Search results for: reduced private care use

Authors: Dijiang Lyu, Shaoying Li, Zhangzhi Tan, Zhifeng Wu, Feng Gao

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Nowadays, China is experiencing rapidly urban rail transit expansions in the world. The purpose of this study is to finely model factors influencing transit ridership at multi-time dimensions within transit stations’ pedestrian catchment area (PCA) in Guangzhou, China. This study was based on multi-sources spatial data, including smart card data, high spatial resolution images, points of interest (POIs), real-estate online data and building height data. Eight multiple linear regression models using backward stepwise method and Geographic Information System (GIS) were created at station-level. According to Chinese code for classification of urban land use and planning standards of development land, residential land-use were divided into three categories: first-level (e.g. villa), second-level (e.g. community) and third-level (e.g. urban villages). Finally, it concluded that: (1) four factors (CBD dummy, number of feeder bus route, number of entrance or exit and the years of station operation) were proved to be positively correlated with transit ridership, but the area of green land-use and water land-use negative correlated instead. (2) The area of education land-use, the second-level and third-level residential land-use were found to be highly connected to the average value of morning peak boarding and evening peak alighting ridership. But the area of commercial land-use and the average height of buildings, were significantly positive associated with the average value of morning peak alighting and evening peak boarding ridership. (3) The area of the second-level residential land-use was rarely correlated with ridership in other regression models. Because private car ownership is still large in Guangzhou now, and some residents living in the community around the stations go to work by transit at peak time, but others are much more willing to drive their own car at non-peak time. The area of the third-level residential land-use, like urban villages, was highly positive correlated with ridership in all models, indicating that residents who live in the third-level residential land-use are the main passenger source of the Guangzhou Metro. (4) The diversity of land-use was found to have a significant impact on the passenger flow on the weekend, but was non-related to weekday. The findings can be useful for station planning, management and policymaking.

Keywords: fine-scale modeling, Guangzhou city, multi-time dimensions, multi-sources spatial data, transit ridership

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Authors: Laid Fekih

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Background: Depression affects people in all communities across the world and in all aspects of their lives. Its spread varies from one country to another, can happen at any age and get rid of it is not easy. There is no clear policy in Algeria's higher education institutions to detect and treat these disorders or pay particular attention to those at risk. Identifying the prevalence of depression among Algerian students, its correlation with different variables, and studying gender differences in the light of a range of variables is necessary to develop an appropriate plan to raise the level of hope and love of life among students. Method: Random samples of 1500 University of Tlemcen students (967 girls and 533 boys), aged 19 to 24 years completed a self-administered questionnaire that included Beck's Depression Inventory ®-II (BDI®-II), (School Health Promotion: The Mood part), Other questions included in this survey focused on demographic characteristics including gender, age and year of study, academic performance (Annual Average Score (0-20) AAS), were examined. Results: The rate of depression (moderate, severe and extreme) varied from 03% to 13% among university students in Tlemcen University. There was no difference in the rates of depression in male and female students, which means that male and female students do have similar rates of depression. The rate of depression in the first-year of the study shows a higher score relative to students of other years. Depression has a negative relationship with academic performance, which means that depressed students have many difficulties in academic tasks at university. Conclusion: Depression among university students is an important center of interest in the world, not only because of the ease with which they can be followed, or the difficulties encountered during their studies and their technical courses but for the link between the level of depression and the quality of care of mental health services, especially if many students with mood and emotional problems don't meet the criteria for psychotherapy.

Keywords: depression, epidemiology, university students, academic performance

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Authors: N. S. Aggangan, B. Dell, P. Jeffries

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Two moderately nickel-tolerant isolates of Pisolithus were compared with a non-Ni tolerant isolate for the ability to increase the growth of Eucalyptus urophylla seedlings in the presence of nickel (Ni) in pots in a glasshouse. Seedlings, either inoculated with mycorrhizal fungi or uninoculated, were transplanted into pots containing 3 kg steam-pasteurized yellow sand amended with five concentrations of nickel (0, 6, 12, 24 and 48 mg Ni kg-1 soil). Within a day after transplanting, all seedlings subjected to Ni rates greater than 12 mg Ni kg-1 showed symptoms of wilting and all died within two weeks. At lower nickel concentrations, inoculation with all 3 Pisolithus strains increased rates of seedling survival after 12 weeks. Inoculation with all 3 isolates Pisolithus significantly increased the growth of plants in Ni-free soils between 2 to 4 fold dependent on isolate. However, seedlings growing in soils containing 12 mg Ni kg-1 grew poorly, mycorrhizal development was inhibited and no beneficial effects of inoculation were noted. In contrast, in soils containing 6mg Ni kg-1, inoculated seedlings did not show the reduced root growth and severe toxicity symptoms (chlorosis on young leaves and shoot tips) of uninoculated seedlings. Only the Ni-tolerant Pisolithus strains conferred a significant growth benefit compared to non-inoculated controls, and plants inoculated with one of these strains grew twice the size as those inoculated with the other Ni-tolerant strain. Inorganic plant analysis revealed that inoculation increased plant growth through improved P uptake but did not prevent Ni uptake. However, toxicity may have been minimized by dilution due to an increase in plant biomass. The results suggest that only one of the Ni-tolerant strains of Pisolithus has the potential to improve the growth and survival of E. urophylla seedlings in serpentine soils in the Philippines.

Keywords: ectomycorrhizas, Eucalyptus urophylla, nickel tolerance, pisolithus

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Authors: Hanieh Sakha, Nader Nader, Haleh Farzin

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Introduction: Throughout history, pain theories have been supposed by biomedicine, especially regarding its diagnosis and treatment aspects. Therefore, the feeling of pain is not only a personal experience and is affected by social background; therefore, it involves extensive systems of signals. The challenges in emotional and sentimental dimensions of pain originate from scientific medicine (i.e., the dominant theory is also referred to as the specificity theory); however, this theory has accepted some alterations by emerging physiology. Then, Von Frey suggested the theory of cutaneous senses (i.e., Muller’s concept: the common sensation of combined four major skin receptors leading to a proper sensation) 50 years after the specificity theory. The pain pathway was composed of spinothalamic tracts and thalamus with an inhibitory effect on the cortex. Pain is referred to as a series of unique experiences with various reasons and qualities. Despite the gate control theory, the biological aspect overcomes the social aspect. Vrancken provided a more extensive definition of pain and found five approaches: Somatico-technical, dualistic body-oriented, behaviorist, phenomenological, and consciousness approaches. The Western model combined physical, emotional, and existential aspects of the human body. On the other hand, Kotarba felt confused about the basic origins of chronic pain. Freund demonstrated and argued with Durkhemian about the sociological approach to emotions. Lynch provided a piece of evidence about the correlation between cardiovascular disease and emotionally life-threatening occurrences. Helman supposed a distinction between private and public pain. Conclusion: The consideration of the emotional aspect of pain could lead to effective, emotional, and social responses to pain. On the contrary, the theory of embodiment is based on the sociological view of health and illness. Social epidemiology shows an imbalanced distribution of health, illness, and disability among various social groups. The social support and socio-cultural level can result in several types of pain. It means the status of athletes might define their pain experiences. Gender is one of the important contributing factors affecting the type of pain (i.e., females are more likely to seek health services for pain relief.) Chronic non-cancer pain (CNCP) has become a serious public health issue affecting more than 70 million people globally. CNCP is a serious public health issue which is caused by the lack of awareness about chronic pain management among the general population.

Keywords: pain, sociology, sociological, body

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

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Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

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Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

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Authors: Prangya Ranjan Rout, Rajesh Roshan Dash, Puspendu Bhunia

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With the aim of enhancing the nutrient (ammonium and phosphate) removal from eutrophic wastewater with reduced cost, a novel media based multistage bio filter with drop aeration facility was developed in this work. The bio filter was packed with a discarded sponge iron industry by product, ‘dolochar’ primarily to remove phosphate via physicochemical approach. In the multi stage bio-filter drop, aeration was achieved by the process of percolation of the gravity-fed wastewater through the filter media and dropping down of wastewater from stage to stage. Ammonium present in wastewater got adsorbed by the filter media and biomass grown on the filter media and subsequently, got converted to nitrate through biological nitrification in the aerobic condition, as realized by drop aeration. The performance of the bio-filter in treating real eutrophic wastewater was monitored for a period of about 2 months. The influent phosphate concentration was in the range of 16-19 mg/L, and ammonium concentration was in the range of 65-78 mg/L. The average nutrient removal efficiency observed during the study period were 95.2% for phosphate and 88.7% for ammonium, with mean final effluent concentration of 0.91, and 8.74 mg/L, respectively. Furthermore, the subsequent release of nutrient from the saturated filter media, after completion of treatment process has been undertaken in this study and thin layer funnel analytical test results reveal the slow nutrient release nature of spent dolochar, thereby, recommending its potential agricultural application. Thus, the bio-filter displays immense prospective for treating real eutrophic wastewater, significantly decreasing the level of nutrients and keeping the effluent nutrient concentrations at par with the permissible limit and more importantly, facilitating the conversion of the waste materials into usable ones.

Keywords: ammonium removal, phosphate removal, multi-stage bio-filter, dolochar

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Authors: Dirk Winkler, Leon Koevener, Lamees AlHayary

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This paper contributes to the improvement of the municipal wastewater systems in Jordan. An important goal is increased energy efficiency in wastewater treatment plants and therefore lower expenses due to reduced electricity consumption. The chosen way to achieve this goal is through the implementation of Technical Sustainable Management adapted to the Jordanian context. Three wastewater treatment plants in Jordan have been chosen as a case study for the investigation. These choices were supported by the fact that the three treatment plants are suitable for average performance and size. Beyond that, an energy assessment has been recently conducted in those facilities. The project succeeded in proving the following hypothesis: Energy efficiency in wastewater treatment plants can be improved by implementing principles of Technical Sustainable Management adapted to the Jordanian context. With this case study, a significant increase in energy efficiency can be achieved by optimization of operational performance, identifying and eliminating shortcomings and appropriate plant management. Implementing Technical Sustainable Management as a low-cost tool with a comparable little workload, provides several additional benefits supplementing increased energy efficiency, including compliance with all legal and technical requirements, process optimization, but also increased work safety and convenient working conditions. The research in the chosen field continues because there are indications for possible integration of the adapted tool into other regions and sectors. The concept of Technical Sustainable Management adapted to the Jordanian context could be extended to other wastewater treatment plants in all regions of Jordan but also into other sectors including water treatment, water distribution, wastewater network, desalination, or chemical industry.

Keywords: energy efficiency, quality management system, technical sustainable management, wastewater treatment

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Authors: David Cobham

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In higher education, a great degree of importance is placed on the internationalization of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks and connections, and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment through learning approaches, assessment methods, and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country, either to study, to work, to volunteer or to gain cultural and social enhancement, has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience, and adopting collaborative online projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learned and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways and that they will persist beyond the present to become part of the 'new normal' for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Keywords: higher education management, internationalization, transnational education, virtual mobility

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Authors: Techale B., Hongxu Dong, Mihrete Getinet, Aregash Gabizew, Andrew H. Paterson, Kassahun Bantte

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The genetic architecture of drought tolerance is expected to involve multiple loci that are unlikely to all segregate for alternative alleles in a single bi-parental population. Therefore, the identification of quantitative trait loci (QTL) that are expressed in diverse genetic backgrounds of multiple bi-parental populations provides evidence about both background-specific and common genetic variants. The purpose of this study was to map QTL related to drought tolerance using three connected mapping populations of different genetic backgrounds to gain insight into the genomic landscape of this important trait in elite Ethiopian germplasm. The three bi-parental populations, each with 207 F₂:₃ lines, were evaluated using an alpha lattice design with two replications under two moisture stress environments. Drought tolerance related traits were analyzed separately for each population using composite interval mapping, finding a total of 105 QTLs. All the QTLs identified from individual populations were projected on a combined consensus map, comprising a total of 25 meta QTLs for seven traits. The consensus map allowed us to deduce locations of a larger number of markers than possible in any individual map, providing a reference for genetic studies in different genetic backgrounds. The mQTL identified in this study could be used for marker-assisted breeding programs in sorghum after validation. Only one trait, reduced leaf senescence, showed a striking bias of allele distribution, indicating substantial standing variation among present varieties that might be employed in improving drought tolerance of Ethiopian and other sorghums.

Keywords: Drought tolerance , Mapping populations, Meta QTL, QTL mapping, Sorghum

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Authors: F. Longo, G. Granello, G. Tecchio, F. Da Porto

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Unreinforced masonry (URM) infill walls are widely used throughout the world, also in seismic prone regions, as partitions in reinforced concrete building frames. Even if they do not represent structural elements, they can dramatically affect both strength and stiffness of RC structures by acting as a diagonal strut, modifying shear and displacements distribution along the building height, with uncertain consequences on structural safety. In the last decades, many refined models have been developed to describe infill walls effect on frame structural behaviour, but generally restricted to in-plane actions. Only very recently some new approaches were implemented to consider in-plane/out-of-plane interaction of URM infill walls in progressive collapse simulations. In the present work, a particularly promising macro-model was adopted for the progressive collapse analysis of infilled RC frames. The model allows to consider the bi-directional interaction in terms of displacement and strength capacity for URM infills, and to remove the infill contribution when the URM wall is supposed to fail during the analysis process. The model was calibrated on experimental data regarding two different URM panels thickness, modelling with particular care the post-critic softening branch. A frame specimen set representing the most common Italian structures was built considering two main normative approaches: a traditional design philosophy, corresponding to structures erected between 50’s-80’s basically designed to support vertical loads, and a seismic design philosophy, corresponding to current criteria that take into account horizontal actions. Non-Linear Static analyses were carried out on the specimen set and some preliminary evaluations were drawn in terms of different performance exhibited by the RC frame when the contemporary effect of the out-of-plane damage is considered for the URM infill.

Keywords: infill Panels macromodels, in plane-out of plane interaction, RC frames, URM infills

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Authors: Ying Han, Yuanxiang Chen, Yongtao Huang, Jia Fu, Kaile Li, Shangjing Lin, Jianguo Yu

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In long-haul and high-speed optical transmission system, the orthogonal frequency division multiplexing (OFDM) signal suffers various linear and non-linear impairments. In recent years, researchers have proposed compensation schemes for specific impairment, and the effects are remarkable. However, different impairment compensation algorithms have caused an increase in transmission delay. With the widespread application of deep neural networks (DNN) in communication, multi-impairment compensation based on DNN will be a promising scheme. In this paper, we propose and apply DNN to compensate multi-impairment of 16-QAM coherent optical OFDM signal, thereby improving the performance of the transmission system. The trained DNN models are applied in the offline digital signal processing (DSP) module of the transmission system. The models can optimize the constellation mapping signals at the transmitter and compensate multi-impairment of the OFDM decoded signal at the receiver. Furthermore, the models reduce the peak to average power ratio (PAPR) of the transmitted OFDM signal and the bit error rate (BER) of the received signal. We verify the effectiveness of the proposed scheme for 16-QAM Coherent Optical OFDM signal and demonstrate and analyze transmission performance in different transmission scenarios. The experimental results show that the PAPR and BER of the transmission system are significantly reduced after using the trained DNN. It shows that the DNN with specific loss function and network structure can optimize the transmitted signal and learn the channel feature and compensate for multi-impairment in fiber transmission effectively.

Keywords: coherent optical OFDM, deep neural network, multi-impairment compensation, optical transmission

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Authors: Atiq U. Zaman, Juliet Arnott

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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.

Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management

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Authors: S. M. Rifat, André L. Marchildon, Mark F. Tachie

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Experiments were performed to investigate the effects of roughness on the reattachment and redevelopment regions over a 12 mm forward facing step (FFS) in an open channel flow. The experiments were performed over an upstream smooth wall and a smooth FFS, an upstream wall coated with sandpaper 36 grit and a smooth FFS and an upstream rough wall produced from sandpaper 36 grit and a FFS coated with sandpaper 36 grit. To investigate only the wall roughness effects, Reynolds number, Froude number, aspect ratio and blockage ratio were kept constant. Upstream profiles showed reduced streamwise mean velocities close to the rough wall compared to the smooth wall, but the turbulence level was increased by upstream wall roughness. The reattachment length for the smooth-smooth wall experiment was 1.78h; however, when it is replaced with rough-smooth wall the reattachment length decreased to 1.53h. It was observed that the upstream roughness increased the physical size of contours of maximum turbulence level; however, the downstream roughness decreased both the size and magnitude of contours in the vicinity of the leading edge of the step. Quadrant analysis was performed to investigate the dominant Reynolds shear stress contribution in the recirculation region. The Reynolds shear stress and turbulent kinetic energy profiles after the reattachment showed slower recovery compared to the streamwise mean velocity, however all the profiles fairly collapse on their corresponding upstream profiles at x/h = 60. It was concluded that to obtain a complete collapse several more streamwise distances would be required.

Keywords: forward facing step, open channel, separated and reattached turbulent flows, wall roughness

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Authors: Tri Harianto, Lawalenna Samang, St. Hijraini Nur, Arwin

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Recently, a port development is constructed in Makassar city, South Sulawesi Province, Indonesia. Makassar city is located in lowland area that dominated by soft marine clay deposit. A two kilometers causeway construction was built which is situated on the soft clay layer. In order to investigate the behavior of causeway embankment, a full-scale test was conducted of high embankment built on a soft clay deposit. The embankment with 3,5 m high was supported by two types of reinforcement such as raft and raft-aggregate column foundation. Since the ground was undergoing consolidation due to the preload, the raft and raft-aggregate column foundations were monitored in order to analyze the vertical ground movement by inducing the settlement of the foundation. In this study, two types of foundation (raft and raft-aggregate column) were tested to observe the effectiveness of raft-aggregate column compare to raft foundation in reducing the settlement. The settlement monitored during the construction stage by using the settlement plates, which is located in the center and toe of the embankment. Measurements were taken every day for each embankment construction stage (4 months). In addition, an analytical calculation was conducted in this study to compare the full-scale test result. The result shows that the raft-aggregate column foundation significantly reduces the settlement by 30% compared to the raft foundation. A raft-aggregate column foundation also reduced the time period of each loading stage. The Good agreement of analytical calculation compared to the full-scale test result also found in this study.

Keywords: full-scale, preloading, raft-aggregate column, soft clay

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Authors: Dimitra V. Peristeri, Hussameldin M. Nour, Amiya Ahsan, Sameh Abogabal, Krishna K. Singh, Muhammad Shafique Sajid

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Introduction: The use of optimal skin antiseptic agents for the prevention of surgical site infection (SSI) is of critical importance, especially during abdominal surgical procedures. Alcohol-based chlorhexidine gluconate (CHG) and aqueous-based povidone-iodine (PVI) are the two most common skin antiseptics used nowadays. The objective of this article is to evaluate the effectiveness of alcohol-based CHG versus aqueous-based PVI used for skin preparation before abdominal surgery to reduce SSIs. Methods: Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomised, controlled trials (RCTs) comparing alcohol-based CHG skin preparation versus aqueous-based PVI in patients undergoing abdominal surgery. The combined outcomes of SSIs were calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). All data were analysed using Review Manager (RevMan) Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results: A total of 11 studies, all RCTs, were included (n= 12072 participants), recruiting adult patients undergoing abdominal surgery. In the random effect model analysis, the use of alcohol-based CHG in patients undergoing abdominal surgery was associated with a reduced risk of SSI compared to aqueous-based PVI (OR: 0.84; 95% CI [0.74, 0.96], z= 2.61, p= 0.009). Conclusion: Alcohol-based CHG may be more effective for preventing the risk of SSI compared to aqueous-based PVI agents in abdominal surgery. The conclusion of this meta-analysis may add a guiding value to reinforce current clinical practice guidelines.

Keywords: skin preparation, surgical site infection, chlorhexidine, skin antiseptics

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Authors: Mahsa Fathollahzadeh

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The various nanoparticles employed in drug delivery applications include micelles, liposomes, solid lipid nanoparticles, polymeric nanoparticles, functionalized nanoparticles, nanocrystals, cyclodextrins, dendrimers, and nanotubes. Micelles, composed of amphiphilic block copolymers, can encapsulate hydrophobic molecules, allowing for targeted delivery. Liposomes, vesicular structures made up of phospholipids, can encapsulate both hydrophobic and hydrophilic molecules, providing a flexible platform for delivering therapeutic agents. Solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) are designed to improve the stability and bioavailability of lipophilic drugs. Polymeric nanoparticles, such as poly(lactic-co-glycolic acid) (PLGA), are biodegradable and can be engineered to release drugs in a controlled manner. Functionalized nanoparticles, coated with targeting ligands or antibodies, can specifically target diseased cells or tissues. Nanocrystals, engineered to have specific surface properties, can enhance the solubility and bioavailability of poorly soluble drugs. Cyclodextrins, doughnut-shaped molecules with hydrophobic cavities, can be complex with hydrophobic molecules, allowing for improved solubility and bioavailability. Dendrimers, branched polymers with a central core, can be designed to deliver multiple therapeutic agents simultaneously. Nanotubes and metallic nanoparticles, such as gold nanoparticles, offer real-time tracking capabilities and can be used to detect biomolecular interactions. The use of these nanoparticles has revolutionized the field of drug delivery, enabling targeted and controlled release of therapeutic agents, reduced toxicity, and improved patient outcomes.

Keywords: nanotechnology, nanopharmaceuticals, drug-delivery, proteins, ligands, nanoparticles, chemistry

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Authors: Aparna M. Joshi

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Methyl vinyl silicone polymer (VMQ) - alkaline earth metal doped aluminium oxide composites are prepared by conventional two rolls open mill mixing method. Doped aluminium oxides (DAO) using silvery white coloured alkaline earth metals such as Mg and Ca as dopants in the concentration of 0.4 % are synthesized by microwave combustion method and referred as MA ( Mg doped aluminium oxide) and CA ( Ca doped aluminium oxide). The as-synthesized materials are characterized for the electrical resistance, X–ray diffraction, FE-SEM, TEM and FTIR. The electrical resistances of the DAOs are observed to be ~ 8-20 MΩ. This means that the resistance of aluminium oxide (Corundum) α-Al2O3 which is ~ 1010Ω is reduced by the order of ~ 103 to 104 Ω after doping. XRD studies reveal the doping of Mg and Ca in aluminium oxide. The microstructural study using FE-SEM shows the flaky clusterous structures with the thickness of the flakes between 10 and 20 nm. TEM images depict the rod-shaped morphological geometry of the particles with the diameter of ~50-70 nm. The nanocomposites are synthesized by incorporating the DAOs in the concentration of 75 phr (parts per hundred parts of rubber) into VMQ polymer. The electrical resistance of VMQ polymer, which is ~ 1015Ω, drops by the order of 108Ω. There is a retention of the electrical resistance of ~ 30-50 MΩ for the nanocomposites which is a static dissipative range of electricity. In this work white coloured electrically conductive VMQ polymer-DAO nanocomposites (MAVMQ for Mg doping and CAVMQ for Ca doping) have been synthesized. The physical and mechanical properties of the composites such as specific gravity, hardness, tensile strength and rebound resilience are measured. Hardness and tensile strength are found to increase, with the negligible alteration in the other properties.

Keywords: doped aluminium oxide, methyl vinyl silicone polymer, microwave synthesis, static dissipation

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Authors: Christakis Chatzichristou, Elias Kranos

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Architectural awards, especially if they are given by the state, recognize excellence in the field and, at the same time, strongly contribute to the making of the architectural culture of a place. The present research looks at the houses that have been awarded through such a system in Cyprus in order to discuss the values promoted, directly or not, by such a setup which is quite similar to other prestigious award systems such as the Mies van de Rohe Prize in Europe. In fact, many of the projects signed out through the state award system end up being selected to represent the country for the European awards. The residential architecture encouraged by such systems is quite interesting in that the most public of institutions influence how the most private unit of society is architecturally accommodated. The methodology uses both qualitative as well as quantitative research tools in order to analyze: the official state call for entries to the competition; the final report of the evaluation committee; the spatial characteristics of the houses through the Space Syntax methodology; the statements of the architects regarding their intentions and the final outcome; the feelings of the owners and users of the houses regarding the design process as well as the degree of satisfaction regarding the final product. The above-mentioned analyses allow for a more thorough discussion regarding not only the values promoted explicitly by the system through the brief that describes what the evaluation committee is looking for but also the values that are actually being promoted indirectly through the results of the actual evaluation itself. The findings suggest that: the strong emphasis in brief on bioclimatic design and issues of sustainability weakens significantly, if at all present, in the actual selection process; continuous improvement seems to be fuzzily used as a concept; most of the houses tend to have a similar spatial genotype; most of the houses have similar aesthetic qualities; discrepancies between the proposed lifestyle through the design and the actual use of the spaces do not seem to be acknowledged in the evaluation as an issue; the temporal factor seems to be ignored as the projects are required to be ‘finished projects’ as though the users and their needs do not change through time. The research suggests that, rather than preserving a critical attitude regarding the role of the architect in society, the state award system tends, like any other non-reflective social organism, to simply promote its own unexamined values as well as prejudices. This is perhaps more evident in the shared aesthetic character of the awarded houses and less so in the hidden spatial genotype to which they belong. If the design of houses is indeed a great opportunity for architecture to contribute in a more deliberate manner to the evolution of society, then what the present study shows is that this opportunity seems to be largely missed. The findings may serve better less as a verdict and more as a chance for introspection and discussion.

Keywords: award systems, houses, spatial genotype, aesthetic qualities

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Authors: Sabah Yasin, Anum Obaid

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Abstract—Working women in Pakistan should not be neglected, as women make up to half of the population, and are highly educated and diversified in their skills and capabilities. With a shift in global economic and social demands the obligations of a women have altered significantly, impacted by the dual pressures of career and personal life. Despite global efforts to improve economic empowerment and health of women, through Sustainable Development Goals, they suffer from social, economic, psychological and physiological challenges. A sound understanding of working women’s nutrition and health-related stress is a prompt necessity, in areas like Faisalabad, thus leading to a public health issue. The current qualitative study is grounded under the paradigm of in-depth interviews with working women, currently working full time in Faisalabad. Participants collected through snowball sampling were women ages 30-40. This study explores the perceptions and experiences as well as barriers and factors effecting the overall wellbeing of working women, regarding nutrition and health-related stress. Findings of the current study disclosed that the nutritional and health well-being of working women in Faisalabad suffers from the impact of various stressors, like long working hours, excessive workload, low income, poor work place culture, unavailability of healthy food choices at work, lack of time, lack of self-care, unattended nutritional deficiencies and overburdened share of responsibilities. Hence, these findings highlight the need for effective strategies and support systems that will address the unique stressors faced by working women and also by educating them in changing their attitudes and understanding psychosocial barriers that impede their ability to maintain nutrition and overall well-being.

Keywords: health triangle, lifestyle behaviors, nutrition-related, professional life, stress, working women

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Authors: Jie Ji, Jing Xu, Yuehong Zhuang, Xiangqing Kang, Ying Qian, Ping Zhou, Di Xue

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Background: In 2014, there were 28,341 health professionals in Pudong new area of Shanghai and the number per 1000 population was 5.199, 55.55% higher than that in 2006. But it was always less than the average number of health professionals per 1000 population in Shanghai from 2006 to 2014. Therefore, allocation planning for the health professionals in Pudong new area has become a high priority task in order to meet the future demands of health care. In this study, we constructed an objective-based system dynamics model to forecast the number of health professionals in Pudong new area of Shanghai in 2020. Methods: We collected the data from health statistics reports and previous survey of human resources in Pudong new area of Shanghai. Nine experts, who were from health administrative departments, public hospitals and community health service centers, were consulted to estimate the current and future status of nine variables used in the system dynamics model. Based on the objective of the number of health professionals per 1000 population (8.0) in Shanghai for 2020, the system dynamics model for health professionals in Pudong new area of Shanghai was constructed to forecast the number of health professionals needed in Pudong new area in 2020. Results: The system dynamics model for health professionals in Pudong new area of Shanghai was constructed. The model forecasted that there will be 37,330 health professionals (6.433 per 1000 population) in 2020. If the success rate of health professional recruitment changed from 20% to 70%, the number of health professionals per 1000 population would be changed from 5.269 to 6.919. If this rate changed from 20% to 70% and the success rate of building new beds changed from 5% to 30% at the same time, the number of health professionals per 1000 population would be changed from 5.269 to 6.923. Conclusions: The system dynamics model could be used to simulate and forecast the health professionals. But, if there were no significant changes in health policies and management system, the number of health professionals per 1000 population would not reach the objectives in Pudong new area in 2020.

Keywords: allocation planning, forecast, health professional, system dynamics

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Authors: Biruk Abate

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Evaporative cooling occurs when air with high temperature and reduced humidity passes over a wet porous surface and a higher degree of cooling process is achieved for storage of fruits and vegetables due to greater rate of evaporation. The main objective of this reviewed study is to understand the effect of evaporative surface pad thickness and geometric configuration on the saturation efficiency of evaporative cooler and to state some related factors affecting the performance of the system. From this overview, selection of pad thickness and geometrical shape with suitable characteristics of heat and mass transfer and water holding capacity of the pads was reviewed as these parameters are important for saturation efficiency of evaporative cooling. Increasing the cooling pad thickness through increasing the face velocity increases the effectiveness of wet-bulb saturation. Increasing ambient temperature, inlet air speed and ambient air humidity decreases the wet bulb effectiveness and it increases with increasing length of the pad. Increasing the ambient temperature and inlet air velocity decreases the humidity ratio, but increases with increasing ambient air humidity and lengths of the pad. Increasing the temperature-humidity index is possible with increasing ambient temperature, inlet air velocity, ambient air humidity and pad length. Generally, all materials having a higher wetted surface area per unit volume give higher efficiency. Materials with higher thickness increase the wetted surface area for better mix-up of air and water to give higher efficiency for the same shape and this in turn helps to store fruits and vegetables.

Keywords: Degree of cooling, heat and mass transfer, evaporative cooling, porous surface

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Authors: Roaa Al Sharif, Salsabil Abo Al-Azayem, Nimah Alsomali, Wjoud Alsaeed, Nawal Alshammari, Abdulaziz Alwatban, Yaseen Alrabae, Razan Orfali, Faisal Alqarni, Ahmad Alrasheedi

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from various countries have revealed that nurses possess only a basic understanding of the GCS. Regarding this matter, limited knowledge is available about the situation in Saudi Arabia. Overall, the available research suggests that there is room for improvement in the knowledge of the GCS among nurses in Saudi Arabia. Further training and education programs may be beneficial in enhancing nurses' understanding and application of the GCS in clinical practice. Objective: To determine the level of knowledge and competence in assessing the GCS among staff nurses and to identify factors that might influence their knowledge at King Fahd Medical City in Riyadh, Saudi Arabia. Methods: A descriptive, cross-sectional survey involving 199 KFMC staff nurses was conducted. Nurses were provided with a structured questionnaire, and data were collected and analyzed using SPSS version 16, employing descriptive statistics and Chi-square tests. Results: The majority, 81.4% of nurses, had an average level of knowledge in assessing the Glasgow Coma Scale (GCS). The mean score for measuring the level of knowledge among staff nurses in GCS assessment was 8.8 ± 1.826. Overall, 13.6% of respondents demonstrated good knowledge of the GCS, scoring between 11 and 15 points, while only 5% of nurses exhibited poor knowledge of the GCS assessment. There was a significant correlation between knowledge and nurses' departments (χ2(2) = 19.184, p < 0.001). χ2(2) = 19.184," representing a Chi-square statistic with 2 degrees of freedom used to test the association between categorical variables in the data analysis. Conclusion: The findings indicate that knowledge of GCS assessment among staff nurses in a single center in Saudi Arabia is moderate. Therefore, there is a need for continuous education programs to enhance their competence in using this assessment.

Keywords: Glasgow Coma Scale, brain injury, nurses’ knowledge assessment, continuous education programs

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Authors: Azadeh Jafari, Robert G. Owens

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In this study, a geometrical multiscale approach which means coupling together the 2-D Navier-Stokes equations, constitutive equations and 0-D lumped parameter models is investigated. A multiscale approach, suggest a natural way of coupling detailed local models (in the flow domain) with coarser models able to describe the dynamics over a large part or even the whole cardiovascular system at acceptable computational cost. In this study we introduce a new velocity correction scheme to decouple the velocity computation from the pressure one. To evaluate the capability of our new scheme, a comparison between the results obtained with Neumann outflow boundary conditions on the velocity and Dirichlet outflow boundary conditions on the pressure and those obtained using coupling with the lumped parameter model has been performed. Comprehensive studies have been done based on the sensitivity of numerical scheme to the initial conditions, elasticity and number of spectral modes. Improvement of the computational algorithm with stable convergence has been demonstrated for at least moderate Weissenberg number. We comment on mathematical properties of the reduced model, its limitations in yielding realistic and accurate numerical simulations, and its contribution to a better understanding of microvascular blood flow. We discuss the sophistication and reliability of multiscale models for computing correct boundary conditions at the outflow boundaries of a section of the cardiovascular system of interest. In this respect the geometrical multiscale approach can be regarded as a new method for solving a class of biofluids problems, whose application goes significantly beyond the one addressed in this work.

Keywords: geometrical multiscale models, haemorheology model, coupled 2-D navier-stokes 0-D lumped parameter modeling, computational fluid dynamics

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Authors: Ellen Bautista, Rebecca M. Flueckiger, Easter Dasmarinas, Rajeev Colaco, Fulbert Alec R. Gillego, Alma M. Lozada, Cristina Bisson

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Lactational Amenorrhea Method (LAM) for family planning is at least 98% effective at preventing pregnancy when all criteria are met; (1) the mother is exclusively or nearly exclusively breastfeeding, (2) the mother is amenorrheic (not menstruating), and (3) the baby is six months old or younger. LAM is particularly suited for women interested in family planning accepted by religious authorities. As a majority catholic nation, LAM is a common and accepted form of family planning in the Philippines. The USAID funded, LuzonHealth project conducted a prospective evaluation in Legazpi City to inform the enhancement of guidelines aimed at increasing LAM compliance and encouraging a second form of contraceptive once LAM protection expires. LAM compliance, reasons for non-compliance, family planning referral and uptake of secondary modern family planning methods were tracked over a nine-month period among 521 postpartum women. The evaluation found that at three months postpartum, 97% of women either met LAM criteria or had shifted to a non-LAM modern family planning method. In month six 87% of women no longer met LAM criteria and of these only 35% had shifted to an alternative modern family planning method. This means that at six-months postpartum 65% of the women in this evaluation were not protected against pregnancy through modern family planning methods. By postpartum month nine, 70% of the women had been referred to family planning counseling, yet of those referred only 34% reported using modern family planning methods. This evaluation clearly indicates scale-up of non-LAM modern family planning does not sufficiently complement the scale-down of LAM compliance. There is a need to increase client knowledge and understanding of LAM as a temporary family planning method with a strong focus on preparing to shift to another form of modern family planning once LAM protection expires. Additionally, there is great need to restructure the referral mechanism to ensure efficacy and quality of care.

Keywords: Philippines, family planning, lactational amenorrhea method, contraceptives

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Authors: Rati Sandeep Choudhari

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Mobility flows are considered one of the most important elements of urbanisation, with transport infrastructure serving as a backbone of urban fabrics. Although rapid urbanisation and changing land use patterns have led to an increase in urban mobility levels around the globe, mobility, in general, has become an unpleasant experience for city dwellers, making locations around the city inconvenient to access. With public transport featured in almost every sustainable mobility plan in developing countries, the intermodality and integration with appropriate non–motorised transport infrastructure is often neglected. As a result, people choose to use private cars and two-wheelers to travel, rendering public transit systems underutilised, and encroaching onto pedestrian space on streets, thus making urban mobility unsafe and inconvenient for a major section of society. On the other hand, cities in the West, especially in Europe, depend heavily on inter–modal transit systems, allowing people to shift between metros, buses, trams, walking, and cycling to access even the remote locations of the city. Keeping accessibility as the focal point while designing urban mobility plans and policies, these cities have appropriately refined their urban form, optimised urban densities, developed a multimodal transit system, and adopted place-making strategies to foster a sense of place, thus, improving the quality of urban mobility experience in cities. Using a qualitative research approach, the research looks in detail into the existing literature on what kind of strategies can be applied to improve the urban mobility experience for city dwellers. It further studies and draws out a comparative analysis of cities in both developed and developing parts of the world where these strategies have been used to create people-centric mobility systems, fostering a sense of place with respect to urban mobility and how these strategies affected their social, economic, and environmental dynamics. The examples reflect on how different strategies like redefining land use patterns to form close knit neighbourhoods, development of non – motorise transit systems, and their integration with public transport infrastructure and place-making approach has helped in enhancing the quality and experience of mobility infrastructure in cities. The research finally concludes by laying out strategies that can be adopted by cities of the Global South to develop future mobility systems in a people-centric and sustainable way.

Keywords: urban mobility, sustainable transport, strategic planning, people-centric approach

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Authors: Hajar Hajmohammadi, Paul Pfeffer, Anna De Simoni, Jim Cole, Chris Griffiths, Sally Hull, Benjamin Heydecker

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Background: There is strong interest in the relationship between short-term air pollution exposure and human health. Most studies in this field focus on serious health effects such as death or hospital admission, but air pollution exposure affects many people with less severe impacts, such as exacerbations of respiratory conditions. A lack of quantitative analysis and inconsistent findings suggest improved methodology is needed to understand these effectsmore fully. Method: We developed a time series regression model to quantify the relationship between daily NOₓ concentration and Asthma exacerbations requiring oral steroids from primary care settings. Explanatory variables include daily NOₓ concentration measurements extracted from 8 available background and roadside monitoring stations in east London and daily ambient temperature extracted for London City Airport, located in east London. Lags of NOx concentrations up to 21 days (3 weeks) were used in the model. The dependent variable was the daily number of oral steroid courses prescribed for GP registered patients with asthma in east London. A mixed distribution model was then fitted to the significant lags of the regression model. Result: Results of the time series modelling showed a significant relationship between NOₓconcentrations on each day and the number of oral steroid courses prescribed in the following three weeks. In addition, the model using only roadside stations performs better than the model with a mixture of roadside and background stations.

Keywords: air pollution, time series modeling, public health, road transport

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Authors: Zulkifli Zainal Abidin, Ahmad Shahril Mohd Ghani

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Agent-based systems technology has been addressed as a new paradigm for conceptualizing, designing, and implementing software systems. Agents are sophisticated systems that act autonomously across open and distributed environments in solving problems. Nevertheless, it is impractical to rely on a single agent to do all computing processes in solving complex problems. An increasing number of applications lately require multiple agents to work together. A multi-agent system (MAS) is a loosely coupled network of agents that interact to solve problems that are beyond the individual capacities or knowledge of each problem solver. However, the network of MAS still requires a main system to govern or oversees the operation of the agents in order to achieve a unified goal. We had developed a fleet management system (FMS) in order to manage the fleet of agents, plan route for the agents, perform real-time data processing and analysis, and issue sets of general and specific instructions to the agents. This FMS should be able to perform real-time data processing, communicate with the autonomous surface vehicle (ASV) agents and generate bathymetric map according to the data received from each ASV unit. The first algorithm is developed to communicate with the ASV via radio communication using standard National Marine Electronics Association (NMEA) protocol sentences. Next, the second algorithm will take care of the path planning, formation and pattern generation is tested using various sample data. Lastly, the bathymetry map generation algorithm will make use of data collected by the agents to create bathymetry map in real-time. The outcome of this research is expected can be applied on various other multi-agent systems.

Keywords: autonomous surface vehicle, fleet management system, multi agent system, bathymetry

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Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail

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Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.

Keywords: sanitation, toilet, economic cost of health, water, Punjab

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Authors: Sara Matsuzaka

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At the center of emerging policy debates on the rights of transgender individuals in public accommodations is the collision of gender binary views with transgender perspectives that challenge conventional gender norms. The results of such socio-political debates could have significant ramifications for the policies and infrastructures of public and private institutions nationwide, including within the addiction treatment field. Despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat heterosexual cisgender populations and, as such, feature gender segregated housing, bathrooms, and counseling sessions. Such heteronormative structural barriers, combined with exposures to stigmatic al attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. A literature review is performed to explore the mechanisms by which gender segregation alienates transgender populations within inpatient addiction treatment. The constituent parts of the current debate on the rights of transgender individuals in public accommodations are situated the context of inpatient addiction treatment facilities. Minority Stress Theory is used as a theoretical framework for understanding substance abuse issues among transgender populations as a maladaptive behavioral response for coping with chronic stressors related to gender minority status and intersecting identities. The findings include that despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in and benefiting from addiction treatment. These barriers are present in the form of anticipated or real interpersonal stigma and discrimination by service providers and structural stigma in the form of policy and programmatic components in addiction treatment that marginalize transgender populations. Transphobic manifestations within addiction treatment may dissuade transgender individuals from seeking help, if not reinforce a lifetime of stigmatic experience, potentially exacerbating their substance use issues. Conclusive recommendations for social workers and addiction treatment professionals include: (1) dismantling institutional policies around gender segregation that alienate transgender individuals, (2) developing policies that provide full protections for transgender clients against discrimination based on their gender identity, and (3) implementing trans-affirmative cultural competency training requirements for all staff. Directions for future research are provided.

Keywords: addiction treatment, gender segregation, stigma, transgender

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