Search results for: problems of care

Authors: Chiung-Hua Chan, Fang-Yuan Chang, Li-Chi Huang

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Stroke patients received regular rehabilitation therapy have measurable advancement in muscle strength, balance, control upper and lower physical activity, walking speed and endurance. This study aimed to investigate the relationship between increases in bedside rehabilitation time and the function of activities and daily living (ADL) in stroke patients. The study was quasi-experimental research design and randomized sampling. The researcher collected 12 stroke patients of stroke patients transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. All participants then were assigned to case group and control group. Data collection was through direct observation of assessment ADL of stroke patients by researchers on Day 1. Case group received regular rehabilitation, exercises in increase of bedside rehabilitation schedules exercise programs by ward nurses. Bedside rehabilitation exercise content with physical, functional and linguistic frequency and time, Control group only give routine rehabilitation schedule care. This was a randomized study performed in 12 patients who were stroke patients and transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. First, the researcher explained the purpose and method of the study to the patients or the family members. All participants completed a consent informed before participation. Patients were randomly assigned to a ‘bedside rehabilitation program’ (BRP) group and a control (C) group. The BRP group received bedside rehabilitation schedules exercise programs by ward nurses. while the C group did not. Both groups received routine rehabilitation schedule. The Functional Independence Measure was used to measure outcome at the first, 14th and the 28th day of rehabilitation ward admitted. Data were analyzed using SPSS 22.0. After implementation of standardized ‘‘bedside rehabilitation program’, the results were: (1) the increasing of bedside rehabilitation had significant difference (p<.05) in promotion ADL function of stroke patients (2) the extend time of the bedside rehabilitation has significant difference (p<.05) in promotion ADL function of stroke patients compared with the control group. This study demonstrated that the ‘bedside rehabilitation program’ enhanced the ADL function in stroke patients. The nurses and rehabilitation ward managers need to understand that the extend time and frequency of rehabilitation provide a chance to enhanced the ADL function of stroke patients.

Keywords: stroke, bedside rehabilitation, functional activity, ADL

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Authors: Zyra Cheska Hidalgo, Joehiza Mae Renon, Kzarina Buen, Girlie Mitrado

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ABSTRACT: The global coronavirus disease (COVID-19) has dramatically impacted the lives of many, including education and our economy. Thus, it presents a massive challenge for medical education as instructors are mandated to deliver their lectures virtually to ensure the continuity of the medical education process and ensure students' safety. The purpose of this research paper is to determine the lived experiences of paramedical students who are engaged in virtual hands-on learning and to determine the different coping strategies they used to deal with virtual hands-on learning. The researchers used the survey method of descriptive research design to determine the lived experiences and coping strategies of twenty (20) paramedical students from Lorma Colleges (particularly the College of Medicine Department). The data were collected through online questionnaires, particularly with the use of google forms. This study shows technical issues, difficulty in adapting styles, distractions and time management issues, mental and physical health issues, and lack of interest and motivation are the most common problems and challenges experienced by paramedical students. On the other hand, the coping strategies used by paramedical students to deal with those challenges include time management, engagement in leisure activities, acceptance of responsibilities, studying, and adapting. With the data gathered, the researchers concluded that virtual hands-on learning effectively increases the knowledge of paramedical students. However, teaching and learning barriers must have to be considered to implement virtual hands-on learning successfully.

Keywords: virtual hands-on learning, E-learning, paramedical students, medical education

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Authors: Longondjo Etambakonga Clement

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Local municipality responsible for solid waste management (SWM) in many developing countries is facing real challenge. This is even more critical in the country facing political instability. Few decades ago, it has emerged new urban governance including partnerships and involvement of formal and informal actors for an effective and sustainable solid waste management. This paper identifies SWM actors and analyzes their roles to sustainable development in Kinshasa. An attempt has been to examine the challenges facing the actors in managing effectively waste in the city. The study is based on the empirical data gathered in the years 2009 and 2014 in Kinshasa using expert interviews, observation and documentation. The findings indicate that solid waste in the city is poorly managed, activities not coordinated and fragmented, as consequence severe public health and environmental problems. Five group actors are involved in SWM in the city including government, private business, NGOs/CBOs/donors, household, scavengers, in which, scavengers are more visible in collection and recycling activities. The results suggest that recognition of informal collectors and recyclers (scavengers) and strengthening alliances among all SWM stakeholders can lead to greater effective SWM in the city. The key lessons learned include lack of city’s SWM culture over SWM, unwillingness to pay and lack of environmental consciences are the main obstructions to sustainable SWM, therefore there is a need for social capital approach to empower individual and group actors as to create capabilities for an sustainable SWM.

Keywords: challenges, institutions, political instability, scavengers, solid waste management, sustainable development

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Authors: Letizia Marchetti, Federica Annunzi, Federico Fiorini, Cristiano Nicolella

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Automotive shredder residue (ASR) is a mixture of waste that makes up 20-25% of end-of-life vehicles. For many years, ASR was commonly disposed of in landfills or incinerated, causing serious environmental problems. Nowadays, thermochemical treatments are a promising alternative, although the heterogeneity of ASR still poses some challenges. One of the emerging thermochemical treatments for ASR is pyrolysis, which promotes the decomposition of long polymeric chains by providing heat in the absence of an oxidizing agent. In this way, pyrolysis promotes the conversion of ASR into solid, liquid, and gaseous phases. This work aims to improve the performance of a two-step pyrolysis process. After the characterization of the analysed ASR, the focus is on determining the effects of residence time on product yields and gas composition. A batch experimental setup that reproduces the entire process was used. The setup consists of three sections: the pyrolysis section (made of two reactors), the separation section, and the analysis section. Two different residence times were investigated to find suitable conditions for the first sample of ASR. These first tests showed that the products obtained were more sensitive to residence time in the second reactor. Indeed, slightly increasing residence time in the second reactor managed to raise the yield of gas and carbon residue and decrease the yield of liquid fraction. Then, to test the versatility of the setup, the same conditions were applied to a different sample of ASR coming from a different chemical plant. The comparison between the two ASR samples shows that similar product yields and compositions are obtained using the same setup.

Keywords: automotive shredder residue, experimental tests, heterogeneity, product yields, two-step pyrolysis

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: Rully D. Purwati, Tantri D.A. Anggraeni, Bambang Heliyanto, M. Machfud, Joko Hartono

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The availability of fuel in the world will be reduced in next few years, it is necessary to find alternative energy sources. Jatropha curcas L. is one of oil crops producing non-edible oil which is potential for bio-diesel. Jatropha cultivation and development program in Indonesia is facing several problems especially low seed yield resulting in inefficient crop cultivation cost. To cope with the problem, development of high yielding varieties is necessary. Development of new varieties to improve seed yield was conducted by hybridization and selection and resulted in fourteen potential genotypes. The yield potential of the fourteen genotypes were evaluated and compared with two check varieties. The objective of the evaluation was to find Jatropha hybrids with some characters i.e. their productivity was higher than check varieties, oil content > 40% and harvesting age ≤ 110 days. Hybridization and individual plant selection were carried out from 2010 to 2014. Evaluation of high yield was conducted in Asembagus experimental station, Situbondo, East Java in three years (2015-2017). The experimental designed was Randomized Complete Block Design with three replication, and plot size 10 m x 8 m. The characters observed were number of capsules per plant, dry seed yield (kg/ha) and seed oil content (%). The results of this experiment indicated that all the hybrids evaluated have higher productivity than check variety IP-3A. There were two superior hybrids i.e. HS-49xSP-65/32 and HS-49xSP-19/28 with highest seed yield per hectare and number of capsules per plant for three years.

Keywords: Jatropha, bio energy, hybrid, high seed yield

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Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

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Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m²), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

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Authors: Piyush V. Surjagade, Jiamei Deng, Paul Doney, S. R. Shimjith, A. John Arul

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In sophisticated and complex systems such as nuclear power plants, maintaining the system's stability in the presence of uncertainties and disturbances and obtaining a fast dynamic response are the most challenging problems. Thus, to ensure the satisfactory and safe operation of nuclear power plants, this work proposes a new fast, robust optimal switching control strategy for pressurized water reactor-type nuclear power plants. The proposed control strategy guarantees a substantial degree of robustness, fast dynamic response over the entire operational envelope, and optimal performance during the nominal operation of the plant. To improve the robustness, obtain a fast dynamic response, and make the system optimal, a bank of controllers is designed. Various controllers, like a baseline proportional-integral-derivative controller, an optimal linear quadratic Gaussian controller, and a robust adaptive L1 controller, are designed to perform distinct tasks in a specific situation. At any instant of time, the most suitable controller from the bank of controllers is selected using the switching logic unit that designates the controller by monitoring the health of the nuclear power plant or transients. The proposed switching control strategy optimizes the overall performance and increases operational safety and efficiency. Simulation studies have been performed considering various uncertainties and disturbances that demonstrate the applicability and effectiveness of the proposed switching control strategy over some conventional control techniques.

Keywords: switching control, robust control, optimal control, nuclear power control

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Authors: Farouk Metiri, Halim Zeghdoudi, Mohamed Riad Remita

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Credibility theory is an experience rating technique in actuarial science which can be seen as one of quantitative tools that allows the insurers to perform experience rating, that is, to adjust future premiums based on past experiences. It is used usually in automobile insurance, worker's compensation premium, and IBNR (incurred but not reported claims to the insurer) where credibility theory can be used to estimate the claim size amount. In this study, we focused on a popular tool in credibility theory which is the Bayesian premium estimator, considering Lindley distribution as a claim distribution. We derive this estimator under entropy loss which is asymmetric and squared error loss which is a symmetric loss function with informative and non-informative priors. In a purely Bayesian setting, the prior distribution represents the insurer’s prior belief about the insured’s risk level after collection of the insured’s data at the end of the period. However, the explicit form of the Bayesian premium in the case when the prior is not a member of the exponential family could be quite difficult to obtain as it involves a number of integrations which are not analytically solvable. The paper finds a solution to this problem by deriving this estimator using numerical approximation (Lindley approximation) which is one of the suitable approximation methods for solving such problems, it approaches the ratio of the integrals as a whole and produces a single numerical result. Simulation study using Monte Carlo method is then performed to evaluate this estimator and mean squared error technique is made to compare the Bayesian premium estimator under the above loss functions.

Keywords: bayesian estimator, credibility theory, entropy loss, monte carlo simulation

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Authors: M. Łęgowik-Małolepsza

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The article discusses the problem related to the use of modern information technologies to achieve pro-environmental marketing goals in business-to-customer (B2C) relationships. The topic is important and topical due to the strong social need to implement the concept of sustainable development. The aim of the article is to understand and evaluate the possibilities of implementing modern information technologies, such as Customer Relationship Management platforms (CRM), in the area of implementing marketing activities of companies operating in the Business to Customer model. In B2C relations, marketing departments struggle with problems resulting from the need for quick customer segmentation and the fragmentation of data existing in many systems, which significantly hinders the achievement of the assumed marketing goals. Therefore, the article proposes the use of modern information technology solutions in the area of marketing activities of enterprises, taking into account their pro-environmental goals. The most important results of the research carried out include an in-depth understanding of the possibilities of implementing modern information technologies to achieve marketing goals in B2C relationships. Moreover, a better understanding of the coexistence of opportunities and threats related to the implementation of marketing activities, taking into account pro-environmental goals and modern technologies, allows for more effective implementation of sustainable development management in enterprises. The methods used to achieve the goal are literature studies, descriptive analysis, and case studies. The study contributes to the discussion on the scope of application of modern information technologies in the area of B2C marketing activity, taking into account the implementation of pro-environmental goals of enterprises.

Keywords: B2C marketing activity, implementation of technologies, modern information technologies, pro-environmental activities

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Authors: Rachmat Mudiyono, Siti Sumiati

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In the next few years, traffic will happen most of the time. This was triggered by the growing rate of vehicles againts the road capacity which is not balance. All the time the congestion in the city of Semarang has been occured at peak hours. Congestion also occured in between Teuku Umar and Setia Budi road Jatingaleh because of a plot intersection (Kesatrian intersection, PLN intersection and Jatingaleh intersection) with the Toll Road. Jatingaleh is located in the southern city of Semarang which is a central meeting point between the upper and lower Semarang where the vehicle flows in through a combination of local current and regional traffic, and the flow of vehicles coming in and out from highway. The main cause of the problems that occurred in the area of Jatingaleh is due to the numbers of vehicles movement that occurs at the intersections. With the above issues, it is necessary to analyse the existing conditions and look into some solutions. Before carrying out an analysis of field surveys at peak hours for example morning (06:00 to 08:00 am) and for the afternoon (04:00 to 06:00 pm)should be conducted, then the number of vehicles is counted manually with “short-breakcounting” according to types of vehicles. From the analysis we found that the degree of saturation (DS) is 1.61 between Teuku Umar and Setia Budi road during the morning peak hours and 1.56 during the afternoon peak hours. This means that the capacity of the existing road is no longer able to accommodate the traffic flow. One of the solutions for the congestion that occurs at the intersection of Jatingaleh is to apply the efficiency of the intersection that is not in a plot with a Fly over, Underpass and the combination of Fly Over-Underpass. Base on the flow reduction calculation with 3 comparative modeling it shows that the Fly Over is the most technically efficient to be applied in this research.

Keywords: single fly over, congestion, intersection, interchange

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Authors: A. M. Malagon Escandon, J. A. Arenas Alatorre, C. P. Chaires Rosas, N. A. Vazquez Torres, B. Hernandez Tellez, G. Pinon Zarate, M. Herrera Enriquez, A. E. Castell Rodriguez

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The current approach to the treatment of bone defects involves the use of scaffolds that provide a biological and mechanically stable niche to favor tissue repair. Despite the significant progress in the field of bone tissue engineering, several main problems associated are attributed to giving a low biodegradation degree, does not promote osseointegration and regeneration, if the bone is not healing as well as expected or fails to heal, will not be given a proper ossification or new bone formation. The actual approaches of bone tissue regeneration are directed to the use of decellularized native extracellular matrices, which are able of retain their own architecture, mechanic properties, biodegradability and promote new bone formation because they are capable of conserving proteins and other factors that are founded in physiological concentrations. Therefore, we propose an extracellular matrix-based bioscaffolds derived from bovine cancellous bone, which is processed by decellularization, demineralization, and hydrolysis of the collagen protein, these protocols have been successfully carried out in other organs and tissues; the effectiveness of its biosafety has also been previously evaluated in vivo and Food and Drug Administration (FDA) approved. In the specific case of bone, a more complex treatment is needed in comparison with other organs and tissues because is necessary demineralization and collagen denaturalization. The present work was made in order to obtain a temporal scaffold that succeed in degradation in an inversely proportional way to the synthesis of extracellular matrix and the maturation of the bone by the cells of the host.

Keywords: bioactive, biodegradable, bone, extracellular matrix-based bioscaffolds, stem cells, tissue engineering

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Authors: Alan Berman, Mark Brady

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The phenomenon of homophobia and transphobia in the United States detrimentally impacts the health, wellbeing, and dignity of school students who identify with the LGBTQ+ community. These negative impacts also compromise the participation of LGBTQ+ individuals in the wider life of educational domains and endanger the potential economic, social and cultural contribution this community can make to American society. The recent 6:3 majority decision of the US Supreme Court in Dobbs v Jackson Women’s Health Organization expressly overruled the 1973 decision in Roe v Wade and the 1992 Planned Parenthood v Casey decision. This study will canvass the bases upon which the court in Dobbs overruled longstanding precedent established in Roe and Casey. It will examine the potential implications for the LGBTQ community of the result in Dobbs. The potential far-reaching consequences of this case are foreshadowed in a concurring opinion by Justice Clarence Thomas, suggesting the Court should revisit all substantive due process cases. This includes notably the Lawrence v Texas case (invalidating sodomy laws criminalizing same-sex relations) and the Obergefellcase (upholding same-sex marriage). Finally, the study will examine the likely impact of the uncertainty brought about by the decision in Doddsfor LGBTQ students in US educational institutions. The actions of several states post-Dobbs, reflects and exacerbates the problems facing LGBTQ+ students and uncovers and highlights societal homophobia and transphobia.

Keywords: human rights, LGBT rights, right to personal dignity and autonomy, substantive due process rights

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Authors: S. Jalilzadeh, S. M. Mohseni Bonab

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Solar and battery energy storage systems are very useful for consumers who live in deprived areas and do not have access to electricity distribution networks. Nowadays one of the problems that photo voltaic systems (PV) have changing of output power in temperature and irradiance variations, which directly affects the load that is connected to photo voltaic systems. In this paper, with considering the fact that the solar array varies with change in temperature and solar power radiation, a voltage stabilizer system of a load connected to photo voltaic array is designed to stabilize the load voltage and to transfer surplus power of the battery. Also, in proposed hybrid system, the needed load power amount is supplemented considering the voltage stabilization in standalone operation for supplying unbalanced AC load. Electrical energy storage system for voltage control and improvement of the performance of PV by a DC/DC converter is connected to the DC bus. The load is also feed by an AC/DC converter. In this paper, when the voltage increases in its reference limit, the battery gets charged by the photo voltaic array and when it decreases in its defined limit, the power gets injected to the DC bus by this battery. The constant of DC bus Voltage is the cause for the reduced harmonics generated by the inverter. In addition, a series of filters are provided in the inverter output in to reduced harmonics. The inverter control circuit is designed that the voltage and frequency of the load remain almost constant at different load conditions. This paper has focused on controlling strategies of converters to improve their performance.

Keywords: photovoltaic array (PV), DC/DC Boost converter, battery converter, inverters control

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Authors: K. M. Wong

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Engineering education is crucial to technological innovation and advancement worldwide by generating young talents who are able to integrate scientific principles and design practical solutions for real-world problems. Graduates of engineering curriculums are expected to demonstrate an extensive set of learning outcomes as required in international accreditation agreements for engineering academic qualifications, such as the Washington Accord and the Sydney Accord. On the other hand, students have different learning preferences of receiving, processing and internalizing knowledge and skills. If the learning environment is advantageous to the learning styles of the students, there is a higher chance that the students can achieve the intended learning outcomes. With proper identification of the learning styles of the students, corresponding teaching strategies can then be developed for more effective learning. This research was an investigation of learning styles of tertiary students studying higher diploma programmes in Hong Kong. Data from over 200 students in engineering programmes were collected and analysed to identify the learning characteristics of students. A small-scale longitudinal study was then started to gather academic results of the students throughout their two-year engineering studies. Preliminary results suggested that the sample students were reflective, sensing, visual, and sequential learners. Observations from the analysed data not only provided valuable information for teachers to design more effective teaching strategies, but also provided data for further analysis with the students’ academic results. The results generated from the longitudinal study shed light on areas of improvement for more effective engineering curriculum design for better teaching and learning.

Keywords: learning styles, learning characteristics, engineering education, vocational education, Hong Kong

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Authors: Maulana Ayoub Ali, Pradeep Kulshrestha

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Laws of any given secular state have a huge contribution in the growth of the Islamic banking system because the system uses conventional laws to govern its activities. Therefore, the former should be ready to accommodate the latter in order to make the Islamic banking system work properly without affecting the current conventional banking system and therefore without affecting its system. Islamic financial rules have been practiced since the birth of Islam. Following the recent world economic challenges in the financial sector, a quick rebirth of the contemporary Islamic ethical banking system took place. The coming of the Islamic banking system is due to various reasons including but not limited to the failure of the interest based economy in solving financial problems around the globe. Therefore, the Islamic banking system has been adopted as an alternative banking system in order to recover the highly damaged global financial sector. But the Islamic banking system has been facing a number of challenges which hinder its smooth operation in different parts of the world. It has not been the aim of this paper to discuss other challenges rather than the legal ones, but the same was partly discussed when it was justified that it was proper to do so. Generally, there are so many things which have been discovered in the course of writing this paper. The most important part is the issue of the regulatory and supervisory framework for the Islamic banking system in Tanzania and in other nations is considered to be a crucial part for the development of the Islamic banking industry. This paper analyses what has been observed in the study on that area and recommends for necessary actions to be taken on board in a bid to make Islamic banking system reach its climax of serving the larger community by providing ethical, equitable, affordable, interest-free and society cantered banking system around the globe.

Keywords: Islamic banking, interest free banking, ethical banking, legal framework

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Authors: Choon Seong Ng, P. Petrick, C. L. Lau

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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.

Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital

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Authors: Mouhamadou Diop, Mohamed I. Hassan

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Molten metallic flow in metallurgical plant is highly turbulent and presents a complex coupling with heat transfer, phase transfer, chemical reaction, momentum transport, etc. Molten silicon flow has significant effect in directional solidification of multicrystalline silicon by affecting the temperature field and the emerging crystallization interface as well as the transport of species and impurities during casting process. Owing to the complexity and limits of reliable measuring techniques, computational models of fluid flow are useful tools to study and quantify these problems. The overall objective of this study is to investigate the potential of a traveling magnetic field for an efficient operating control of the molten metal flow. A multidimensional numerical model will be developed for the calculations of Lorentz force, molten metal flow, and the related phenomenon. The numerical model is implemented in a laboratory-scale silicon crystallization furnace. This study presents the potential of traveling magnetic field approach for an efficient operating control of the molten flow. A numerical model will be used to study the effects of magnetic force applied on the molten flow, and their interdependencies. In this paper, coupled and decoupled, steady and unsteady models of molten flow and crystallization interface will be compared. This study will allow us to retrieve the optimal traveling magnetic field parameter range for crystallization furnaces and the optimal numerical simulations strategy for industrial application.

Keywords: multidimensional, numerical simulation, solidification, multicrystalline, traveling magnetic field

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Authors: Saad M. Darwish, Adel A. El-Zoghabi, Moustafa F. Ashry

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The popularity of the Internet and the availability of powerful computers and high-speed networks as low-cost commodity components are changing the way we use computers today. These technical opportunities have led to the possibility of using geographically distributed and multi-owner resources to solve large-scale problems in science, engineering, and commerce. Recent research on these topics has led to the emergence of a new paradigm known as Grid computing. To achieve the promising potentials of tremendous distributed resources, effective and efficient load balancing algorithms are fundamentally important. Unfortunately, load balancing algorithms in traditional parallel and distributed systems, which usually run on homogeneous and dedicated resources, cannot work well in the new circumstances. In this paper, the concept of a fast fractal transform in heterogeneous grid computing based on R-tree and the domain-range entropy is proposed to improve fault tolerance and load balancing algorithm by improve connectivity, communication delay, network bandwidth, resource availability, and resource unpredictability. A novel two-dimension figure of merit is suggested to describe the network effects on load balance and fault tolerance estimation. Fault tolerance is enhanced by adaptively decrease replication time and message cost while load balance is enhanced by adaptively decrease mean job response time. Experimental results show that the proposed method yields superior performance over other methods.

Keywords: Grid computing, load balancing, fault tolerance, R-tree, heterogeneous systems

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Authors: Trina Isabel Santiago, Daniel Chua, Jumee Tayaban, Joseph Daniel Timbol, Joshua Yanes

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Numerous instances of human rights violations on healthcare workers have been reported during the COVID-19 pandemic in the Philippines. This brief aims to explore these civil and political rights violations and propose recommendations to address these. Our review shows that a wide range of civic and political human rights violations have been committed by individual citizens and government agencies on individual healthcare workers and health worker groups. These violations include discrimination, red-tagging, evictions, illegal arrests, and acts of violence ranging from chemical attacks to homicide. If left unchecked, these issues, compounded by the pandemic, may lead to the exacerbations of the pre-existing problems of the Philippine healthcare system. Despite all pre-existing reports by human rights groups and public media articles, there still seems to be a lack of government action to condemn and prevent these violations. The existence of government agencies which directly contribute to these violations with the lack of condemnation from other agencies further propagate the problem. Given these issues, this policy brief recommends the establishment of an interagency task force for the protection of human rights of healthcare workers as well as the expedited passing of current legislative bills towards the same goal. For more immediate action, we call for the establishment of a dedicated hotline for these incidents with adequate appointment and training of point persons, construction of clear guidelines, and closer collaboration between government agencies in being united against these issues.

Keywords: human rights violations, healthcare workers, COVID-19 pandemic, Philippines

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Authors: Alia Alghosoun, Ashraf Osman, Mohammed Seaid

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A coupled two-layer finite volume/finite element method was proposed for solving dam-break flow problem over deformable beds. The governing equations consist of the well-balanced two-layer shallow water equations for the water flow and a linear elastic model for the bed deformations. Deformations in the topography can be caused by a brutal localized force or simply by a class of sliding displacements on the bathymetry. This deformation in the bed is a source of perturbations, on the water surface generating water waves which propagate with different amplitudes and frequencies. Coupling conditions at the interface are also investigated in the current study and two mesh procedure is proposed for the transfer of information through the interface. In the present work a new procedure is implemented at the soil-water interface using the finite element and two-layer finite volume meshes with a conservative distribution of the forces at their intersections. The finite element method employs quadratic elements in an unstructured triangular mesh and the finite volume method uses the Rusanove to reconstruct the numerical fluxes. The numerical coupled method is highly efficient, accurate, well balanced, and it can handle complex geometries as well as rapidly varying flows. Numerical results are presented for several test examples of dam-break flows over deformable beds. Mesh convergence study is performed for both methods, the overall model provides new insight into the problems at minimal computational cost.

Keywords: dam-break flows, deformable beds, finite element method, finite volume method, hybrid techniques, linear elasticity, shallow water equations

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Authors: Lucksini Raveendran

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Introduction: This mixed-methods study focuses on the experiences of ethnocultural youth and families in Canada, identifying key barriers and opportunities to inform service programming and policies that can better meet their mental health needs during the COVID-19 pandemic and beyond. Methods: Mental Health Commission of Canada's Headstrong initiative administered the youth survey (April – June 2020) and family survey (June – August 2020) with a total sample size of 137 and 481 respondents, respectively. Thematic analysis was conducted to identify key challenges faced, coping strategies used, and help-seeking behaviours. A similar approach was also applied to the family survey data, but instead, a representative sample was collated to analyze geographically variable and ethnically diverse subgroups. Results and analysis: Multiple challenges have impacted families, including increased feelings of loneliness and distress from border travel restrictions, especially among those navigating pregnancy alone or managing children with developmental needs, which is often understudied. Also, marginalized groups were disproportionately affected by inequitable access to communication technologies, further deepening the digital divide. Some reported living in congregated homes with regular conflicts, thus leading to increased anxiety and exposure to violence. For many families, urbanicity and ethnicity played a key role in how families reported coping with feelings of uncertainty while managing work commitments, navigating community resources, fulfilling care responsibilities, and homeschooling children of all ages. Despite these challenges, there was evidence of post-traumatic growth and building community resiliency. Conclusions and implications for policy, practice, or additional research: There is a need to foster opportunities to promote and sustain mental health, wellness, and resilience for families through social connections. Also, intersectionality must be embedded in the collection, analysis, and application of data to improve equitable access to evidence-based and recovery-oriented mental health supports among diverse families in Canada. Lastly, address future research on the long-term COVID-19 impacts of travel border restrictions on family wellness.

Keywords: mental health, youth mental health, family wellness, health equity

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Authors: Carlos Alberto Ríos Reyes

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Traditionally, clays have been considered as one of the main problems in the flow of fluids in hydrocarbon reservoirs. However, there is not known the significance of zeolites formed from the reactivity of clays and their effect not only on the costs of operations carried out by the oil industry in the world but also on production. The present work focused on understanding the interaction between clay minerals with brines and alkaline solutions used in the oil industry. For this, a comparative study was conducted where the reaction of sedimentary rocks under laboratory conditions was examined. Original and treated rocks were examined by X-ray powder diffraction (XRPD) and Scanning Electron Microscopy (SEM) to determine the changes that these rocks underwent upon contact with fluids of variable chemical composition. As a result, zeolite Linde Type A (LTA), sodalite (SOD), and cancrinite (CAN) can be formed after experimental work, which coincided with the dissolution of kaolinite and smectite. Results reveal that the Oil Industry should invest efforts and focus its gaze to understand at the pore scale the problem that could arise as a consequence of the clay-fluid interaction in hydrocarbon reservoir rocks due to the presence of clays in their porous system, as well as the formation of zeolites, which are better hydrocarbon absorbents. These issues could be generating losses in world production. We conclude that there is a critical situation that may be occurring in the stimulation of hydrocarbon reservoirs, where real solutions are necessary not only for the formulation of more efficient and effective injection fluids but also to contribute to the improvement of production and avoid considerable losses in operating costs.

Keywords: clay minerals, zeolites, rock-fluid interaction, experimental work, reactivity

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Authors: Zhen Cao, Yu Zhu, Junxue Fu

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Immunoassay, i.e., antigen-antibody reaction, is crucial for disease diagnostics. To achieve the adequate signal of the antigen protein detection, a large amount of sample and long incubation time is needed. However, the amount of protein is usually small at the early stage, which makes it difficult to detect. Unlike cells and DNAs, no valid chemical method exists for protein amplification. Thus, an alternative way to improve the signal is through particle manipulation techniques to concentrate proteins, among which dielectrophoresis (DEP) is an effective one. DEP is a technique that concentrates particles to the designated region through a force created by the gradient in a non-uniform electric field. Since DEP force is proportional to the cube of particle size and square of electric field gradient, it is relatively easy to capture larger particles such as cells. For smaller ones like proteins, a super high gradient is then required. In this work, three-dimensional Ag/SiO2 nanorods arrays, fabricated by an easy physical vapor deposition technique called as oblique angle deposition, have been integrated with a DEP device and created the field gradient as high as of 2.6×10²⁴ V²/m³. The nanorods based DEP device is able to enrich bovine serum albumin (BSA) protein by 1800-fold and the rate has reached 180-fold/s when only applying 5 V electric potential. Based on the above nanorods integrated DEP platform, an immunoassay of mouse immunoglobulin G (IgG) proteins has been performed. Briefly, specific antibodies are immobilized onto nanorods, then IgG proteins are concentrated and captured, and finally, the signal from fluorescence-labelled antibodies are detected. The limit of detection (LoD) is measured as 275.3 fg/mL (~1.8 fM), which is a 20,000-fold enhancement compared with identical assays performed on blank glass plates. Further, prostate-specific antigen (PSA), which is a cancer biomarker for diagnosis of prostate cancer after radical prostatectomy, is also quantified with a LoD as low as 2.6 pg/mL. The time to signal saturation has been significantly reduced to one minute. In summary, together with an easy nanorod fabrication and integration method, this nanorods based DEP platform has demonstrated highly sensitive immunoassay performance and thus poses great potentials in applications for early point-of-care diagnostics.

Keywords: dielectrophoresis, immunoassay, oblique angle deposition, protein concentration

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Authors: Ayesha Aihetasham, Najma Arshad, Sobia Khan

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Damage causes by subterranean termites are of major concern today. Termites majorly treated with pesticides resulted in several problems related to health and environment. For this reason, plant-derived natural products specifically essential oils have been evaluated in order to control termites. The aim of the present study was to investigate the antitermitic potential of six essential oils on Heterotermes indicola subterranean termite. No-choice bioassay was used to assess the termiticidal action of essential oils. Further, gut from each set of treated termite group was extracted and analyzed for reduction in number of protozoa and bacteria by protozoal count method using haemocytometer and viable bacterial plate count (dilution method) respectively. In no-choice bioassay it was found that Foeniculum vulgare oil causes high degree of mortality 90 % average mortality at 10 mg oil concentration (10mg/0.42g weight of filter paper). Least mortality appeared to be due to Citrus sinensis oil (43.33 % average mortality at 10 mg/0.42g). The highest activity verified to be of Foeniculum vulgare followed by Eruca sativa, Trigonella foenum-graecum, Peganum harmala, Syzygium cumini and Citrus sinensis. The essential oil which caused maximum reduction in number of protozoa was P. harmala followed by T. foenum-graecum and E. sativa. In case of bacterial count E. sativa oil indicated maximum decrease in bacterial number (6.4×10⁹ CFU/ml). It is concluded that F. vulgare, E. sativa and P. harmala essential oils are highly effective against H. indicola termite and its gut microflora.

Keywords: bacterial count, essential oils, Heterotermes indicola, protozoal count

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Authors: Yemane Hailu Fissuh, Zhongzhan Zhang

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An estimating equation technique is an alternative method of the widely used maximum likelihood methods, which enables us to ease some complexity due to the complex characteristics of time-varying covariates. In the situations, when both the time-varying covariates and left-truncation are considered in the model, the maximum likelihood estimation procedures become much more burdensome and complex. To ease the complexity, in this study, the modified estimating equations those have been given high attention and considerations in many researchers under semiparametric transformation model was proposed. The purpose of this article was to develop the modified estimating equation under flexible and general class of semiparametric transformation models for left-truncated and right censored survival data with time-varying covariates. Besides the commonly applied Cox proportional hazards model, such kind of problems can be also analyzed with a general class of semiparametric transformation models to estimate the effect of treatment given possibly time-varying covariates on the survival time. The consistency and asymptotic properties of the estimators were intuitively derived via the expectation-maximization (EM) algorithm. The characteristics of the estimators in the finite sample performance for the proposed model were illustrated via simulation studies and Stanford heart transplant real data examples. To sum up the study, the bias for covariates has been adjusted by estimating density function for the truncation time variable. Then the effect of possibly time-varying covariates was evaluated in some special semiparametric transformation models.

Keywords: EM algorithm, estimating equation, semiparametric transformation models, time-to-event outcomes, time varying covariate

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Authors: Tamer M. Shehata, Heba S. Elsewedy, Mashel Al Dosary, Alaa Elshehry, Mohamed A. Khedr, Maged E. Mohamed

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Objective: 2,4-Dichlorophenoxy acetic acid (2,4-D) is a well-known herbicide widely used as a weed killer. Recently, 2,4-D was rediscovered as a new anti-inflammatory agent through in silico as well as in-vivo experiments. However, poor solubility of 2,4-D could represent a problems during pharmaceutical development in addition to lower bioavailability. Solid dispersion (SD) refers to a group of solid products consisting of at least two different components, usually a hydrophobic drug and hydrophilic matrix. It is well known technique for enhancing drug solubility. Therefore, selecting SD as a tool for enhancing 2,4-D could be of great interest to the formulator. Method: In our project, several polymers were investigated (such as PEG, HPMC, citric acid and others) in addition to drug polymer ratios and its effect on solubility. Evaluation of drug polymer interaction was investigated through both Fourier Transform Infrared (FTIR) and Differential Scanning Calorimetry (DSC). Finally, in-vivo evaluation was performed for the best selected preparation through inflammatory response of rat induce hind paw. Results: Results indicated that, citric acid 2,4-D and in ratio of 0.75 : 1 showed modified the dissolution profile of the drug. The FTIR resltes indicated no significant chemical interaction, however DSC showed shifting of the drug melting point. Finally, Carragenan induced rat hind paw edema showed significant reduction of the drug solid dispersion in comparison to the pure drug, indicating rapid and complete absorption of the drug in solid dispersion form. Conclusion: Solid dispersion technology can be utilized efficiently to enhance the solubility of 2,4-D.

Keywords: solid dispersion, 2, 4-D solubility, carragenan induced edema

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Authors: Kazuhisa Koda, Tsutomu Kobayashi, Rebecca Lorennji, Alington Robert, Halston DeBrum, Julious Lucky, Paul Paul

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Atolls are low-lying small islands with highly permeable ground that does not allow rivers and lakes to develop. As the water resources on these atolls basically rely on precipitation, groundwater becomes a very important water resource during droughts. Freshwater lenses develop as groundwater on relatively large atoll islands and play a key role in the stable water supply. Atoll islands in the Pacific Ocean sometimes suffer from drought due to El Nino. The global warming effects are noticeable, particularly on atoll islands. The Republic of the Marshall Islands in Oceania is burdened with the problems common to atoll islands. About half of its population lives in the capital, Majuro, and securing water resources for these people is a crucial issue. There is a freshwater lens on the largest, Laura Island, which serves as a water source for the downtown area. A serious drought that occurred in 1998 resulted in excessive water intake from the freshwater lens on Laura Island causing up-coning. Up-coning mixes saltwater into groundwater pumped from water-intake wells. Because up-coning makes the freshwater lens unusable, there was a need to investigate the freshwater lens on Laura Island. In this study, we observed the electrical conductivities of the groundwater at different depths in existing monitoring wells to determine the total storage volume of the freshwater lens on Laura Island from 2010 to 2013. Our results indicated that most of the groundwater that seeped into the freshwater lens had flowed out into the sea.

Keywords: Atoll islands, drought, El-Nino, freshwater lens, groundwater observation

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Authors: Najmeh Arabnejad, Mohammad Hossein Yousefi

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The risk of injuring is possible in most sports. These injuries are inevitable in contact sports. Since sports injuries result in financial, physical, physiological and social problems for most athletes and endanger their professional future, studying the happening of sports injuries in sports changes to an important issue. This study can be conducted through different aspects including psychological, pathological, social, managerial, etc. Therefore, the present study was designed and conducted with the aim Survey of Sports Injuries In Ten Sports from 2006 to 2011.This descriptive study was carried out in a documentary form. Thus, data related to sports insurance and sport injuries happened in soccer, volleyball, basketball, handball, badminton, karate, track and field, taekwondo, gymnastics and wrestling was collected from Sports Medical Board of Kerman Province, as the largest province in Iran, and then was analyzed. Data collection method was library one. Furthermore, information related to 210406 insured athletes was analyzed using Descriptive Statistical Indexes in the level mean and SPSS20 Software. The research findings showed that the number of male athletes who injured was higher than female athletes in most sports within various years. Soccer, karate, volleyball, wrestling, handball, taekwondo, gymnastics, basketball, track and field, and badminton had the most injuries, respectively. Moreover, the number of injured athletes and their ratio to insured ones during six years were studied; in general, an increase in ratio of sports injuries was observed. Thus, upward movement of sports injuries in different sports, as the results of this study confirm it, is a warning which results in losing young forces and wasting of sports potential in Iran.

Keywords: sports, sports injuries, survey, Kerman

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Authors: I. Yordanova, H. Kolev, S. Todorova, Z. Cherkezova-Zheleva

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Catalysis plays a key role in solving many environmental problems by establishing efficient catalytic systems for environmental protection and reducing emissions of greenhouse gases from industry. Volatile organic compounds are major air pollutants. There are several ways to dispose of emissions like - adsorption, condensation, absorption, bio-filtration, thermal, catalytic, plasma and ultraviolet oxidation. The catalytic oxidation has more advantages over other methods. For example - lower energy consumption; the concentration of the organic contaminant may be low or may vary within wide limits. Catalysts for complete oxidation of VOCs can be classified into three categories: noble metal, metal oxides or supported metal oxides and mixture of noble metals and metal oxides. Most of the catalysts for the complete catalytic oxidation are based on Pt, Pd, Rh or a combination thereof. The oxides of the transition metal are one of the alternatives to noble metal catalysts for these reactions. They are less active at low temperatures, but at higher - their activity is similar. The properties of the catalyst depend on the distribution of the active phase, the medium type of the pre-treatment, the interaction between the active phase and the support and the interaction between the active phase and the reaction medium. Supported mono-component Mn and bi-component Mn-Co systems are examined in present study. The samples are prepared using co-precipitation method. SiO2 (Aerosil) is used as a support. The studied samples were precipitated by NH4OH. The synthesized samples were characterized by XRD, XPS, TPR and tested in the catalytic reaction of complete oxidation of n-hexane, propane, methanol, ethanol and propanol.

Keywords: catalytic oxidation, Co-Mn oxide, oxidation of hydrocarbons and alcohols, environmental protection

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