this paper, we present how the UWC eLearning Division (ED) first evolved into the eLearning Development and Support Unit (EDUS), currently called the ‘Centre for Innovative Education and Communication Technologies (CIECT). CIECT was strategically separated from the Department of Information and Communication Services (ICS) in 2009 and repositioned as an independent structure at UWC. Using a comparative research method, we highlight the transformative eLearning landscape at UWC by doing a detailed account of the shift in practices. Our research method will determine the initial vision and outcomes of institutionalizing an eLearning division. The study aims to compare across space or time the eLearning division’s rate of growth. By comparing the progressive growth of the UWCs eLearning division over the years, we will be able to document the successes and achievements of the eLearning division precisely. This study’s outcomes will act as a reference for novel research subjects on formalising eLearning. More research that delves into the effectiveness of having an eLearning division at HEIs in support of students’ teaching and learning is needed.

Keywords: eLearning, institutionalization, teaching and learning, transformation

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Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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Authors: Marcelo Dias Carvalho, Leticia Ishikawa

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Supply Chain Risk Management refers to a set of strategies used by companies to avoid supply chain disruption caused by damage at production facilities, natural disasters, capacity issues, inventory problems, incorrect forecasts, and delays. Many companies use the techniques of the Toyota Production System, which in a way goes against a better management of supply chain risks. This paper studies key events in some multinationals to analyze the trade-off between the best supply chain risk management techniques and management policies designed to create lean enterprises. The result of a good balance of these actions is the reduction of losses, increased customer trust in the company and better preparedness to face the general risks of a supply chain.

Keywords: just in time, lean manufacturing, supply chain disruptions, supply chain management

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Authors: Riham Hazzaa , Mohamed Hussien Abd El Megid

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Dyes are toxic and cause severe problems to aquatic environment. The use of agricultural solid wastes is considered as low-cost and eco-friendly adsorbents for removing dyes from waste water. Date palm fibre, an abundant agricultural by-product in Egypt was used to prepare activated carbon by physical activation method. This study investigates the use of date palm fiber (DPF) and activated carbon (DPFAC) for the removal of a basic dye, methylene blue (MB) from simulated waste water. The effects of temperature, pH of solution, initial dye (concentration, adsorbent dosage and contact time were studied. The experimental equilibrium adsorption data were analyzed by Langmuir, Freundlich, Temkin, Dubinin, Radushkevich and Harkins–Jura isotherms. Adsorption kinetics data were modeled using the pseudo-first and pseudo-second order and Elvoich equations. The mechanism of the adsorption process was determined from the intraparticle diffusion model. The results revealed that as the initial dye concentration , amount of adsorbent and temperature increased, the percentage of dye removal increased. The optimum pH required for maximum removal was found to be 6. The adsorption of methylene blue dye was better described by the pseudo-second-order equation. Results indicated that DPFAC and DPF could be an alternative for more costly adsorbents used for dye removal.

Keywords: adsorption, basic dye, palm fiber, activated carbon

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Authors: Aderonke A. Okoya, Oluwaseun A. Somoye, Omotayo S. Amuda, Ifeanyi E. Ofoezie

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This study assessed the efficiency of Hydroxyapatite Powder (HAP) in the removal of dyes in wastewater in comparison with Commercial Activated Carbon (CAC). This was with a view to developing cost effective method that could be more environment friendly. The HAP and CAC were used as adsorbent while Indigo dye was used as the adsorbate. The batch adsorption experiment was carried out by varying initial concentrations of the indigo dye, contact time and adsorbent dosage. Adsorption efficiency was classified by adsorption Isotherms using Langmuir, Freundlich and D-R isotherm models. Physicochemical parameters of a textile industry wastewater were determined before and after treatment with the adsorbents. The results from the batch experiments showed that at initial concentration of 125 mg/L of adsorbate in simulated wastewater, 0.9276 ± 0.004618 mg/g and 3.121 ± 0.006928 mg/g of indigo adsorbed per unit time (qt) of HAP and CAC respectively. The ratio of HAP to CAC required for the removal of indigo dye in simulated wastewater was 2:1. The isotherm model of the simulated wastewater fitted well to Freundlich model, the adsorption intensity (1/n) presented 1.399 and 0.564 for HAP and CAC, respectively. This revealed that the HAP had weaker bond than the electrostatic interactions which were present in CAC. The values of some physicochemical parameters (acidity, COD, Cr, Cd) of textile wastewater when treated with HAP decreased. The study concluded that HAP, an environment-friendly adsorbent, could be effectively used to remove dye from textile industrial wastewater with added advantage of being regenerated.

Keywords: adsorption isotherm, commercial activated carbon, hydroxyapatite powder, indigo dye, textile wastewater

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Authors: Nazli W. Hardy

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A critical component in the Internet of Things (IoT) ecosystem is the need for secure and appropriate transmission, processing, and storage of the data. Our current forms of authentication, and identity and access management do not suffice because they are not designed to service cohesive, integrated, interconnected devices, and service applications. The seemingly endless opportunities of IoT are in fact circumscribed on multiple levels by concerns such as trust, privacy, security, loss of control, and related issues. This paper considers multi-factor authentication (MFA) mechanisms and cohesive identity relationship management (IRM) standards. It also surveys messaging protocols that are appropriate for the IoT ecosystem.

Keywords: identity relation management, multifactor authentication, protocols, survey of internet of things ecosystem

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Authors: Sunday B. Alabi, Edikan P. Felix, Aniediong M. Umo

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Crystal size distribution is of great importance in the sugar factories. It determines the market value of granulated sugar and also influences the cost of production of sugar crystals. Typically, sugar is produced using fed-batch vacuum evaporative crystallizer. The crystallization quality is examined by crystal size distribution at the end of the process which is quantified by two parameters: the average crystal size of the distribution in the mean aperture (MA) and the width of the distribution of the coefficient of variation (CV). Lack of real-time measurement of the sugar crystal size hinders its feedback control and eventual optimisation of the crystallization process. An attractive alternative is to use a soft sensor (model-based method) for online estimation of the sugar crystal size. Unfortunately, the available models for sugar crystallization process are not suitable as they do not contain variables that can be measured easily online. The main contribution of this paper is the development of a regression model for estimating the sugar crystal size as a function of input variables which are easy to measure online. This has the potential to provide real-time estimates of crystal size for its effective feedback control. Using 7 input variables namely: initial crystal size (Lo), temperature (T), vacuum pressure (P), feed flowrate (Ff), steam flowrate (Fs), initial super-saturation (S0) and crystallization time (t), preliminary studies were carried out using Minitab 14 statistical software. Based on the existing sugar crystallizer models, and the typical ranges of these 7 input variables, 128 datasets were obtained from a 2-level factorial experimental design. These datasets were used to obtain a simple but online-implementable 6-input crystal size model. It seems the initial crystal size (Lₒ) does not play a significant role. The goodness of the resulting regression model was evaluated. The coefficient of determination, R² was obtained as 0.994, and the maximum absolute relative error (MARE) was obtained as 4.6%. The high R² (~1.0) and the reasonably low MARE values are an indication that the model is able to predict sugar crystal size accurately as a function of the 6 easy-to-measure online variables. Thus, the model can be used as a soft sensor to provide real-time estimates of sugar crystal size during sugar crystallization process in a fed-batch vacuum evaporative crystallizer.

Keywords: crystal size, regression model, soft sensor, sugar, vacuum evaporative crystallizer

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Authors: Akwesi Assensoh-Kodua

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Online Social Networks (OSN) has come and gone, yet the explosion of business activities on such platforms continuous to surge high, giving advantage to the bold entrepreneurs. It is therefore a practical requirement that practitioners and researchers understand the key determinants of costumers’ online social network business activities and continuance intention. An exploratory literature research to examine OSN continuous intention of business participants on OSN revealed that the practice of doing business on social network has come to stay and the following factors are the likely drivers for this new business model: perceived trust, perceived ease of use, confirmation, habit, social norm, perceived behavioural control, expected benefit, and satisfaction are the most probable factors that can lead to online social network (OSN) continuance intention.

Keywords: online social network, continuance intention, business continuance

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Authors: Andrey V. Malyshev, Anna B. Petrova, Anatoly P. Surzhikov

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The article presents the results of the influence of diamagnetic additives on the defects level of ferrite ceramics. For this purpose, we use a previously developed method based on the mathematical analysis of experimental temperature dependences of the initial permeability. A phenomenological expression for the description of such dependence was suggested and an interpretation of its main parameters was given. It was shown, that the main criterion of the integral defects level of ferrite ceramics is the relation of two parameters correlating with elastic stress value in a material. Model samples containing a controlled number of intergranular phase inclusions served to prove the validity of the proposed method, as well as to assess its sensitivity in comparison with the traditional XRD (X-ray diffraction) analysis. The broadening data of diffraction reflexes of model samples have served for such comparison. The defects level data obtained by the proposed method are in good agreement with the X-ray data. The method showed high sensitivity. Therefore, the legitimacy of the selection relationship β/α parameters of phenomenological expression as a characteristic of the elastic state of the ferrite ceramics confirmed. In addition, the obtained data can be used in the detection of non-magnetic phases and testing the optimal sintering production technology of soft magnetic ferrites.

Keywords: cure point, initial permeability, integral defects level, homogeneity

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Authors: Gaurav Bisht, Rahul Rathnakumar, Ravikumar Duggirala

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Predictive simulations are one of the key focus areas in safety-critical industries such as aerospace and high-performance automotive engineering. The stone-chipping study is one such effort taken up by the industry to predict and evaluate the damage caused due to gravel impact on vehicles. This paper describes a finite elements based method that can simulate the ejection of gravel chips from a vehicle tire. The FE simulations were used to obtain the initial ejection velocity of the stones for various driving conditions using a computational contact mechanics approach. To verify the accuracy of the tire model, several parametric studies were conducted. The FE simulations resulted in stone loft velocities ranging from 0–8 m/s, regardless of tire speed. The stress on the tire at the instant of initial contact with the stone increased linearly with vehicle speed. Mesh convergence studies indicated that a highly resolved tire mesh tends to result in better momentum transfer between the tire and the stone. A fine tire mesh also showed a linearly increasing relationship between the tire forward speed and stone lofting speed, which was not observed in coarser meshes. However, it also highlighted a potential challenge, in that the ejection velocity vector of the stone seemed to be sensitive to the mesh, owing to the FE-based contact mechanical formulation of the problem.

Keywords: abaqus, contact mechanics, foreign object debris, stone chipping

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Authors: Amy Whelan

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This paper presents the reader with the overarching research topic: Examining the drivers to sustainable consumer behavioural intention in the Irish aviation industry. This research will examine the underlying factors that facilitate or hinder a consumer’s sustainable consumption pertaining to aviation, in order to advance the Sustainable Development Goals (SDG’s). The SDG’s were adopted by all United Nations Member States in 2015 as a call to end poverty, to protect the planet and to ensure that all people enjoy peace and prosperity by the year 2030. Consumers are becoming increasingly concerned about environmental, social and economic issues, and are willing to act on those concerns. More recently, the impact of a consumers environmental footprint has led consumers to re-evaluate their purchase habits and in some cases consumers are more willing to spend more on products and services with environmental characteristics. Accordingly, this has pushed businesses to re-examine their sustainable efforts. However, although consumers may feel a moral responsibility to live sustainably, they cannot do so without effective support from governments, NGOs and the businesses with which they interact. Through the use of Ajzen’s amended TPB model, this research seeks to understand consumers attitudes and behavioural intention towards sustainable aviation and travel and examine the attitude-behaviour gap in sustainable tourism and aviation in Ireland. This research is a mixed methods study and will include an initial elicitation study in the form of focus groups supported by a quantitative survey to inform the initial findings of this research.

Keywords: aviation, consumer behaviour, marketing, sustainability

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Authors: James Adewale, Joshua Sunday

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In this paper, we developed a linear multistep method, which is implemented in predictor corrector-method. The corrector is developed by method of collocation and interpretation of power series approximate solutions at some selected grid points, to give a continuous linear multistep method, which is evaluated at some selected grid points to give a discrete linear multistep method. The predictors were also developed by method of collocation and interpolation of power series approximate solution, to give a continuous linear multistep method. The continuous linear multistep method is then solved for the independent solution to give a continuous block formula, which is evaluated at some selected grid point to give discrete block method. Basic properties of the corrector were investigated and found to be zero stable, consistent and convergent. The efficiency of the method was tested on some linear, non-learn, oscillatory and stiff problems of first order, initial value problems of ordinary differential equations. The results were found to be better in terms of computer time and error bound when compared with the existing methods.

Keywords: predictor, corrector, collocation, interpolation, approximate solution, independent solution, zero stable, consistent, convergent

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Authors: Mbuotidem Brendan, Nathanael Afolabi

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Teenage pregnancy is a major health concern because of its association with high morbidity and mortality for both mother and child. In 2013, 23% of women in Nigeria, aged 15 - 19 yr have begun childbearing: 17% have had a child and 5% are pregnant with their first child. Reported differences across locations have been attributed to factors such as educational attainment and exposure to mass media. This study therefore seeks to determine the difference in the level of exposure among teenage mothers and older women of reproductive age in Nigeria. Over 12,000 women of reproductive age (18 – 49 yr) were interviewed across 8 states from the Northern and Southern region of Nigeria. The women were further segregated into two groups of 0 (women aged 18 – 20 yr who had children of their own) and 1 (women of reproductive age excluding teenage mothers). Data was collected via structured questionnaires on mobile devices using the open data kit platform. Initial data formatting and recoding was done using STATA 13 package. Initial analysis was also conducted using SPSS version 21 and the data points were mapped on QuantumGIS package. From the results of analyzed data obtained from the studied states, there were various mean ages of first births across the supported states. Though Akwa Ibom had one of the oldest mean ages (21.2 yr) at first birth and the lowest fertility rate of 3.9 births/woman according to the National Demographic Health Survey 2013, Akwa Ibom had the highest rate of teenage pregnancy (18.2%) across the respondents. Based on education, the respondents that had completed secondary school education (56.9%) made up the greatest cohorts of the teenage parents. This is counter indicative of the initial thinking that there is an inverse relationship between level of education and teenage pregnancy. Akwa Ibom, Bauchi and Delta states are states where respondents felt that contraceptive use is dangerous to health and they were the top 4 states that had a large proportion of teenage mothers. Similarly, across the states examined, all the women of reproductive age felt they could convince their spouses to use contraceptives, as using family planning does not cause women to be promiscuous. This study thus reveals that across the states studied, there was no marked variation in the perception of family planning between teenage parents and women of reproductive age. The study also highlights the need for future planning and exposure to family planning messages at secondary school level.

Keywords: adolescent, family planning, mass media, teenage mothers

Procedia PDF Downloads 177

Authors: Tahsien Mohamed Okasha

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We hypothesized that Post cardiac arrest patients with Glasgow coma scale (GCS) score of less than (8) and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. Purposive sample of 17 patients who were fulfilling the inclusion criteria during one year collected. The study carried out using Quasi-experimental research design. Four Tools used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). Result: the mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% with initial arrest rhythm ventricular tachycardia (VT), 23.5% with ventricular fibrillation (VF), and 29.4% with A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also Initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than (8). replication of the study on larger probability sample, with randomized control trial design. Further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia.

Keywords: therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest., resuscitation

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Authors: M. Hadi Kusuma, Nandy Putra, Anhar Riza Antariksawan, Ficky Augusta Imawan

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Heat pipe is considered to be applied as a passive system to remove residual heat that generated from reactor core when incident occur or from spent fuel storage pool. The objectives are to characterized the heat transfer phenomena, performance of heat pipe, and as a model for large heat pipe will be applied as passive cooling system on nuclear spent fuel pool storage. In this experimental wickless heat pipe or two-phase closed thermosyphon (TPCT) is used. Variation of heat flux are 611.24 Watt/m² - 3291.29 Watt/m². Variation of filling ratio are 45 - 70%. Variation of initial pressure are -62 to -74 cm Hg. Demineralized water is used as working fluid in the TPCT. The results showed that increasing of heat load leads to an increase of evaporation of the working fluid. The optimum filling ratio obtained for 60% of TPCT evaporator volume, and initial pressure variation gave different TPCT wall temperature characteristic. TPCT showed best performance with 60% filling ratio and can be consider to be applied as passive residual heat removal system or passive cooling system on spent fuel storage pool.

Keywords: two-phase closed term syphon, heat pipe, passive cooling, spent fuel storage pool

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Authors: Muhammad B. Ibrahim, Muhammad S. Sulaiman, Sadiq Sani

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Neem leaves were studied as plant wastes derived adsorbents for detoxification of Congo Red (CR) and Methyl Orange (MO) from aqueous solutions using batch adsorption technique. The objectives involved determining the effects of the basic adsorption parameters are namely, agitation time, adsorbent dosage, adsorbents particle size, adsorbate loading concentrations and initial pH, on the adsorption process as well as characterizing the adsorbents by determining their physicochemical properties, functional groups responsible for the adsorption process using Fourier Transform Infrared (FTIR) spectroscopy and surface morphology using scanning electron microscopy (SEM) coupled with energy dispersion X – ray spectroscopy (EDS). The adsorption behaviours of the materials were tested against Langmuir, Freundlich, etc. isotherm models. Percent adsorption increased with increase in agitation time (5 – 240 minutes), adsorbent dosage (100-500mg), initial concentration (100-300mg/L), and with decrease in particle size (≥75μm to ≤300μm) of the adsorbents. Both processes are dye pH-dependent, increasing or decreasing percent adsorption in acidic (2-6) or alkaline (8-12) range over the studied pH (2-12) range. From the experimental data the Langmuir’s separation factor (RL) suggests unfavourable adsorption for all processes, Freundlich constant (nF) indicates unfavourable process for CR and MO adsorption; while the mean free energy of adsorption

Keywords: adsorption, congo red, methyl orange, neem leave

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Authors: Karakhalis N. B.

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This study aimed to determine the prevalence of heparin resistance among cardiac surgical pediatric and neonatal patients and identify associated risk factors. Materials and Methods: The study included 306 pediatric and neonatal patients undergoing on-pump cardiac surgery. Patients whose activated clotting time (ACT) targets were achieved after the first administration of heparin formed the 1st group (n=280); the 2nd group (n=26) included patients with heparin resistance. The initial assessment of the haemostasiological profile included determining the PT, aPPT, FG, AT III activity, and INR. Intraoperative control of heparinization was carried out with a definition of ACT using a kaolin activator. A weight-associated protocol at the rate of 300 U/kg with target values of ACT >480 sec was used for intraoperative heparinization. Results: The heparin resistance was verified in 8.5% of patients included in the study. Repeated heparin administration at the maximum dose of≥600 U/kg is required in 80.77% of cases. Despite additional heparinization, 19.23% of patients had FFP infusion. There was reduced antithrombin activity in the heparin resistance group (p=0.01). Most patients with heparin resistance (57.7%) were pretreated with low molecular weight heparins during the preoperative period. Conclusion: Determining the initial level of antithrombin activity can predict the risk of developing heparin resistance. The factor analysis verified hidden risk factors for heparin resistance to the heparin pretreatment, chronic hypoxia, and chronic heart failure.

Keywords: congenital heart disease, heparin, antithrombin, activated clotting time, heparin resistance

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Authors: M. Leonora D. Guerrero

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The study attempted to uncover the most and least frequent phonological variation evident in the speech patterns of grade 1 teachers in select public elementary schools in the Philippines. It also determined the lectal description of the participants based on Tayao’s consonant charts for American and Philippine English. Descriptive method was utilized. A total of 24 grade 1 teachers participated in the study. The instrument used was word list. Each column in the word list is represented by words with the target consonant phonemes: labiodental fricatives f/ and /v/ and lingua-alveolar fricative /z/. These phonemes were in the initial, medial, and final positions, respectively. Findings of the study revealed that the most frequent variation happened when the participants read words with /z/ in the final position while the least frequent variation happened when the participants read words with /z/ in the initial position. The study likewise proved that the grade 1 teachers exhibited the segmental features of both the mesolect and basilect. Based on these results, it is suggested that teachers of English in the Philippines must aspire to manifest the features of the mesolect, if not, the acrolect since it is expected of the academicians not to be displaying the phonological features of the acrolects since this variety is only used by the 'uneducated.' This is especially so with grade 1 teachers who are often mimicked by their students who classify their speech as the 'standard.'

Keywords: consonant phonemes, lectal description, Philippine English, phonological variation

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Authors: Rameez Ahmad, Aqib Mehmood, Imran Khan

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Self-directed car (SDC) that can drive itself from one fact to another without support from a driver. Certain trust that self-directed car obligate the probable to transform the transportation manufacturing while essentially removing coincidences, and cleaning up the environment. This study realizes the effects that SDC (also called a self-driving, driver or robotic) vehicle travel demands and ride scheme is likely to have. Without the typical obstacles that allows detection of a audio vision based hardware and software construction (It (SDC) and cost benefits, the vehicle technologies, Gold (Generic Obstacle and Lane Detection) to a knowledge-based system to predict their potential and consider the shape, color, or balance) and an organized environment with colored lane patterns, lane position ban. Discovery the problematic consequence of (SDC) on GT (grand trunk road) road and brand the car further effectual.

Keywords: SDC, gold, GT, knowledge-based system

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Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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Authors: M. Hadi Bordbar, Matthew England, Alex Sen Gupta, Agus Santoso, Andrea Taschetto, Thomas Martin, Wonsun Park, Mojib Latif

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Climate models generally simulate long-term reductions in the Pacific Walker Circulation with increasing atmospheric greenhouse gases. However, over two recent decades (1992-2011) there was a strong intensification of the Pacific Trade Winds that is linked with a slowdown in global surface warming. Using large ensembles of multiple climate models forced by increasing atmospheric greenhouse gas concentrations and starting from different ocean and/or atmospheric initial conditions, we reveal very diverse 20-year trends in the tropical Pacific climate associated with a considerable uncertainty in the globally averaged surface air temperature (SAT) in each model ensemble. This result suggests low confidence in our ability to accurately predict SAT trends over 20-year timescale only from external forcing. We show, however, that the uncertainty can be reduced when the initial oceanic state is adequately known and well represented in the model. Our analyses suggest that internal variability in the Pacific trade winds can mask the anthropogenic signal over a 20-year time frame, and drive transitions between periods of accelerated global warming and temporary slowdown periods.

Keywords: trade winds, walker circulation, hiatus in the global surface warming, internal climate variability

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Authors: Andrew Read, Alice Parry, Kate Woods

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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

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Authors: Hamidreza Torabi, Mohsen Moghtaderi

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Introduction: Currently, deep vitrectomy with silicone oil tamponade is the standard treatment method for patients with Rhegmatogenous Retinal Detachment (RRD). After retinal repair, it is necessary to remove silicone oil from the eye, but the appropriate time to remove the oil and complications related to that time has been less studied. The aim of this study was to compare the results of the early removal of silicone oil with the delayed removal of silicone oil in patients with RRD. Method & material: Patients who were referred to the Ophthalmology Clinic of Baqiyatallah Hospital, Tehran, Iran, due to RRD with detached macula in 2021 & 2022 were evaluated. These patients were treated with deep vitrectomy and silicone oil tamponade. Patients whose retinas were attached after the passage of time were candidates for silicone oil removal (SOR) surgery. For patients in the early SOR group, SOR surgery was performed 3-6 months after the initial vitrectomy surgery, and for the late SOR group, SOR was performed after 6 months after the initial vitrectomy surgery. Results: In this study, 60 patients with RRD were evaluated. 23 (38.3%) patients were in the early group, and 37 (61.7%) patients were in the late group. Based on our findings, it was seen that the mean visual acuity of patients based on the Snellen chart in the early group (0.48 ± 0.23 Decimal) was better than the late group (0.33 ± 0.18 Decimal) (P-value=0.009). Retinal re-detachment has happened only in one patient with early SOR. Conclusion: Early removal of silicone oil (less than 6 months) from the eyes of patients undergoing RRD surgery has been associated with better vision results compared to late removal.

Keywords: retinal detachment, vitrectomy, silicone oil, silicone oil removal, visual acuity

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Authors: Patarapan Odton

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This study investigates demographic and socio-economic factors of breastfeeding practice, including exclusively breastfeeding among children in Thailand using the Multiple Indicator Cluster Survey (MICS3 and MICS4). Logistic regression models were used to examine the determinants of initial breastfeeding, exclusively breastfeeding, and predominant breastfeeding, using data from women and children section of the survey. For initial breastfeeding, women live in rural area were more likely to start breastfeeding within one day of birth rather than who live in urban area in both round of the surveys. In year 2012, there were significantly higher probabilities of women in rural area started breastfeeding within one hour of birth compare to urban area. Women in southern Thailand have higher probabilities of start breastfeeding within one hour and one day than women in Bangkok and central region. During the year 2005-2006, children aged less than 5 years old lived in rural area have been breastfed higher than children in urban area. Children live in the northeast region were more likely to have been breastfed than the other regions. Only the second wealth quintile group was significant higher probability of ever been breastfed than the poorest group. The findings in the second round of the survey are different from the year 2005-06. In 2012, there was no difference in probability of ever been breastfed among children live in urban and rural area, children in Bangkok and central region were less probability of ever been breastfed than the others.

Keywords: Breastfeeding, Exclusive Breastfeeding, Predominant Breastfeeding, Urban-Rural Difference

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Authors: Rosangliana Chawngthu, Ramkumar K. Thapa

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A model calculation of photoassisted field emission current (PFEC) by using transfer Hamiltonian method will be present here. When the photon energy is incident on the surface of the metals, such that the energy of a photon is usually less than the work function of the metal under investigation. The incident radiation photo excites the electrons to a final state which lies below the vacuum level; the electrons are confined within the metal surface. A strong static electric field is then applied to the surface of the metal which causes the photoexcited electrons to tunnel through the surface potential barrier into the vacuum region and constitutes the considerable current called photoassisted field emission current. The incident radiation is usually a laser beam, causes the transition of electrons from the initial state to the final state and the matrix element for this transition will be written. For the calculation of PFEC, transfer Hamiltonian method is used. The initial state wavefunction is calculated by using Kronig-Penney potential model. The effect of the matrix element will also be studied. An appropriate dielectric model for the surface region of the metal will be used for the evaluation of vector potential. FORTRAN programme is used for the calculation of PFEC. The results will be checked with experimental data and the theoretical results.

Keywords: photoassisted field emission, transfer Hamiltonian, vector potential, wavefunction

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Authors: Andriy Didenko, Zanin Kavazovic

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Engineering students often have certain difficulties in mastering major theoretical concepts in mathematical courses such as differential equations. Student projects were proposed to motivate students’ learning and can be used as a tool to promote students’ interest in the material. Authors propose a student project that includes the use of Microsoft Excel. This instructional tool is often overlooked by both educators and students. An integral component of the experimental part of such a project is the exploration of an interactive spreadsheet. The aim is to assist engineering students in better understanding of Euler’s method. This method is employed to numerically solve first order differential equations. At first, students are invited to select classic equations from a list presented in a form of a drop-down menu. For each of these equations, students can select and modify certain key parameters and observe the influence of initial condition on the solution. This will give students an insight into the behavior of the method in different configurations as solutions to equations are given in numerical and graphical forms. Further, students could also create their own equations by providing functions of their own choice and a variety of initial conditions. Moreover, they can visualize and explore the impact of the length of the time step on the convergence of a sequence of numerical solutions to the exact solution of the equation. As a final stage of the project, students are encouraged to develop their own spreadsheets for other numerical methods and other types of equations. Such projects promote students’ interest in mathematical applications and further improve their mathematical and programming skills.

Keywords: student project, Euler's method, spreadsheet, engineering education

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Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

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Authors: Rishabh Garg

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Traditionally, business parties build trust with a centralized operating mechanism, such as payment by letter of credit. However, the increase in cyber-attacks and malicious hacking has jeopardized business operations and finance practices. Emerging markets, owing to their higher banking risks and bigger presence of digital financing, are looking forward to technology-driven solutions, financial inclusion and innovative working paradigms. Blockchain has the potential to enhance transaction transparency and supply chain traceability. It has captured a vast landscape with 200 million crypto users worldwide. Fintech and blockchain products are popping up across brokerage, digital wallets, exchanges, post-trade clearance, settlement, middleware, infrastructure, and base protocols.

Keywords: blockchain, distributed ledger technology, decentralized applications, ethereum, smart contracts, trade finance

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Authors: Chien-Kuo Chang, You-Syuan Wu, Min-Chiu Wu, Bharath-Kumar Boyanapalli

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The electrical treeing mechanism in epoxy resin insulation is a critical area of study concerning the degradation of high-voltage electrical equipment. In this study, we conducted pressure-induced degradation experiments on epoxy resin specimens using a needle-plane electrode structure to simulate electrical treeing. The specimens featured two different defect spacings, allowing for detailed observation facilitated by time-lapse photography. Our investigation revealed four distinct stages of insulation degradation: initial dark tree growth, filamentary tree growth, reverse tree growth, and eventual insulation breakdown. The initial dark treeing stage, though shortest in duration, exhibited a thicker main branch and shorter branching, ceasing upon the appearance of filamentary treeing. Filamentary treeing manifested in two forms: dark filamentary treeing during the resin's glassy state, characterized by branching structures, and fuzzy filamentary treeing during the rubbery state, resembling white feathers. The channels formed by filamentary treeing were observed to be as narrow as a few micrometers and continued to grow until the end of the experiment. Additionally, the transition to reverse treeing occurred when filamentary treeing reached the ground electrode, with the earliest manifestation being growth from the ground electrode towards the high-voltage end.

Keywords: epoxy resin insulation, high-voltage equipment, electrical treeing mechanism

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Authors: Morteza Shayan Arani, Mohammadamin Esmailzadehazimi, Mohammadreza Moeini, Mohammad Toorani, Aouni A. Lakis

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This paper investigates the nonlinear response of thin, incompressible, hyperelastic cylindrical shells in the presence of a time-varying temperature field while considering initial geometric imperfections. The governing equations of motion are derived using an improved Donnell's shallow shell theory. The hyperelastic material is modeled using the Mooney-Rivlin model with two parameters, incorporating temperature-dependent terms. The Lagrangian method is applied to obtain the equation of motion. The resulting governing equation is addressed through the Lindstedt-Poincaré and Multiple Scale methods. The linear and nonlinear models presented in this study are verified against existing open literature, demonstrating the accuracy and reliability of the presented model. The study focuses on understanding the influence of temperature variations and geometrical imperfections on the natural frequency and amplitude-frequency response of the systems. Notably, the investigation reveals the coexistence of hardening and softening peaks in the amplitude-frequency response, which vary in magnitude depending on these parameters. Additionally, resonance peaks exhibit changes as a result of temperature and geometric imperfections.

Keywords: hyperelastic material, cylindrical shell, geometrical nonlinearity, material naolinearity, initial geometric imperfection, temperature gradient, hardening and softening

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