Search results for: acute primary angle closure glaucoma

Authors: Jongho Park, Jinwoong Choi, Sungnam Hong, Seung-Kyung Kye, Sun-Kyu Park

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Recently, to cope with the rapidly changing construction trend because of aging infrastructures, modular bridge technology has been studied actively. Modular bridge is easily constructed by assembling standardized precast structure members in the field. It will be possible to construct rapidly and reduce construction cost efficiently. However, the shape examination of the transverse connection of T-type girder newly developed between the segmented modules is not performed. Therefore, the investigation of the connection shape is needed. In this study, shape of the modular T-girder bridge transverse connection was analyzed by finite element model that was verified in study which was verification of model for transverse connection using Abaqus. Connection angle was chosen as the parameter. The result of analyses showed that optimal value of angle is 130 degree.

Keywords: modular bridge, optimal transverse shape, parameter, FEM

Procedia PDF Downloads 636

Authors: Mahtab Assadian, Mohd Hasbullah Idris, Mostafa Rezazadeh Shirdar, Mohammad Mahdi Taheri, ‎S. Izman

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Corrosion behaviour and surface roughness of magnesium substrate were investigated after NaOH pretreatment in different concentrations (1, 5, and 10 molar) and duration of (10 min, 30 min, 1 h, 3 h, 6 h and 24 h). Creation of Mg(OH)2 barrier layer after pretreatment enhanced corrostion resistance as well as wettability of substrate surface. Characterization including Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) was conducted to detect the existence of this barrier layer. Surface roughness and wettability of substrate was evaluated using atomic force microscopy (AFM) and contact angle measurement respectively. It is found that magnesium treated by 1M NaOH for 30 min reveals higher corrosion resistance and lower water contact angle of substrate surface. In addition, this investigation indicates that pH value of SBF solution is strongly influenced by different time and concentration of alkaline pretreatment.

Keywords: magnesium, NaOH pretreatment, corrosion resistance, wettability

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Authors: Koswaththage Dilushika Sewwandi, Aminda Lakmal

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From an activity reserved for the privileged few only some decades ago, tourism today moves more than one billion people across international borders each year. As the main part of the tourism industry, MICE tourism came to the floor and nowadays it became the main part of tourism especially in developing countries. Currently due to the fast development projects and infrastructure building, focus on tourism development in Sri Lanka could earn a global identity by practicing MICE tourism especially international conferences. Examine the behavior of conference travelers who looking for Sri Lanka as a conference destination must be required. Since the tourism industry highly involved with the personal factor and the destination selections taken by human beings it is vital to explore the factors affecting to their primary emotions which are shaped up with environmental factors. The Environmental Psychology studies the cognitive and affective behavior of human beings and based on that this study was carried out to examine the impact of environment psychology on customer primary emotions; with special reference to conference travelers to Sri Lanka. Finally, the study concludes with identifying the number of environmental factors as Accommodation, Travel Mode and Hotel Atmosphere that could impact the customer primary emotions of conference travelers to Sri Lanka.

Keywords: MICE tourism, envionmental psychology, primary emotions, destination selection

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Authors: Artur Cichowicz

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The last active mine in the Central Rand Goldfields area (50 km x 15 km) ceased operations in 2008. This resulted in the closure of the pumping stations, which previously maintained the underground water level in the mining voids. As a direct consequence of the water being allowed to flood the mine voids, seismic activity has increased directly beneath the populated area of Johannesburg. Monitoring of seismicity in the area has been on-going for over five years using the network of 17 strong ground motion sensors. The objective of the project is to improve strategies for mine closure. The evolution of the seismicity pattern was investigated in detail. Special attention was given to seismic source parameters such as magnitude, scalar seismic moment and static stress drop. Most events are located within historical mine boundaries. The seismicity pattern shows a strong relationship between the presence of the mining void and high levels of seismicity; no seismicity migration patterns were observed outside the areas of old mining. Seven years after the pumping stopped, the evolution of the seismicity has indicated that the area is not yet in equilibrium. The level of seismicity in the area appears to not be decreasing over time since the number of strong events, with Mw magnitudes above 2, is still as high as it was when monitoring began over five years ago. The average rate of seismic deformation is 1.6x1013 Nm/year. Constant seismic deformation was not observed over the last 5 years. The deviation from the average is in the order of 6x10^13 Nm/year, which is a significant deviation. The variation of cumulative seismic moment indicates that a constant deformation rate model is not suitable. Over the most recent five year period, the total cumulative seismic moment released in the Central Rand Basin was 9.0x10^14 Nm. This is equivalent to one earthquake of magnitude 3.9. This is significantly less than what was experienced during the mining operation. Characterization of seismicity triggered by a rising water level in the area can be achieved through the estimation of source parameters. Static stress drop heavily influences ground motion amplitude, which plays an important role in risk assessments of potential seismic hazards in inhabited areas. The observed static stress drop in this study varied from 0.05 MPa to 10 MPa. It was found that large static stress drops could be associated with both small and large events. The temporal evolution of the inter-event time provides an understanding of the physical mechanisms of earthquake interaction. Changes in the characteristics of the inter-event time are produced when a stress change is applied to a group of faults in the region. Results from this study indicate that the fluid-induced source has a shorter inter-event time in comparison to a random distribution. This behaviour corresponds to a clustering of events, in which short recurrence times tend to be close to each other, forming clusters of events.

Keywords: inter-event time, fluid induced seismicity, mine closure, spectral parameters of seismic source

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Authors: Rahaf Alasiri, Tarek Alghamdi, Abdullah Zarkan

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Background: Due to measures such as school closure, social distancing, and virtual teaching during the pandemic, primary school children's psychological well-being is greatly affected. These measures have short and long-term consequences on the children's well-being and mental health. Identifying these consequences is important. Aim: This study aimed to evaluate mood and behavior changes in children who attended school virtually. Subjects and methods: This is a cross-sectional study conducted among children and their parents who visited the outpatient clinic. A self-administered questionnaire was given to the parents of children aged between 6 to 14 years. The questionnaire includes socio-demographic characteristics, Conor's modifies scale to assess the attention deficit hyperactivity disorder (ADHD) of children, and the parental stress scale (PSS) to assess the stress symptoms of the parents. Results: Of the 66 surveyed children, 60.6% were aged between 10 to 14 years old, with the female being dominant (77.3%). The most common medical condition was asthma (7.6%), and nearly two-thirds (63.6%) indicated good health conditions during the pandemic. There was a significant inverse correlation observed between ADHD score and PSS score (r=-0.387). No significant differences are in ADHD and PSS scores in relation to the socio-demographic characteristics of the children, including age, gender, and having an associated medical condition (p>0.05). Conclusion: During the pandemic, children who attended virtual classes did not seem to affect even with restrictions. Most children indicated good health conditions during the pandemic. However, it is surprising to know that in spite of children’s high spirits during the pandemic, their parents were seen to have an increased level of stress. Strategies to address parents’ psychological disorders during the pandemic are warranted.

Keywords: children's mood, COVID-19, ADHD, parental stress

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Authors: Emanuela Chiarella, Annamaria Aloisio, Nisticò Clelia, Maria Mesuraca

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ZNF521 is a stem cell-associated transcription co-factor, that plays a crucial role in the homeostatic regulation of the stem cell compartment in the hematopoietic, osteo-adipogenic, and neural system. In normal hematopoiesis, primary human CD34+ hematopoietic stem cells display typically a high expression of ZNF521, while its mRNA levels rapidly decrease when these progenitors progress towards erythroid, granulocytic, or B-lymphoid differentiation. However, most acute myeloid leukemias (AMLs) and leukemia-initiating cells keep high ZNF521 expression. In particular, AMLs are often characterized by chromosomal translocations involving the Mixed Lineage Leukemia (MLL) gene, which MLL gene includes a variety of fusion oncogenes arisen from genes normally required during hematopoietic development; once they are fused, they promote epigenetic and transcription factor dysregulation. The chromosomal translocation t(9;11)(p21-22;q23), fusing the MLL gene with AF9 gene, results in a monocytic immune phenotype with an aggressive course, frequent relapses, and a short survival time. To better understand the dysfunctional transcriptional networks related to genetic aberrations, AML gene expression profile datasets were queried for ZNF521 expression and its correlations with specific gene rearrangements and mutations. The results showed that ZNF521 mRNA levels are associated with specific genetic aberrations: the highest expression levels were observed in AMLs involving t(11q23) MLL rearrangements in two distinct datasets (MILE and den Boer); elevated ZNF521 mRNA expression levels were also revealed in AMLs with t(7;12) or with internal rearrangements of chromosome 16. On the contrary, relatively low ZNF521 expression levels seemed to be associated with the t(8;21) translocation, that in turn is correlated with the AML1-ETO fusion gene or the t(15;17) translocation and in AMLs with FLT3-ITD, NPM1, or CEBPα double mutations. Invitro, we found that the enforced co-expression of ZNF521 in cord blood-derived CD34+ cells induced a significant proliferative advantage, improving MLL-AF9 effects on the induction of proliferation and the expansion of leukemic progenitor cells. Transcriptome profiling of CD34+ cells transduced with either MLL-AF9, ZNF521, or a combination of the two transgenes highlighted specific sets of up- or down-regulated genes that are involved in the leukemic phenotype, including those encoding transcription factors, epigenetic modulators, and cell cycle regulators as well as those engaged in the transport or uptake of nutrients. These data enhance the functional cooperation between ZNF521 and MA9, resulting in the development, maintenance, and clonal expansion of leukemic cells. Finally, silencing of ZNF521 in MLL-AF9-transformed primary CD34+ cells inhibited their proliferation and led to their extinction, as well as ZNF521 silencing in the MLL-AF9+ THP-1 cell line resulted in an impairment of their growth and clonogenicity. Taken together, our data highlight ZNF521 role in the control of self-renewal and in the immature compartment of malignant hematopoiesis, which, by altering the gene expression landscape, contributes to the development and/or maintenance of AML acting in concert with the MLL-AF9 fusion oncogene.

Keywords: AML, human zinc finger protein 521 (hZNF521), mixed lineage leukemia gene (MLL) AF9 (MLLT3 or LTG9), cord blood-derived hematopoietic stem cells (CB-CD34+)

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Authors: Robert Krause

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Primary progressive aphasia (PPA) is a neurodegenerative disease similar to frontotemporal and semantic dementia, while having a different clinical image and anatomic pathology topography. Nonetheless, they are often included under an umbrella term: frontotemporal lobar degeneration (FTLD). In the study, examples of diagnosing PPA are presented through the multidisciplinary lens of specialists from different fields (neurologists, psychiatrists, clinical speech therapists, clinical neuropsychologists and others) using a variety of diagnostic tools such as MR, PET/CT, genetic screening and neuropsychological and logopedic methods. Thanks to that, specialists can get a better and clearer understanding of PPA diagnosis. The study summarizes the concrete procedures and results of different specialists while diagnosing PPA in a patient of younger middle age and illustrates the importance of multidisciplinary approach to differential diagnosis of PPA.

Keywords: primary progressive aphasia, etiology, diagnosis, younger middle age

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Authors: Hsin-Jen Chen

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Primary schooling in Taiwan is in a process of radical restructuring during the decade. At the center of these restructuring is the position of the principal and questions to do with how principals, as school leaders, respond to radical change. Adopting a case-study approach, the study chose a middle Taiwanese primary school to investigate how the principal learned to be political. Using micropolitical leadership, the principal at the researched site successfully coped with internal change and external demands. On the whole, judging from the principal’s leadership style on the mediation between parents and teachers, as well as school-based curriculum development, it could be argued that the principal was on the stance of being a leader of the cultural transformation instead of cultural reproduction. In doing so, the qualitative evidence has indicated that the principal seemed to be successful in coping with the demands of rapid change. Continuing learning for leadership is the core of working as a principal.

Keywords: micropolitics, leadership, micropolitical leadership, learning for leadership

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Authors: Radhwane Boudjelthia

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Based upon elaborate analysis on torsional design methods of asymmetric and irregular structure under horizontal earthquake action, it points out that the main design principles of an asymmetric building subjected to horizontal earthquake are: the torsion of vertical members induced by the torsion angle of the floor (rigid diaphragm) cannot exceed the allowable value, the inter-story displacement at outermost frame or shear wall should be less than that required by design code, stresses in plane of the slab should be controlled within acceptable extent under different intensity earthquakes. That current seismic design code only utilizes the torsion displacement ratio to control the floor torsion, which seems not reasonable enough since its connotation is the multiple of the floor torsion angle and the distance of floor mass center to the edge frame or shear wall.

Keywords: earthquake, building, seismic forces, displacement, resonance, response

Procedia PDF Downloads 328

Authors: Chul Hyun Park

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Background:Repair using the Achillon deviceis a representative mini-open repair technique;however, the limitations of this technique includethe need for special instruments and decreasedrepair strength.A modifiedmini-open repair using ring forcepsmight overcome these limitations. Purpose:This study was performed to compare the Achillon device with ring forceps in mini-open repairsof acute Achilles tendon rupture. Study Design:This was a retrospective cohort study, and the level of evidence was3. Methods:Fifty patients (41 men and 9 women), withacute Achilles tendon rupture on one foot, were consecutively treated using mini-open repair techniques. The first 20 patients were treated using the Achillon device (Achillon group) and the subsequent 30 patients were treated using a ring forceps (Forcep group). Clinical, functional, and isokinetic results,and postoperative complications were compared between the two groups at the last follow-up. Clinical evaluations wereperformed using the American Orthopedic Foot and Ankle Society (AOFAS) score, Achilles tendon Total Rupture Score (ATRS), length of incision, and operation time. Functional evaluationsincludedactive range of motion (ROM) of the ankle joint, maximum calf circumference (MCC), hopping test, and single limb heel-rise (SLHR) test. Isokinetic evaluations were performed using the isokinetic test for ankle plantar flexion. Results:The AOFAS score (p=0.669), ATRS (p=0.753), and length of incision (p=0.305) were not significantly different between the groups. Operative times in the Achillon group were significantly shorter than that in the Forcep group (p<0.001).The maximum height of SLHR (p=0.023) and number of SLHRs (p=0.045) in the Forcep group were significantly greater than that in the Achillon group. No significant differences in the mean peak torques for plantar flexion at angular speeds of 30°/s (p=0.219) and 120°/s (p=0.656) were detected between the groups. There was no significant difference in the occurrence of postoperative complications between the groups (p=0.093). Conclusion:The ring forceps technique is comparable with the Achillon technique with respect to clinical, functional, and isokinetic results and the postoperative complications. Given that no special instrument is required, the ring forceps technique could be a better option for acute Achilles tendon rupture repair.

Keywords: achilles tendon, acute rupture, repair, mini-open

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: El Metmati Abdelhaq

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Shear strength of sandy soils has been considered as the important parameter to study the stability of different civil engineering structures when subjected to monotonic, cyclic and earthquake loading conditions. The objective of this laboratory investigation is to study the influence of the fraction of low plastic fines and gradation on the mechanical behavior of sand-silt mixtures reconstituted in the laboratory. For this purpose, a series of Casagrande shear box tests were carried out on different reconstituted samples of sand-silt mixtures with various gradations at two initial relative densities (Dr = 20 and 91 %) with different fines content ranging from 0 to 40 %. The soil samples were tested under different normal stresses (100, 200 and 300 kPa). The evaluation of the data indicates that the fines content and the gradation have significant influence on the friction angle and the cohesion.

Keywords: mechanical behavior, silty sand, friction angle, cohesion, fines content

Procedia PDF Downloads 358

Authors: István Patkó, Hosam Bayoumi Hamuda, András Szeder

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In order to efficiently solve the problems created by the deepening energy crisis affecting Europe and the world, governments cannot neglect the opportunities of using the energy produced by sun collectors. In many of the EU countries there are sun collectors producing heat energy, e.g. in 2011 in the area of EU27 (countries which belong to European Union) + Switzerland altogether 37519126 m2 were operated, which are capable of producing 26.3 GWh heat energy. The energy produced by these sun collectors is utilized at the place of production. In the near future governments will have to focus more on spreading and using sun collectors. Among the complex problems of operating sun collectors, this article deals with determining the optimal tilt angle, directions of sun collectors. We evaluate the contamination of glass surface of sun collector to the produced energy. Our theoretically results are confirmed by laboratory measurements. The purpose of our work is to help users and engineers in determination of optimal operation parameters of sun collectors.

Keywords: heat energy, tilt angle, direction of sun collector, contamination of surface

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Authors: Vasilis C. Hristidis, Ricardo Caceda, Ji Soo Kim, Brian Bronson, Emily A. Hill

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Objective: Leave passes to provide authorized leave for hospitalized patients from a psychiatric inpatient unit. Though providing day passes was once a relatively common practice, there is relatively little data describing their safety and efficacy. Methods: This descriptive study examines the use of leave passes in an adult inpatient unit at a university hospital between 2017 and 2021, with attention to reasons for granting the day pass, duration, and outcome of the pass. Results: During the study period, ten patients with primary psychotic or mood disorders received 12 passes for either housing coordination, COVID-19 vaccination, or major family events. There were no fatalities or elopements. One patient experienced severe agitation and engaged in non-suicidal self-injurious behavior. A second patient showed mild, redirectable psychomotor agitation upon return to the unit. The remaining 10 passes were uneventful. Conclusions: Our findings support the view that patients with diverse diagnoses can safely be provided leave from an inpatient setting with adequate planning and support, yielding a low incidence of adverse events.

Keywords: passes, inpatient, psychiatry, inpatient leave, outcome

Procedia PDF Downloads 178

Authors: S. V. Ukwungwu, A. J. Abbas, G. G. Nasr

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The increasing high price of natural gas and oil with attendant increase in energy demand on world markets in recent years has stimulated interest in recovering residual oil saturation across the globe. In order to meet the energy security, efforts have been made in developing new technologies of enhancing the recovery of oil and gas, utilizing techniques like CO2 flooding, water injection, hydraulic fracturing, surfactant flooding etc. Surfactant flooding however optimizes production but poses risk to the environment due to their toxic nature. Amongst proven records that have utilized other type of bacterial in producing biosurfactants for enhancing oil recovery, this research uses a technique to combine biosurfactants that will achieve a scale of EOR through lowering interfacial tension/contact angle. In this study, three biosurfactants were produced from three Bacillus species from freeze dried cultures using sucrose 3 % (w/v) as their carbon source. Two of these produced biosurfactants were screened with the TEMCO Pendant Drop Image Analysis for reduction in IFT and contact angle. Interfacial tension was greatly reduced from 56.95 mN.m-1 to 1.41 mN.m-1 when biosurfactants in cell-free culture (Bacillus licheniformis) were used compared to 4. 83mN.m-1 cell-free culture of Bacillus subtilis. As a result, cell-free culture of (Bacillus licheniformis) changes the wettability of the biosurfactant treatment for contact angle measurement to more water-wet as the angle decreased from 130.75o to 65.17o. The influence of microbial treatment on crushed rock samples was also observed by qualitative wettability experiments. Treated samples with biosurfactants remained in the aqueous phase, indicating a water-wet system. These results could prove that biosurfactants can effectively change the chemistry of the wetting conditions against diverse surfaces, providing a desirable condition for efficient oil transport in this way serving as a mechanism for EOR. The environmental friendly effect of biosurfactants applications for industrial purposes play important advantages over chemically synthesized surfactants, with various possible structures, low toxicity, eco-friendly and biodegradability.

Keywords: bacillus, biosurfactant, enhanced oil recovery, residual oil, wettability

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Authors: Hannah Bigelow, Marcus D. Gottlieb, Michelle Ogrodnik, Jeffrey, D. Graham, Barbara Fenesi

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders affecting approximately 6% of children worldwide. ADHD is characterized by a combination of persistent deficits including impaired inhibitory control, working memory and task-switching. Many children with ADHD also have comorbid mental health issues such as anxiety and depression. There are several treatment options to manage ADHD impairments, including drug and behavioural management therapy, but they all have drawbacks, such as worsening mood disturbances or being inaccessible to certain demographics. Both physical exercise and mindfulness meditation serve as alternative options to potentially help mitigate ADHD symptoms. Although there is extensive support for the benefits of long-term physical exercise or mindfulness meditation programs, there is insufficient research investigating how acute bouts (i.e., single, short bouts) can help children with ADHD. Thus, the current study aimed to understand how single, short bouts of exercise and mindfulness meditation impacts executive functioning and psycho-emotional well-being in children with ADHD, as well as to directly compare the efficacy of these two interventions. The study used a a pre- post-test, within-subjects design to assess the effects of a 10-minute bout of moderate intensity exercise versus a 10-minute bout of mindfulness meditation (versus 10 minutes of a reading control) on the executive functioning and psycho-emotional well-being of 16 children and youth with ADHD aged 10-14 (male=11; White=80%). Participants completed all three interventions: 10 minutes of exercise, 10 minutes of mindfulness meditation, and 10 minutes of reading (control). Executive functioning (inhibitory control, working memory, task-switching) and psycho-emotional well-being (mood, self-efficacy) were assessed before and after each intervention. Mindfulness meditation promoted executive functioning, while exercise enhanced positive mood and self-efficacy. Critically, this work demonstrates that a single, short bout of mindfulness meditation session can promote inhibitory control among children with ADHD. This is especially important for children with ADHD as inhibitory control deficits are among the most pervasive challenges that they face. Furthermore, the current study provides preliminary evidence for the benefit of acute exercise for promoting positive mood and general self-efficacy for children and youth with ADHD. These results may increase the accessibility of acute exercise for children with ADHD, providing guardians and teachers a feasible option to incorporate just 10 minutes of exercise to assist children emotionally. In summary, this research supports the use of acute exercise and mindfulness meditation on varying aspects of executive functioning and psycho-emotional well-being in children and youth with ADHD. This work offers important insight into how behavioural interventions could be personalized according to a child’s needs.

Keywords: attention-deficit hyperactivity disorder (ADHD), acute exercise, mindfulness meditation, executive functioning, psycho-emotional well-being

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Authors: Tahira Pirzada, Zahra Ashrafi, Saad Khan

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We present a facile and sustainable solid templating approach to fabricate highly porous, flexible and superhydrophobic aerogels of composite nanofibers of cellulose diacetate and silica which are produced through sol gel electrospinning. Scanning electron microscopy, contact angle measurement, and attenuated total reflection-Fourier transform infrared spectrometry are used to understand the structural features of the resultant aerogels while thermogravimetric analysis and differential scanning calorimetry demonstrate their thermal stability. These aerogels exhibit a self-supportive three-dimensional network abundant in large secondary pores surrounded by primary pores resulting in a highly porous structure. Thermal crosslinking of the aerogels has further stabilized their structure and flexibility without compromising on the porosity. Ease of processing, thermal stability, high porosity and oleophilic nature of these aerogels make them promising candidate for a wide variety of applications including acoustic and thermal insulation and oil and water separation.

Keywords: hybrid aerogels, sol-gel electrospinning, oil-water separation, nanofibers

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Authors: Zhang Jun, Zhai Shucheng, Bai Yaqiang, Zhang Guoping

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The Gymnarchus Niioticus fish(GNF) cruises generally with high efficiency by undulating ribbon-fin propulsion while keeping its body for straight line. The swing amplitude of GNF fins is usually in 60° to 90°, and in normal state the amplitude is close to 90°, only in the control of hovering or swimming at very low speed, the amplitude is smaller (about 60°). It provides inspiration for underwater robot design. In the paper, the unsteady flow of undulating ribbon-fin propulsion is numerical simulated by the dynamic grid technique including spring-based smoothing model and local grid remeshing to adapt to the fin surface significantly deforming, and the swing amplitude of fin ray reaches 850. The numerical simulation method is validated by thrust experiments. The spatial vortex structure and its evolution with phase angle is analyzed. The propulsion mechanism is investigated by comprehensive analysis of the hydrodynamics, vortex structure, and pressure distribution on the fin surface. The numerical results indicates that there are mainly three kinds of vortexes, i.e. streamwise vortex, crescent vortex and toroidal vortex. The intensity of streamwise vortex is the strongest among all kinds of vortexes. Streamwise vortexes and crescent vortexes all alternately distribute on the two sides of mid-sagittal plane. Inside the crescent vortexes is high-speed flow, while outside is low-speed flow. The crescent vortexes mainly induce high-speed axial jet, which produces the primary thrust. This is hydrodynamic mechanism undulating ribbon-fin propulsion. The streamwise vortexes mainly induce the vertical jet, which generates the primary heave force. The effect on hydrodynamics of main geometry and movement parameters including wave length, amplitude and advanced coefficients is investigated. A bionic underwater robot with bilateral undulating ribbon-fins is designed, and its navigation performance and maneuverability are measured.

Keywords: bionic propulsion, mobile robot, underwater robot, undulating ribbon-fins

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Authors: Villiam Ambong, Kevin Banawag, Wynne Shane Bugatan, Mark Alvin Jay Carpio, Hwan Hee Choi, Moises Kevin Chungalao

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This survey research investigated the perception of primary school teachers on the efficacy of MTB-MLE in SLU-LES, Baguio City. SLU-LES has a total of 21 primary school teachers who served as respondents of this study in an attempt to answer the major questions regarding the efficacy of MTB-MLE among primary school teachers. A questionnaire was used in collecting the data which were analyzed using weighted mean and ANOVA. The questionnaire was validated by a statistician and it was administered to a school which does not differ from the intended respondents for further validation of the items. Findings revealed from the intended respondents that they perceive MTB-MLE as effective; however, they do not prefer the use of Mother Tongue as a medium of instruction. A research on the same topic was conducted in Ibadan, Nigeria by Dr. David O. Fakeye and although his respondents were students; the results came out that the respondents do perceive MTB-MLE to be efficacious. The results of this study also showed that years of teaching experience and the number of languages spoken by the teachers have no bearing on the preference of the respondents between MT medium and English medium gave that the respondents are in melting pot community. Comparative studies between rural and urban schools are encouraged. Future researchers should include questions that elicit reasons of the respondents on the efficacy of mother tongue as well as their preference between mother tongue medium and English.

Keywords: mother tongue, primary teachers, perception, multilingual education

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Authors: Villiam C. Ambong, Kevin G. Banawag, Wynne Shane B. Bugatan, Mark Alvin Jay R. Carpio, Hwan Hee Choi, Moses Kevin L. Chungalao

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This survey research investigated the perception of primary school teachers on the efficacy of MTB-MLE in SLU-LES, Baguio City. SLU-LES has a total of 21 primary school teachers who served as the respondents of this study in an attempt to answer three major questions regarding the efficacy of MTB-MLE among primary school teachers. A questionnaire was used in collecting the data which were analyzed using weighted mean and ANOVA. The questionnaire was validated by a statistician and it was administered to a school which does not differ from the intended respondents for further validation of the items. Findings revealed from the intended respondents that they perceive MTB-MLE as effective; however, they do not prefer the use of Mother Tongue as medium of instruction. A research of the same topic was conducted in Ibadan, Nigeria by Dr. David O. Fakeye and although his respondents were students; the results came out that the respondents do perceive MTB-MLE to be efficacious. The results of this study also showed that years of teaching experience and number of languages spoken by the teachers have no bearing on the preference of the respondents between MT medium and English medium given that the respondents are in a melting pot community. Comparative studies between rural schools and urban schools are encouraged. Future researches should include questions that elicit reasons of the respondents on the efficacy of mother tongue as well as their preference between mother tongue medium and English.

Keywords: mother tongue, primary teachers, perception, multilingual education

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Authors: Zakiullah Kalwar, Shabeer Ahmed Abbasi

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This research encompasses the study of Cretaceous Sembar Formation Shale Gas potential at Hajipur area. This study has been done with the approach of geophysical data integration. The structure is NE – SW trending anticline with two map able compartments at Cretaceous Sembar level. The study area is located within proven petroleum system. Cretaceous Sembar/Goru formation is in a Wet gas window and Tertiary source is possibly in the oil window. Potential seals are present in Upper Ranikot shale beds and Intra-Lower Ranikot shales. The effectiveness and presence of source and reservoir rocks are favorable in the area of interest. Cretaceous Sembar Shale and Goru Shale beds with good organic content (TOC upto 4%, Type II/III) are currently in gas generation window in the area. Source rock intervals are also reported in Eocene Kirthar Group (TOC upto 8%, Type –II). Good reservoir quality Paleocene Lower Ranikot and Cretaceous Sembar shale beds exist in the area. The collision between Indian and Eurasian Plates during Tertiary initiated folding and thrusting. The first phase of thrusting involved ophiolite emplacement along the western margins of the Indian Plate (west of the area under review). The main phase of thrusting in the Sulaiman region was from Late Miocene to the present. The study area contains Permian to Recent clastics and carbonates. The succession generally is younger in the southeast than in northwest. Intraformational sedimentation breaks are pronounced in Permian and Jurassic. Sulaiman Range is bounded by the Western Sulaiman Transform Fault Zone (of which the Kingri Fault is the major fault) to the west and by the Domanda Fault to the east. The Domanda Fault also constitutes the western boundary of the Sulaiman Foredeep, lies in sulaiman foredeep where subsurface having prominent independent closure. Several reservoir horizons of Jurassic to Eocene are established hydrocarbon producers in the Hajipur area.

Keywords: enough size, good potential, shale gas, structure closure

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Authors: K. G. Adeosun, K. Osunaiye, E. C. Chinaguh, M. A. Aliyu, C. A. Onifade

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This study examined the effects of incompetence in the use of the mother tongue on the spoken English of selected Primary School pupils in Abeokuta South Local Government, Ogun State, Nigeria. The study used a structured questionnaire and interview guide as data collection instruments. The target population was 110 respondents. The sample was obtained by the use of simple random and stratified sampling techniques. The study samples were pupils from Government Primary Schools in Abeokuta South Local Government. The result revealed that the majority of pupils exhibited mother tongue interference in their oral production stage and that the local indigenous languages interfered with the pronunciation of English words to a large extent such that they pronounced ‘people’ as ‘fitful.’ The findings also revealed that there is no significant difference between inadequate teaching materials, shortage of funds towards the promotion of the mother tongue (Yoruba) and spoken English of Primary school pupils in the study area. The study recommended, among other things, that government should provide the necessary support for schools in the areas of teaching and learning materials, funds and other related materials that can enhance the effective use of the mother tongue towards spoken English by Primary School pupils. Government should ensure that oral English is taught to the pupils and the examination at the end of Primary school education should be made compulsory for all pupils. More so, the Government should provide language laboratories and other equipment to facilitate good teaching and learning of oral English.

Keywords: education, effective, government, learning, teaching

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Authors: Mamatha Hosapatna, Anne D. Souza, Vrinda Hari Ankolekar, Antony Sylvan D. Souza

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Introduction: The lower extremity of the femur is characterized by an anterior groove in which patella is held during motion. This groove separates the two lips of the trochlea (medial and lateral), prolongation of the two condyles. In humans, the lateral trochlear lip is more developed than the medial one, creating an asymmetric groove that is also specific to the human body. Because of femoral obliquity, contraction of quadriceps leads to a lateral dislocation stress on the patella, and the more elevated lateral side of the patellar groove helps the patella stays in its correct place, acting as a wall against lateral dislocation. This specific shape fits an oblique femur. It is known that femoral obliquity is not genetically determined but comes with orthostatism and biped walking. Material and Methodology: To measure the various dimensions of the Femoropatellar groove (FPG) and femoral condyle using digital image analyser. 37 dried adult femora (22 right,15 left) were used for the study. End on images of the lower end of the femur was taken. Various dimensions of the Femoropatellar groove and FP angle were measured using image J software. Results were analyzed statistically. Results: Maximum of the altitude of medial condyle of the right femur is 4.98± 0.35 cm and of the left femur is 5.20±.16 cm. Maximum altitude of lateral condyle is 5.44±0.4 and 5.50±0.14 on the right and left side respectively. Medial length of the groove is 1.30±0.38 cm on the right side and on the left side is 1.88±0.16 cm. The lateral length of the groove on the right side is 1.900±.16 cm and left side is 1.88±0.16 cm. Femoropatellar angle is 136.38◦±2.59 on the right side and on the left side it is 142.38◦±7.0 Angle and dimensions of the femoropatellar groove on the medial and lateral sides were measured. Asymmetry in the patellar groove was observed. The lateral lip was found to be wider and bigger which correlated with the previous studies. An asymmetrical patellar groove with a protruding lateral side associated with an oblique femur is a specific mark of bipedal locomotion. Conclusion: Dimensions of FPG are important in maintaining the stability of patella and also in knee replacement surgeries. The implants used in to replace the patellofemoral compartment consist of a metal groove to fit on the femoral end and a plastic disc that attaches to the undersurface of the patella. The location and configuration of the patellofemoral groove of the distal femur are clinically significant in the mechanics and pathomechanics of the patellofemoral articulation.

Keywords: femoral patellar groove, femoro patellar angle, lateral condyle, medial condyle

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Authors: R. Botrugno, S Basyuni, G. Nugent, I. Jenkyn, A. Ferro, H. Bennett, C. Hjalmarsson, J. Chu, V. Santhanam

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This trainee led randomised controlled trial (RCT) aims to assess various outcomes for resorbable versus non-resorbable sutures for traumatic lacerations to the face. Within this trial of resorbable versus non-resorbable sutures for traumatic lacerations of the face (TORNFace), patient recruitment was facilitated by trainees who were employed at an NHS University Teaching Hospital in the United Kingdom. The trainees received appropriate training prior to recruiting patients for the trial. This included the completion of a national research e-learning module and face-to-face training that was provided locally. The locally delivered training provided an understanding of the eligibility criteria for the trial and the consent process. Existing trainee skills were utilised involving clinical photography to record baseline data and delivering the intervention based on the treatment arm selected. Eligible patients who required primary closure of traumatic lacerations of the face were randomised into one of two treatment arms. These comprised of resorbable (vicryl rapide) or non-resorbable sutures (ethilon). Primarily the cosmetic outcome was assessed. Secondary outcomes included: complications rates, health care economics, and patient-reported outcomes. Remote follow-up of recruited patients utilised photographs of the facial laceration which had received the intervention. These took place at 1 week, 3 months and 6 months post-intervention. This study aims to demonstrate an example of trainee-led research within the specialty of oral and maxillofacial surgery. The available data for the randomised controlled trial will also be presented.

Keywords: laceration, suture, trauma, trial

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Authors: S. Naderizadeh, A. Athanassiou, I. S. Bayer

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This work describes a layer-by-layer spraying method to produce a non-wetting coating, based on thermoplastic polyurethane (TPU) and silica nanoparticles (Si-NPs). The main purpose of this work was to transform a hydrophilic polymer to superhydrophobic coating. The contact angle of pure TPU was measured about 77˚ ± 2, and water droplets did not roll away upon tilting even at 90°. But after applying a layer of Si-NPs on top of this, not only the contact angle increased to 165˚ ± 2, but also water droplets can roll away even below 5˚ tilting. The most important restriction in this study was the weak interfacial adhesion between polymer and nanoparticles, which had a bad effect on durability of the coatings. To overcome this problem, we used a very thin layer of graphene nanoplatelets (GNPs) as an interlayer between TPU and Si-NPs layers, followed by thermal treatment at 150˚C. The sample’s morphology and topography were characterized by scanning electron microscopy (SEM), EDX analysis and atomic force microscopy (AFM). It was observed that Si-NPs embedded into the polymer phase in the presence of GNPs layer. It is probably because of the high surface area and considerable thermal conductivity of the graphene platelets. The contact angle value for the sample containing graphene decreased a little bit respected to the coating without graphene and reached to 156.4˚ ± 2, due to the depletion of the surface roughness. The durability of the coatings against abrasion was evaluated by Taber® abrasion test, and it was observed that superhydrophobicity of the coatings remains for a longer time, in the presence of GNPs layer. Due to the simple fabrication method and good durability of the coating, this coating can be used as a durable superhydrophobic coating for metals and can be produced in large scale.

Keywords: graphene, silica nanoparticles, superhydrophobicity, thermoplastic polyurethane

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Authors: Zbigniew Czyz, Krzysztof Skiba, Miroslaw Wendeker

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This paper discusses the results of aerodynamic investigation of the Tajfun gyroplane body designed by a Polish company, Aviation Artur Trendak. This gyroplane has been studied as a 1:8 scale model. Scaling objects for aerodynamic investigation is an inherent procedure in any kind of designing. If scaling, the criteria of similarity need to be satisfied. The basic criteria of similarity are geometric, kinematic and dynamic. Despite the results of aerodynamic research are often reduced to aerodynamic coefficients, one should pay attention to how values of coefficients behave if certain criteria are to be satisfied. To satisfy the dynamic criterion, for example, the Reynolds number should be focused on. This is the correlation of inertial to viscous forces. With the multiplied flow speed by the specific dimension as a numerator (with a constant kinematic viscosity coefficient), flow speed in a wind tunnel research should be increased as many times as an object is decreased. The aerodynamic coefficients specified in this research depend on the real forces that act on an object, its specific dimension, medium speed and variations in its density. Rapid prototyping with a 3D printer was applied to create the research object. The research was performed with a T-1 low-speed wind tunnel (its diameter of the measurement volume is 1.5 m) and a six-element aerodynamic internal scales, WDP1, at the Institute of Aviation in Warsaw. This T-1 wind tunnel is low-speed continuous operation with open space measurement. The research covered a number of the selected speeds of undisturbed flow, i.e. V = 20, 30 and 40 m/s, corresponding to the Reynolds numbers (as referred to 1 m) Re = 1.31∙106, 1.96∙106, 2.62∙106 for the angles of attack ranging -15° ≤ α ≤ 20°. Our research resulted in basic aerodynamic characteristics and observing the impact of undisturbed flow speed on the correlation of aerodynamic coefficients as a function of the angle of attack of the gyroplane body. If the speed of undisturbed flow in the wind tunnel changes, the aerodynamic coefficients are significantly impacted. At speed from 20 m/s to 30 m/s, drag coefficient, Cx, changes by 2.4% up to 9.9%, whereas lift coefficient, Cz, changes by -25.5% up to 15.7% if the angle of attack of 0° excluded or by -25.5% up to 236.9% if the angle of attack of 0° included. Within the same speed range, the coefficient of a pitching moment, Cmy, changes by -21.1% up to 7.3% if the angles of attack -15° and -10° excluded or by -142.8% up to 618.4% if the angle of attack -15° and -10° included. These discrepancies in the coefficients of aerodynamic forces definitely need to consider while designing the aircraft. For example, if load of certain aircraft surfaces is calculated, additional correction factors definitely need to be applied. This study allows us to estimate the discrepancies in the aerodynamic forces while scaling the aircraft. This work has been financed by the Polish Ministry of Science and Higher Education.

Keywords: aerodynamics, criteria of similarity, gyroplane, research tunnel

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Authors: Alakija Temitope Olufunmilayo, Akinyemi, Yagba Joy

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Hepatitis is the inflammation of the liver tissue that can cause whiteness of the eyes (Jaundice), lack of appetite, vomiting, tiredness, abdominal pain, diarrhea. Hepatitis is acute if it resolves within 6 months and chronic if it last longer than 6 months. Acute hepatitis can resolve on its own, lead to chronic hepatitis or rarely result in acute liver failure. Chronic hepatitis may lead to scarring of the liver (Cirrhosis), liver failure and liver cancer. Modelling Hepatitis B may become necessary in order to reduce its spread. So, dynamic SIR model can be used. This model consists of a system of three coupled non-linear ordinary differential equation which does not have an explicit formula solution. It is an epidemiological model used to predict the dynamics of infectious disease by categorizing the population into three possible compartments. In this study, a five-compartment dynamic model of Hepatitis B disease was proposed and developed by adding control measure of sensitizing the public called awareness. All the mathematical and statistical formulation of the model, especially the general equilibrium of the model, was derived, including the nonlinear least square estimators. The initial parameters of the model were derived using nonlinear least square embedded in R code. The result study shows that the proportion of Hepatitis B patient in the study population is 1.4 per 1,000,000 populations. The estimated Hepatitis B induced death rate is 0.0108, meaning that 1.08% of the infected individuals die of the disease. The reproduction number of Hepatitis B diseases in Nigeria is 6.0, meaning that one individual can infect more than 6.0 people. The effect of sensitizing the public on the basic reproduction number is significant as the reproduction number is reduced. The study therefore recommends that programme should be designed by government and non-governmental organization to sensitize the entire Nigeria population in order to reduce cases of Hepatitis B disease among the citizens.

Keywords: hepatitis B, modelling, non-linear ordinary differential equation, sihar model, sensitization

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Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: Wipada Prasansaph

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The aim of this research is twofold: to develop a local literature (simplified English translation version) reading booklet for Thai primary school children (the fourth graders) and to encourage the love of reading in English by reading local literature. An excerpt from Thai literature namely Phra-apaimani, the reading requirement for Primary 4 was selected to be translated into English in simplified language with cartoon pictures to illustrate the key happenings of the story. After the first draft of the booklet development, the samples of the booklets were distributed to 3 educator experts to call for validity and comments on 1) the appropriateness of the English language, 2) the organization of the booklet, 3) the comprehension of the story, and 4) the relevance to the core curriculum of Basic Education of Thailand (B.E.2551). The IOC (Index of Item – Objective Congruence) was 0.9 indicated that the material is applicable (with some comments and suggestions). After the first amendment, the booklets were distributed to 30 fourth graders (in 3 schools – 10 in each school), 10 English teachers of Primary 4, and 10 educational supervisors for English subjects (in primary level) to call for comments on 1) the comprehension of the story 2) the organization of the booklet, and 3) the encouragement for the love of reading in English. The English reading booklet on Phra-apaimani for Thai primary children, the IOC questionnaire (with the open-ended questions) for the educator experts, and the rating scales for the students, the teachers, and the educational supervisors were used as the instruments of the research. The findings revealed that most students rated ‘positive’ level for the comprehension of the story, while the teachers and the educational supervisors rated ‘highly positive’. The 3 groups rated ‘highly positive’ for both the organization of the booklet and for the encouragement for the love of reading in English. It is recommended that there should be more production of English reading texts for children, especially the texts that children already have some background knowledge. Moreover, illustration is the most crucial part for the children’s reading texts.

Keywords: English language, reading skill, primary children, Thai literature

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Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

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