Search results for: optimal allocation ratio

Authors: Hanaa M. M. El-Khayat, Hanan S. Gaber, Hoda Abdel-Hamid, Kadria M. A. Mahmoud, Hoda M. A. Abu Taleb

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This work aimed to examine Oreochromis niloticus fish from Lake Manzala in Port Said, Dakahlya and Damietta governorates, Egypt, as a bio-indicator for the lake water pollution through recording alterations in their hematological, physiological, and histopathological parameters. All fish samples showed a significant increase in levels of alkaline phosphatase (ALP), creatinine and glutathione-S-transferase (GST); only Dakahlya samples showed a significant increase (p<0.01) in aspartate aminotransferase (AST) level and most Dakahlya and Damietta samples showed reversed albumin and globulin ratio and a significant increase in γ-glutamyltransferase (GGT) level. Port-Said and Damietta samples showed a significant decrease of hemoglobin (Hb) while Dakahlya samples showed a significant decrease in white blood cell (WBC) count. Histopathological investigation for different fish organs showed that Port-Said and Dakahlya samples were more altered than Damietta. The muscle and gill followed by intestine were the most affected organs. The muscle sections showed severe edema, neoplasia, necrotic change, fat vacuoles and splitting of muscle fiber. The gill sections showed dilated blood vessels of the filaments, curling of gill lamellae, severe hyperplasia, edema and blood vessels congestion of filaments. The intestine sections revealed degeneration, atrophy, dilation in blood vessels and necrotic changes in sub-mucosa and mucosa with edema in between. The recorded significant alterations, in most of the physiological and histological parameters in O. niloticus samples from Lake Manzala, were alarming for water pollution impacts on lake fish community, which constitutes the main diet and the main source of income for the people inhabiting these areas, and were threatening their public health and economy. Also, results evaluate the use of O. niloticus fish as important bio-indicator for their habitat stressors.

Keywords: Lake Manzala, Oreochromis niloticus fish, water pollution, physiological, hematological and histopathological parameters

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Authors: Fang Liu, JunShuai Xue, JiaJia Yao, GuanLin Wu, ZuMaoLi, XueYan Yang, HePeng Zhang, ZhiPeng Sun

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Terahertz spectra is in great demand since last two decades for many photonic and electronic applications. III-Nitride resonant tunneling diode is one of the promising candidates for portable and compact THz sources. Room temperature microwave oscillator based on GaN/AlN resonant tunneling diode was reported in this work. The devices, grown by plasma-assisted molecular-beam epitaxy on free-standing c-plane GaN substrates, exhibit highly repeatable and robust negative differential resistance (NDR) characteristics at room temperature. To improve the interface quality at the active region in RTD, indium surfactant assisted growth is adopted to enhance the surface mobility of metal atoms on growing film front. Thanks to the lowered valley current associated with the suppression of threading dislocation scattering on low dislocation GaN substrate, a positive peak current density of record-high 2.1 MA/cm2 in conjunction with a peak-to-valley current ratio (PVCR) of 1.2 are obtained, which is the best results reported in nitride-based RTDs up to now considering the peak current density and PVCR values simultaneously. When biased within the NDR region, microwave oscillations are measured with a fundamental frequency of 0.31 GHz, yielding an output power of 5.37 µW. Impedance mismatch results in the limited output power and oscillation frequency described above. The actual measured intrinsic capacitance is only 30fF. Using a small-signal equivalent circuit model, the maximum intrinsic frequency of oscillation for these diodes is estimated to be ~260GHz. This work demonstrates a microwave oscillator based on resonant tunneling effect, which can meet the demands of terahertz spectral devices, more importantly providing guidance for the fabrication of the complex nitride terahertz and quantum effect devices.

Keywords: GaN resonant tunneling diode, peak current density, microwave oscillation, intrinsic capacitance

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Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

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Authors: Kaddour Fellague Mohammed

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The world has seen in recent years, significant developments affected various aspects of life and influenced the different types of institutions, thus was born a new world is a world of globalization, which dominated the scientific revolution and the tremendous technological developments, and that contributed to the re-formation of human resources in contemporary organizations, and made patterns new regulatory and at the same time raised and strongly values and new ideas, the organizations have become more flexible, and faster response to consumer and environmental conditions, and exceeded the problem of time and place in the framework of communication and human interaction and use of advanced information technology and adoption mainly mechanism in running its operations , focused on performance and based strategic thinking and approach in order to achieve its strategic goals high degrees of superiority and excellence, this new reality created an increasing need for a new type of human resources, quality aims to renew and aspire to be a strategic player in managing the organization and drafting of various strategies, think globally and act locally, to accommodate local variables in the international markets, which began organizations tend to strongly as well as the ability to work under different cultures. Human resources management of the most important management functions to focus on the human element, which is considered the most valuable resource of the Department and the most influential in productivity at all, that the management and development of human resources Tattabra a cornerstone in the majority of organizations which aims to strengthen the organizational capacity, and enable companies to attract and rehabilitation of the necessary competencies and are able to keep up with current and future challenges, human resources can contribute to and strongly in achieving the objectives and profit organization, and even expand more than contribute to the creation of new jobs to alleviate unemployment and achieve full operation, administration and human resources mean short optimal use of the human element is available and expected, where he was the efficiency and capabilities, and experience of this human element, and his enthusiasm for the work stop the efficiency and success in reaching their goals, so interested administration scientists developed the principles and foundations that help to make the most of each individual benefit in the organization through human resources management, these foundations start of the planning and selection, training and incentives and evaluation, which is not separate from each other, but are integrated with each other as a system systemic order to reach the efficient functioning of the human resources management and has been the organization as a whole in the context of development sustainable.

Keywords: configuration, training, development, human resources, operating

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Authors: A. Priyanka, Sunil Kumar Kainoor, Parinitha Nayaka

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Introduction: Ever since the ancient times, rape and other sexual offences are considered to be heinous crimes. Rape is not just another word in the dictionary, but it is the most barbaric act of violence committed with sex being the weapon. Rape is among the highest forms of crime experienced by women and children in all sectors of the society. In recent years, there has been an alarming rise in ratio of rape in India. The burden of such crimes on the society is very huge. The venereal diseases are the worst consequence along with unwanted pregnancies. Aims and Objectives: To determine the socio-demographic profile of the survivors of sexual offences reported to Dept. of Forensic Medicine of a South Indian medical college. Material methods: This retrospective study was conducted in the Department of Forensic Medicine of Raichur Institute of Medical Sciences, Raichur, Karnataka, India. Only survivors of sexual offences cases were included in the study group. Examination of all survivors was carried out by doctors of the said Department. Study period is one year six months, January 2015 to June 2016. Results/ case history: In total 140 cases of sexual offences were examined during study period of which the total survivors accounted to 62.85% i.e. 88 cases. Of the 88 survivors, 61 (69.31%) were registered under POCSO Act. The most affected age group of victims was 10-18 years in 59 (67%) cases. 61% were in acquaintance with the assailants, 18% were classmates/ friends, 13% of accused were Family members/ Relatives, 8% were strangers. 85% of the survivors were hailing from rural setup, while 15% were from urban. 60.65% of the survivors were students, 37.7% were doing Coolie/ Agricultural works. Conclusion: Delay in reporting of cases resulted in loss of vital physical evidences as no concrete report could be generated from the forensic lab after examination of specimens thus there should be coordination among doctors, forensic experts and investigating agency. It is worth mentioning that though a large number of cases of sexual offences are reported as rape many among them are consented acts and hence definite evidence of forceful sexual intercourse is lagging.

Keywords: consensual sex, India, POCSO Act- 2012, India, pregnancy, rape, sexual offence

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Authors: S. M. Ali, S. I. Mohamed

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Reduction of feed cost for broiler production is at most importance in decreasing the cost of production. The objectives of this study were to evaluate the use of synthetic amino acids (L-lysine – DL-methionine) instead of super concentrate and groundnut cake versus meat powder as protein sources. A total of 180 male broiler chicks (Cobb – strain) at 15 day of age (DOA) were selected according to their average body weight (380 g) from a broiler chicks flock at Elbashair Farm. The chicks were randomly divided into six groups of 30 chicks. Each group was further sub divided into three replicates with 10 birds. Six experimental diets were formulated. The first diet contained groundnut cake and super concentrate as the control (GNC + C); in the second diet, meat powder and super concentrate (MP + C) were used. The third diet contained groundnut cake and amino acids (GNC + AA); the forth diet contained meat powder and amino acids (MP + AA). The fifth diet contained groundnut cake, meat powder and super concentrate (GNC + MP + C) and the sixth diet contained groundnut cake, meat powder and amino acids (GNC + MP + AA). The formulated rations were randomly assigned for the different sub groups in a completely randomized design of six treatments and three replicates. Weekly feed intake, body weight and mortality were recorded and body weight gain and feed conversion ratio were calculated. At the end of the experiment (49 DOA), nine birds from each treatment were slaughtered. Live body weight, carcass weight, head, shank, and some internal organs (gizzard, heart, liver, small intestine, and abdominal fat pad) weights were taken. For the overall experimental period the (GNC + C +MP) consumed significantly (P≤0.01) the highest cumulative feed while the (MP + AA) group consumed the lowest amount of feed. The (GNC + C) and the (GNC + AA) groups had the heaviest live body weight while (MP + AA) had the lowest live body weight. The overall FCR was significantly (P≤0.01) the best for (GNC + AA) group while the (MP + AA) reported the worst FCR. However, the (GNC + AA) had significantly (P≤0.01) the lowest AFP. The (GNC + MP + Con) group had the highest dressing % while the (MP + AA) group had the lowest dressing %. It is concluded that amino acids can be used instead of super concentrate in broiler feeding with perfect performance and less cost and that meat powder is not advisable to be used with amino acids.

Keywords: broiler chickens, DL-lysine, methionine, performance

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Authors: Tridipa Biswas, Kamal Pandey

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A Digital Elevation Model (DEM) is a simple representation of a surface in 3 dimensional space with elevation as the third dimension along with X (horizontal coordinates) and Y (vertical coordinates) in rectangular coordinates. DEM has wide applications in various fields like disaster management, hydrology and watershed management, geomorphology, urban development, map creation and resource management etc. Cartosat-1 or IRS P5 (Indian Remote Sensing Satellite) is a state-of-the-art remote sensing satellite built by ISRO (May 5, 2005) which is mainly intended for cartographic applications.Cartosat-1 is equipped with two panchromatic cameras capable of simultaneous acquiring images of 2.5 meters spatial resolution. One camera is looking at +26 degrees forward while another looks at –5 degrees backward to acquire stereoscopic imagery with base to height ratio of 0.62. The time difference between acquiring of the stereopair images is approximately 52 seconds. The high resolution stereo data have great potential to produce high-quality DEM. The high-resolution Cartosat-1 stereo image data is expected to have significant impact in topographic mapping and watershed applications. The objective of the present study is to generate high-resolution DEM, quality evaluation in different elevation strata, generation of ortho-rectified image and associated accuracy assessment from CARTOSAT-1 data based Ground Control Points (GCPs) for Aglar watershed (Tehri-Garhwal and Dehradun district, Uttarakhand, India). The present study reveals that generated DEMs (10m and 30m) derived from the CARTOSAT-1 stereo pair is much better and accurate when compared with existing DEMs (ASTER and CARTO DEM) also for different terrain parameters like slope, aspect, drainage, watershed boundaries etc., which are derived from the generated DEMs, have better accuracy and results when compared with the other two (ASTER and CARTO) DEMs derived terrain parameters.

Keywords: ASTER-DEM, CARTO-DEM, CARTOSAT-1, digital elevation model (DEM), ortho-rectified image, photogrammetry, RPC, stereo pair, terrain parameters

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Authors: Iyd Eqqab Maree, Moouyad Ibrahim Abbood

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The purpose behind this study is to predict damping effect for steel cantilever beam by using two methods of passive viscoelastic constrained layer damping. First method is Matlab Program, this method depend on the Ross, Kerwin and Unger (RKU) model for passive viscoelastic damping. Second method is experimental lab (frequency domain method), in this method used the half-power bandwidth method and can be used to determine the system loss factors for damped steel cantilever beam. The RKU method has been applied to a cantilever beam because beam is a major part of a structure and this prediction may further leads to utilize for different kinds of structural application according to design requirements in many industries. In this method of damping a simple cantilever beam is treated by making sandwich structure to make the beam damp, and this is usually done by using viscoelastic material as a core to ensure the damping effect. The use of viscoelastic layers constrained between elastic layers is known to be effective for damping of flexural vibrations of structures over a wide range of frequencies. The energy dissipated in these arrangements is due to shear deformation in the viscoelastic layers, which occurs due to flexural vibration of the structures. The theory of dynamic stability of elastic systems deals with the study of vibrations induced by pulsating loads that are parametric with respect to certain forms of deformation. There is a very good agreement of the experimental results with the theoretical findings. The main ideas of this thesis are to find the transition region for damped steel cantilever beam (4mm and 8mm thickness) from experimental lab and theoretical prediction (Matlab R2011a). Experimentally and theoretically proved that the transition region for two specimens occurs at modal frequency between mode 1 and mode 2, which give the best damping, maximum loss factor and maximum damping ratio, thus this type of viscoelastic material core (3M468) is very appropriate to use in automotive industry and in any mechanical application has modal frequency eventuate between mode 1 and mode 2.

Keywords: 3M-468 material core, loss factor and frequency, domain method, bioinformatics, biomedicine, MATLAB

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Authors: Swathi Ganesan, Nalinda Somasiri, Rebecca Jeyavadhanam, Gayathri Karthick

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The COVID-19 crisis presents a substantial and critical hazard to worldwide health. Since the occurrence of the disease in late January 2020 in the UK, the number of infected people confirmed to acquire the illness has increased tremendously across the country, and the number of individuals affected is undoubtedly considerably high. The purpose of this research is to figure out a predictive machine learning archetypal that could forecast COVID-19 cases within the UK. This study concentrates on the statistical data collected from 31st January 2020 to 31st March 2021 in the United Kingdom. Information on total COVID cases registered, new cases encountered on a daily basis, total death registered, and patients’ death per day due to Coronavirus is collected from World Health Organisation (WHO). Data preprocessing is carried out to identify any missing values, outliers, or anomalies in the dataset. The data is split into 8:2 ratio for training and testing purposes to forecast future new COVID cases. Support Vector Machines (SVM), Random Forests, and linear regression algorithms are chosen to study the model performance in the prediction of new COVID-19 cases. From the evaluation metrics such as r-squared value and mean squared error, the statistical performance of the model in predicting the new COVID cases is evaluated. Random Forest outperformed the other two Machine Learning algorithms with a training accuracy of 99.47% and testing accuracy of 98.26% when n=30. The mean square error obtained for Random Forest is 4.05e11, which is lesser compared to the other predictive models used for this study. From the experimental analysis Random Forest algorithm can perform more effectively and efficiently in predicting the new COVID cases, which could help the health sector to take relevant control measures for the spread of the virus.

Keywords: COVID-19, machine learning, supervised learning, unsupervised learning, linear regression, support vector machine, random forest

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Authors: Alon Cohen, Jeffrey Kantor, Shalom Levy

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Technology adoption models are extensively used in the literature to explore drivers and inhibitors affecting the adoption of Computer Assisted Audit Techniques and Tools (CAATTs). Further studies from recent years suggested additional factors that may affect technology adoption by CPA firms. However, the adoption of CAATTs by financial auditors differs from the adoption of technologies in other industries. This is a result of the unique characteristics of the auditing process, which are expressed in the audit risk elements and the risk-based auditing approach, as encoded in the auditing standards. Since these audit risk factors are not part of the existing models that are used to explain technology adoption, these models do not fully correspond to the specific needs and requirements of the auditing domain. The overarching objective of this qualitative research is to fill the gap in the literature, which exists as a result of using generic technology adoption models. Followed by a pretest and based on semi-structured in-depth interviews with 16 Israeli CPA firms of different sizes, this study aims to reveal determinants related to audit risk factors that influence the adoption of CAATTs in audits and proposes a new modeling approach for the successful adoption of CAATTs. The findings emphasize several important aspects: (1) while large CPA firms developed their own inner guidelines to assess the audit risk components, other CPA firms do not follow a formal and validated methodology to evaluate these risks; (2) large firms incorporate a variety of CAATTs, including self-developed advanced tools. On the other hand, small and mid-sized CPA firms incorporate standard CAATTs and still need to catch up to better understand what CAATTs can offer and how they can contribute to the quality of the audit; (3) the top management of mid-sized and small CPA firms should be more proactive and updated about CAATTs capabilities and contributions to audits; and (4) All CPA firms consider professionalism as a major challenge that must be constantly managed to ensure an optimal CAATTs operation. The study extends the existing knowledge of CAATTs adoption by looking at it from a risk-based auditing approach. It suggests a new model for CAATTs adoption by incorporating influencing audit risk factors that auditors should examine when considering CAATTs adoption. Since the model can be used in various audited scenarios and supports strategic, risk-based decisions, it maximizes the great potential of CAATTs on the quality of the audits. The results and insights can be useful to CPA firms, internal auditors, CAATTs developers and regulators. Moreover, it may motivate audit standard-setters to issue updated guidelines regarding CAATTs adoption in audits.

Keywords: audit risk, CAATTs, financial auditing, information technology, technology adoption models

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Authors: C. D’Urso, L. Frusteri, M. Samperi, G. Leonardi

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Solid metal halides are used as active cathode ingredients in the case of Na-NiCl2 batteries that require a fused secondary electrolyte, sodium tetrachloraluminate (NaAlCl4), to facilitate the movement of the Na+ ion into the cathode. The sodium-nickel chloride (Na - NiCl2) battery has been extensively investigated as a promising system for large-scale energy storage applications. The growth of Ni and NaCl particles in the cathodes is one of the most important factors that degrade the performance of the Na-NiCl2 battery. The larger the particles of active ingredients contained in the cathode, the smaller the active surface available for the electrochemical reaction. Therefore, the growth of Ni and NaCl particles can lead to an increase in cell polarization resulting from the reduced active area. A higher current density, a higher state of charge (SOC) at the end of the charge (EOC) and a lower Ni / NaCl ratio are the main parameters that result in the rapid growth of Ni particles. In light of these problems, cathode and chemistry Nano-materials with recognized and well-documented electrochemical functions have been studied and manufactured to simultaneously improve battery performance and develop less expensive and more performing, sustainable and environmentally friendly materials. Starting from the well-known cathodic material (Na-NiCl2), the new electrolytic materials have been prepared on the replacement of nickel with iron (10-90%substitution of Nichel with Iron), to obtain a new material with potential advantages compared to current battery technologies; for example,, (1) lower cost of cathode material compared to state of the art as well as (2) choices of cheaper materials (stainless steels could be used for cell components, including cathode current collectors and cell housings). The study on the particle size of the cathode and the physicochemical characterization of the cathode was carried out in the test cell using, where possible, the GITT method (galvanostatic technique of intermittent titration). Furthermore, the impact of temperature on the different cathode compositions of the positive electrode was studied. Especially the optimum operating temperature is an important parameter of the active material.

Keywords: critical raw materials, energy storage, sodium metal halide, battery

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Authors: Zh. Karaulova, D. Baizhigitov

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At the Aktogay deposit, the oxidized ore section has been developed since 2015; by now, the reserves of easily enriched ore are decreasing, and a large number of copper-poor, difficult-to-enrich ores has been accumulated in the dumps of the KAZ Minerals Aktogay deposit, which is unprofitable to mine using the traditional mining methods. Hence, another technology needs to be implemented, which will significantly expand the raw material base of copper production in Kazakhstan and ensure the efficient use of natural resources. Heap and dump bacterial recovery are the most acceptable technologies for processing low-grade secondary copper sulfide ores. Test objects were the copper ores of Aktogay deposit and chemolithotrophic bacteria Leptospirillum ferrooxidans (L.f.), Acidithiobacillus caldus (A.c.), Sulfobacillus Acidophilus (S.a.), which are mixed cultures were both used in bacterial oxidation systems. They can stay active in the 20-400C temperature range. These bacteria were the most extensively studied and widely used in sulfide mineral recovery technology. Biocatalytic acceleration was achieved as a result of bacteria oxidizing iron sulfides to form iron sulfate, which subsequently underwent chemical oxidation to become sulfate oxide. The following results have been achieved at the initial stage: the goal was to grow and maintain the life activity of bacterial cultures under laboratory conditions. These bacteria grew the best within the pH 1,2-1,8 range with light stirring and in an aerated environment. The optimal growth temperature was 30-33оC. The growth rate decreased by one-half for each 4-5°C fall in temperature from 30°C. At best, the number of bacteria doubled every 24 hours. Typically, the maximum concentration of cells that can be grown in ferrous solution is about 107/ml. A further step researched in this case was the adaptation of microorganisms to the environment of certain metals. This was followed by mass production of inoculum and maintenance for their further cultivation on a factory scale. This was done by adding sulfide concentrate, allowing the bacteria to convert the ferrous sulfate as indicated by the Eh (>600 mV), then diluting to double the volume and adding concentrate to achieve the same metal level. This process was repeated until the desired metal level and volumes were achieved. The final stage of bacterial recovery was the transportation and irrigation of secondary sulfide copper ores of the oxidized ore section. In conclusion, the project was implemented at the Aktogay mine since the bioleaching process was prolonged. Besides, the method of bacterial recovery might compete well with existing non-biological methods of extraction of metals from ores.

Keywords: bacterial recovery, copper ore, bioleaching, bacterial inoculum

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Authors: Anis Al-Yakhiri

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Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.

Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results

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Authors: Luís F. da Silva, Ariadne C. Catto, Osmando F. Lopes, Khalifa Aguir, Valmor R. Mastelaro, Caue Ribeiro, Elson Longo

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Gas detection is important for controlling industrial, and vehicle emissions, agricultural residues, and environmental control. In last decades, several semiconducting oxides have been used to detect dangerous or toxic gases. The excellent gas-sensing performance of these devices have been observed at high temperatures (~250 °C), which forbids the use for the detection of flammable and explosive gases. In this way, ultraviolet light activated gas sensors have been a simple and promising alternative to achieve room temperature sensitivity. Among the semiconductor oxides which exhibit a good performance as gas sensor, the zinc oxide (ZnO) and tin oxide (SnO2) have been highlighted. Nevertheless, their poor selectivity is the main disadvantage for application as gas sensor devices. Recently, heterostructures combining these two semiconductors (ZnO-SnO2) have been studied as an alternative way to enhance the gas sensor performance (sensitivity, selectivity, and stability). In this work, we investigated the influence of mass ratio Zn:Sn on the properties of ZnO-SnO2 nanocomposites prepared by hydrothermal treatment for 4 hours at 200 °C. The crystalline phase, surface, and morphological features were characterized by X-ray diffraction (XRD), high-resolution transmission electron (HR-TEM), and X-ray photoelectron spectroscopy (XPS) measurements. The gas sensor measurements were carried out at room-temperature under ultraviolet (UV) light irradiation using different ozone levels (0.06 to 0.61 ppm). The XRD measurements indicate the presence of ZnO and SnO2 crystalline phases, without the evidence of solid solution formation. HR-TEM analysis revealed that a good contact between the SnO2 nanoparticles and the ZnO nanorods, which are very important since interface characteristics between nanostructures are considered as challenge to development new and efficient heterostructures. Electrical measurements proved that the best ozone gas-sensing performance is obtained for ZnO:SnO2 (50:50) nanocomposite under UV light irradiation. Its sensitivity was around 6 times higher when compared to SnO2 pure, a traditional ozone gas sensor. These results demonstrate the potential of ZnO-SnO2 heterojunctions for the detection of ozone gas at room-temperature when irradiated with UV light irradiation.

Keywords: hydrothermal, zno-sno2, ozone sensor, uv-activation, room-temperature

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Authors: Nikita Rajendra Sharma, Jai Prakash Kushvah, Gerhard Rinkenauer

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Driving a car is a discrete aiming movement in which drivers aim at successful extraction of relevant information and elimination of potentially distracting one. It is the motor preparation which enables one to react to certain stimuli onsite by allowing perceptual process for optimal adjustment. Drivers prepare their responses according to the available resources of advanced and ongoing information to drive efficiently. It requires constant programming and reprogramming of the motor system. The reaction time (RT) is shorter when a response signal is preceded by a warning signal. The reason behind this reduced time in responding to targets is that the warning signal causes the participant to prepare for the upcoming response by updating the motor program before the execution. While performing the primary task of changing lanes while driving, the simultaneous occurrence of additional information during the presentation of cues (congruent or incongruent with respect to target cue) might impact the motor preparation and execution. The presence of additional information (other than warning or response signal) between warning signal and imperative stimulus influences human motor preparation to a reasonable extent. The present study was aimed to assess the impact of congruent and incongruent additional information (with respect to imperative stimulus) on driving performance (reaction time, steering wheel amplitude, and steering wheel duration) during a lane change task. implementing movement pre-cueing paradigm. 22 young valid car-drivers (Mage = 24.1+/- 3.21 years, M = 10, F = 12, age-range 21-33 years) participated in the study. The study revealed that additional information influenced the overall driving performance as potential distractors and relevant information. Findings suggest that the events of additional information relatively influenced the reaction time and steering wheel angle as potential distractor or irrelevant information. Participants took longer to respond, and higher steering wheel angles were reported for targets coupled with additional information in comparison with warning signs preceded by potential distractors and the participants' response time was more for a higher number of lanes (2 Lanes > 1 Lane). The same additional information appearing interchangeably at warning signals and targets worked as relevant information facilitating the motor programming in the trails where they were congruent with the direction of lane change direction.

Keywords: additional information, lane change task, motor preparation, movement pre-cueing, reaction time, steering wheel amplitude

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Authors: Braden M. Li, Inhwan Kim, Jesse S. Jur

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One of the fundamental challenges in the electronic textile (e-textile) industry is the mismatch in compliance between the rigid electronic components integrated onto soft textile platforms. To address these problems, various printing technologies using conductive inks have been explored in an effort to improve the electromechanical performance without sacrificing the innate properties of the printed textile. However, current printing methods deposit densely layered coatings onto textile surfaces with low through-plane wetting resulting in poor electromechanical properties. This work presents an inkjet printing technique in conjunction with unique Kirigami cut designs to address these issues for printed smart textiles. By utilizing particle free reactive silver inks, our inkjet process produces conformal and micron thick silver coatings that surround individual fibers of the printed smart textile. This results in a highly conductive (0.63 Ω sq-1) printed e-textile while also maintaining the innate properties of the textile material including stretchability, flexibility, breathability and fabric hand. Kirigami is the Japanese art of paper cutting. By utilizing periodic cut designs, Kirigami imparts enhanced flexibility and delocalization of stress concentrations. Kirigami cut design parameters (i.e., cut spacing and length) were correlated to both the mechanical and electromechanical properties of the printed textiles. We demonstrate that designs using a higher cut-out ratio exponentially softens the textile substrate. Thus, our designs achieve a 30x improvement in the overall stretchability, 1000x decrease in elastic modulus, and minimal resistance change over strain regimes of 100-200% when compared to uncut designs. We also show minimal resistance change of our Kirigami inspired printed devices after being stretched to 100% for 1000 cycles. Lastly, we demonstrate a Kirigami-inspired electrocardiogram (ECG) monitoring system that improves stretchability without sacrificing signal acquisition performance. Overall this study suggests fundamental parameters affecting the performance of e-textiles and their scalability in the wearable technology industry

Keywords: kirigami, inkjet printing, flexible electronics, reactive silver ink

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Authors: F. Mohammadsadeghi

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Relevance of research: Axial compressors are used in both aircraft engine construction and ground-based gas turbine engines. The compressor is considered to be one of the main gas turbine engine units, which define absolute and relative indicators of engine in general. Failure of compressor often leads to drastic consequences. Therefore, safe (stable) operation must be maintained when using axial compressor. Currently, we can observe a tendency of increase of power unit, productivity, circumferential velocity and compression ratio of axial compressors in gas turbine engines of aircraft and ground-based application whereas metal consumption of their structure tends to fall. This causes the increase of dynamic loads as well as danger of damage of high load compressor or engine structure elements in general due to transient processes. In operating practices of aeronautical engineering and ground units with gas turbine drive the operational stability failure of gas turbine engines is one of relatively often failure causes what can lead to emergency situations. Surge occurrence is considered to be an absolute buckling failure. This is one of the most dangerous and often occurring types of instability. However detailed were the researches of this phenomenon the development of measures for surge before-the-fact prevention is still relevant. This is why the research of transient processes for axial compressors is necessary in order to provide efficient, stable and secure operation. The paper addresses the problem of automatic control system improvement by integrating the anti-surge algorithms for axial compressor of aircraft gas turbine engine. Paper considers dynamic exhaustion of gas dynamic stability of compressor stage, results of numerical simulation of airflow flowing through the airfoil at design and stalling modes, experimental researches to form the criteria that identify the compressor state at pre-surge mode detection. Authors formulated basic ways for developing surge preventing systems, i.e. forming the algorithms that allow detecting the surge origination and the systems that implement the proposed algorithms.

Keywords: axial compressor, rotation stall, Surg, unstable operation of gas turbine engine

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Authors: Moses Pinto, Ana Paula Monte

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The present research analyses the interactions between various categories of corporate social responsibility (CSR) that mediate the relationship between CSR and financial performance in Multinational Enterprises (MNE) in light of the present socio-political factors prevalent in the countries under observation. In the research it has been hypothesized that the absence of consensus in the empirical literature on the CSR–financial performance relationship may be explained by the existence of synergies (Complementarities) between the different CSR components. Upon investigation about whether such relationships exist, a final unbalanced panel sample of 1000 observations taken from 100 Multinational Enterprises per year functioning in the Schengen countries and one south east Asian country namely: India, over the span of 10 years i.e. from the year 2008 to 2018 has been analyzed. The empirical analysis used in the research methodology employs dynamic Panel Data in time series specifically, the system Generalized Method of Moments (GMM) which had been used to detect the varying degrees of relationships between the CSR and financial performance parameters in the background of the socio-political factors prevailing in the countries at the time and also taking into account the bilateral treaty obligations between the countries under observation. The econometric model has employed the financial ratio namely the Return on Assets (ROA) as an indicator of financial performance in order to gauge the internal performance and valuation of a firm as opposed to the Tobin’s Q that provides for the external evaluation of a firm’s financial performance which may not always be accurate. The various CSR dimensions have demonstrated significant correlations to the ‘ROA’ which include some negatively associated correlations and one positively associated correlation that is highly significant throughout the analysis of the observations, namely the correlation between the ‘ROA’ and the CSR dimension: ‘Environment’. The results provide a deeper insight in the synergistic CSR activities that managers could adapt into their Firm’s CSR strategy in order to enhance the ‘ROA’ and also to understand which interactions between the CSR dimensions can be adapted together due to their positively correlated association with each other and the ROA. The future lines of research would be inclined to investigate the effects of socio-political factors on the ROA of the MNEs through better designed econometric models.

Keywords: CSR, financial performance, complementarity, sociopolitical factors

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Authors: Uttam Kumar Ghorai, Madhupriya Samanta, Subhajit Saha, Swati Das, Nilesh Mazumder, Kalyan Kumar Chattopadhyay

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Organic semiconductors have gained potential interest in the last few decades for their significant contributions in the various fields such as solar cell, non-volatile memory devices, field effect transistors and light emitting diodes etc. The most important advantages of using organic materials are mechanically flexible, light weight and low temperature depositing techniques. Recently with the advancement of nanoscience and technology, one dimensional organic and inorganic nanostructures such as nanowires, nanorods, nanotubes have gained tremendous interests due to their very high aspect ratio and large surface area for electron transport etc. Among them, self-assembled organic nanostructures like Copper, Zinc Phthalocyanine have shown good transport property and thermal stability due to their π conjugated bonds and π-π stacking respectively. Field emission properties of inorganic and carbon based nanostructures are reported in literatures mostly. But there are few reports in case of cold cathode emission characteristics of organic semiconductor nanostructures. In this work, the authors report the field emission characteristics of chemically and physically synthesized Copper Phthalocyanine (CuPc) nanostructures such as nanowires, nanotubes and nanotips. The as prepared samples were characterized by X-Ray diffraction (XRD), Ultra Violet Visible Spectrometer (UV-Vis), Fourier Transform Infra-red Spectroscopy (FTIR), and Field Emission Scanning Electron Microscope (FESEM) and Transmission Electron Microscope (TEM). The field emission characteristics were measured in our home designed field emission set up. The registered turn-on field and local field enhancement factor are found to be less than 5 V/μm and greater than 1000 respectively. The field emission behaviour is also stable for 200 minute. The experimental results are further verified by theoretically using by a finite displacement method as implemented in ANSYS Maxwell simulation package. The obtained results strongly indicate CuPc nanostructures to be the potential candidate as an electron emitter for field emission based display device applications.

Keywords: organic semiconductor, phthalocyanine, nanowires, nanotubes, field emission

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Authors: K. Graniczkowska, N. Beloglazova, S. De Saeger

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The threat of synthetic drugs is one of the most significant current drug problems worldwide. The use of drugs of abuse has increased dramatically during the past three decades. Among others, Amphetamine-Type Stimulants (ATS) are globally the second most widely used drugs after cannabis, exceeding the use of cocaine and heroin. ATS are potent central nervous system (CNS) stimulants, capable of inducing euphoric static similar to cocaine. Recreational use of ATS is widespread, even though warnings of irreversible damage of the CNS were reported. ATS pose a big problem and their production contributes to the pollution of the environment by discharging big volumes of liquid waste to sewage system. Therefore, there is a demand to develop robust and sensitive sensors that can detect ATS and their intermediates in environmental water samples. A rapid and simple test is required. Analysis of environmental water samples (which sometimes can be a harsh environment) using antibody-based tests cannot be applied. Therefore, molecular imprinted polymers (MIPs), which are known as synthetic antibodies, have been chosen for that approach. MIPs are characterized with a high mechanical and thermal stability, show chemical resistance in a broad pH range and various organic or aqueous solvents. These properties make them the preferred type of receptors for application in the harsh conditions imposed by environmental samples. To the best of our knowledge, there are no existing MIPs-based sensors toward amphetamine and its intermediates. Also not many commercial MIPs for this application are available. Therefore, the aim of this study was to compare different techniques to obtain MIPs with high specificity towards ATS and characterize them for following use in a sensing unit. MIPs against amphetamine and its intermediates were synthesized using a few different techniques, such as electro-, thermo- and UV-initiated polymerization. Different monomers, cross linkers and initiators, in various ratios, were tested to obtain the best sensitivity and polymers properties. Subsequently, specificity and selectivity were compared with commercially available MIPs against amphetamine. Different linkers, such as lipoic acid, 3-mercaptopioponic acid and tyramine were examined, in combination with several immobilization techniques, to select the best procedure for attaching particles on sensor surface. Performed experiments allowed choosing an optimal method for the intended sensor application. Stability of MIPs in extreme conditions, such as highly acidic or basic was determined. Obtained results led to the conclusion about MIPs based sensor applicability in sewage system testing.

Keywords: amphetamine type stimulants, environment, molecular imprinted polymers, MIPs, sensor

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Authors: Yi Zhang, Yuan Tian, Jiehua Chen, Sihong Gu

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Chip-scale spin-exchange relaxation free (SERF) atomic magnetometer makes use of millimeter-scale vapor cells micro-fabricated by Micro-electromechanical Systems (MEMS) technique and SERF mechanism, resulting in the characteristics of high spatial resolution and high sensitivity. It is useful for biomagnetic imaging including magnetoencephalography and magnetocardiography. In a prevailing scheme, circularly polarized on-resonance laser beam is adapted for both pumping and probing the atomic polarization. And the magnetic-field-sensitive signal is extracted by transmission laser intensity enhancement as a result of atomic polarization increase on zero field level crossing resonance. The scheme is very suitable for integration, however, the laser amplitude modulation (AM) noise and laser frequency modulation to amplitude modulation (FM-AM) noise is superimposed on the photon shot noise reducing the signal to noise ratio (SNR). To suppress AM and FM-AM noise the paper puts forward a novel scheme which adopts circularly polarized on-resonance light pumping and linearly polarized frequency-detuning laser probing. The transmission beam is divided into transmission and reflection beams by a polarization analyzer, the angle between the analyzer's transmission polarization axis and frequency-detuning laser polarization direction is set to 45°. The magnetic-field-sensitive signal is extracted by polarization rotation enhancement of frequency-detuning laser which induces two beams intensity difference increase as the atomic polarization increases. Therefore, AM and FM-AM noise in two beams are common-mode and can be almost entirely canceled by differential detection. We have carried out an experiment to study our scheme. The experiment reveals that the noise in the differential signal is obviously smaller than that in each beam. The scheme is promising to be applied for developing more sensitive chip-scale magnetometer.

Keywords: atomic magnetometer, chip scale, differential detection, spin-exchange relaxation free

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Authors: Sunbul Jassim Hamodi, Muna Khalid Khudayer, Firas Muzahem Hussein

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The experiment was conducted to study the effect of supplement sources of Phytase enzyme (bacterial, fungal, enzymes mixture) using levels (250, 500, 750) FTY/ kg feed to diets compared with control on the performance for one thousand fifty broiler chicks (Ross 308) from 1day old with initial weight 39.78 gm till 42 days. The study involved 10 treatments, three replicates per treatment (35 chicks/replicate). Treatments were as follows: T1: control diet (without any addition). T2: added bacterial phytase enzyme 250FTY/ kg feed. T3: added bacterial phytase enzyme 500FTY/ kg feed. T4: added bacterial phytase enzyme 750FTY/ kg feed. T5: added fungal phytase enzyme 250FTY/ kg feed. T6: added fungal phytase enzyme 500FTY/ kg feed. T7: added fungal phytase enzyme 750FTY/ kg feed. T8 added enzymes mixture 250U/ kg feed. T9: added enzymes mixture 500U/ kg feed. T10: added enzymes mixture 750U/ kg feed. The results revealed that supplementing 750 U from enzymes mixture to broiler diet increased significantly (p <0.05) body weight compared with (250 FTY bacterial phytase/Kgfeed), (750 FTY bacterial phytase/Kg feed), (750FTY fungal phytase/Kgfeed) at 6 weeks, also supplemented different sources and levels from phytase enzyme improved a cumulative weight gain for (500 FTY bacterial phytase/Kgfeed), (250FTY fungal phytase/Kgfeed), (500FTY fungal phytase/Kgfeed), (250 Uenzymes mixture/Kgfeed), (500 Uenzymes mixture/Kgfeed) and (750 U enzymes mixture/Kgfeed) treatments compared with (750 FTY fungal phytase/Kgfeed)treatment, about accumulative feed consumption (500 FTY fungal phytase/Kgfeed) and (250 Uenzymes mixture/Kgfeed) increased significantly compared with control group and (750FTY fungal phytase/Kgfeed) during 1-6 weeks. There were significantly improved in cumulative feed conversion for (500U enzymes mixture/Kgfeed) compared with the worse feed conversion ratio that recorded in (250 FTY bacterial phytase/Kgfeed). No significant differences between treatments in internal organs relative weights, carcass cuts, dressing percentage and production index. Mortality was increased in (750FTY fungal phytase/Kgfeed) compared with other treatments.

Keywords: phytase, phytic acid, broiler, productive performance

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Authors: Tebeu Pierre Marie

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Introduction: WHO defines community participation as a process in which the local population, take responsibility in planning for their health, participates in the strategy’s development for implementation and accessibility to physical, moral and social well-being. For the purpose of dealing with health, the community participation is made through the organization called health Centre committee leader (HCCL/COSA) for Integrated health Center and District hospital committee leaser (HDCL/COGES) for District Hospital. Little is known about the effective participation of the community in health related activities in Ignié-Ngabé-Mayama health district. Objective: This study aimed at assessing the involvement of community in the health system running at the Ignié-Ngabé-Mayama health district. Methods: This was a qualitative cross-sectional study conducted in the Ignié-Ngabé-Mayama health district from 15 December 2020 to 30 April 2021. The study population consisted of 10 HCCL and one District hospital committee leaser (DHCL). Data were collected using a pretested questionnaire and validated by the investigating team. The variables of interest were; effective existence of HCCL/DHCL, their involvement HCCL/DHCL in health related activities, their financing management, planning of activities and leadership. Results: A total of 11 participants were interviewed, including 10 HCCL and 1 DHCL. The Sex-Ratio was 9/11; with primary level 6/11 and were mostly farmers 6/11. Analyzing the involvement of the HDCL/DHCL in health promotion and preventive activities; this was effective only for two of them (2/11). Analyzing the barriers for their involvement, the leaders reported the lack of financial support by the state, lack NGO support. Additionally, they reported to have been very active when there was Performance Based Founding Project in the District. Conclusion: Only two of the (HDCL/HCCL) out of 11 were really functioning. Reported barriers to their running were: lack of state/NGOs support and ending of PBF Project. There is a need to organize a tripartite forum including stats, NGOs and Community for boosting the community participation in health related activities in Ignié-Ngabé-Mayama health district.

Keywords: health district committee, health Centre committee, community participation, Brazzaville, Congo

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Authors: Nora Alomar, Bianca Alexandra Stefa, Saleh Bazi

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This research uncovers the determinants that drive millennial consumers to adhere to product return of fast-fashion products purchases via e-commerce and what effects it has on consumer experience and satisfaction. Online consumption has skyrocketed, with e-commerce being the only, most reliable, and safe method of shopping during and post Covid-19. It has been noted customers are demanding a wide variety of product characteristics and a generous optimal return policy. The authors have selected to examine millennial consumers as they are digital natives and have an affinity for researching, reading product reviews, and shopping online, with a great spending power due to a higher disposable income in comparison to other generations. A multi-study approach is adopted, where study one (interviews, sample of 20 respondents) investigates the factors that drive product return, and study two (PLS-SEM, sample of 250 respondents) looks into the relationships of product return management against behavioral outcomes by having the generated factors (from study one) as moderators. Five themes are generated from study one (return policies, product characteristics, delivery lead time, seasonality, product trial & overspending). The authors identify that two out of the five factors (seasonality, product trial & overspending) have not been highlighted by the literature. The paper examines 11 hypotheses, where 10 are supported. Findings highlight the quality of the product return management influences the overall millennial customer experience and satisfaction. Findings also indicate that product return management was identified to have a significant negative effect on customer experience. Additionally, seasonality has a significant but negative moderation, which means increasing seasonality decreases the relationship between product return management and customer experience and satisfaction. Results highlight that return policies have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. Moreover, product characteristics are also identified to have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. This study further examines the influence of the factors on direct e-commerce websites and third-party e-commerce websites. Findings showcase a strong statistical significance for the increased rate of return of fast-fashion products on third-party websites. This paper aids practitioners in taking strategic decisions related to return management, to improve the quality of logistical services and, in turn, increase profitability.

Keywords: customer experience, customer satisfaction, e-commerce, fast-fashion, product returns

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Authors: Mohammed S. Bhader, Abdullah A. Ghaddaf, Anas Alamoudi, Amal Abualola, Renad Kalantan, Noura Alkhulaifi, Ibrahim Halawani, Mohammed Alhindi

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Background: Noninvasive neurally adjusted ventilatory assist (NAVA) is a relatively new mode of noninvasive ventilation with promising clinical and patient-ventilator outcomes for preterm infants. The aim of this systematic review was to compare NAVA to nasal continuous or positive airway pressure (NCPAP) or intermittent positive airway pressure (NIPP) for preterm infants. Methods: We searched the online databases Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared NAVA to NCPAP or NIPP for preterm infants < 37 weeks gestational age. We sought to evaluate the following outcomes: noninvasive intubation failure rate, desaturation rate, the fraction of inspired oxygen (FiO2), and length of stay in the neonatal intensive care unit (NICU). We used the mean difference (MD) to represent continuous outcomes, while the odds ratio (OR) was used to represent dichotomous outcomes. Results: A total of 11 RCTs that enrolled 429 preterm infants were deemed eligible. NAVA showed similar clinical outcomes to NCPAP or NIPP with respect to noninvasive intubation failure (RR for NAVA versus NCPAP: 0.82, 95% confidence interval (CI): 0.49 to 1.37), desaturation rate (RR for NAVA versus NCPAP: 0.69, 95%CI: 0.36 to 1.29; RR for NAVA versus NIPP: 0.58, 95%CI: 0.08 to 4.25), FiO2 (MD for NAVA versus NCPAP: –0.01, 95%CI: –0.04 to 0.02; MD for NAVA versus NIPP: –7.16, 95%CI: –22.63 to 8.31), and length of stay in the NICU (MD for NAVA versus NCPAP: 1.34, 95%CI: –4.17 to 6.85). Conclusion: NAVA showed similar clinical and ventilator-related outcomes compared to the usual care noninvasive respiratory support measures NCPAP or NIPP for preterm infants.

Keywords: preterm infants, noninvasive neurally adjusted ventilatory assist, NIV-NAVA, non-invasive ventilation, nasal continuous or positive airway pressure, NCPAP, intermittent positive airway pressure ventilation, NIPP, respiratory distress syndrome, RDS

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Authors: Rebecca Greenberg, Nipa Chauhan, Rashad Rehman

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Paternalism, in its traditional form, seems largely incompatible with Western medicine. In contrast, Family-Centred Care, a partial response to historically authoritative paternalism, carries its own challenges, particularly when operationalized as family-directed care. Specifically, in neonatology, decision-making is left entirely to Substitute Decision Makers (most commonly parents). Most models of shared decision-making employ both the parents’ and medical team’s perspectives but do not recognize the inherent asymmetry of information and experience – asking parents to act like physicians to evaluate technical data and encourage physicians to refrain from strong medical opinions and proposals. They also do not fully appreciate the difficulties in adjudicating which perspective to prioritize and, moreover, how to mitigate disagreement. Introducing a mild form of paternalism can harness the unique skillset both parents and clinicians bring to shared decision-making and ultimately work towards decision-making in the best interest of the child. The notion expressed here is that within the model of shared decision-making, mild paternalism is prioritized inasmuch as optimal care is prioritized. This mild form of paternalism is known as Beneficent Paternalism and justifies our encouragement for physicians to root down in their own medical expertise to propose treatment plans informed by medical expertise, standards of care, and the parents’ values. This does not mean that we forget that paternalism was historically justified on ‘beneficent’ grounds; however, our recommendation is that a re-integration of mild paternalism is appropriate within our current Western healthcare climate. Through illustrative examples from the NICU, this paper explores the appropriateness and merits of Beneficent Paternalism and ultimately its use in promoting family-centered care, patient’s best interests and reducing moral distress. A distinctive feature of the NICU is the fact that communication regarding a patient’s treatment is exclusively done with substitute decision-makers and not the patient, i.e., the neonate themselves. This leaves the burden of responsibility entirely on substitute decision-makers and the clinical team; the patient in the NICU does not have any prior wishes, values, or beliefs that can guide decision-making on their behalf. Therefore, the wishes, values, and beliefs of the parent become the map upon which clinical proposals are made, giving extra weight to the family’s decision-making responsibility. This leads to why Family Directed Care is common in the NICU, where shared decision-making is mandatory. However, the zone of parental discretion is not as all-encompassing as it is currently considered; there are appropriate times when the clinical team should strongly root down in medical expertise and perhaps take the lead in guiding family decision-making: this is just what it means to adopt Beneficent Paternalism.

Keywords: care, ethics, expertise, NICU, paternalism

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Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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Authors: Sarah Elsayed Mohammed, Lamiaa Ahmed Ahmed, Mahmoud Mohammed Khattab

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Aim: The aim of the present study was to investigate whether combined nicorandil and bone marrow-derived mesenchymal stem cells (BMDMSC) treatment could offer an additional benefit in ameliorating isoproterenol (ISO)-induced heart failure in rats. Methods: ISO (85 and 170 mg/kg/day) was injected subcutaneously for 2 successive days, respectively. By day 3, electrocardiographic changes were recorded and serum was separated for determination of CK-MB level for confirmation of myocardial damage. Nicorandil (3 mg/kg/day) was then given orally with or without a single i.v. BMDMSC administration. Electrocardiography and echocardiography were recorded 2 weeks after beginning of treatment. Rats were then sacrificed and ventricles were isolated for estimation of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) contents, caspase-3 activity as well as inducible nitric oxide synthase (iNOS) and connexin-43 protein expressions. Moreover, histological analysis of myocardial fibrosis was performed and cryosections were done for estimation of homing of BMDMSC. Results: ISO induced a significant increase in ventricles/body weight ratio, left ventricular end diastolic (LVEDD) and systolic dimensions (LVESD), ST segment and QRS duration. Moreover, myocardial fibrosis as well as VEGF, TNF-α and TGF-β contents were significantly increased. On the other hand, connexin-43 protein expression was significantly decreased, while caspase-3 and iNOS protein expressions were significantly increased. Combined therapy provided additional improvement compared to cell treatment alone towards reducing cardiac hypertrophy, fibrosis and inflammation. Furthermore, combined therapy induced significant increase in angiogenesis and BMDMSC homing and prevented ISO induced changes in iNOS, connexin-43 and caspase-3 protein expressions. Conclusion: Combined nicorandil/BMDMSC treatment was superior to BMDMSC alone towards preventing ISO-induced heart failure in rats.

Keywords: fibrosis, isoproterenol, mesenchymal stem cells, nicorandil

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Authors: SeyedKeivan Nateghi, Jan Kaczmarczyk

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People nowadays spend most of their time in buildings. Accordingly, maintaining a good quality of indoor air is very important. New universal matters related to the prevalence of Covid-19 also highlight the importance of indoor air conditioning in reducing the risk of virus infection. Cooling and Heating of a house will provide a suitable zone of air temperature for residents. One of the significant factors in energy demand is energy consumption in the building. In general, building divisions compose more than 30% of the world's fundamental energy requirement. As energy demand increased, greenhouse effects emerged that caused global warming. Regardless of the environmental damage to the ecosystem, it can spread infectious diseases such as malaria, cholera, or dengue to many other parts of the world. With the advent of the Covid-19 phenomenon, the previous instructions to reduce energy consumption are no longer responsive because they increase the risk of virus infection among people in the room. Two problems of high energy consumption and coronavirus infection are opposite. A classroom with 30 students and one teacher in Katowice, Poland, considered controlling two objectives simultaneal. The probability of transmission of the disease is calculated from the carbon dioxide concentration of people. Also, in a certain period, the amount of energy consumption is estimated by EnergyPlus. The effect of three parameters of number, angle, and time or schedule of opening windows on the probability of infection transmission and energy consumption of the class were investigated. Parameters were examined widely to determine the best possible condition for simultaneous control of infection spread and energy consumption. The number of opening windows is discrete (0,3), and two other parameters are continuous (0,180) and (8 AM, 2 PM). Preliminary results show that changes in the number, angle, and timing of window openings significantly impact the likelihood of virus transmission and class energy consumption. The greater the number, tilt, and timing of window openings, the less likely the student will transmit the virus. But energy consumption is increasing. When all the windows were closed at all hours of the class, the energy consumption for the first day of January was only 0.2 megajoules. In comparison, the probability of transmitting the virus per person in the classroom is more than 45%. But when all windows were open at maximum angles during class, the chance of transmitting the infection was reduced to 0.35%. But the energy consumption will be 36 megajoules. Therefore, school classrooms need an optimal schedule to control both functions. In this article, we will present a suitable plan for the classroom with natural ventilation through windows to control energy consumption and the possibility of infection transmission at the same time.

Keywords: Covid-19, energy consumption, building, carbon dioxide, energyplus

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Authors: Abdullahi Yahaya Musa, Harun Rann Bakari

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The study examined the determinants of food security among households in Maiduguri, Metropolis, Borno State, Nigeria. The objectives of the study are to: examine the determinants of food security among households; identify the coping strategies employed by food-insecure households in Maiduguri, Metropolis, Borno State, Nigeria. The population of the study is 843,964 respondents out of which 400 respondents were sampled. The study used a self-developed questionnaire to collect data from four hundred (400) respondents. Four hundred (400) copies of questionnaires were administered and all were retrieved, making 100% return rate. The study employed descriptive and inferential statistics for data analysis. Descriptive statistics (frequency counts and percentages) was used to analyze the socio-economic characteristics of the respondents and objective four, while inferential statistics (logit regression analysis) was used to analyze one. Four hundred (400) copies of questionnaires were administered and all the four hundred (400) were retrieved, making a 100% return rate. The results were presented in tables and discussed according to the research objectives. The study revealed that HHA, HHE, HHSZ, HHSX, HHAS, HHI, HHFS, HHFE, HHAC and HHCDR were the determinants of food security in Maiduguri Metropolis. Relying on less preferred foods, purchasing food on credit, limiting food intake to ensure children get enough, borrowing money to buy foodstuffs, relying on help from relatives or friends outside the household, adult family members skipping or reducing a meal because of insufficient finances and ration money to household members to buy street food were the coping strategies employed by food-insecure households in Maiduguri metropolis. The study recommended that Nigeria Government should intensify the fight against the Boko haram insurgency. This will put an end to Boko Haram Insurgency and enable farmers to return to farming in Borno state.

Keywords: internally displaced persons, food security, coping strategies, descriptive statistics, logistics regression model, odd ratio

Procedia PDF Downloads 122