Search results for: hospital factors

Authors: S. Chikh, S. Boulifa

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The present study addresses the problem of ammonia evaporation during filling of a vertical cylindrical tank and the influence of various external factors on the stability of storage by determining the conditions for minimum evaporation. Numerical simulation is carried out by solving the governing equations namely, continuity, momentum, energy, and diffusion of species. The effect of temperature of surrounding air, the filling speed of the reservoir and the temperature of the filling liquid ammonia on the evaporation rate is investigated. Results show that the temperature of the filling liquid has little effect on the liquid ammonia for a short period, which, in fact, is function of the filling speed. The evaporation rate along the free surface of the liquid is non-uniform. The inlet temperature affects the vapor ammonia temperature because of pressure increase. The temperature of the surrounding air affects the temperature of the vapor phase rather than the liquid phase. The maximum of evaporation is reached at the final step of filling. In order to minimize loss of ammonia vapors automatically causing losses in quantity of the liquid stored, it is suggested to ensure the proper insulation for the walls and roof of the reservoir and to increase the filling speed.

Keywords: evaporation, liquid ammonia, storage tank, numerical simulation

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Authors: Aishwarya Venkat, Anastasia Marshak, Ryan B. Simpson, Elena N. Naumova

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Livestock ownership is simultaneously linked to improved nutritional status through increased availability of animal-source protein, and increased risk of enteric infections through higher exposure to contaminated water sources. Agrarian and agro-pastoral households, especially those with cattle, goats, and sheep, are highly dependent on seasonally various environmental conditions, which directly impact nutrition and health. This study explores global spatiotemporally explicit evidence regarding the relationship between livestock ownership, enteric infections, and malnutrition. Seasonal and cyclical fluctuations, as well as mediating effects, are further examined to elucidate health and nutrition outcomes of individual and communal livestock ownership. The US Agency for International Development’s Demographic and Health Surveys (DHS) and the United Nations International Children's Emergency Fund’s Multi-Indicator Cluster Surveys (MICS) provide valuable sources of household-level information on anthropometry, asset ownership, and disease outcomes. These data are especially important in data-sparse regions, where surveys may only be conducted in the aftermath of emergencies. Child-level disease history, anthropometry, and household-level asset ownership information have been collected since DHS-V (2003-present) and MICS-III (2005-present). This analysis combines over 15 years of survey data from DHS and MICS to study 2,466,257 children under age five from 82 countries. Subnational (administrative level 1) measures of diarrhea prevalence, mean livestock ownership by type, mean and median anthropometric measures (height for age, weight for age, and weight for height) were investigated. Effects of several environmental, market, community, and household-level determinants were studied. Such covariates included precipitation, temperature, vegetation, the market price of staple cereals and animal source proteins, conflict events, livelihood zones, wealth indices and access to water, sanitation, hygiene, and public health services. Children aged 0 – 6 months, 6 months – 2 years, and 2 – 5 years of age were compared separately. All observations were standardized to interview day of year, and administrative units were harmonized for consistent comparisons over time. Geographically weighted regressions were constructed for each outcome and subnational unit. Preliminary results demonstrate the importance of accounting for seasonality in concurrent assessments of malnutrition and enteric infections. Household assets, including livestock, often determine the intensity of these outcomes. In many regions, livestock ownership affects seasonal fluxes in malnutrition and enteric infections, which are also directly affected by environmental and local factors. Regression analysis demonstrates the spatiotemporal variability in nutrition outcomes due to a variety of causal factors. This analysis presents a synthesis of evidence from global survey data on the interrelationship between enteric infections, malnutrition, and livestock. These results provide a starting point for locally appropriate interventions designed to address this nexus in a timely manner and simultaneously improve health, nutrition, and livelihoods.

Keywords: diarrhea, enteric infections, households, livestock, malnutrition, seasonality

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Authors: Carly Nesvat, Dominic Jarrett, Colin Thomson, Wilma Coltart, Thelma Bowers, Jan Thomson

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Introduction: Within Scotland, the Same As You strategy committed to moving people with learning disabilities out of long-stay hospital accommodation into homes in the community. Much of the focus of this movement was on the placement of people within individual homes. In order to achieve this, potentially excessive supports were put in place which created dependence, and carried significant ongoing cost primarily for local authorities. The greater focus on empowerment and community participation which has been evident in more recent learning disability strategy, along with the financial pressures being experienced across the public sector, created an imperative to re-examine that provision, particularly in relation to the use of expensive sleepover supports to individuals, and the potential for this to be appropriately scaled back through the use of telecare. Method: As part of a broader programme of redesigning overnight supports within North Ayrshire, a cluster of individuals living in close proximity were identified, who were in receipt of overnight supports, but who were identified as having the capacity to potentially benefit from their removal. In their place, a responder service was established (an individual staying overnight in a nearby service user’s home), and a variety of telecare solutions were placed within individual’s homes. Active and passive technology was connected to an Alarm Receiving Centre, which would alert the local responder service when necessary. Individuals and their families were prepared for the change, and continued to be informed about progress with the pilot. Results: 4 individuals, 2 of whom shared a tenancy, had their sleepover supports removed as part of the pilot. Extensive data collection in relation to alarm activation was combined with feedback from the 4 individuals, their families, and staff involved in their support. Varying perspectives emerged within the feedback. 3 of the individuals were clearly described as benefitting from the change, and the greater sense of independence it brought, while more concerns were evident in relation to the fourth. Some family members expressed a need for greater preparation in relation to the change and ongoing information provision. Some support staff also expressed a need for more information, to help them understand the new support arrangements for an individual, as well as noting concerns in relation to the outcomes for one participant. Conclusion: Developing a telecare response in relation to a cluster of individuals was facilitated by them all being supported by the same care provider. The number of similar clusters of individuals being identified within North Ayrshire is limited. Developing other solutions such as a response service for redesign will potentially require greater collaboration between different providers of home support, as well as continuing to explore the full range of telecare, including digital options. The pilot has highlighted the need for effective preparatory and ongoing engagement with staff and families, as well as the challenges which can accompany making changes to long-standing packages of support.

Keywords: challenges, change, engagement, telecare

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Authors: Hong Mengdi, Li Jianan, Ji Fei, Chen Aiting, Wang Qian

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Objective: To overcome the communication barriers that audiologists encounter during cochlear implant mapping, particularly the challenge of eliciting subjective feedback from recipients regarding electrical stimulation, and to enhance the capabilities of existing technologies, we teamed up with software engineers to design an interactive approach for patient-audiologist communication. This approach employs a tablet (PAD) as the interface for a communication and feedback system between patients and audiologists during the mapping process, known as the Cochlear Implant Mapping Assistance System. Methods: Capitalizing on the touchscreen functionality of the PAD, the recipients' subjective feedback during cochlear implant mapping is instantly transmitted to the audiologist's mapping computer. The system acts as a platform for auditory assessment instruments, facilitating immediate evaluation of recipients' post-mapping hearing and speech discrimination capabilities. Furthermore, the system is designed to augment the visual reinforcement audiometry (VRA) process. The system consists of six modules, including three testing projects: loudness testing, hearing threshold testing, and loudness balance testing; two assessment projects: warble tone testing and digit speech testing; and one VRA animation project. It also incorporates speech-to-text and text input display functions tailored to accommodate speech communication difficulties in hearing-impaired individuals, with pre-installed common exchange content between audiologists and recipients. Audiologists can input sentences by selecting options. The system supports switching between Chinese and English versions, suitable for audiologists and recipients who use English, facilitating international application of the system. Results: The Cochlear Implant Mapping Assistance System has been in use for over a year in the Auditory Implant Center of the Department of Otology and Neurotology, Medical Center of Otology and Head & Neck Surgery, Chinese PLA General Hospital, with more than 300 recipients using this mapping system. Currently, the system operates stably, with both audiologists and recipients providing positive feedback, indicating a significant improvement over previous methods. It is particularly well-received by pediatric recipients, significantly enhancing the work efficiency of audiologists and improving the feedback efficiency and accuracy of recipients. The system enhances the comprehensibility for cochlear implant recipients, improves wearing comfort and user experience, facilitates cochlear implant auditory mapping, and increases the collection of previously challenging-to-obtain data during the existing assisted mapping process, such as loudness testing data, electrical stimulation testing data, warble tone testing data, loudness balance testing data, digit speech testing data, and visual reinforcement audiometry testing data. Real-time data recording improves the accuracy of assisted mapping. The interface design is meticulously crafted to accommodate patients of varying ages and cognitive abilities, featuring an intuitive design that allows for effortless, guidance-free use by patients.

Keywords: audiologist, subjective feedback, mapping, cochlear implant

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Authors: Büşra Elibol, İsmail Sait Soyer, Hamid Farrokh Ghatte

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The continuity of the structural and non-structural elements within the envelope of the buildings is one of the fundamental factors in buildings during seismic actions. This investigation aims to make a comparison between Van and İzmir earthquakes in terms of damage assessment of the various facades. A strong earthquake (magnitude 7.2) struck the city of Van in the east of Turkey on 23 October 2011, and similarly, another strong earthquake struck the city of İzmir (magnitude 6.9) in Turkey on 30 October 2020. This paper presents the damage assessment of the current facade systems from multi-story buildings in Van and İzmir, Turkey. This investigation covers the buildings greater than three stories in height, excluding most unreinforced masonry facades. Regarding a building that can have more than one facade system, any of the facade systems are considered individually. Observation of different kinds of damages in the facade is discussed and represented in terms of its performance level throughout the seismic actions. Furthermore, presenting the standard design guidelines (i.e., Turkish seismic design code) is required not only for designers but also for installers of facade systems.

Keywords: damage, earthquake, facade, structural element, seismic action

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Authors: Sadeq Al Yaari, Nassr Almaflehi, Ayman Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari

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Background: Measuring hearing functional capabilities by Auditory Brainstem Responses (ABR) may contribute to better treatment and possible differences in this process may have important clinical implications. Objectives: To measure the validity and reliability of ABR through screening, estimating, and intraoperative monitoring of auditory capabilities of Arab infants and children and the degree of their seriousness. Design: Pre-and-posttest was administered to measure the validity and reliability of ABR. Participants: The subjects of the present study are sixty (60) individuals. The study classified them into two groups: Infants (N=30, ages range between 0-40 weeks) and children (N=30, ages range between 10 months and -3 years) diagnosed with auditory problems. Procedures: The ABR pre- and posttest measurement was administered over two weeks. The outcomes were neuropsycholinguistically and statistically analyzed. Results: The results of the pre-and-posttest for both infants and children did not vary significantly. Also consistent with expectations, higher scores were not registered for the infants’ measurements due to age factors. The findings from this study largely indicate that ABR is valid and reliable.

Keywords: auditory, brainstem, response, children, measurement, function, experimental study

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Authors: Onur Özdemir, M.Erhan ORHAN

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Knowledge Development (KD) is just one of the important phases of Knowledge Management (KM). KD is the phase in which intelligence is used to see the big picture. In order to understand whether information is important or not, we have to use the intelligence cycle that includes four main steps: aiming, collecting data, processing and utilizing. KD also needs these steps. To make a precise decision, the decision maker has to be aware of his subordinates’ ideas. If the decision maker ignores the ideas of his subordinates or participants of the organization, it is not possible for him to get the target. KD is a way of using wisdom to accumulate the puzzle. If the decision maker does not bring together the puzzle pieces, he cannot get the big picture, and this shows its effects on the battlefield. In order to understand the battlefield, the decision maker has to use the intelligence cycle. To convert information to knowledge, KD is the main means for the intelligence cycle. On the other hand, the “Z Generation” born after the millennium are really the game changers. They have different attitudes from their elders. Their understanding of life is different - the definition of freedom and independence have different meanings to them than others. Decision makers have to consider these factors and rethink their decisions accordingly. This article tries to explain the relation between KD and Generation Z. KD is the main method of target managing. But if leaders neglect their people, the world will be seeing much more movements like the Arab Spring and other insurgencies.

Keywords: knowledge development, knowledge management, generation Z, intelligence cycle

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Authors: Yao Huang, Hongjie Yu, Fangrong Xu, Longbiao Cai, Qiqiang He

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The Klotho gene has been found to be involved in cardiovascular health, and epigenetic mechanism has risen as good candidates to understand the role of lifestyle factors in obesity. The aim of this study was to investigate the effect of exercise intervention on the expression and DNA methylation of Klotho gene in high-fat diet induced obese mice. C57BL/6 male mice were fed a normal diet (ND) or a high-fat diet (HFD) for 12 weeks. HFD induced obese mice were divided into secondary group (SED) and exercise group (EX) randomly. The treadmill exercise was performed in EX group for 8 weeks. The expression and DNA methylation of Klotho were evaluated by Western blot, RT-PCR, and Methylation-specific PCR. Results indicated that Klotho protein and mRNA expression were significantly lower in the SED group than those in the ND and EX groups (P<0.01), whereas no significant difference, was found between ND group and EX group (P>0.05). Furthermore, mice in the ND group and SED group showed significantly lower levels of completely methylated Klotho DNA in ND group (0%) and SED group (50%) compared with the EX group (90%), and unmethylated Klotho DNA level in ND group (80%) was significantly higher than those in the SED (0%) and EX (0%) groups. These results suggested that exercise leads to increased Klotho expression and reduced Klotho DNA methylation level in HFD induced obese mice.

Keywords: DNA methylation, exercise intervention, klotho, obese mice

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Authors: A. K. M. Anisur Rahman

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Brucellosis is an ancient and one of the world's most widespread zoonotic diseases affecting both, public health and animal production. Its current status in humans and domestic ruminants along with probable means to control further in Bangladesh are described. The true exposure prevalence of brucellosis in cattle, goats, and sheep seems to be low: 0.3% in cattle, 1% in goats and 1.2% in sheep. The true prevalence of brucellosis in humans was also reported to be around 2%. In such a low prevalence scenario both in humans and animals, the positive predictive values of the diagnostic tests were very low. The role Brucella species in the abortion of domestic ruminants is less likely. Still now, no Brucella spp. was isolated from animal and human samples. However, Brucella abortus DNA was detected from seropositive humans, cattle, and buffalo; milk of cow, goats, and gayals and semen of an infected bull. Consuming raw milk and unpasteurized milk products by Bangladeshi people are not common. Close contact with animals, artificial insemination using semen from infected bulls, grazing mixed species of animals together in the field and transboundary animal movement are important factors, which should be considered for the further control of this zoonosis in Bangladesh.

Keywords: brucellosis, control, human, zoonosis

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Authors: Sana Shokat, Rabia Riaz, Raja Shoaib Hussain, Saba Shabir

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Digital divide is usually measured in terms of gap between those who can efficiently use new technological tools, such as Internet, and those who cannot. It is also hypothesized that web 2.0 tools motivate people to use technology i.e. Social networking sites can play an important role in bridging digital gap. This study was to determine the presence of digital divide in urban and rural areas of district Muzaffrabad, Azad Jammu & Kashmir taking internet usage as the key element. A cross-sectional community based survey was conducted involving 384 respondents from city Muzaffrabad and village Garhi Doppta. The existence of digital divide was accessed on the basis of the questionnaires given. Chi- square test was used to find the association of different demographic and ICT related factors with internet usage. Age based and area based divide still exist among the targeted population but gender based digital divide is vanishing from the intended area of study. Outcomes of the survey also revealed that web 2.0-based web sites are also becoming popular and attracting people to use internet. Trend of using internet and communication technologies can be increased by solving the highlighted problems.

Keywords: Azad Jammu and Kashmir, digital divide, ICT, information and communication technology, Web2.0

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Authors: Aktan Ozsoy, Ali Fırat Cabalar, Eyyub Karakan

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Climate change is one of the biggest issues facing communities. Increasing population, growing economies, rapid industrialization are the main factors triggering it. On the other hand, the millions of tons of waste have generated by the period of rapid global growth not only harm to the environment but also lead to the use of valuable lands around the world as landfill sites. Moreover, it is rapidly consuming our resources and this forcing the human population and wildlife to share increasingly shrinking space. In this direction, it is vital to reuse waste materials with a sustainability philosophy. This study was carried out to contribute to the combat against climate change, conserve our natural resources and the environment. An oedometer (consolidation) test was performed on two waste materials combined in certain proportions to evaluate their sustainable usage. Crushed brick (BD) was mixed with rock powder (RP) in 0, 5, 10, 20, 30, 40, and 50% (dry weight of soil). The results obtained revealed the importance of the gradation of the material used in the consolidation test. It was found that there was a negligible difference between the initial and final void ratio of mixtures with brick dust added.

Keywords: waste material, oedometer test, environmental geotechnics, sustainability

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Authors: Madhan Vinu, Yue-Chun Jiang, Yi-Feng Lin, Chia-Her Lin

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An effective approach to enhance the ethanol/water pervaporation of mixed matrix membranes prepared from three microporous aluminium based metal-organic frameworks (MOFs), [Al(OH)(BPDC)] (DUT-5), [Al(OH)(NDC)] (DUT-4) and [Al(OH)(BzPDC)] (CAU-8) have been synthesized by employing solvothermal reactions. Interestingly, all Al-MOFs showed attractive surface area with microporous 12.3, 10.2 and 8.0 Å for DUT-5, DUT-4 and CAU-8 MOFs which are confirmed through N₂ gas sorption measurements. All the microporous compounds are highly stable as confirmed by thermogravimetric analysis and temperature-dependent powder X-ray diffraction measurements. Furthermore, the synthesized microporous MOF particles of DUT-5, DUT-4, and CAU-8 were successfully incorporated into biological chitosan (CS) membranes to form DUT-5@CS, DUT-4@CS, and CAU-8@CS membranes. The different MOF loadings such as 0.1, 0.15, and 0.2 wt% in CS networks have been prepared, and the same were used to separate mixtures of water and ethanol at 25ºC in the pervaporation process. In particular, when 0.15 wt% of DUT-5 was loaded, MOF@CS membrane displayed excellent permeability and selectivity in ethanol/water separation than that of the previous literature. These CS based membranes separation through functionalized microporous MOFs reveals the key governing factors that are essential for designing novel MOF membranes for bioethanol purification.

Keywords: metal-organic framework, microporous materials, separation, chitosan membranes

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Authors: Christabel Ihedike, John Mooney, Monica Price

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Summary: This study aims to critically evaluate effect of photochemical smog on respiratory health in Nigeria. Cohort of chronic obstructive pulmonary disease (COPD) patients was recruited from two large hospitals in Abuja Nigeria. Respiratory health questionnaires, daily diaries, dyspnoea scale and lung function measurement were used to obtain health data and investigate the relationship with air quality data (principally ozone, NOx and particulate pollution). Concentrations of air pollutants were higher than WHO and Nigerian air quality standard. The result suggests a correlation between measured air quality and exacerbation of respiratory illness. Introduction: Photochemical smog is a significant health challenge in most cities and its effect on respiratory health is well acknowledged. This type of pollution is most harmful to the elderly, children and those with underlying respiratory disease. This study aims to investigate impact of increasing temperature and photo-chemically generated secondary air pollutants on respiratory health in Abuja Nigeria. Method and Result: Health data was collected using spirometry to measure lung function on routine attendance at the clinic, daily diaries kept by patients and information obtained using respiratory questionnaire. Questionnaire responses (obtained using an adapted and internally validated version of St George’s Hospital Respiratory Questionnaire), shows that ‘time of wheeze’ showed an association with participants activities: 30% had worse wheeze in the morning: 10% cannot shop, 15% take long-time to get washed, 25% walk slower, 15% if hurry have to stop and 5% cannot take-bath. There was also a decrease in Forced expiratory volume in the first second and Forced Vital Capacity, and daily change in the afternoon–morning may be associated with the concentration level of pollutants. Also, dyspnoea symptoms recorded that 60% of patients were on grade 3, 25% grade 2 and 15% grade 1. Daily frequency of the number of patients in the cohort that cough /brought sputum is 78%. Air pollution in the city is higher than Nigerian and WHO standards with NOx and PM10 concentrations of 693.59ug/m-3 and 748ugm-3 being measured respectively. The result shows that air pollution may increase occurrence and exacerbation of respiratory disease. Conclusion: High temperature and local climatic conditions in urban Nigeria encourages formation of Ozone, the major constituent of photochemical smog, resulting also in the formation of secondary air pollutants associated with health challenges. In this study we confirm the likely potency of the pattern of secondary air pollution in exacerbating COPD symptoms in vulnerable patient group in urban Nigeria. There is need for better regulation and measures to reduce ozone, particularly when local climatic conditions favour development of photochemical smog in such settings. Climate change and likely increasing temperatures add impetus and urgency for better air quality standards and measures (traffic-restrictions and emissions standards) in developing world settings such as Nigeria.

Keywords: Abuja-Nigeria, effect, photochemical smog, respiratory health

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Authors: Pathinathan Theresanathan, Ajay Minj

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Ignatian Discernment Process (IDP) is an intense decision-making tool to decide on life-issues. Decisions are influenced by various factors outside of the decision maker and inclination within. This paper develops IDP in the context of Fuzzy Multi-criteria Decision Making (FMCDM) process. Extended VIKOR method is a decision-making method which encompasses even conflict situations and accommodates weightage to various issues. Various aspects of IDP, namely three ways of decision making and tactics of inner desires, are observed, analyzed and articulated within the frame work of fuzzy rules. The decision-making situations are broadly categorized into two types. The issues outside of the decision maker influence the person. The inner feeling also plays vital role in coming to a conclusion. IDP integrates both the categories using Extended VIKOR method. Case studies are carried out and analyzed with FMCDM process. Finally, IDP is verified with an illustrative case study and results are interpreted. A confused person who could not come to a conclusion is able to take decision on a concrete way of life through IDP. The proposed IDP model recommends an integrated and committed approach to value-based decision making.

Keywords: AHP, FMCDM, IDP, ignatian discernment, MCDM, VIKOR

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Authors: Basiliyos Tilahun Betru, Charles Awono Onana, Bernabe Batchakui

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Recommender systems have become increasingly popular in recent years, and are utilized in numerous areas. Nowadays many web services provide several information for users and recommender systems have been developed as critical element of these web applications to predict choice of preference and provide significant recommendations. With the help of the advantage of deep learning in modeling different types of data and due to the dynamic change of user preference, building a deep model can better understand users demand and further improve quality of recommendation. In this paper, deep neural network models for recommender system are evaluated. Most of deep neural network models in recommender system focus on the classical collaborative filtering user-item setting. Deep learning models demonstrated high level features of complex data can be learned instead of using metadata which can significantly improve accuracy of recommendation. Even though deep learning poses a great impact in various areas, applying the model to a recommender system have not been fully exploited and still a lot of improvements can be done both in collaborative and content-based approach while considering different contextual factors.

Keywords: big data, decision making, deep learning, recommender system

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Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki

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The assessment variables of the accessibility and the sustainability of access infrastructure for remote regions may vary significant by location and a wide range of factors may affect the decision process. In this paper, the environmental disturbance implications of transportation system to key demand and supply variables impact the economic system in remote destination are descripted. According to a systemic approach, the key sustainability variables deals with decision making process that have to be included in strategic plan for the critical transport infrastructure development and their relationship to regional socioeconomic system are presented. The application deals with the development of railway in remote destinations, where the traditional CBA not include the external cost generated by the environmental impacts that may have a range of diverse impacts on transport infrastructure and services. The analysis output provides key messages to decision and policy makers towards sustainable development of transport infrastructure, especially for remote destinations where accessibility is a key factor of regional economic development and social stability. The key conclusion could be essential useful for relevant applications in remote regions in the same latitude.

Keywords: sustainable development in remote regions, transport infrastructure, strategic planning, sustainability variables

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Authors: Rupali Bhatia, Deepthi Nair, Geetika Khanna, Seema Singhal

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Introduction: Genital tract tuberculosis is a chronic disease (caused by reactivation of organisms from systemic distribution of Mycobacterium tuberculosis) that often presents with low grade symptoms and non-specific complaints. Patients with genital tuberculosis are usually young women seeking workup and treatment for infertility. Infertility is the commonest presentation due to involvement of the fallopian tubes, endometrium and ovarian damage with poor ovarian volume and reserve. The diagnosis of genital tuberculosis is difficult because of the fact that it is a silent invader of genital tract. Since tissue cannot be obtained from fallopian tubes, the diagnosis is made by isolation of bacilli from endometrial tissue obtained by endometrial biopsy curettage and/or aspiration. Problems are associated with sampling technique as well as diagnostic modality due to lack of adequate sample volumes and the segregation of the sample for various diagnostic tests resulting in non-uniform distribution of microorganisms. Moreover, lack of an efficient sampling technique universally applicable for all specific diagnostic tests contributes to the diagnostic challenges. Endometrial sampling plays a key role in accurate diagnosis of female genital tuberculosis. It may be done by 2 methods viz. endometrial curettage and endometrial aspiration. Both endometrial curettage and aspirate have their own limitations as curettage picks up strip of the endometrium from one of the walls of the uterine cavity including tubal osteal areas whereas aspirate obtains total tissue with exfoliated cells present in the secretory fluid of the endometrial cavity. Further, sparse and uneven distribution of the bacilli remains a major factor contributing to the limitations of the techniques. The sample that is obtained by either technique is subjected to histopathological examination, AFB staining, culture and PCR. Aim: Comparison of the sampling techniques viz. endometrial biopsy curettage and endometrial aspiration using different laboratory methods of histopathology, cytology, microbiology and molecular biology. Method: In a hospital based observational study, 75 Indian females suspected of genital tuberculosis were selected on the basis of inclusion criteria. The women underwent endometrial tissue sampling using Novaks biopsy curette and Karmans cannula. One part of the specimen obtained was sent in formalin solution for histopathological testing and another part was sent in normal saline for acid fast bacilli smear, culture and polymerase chain reaction. The results so obtained were correlated using coefficient of correlation and chi square test. Result: Concordance of results showed moderate agreement between both the sampling techniques. Among HPE, AFB and PCR, maximum sensitivity was observed for PCR, though the specificity was not as high as other techniques. Conclusion: Statistically no significant difference was observed between the results obtained by the two sampling techniques. Therefore, one may use either EA or EB to obtain endometrial samples and avoid multiple sampling as both the techniques are equally efficient in diagnosing genital tuberculosis by HPE, AFB, culture or PCR.

Keywords: acid fast bacilli (AFB), histopatholgy examination (HPE), polymerase chain reaction (PCR), endometrial biopsy curettage

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Authors: Amanda R. R. Oliveira, Caio F. F. C. Cunha, Juan C. L. Junior, Amorim H. P. Junior

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Children deaths are traumatic events that most often can be prevented. The technology of prevention and intervention in cases of infant deaths is available at low cost and with solid evidence and favorable results, however, with low access cover. Weight is one of the main factors related to death in the neonatal period, so the newborns of low birth weight are a population at high risk of death in the neonatal period, especially early neonatal period. This paper describes the development of a model based in neural network analysis to predict the mortality risk rating in the early neonatal period for newborns of low birth weight to identify the individuals of this population with increased risk of death. The neural network applied was trained with a set of newborns data obtained from Brazilian health system. The resulting network presented great success rate in identifying newborns with high chances of death, which demonstrates the potential for using this tool in an integrated manner to the health system, in order to direct specific actions for improving prognosis of newborns.

Keywords: low birth weight, neonatal death risk, neural network, newborn

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Authors: Dagnija Blumberga, Toms Prodanuks, Ivars Veidenbergs, Andra Blumberga

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Gas condensing units with inner tubes heat exchangers represent third generation technology and differ from second generation heat and mass transfer units, which are fulfilled by passive filling material layer. The first one improves heat and mass transfer by increasing cooled contact surface of gas and condensate drops and film formed in inner tubes heat exchanger. This paper presents a selection of significant factors which influence the heat and mass transfer. Experimental planning is based on the research and analysis of main three independent variables; velocity of water and gas as well as density of spraying. Empirical mathematical models show that the coefficient of heat transfer is used as dependent parameter which depends on two independent variables; water and gas velocity. Empirical model is proved by the use of experimental data of two independent gas condensing units in Lithuania and Russia. Experimental data are processed by the use of heat transfer criteria-Kirpichov number. Results allow drawing the graphical nomogram for the calculation of heat and mass transfer conditions in the innovative and energy efficient gas cooling unit.

Keywords: gas condensing unit, filling, inner heat exchanger, package, spraying, tunes

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Authors: Uwalomwa Uwuigbe, Olubukola Ranti Uwuigbe, Jinadu Olugbenga, Otekunrin Adegbola

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Corporate reporting has evolved over the years resulting from criticisms of the precedent by shareholders, stakeholders and other relevant financial institutions. Integrated reporting has become a globalized corporate reporting style, with its adoption around the world occurring rapidly to bring about an improvement in the quality of corporate reporting. While some countries have swiftly clinched into reporting in an integrated manner, others have not. In addition, there are ample research that has been conducted on the benefits of adopting integrated reporting, however, the same is not true in developing economies like Nigeria. Hence, this study basically examined the factors determining the adoption of integrated reporting in Nigeria. One hundred (100) copies of questionnaire was administered to financial managers of 20 selected listed companies in the Nigeria stock exchange market. The data obtained was analysed using the Spearman Rank Order Correlation via the Statistical Package for Social Science. This study observed that there is a significant relationship between the social pressures of isomorphic changes and integrated reporting adoption in Nigeria. The study recommends the need for an enforcement mechanism to be put in place while considering the adoption of integrated reporting in Nigeria, enforcement mechanisms should put into consideration the investors demand, the level of economic development, and the degree of corporate social responsibility.

Keywords: corporate social responsibility, isomorphic, integrated reporting, Nigeria, sustainability

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Authors: Gulnaz Erkomaishvili

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The paper discusses mineral water consumer market and development policy in Georgia, the tools and measures, which will contribute to the production of mineral waters and increase its export. The paper studies and analyses current situation in mineral water production sector as well as the factors affecting increase and reduction of its export. It’s noted that in order to gain and maintain competitive advantage, it’s necessary to provide continuous supply of high-quality goods with modern design, open new distribution channels to enter new markets, carry out broad promotional activities, organize e-commerce. Economic policy plays an important role in protecting markets from counterfeit goods. The state also plays an important role in attracting foreign direct investments. Stable business environment and export-oriented strategy is the basis for the country’s economic growth. Based on the research, the paper suggests the strategy for improving the competitiveness of Georgian mineral waters, relevant conclusions and recommendations are provided.

Keywords: mineral waters, consumer market for mineral waters, export of mineral waters, mineral water development policy in Georgia

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Authors: Chyi Jaw

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Prior literature on innovation diffusion or acceptance has almost exclusively concentrated on consumers’ positive attitudes and behaviors for new products/services. Consumers’ negative attitudes or behaviors to innovations have received relatively little marketing attention, but it happens frequently in practice. This study discusses consumer psychological factors when they try to learn or use new technologies. According to recent research, technological innovation acceptance has been considered as a dynamic or mediated process. This research argues that consumers can experience inertia and emotions in the initial use of new technologies. However, given such consumer psychology, the argument can be made as to whether the inclusion of consumer inertia (routine seeking and cognitive rigidity) and emotions increases the predictive power of new technology acceptance model. As data from the empirical study find, the process is potentially consumer emotion changing (independent of performance benefits) because of technology complexity and consumer inertia, and impact innovative technology use significantly. Finally, the study presents the superior predictability of the hypothesized model, which let managers can better predict and influence the successful diffusion of complex technological innovations.

Keywords: cognitive rigidity, consumer emotions, new technology acceptance, routine seeking, technology complexity

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Authors: Carmen W. H. Chan, Helen Y. L. Chan, Kai Chow Choi, Ka Ming Chow, Cecilia W. M. Kwan, Nancy H. Y. Ng, Jackie Robinson

Abstract:

Introduction: In Hong Kong, a significant number of deaths occur in acute care wards, which requires nurses in these settings to provide end-of-life care and lead ACP implementation. However, nurses in these settings, in fact, have very low-level involvement in ACP discussions because of limited training in ACP conversations. Objective: This study aims to assess the impact of a multi-media experiential ACP (MEACP) training program, which is guided by the experiential learning model and theory of planned behaviour, on nurses' knowledge and confidence in assisting patients with ACP. Methodology: The study utilizes a cluster randomized controlled trial with a 12-week follow-up. Eligible nurses working in acute care hospital wards are randomly assigned at the ward level, in a 1:1 ratio, to either the control group (no ACP education) or the intervention group (4-week MEACP training program). The training programme includes training through a webpage and mobile application, as well as a face-to-face training workshop with enhanced lectures and role play, which is based on the Theory of Planned Behavior and Kolb's Experiential Learning Model. Questionnaires were distributed to assess nurses' knowledge (a 10-item true/false questionnaire) and level of confidence (five-point Likert scale) in ACP at baseline (T0), four weeks after the baseline assessment (T1), and 12 weeks after T1 (T2). In this interim report, data analysis was mainly descriptive in nature. Result: The interim report focuses on the preliminary results of 165 nurses at T0 (Control: 74, Intervention: 91) over a 5-month period, 69 nurses from the control group who completed the 4-week follow-up and 65 nurses from the intervention group who completed the 4-week MEACP training program at T1. The preliminary attrition rate is 6.8% and 28.6% for the control and intervention groups, respectively, as some nurses did not complete the whole set of online modules. At baseline, the two groups were generally homogeneous in terms of their years of nursing practice, weekly working hours, working title, and level of education, as well as ACP knowledge and confidence levels. The proportion of nurses who answered all ten knowledge questions correctly increased from 13.8% (T0) to 66.2% (T1) for the intervention group and from 13% (T0) to 20.3% (T1) for the control group. The nurses in the intervention group answered an average of 7.57 and 9.43 questions correctly at T0 and T1, respectively. They showed a greater improvement in the knowledge assessment at T1 with respect to T0 when compared with their counterparts in the control group (mean difference of change score, Δ=1.22). They also exhibited a greater gain in level of confidence at T1 compared to their colleagues in the control group (Δ=0.91). T2 data is yet available. Conclusion: The prevalence of nurses engaging in ACP and their level of knowledge about ACP in Hong Kong is low. The MEACP training program can enrich nurses by providing them with more knowledge about ACP and increasing their confidence in conducting ACP.

Keywords: advance directive, advance care planning, confidence, knowledge, multi-media experiential, randomised control trial

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Authors: Harriet Nalubega, Eddie Mwebesa

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In Uganda, over 90% of people use herbal remedies. Herbal medicine use has been associated with delayed clinical appointments, presentation with advanced cancers, financial constraints, and misdiagnosis. This study aimed to evaluate the prevalence of herbal medicine use and practices amongst cancer patients receiving Palliative Care at Mobile Hospice Mbarara (MHM) and the associated challenges. This was a mixed-methods prospective study conducted in 2022 at MHM, where patients were interviewed, and a questionnaire was completed. 87% of the patients had used herbal medicine. Of these, 83% were female, and 59% had not received formal education. 27% of patients had used herbal remedies for a year or more. 51% of patients who were consuming herbs stopped using them after starting palliative care treatment. Motivations for herbal medicine use were in the hope for a cure in 59%, for pain relief in 30%, and peer influence in 10%. There is a high prevalence of herbal medicine use in Palliative Care. Female gender and lack of formal education were disproportionately associated with herbal remedy use. Most patients consume herbal remedies in search of a cure or to relieve severe pain. Education of cancer patients about herbal remedy use may improve treatment outcomes in Palliative Care.

Keywords: prevalence, herbal medicine, cancer patients, palliative care

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Authors: Anas Abdulrahman A. Almiman

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In recent decades, efforts to combat extremism have focused on non-physical dimensions, as various countries have attempted to raise security awareness or promote authentic and moderate Islamic education. The Kingdom of Saudi Arabia is one of the most successful and unique cases because it has focused on the immunization of Islamic intellectual security to combat extremism. This study aims to define the concept and importance of Islamic intellectual security in the Kingdom of Saudi Arabia through a descriptive-analytical study. It describes the potential role of Islamic intellectual security immunization in reducing extremism in the Kingdom of Saudi Arabia from 1979 to 2019, identifying various factors that connect Islamic intellectual security immunization to extremism reduction. One such factor is the MISK Foundation’s forums and conferences intended to raise Islamic intellectual security and reduce intellectual deviation, thus reducing extremism. It concludes that the common significant factor for Islamic intellectual deviation is direct commands and prohibitions. This study supports the efforts made by the Kingdom of Saudi Arabia to immunize Islamic intellectual security and fight extremism as a consequence.

Keywords: extremism, intellectual security immunization , Saudi Arabia, Islamic

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Authors: Qian Zaijian

Abstract:

E-government is one of the hot issues in the current academic research of public policy and management. As the organic integration of information and communication technology (ICT) and public administration, e-government is one of the most important areas in contemporary information society. Policy information system is a basic subsystem of public policy system, its operation affects the overall effect of the policy process or even exerts a direct impact on the operation of a public policy and its success or failure. The basic principle of its operation is information collection, processing, analysis and release for a specific purpose. The function of E-government for public policy information system lies in the promotion of public access to the policy information resources, information transmission through e-participation, e-consultation in the process of policy analysis and processing of information and electronic services in policy information stored, to promote the optimization of policy information systems. However, due to many factors, the function of e-government to promote policy information system optimization has its practical limits. In the building of E-government in our country, we should take such path as adhering to the principle of freedom of information, eliminating the information divide (gap), expanding e-consultation, breaking down information silos and other major path, so as to promote the optimization of public policy information systems.

Keywords: China, e-consultation, e-democracy, e-government, e-participation, ICTs, public policy information systems

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Authors: Amna B. Medani, M. A. Elbadwi Samia, Hassan A. Khalid

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In our study, nine Nubian goat kids were obtained, allotted into three groups, and healthily adapted in pens within the premises of the Veterinary Teaching Hospital, University of Khartoum to be given the oral doses of the dried herb shoots at daily doses of 1 and 5 gm/kg/day with drinking water, while the kids of the control group were left undosed. All goats were slaughtered,if not died, after 35 days. S. argel at the given doses caused signs of arched posture, ruffled hair, shivering and paralysis of limbs. On post mortem, lesions were seen to be hepatic fatty changes, renal necrosis, congested lungs and inflamed intestines. Serum chemistry investigations revealed significant increase (P< 0.05-0.01) in the activities of ALP(alkaline phosphates) and AST( aspartate-aminotransferase) in goats dosed with 5 gm /kg/ day. Also observed were significant increases in inorganic phosphorus and urea concentrations (P < 0.05-0.01) in both dosed goat groups. .Other investigations including the activity of GGT( gamma glutamyltransferase), creatinine, calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. On haematological evaluation , the goat kids dosed with 5 gm/kg/dayshowed a decrease in haemoglobin concentration and red blood cells count of (P < 0.05-0.01).Both groups of dosed goats showed a higher packed cell volume values of (P < 0.05) when compared to the control goats .Mean corpuscular haemoglobin values were not different from those of the control kids. S. argel at the given doses caused signs of arched posture, ruffled hair, shivering and paralysis of limbs. On post mortem, lesions were seen to be hepatic fatty changes, renal necrosis, congested lungs and inflamed intestines. Serum chemistry investigations revealed significant increase (P < 0.05-0.01) in the activities of ALP(alkaline phosphates) and AST( aspartate-aminotransferase) in goats dosed with 5 gm /kg/ day. Also observed were significant increases in inorganic phosphorus and urea concentrations (P < 0.05-0.01) in both dosed goat groups. .Other investigations including the activity of GGT( gamma-glutamyltransferase), creatinine, calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. calcium, total protein and albumin illustrated no significant difference from that of the undosed controls. On haematological evaluation , the goat kids dosed with 5 gm/kg/dayshowed a decrease in haemoglobin concentration and red blood cells count of (P < 0.05-0.01).Both groups of dosed goats showed a higher packed cell volume values of (P < 0.05) when compared to the control goats .Mean corpuscular haemoglobin values were not different from those of the control kids. Data obtained were then discussed to find S. argel irritable to intestines , toxic to the kidney and liver and a haematological mild toxin.Suggestions for future were forwarded.

Keywords: hargal, nubian goats, solenstemma argel, toxicity

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Authors: Jun Zhou, Xingping Wang, Paul Milbourne

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Evidences in the world shows that the industry and population have being greatly concentrated in metropolitan regions which is getting to be the most important area for the economic power and people living standard in the future. In the meanwhile, the relevant innovation theories of Agglomeration, New Industrial Geography and Modern Evolutionary innovation prove that the reason why the agglomeration in world-class city and metropolitan areas and also verify innovation is the key point for the development of metropolis. The primary purpose of this paper is to analyze the geographical spatial characteristics of innovative subjects which contain firm, university, research institution, government and intermediary organ in metropolis throughout the amount data analysis in Yangtze River Metropolis in China. The results show three main conclusions. The first is different subjects in different regions have different spatial characteristics. The second one is different structure and pattern between the subjects also can produce different innovative effect. The last but not the least is agglomeration of innovative subjects’ is not only influenced by the innovative network or local policies but also affected by the localized industry characteristics and culture which are getting to be the most important crucial factors.

Keywords: metropolitan development, innovative subject, spatial, Yangtze River Metropolis, China

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Authors: Kuo-Kai Lin, Po-Lun Chang

Abstract:

Research Background and Purpose: Following the development of the Internet and multimedia, the Internet and information technology have become crucial avenues of modern communication and knowledge acquisition. The advantages of using mobile devices for learning include making learning borderless and accessible. Mobile learning has become a trend in disease management and health promotion in recent years. End-stage renal disease (ESRD) is an irreversible chronic disease, and patients who do not receive kidney transplants can only rely on hemodialysis or peritoneal dialysis to survive. Due to the complexities in caregiving for patients with ESRD that stem from their advanced age and other comorbidities, the patients’ incapacity of self-care leads to an increase in the need to rely on their families or primary caregivers, although whether the primary caregivers adequately understand and implement patient care is a topic of concern. Therefore, this study explored whether primary caregivers’ health care provisions can be improved through the intervention of an automatic speech intelligent system, thereby improving the objective health outcomes of patients undergoing long-term dialysis. Method: This study developed an automatic speech intelligent system with healthcare functions such as health information voice prompt, two-way feedback, real-time push notification, and health information delivery. Convenience sampling was adopted to recruit eligible patients from a hemodialysis center at a regional teaching hospital as research participants. A one-group pretest-posttest design was adopted. Descriptive and inferential statistics were calculated from the demographic information collected from questionnaires answered by patients and primary caregivers, and from a medical record review, a health care scale (recorded six months before and after the implementation of intervention measures), a subjective health assessment, and a report of objective physiological indicators. The changes in health care behaviors, subjective health status, and physiological indicators before and after the intervention of the proposed automatic speech intelligent system were then compared. Conclusion and Discussion: The preliminary automatic speech intelligent system developed in this study was tested with 20 pretest patients at the recruitment location, and their health care capacity scores improved from 59.1 to 72.8; comparisons through a nonparametric test indicated a significant difference (p < .01). The average score for their subjective health assessment rose from 2.8 to 3.3. A survey of their objective physiological indicators discovered that the compliance rate for the blood potassium level was the most significant indicator; its average compliance rate increased from 81% to 94%. The results demonstrated that this automatic speech intelligent system yielded a higher efficacy for chronic disease care than did conventional health education delivered by nurses. Therefore, future efforts will continue to increase the number of recruited patients and to refine the intelligent system. Future improvements to the intelligent system can be expected to enhance its effectiveness even further.

Keywords: automatic speech intelligent system for health care, primary caregiver, long-term hemodialysis, health care capabilities, health outcomes

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Authors: Liang Zhao, Chongquan Zhong

Abstract:

Introduction: According to statistics, people spend 80% to 90% of time indoor, so indoor air quality, either at home or in the office, greatly impacts the quality of life, health and work efficiency. Therefore, indoor air quality is very important to human activities. With the acceleration of urbanization, people are spending more time in indoor activity. The time in indoor environment, the living space, and the frequency interior decoration are all increasingly increased. However, housing decoration materials contain formaldehyde and other harmful substances, causing environmental and air quality problems, which have brought serious damage to countless families and attracted growing attention. According to World Health Organization statistics, the indoor environments in more than 30% of buildings in China are polluted by poisonous and harmful gases. Indoor pollution has caused various health problems, and these widespread public health problems can lead to respiratory diseases. Long-term inhalation of low-concentration formaldehyde would cause persistent headache, insomnia, weakness, palpitation, weight loss and vomiting, which are serious impacts on human health and safety. On the other hand, as for offices, some surveys show that good indoor air quality helps to enthuse the staff and improve the work efficiency by 2%-16%. Therefore, people need to further understand the living and working environments. There is a need for easy-to-use indoor environment monitoring instruments, with which users only have to power up and monitor the environmental parameters. The corresponding real-time data can be displayed on the screen for analysis. Environment monitoring should have the sensitive signal alarm function and send alarm when harmful gases such as formaldehyde, CO, SO2, are excessive to human body. System design: According to the monitoring requirements of various gases, temperature and humidity, we designed a portable, light, real-time and accurate monitor for various environmental parameters, including temperature, humidity, formaldehyde, methane, and CO. This monitor will generate an alarm signal when a target is beyond the standard. It can conveniently measure a variety of harmful gases and provide the alarm function. It also has the advantages of small volume, convenience to carry and use. It has a real-time display function, outputting the parameters on the LCD screen, and a real-time alarm function. Conclusions: This study is focused on the research and development of a portable parameter monitoring instrument for indoor environment. On the platform of an STM32 development board, the monitored data are collected through an external sensor. The STM32 platform is for data acquisition and processing procedures, and successfully monitors the real-time temperature, humidity, formaldehyde, CO, methane and other environmental parameters. Real-time data are displayed on the LCD screen. The system is stable and can be used in different indoor places such as family, hospital, and office. Meanwhile, the system adopts the idea of modular design and is superior in transplanting. The scheme is slightly modified and can be used similarly as the function of a monitoring system. This monitor has very high research and application values.

Keywords: indoor air quality, gas concentration detection, embedded system, sensor

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