Search results for: intensive%20care%20unit

Authors: Hung-Jen Lin, Chien-Hao Wang, Chien-Peng Huang, Yu-Sheng Tseng, En-Cheng Yang, Joe-Air Jiang

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Bees’ incoming and outgoing behavior is a decisive index which can indicate the health condition of a colony. Traditional methods for monitoring the behavior of honey bees (Apis mellifera) take too much time and are highly labor-intensive, and the lack of automation and synchronization disables researchers and beekeepers from obtaining real-time information of beehives. To solve these problems, this study proposes to use an Internet of Things (IoT)-based system for counting honey bees’ incoming and outgoing activities using an infrared interruption technique, while environmental factors are recorded simultaneously. The accuracy of the established system is verified by comparing the counting results with the outcomes of manual counting. Moreover, this highly -accurate device is appropriate for providing quantitative information regarding honey bees’ incoming and outgoing behavior. Different statistical analysis methods, including one-way ANOVA and two-way ANOVA, are used to investigate the influence of environmental factors, such as temperature, humidity, illumination and ambient pressure, on bees’ incoming and outgoing behavior. With the real-time data, a standard model is established using the outcomes from analyzing the relationship between environmental factors and bees’ incoming and outgoing behavior. In the future, smart control systems, such as a temperature control system, can also be combined with the proposed system to create an appropriate colony environment. It is expected that the proposed system will make a considerable contribution to the apiculture and researchers.

Keywords: ANOVA, environmental factors, honey bee, incoming and outgoing behavior

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Authors: Rafeza Begum, Mohammad Mokhlesur Rahman, Safikul Moula, Rafiqul Islam

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Potassium (K) is crucial for healthy soil and plant growth. However, K fertilization is either disregarded or poorly underutilized in Bangladesh agriculture, despite the great demand for crops. This could eventually result in a significant depletion of the soil's potassium reserves, irreversible alteration of the minerals that contain potassium, and detrimental effects on crop productivity. Soil K mining in Bangladesh is a worrying problem, and we need to evaluate it thoroughly and find remedies. A pot culture experiment was conducted in the greenhouse of Bangladesh Institute of Nuclear Agriculture (BINA) using eleven soil series of Bangladesh in order to see the depletion behaviour of potassium (K) by continuous cropping using rice (var. Iratom-24) as the test crop. The soil series were Ranishankhail, Kaonia. Sonatala, Silmondi, Gopalpur, Ishurdi, Sara, Kongsha, Nunni, Lauta and Amnura on which four successive rice plants (45 days duration) were raised with (100 ppm K) or without addition of potassium. Nitrogen, phosphorus, sulfur and zinc were applied as basal to all pots. Potassium application resulted in higher dry matter yield, increased K concentration and uptake in all the soils compared with no K treatment; which gradually decreased in the subsequent harvests. Furthermore, plant takes up K not only from exchangeable pool but also from non-exchangeable sites and a minimum replenishment of K from the soil reserve was observed. Continuous cropping has resulted in the depletion of available K of the soil. The result indicated that in order to sustain higher crop yield under intensive cultivation, the addition of potash fertilizer is necessary.

Keywords: potassium, exchangeable pool, depletion behavior., Soil series

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Authors: Ayat N. El-Shazly, Dina Magdy Abdo, Hamdy Maamoun Abdel-Ghafar, Xiangju Song, Heqing Jiang

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Product water recovery and draw solution (DS) reuse is the most energy-intensive stage in forwarding osmosis (FO) technology. Sucrose solution is the most suitable DS for FO application in food and beverages. However, sucrose DS recovery by conventional pressure-driven or thermal-driven concentration techniques consumes high energy. Herein, we developed a spontaneous and sustainable solar-driven evaporation process based on a photothermal membrane for the concentration and recovery of sucrose solution. The photothermal membrane is composed of multi-walled carbon nanotubes (f-MWCNTs)photothermal layer on a hydrophilic polyvinylidene fluoride (PVDF) substrate. The f-MWCNTs photothermal layer with a rough surface and interconnected network structures not only improves the light-harvesting and light-to-heat conversion performance but also facilitates the transport of water molecules. The hydrophilic PVDF substrate can promote the rapid transport of water for adequate water supply to the photothermal layer. As a result, the optimized f-MWCNTs/PVDF photothermal membrane exhibits an excellent light absorption of 95%, and a high surface temperature of 74 °C at 1 kW m−2 . Besides, it realizes an evaporation rate of 1.17 kg m−2 h−1 for 5% (w/v) of sucrose solution, which is about 5 times higher than that of the natural evaporation. The designed photothermal evaporation process is capable of concentrating sucrose solution efficiently from 5% to 75% (w/v), which has great potential in FO process and juice concentration.

Keywords: solar, pothothermal, membrane, MWCNT

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Authors: N. Hedayat, E. Karamifar

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Sustainable food and fiber production is emerging as an irresistible option in agrarian planning. Although one should not underestimate the successes of the Green Revolution in enhancing crop production, its adverse environmental and ecosystem consequences have also been remarkable. The aim of this paper is to identify ways of improving crop production to ensure agricultural sustainability and environmental integrity. Systematic observations are used for data collection on intensive farming, deforestation and the environmental implications of industrial pollutants on agricultural sustainability at national and international levels. These were achieved within a comparative analytical model of data interpretation. Results show that while multiple factors enhance yield, they have a simultaneous effect in undermining the ecosystem and environmental integrity. Results show that application of excessive agrichemical have been one of the major cause of polluting the surface and underground water bodies as well as soil layers in affected croplands. Results consider rapid deforestation in the tropical regions has been the underlying cause of impairing the integrity of biodiversity and oxygen-generation regime. These, coupled with production of greenhouse gasses, have contributed to global warming and hydrological irregularities. Continuous production of pollutants and effluents has affected marine and land biodiversity arising from acid rains generated by modern farming and deforestation. Continuous production of greenhouse gases has also been instrumental in affecting climatic behavior manifested in recurring draughts and contraction of lakes and ponds as well as emergence of potential flooding of waterways and floodplains in the future.

Keywords: agricultural sustainability, environmental integrity, pollution, eco-system

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Authors: Wardoyo, Humairoh

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In global competition nowadays, the world economy heavily depends upon high technology and capital intensive industries that are mainly owned by well-established economic and developed countries, such as United States of America, United Kingdom, Japan, and South Korea. Indonesia as a developing country is building its economic activities towards industrial country as well, although a slightly different approach was implemented. For example, similar to the concept of one village one product (OVOP) implemented in Japan, Indonesia also adopted this concept by promoting local traditional products to improve incomes of village people and to enhance local economic activities. Analysis on how OVOP program increase local people’s income and influence customer satisfaction were the objective of this paper. Behavioral intention to purchase and re-purchase, customer satisfaction and promotion are key factors for local products to play significant roles in improving local income and economy of the region. The concepts of OVOP and key factors that influence economic activities of local people and the region will be described and explained in the paper. Results of research, in a case study based on 300 respondents, customers of a local restaurant at Tangerang City, Banten Province of Indonesia, indicated that local product, service quality and behavioral intention individually have significant influence to customer satisfaction; whereas simultaneous tests to the variables indicated positive and significant influence to the behavioral intention through customer satisfaction as the intervening variable.

Keywords: behavioral intention, customer satisfaction, local products, one village one product (OVOP)

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Authors: Raghav Srivastava, Namrata Ramachandran

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Strong sustainability has been, by consensus, imagined as comprising economic and extra-economic variables and cannot be viewed merely in terms of a trade-off between the economic needs of today and the potential left for tomorrow. Specifically, the cultural as well the ecological impacts of development projects on the affected communities should be evaluated, in addition to the economic. In developing and densely populated economies such as India, energy intensive development is seen as a sine qua non – a necessary trade off with ecological conservation. Although social impact assessment has been included as an inalienable part of the Environmental Impact Assessment required to be conducted under Indian law, it seems that the same is unable to meet the ends it seeks to achieve. The dissociation between those bearing the costs of development, and those reaping its benefits, lies at the heart of this failure. This paper attempts to study the various cost–benefit relationships for these minority stakeholders using the proposed Nyamjang Chhu hydroelectric power plant in Tawang District of Arunachal Pradesh (in North-east India) as the chief object of study, and discusses whether the current model of sustainable development is truly sustainable, given the level of social dissociation and disintegration that occurs between affected communities and their environment. The economic allure of hydroelectric projects in the hilly regions of India very rarely results in a proper assessment of their ecological and social externalities. Examining the various issues that have been agitated in the course of litigation over the Nyamjang Chhu hydroelectric project, the authors argue that there is a pressing need to re-evaluate the current Indian model of sustainable development going forward.

Keywords: hydroelectric power, socio-cultural dissociation, sustainable development, trade offs

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Authors: Rohollah Asadian Kohestani, Nazanin Sedghi

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As the number of banks and financial institutions working in Iran has been significantly increased, the attracting and retaining customers and encouraging them to continually use the modern banking services have been important and vital issues. Therefore, there would be a serious competition without a deep perception of consumers and fitness of banking services with their needs in the current economic conditions of Iran. It should be noted that concepts such as 'brand equity' is defined based on the view of consumers; however, it is also focused by shareholders, competitors and other beneficiaries of a firm in addition to bank and its consumers. This study examines the impact of brand equity on the competitive advantage in the banking industry as intensive competition between brands of different banks leads to pay more attention to the brands. This research is based on the Aaker’s model examining the impact of four dimensions of brand equity on the competitive advantage of private banks in Behshahr city. Moreover, conducting an applied research and data analysis has been carried out by a descriptive method. Data collection was done using literature review and questionnaire. A 'simple random' methodology was selected for sampling staff of banks while sampling methodology to select consumers of banks was the distribution of questionnaire between staff and consumers of five private banks including Tejarat, Mellat, Refah K., Ghavamin and, Tose’e Ta’avon banks. Results show that there is a significant relationship between brand equity and their competitive advantage. In this research, software of SPSS 16 and LISREL 8.5, as well as different methods of descriptive inferential statistics for analyzing data and test hypotheses, were employed.

Keywords: brand awareness, brand loyalty, brand equity, competitive advantage

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Authors: Emel Bayraktar, Gulengun Turk

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Introduction and Objective: Safe administration of medicines is one of the main responsibilities of nurses. Intramuscular drug administration is among the most common methods used by nurses among all drug applications. This study was carried out in order to determine determine the effect of education given on injection in ventrogluteal area on the level of knowledge of nurses on this subject. Methods: The sample of the study consisted of 20 nurses who agreed to participate in the study between 01 October and 31 December 2019. The research is a pretest-posttest comparative, quasi-experimental type pilot study. The nurses were given a 4-hour training prepared on injection into the ventrogluteal area. The training consisted of two hours of theoretical and two hours of laboratory practice. Before the training and 4 weeks after the training, a questionnaire form containing questions about their knowledge and practices regarding the injection of the ventrogluteal region was applied to the nurses. Results: The average age of the nurses is 26.55 ± 7.60, 35% (n = 7) of them are undergraduate and 30% (n = 6) of them work in intensive care units. Before the training, 35% (n = 7) of the nurses stated that the most frequently used intramuscular injection site was the ventrogluteal area, and 75% (n = 15) stated that the safest area was the rectus femoris muscle. After the training, 55% (n = 11) of the nurses stated that they most frequently used the ventrogluteal area and 100% (n = 20) of them stated that the ventrogluteal area was the safest area. The average score the nurses got from the premises before the training is 14.15 ± 6.63 (min = 0, max = 20), the total score is 184. The average score obtained after the training was determined as 18.69 ± 2.35 (min = 12, max = 20), and the total score was 243. Conclusion: As a result of the research, it was determined that the training given on the injection of ventrogluteal area increased the knowledge level of the nurses. It is recommended to organize in-service trainings for all nurses on the injection of ventrogluteal area.

Keywords: safe injection, knowledge level, nurse, intramuscular injection, ventrogluteal area

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Authors: Ratih Fitria Putri, Josaphat Tetuko Sri Sumantyo, Hiroaki Kuze

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Jakarta Metropolitan City is located on the northwest coast of West Java province with geographical location between 106º33’ 00”-107º00’00”E longitude and 5º48’30”-6º24’00”S latitude. Jakarta urban area has been suffered from land subsidence in several land use type as trading, industry and settlement area. Land subsidence hazard is one of the consequences of urban development in Jakarta. This hazard is caused by intensive human activities in groundwater extraction and land use mismanagement. Geologically, the Jakarta urban area is mostly dominated by alluvium fan sediment. The objectives of this research are to make an analysis of Jakarta urban land use type on land subsidence zone areas. The process of producing safer land use and settlements of the land subsidence areas are very important. Spatial distributions of land subsidence detection are necessary tool for land use management planning. For this purpose, Differential Synthetic Aperture Radar Interferometry (DInSAR) method is used. The DInSAR is complementary to ground-based methods such as leveling and global positioning system (GPS) measurements, yielding information in a wide coverage area even when the area is inaccessible. The data were fine tuned by using X-Band image satellite data from 2010 to 2013 and land use mapping data. Our analysis of land use type that land subsidence movement occurred on the northern part Jakarta Metropolitan City varying from 7.5 to 17.5 cm/year as industry and settlement land use type areas.

Keywords: land use analysis, land subsidence mapping, urban area, X-band satellite image

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Authors: Liyang Yue, Bing Yan, James N. Monks, Rakesh Dhama, Zengbo Wang, Oleg V. Minin, Igor V. Minin

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A particle can function as a refractive lens to focus a plane wave, generating a narrow, high intensive, weak-diverging beam within a sub-wavelength volume, known as the ‘photonic jet’. Refractive index contrast (particle to background media) and scaling effect of the dielectric particle (relative-to-wavelength size) play key roles in photonic jet formation, rather than the shape of particle-lens. Waist (full width of half maximum, FWHM) of a photonic jet could be beyond the diffraction limit and smaller than the Airy disk, which defines the minimum distance between two objects to be imaged as two instead of one. Many important applications for imaging and sensing have been afforded based upon the super-resolution characteristic of the photonic jet. It is known that apodization method, in the form of an amplitude pupil-mask centrally situated on a particle-lens, can further reduce the waist of a photonic nanojet, however, usually lower its intensity at the focus due to blocking of the incident light. In this paper, the anomalously intensity-enhanced apodization effect was discovered in the near-field via numerical simulation. It was also experimentally verified by a scale model using a copper-masked Teflon cuboid solid immersion lens (SIL) with 22 mm side length under radiation of a plane wave with 8 mm wavelength. Peak intensity enhancement and the lateral resolution of the produced photonic jet increased by about 36.0 % and 36.4 % in this approach, respectively. This phenomenon may possess the scale effect and would be valid in multiple frequency bands.

Keywords: apodization, particle-lens, scattering, near-field optics

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Authors: Simona Pileviciene

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On 24th January 2014, Lithuania notified two primary cases of African swine fever (ASF) in wild boars. The animals were tested positive for ASF virus (ASFV) genome by real-time PCR at the National Reference Laboratory for ASF in Lithuania (NRL), results were confirmed by the European Union Reference Laboratory for African swine fever (CISA-INIA). Intensive wild and domestic animal monitoring program was started. During the period of 2014-2017 ASF was confirmed in two large commercial pig holding with the highest biosecurity. Pigs were killed and destroyed. Since 2014 ASF outbreak territory from east and south has expanded to the middle of Lithuania. Diagnosis by PCR is one of the highly recommended diagnostic methods by World Organization for Animal Health (OIE) for diagnosis of ASF. The aim of the present study was to compare singleplex real-time PCR assays to a duplex assay allowing the identification of ASF and internal control in a single PCR tube and to compare primers, that target the p72 gene (ASF 250 bp and ASF 75 bp) effectivity. Multiplex real-time PCR assays prove to be less time consuming and cost-efficient and therefore have a high potential to be applied in the routine analysis. It is important to have effective and fast method that allows virus detection at the beginning of disease for wild boar population and in outbreaks for domestic pigs. For experiments, we used reference samples (INIA, Spain), and positive samples from infected animals in Lithuania. Results show 100% sensitivity and specificity.

Keywords: African swine fewer, real-time PCR, wild boar, domestic pig

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Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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Authors: Laleh Boroumand, Muhammad Shiraz, Abdullah Gani, Rashid Hafeez Khokhar

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Cloud computing being the use of hardware and software that are delivered as a service over a network has its application in the area of health care. Due to the emergency cases reported in most of the medical centers, prompt for an efficient scheme to make health data available with less response time. To this end, we propose a mobile global healthcare village (MGHV) model that combines the components of three deployment model which include country, continent and global health cloud to help in solving the problem mentioned above. In the creation of continent model, two (2) data centers are created of which one is local and the other is global. The local replay the request of residence within the continent, whereas the global replay the requirements of others. With the methods adopted, there is an assurance of the availability of relevant medical data to patients, specialists, and emergency staffs regardless of locations and time. From our intensive experiment using the simulation approach, it was observed that, broker policy scheme with respect to optimized response time, yields a very good performance in terms of reduction in response time. Though, our results are comparable to others when there is an increase in the number of virtual machines (80-640 virtual machines). The proportionality in increase of response time is within 9%. The results gotten from our simulation experiments shows that utilizing MGHV leads to the reduction of health care expenditures and helps in solving the problems of unqualified medical staffs faced by both developed and developing countries.

Keywords: cloud computing (MCC), e-healthcare, availability, response time, service broker policy

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Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

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Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

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In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: data security, flow cytometry, leukaemia, telematics platform, telemedicine

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Authors: Rahim Sarvar, Bahram Azadbakht, Samira Safaee

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The leading goal of all planning is to attain sustainable development, regional balance, suitable distribution of activities, and maximum use of environmental capabilities in the process of development of regions. Intensive concentration of population and activities in one or some limited geographical locality is of main characteristics of most developing countries, especially Iran. Not considering the long-term programs and relying on temporary and superficial plans by people in charge of decision-making to attain their own objectives causes obstacles, resulting in unbalance development. The basic reason for these problems is to establish the development planning while economic aspects are merely considered and any attentions are not paid to social and regional feedbacks, what have been ending up to social and economic inequality, unbalanced distribution of development among the regions as well. In addition to study of special planning and structure of the county of Malekan, this research tries to achieve some other aims, i.e. recognition and introduction of approaches in order to utilize resources optimally, to distribute the population, activities, and facilities in optimum fashion, and to investigate and identify the spatial development potentials of the County. Based on documentary, descriptive, analytical, and field studies, this research employs maps to analyze the data, investigates the variables, and applies SPSS, Auto CAD, and Arc View software. The results show that the natural factors have a significant influence on spatial layout of settlements; distribution of facilities and functions are not equal among the rural districts of the county; and there is a spatial equivalence in the region area between population and number of settlements.

Keywords: development, entropy index, Malekan City, planning, regional equilibrium

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Authors: P. Gil Del Álamo, J. García Pereda, A. Castañeda De La Paz, D. Arazola Lopez, M. D. Cubiles De La Vega, A. Enguíx González, J. M. Muñoz Pichardo

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In the last decades, obesity has more than doubled and is, with overweight, the second leading cause of preventable death. Despite multiple strategies against obesity, no country to date has reduced the number of obese people. To achieve World Health Organization’s target to reverse this tendency we need dramatic and different actions to engage the civil society in creating demand for a healthy style of life. The objective of this study is to demonstrate that a social media as the television can be used to convince the civil society that a healthy nutrition and physical activity are affordable, effective and necessary to prevent and to treat the obesity. Methodology: 61 individuals (34 women and 27 men) with obesity (mean BMI 45,51) were recruited to follow during 22 weeks an intensive lifestyle intervention in order to lose weight in a healthy manner. They were not isolated or moved from their usual environment. This program included endocrinological and nutritional assessment, promotion of physical activity and psychological support. BMI was measured every week. Time to leave obesity between men and women was analyzed with a survival analysis. Results: BMI decreased in all the cases. Analysing Time to leave obesity, around the week 30, 25% of men leave the obesity and around the week 39, 25% of women leave the obesity too. Conclusion: We demonstrate the audience that improving the quality of the diet and increasing the physical activity is a realistic way to lose weight. This evidence can encourage the people to act in their own self-interest changing their style of life in order to prevent or to reduce their overweight.

Keywords: obesity epidemic, obesity prevention, obesity strategies, social media

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Authors: Fares Mahdi

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Background: Infection control is an important concern for all health care professionals, especially nurses. Nurses have a higher risk for both self-acquiring and transmitting infections to other patients. Aim of this study: to assess nurses' knowledge regarding infection control for wound care. Methodology: a descriptive research design was used in the study. The total number studied sample was 200 nurses, were conducting in Amran Public Hospitals in Amran City- Yemen. The study covered sample nurses in the hospital according to the study population; a standard closed-ended questionnaire was used to collect the data. Results: The results showed less than half (37.5 %) of nurses were from 22 May Hospital, also followed by (62.5%) of them were from Maternal and Child Hospital. Also according to the department name. Most (22.5%) of nurses worked in an intensive care unit, followed by (20%) of them were working in the pediatric world, also about (19%) of them were working in the surgical department. While in finally, only about (8.5%) of them worked from another department. According to course training, The results showed about (21%) of nurses had course training in wound care management. At the same time, others (79%) of them have not had course training in wound care management. According to the total nurse's knowledge of infection control for wound care, that find more than two-thirds (68%) of nurses had fair knowledge according to total all of nurse's knowledge of infection control wound care. Conclusion:The results showed that more than two-thirds (68%) of nurses had fair knowledge according to total all of the nurse's knowledge of infection control for wound care. Recommendations: There should be providing training program about infection control masseurs and it's important for new employees of nurses. Providing continuing refreshment training courses about infection control programs and about evidence-based practice in infection control for all health care teams.

Keywords: assessment, knowledge, infection control, wound care, nurses, amran hospitals

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Authors: Ahsan R. Khokhar, Fizza Hassan

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Alkali-Silica Reaction (ASR) has been recognized as a potential cause of concrete degradation in the world since the 1940s. In Pakistan, mega hydropower structures like dams, weirs constructed from aggregates extracted from a local riverbed exhibited different levels of alkali-silica reactivity over an extended service period. The concrete expansion potential due to such aggregates has been categorized as slow-reactive. Apart from hydropower structures, ASR existence has been identified in the concrete structural elements of a Textile Mill building which used aggregates extracted from the nearby riverbed. The original structure of the Textile Mill was erected in the 80s with the addition of a textile ‘sizing and wrapping’ hall constructed in the 90s. In the years to follow, intensive spalling was observed in the structural members of the subject hall; enough to threat to the overall stability of the building. Limitations such as incomplete building data posed hurdles during the detailed structural investigation. The paper lists observations made while assessing the extent of damage and its effect on the building hall structure. Core testing and Petrographic tests were carried out as per the ASTM standards for strength degradation analysis followed by the identifying its root cause. Results confirmed significant structural strength reduction because of ASR which necessitated the formulation of an immediate re-strengthening solution. The paper also discusses the possible tracks of rehabilitative measures which are being adapted to stabilize the structure and seize further concrete expansion.

Keywords: Alkali-Silica Reaction (ASR), concrete strength degradation, damage assessment, damage evaluation

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Authors: Abdalla Mansour, Dan Brown, Adel Helmy, Rikin Trivedi, Mathew Guilfoyle

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Introduction: Diagnosing delayed cerebral ischaemia (DCI) following aneurysmal subarachnoid haemorrhage (SAH) can be challenging, particularly in poor-grade patients. Objectives: This study sought to assess the value of routine CTP in identifying (or excluding) DCI and in guiding management. Methods: Eight-year retrospective neuroimaging study at a large UK neurosurgical centre. Subjects included a random sample of adult patients with confirmed aneurysmal SAH that had a CTP scan during their inpatient stay, over a 8-year period (May 2014 - May 2022). Data collected through electronic patient record and PACS. Variables included age, WFNS scale, aneurysm site, treatment, the timing of CTP, radiologist report, and DCI management. Results: Over eight years, 916 patients were treated for aneurysmal SAH; this study focused on 466 patients that were randomly selected. Of this sample, 181 (38.84%) had one or more CTP scans following brain aneurysm treatment (Total 318). The first CTP scan in each patient was performed at 1-20 days following ictus (median 4 days). There was radiological evidence of DCI in 83, and no reversible ischaemia was found in 80. Findings were equivocal in the remaining 18. Of the 103 patients treated with clipping, 49 had DCI radiological evidence, in comparison to 31 of 69 patients treated with endovascular embolization. The remaining 9 patients are either unsecured aneurysms or non-aneurysmal SAH. Of the patients with radiological evidence of DCI, 65 had a treatment change following the CTP directed at improving cerebral perfusion. In contrast, treatment was not changed for (61) patients without radiological evidence of DCI. Conclusion: CTP is a useful adjunct to clinical assessment in the diagnosis of DCI and is helpful in identifying patients that may benefit from intensive therapy and those in whom it is unlikely to be effective.

Keywords: SAH, vasospasm, aneurysm, delayed cerebral ischemia

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Authors: Polychronis Kapalidis

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In recent years, researchers have started to turn their attention to cyber security and maritime security independently, neglecting, in most cases, to examine the areas where these two critical issues are intertwined. The impact of cybersecurity issues on the maritime economy is emerging dramatically. Maritime transport and all related activities are conducted by technology-intensive platforms, which today rely heavily on information systems. The paper’s argument is that when no defense is completely effective against cyber attacks, it is vital to test responses to the inevitable incursions. Hence, preparedness in the form of testing existing cybersecurity structure via different tools for potential attacks is vital for minimizing risks. Traditional criminal activities may further be facilitated and evolved through the misuse of cyberspace. Kidnap, piracy, fraud, theft of cargo and imposition of ransomware are the major of these activities that mainly target the industry’s most valuable asset; the ship. The paper, adopting a case-study analysis, based on stakeholder consultation and secondary data analysis, namely policy and strategic-related documentation, presents the importance of holistic testing in the sector. Arguing that poor understanding of the issue leads to the adoption of ineffective policies the paper will present the level of awareness within the industry and assess the risks and vulnerabilities of ships to these cybercriminal activities. It will conclude by suggesting that testing procedures must be focused on three main pillars within the maritime transport sector: the human factor, the infrastructure, and the procedures.

Keywords: cybercrime, cybersecurity, organized crime, risk mitigation

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Authors: Ayesha Khatun

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In 21st century where markets are unstable, technologies rapidly proliferate, competitors multiply, products and services become obsolete almost overnight and customers demand low cost high value product, leveraging and harnessing knowledge is not just a potential source of competitive advantage rather a necessity in technology based and information intensive industries. Knowledge management focuses on leveraging the available knowledge and sharing the same among the individuals in the organization so that the employees can make best use of it towards achieving the organizational goals. Knowledge is not a discrete object. It is embedded in people and so difficult to transfer outside the immediate context that it becomes a major competitive advantage. However, internal transfer of knowledge among the employees is essential to maximize the use of knowledge available in the organization in an unstructured manner. But as knowledge is the source of competitive advantage for the organization it is also the source of competitive advantage for the individuals. People think that knowledge is power and sharing the same may lead to lose the competitive position. Moreover, the very nature of tacit knowledge poses many difficulties in sharing the same. But sharing tacit knowledge is the vital part of knowledge management process because it is the tacit knowledge which is inimitable. Knowledge management has been made synonymous with the use of software and technology leading to the management of explicit knowledge only ignoring personal interaction and forming of informal networks which are considered as the most successful means of sharing tacit knowledge. Factors responsible for effective sharing of tacit knowledge are grouped into –individual, organizational and technological factors. Different factors under each category have been identified. Creating a positive organizational culture, encouraging personal interaction, practicing reward system are some of the strategies that can help to overcome many of the barriers to effective sharing of tacit knowledge. Methodology applied here is completely secondary. Extensive review of relevant literature has been undertaken for the purpose.

Keywords: knowledge, tacit knowledge, knowledge management, sustainable competitive advantage, organization, knowledge sharing

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Authors: John Okanda Okwaro

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Carbon (IV) oxide (CO₂) is emitted majorly from fossil fuel combustion and industrial production. The sources of interest of carbon (IV) oxide in the study area are mining activities, transport systems, and industrial processes. This study is aimed at building models that will help in monitoring the emissions within the study area. Three scenarios were discussed, namely: pessimistic scenario, business-as-usual scenario, and optimistic scenario. The result showed that there was a reduction in carbon dioxide concentration by approximately 50.5 ppm between March 2020 and January 2021 inclusive. This is majorly due to reduced human activities that led to decreased consumption of energy. Also, the CO₂ concentration trend follows the business-as-usual scenario (BAU) path. From the models, the pessimistic, business-as-usual, and optimistic scenarios give CO₂ concentration of about 545.9 ppm, 408.1 ppm, and 360.1 ppm, respectively, on December 31st, 2021. This research helps paint the picture to the policymakers of the relationship between energy sources and CO₂ emissions. Since the reduction in CO₂ emission was due to decreased use of fossil fuel as there was a decrease in economic activities, then if Kenya relies more on green energy than fossil fuel in the post-COVID-19 period, there will be more CO₂ emission reduction. That is, the CO₂ concentration trend is likely to follow the optimistic scenario path, hence a reduction in CO₂ concentration of about 48 ppm by the end of the year 2021. This research recommends investment in solar energy by energy-intensive companies, mine machinery and equipment maintenance, investment in electric vehicles, and doubling tree planting efforts to achieve the 10% cover.

Keywords: forecasting, greenhouse gas, green energy, hierarchical data format

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Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

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Authors: Hsiao-Chuan Huang, King-Lung Kuo, Mei-Hsin Lo, Hsiao-Yun Chou, Yusen Lin

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The most robust and economical method for laboratory diagnosis of TB is to identify mycobacterial bacilli (AFB) under acid-fast staining despite its disadvantages of low sensitivity and labor-intensive. Though digital pathology becomes popular in medicine, an automated microscopic system for microbiology is still not available. A new AI-assisted automated microscopic system, consisting of a microscopic scanner and recognition program powered by big data and deep learning, may significantly increase the sensitivity of TB smear microscopy. Thus, the objective is to evaluate such an automatic system for the identification of AFB. A total of 5,930 smears was enrolled for this study. An intelligent microscope system (TB-Scan, Wellgen Medical, Taiwan) was used for microscopic image scanning and AFB detection. 272 AFB smears were used for transfer learning to increase the accuracy. Referee medical technicians were used as Gold Standard for result discrepancy. Results showed that, under a total of 1726 AFB smears, the automated system's accuracy, sensitivity and specificity were 95.6% (1,650/1,726), 87.7% (57/65), and 95.9% (1,593/1,661), respectively. Compared to culture, the sensitivity for human technicians was only 33.8% (38/142); however, the automated system can achieve 74.6% (106/142), which is significantly higher than human technicians, and this is the first of such an automated microscope system for TB smear testing in a controlled trial. This automated system could achieve higher TB smear sensitivity and laboratory efficiency and may complement molecular methods (eg. GeneXpert) to reduce the total cost for TB control. Furthermore, such an automated system is capable of remote access by the internet and can be deployed in the area with limited medical resources.

Keywords: TB smears, automated microscope, artificial intelligence, medical imaging

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Authors: Lucero Luciano, Cesar Celis, Jose Ramos

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Polygeneration improves energy efficiency and reduce both energy consumption and pollutant emissions compared to conventional generation technologies. A polygeneration system is a variation of a cogeneration one, in which more than two outputs, i.e., heat, power, cooling, water, energy or fuels, are accounted for. In particular, polygeneration systems integrating solar energy and water desalination represent promising technologies for energy production and water supply. They are therefore interesting options for coastal regions with a high solar potential, such as those located in southern Peru and northern Chile. Notice that most of the Peruvian and Chilean mining industry operations intensive in electricity and water consumption are located in these particular regions. Accordingly, this work focus on the design and integration of a polygeneration system producing industrial heating, cooling, electrical power and water for an industrial plant. The design procedure followed in this work involves integer linear programming modeling (MILP), operational planning and dynamic operating conditions. The technical and economic feasibility of integrating renewable energy technologies (photovoltaic and solar thermal, PV+CPS), thermal energy store, power and thermal exchange, absorption chillers, cogeneration heat engines and desalination technologies is particularly assessed. The polygeneration system integration carried out seek to minimize the system total annual cost subject to CO2 emissions restrictions. Particular economic aspects accounted for include investment, maintenance and operating costs.

Keywords: desalination, design and integration, polygeneration systems, renewable energy

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Authors: Muhammad Shahzad Tufail, Iram Liaqat

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Silver nanoparticles (AgNPs) have wider biomedical applications due to their intensive antimicrobial activities. However, toxicity and side effects of nanomaterials like AgNPs is a subject of great controversy towards the further studies in this direction. In this study, biogenically synthesized AgNPs, previously characterized via ultraviolet (UV) visible spectroscopy, scanning electron microscopy (SEM), X-ray diffraction (XRD) and fourier transform infrared spectroscopy (FTIR), were subjected to toxicity evaluation using mice model. Albino male mice (BALB/c) were administered with 50 mgkg-1, 100 mgkg-1 and 150 mgkg-1 of AgNPs, respectively, except for control for 30 days. Log-probit regression analysis was used to measure the dosage response to determine the median lethal dose (LD50). Exposure to AgNPs caused significant changes in the levels of serum AST (P ˂ 0.05) at the 100mgkg-1 and 150mgkg-1 of AgNPs exposure, while ALT and serum creatinine (P ˃ 0.05) levels remained normal. Histopathology of male albino mice liver and kidney was studied after 30 days experimental period. Results revealed that mice exposed to heavy dose (150 mgkg-1) of AgNPs showed cell distortion, necrosis and detachment of hepatocytes in the liver. Regarding kidney, at lower concentration, normal renal structure with normal glomeruli was observed. However, at higher concentration (150 mgkg-1), kidneys showed smooth surface and dark red colour with proliferation of podocytes. It can be concluded from present study that biologically synthesized AgNPs are small to be eliminated easily by kidney and therefore the liver and kidney did not show toxicity at low concentrations.

Keywords: silver nanoparticles, pseudomonas aeruginosa, male albino mice, toxicity assessment

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Authors: Garima Joshi, Pratap Sharan, V. Sreenivas, Nand Kumar, Kameshwar Prasad, Ashima N. Wadhawan

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Schizophrenia is a debilitating disorder and is marked by cognitive impairment, which deleteriously impacts the social and professional functioning along with the quality of life of the patients and the caregivers. Often the cognitive symptoms are in their prodromal state and worsen as the illness progresses; they have proven to have a good predictive value for the prognosis of the illness. It has been shown that intensive cognitive rehabilitation (CR) leads to improvements in the healthy as well as cognitively-impaired subjects. As the majority of population in India falls in the lower to middle socio-economic status and have low education levels, using the existing packages, a majority of which are developed in the West, for cognitive rehabilitation becomes difficult. The use of technology is also restricted due to the high costs involved and the limited availability and familiarity with computers and other devices, which pose as an impedance for continued therapy. Cognitive rehabilitation in India uses a plethora of retraining methods for the patients with schizophrenia targeting the functions of attention, information processing, executive functions, learning and memory, and comprehension along with Social Cognition. Psychologists often have to follow an integrative therapy approach involving social skills training, family therapy and psychoeducation in order to maintain the gains from the cognitive rehabilitation in the long run. This paper reviews the methodologies and cognitive retaining programs used in India. It attempts to elucidate the evolution and development of methodologies used, from traditional paper-pencil based retraining to more sophisticated neuroscience-informed techniques in cognitive rehabilitation of deficits in schizophrenia as home-based or supervised and guided programs for cognitive rehabilitation.

Keywords: schizophrenia, cognitive rehabilitation, neuropsychological interventions, integrated approached to rehabilitation

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