Search results for: pavement condition assessment

Authors: Farrah Anne Robert, Robert McClelland, Seng Kiat Kok

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Higher education service quality is widely regarded as key factors in the long term success of a higher education institution in attracting and retaining students. This research attempted to establish the impact of service quality on recruiting and retaining students in private higher education institutions (PHEI’s). 501 local and international students responded to a 49 item educational service measure questionnaire from PHEIs in Kuala Lumpur and Selangor, two states in Malaysia which together account for 60% of private colleges in Malaysia. Results from this research revealed that, inter-alia, facilities, employability, management and administration services, academic staff competence, curriculum and student overall experiences were key driving factors in attracting and retaining students. Lack of “campus-like building” facilities and lecturer’s effectiveness in delivering lectures were keys concerns in the provision of service quality by PHEI’s in Malaysia. Over the last decade, the Government of Malaysia has set a target of recruiting 200,000 international students to study in Malaysia by PHEI’s and PHEI’s have failed to achieve this target. This research suggests that service quality issues identified above are impacting efforts to recruit and retain both local and international students by PHEIs. The researcher recommends that further and detailed research be carried on these factors and its impact on recruitment and retention. PHEI administrators can benefit from this research by conducting an evaluation of service measures delivered in their institutions and take corrective measures. Prospective students can benefit from this study by including in their choice factors the “service quality delivery” of PHEI’s when deciding to enroll in a particular PHEI.

Keywords: higher education, recruitment, retention, service quality

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: K. Rumchev, S. Gilbey

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Airborne particulate matter is a known hazard to human health, with a considerable body of evidence linking agricultural dust exposures to adverse human health effects in exposed populations. It is also known that agricultural workers are exposed to high levels of soil dust and other types of airborne particulate matter within the farming environment. The aim of this study was to examine exposure to agricultural dust among farm workers during the seeding season. Twenty-one wheat-belt farms consented to participate in the study with 30 workers being monitored for dust exposure whilst seeding or undertaking seeding associated tasks. Each farm was visited once and farmers’ were asked to wear a personal air sampler for a 4-hour sampling period. Simultaneous, real-time, tractor cabin air quality monitoring was also undertaken. Data for this study was collected using real-time aerosol dust monitors to determine in-tractor cabin PM exposure to five size fractions (total, PM10, respirable, PM2.5 and PM1), and personal sampling was undertaken to establish individual exposure to inhalable and respirable dust concentrations. The study established a significant difference between personal exposures and simultaneous real-time in-cabin exposures for both inhalable and respirable fractions. No significant difference was shown between in-cabin and personal inhalable dust concentrations during seeding and spraying tasks, although both in-cabin and personal concentrations were two times greater for seeding than spraying. Future research should focus on educating and providing farm owners and workers with more information on adopting safe work practices to minimise harmful exposures to agricultural dust.

Keywords: agriculture, air quality, Australia, particulate matter

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Authors: Saroj Panthi, Sher Singh Thagunna

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Reliable and sufficient information regarding status, distribution and habitat preference of red panda (Ailurus fulgens fulgens) is lacking in Nepal. The research activities on red panda in the mid-western Nepal are very limited, so the status of red panda in the region is quite unknown. The study conducted during May, 2013 in three Village Development Committees (VDCs) namely Godhemahadev, Malikathata and Tamti of Jumla district was an important step for providing vital information including distribution and habitat preference of this species. The study included the reconnaissance, key informants survey, interviews, and consultation for the most potential area identification, opportunistic survey comprising the direct observation and indirect sign count method for the presence and distribution, habitat assessment consisting vegetation sampling and ocular estimation. The study revealed the presence of red panda in three forests namely Bahirepatan, Imilchadamar and Tyakot of Godhemahadev, Tamti and Malikathata VDCs respectively. The species was found distributed between 2880 and 3244 m with an average dropping encounter rate of 1.04 per hour of searching effort and 12 pellets per dropping. Red panda mostly preferred the habitat in the elevation range of 2900 - 3000 m with southwest facing steep slopes (36˚ - 45˚), associated with water sources at the distance of ≤100 m. Trees such as Acer spp., Betula utilis and Quercus semecarpifolia, shrub species of Elaeagnus parvifolia, Drepanostachyum spp. and Jasminum humile, and the herbs like Polygonatum cirrhifolium, Fragaria nubicola and Galium asperifolium were found to be the most preferred species by red panda. The red panda preferred the habitat with dense crown coverage ( >20% - 100%) and 31% - 50% ground cover. Fallen logs (39%) were the most preferred substrate used for defecation.

Keywords: distribution, habitat preference, jumla, red panda

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Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

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Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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Authors: Mutiara Effendi

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Nunukan Island is located on North Kalimantan of Indonesia. The region is one of Indonesia’s cross-border with Malaysia. In conjunction with its strategic geographic location, its potential as the new oil and gas resources has brought many researchers to do their studies here. The research area consists of claystone which criss-crossed with quarts sandstone. There are also rocks claystone-grained which are the weathering product of basaltic volcanic rocks. In some places, there are argillic clays which are the hydrothermal-altered product of Sei Apok ancient volcano. Geochemical study was established to learn the origin of the claystones, whether it came from weathering, hydrothermal alteration, or both. The samples used in this research are fresh rock, weathering rocks, hydrothermally-altered rock, and claystones. Chemical compositions of each sample were determined and their relations was studied. The studies encompass major and minor elements analysis using X-Ray Fluoresence (XRF) method and trace elements analysis, specifically rare earth elements, using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) method. The results were plotted on certain graphics to learn about the trend and the relations of each sample and element. Any changes in chemical compositions, like increase and decrease of elements or species, was analysed to learn about geological phenomenon that happens during the formation of claystones. The result of this study shows that claystones of Nunukan Island have relation with volcanic rocks of its surrounding area. Its chemical composition profile corresponds to weathering product of volcanic rocks rather than hydrothermally-altered product. The general profile also resembles claystone minerals of illite or montmorillonite, especially in the existence of aluminum, iron, potassium, and magnesium. Both minerals are formed in basic condition and commonly happen to shales. It is consistent with the fact that claystone was found mixing with shales and silt to clay grained mudstones in field exploration. Even though the general profile is much alike, the amount of each elements is not precisely the same as theoretically claystone mineral compositions because the mineral have not formed completely yet.

Keywords: claystone, geochemistry, ICP-MS, XRF

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Authors: Levylee Bautista, Dawn Grace Santos, Aishwarya Veluchamy, Jesusa Santos, Ghafoor, Jr. I Haque, Rodolfo Rafael

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The booming interest in using natural compounds as an alternative to conventional medications has paved way to focus the attention on plants that provide rich sources of bioactive phytochemicals. For regulatory purposes, evaluation of the genotoxic effects of such alternatives is therefore empirical as part of the plant’s hazard assessment. Sesbania grandiflora is among the plants used as a traditional remedy in folk medicine and a subject of research for its medicinal benefits. This study aimed to evaluate the genotoxic potential induced by S. grandiflora flower methanol extract (SGFME) in terms of the frequency of micronucleus (MN) in polychromatic erythrocyte (PCE) (MNPCE) and PCE ratio employing the micronucleus assay. The frequency of MN was examined in bone marrow cells (BMCs) obtained from male Swiss albino mice exposed in vivo to four different concentrations (11.25, 22.5, 40, and 90 mg/kg) of SGFME and MMC (70 mg/kg; positive control) and sacrificed 24 hours post-intraperitoneal injection. Results showed a significant (p < 0.01) rate of MNPCEs for 11.25 and 22.5 tested concentrations of SGFME and is comparable with the MMC-treated mice. Although PCE ratio values in all doses of SGFME-treated mice were over 0.20, it is worth noting that 40 and 90 tested concentrations of SGFME-treated mice exhibited the lowest value, i.e., 0.22 and 0.28, respectively. The present study has demonstrated that S. grandiflora possesses genotoxic potential for murine BMCs. Such activity could be ascribed from the bioactive compounds present in S. grandiflora that require further isolation and characterization of the active molecules. Likewise, findings of this study warrant a caution of the use of S. grandiflora insomuch as further investigations do not demonstrate their safety.

Keywords: genotoxicity, micronucleus, phytochemicals, Sesbania grandiflora

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Authors: Fundime Miri, Emanuela Sulaj

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Benthic ecosystems constitute important ecological habitats, providing fundamental services for spawning, foraging, and sheltering aquatic organisms. Benthic faunal communities are characterized by a large biological diversity, supported by a great physical variety of benthic habitats. Until late, the study of meiobenthic communities in Albania has been neglectedthus excluding an important component of benthos. The present study aims to bring characteristics of distribution pattern of meiofaunal communities with further focus on nematode genus-based diversity from different intertidal habitats along Albanian Adriatic Sea Coast. The investigation area is extended from Shkodra to Vlora District, including six sandy sampling sites in beaches and areas near river estuaries. Sediment samples were collected manually in low intertidal zone by using a cylindrical corer, with an internal diameter of 5 cm. The richness onmeiofaunalmajor taxon level did not show any significant change between different sampling sites compare to significant changes in nematode diversity at genus level, with distinct nematode assemblages per sampling sites and presence of exclusive genera. All meiofaunal communities under study were dominated by nematodes. Further assessment of functional diversity on nematode assemblages exhibited changes as well on trophic groups and life strategies due to diverse feeding behaviors and c-p values of nematode genera. This study emphasize the need for lower level taxonomic identification of meiofaunal organisms and extending of ecological assessments on trophic diversity and life strategies to understanding functional consequences.

Keywords: benthos, meiofauna, nematode genus-based diversity, functional diversity, intertidal, albanian adriatic coast

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Authors: Ismail Elkhrachy

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Determination of land use changing is an important component of regional planning for applications ranging from urban fringe change detection to monitoring change detection of land use. This data are very useful for natural resources management.On the other hand, the technologies and methods of change detection also have evolved dramatically during past 20 years. So it has been well recognized that the change detection had become the best methods for researching dynamic change of land use by multi-temporal remotely-sensed data. The objective of this paper is to assess, evaluate and monitor land use change surrounding the area of Najran city, Kingdom of Saudi Arabia (KSA) using Landsat images (June 23, 2009) and ETM+ image(June. 21, 2014). The post-classification change detection technique was applied. At last,two-time subset images of Najran city are compared on a pixel-by-pixel basis using the post-classification comparison method and the from-to change matrix is produced, the land use change information obtained.Three classes were obtained, urban, bare land and agricultural land from unsupervised classification method by using Erdas Imagine and ArcGIS software. Accuracy assessment of classification has been performed before calculating change detection for study area. The obtained accuracy is between 61% to 87% percent for all the classes. Change detection analysis shows that rapid growth in urban area has been increased by 73.2%, the agricultural area has been decreased by 10.5 % and barren area reduced by 7% between 2009 and 2014. The quantitative study indicated that the area of urban class has unchanged by 58.2 km〗^2, gained 70.3 〖km〗^2 and lost 16 〖km〗^2. For bare land class 586.4〖km〗^2 has unchanged, 53.2〖km〗^2 has gained and 101.5〖km〗^2 has lost. While agriculture area class, 20.2〖km〗^2 has unchanged, 31.2〖km〗^2 has gained and 37.2〖km〗^2 has lost.

Keywords: land use, remote sensing, change detection, satellite images, image classification

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Authors: Muhammad Nasar-u-Minallah, Dagmar Haase, Salman Qureshi

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Rapid urbanization significantly change land use, urban nature, land surface vegetation cover, and heat distribution, leading to the formation of urban heat island (UHI) effect and affecting the healthy growth of cities and the comfort of human living style. Past information and present changes in Land Surface Temperature (LST) and urban landscapes could be useful to geographers, environmentalists, and urban planners in an attempt to shape the urban development process and mitigate the effects of urban heat islands (UHI). This study aims at using Satellite Remote Sensing (SRS) and GIS techniques to develop an approach for assessing the urban nature and UHI effects in Lahore, Pakistan. The study employed the Radiative Transfer Method (RTM) in estimating LST to assess the SUHI effect during the interval of 20 years (2000-2020). The assessment was performed by the available Landsat 7/ETM+ and Landsat 8/OIL_TIRs data for the years 2000, 2010, and 2020 respectively. Pearson’s correlation and normalized mutual information were applied to investigate the relationship between green space characteristics and LST. The result of this work revealed that the influence of urban heat island is not always at the city centers but sometimes in the outskirt where a lot of development activities were going on towards the direction of expansion of Lahore, Pakistan. The present study explores the usage of image processing and spatial analysis in the drive towards achieving urban greening of Lahore and a sustainable urban environment in terms of urban planning, policy, and decision making and promoting the healthy and sustainable urban environment of the city.

Keywords: urban nature, urban heat islands, urban green space, land use, Lahore

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Authors: Abeer Ahmed Abdehameed

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Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common micro vascular complications of type 2 diabetes. Loss of sensation is thought to contribute to lake of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low level laser (LLL) and monochromatic near infrared photo energy (MIRE) on pain , cutaneous sensation, static stability and index of lower limb blood flow in diabetic with peripheral neuropathy. Methods: Forty subjects with diabetic peripheral neuropathy were recruited for study. They were divided into two groups: The ( MIRE) group that included (20) patients and (LLL) group included (20) patients. All patients in the study had been subjected to various physical assessment procedures including pain, cutaneous sensation, Doppler flow meter and static stability assessments. The baseline measurements were followed by treatment sessions that conducted twice a week for 6 successive weeks. Results: The statistical analysis of the data had revealed significant improvement of the pain in both groups, with significant improvement in cutaneous sensation and static balance in (MIRE) group compared to (LLL) group; on the other hand results showed no significant differences on lower limb blood flow in both groups. Conclusion: Low level laser and monochromatic near infrared therapy can improve painful symptoms in patients with diabetic neuropathy. On the other hand (MIRE) is useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: diabetic neuropathy, doppler flow meter, low level laser, monochromatic near infrared photo energy

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Authors: Gabrielle Veloso, Melanie Porter, Kelsie Boulton, Adam Guastella

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The aim of the current systematic review was to examine child and parent factors and their associations with parent sensitivity towards children with Autism Spectrum Disorder (ASD). Eight bibliographic databases were used to identify peer-reviewed journal articles examining these associations via quantitative analyses, with parent sensitivity measured via validated and reliable observation coding systems. Thirty-one studies were finalized as having met full criteria for inclusion. The review found agreement across studies that parent sensitivity was positively associated with the child’s initiations and responsiveness toward their parent, with more frequent parent-directed behaviors providing greater opportunity for parents to act and react in sensitive manner. There was also substantial evidence that parent sensitivity predicted later growth in child language ability and child social skills. Other factors such as child attachment, parent insightfulness toward their child, and parent resolution of the diagnosis were also identified across a number of studies as being positively associated with parent sensitivity, however, interpretations of these findings were limited by the absence of covariates identified in the literature as explaining much of the variance in parent sensitivity. With respect to non-significant associations, the literature reliably found that parents showed sensitivity toward their child with ASD, regardless of child age, ASD symptomology, concurrent child social skills, and concurrent child cognitive abilities. The robust associations found in this review and their potential explanations can serve as a jump off point in identifying an understanding protective and risk factors for families of children with ASD. With regard to future directions in research, assessment of the studies’ methodological quality identified points for improvement with respect to the measurement of parent sensitivity, as well as the consideration of several important methodological confounds that may be controlled for in statistical analyses.

Keywords: ASD, autism, parenting, parent sensitivity

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Authors: Ahsan Ali, Mayank Ostwal, Nikhil Agarwal

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Abstract—According to a World Bank report, millions of people across the globe still do not have access to improved water services. With uninterrupted growth of cities and urban inhabitants, there is a mounting need to safeguard the sustainable expansion of cities. Efficient functioning of the urban components and high living standards of the residents are needed to be ensured. The water and sanitation network of an urban development is one of its most essential parts of its critical infrastructure. The growth in urban population is leading towards increased water demand, and thus, the local water resources are severely strained. 'Smart water' is referred to water and waste water infrastructure that is able to manage the limited resources and the energy used to transport it. It enables the sustainable consumption of water resources through co-ordinate water management system, by integrating Information Communication Technology (ICT) solutions, intended at maximizing the socioeconomic benefits without compromising the environmental values. This paper presents a case study from a medium sized city in North-western Pakistan. Currently, water is getting contaminated due to the proximity between water and sewer pipelines in the study area, leading to public health issues. Due to unsafe grey water infiltration, the scarce ground water is also getting polluted. This research takes into account the design of smart urban water network by integrating ICT (Information and Communication Technology) with urban water network. The proximity between the existing water supply network and sewage network is analyzed and a design of new water supply system is proposed. Real time mapping of the existing urban utility networks will be projected with the help of GIS applications. The issue of grey water infiltration is addressed by providing sustainable solutions with the help of locally available materials, keeping in mind the economic condition of the area. To deal with the current growth of urban population, it is vital to develop new water resources. Hence, distinctive and cost effective procedures to harness rain water would be suggested as a part of the research study experiment.

Keywords: GIS, smart water, sustainability, urban water management

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Authors: Nida Rizvi, Deeksha Katyal, Varun Joshi

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River Hindon is an important river catering the demand of highly populated rural and industrial cluster of western Uttar Pradesh, India. Water quality of river Hindon is deteriorating at an alarming rate due to various industrial, municipal and agricultural activities. The present study aimed at identifying the pollution sources and quantifying the degree to which these sources are responsible for the deteriorating water quality of the river. Various water quality parameters, like pH, temperature, electrical conductivity, total dissolved solids, total hardness, calcium, chloride, nitrate, sulphate, biological oxygen demand, chemical oxygen demand and total alkalinity were assessed. Water quality data obtained from eight study sites for one year has been subjected to the two multivariate techniques, namely, principal component analysis and cluster analysis. Principal component analysis was applied with the aim to find out spatial variability and to identify the sources responsible for the water quality of the river. Three Varifactors were obtained after varimax rotation of initial principal components using principal component analysis. Cluster analysis was carried out to classify sampling stations of certain similarity, which grouped eight different sites into two clusters. The study reveals that the anthropogenic influence (municipal, industrial, waste water and agricultural runoff) was the major source of river water pollution. Thus, this study illustrates the utility of multivariate statistical techniques for analysis and elucidation of multifaceted data sets, recognition of pollution sources/factors and understanding temporal/spatial variations in water quality for effective river water quality management.

Keywords: cluster analysis, multivariate statistical techniques, river Hindon, water quality

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Authors: Joao Paulo Matheus, Renan Fangel

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Rheumatoid arthritis is a chronic, inflammatory, systemic and progressive disease that affects the synovial joints bilaterally, causing definitive orthopedic damage. It has a higher prevalence in postmenopausal female patients. It is a disabling disease that causes joint deformities that may compromise the functionality of the affected segment. The aim of this study was to evaluate the influence of low-intensity therapeutic laser on the perception of pain and quality of life in patients with rheumatoid arthritis. This is a randomized clinical study involving 6 women with a mean age of 56.8+6.3 years. Exclusion criteria: patients with acute pain, chronic infectious disease, underlying acute or chronic underlying disease. An AsGaAl laser with 808nm wavelength, 100mW power, beam output area of 0.028cm2, power density of 3.57W/cm2 was used. The laser was applied at pre-defined points in the interphalangeal and metacarpophalangeal joints, totaling 24 points, 2 times a week, for 4 weeks, totaling 8 sessions. The Pain Inventory (IBD) and Visual Analogue Scale (VAS) were used for the analysis of pain and for the WHOQOL-bref quality of life assessment. There was no statistical difference between the onset (5.67±2.66) and the final (4.67±3.78) of treatments (p=0.70). There was also no statistical difference between the beginning (5.67±2.66) and the final (4.67±3.78) of the treatments in the VAS analysis (p=0.68). The overall mean quality of life obtained by the questionnaire at the start of treatment was 42.3±7.6, while at the end of treatment it was 58.5±7.6 (p=0.01) and the domains of the questionnaire with significant differences were: psychological domain 42.9±6.8 and 66.7±12.9 (p=0.004), social domain 39.9±5.7 and 68.1±6.3 (p=0,0005) and environmental domain 36.3±7.3 and 56.3±12.5 (p=0.003). It can be concluded that the low-intensity therapeutic laser did not produce significant changes in the painful period of rheumatoid arthritis patients. However, there was an improvement in patients' quality of life in the psychological, social and environmental aspects.

Keywords: laser therapy, pain, quality of life, rheumatoid arthritis

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Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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Authors: Olubunmi S. Shittu, Olufemi J. Ayodele, Augustus O. A. Ilori, Abidemi O. Filani, Adetola T. Afuye

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Indiscriminate refuse dumping in and around Ado-Ekiti combined with improper management of few available dumpsites, such as Ilokun dumpsite, posed the threat of heavy metals pollution in the surrounding soils and underground water that needs assessment using pollution indices. Surface soils (0-15 cm) were taken from the centre of Ilokun dumpsite (0 m) and environs at different directions and distances during the dry and wet seasons, as well as a background sample at 1000 m away, adjacent to the dumpsite at Ilokun, Ado-Ekiti, Nigeria. The concentration of heavy metals used to calculate the pollution indices for the soils were determined using Atomic Adsorption Spectrophotometer. The soils recorded high concentrations of all the heavy metals above the background concentrations irrespective of the season with highest concentrations at the 0 m except Ni and Fe at 50 m during the dry and wet season, respectively. The heavy metals concentration were in the order of Ni > Mn > Pb > Cr > Cu > Cd > Fe during the dry season, and Fe > Cr > Cu > Pb > Ni > Cd > Mn during the wet season. Using the Contamination Factor (CF), the soils were classified to be moderately contaminated with Cd and Fe to very high contamination with other metals during the dry season and low Cd contamination (0.87), moderate contamination with Fe, Pb, Mn and Ni and very high contamination with Cr and Cu during the wet season. At both seasons, the Pollution Load Index (PLI) indicates the soils to be generally polluted with heavy metals and the Geoaccumulation Index (I_geo) calculated shown the soils to be in unpolluted to moderately polluted levels. Enrichment Factor (EF) implied the soils to be deficiently enriched with all the heavy metals except Cr (7.90) and Cu (6.42) that were at significantly enrichment levels during the wet season. Modified Degree of Contamination (mC_d) recorded, indicated the soils to be of very high to extremely high degree of contamination during the dry season and moderate degree of contamination during the wet season except 0 m with high degree of contamination. The concentration of heavy metals in the soils combined with some of the pollution indices indicated the soils in and around the Ilokun Dumpsite are being polluted with heavy metals from anthropogenic sources constituted by the indiscriminate refuse dumping.

Keywords: contamination factor, enrichment factor, geoaccumulation index, modified degree of contamination, pollution load index

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Authors: G. K. Sruthi, Sila Bhattacharya

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Sorghum is an important food crop in the dry tropical areas of the world, and possesses significant levels of phytochemicals and dietary fiber to offer health benefits. However, the absence of gluten is a limitation for converting the sorghum dough into sheeted/flattened/rolled products. Chapathi/roti (flat unleavened bread prepared conventionally from whole wheat flour dough) was attempted from sorghum as wheat gluten causes allergic reactions leading to celiac disease. Dynamic oscillatory rheology of sorghum flour dough (control sample) and enzyme treated sorghum doughs were studied and linked to the attributes of the finished ready-to-eat product. Enzymes like amylase, xylanase, and a mix of amylase and xylanase treated dough affected drastically the rheological behaviour causing a lowering of dough consistency. In the case of amylase treated dough, marked decrease of the storage modulus (G') values from 85513 Pa to 23041 Pa and loss modulus (G") values from 8304 Pa to 7370 Pa was noticed while the phase angle (δ) increased from 5.6 to 10.1o for treated doughs. There was a 2 and 3 fold increase in the total sugar content after α-amylase and xylanase treatment, respectively, with simultaneous changes in the structure of the dough and finished product. Scanning electron microscopy exhibited enhanced extent of changes in starch granules. Amylase and mixed enzyme treatment produced a sticky dough which was difficult to roll/flatten. The dough handling properties were improved by the use of xylanase and quality attributes of the chapath/roti. It is concluded that enzyme treatment can offer improved rheological status of gluten free doughs and products.

Keywords: sorghum dough, amylase, xylanase, dynamic oscillatory rheology, sensory assessment

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Authors: Saif K. Al-Qaisi, Jad R. Mansour, Aseel W. Sakka, Yousef Al-Abdallat

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Handwheels are common to numerous industries, such as power generation plants, oil refineries, and chemical processing plants. The forces required to manually turn handwheels have been shown to exceed operators’ physical strengths, posing risks for injuries. Therefore, the objectives of this research were twofold: (1) to determine humans’ physical strengths on handwheels of different sizes and angles and (2) to subsequently propose recommended torque limits (RTLs) that accommodate the strengths of even the weaker segment of the population. Thirty male and thirty female participants were recruited from a university student population. Participants were asked to exert their maximum possible forces in a counter-clockwise direction on handwheels of different sizes (35 cm, 45 cm, 60 cm, and 70 cm) and angles (0°-horizontal, 45°-slanted, and 90°-vertical). The participant’s posture was controlled by adjusting the handwheel to be at the elbow level of each participant, requiring the participant to stand erect, and restricting the hand placements to be in the 10-11 o’clock position for the left hand and the 4-5 o’clock position for the right hand. A torque transducer (Futek TDF600) was used to measure the maximum torques generated by the human. Three repetitions were performed for each handwheel condition, and the average was computed. Results showed that, at all handwheel angles, as the handwheel diameter increased, the maximum torques generated also increased, while the underlying forces decreased. In controlling the handwheel diameter, the 0° handwheel was associated with the largest torques and forces, and the 45° handwheel was associated with the lowest torques and forces. Hence, a larger handwheel diameter –as large as 70 cm– in a 0° angle is favored for increasing the torque production capacities of users. Also, it was recognized that, regardless of the handwheel diameter size and angle, the torque demands in the field are much greater than humans’ torque production capabilities. As such, this research proposed RTLs for the different handwheel conditions by using the 25th percentile values of the females’ torque strengths. The proposed recommendations may serve future standard developers in defining torque limits that accommodate humans’ strengths.

Keywords: handwheel angle, handwheel diameter, humans’ torque production strengths, recommended torque limits

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Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

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The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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Authors: Moshe Wasserblat, Jonathan Mamou, Oren Pereg

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Natural Language Processing (NLP) has made a major leap in the last few years, in practical integration into medical solutions; for example, extracting clinical concepts from medical texts such as medical condition, medication, treatment, and symptoms. However, training and deploying those models in real environments still demands a large amount of annotated data and NLP/Machine Learning (ML) expertise, which makes this process costly and time-consuming. We present a practical and efficient method for clinical concept extraction that does not require costly labeled data nor ML expertise. The method includes three steps: Step 1- the user injects a large in-domain text corpus (e.g., PubMed). Then, the system builds a contextual model containing vector representations of concepts in the corpus, in an unsupervised manner (e.g., Phrase2Vec). Step 2- the user provides a seed set of terms representing a specific medical concept (e.g., for the concept of the symptoms, the user may provide: ‘dry mouth,’ ‘itchy skin,’ and ‘blurred vision’). Then, the system matches the seed set against the contextual model and extracts the most semantically similar terms (e.g., additional symptoms). The result is a complete set of terms related to the medical concept. Step 3 –in production, there is a need to extract medical concepts from the unseen medical text. The system extracts key-phrases from the new text, then matches them against the complete set of terms from step 2, and the most semantically similar will be annotated with the same medical concept category. As an example, the seed symptom concepts would result in the following annotation: “The patient complaints on fatigue [symptom], dry skin [symptom], and Weight loss [symptom], which can be an early sign for Diabetes.” Our evaluations show promising results for extracting concepts from medical corpora. The method allows medical analysts to easily and efficiently build taxonomies (in step 2) representing their domain-specific concepts, and automatically annotate a large number of texts (in step 3) for classification/summarization of medical reports.

Keywords: clinical concepts, concept expansion, medical records annotation, medical records summarization

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Authors: A. Sathya, C. Manojkumar, D. Visithra

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The South Indian peninsula has rich diversity of both heritage and conventional rice varieties. With the prime focus set on high yield and increased productivity, a number of traditional/heritage rice varieties have dwindled into the forgotten past. At present, in the face of climate change, the hybrids and conventional varieties struggle for sustainable yield. The need of copious irrigation and high nutrient inputs for the hybrids and conventional varieties have cornered the farming and research community to resort to heritage rice varieties for their sturdy survival capability. An ethno-scientific effort has been taken in the Cauvery delta tracts of South India to restore these traditional/heritage rice varieties. A closer field level performance evaluation under organic condition has been undertaken for 10 heritage rice varieties. The morpho-agronomic characterization across vegetative and reproductive stages have revealed a pattern of variation in duration, plant height, number of tillers, productive tillers, etc. The shortest duration was recorded for a variety with the vernacular name of ‘Arubadaam kuruvai’. A traditional rice variety called ‘Maapillai samba’ is claimed to impart instant energy. The supernatant water of the overnight soaked cooked rice of Maapillai samba is a source of instant energy. The physico-chemical analysis of this variety is being explored for its instant nutritional boosting ability. Wide spectrum of nutritional characters including palatability and marketability preferences has also been analyzed for all these 10 heritage rice varieties. A ‘Farmer’s harvest day festival’ was organized, providing opportunity for the ‘Cauvery delta farmers’ to identify the special features and exchange their views on these standing golden ripe paddy varieties directly. The airing of their ethnic knowledge pooled with interesting scientific investigations of these 10 rich heritage rice varieties of South India undertaken will be elaborately discussed enlightening the perspectives on the pathway of resurrection and restoration of this heritage of the past.

Keywords: biodiversity, conservation, heritage, rice, traditional, varieties

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Authors: Aung Aung Kyi, Khin Khin Aye

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The mode of teaching and learning has been changed dramatically due to the Covid-19 pandemic that made schools close and students may have been away from the campus. However, many schools all over the countries are helping students to facilitate e-learning through online teaching and learning platform. Regarding this, Sarasas bilingual school in Bangkok conducted the high school students’ satisfaction survey since it is important for every school to improve its quality of education that must meet the students' need. For the good of the school's reputation, the purpose of the study is to examine the level of satisfaction that enhances the best services in the future. This study applied random sampling techniques and the data were collected using a self-administered survey. Descriptive analysis and independent sample t-tests were used to measure the importance of satisfaction components. The results showed G-11 (A) students were extremely satisfied with “Accessibility of course resources and materials through online platform” and “Ontime homework submission” while G-11 (B) students were extremely satisfied with “Teacher assisted with guiding my learning activities” and “Course teacher for this online course interacted with me in a timely fashion”. Additionally, they were also satisfied with a clear understanding of the teacher’s introduction during online learning. A significant difference in the satisfaction was observed between G-11 (A) and G-11 (B) students in terms of “A clear understanding on introduction was given by the teacher at the beginning of this online course”(P=0.03), “Teacher assisted with guiding my learning activities” (P=0.003), and “Comfortable surrounding during online learning” (P=0.02). With regard to gender, it has been seen that female high school students were extremely satisfied with the amount of course interaction with their teacher and her guidance with learning activities during online learning. By understanding the survey assessment, schools can improve their quality of education through the best digital educational platform that helps satisfy their students in the future.

Keywords: Bangkok high school students., covid-19 pandemic, online learning platform, satisfaction

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Authors: Kyosuke Kamada, Christoph Kapeller, Michael Jordan, Mostafa Mohammadpour, Christy Li, Christoph Guger

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Cortico-cortical evoked potentials (CCEP) refer to responses generated by cortical electrical stimulation at distant brain sites. These responses provide insights into the functional networks associated with language or motor functions, and in the context of epilepsy, they can reveal pathological networks. Locating the origin and spread of seizures within the cortex is crucial for pre-surgical planning. This process can be enhanced by employing cortical stimulation at the seizure onset zone (SOZ), leading to the generation of CCEPs in remote brain regions that may be targeted for disconnection. In the case of a 24-year-old male patient suffering from intractable epilepsy, corpus callosotomy was performed as part of the treatment. DTI-MRI imaging, conducted using a 3T MRI scanner for fiber tracking, along with CCEP, is used as part of an assessment for surgical planning. Stimulation of the SOZ, with alternating monophasic pulses of 300µs duration and 15mA current intensity, resulted in CCEPs on the contralateral frontal cortex, reaching a peak amplitude of 206µV with a latency of 31ms, specifically in the left pars triangularis. The related fiber tracts were identified with a two-tensor unscented Kalman filter (UKF) technique, showing transversal fibers through the corpus callosum. The CCEPs were monitored through the progress of the surgery. Notably, the SOZ-associated CCEPs exhibited a reduction following the resection of the anterior portion of the corpus callosum, reaching the identified connecting fibers. This intervention demonstrated a potential strategy for mitigating the impact of intractable epilepsy through targeted disconnection of identified cortical regions.

Keywords: CCEP, SOZ, Corpus callosotomy, DTI

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Authors: Ashok Tejankar, Rohan K. Pathrikar

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Maharashtra is covered by heterogeneous flows of Deccan basaltic terrains of upper cretaceous to lower Eocene age. It consist mainly different types of basalt flow, having heterogeneous Geohydrological characters. The study area Aurangabad dist. lies in the central part of Maharashtra. The study area is typically covered by Deccan traps formation mainly basalt type of igneous volcanic rock. The area is located in the survey of India toposheet No. 47M and laying between 19° to 20° north latitudes and 74° to 76° east longitudes. Groundwater is the primary source for fresh water in the study area. There has been a growing demand for fresh water in domestic & agriculture sectors. Due to over exploitation and rainfall failure has been created an irrecoverable stress on groundwater in study area. In an effort to maintain the water table condition in balance, artificial recharge is being implemented. The selection of site for artificial recharge is a very important task in recharge basalt. The present study aims at sitting artificial recharge structure at village Pachod in basaltic terrain of the Godavari-Purna river basin in Aurangabad district of Maharashtra, India. where the average annual rainfall is 650mm. In this investigation, integrated remote sensing and GIS techniques were used and various parameters like lithology, structure, etc. aspect of drainage basins, landforms and other parameters were extracted from visual interpretation of IRS P6 Satellite data and Survey of India (SIO) topographical sheets, aided by field checks by carrying well inventory survey. The depth of weathered material, water table conditions, and rainfall data were been considered. All the thematic information layers were digitized and analyzed in Arc-GIS environment and the composite maps produced show suitable site, depth of bed rock flows for successful artificial recharge in village Pachod to increase groundwater potential of low laying area.

Keywords: hard rock, artificial recharge, remote sensing, GIS

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Authors: Rotimi Sunday Ajani, Omowumi Femi-Akinlosotu

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Background: The usually paired human kidneys are retroperitoneal urinary organs with some endocrine functions. Standard text books of anatomy ascribe single value to each of the dimension of length, width and thickness. Research questions: These values do not give consideration to racial and genetic variability in human morphology. They may thus be erroneous to students and clinicians working on Nigerians. Objectives: The study aimed at establishing reference values of the kidney length, width and thickness for Nigerians using the cadaveric model. Methodology: The length, width, thickness and weight of sixty kidneys harvested from cadavers of thirty adult Nigerians (Male: Female; 27: 3) were measured. Respective volume was calculated using the ellipsoid formula. Results: The mean length of the kidney was 9.84±0.89 cm (9.63±0.88 {right}; 10.06±0.86 {left}), width- 5.18±0.70 cm (5.21±0.72 {right}; 5.14±0.70 {left}), thickness-3.45±0.56 cm (3.36±0.58 {right}, 3.53±0.55 {left}), weight-125.06±22.34 g (122.36±21.70 {right}; 127.76 ±24.02 {left}) and volume of 95.45± 24.40 cm3 (91.73± 26.84 {right}; 99.17± 25.75 {left}). Discussion: Though the values of the parameters measured were higher for the left kidney (except for the width), they were not statistically significant. The various parameters obtained by this study differ from those of similar studies from other continents. Conclusion: Stating single value for each of the parameter of length, width and thickness of the kidney as currently obtained in textbooks of anatomy may be incomplete information and hence misleading. Thus, there is the need to emphasize racial differences when stating the normal values of kidney dimensions in textbooks of anatomy. Implication for Research and Innovation: The results of the study showed the dimensions of the kidney (length, width and thickness) have interracial vagaries as they were different from those of similar studies and values stated in standard textbooks of human anatomy. Future direction: This is a preliminary report and the study will continue so that more data will be obtained.

Keywords: kidney dimensions, cadaveric estimation, adult nigerians, racial differences

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Authors: Jun Ying Lin, Tzu Hsiang Yen, Cha'o Kuang Chen

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Nowadays, the great majority believe that there is great potentiality in hydrogen storage alloy storing hydrogen by physical and chemical absorption. However, the hydrogen storage alloy is limited by high operation temperature. Scientists find that adding transition elements can improve the properties of hydrogen storage alloy. In this research, outstanding improvements of kinetic and thermal properties are given by the addition of Palladium and Titanium hydride to Magnesium-based hydrogen storage alloy. Magnesium-based alloy is the main material, into which TiH2 / Pd are added separately. Following that, materials are milled by a Planetary Ball Miller at 650 rpm. TGA/DSC and PCT measure the capacity, spending time and temperature of abs/des-orption. Additionally, SEM and XRD analyze the structures and components of material. It is clearly shown that Pd is beneficial to kinetic properties. 2MgH2-0.1Pd has the highest capacity of all the alloys listed, approximately 5.5 wt%. Secondly, there are not any new Ti-related compounds found from XRD analysis. Thus, TiH2, considered as the catalyst, leads to the condition of 2MgH2-TiH2 and 2MgH2-TiH2-0.1Pd efficiently absorbing hydrogen in low temperature. 2MgH2-TiH2 can reach roughly 3.0 wt% in 82.4 minutes at 50°C and 8 minutes at 100°C, while2MgH2-TiH2-0.1Pd can reach 2.0 wt% in 400 minutes at 50°C and in 48 minutes at 100°C. The lowest temperature of 2MgH2-0.1Pd and 2MgH2-TiH2 is similar (320°C), otherwise the lowest temperature of 2MgH2-TiH2-0.1Pd decrease by 20°C. From XRD, it can be observed that PdTi2 and Pd3Ti are produced by mechanical alloying when adding Pd as well as TiH2 into MgH2. Due to the synergistic effects between Pd and TiH2, 2MgH2-TiH2-0.1Pd owns the lowest dehydrogenation temperature. Furthermore, the Pressure-Composition-Temperature (PCT) curve of 2MgH2-TiH2-0.1Pd is measured at different temperature, 370°C, 350°C, 320°C and 300°C separately. The plateau pressure is given form the PCT curves above. In accordance to different plateau pressures, enthalpy and entropy in the Van’t Hoff equation can be solved. In 2MgH2-TiH2-0.1Pd, the enthalpy is 74.9 KJ/mol and the entropy is 122.9 J/mol. Activation means that hydrogen storage alloy undergoes repeat abs/des-orpting processes. It plays an important role in the abs/des-orption. Activation shortens the abs/des-orption time because of the increase in surface area. From SEM, it is clear that the grain size and surface become smaller and rougher

Keywords: hydrogen storage materials, magnesium hydride, abs-/des-orption performance, Plateau pressure

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Authors: Yahia Massinissa, Afaf Benhouda, Mouloud Yahia

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Objective: The aim of this study was to investigate the toxicity; analgesic and anti-pyretic properties of standardized HA methanolic extract (HAMeOH) in vivo. Methods: The acute toxicity study was performed on rats while adopting the OECD-420 Guidelines (fixed dose procedure). Assessment of analgesic activity was performed in rats with two analgesic models. One was acetic acid induced writhing response and the other formalin-induced paw licking. The anti-pyretic effect was tested by Brewer’s yeast induced fever in rats. Results: For the acute toxicity test, the higher dose administration of 2000 mg/kg bw. of H.albus did not produce any toxic signs or deaths in rats. There were no significant differences (p>0.05) in the body and organ weights between control and treated groups. The (LD50) of 'H. albus' was higher than 2000 g/kg bw. In subacute toxicity study, no mortality and toxic signs were observed with the doses of 100 and 200 mg/kg bw. of extracts of for 28 consecutive days. These analgesic experimental results indicated that HAMeOH (100 mg/kg and 200 mg/kg) decreased the acetic acid-induced writhing responses and HAMeOH (100 mg/kg and 200 mg/kg) decreased the licking time in the second phase of the formalin test. Moreover, in the model of yeast-induced elevation of the body temperature HAMeOH showed dose-dependent lowering of the body temperature up to 3h at both the doses these results obtained, were comparable to that of paracetamol. Conclusion: The present findings indicate that the leaves of Hyoscyamus albus L. possess potent analgesic and antipyretic activity.

Keywords: Hyoscyamus albus, Umbilicus rupestris, secondary metabolites, NMR with protons, pharmacobiologic activities, methanolic extract

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Authors: Aliyu Shitu Said

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One of the major setbacks of every society is the proliferation of crimes that results in the inducement of fear, destruction of properties and loss of lives of people. The rising incidence of crime and general insecurity rate in the society and the inability of the policing agencies to curtail the menace necessitated the introduction of community policing in order to have a collaborative effort with community members in addressing the problem of crime. Thus, this study assessed the impact of community policing in crime prevention and control in Fagge Local Government area, Kano State, Nigeria. The study also examined the elements, roles, and challenges of community policing in crime prevention and control in the study area. The study adopted Broken Window and Routine Activity theories as frame of analysis. Mixed methods of data collection (quantitative and qualitative) were utilized for the study. Multi stage and purposive sampling techniques were adopted in selection of the study population. A total of 308 respondents were sampled for the study. These include 300 members of the public who were sampled through a multi stage sampling for questionnaire administration and 8 other respondents who were purposively sampled for in-depth interview. Findings of the study revealed that community policing has significant impact on crime prevention and control in the study area. Findings of the study further revealed that the elements and roles of community policing are effective and fully utilized, and there is cordial relationship between the police and the community members in the study area. This study therefore recommends that government should provide adequate support to community policing programmes and give more awareness to public, so as to boost the morale of the community in having a collaborative effort with the police in crime prevention and control.

Keywords: community, policing, crime, prevention, control

Procedia PDF Downloads 56

Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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