Search results for: hourly charge rate

Authors: Kamrun Nahar Koly, Saimul Islam

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Overweight and obesity is increasing at an alarming rate and a leading risk factor for morbidity throughout the world. In a country like Bangladesh where under nutrition and overweight both co-exist at the same time, but this issue has been underexplored as expected. The aim of the present study was to assess the knowledge, attitudes and identify the barriers of the physicians regarding overweight and obesity management on an urban hospital of Dhaka city in Bangladesh. A simple cross sectional study was conducted at two selected government and two private hospital to assess the knowledge, attitude and common barriers regarding overweight and obesity management among healthcare professionals. One hundred and fifty five physicians were surveyed. A standard questionnaire was constructed in local language and interview was administrated. Among the 155 physicians, majority 53 (34.20%) were working on SMC, 36 (23.20%) from DMC, 33 (21.30%) were based on SSMC and the rest 33 (21.30%) were from HFRCMH. Mean age of the study physicians were 31.88±5.92. Majority of the physicians 80 (51.60%) were not able to answer the correct prevalence of obesity but also a substantial number of them 75(48.40%) could mark the right answer. Among the physicians 150 (96.77%) reported BMI as a diagnostic index for overweight and obesity, where as 43 (27.74%) waist circumference, 30 (19.35%) waist hip ratio and 26 (16.77%) marked mid-arm circumference. A substantial proportion 71 (46.70%) of the physicians thought that they do not have much to do controlling weight problem in Bangladesh context though it has been opposed by 42 (27.60%) of the physicians and 39(25.70%) was neutral to comment. The majority of them 147 (96.1%) thought that a family based education program would be beneficial followed by 145 (94.8%) physicians mentioned about raising awareness among mothers as she is the primary caregiver. The idea of a school based education program will also help to early intervene referred by 142 (92.8%) of the physicians. Community based education program was also appreciated by 136 (89.5%) of the physicians. About 74 (47.7%) of them think that the patients still lack in motivation to maintain their weight properly at the same time too many patients to deal with can be a barrier as well assumed by 73 (47.1%) of them. Lack of national policy or management guideline can act as an obstacle told by 60 (38.7%) of the physicians. The relationship of practicing as a part of the general examination and chronic disease management was statistically significant (p<0.05) with physician occupational status. As besides, perceived barriers like lack of parents support, lack of a national policy was statistically significant (p<0.05) with physician occupational status. For the young physician, more training programme will be needed to transform their knowledge and attitude into practice. However, several important barriers interface for the physician treatment efforts and need to address.

Keywords: obesity management, physician, awareness, barriers, Bangladesh

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Authors: Prachi Sharma, B. V. Ramkumar

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In current days, autism is a well-known neurodevelopmental disorder that may restrict child development globally. Ignorance or delayed identification or incorrect diagnosis of autism is a major challenge in controlling such an incurable disorder. This may lead to various behavioural complications followed by mental illness in adulthood. Autism is an incurable disorder that is progressive and negatively affects our development globally. This may vary in degree in different skills. However, a deviation from the normal range creates a complex outcome in social and communication areas and restricts or deviates cognitive ability. The primary goal of the present research is to identify and understand the deviations in cognitive, social communication, and behaviour in children during their growing age, with a focus on autism. In this study, five children with mild autism were taken. All the children had achieved normal developmental milestones until the age of one year. The maximum age of observation of children’s development was four years to see the difference in their developmental rates in the areas of cognitive, social communication, and behaviour. The study is based on the parental report about their children from 1 year to 4 years. Videos and pictures of children during their development were also seen as a reference to verify information received by the parents of the children. This research is qualitative, with samples for which were selected using a purposive sampling technique. The data was collected from the OPD, NIEPID RC, NOIDA, India. The data was collected in the form of parental reports based on their observations about their kids. Videos were also seen to verify the information reported by the parents (just shown to verify the facts, not shared). In results, we observed a significant difference in the rate of development in all five children taken for this research. The children having mild autism, at present, showed variations in all three domains (cognitive, social communication, and behaviour). These variations were seen in terms of restricted development in global areas. The result revealed that typical features of ASD had created more cognitive restrictions as compared to the children having ASD features with hyperactivity. Behavioral problems were observed with different levels of severity in the children having ASD with hyperactivity, whereas children with typical ASD are found with some typical problem behaviours like head banging, body rocking, self-biting, etc., with different levels of severity. The social-communication area was observed as equally affected in all children, as no major difference was found in the information received from each parent.

Keywords: autism/ASD, behaviour, cognitive skill, hyperactivity, social-communication skill

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Authors: Ashish Trivedi, Amol Singh

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In the recent years, the magnitude and frequency of disasters have increased at an alarming rate. Every year, more than 400 natural disasters affect global population. A large-scale disaster leads to destruction or damage to houses, thereby rendering a notable number of residents homeless. Since humanitarian response and recovery process takes considerable time, temporary establishments are arranged in order to provide shelter to affected population. These shelter areas are vital for an effective humanitarian relief; therefore, they must be strategically planned. Choosing the locations of temporary shelter areas for accommodating homeless people is critical to the quality of humanitarian assistance provided after a large-scale emergency. There has been extensive research on the facility location problem both in theory and in application. In order to deliver sufficient relief aid within a relatively short timeframe, humanitarian relief organisations pre-position warehouses at strategic locations. However, such approaches have received limited attention from the perspective of providing shelters to disaster-affected people. In present research work, this aspect of humanitarian logistics is considered. The present work proposes a hybrid decision support model to determine relative preference of potential shelter locations by assessing them based on key subjective criteria. Initially, the factors that are kept in mind while locating potential areas for establishing temporary shelters are identified by reviewing extant literature and through consultation from a panel of disaster management experts. In order to determine relative importance of individual criteria by taking into account subjectivity of judgements, a hybrid approach of fuzzy sets and Analytic Hierarchy Process (AHP) was adopted. Further, Technique for order preference by similarity to ideal solution (TOPSIS) was applied on an illustrative data set to evaluate potential locations for establishing temporary shelter areas for homeless people in a disaster scenario. The contribution of this work is to propose a range of possible shelter locations for a humanitarian relief organization, using a robust multi criteria decision support framework.

Keywords: AHP, disaster preparedness, fuzzy set theory, humanitarian logistics, TOPSIS, temporary shelters

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Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: Vipin Kumar Verma, Neeta Sehgal, Om Prakash

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Cyprinus carpio has a wide spread occurrence in the lakes and rivers of Europe and Asia. Heavy losses in natural environment due to anthropogenic activities, including pollution as well as pathogenic diseases have landed this fish in IUCN red list of vulnerable species. The significance of a suitable diet in preserving the health status of fish is widely recognized. In present study, artificial feed supplemented with leaves of two weed plants, Eichhornia crassipes and Ricinus communis were evaluated for their role on the fish immune system. To achieve this objective fish were acclimatized to laboratory conditions (25 ± 1 °C; 12 L: 12D) for 10 days prior to start of experiment and divided into 4 groups: non-challenged (negative control= A), challenged [positive control (B) and experimental (C & D)]. Group A, B were fed with non-supplemented feed while group C & D were fed with feed supplemented with 5% Eichhornia crassipes and 5% Ricinus communis respectively. Supplemented feeds were evaluated for their effect on growth, health, immune system and disease resistance in fish when challenged with Vibrio harveyi. Fingerlings of C. carpio (weight, 2.0±0.5 g) were exposed with fresh overnight culture of V. harveyi through bath immunization (concentration 2 Χ 105) for 2 hours on 10 days interval for 40 days. The growth was monitored through increase in their relative weight. The rate of mortality due to bacterial infection as well as due to effect of feed was recorded accordingly. Immune response of fish was analyzed through differential leucocyte count, percentage phagocytosis and phagocytic index. The effect of V. harveyi on fish organs were examined through histo-pathological examination of internal organs like spleen, liver and kidney. The change in the immune response was also observed through gene expression analysis. The antioxidant potential of plant extracts was measured through DPPH and FRAP assay and amount of total phenols and flavonoids were calculates through biochemical analysis. The chemical composition of plant’s methanol extracts was determined by GC-MS analysis, which showed presence of various secondary metabolites and other compounds. Investigation revealed immuno-modulatory effect of plants, when supplemented with the artificial feed of fish.

Keywords: immuno-modulation, gc-ms, Cyprinus carpio, Eichhornia crassipes, Ricinus communis

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Authors: Ahmed Slami, Med El Amine Brixi Nigassa, Nassima Labdelli, Sofiane Soulimane, Arnaud Pothier

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Many people suffer from diabetes, a disease marked by abnormal levels of sugar in the blood; 285 million people have diabetes, 6.6% of the world adult population (in 2010), according to the International Diabetes Federation. Insulin medicament is invented to be injected into the body. Generally, the injection requires the patient to do it manually. However, in many cases he will be unable to inject the drug, saw that among the side effects of hyperglycemia is the weakness of the whole body. The researchers designed a medical device that injects insulin too autonomously by using micro-pumps. Many micro-pumps of concepts have been investigated during the last two decades for injecting molecules in blood or in the body. However, all these micro-pumps are intended for slow infusion of drug (injection of few microliters by minute). Now, the challenge is to develop micro-pumps for fast injections (1 microliter in 10 seconds) with accuracy of the order of microliter. Recently, studies have shown that only piezoelectric actuators can achieve this performance, knowing that few systems at the microscopic level were presented. These reasons lead us to design new smart microsystems injection drugs. Therefore, many technological advances are still to achieve the improvement of materials to their uses, while going through their characterization and modeling action mechanisms themselves. Moreover, it remains to study the integration of the piezoelectric micro-pump in the microfluidic platform features to explore and evaluate the performance of these new micro devices. In this work, we propose a new micro-pump model based on piezoelectric actuation with a new design. Here, we use a finite element model with Comsol software. Our device is composed of two pumping chambers, two diaphragms and two actuators (piezoelectric disks). The latter parts will apply a mechanical force on the membrane in a periodic manner. The membrane deformation allows the fluid pumping, the suction and discharge of the liquid. In this study, we present the modeling results as function as device geometry properties, films thickness, and materials properties. Here, we demonstrate that we can achieve fast injection. The results of these simulations will provide quantitative performance of our micro-pumps. Concern the spatial actuation, fluid rate and allows optimization of the fabrication process in terms of materials and integration steps.

Keywords: COMSOL software, piezoelectric, micro-pump, microfluidic

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Authors: Samuel Holder

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Mass incarceration in the United States is a human rights issue, not merely a civil rights problem. It is a human rights problem not only because the United States has a high rate of incarceration, but more importantly because of who is jailed, for what purpose they are jailed and, ultimately, the manner in which they are jailed. To sustain the scale of the criminal justice system, one of the darker policies involves a multi-tiered strategy of fee- and fine-collection, targeting, usually, the most vulnerable and poor, many of whom run into the law via small offenses that do not rise to the level of felonies. This paper advances the notion that this debt collection-to-incarceration pipeline is tantamount to a modern-day debtors’ prison system. This article seeks to confront the thorny issue of incarceration via criminal justice debt from a human rights and cause-lawyering position. It will argue that a two-pronged cause-lawyering strategy: the first focused on traditional litigation along constitutional grounds, and the second, an advocacy approach rooted in grassroots campaigns, designed to shift the normative operation and understanding of the rights of marginalized and racialized offenders. Ultimately, the argument suggests that this approach will be effective in combatting the (often highly privatized) criminal justice debt system and bring the roles of 'incapacitation, rehabilitation, deterrence, and retribution' back into the criminal justice legal conversation. Part I contextualizes and historicizes the role of fees, penalties, and fines in American criminal justice. Part II examines the emergence of private industry in the criminal justice system, and its role in the acceleration of profit-driven criminal justice debt collection and incarceration. Part III addresses the failures of the federal and state law and legislation in combatting predatory incarceration and debt collection in the criminal justice system, particularly as waged against the indigent and/or ethnically or racially marginalized. Part IV examines the potential for traditional cause-lawyering litigation along constitutional grounds, using case studies across contexts for illustration. Finally, Part V will review the radical cause-lawyer’s role in the normative struggle in redefining prisoners’ rights and the rights of the marginalized (and racialized) as they intersect at the crossroads of criminal justice debt. This paper will conclude with recommendations for litigation and advocacy, drawing on hypotheses advanced, and informed by case studies from a variety of both national and international jurisdictions.

Keywords: cause-lawyering, criminal justice debt, human rights, judicial fees

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Authors: Dawit Hoyiso, Abinet Arega, Terefe Markos

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Background: - In spite of all the various programs and strategies to promote the use of research finding there is still gap between theory and practice. Difference in outcomes, health inequalities, and poorly performing health service continue to present a challenge to all nurses. A number of studies from various countries have reported that nurses’ experience of evidence-based practice is low. In Ethiopia there is an information gap on the extent of evidence based nursing practice and its associated factors. Objective: - the study aims to assess the implementation of evidence based nursing practice and associated factors among nurses in Jimma zone public hospitals. Method: - Institution based cross-sectional study was conducted from March 1-30/2015. A total of 333 sampled nurses for quantitative and 8 in-depth interview of key informants were involved in the study. Semi-structured questionnaire was adapted from funk’s BARRIER scale and Friedman’s test. Multivariable Linear regression was used to determine significance of association between dependent and independent variables. Pretest was done on 17 nurses of Bedele hospital. Ethical issue was secured. Result:-Of 333 distributed questionnaires 302 were completed, giving 90.6% response rate. Of 302 participants 245 were involved in EBP activities to different level (from seldom to often). About forty five(18.4%) of the respondents had implemented evidence based practice to low level (sometimes), one hundred three (42 %) of respondents had implemented evidence based practice to medium level and ninety seven (39.6 %) of respondents had implemented evidence based practice to high level(often). The first greatest perceived barrier was setting characteristic (mean score=26.60±7.08). Knowledge about research evidence was positively associated with implementation of evidence based nursing practice (β=0.76, P=0.008). Similarly, Place where the respondent graduated was positively associated with implementation of evidence based nursing practice (β=2.270, P=0.047). Also availability of information resources was positively associated with implementation of evidence based practice (β=0.67, P= 0.006). Conclusion: -Even though larger portion of nurses in this study were involved in evidence-based practice whereas small number of participants had implemented frequently. Evidence-based nursing practice was positively associated with knowledge of research, place where respondents graduated, and the availability of information resources. Organizational factors were found to be the greatest perceived barrier. Intervention programs on awareness creation, training, resource provision, and curriculum issues to improve implementation of evidence based nursing practice by stakeholders are recommended.

Keywords: evidence based practice, nursing practice, research utilization, Ethiopia

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Authors: Abraham Dayan

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Remediation of soil containing volatile contaminants is often conducted by vapor extraction (SVE) technique. The operation is based on injection of air at ambient temperatures with or without thermal soil warming. Thermal enhancements of soil vapor extraction (TESVE) processes are usually conducted by soil heating, sometimes assisted by added steam injections. The current study addresses a technique which has not received adequate attention and is based on using exclusively hot air as an alternative to the common TESVE practices. To demonstrate the merit of the hot air TESVE technique, a sandy soil containing contaminated water is studied. Numerical and analytical tools were used to evaluate the rate of decontamination processes for various geometries and operating conditions. The governing equations are based on the Darcy law and are applied to an expanding compressible flow within a sandy soil. The equations were solved to determine the minimal time required for complete soil remediation. An approximate closed form solution was developed based on the assumption of local thermodynamic equilibrium and on a linearized representation of temperature dependence of the vapor to air density ratio. The solution is general in nature and offers insight into the governing processes of the soil remediation operation, where self-similar temperature profiles under certain conditions may exist, and the noticeable role of the contaminants evaporation and recondensation processes in affecting the remediation time. Based on analyses of the hot air TESVE technique, it is shown that it is sufficient to heat the air during a certain period of the decontamination process without compromising its full advantage, and thereby, entailing a minimization of the air-heating-energy requirements. This in effect is achieved by regeneration, leaving the energy stored in the soil during the early period of the remediation process to heat the subsequently injected ambient air, which infiltrates through it for the decontamination of the remaining untreated soil zone. The characteristic time required to complete SVE operations are calculated as a function of, both, the injected air temperature and humidity. For a specific set of conditions, it is demonstrated that elevating the injected air temperature by 20oC, the hot air injection technique reduces the soil remediation time by 50%, while requiring 30% of additional energy consumption. Those evaluations clearly unveil the advantage of the hot air SVE process, which for insignificant cost of added air heating energy, the substantial cost expenditures for manpower and equipment utilization are reduced.

Keywords: Porous Media, Soil Decontamination, Hot Air, Vapor Extraction

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Authors: Florian Kiebert, Hagen Schmidt

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Standing surface acoustic waves (sSAWs) have already been used to manipulate particles in a microfluidic channel made of polydimethylsiloxan (PDMS). Usually two identical facing interdigital transducers (IDTs) are exploited to form an sSAW. Further, it has been reported that an sSAW can be generated by a single IDT using a superstrate resonating cavity or a PDMS post. Nevertheless, both setups utilising a traveling surface acoustic wave (tSAW) to create an sSAW for particle manipulation are costly. We present a simplified setup with a tSAW and a PDMS channel to form an sSAW. The incident tSAW is reflected at the rear PDMS channel wall and superimposed with the reflected tSAW. This superpositioned waves generates an sSAW but only at regions where the distance to the rear channel wall is smaller as the attenuation length of the tSAW minus the channel width. Therefore in a channel of 500µm width a tSAW with a wavelength λ = 120 µm causes a sSAW over the whole channel, whereas a tSAW with λ = 60 µm only forms an sSAW next to the rear wall of the channel, taken into account the attenuation length of a tSAW in water. Hence, it is possible to concentrate and trap particles in a defined region of the channel by adjusting the relation between the channel width and tSAW wavelength. Moreover, it is possible to generate a particle gradient over the channel width by picking the right ratio between channel wall and wavelength. The particles are moved towards the rear wall by the acoustic streaming force (ASF) and the acoustic radiation force (ARF) caused by the tSAW generated bulk acoustic wave (BAW). At regions in the channel were the sSAW is dominating the ARF focuses the particles in the pressure nodes formed by the sSAW caused BAW. On the one side the ARF generated by the sSAW traps the particle at the center of the tSAW beam, i. e. of the IDT aperture. On the other side, the ASF leads to two vortices, one on the left and on the right side of the focus region, deflecting the particles out of it. Through variation of the applied power it is possible to vary the number of particles trapped in the focus points, because near to the rear wall the amplitude of the reflected tSAW is higher and, therefore, the ARF of the sSAW is stronger. So in the vicinity of the rear wall the concentration of particles is higher but decreases with increasing distance to the wall, forming a gradient of particles. The particle gradient depends on the applied power as well as on the flow rate. Thus by variation of these two parameters it is possible to change the particle gradient. Furthermore, we show that the particle gradient can be modified by changing the relation between the channel width and tSAW wavelength. Concluding a single IDT generates an sSAW in a PDMS microchannel enables particle gradient generation in a well-defined microfluidic flow system utilising the ARF and ASF of a tSAW and an sSAW.

Keywords: ARF, ASF, particle manipulation, sSAW, tSAW

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Authors: Mohd Shazad, K. K. Gupta

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Vector borne diseases are a serious global concern. Aedes aegypti, the primary vector for viruses that cause dengue fever, dengue haemorrhagic fever, chikungunya and yellow fever is widespread over large areas of the tropics and subtropics. In last decade, diseases transmitted by Aedes aegypti are of serious concern. In past decade, number of cases of dengue fever, dengue hemorrhagic fever, and chikungunya has increased multifold. Present research work focused on impact of ethanol extract of Ocimum sanctum on dengue vector Aedes aegypti. 0-24 hr. old fourth instar larvae of lab-bred population of Aedes aegypti were exposed to ethanol leaf extract of Ocimum with concentrations ranging from 50 ppm to 400 ppm. Survival and development and the treated larvae and reproductive behaviour of the adults emerged from the treated larvae was evaluated. Our results indicated larvicidal potential of the leaf ethanol extract. The influence of the extract was dose dependent. 77.2% mortality was observed in the larvae exposed to 400 ppm for 24 hr. Treatment at lower concentrations revealed delayed toxicity. The larvae survived after treatment showed severe developmental anomalies. Consequently, there was the significant increase in duration of fourth instar larva. The L4 treated with 400-ppm extract moulted after 4.6 days; this was in sharp contrast to control where the larval period of the fourth instar lasts three days. The treated fourth instar larvae in many cases transformed into larva-pupa intermediates with the combination of larva, pupa characters. The larva-pupa intermediates had reduced life span and failed to moult successfully. The adults emerged from the larvae treated with lower doses had reduced reproductive potential. The females exhibited longer preoviposition period, reduced oviposition rate, abnormal oviposition behaviour and decreased fertility. Our studies indicated the possibility of the presence of JH mimic or JH analogue in the leaf ethanol extract of Ocimum. The present research work explored the potentials of Ocimum sanctum, also known as the queen of herbs, in integrated vector management programme of Aedes aegypti, which is a serious threat to human health.

Keywords: Aedes aegypti, development, mortality, Ocimum sanctum reproduction

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Authors: Mohamed Raouf Benmakrelouf, Joseph Rynkiewicz

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Targeted maximum likelihood estimation (TMLE) is well-established method for causal effect estimation with desirable statistical properties. TMLE is a doubly robust maximum likelihood based approach that includes a secondary targeting step that optimizes the target statistical parameter. A causal interpretation of the statistical parameter requires assumptions of the Rubin causal framework. The causal effect of binary variable, E, on outcomes, Y, is defined in terms of comparisons between two potential outcomes as E[YE=1 − YE=0]. Our aim in this paper is to present an adaptation of TMLE methodology to estimate the causal effect of a non-binary categorical variable, providing a large application. We propose coding on the initial data in order to operate a binarization of the interest variable. For each category, we get a transformation of the non-binary interest variable into a binary variable, taking value 1 to indicate the presence of category (or group of categories) for an individual, 0 otherwise. Such a dummy variable makes it possible to have a pair of potential outcomes and oppose a category (or a group of categories) to another category (or a group of categories). Let E be a non-binary interest variable. We propose a complete disjunctive coding of our variable E. We transform the initial variable to obtain a set of binary vectors (dummy variables), E = (Ee : e ∈ {1, ..., |E|}), where each vector (variable), Ee, takes the value of 0 when its category is not present, and the value of 1 when its category is present, which allows to compute a pairwise-TMLE comparing difference in the outcome between one category and all remaining categories. In order to illustrate the application of our strategy, first, we present the implementation of TMLE to estimate the causal effect of non-binary variable on outcome using simulated data. Secondly, we apply our TMLE adaptation to survey data from the French Political Barometer (CEVIPOF), to estimate the causal effect of education level (A five-level variable) on a potential vote in favor of the French extreme right candidate Jean-Marie Le Pen. Counterfactual reasoning requires us to consider some causal questions (additional causal assumptions). Leading to different coding of E, as a set of binary vectors, E = (Ee : e ∈ {2, ..., |E|}), where each vector (variable), Ee, takes the value of 0 when the first category (reference category) is present, and the value of 1 when its category is present, which allows to apply a pairwise-TMLE comparing difference in the outcome between the first level (fixed) and each remaining level. We confirmed that the increase in the level of education decreases the voting rate for the extreme right party.

Keywords: statistical inference, causal inference, super learning, targeted maximum likelihood estimation

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Authors: Sven Borén, Lisiana Nurhadi, Henrik Ny

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From a theoretical perspective, electric buses can be more sustainable and can be cheaper than fossil fuelled buses in city traffic. The authors have not found other studies based on actual urban public transport in Swedish winter climate. Further on, noise measurements from buses for the European market were found old. The aims of this follow-up study was therefore to test and possibly verify in a real-life environment how energy efficient and silent electric buses are, and then conclude on if electric buses are preferable to use in public transport. The Ebusco 2.0 electric bus, fitted with a 311 kWh battery pack, was used and the tests were carried out during November 2014-April 2015 in eight municipalities in the south of Sweden. Six tests took place in urban traffic and two took place in more of a rural traffic setting. The energy use for propulsion was measured via logging of the internal system in the bus and via an external charging meter. The average energy use turned out to be 8% less (0,96 kWh/km) than assumed in the earlier theoretical study. This rate allows for a 320 km range in public urban traffic. The interior of the bus was kept warm by a diesel heater (biodiesel will probably be used in a future operational traffic situation), which used 0,67 kWh/km in January. This verified that electric buses can be up to 25% cheaper when used in public transport in cities for about eight years. The noise was found to be lower, primarily during acceleration, than for buses with combustion engines in urban bus traffic. According to our surveys, most passengers and drivers appreciated the silent and comfortable ride and preferred electric buses rather than combustion engine buses. Bus operators and passenger transport executives were also positive to start using electric buses for public transport. The operators did however point out that procurement processes need to account for eventual risks regarding this new technology, along with personnel education. The study revealed that it is possible to establish a charging infrastructure for almost all studied bus lines. However, design of a charging infrastructure for each municipality requires further investigations, including electric grid capacity analysis, smart location of charging points, and tailored schedules to allow fast charging. In conclusion, electric buses proved to be a preferable alternative for all stakeholders involved in public bus transport in the studied municipalities. However, in order to electric buses to be a prominent support for sustainable development, they need to be charged either by stand-alone units or via an expansion of the electric grid, and the electricity should be made from new renewable sources.

Keywords: sustainability, electric, bus, noise, greencharge

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Authors: Ahmad Alsheikh Kaddour

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Herbal medicine has been a long-standing phenomenon in Arab countries since ancient times because of its breadth and moderate temperament. Therefore, it possesses a vast natural and economic wealth of medicinal and aromatic herbs. This prompted ancient Egyptians and Arabs to discover and exploit them. The economic importance of the plant is not only from medicinal uses; it is a plant of high economic value for its various uses, especially in food, cosmetic and aromatic industries. It is also an ornamental plant and soil stabilization. The main objective of this research is to study the chemical changes that occur in the plant during the growth period, as well as the production of plant buds, which were previously considered unwanted plants. The research was carried out in the period 2021-2022 in the valley of Al-Shaflah (common caper), located in Qumhana village, 7 km north of Hama Governorate, Syria. The results of the research showed a change in the percentage of chemical components in the plant parts. The ratio of protein content and the percentage of fatty substances in fruits and the ratio of oil in the seeds until the period of harvesting of these plant parts improved, but the percentage of essential oils decreased with the progress of the plant growth, while the Glycosides content where improved with the plant aging. The production of buds is small, with dimensions as 0.5×0.5 cm, which is preferred for commercial markets, harvested every 2-3 days in quantities ranging from 0.4 to 0.5 kg in one cut/shrubs with 3 years’ age as average for the years 2021-2022. The monthly production of a shrub is between 4-5 kg per month. The productive period is 4 months approximately. This means that the seasonal production of one plant is 16-20 kg and the production of 16-20 tons per year with a plant density of 1,000 shrubs per hectare, which is the optimum rate of cultivation in the unit of mass, given the price of a kg of these buds is equivalent to 1 US $; however, this means that the annual output value of the locally produced hectare ranges from 16,000 US $ to 20,000 US $ for farmers. The results showed that it is possible to transform the cultivation of this plant from traditional random to typical areas cultivation, with a plant density of 1,000-1,100 plants per hectare according to the type of soil to obtain production of medicinal and nutritious buds, as well as, the need to pay attention to this national wealth and invest in the optimal manner, which leads to the acquisition of hard currency through export to support the national income.

Keywords: common caper, medicinal plants, propagation, medical, economic importance

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Authors: Mengestie Mulugeta Belay, Serebe Abay Gebrie, Biruk Lambbiso Wamisho, Amare Worku

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Background: Low back pain (LBP) related to nursing profession, is a very common public health problem throughout the world. Various risk factors have been implicated in the etiology and LBP is assumed to be of multi-factorial origin as individual, work-related and psychosocial factors can contribute to its development. Objectives: To determine the prevalence and to identify risk factors of LBP among nurses working in Addis Ababa City Public Hospitals, Ethiopia, in the year 2015. Settings: Addis Ababa University, Black-Lion (‘Tikur Anbessa’) Hospital-BLH, is the country’s highest tertiary level referral and teaching Hospital. The three departments in connection with this study: Radiology, Pathology and Orthopedics, run undergraduate and residency programs and receive referred patients from all over the country. Methods: A cross-sectional study with internal comparison was conducted throughout the period October-December, 2015. Sample was chosen by simple random sampling technique by taken the lists of nurses from human resource departments as a sampling frame. A well-structured, pre-tested and self-administered questionnaire was used to collect quantifiable information. The questionnaire included socio-demographic, back pain features, consequences of back pain, work-related and psychosocial factors. The collected data was entered into EpiInfo version 3.5.4 and was analyzed by SPSS. A probability level of 0.05 or less and 95% confidence level was used to indicate statistical significance. Ethical clearance was obtained from all respected administrative bodies, Hospitals and study participants. Results: The study included 395 nurses and gave a response rate of 91.9%. The mean age was 30.6 (±8.4) years. Majority of the respondents were female (285, 72.2%). Nearly half of the participants (n=181, 45.8% (95% CI (40.8%- 50.6%))) were complained low back pain. There was statistical significant association between low back pain and working shift, physical activities at work; sleep disturbance and felt little pleasure by doing things. Conclusion: A high prevalence of low back pain was found among nurses working in Addis Ababa Public Hospitals. Recognition and preventive measures like providing resting periods should be taken to reduce the risk of low back pain in nurses working in Public hospitals.

Keywords: low back pain, risk factors, nurses, public hospitals

Procedia PDF Downloads 309

Authors: Kaushal Kishore, Vaibhav Jain, Hrishikesh Jugade, Saurabh Hadas, Manashi Adhikary, Goutam Mukhopadhyay, Sandip Bhattacharyya

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Rotary air compressors in air conditioners are used to suck excessive volume of air from the atmosphere in a small space to provide drive to the components attached to them. Hydraulic test is one of the most important methods to decide the suitability of these components for usage. In the present application, projection welding is used to join the hot rolled steel sheets after forming for manufacturing of air compressors. These sheets belong to two different high strength low alloy (HSLA) steel grades. It was observed that one batch of compressors made of a particular grade was cracking from the weld, whereas those made of another grade were passing the hydraulic tests. Cracking was repeatedly observed from the weld location. A detailed comparative study of the compressors which failed and successfully passed pressure tests has been presented. Location of crack initiation was identified to be the interface of fusion zone/heat affected zone. Shear dimples were observed on the fracture surface confirming the ductile mode of failure. Hardness profile across the weld revealed a sharp rise in hardness in the fusion zone. This was attributed to the presence of untempered martensitic lath in the fusion zone. A sharp metallurgical notch existed at the heat affected zone/fusion zone interface due to transition in microstructure from acicular ferrite and bainite in HAZ to untempered martensite in the fusion zone. In contrast, welds which did not fail during the pressure tests showed a smooth hardness profile with no abnormal rise in hardness in the fusion zone. The bainitic microstructure was observed in the fusion zone of successful welds. This difference in microstructural constituents in the fusion zone was attributed to the presence of a small amount of boron (0.002 wt. %) in the sheets which were cracking. Trace amount of boron is known to substantially increase the hardenability of HSLA steel, and cooling rate during resolidification in the fusion zone is sufficient to form martensite. Post-weld heat treatment was recommended to transform untempered martensite to tempered martensite with lower hardness.

Keywords: compressor, cracking, martensite, weld, boron, hardenability, high strength low alloy steel

Procedia PDF Downloads 166

Authors: Elena Listo Ubeda, Miguel Marchamalo Sacristan

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The demand for water doubles every twenty years, at a rate which is twice as fast as the world´s population growth. Despite it´s great importance, water is one of the most degraded natural resources in the world, mainly because of the reduction of natural vegetation coverage, population growth, contamination and changes in the soil use which reduces its capacity to collect water. This situation is especially serious in Central America, as reflected in the Human Development reports. The objective of this project is to assist in the improvement of water production and quality in Central America. In order to do these two watersheds in Costa Rica were selected as experiments: that of the Virilla-Durazno River, located in the extreme north east of the central valley which has an Atlantic influence; and that of the Jabillo River, which flows directly into the Pacific. The Virilla river watershed is located over andisols, and that of the Jabillo River is over alfisols, and both are of great importance for water supply to the Greater Metropolitan Area and the future tourist resorts respectively, as well as for the production of agriculture, livestock and hydroelectricity. The hydrological reaction in different soil-cover complexes, varying from the secondary forest to natural vegetation and degraded pasture, was analyzed according to the evaluation of the properties of the soil, infiltration, soil compaction, as well as the effects of the soil cover complex on erosion, calculated by the C factor of the Revised Universal Soil Loss Equation (RUSLE). A water balance was defined for each watershed, in which the volume of water that enters and leaves were estimated, as well as the evapotranspiration, runoff, and infiltration. Two future scenarios, representing the implementation of reforestation and deforestation plans, were proposed, and were analyzed for the effects of the soil cover complex on the water balance in each case. The results obtained show an increase of the ground water recharge in the humid forest areas, and an extension of the study of the dry areas is proposed since the ground water recharge here is diminishing. These results are of great significance for the planning, design of Payment Schemes for Environmental Services and the improvement of the existing water supply systems. In Central America spatial planning is a priority, as are the watersheds, in order to assess the water resource socially and economically, and securing its availability for the future.

Keywords: Costa Rica, infiltration, soil, water

Procedia PDF Downloads 384

Authors: Daniel Bülz, Franziska Lüttich, Sreetama Banerjee, Georgeta Salvan, Dietrich R. T. Zahn

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For the development of electronics, organic semiconductors are of great interest due to their adjustable optical and electrical properties. Especially for spintronic applications they are interesting because of their weak spin scattering, which leads to longer spin life times compared to inorganic semiconductors. It was shown that some organic materials change their resistance if an external magnetic field is applied. Pentacene is one of the materials which exhibit the so called photoinduced magnetoresistance which results in a modulation of photocurrent when varying the external magnetic field. Also the soluble derivate of pentacene, the 6,13-bis (triisopropylsilylethynyl)-pentacene (TIPS-pentacene) exhibits the same negative magnetoresistance. Aiming for simpler fabrication processes, in this work, we compare TIPS-pentacene organic field effect transistors (OFETs) made from solution with those fabricated by thermal evaporation. Because of the different processing, the TIPS-pentacene thin films exhibit different morphologies in terms of crystal size and homogeneity of the substrate coverage. On the other hand, the interface treatment is known to have a high influence on the threshold voltage, eliminating trap states of silicon oxide at the gate electrode and thereby changing the electrical switching response of the transistors. Therefore, we investigate the influence of interface treatment using octadecyltrichlorosilane (OTS) or using a simple cleaning procedure with acetone, ethanol, and deionized water. The transistors consist of a prestructured OFET substrates including gate, source, and drain electrodes, on top of which TIPS-pentacene dissolved in a mixture of tetralin and toluene is deposited by drop-, spray-, and spin-coating. Thereafter we keep the sample for one hour at a temperature of 60 °C. For the transistor fabrication by thermal evaporation the prestructured OFET substrates are also kept at a temperature of 60 °C during deposition with a rate of 0.3 nm/min and at a pressure below 10-6 mbar. The OFETs are characterized by means of optical microscopy in order to determine the overall quality of the sample, i.e. crystal size and coverage of the channel region. The output and transfer characteristics are measured in the dark and under illumination provided by a white light LED in the spectral range from 450 nm to 650 nm with a power density of (8±2) mW/cm2.

Keywords: organic field effect transistors, solution processed, surface treatment, TIPS-pentacene

Procedia PDF Downloads 446

Authors: M. Turmanauli, T. Todua, O. Gvaberidze, R. Javakhadze, N. Chkhaidze, N. Khatiashvili

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Background: Mining process has the significant influence on human health and quality of life. In recent years the events in Georgia were reflected on the industry working process, especially minimal requirements of labor safety, hygiene standards of workplace and the regime of work and rest are not observed. This situation is often caused by the lack of responsibility, awareness, and knowledge both of workers and employers. The control of working conditions and its protection has been worsened in many of industries. Materials and Methods: For evaluation of the current situation the prospective epidemiological study by face to face interview method was conducted at Georgian “Manganese Zestafoni Ferroalloy Plant” in 2011-2013. 65.7% of employees (1428 bulletin) were surveyed and the incidence rates of temporary disability days were studied. Results: The average length of a temporary disability single accident was studied taking into consideration as sex groups as well as the whole cohort. According to the classes of harmfulness the following results were received: Class 2.0-10.3%; 3.1-12.4%; 3.2-35.1%; 3.3-12.1%; 3.4-17.6%; 4.0-12.5%. Among the employees 47.5% and 83.1% were tobacco and alcohol consumers respectively. According to the age groups and years of work on the base of previous experience ≥50 ages and ≥21 years of work data prevalence respectively. The obtained data revealed increased morbidity rate according to age and years of work. It was found that the bone and articulate system and connective tissue diseases, aggravation of chronic respiratory diseases, ischemic heart diseases, hypertension and cerebral blood discirculation were the leading among the other diseases. High prevalence of morbidity observed in the workplace with not satisfactory labor conditions from the hygienic point of view. Conclusion: According to received data the causes of morbidity are the followings: unsafety labor conditions; incomplete of preventive medical examinations (preliminary and periodic); lack of access to appropriate health care services; derangement of gathering, recording, and analysis of morbidity data. This epidemiological study was conducted at the JSC “Manganese Ferro Alloy Plant” according to State program “ Prevention of Occupational Diseases” (Program code is 35 03 02 05).

Keywords: occupational health, mining process, morbidity level, cerebral blood discirculation

Procedia PDF Downloads 427

Authors: Fouzia Brihmat

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Economic planning models, which are used to build microgrids and distributed energy resources, are the current norm for expressing such confidence (DER). These models often decide both short-term DER dispatch and long-term DER investments. This research investigates the most cost-effective hybrid (photovoltaic-diesel) renewable energy system (HRES) based on Total Net Present Cost (TNPC) in an Algerian Saharan area, which has a high potential for solar irradiation and has a production capacity of 1GW/h. Lead-acid batteries have been around much longer and are easier to understand, but have limited storage capacity. Lithium-ion batteries last longer, are lighter, but generally more expensive. By combining the advantages of each chemistry, we produce cost-effective high-capacity battery banks that operate solely on AC coupling. The financial implications of this research describe the corrosion process that occurs at the interface between the active material and grid material of the positive plate of a lead-acid battery. The best cost study for the HRES is completed with the assistance of the HOMER Pro MATLAB Link. Additionally, during the course of the project's 20 years, the system is simulated for each time step. In this model, which takes into consideration decline in solar efficiency, changes in battery storage levels over time, and rises in fuel prices above the rate of inflation. The trade-off is that the model is more accurate, but it took longer to compute. As a consequence, the model is more precise, but the computation takes longer. We initially utilized the Optimizer to run the model without MultiYear in order to discover the best system architecture. The optimal system for the single-year scenario is the Danvest generator, which has 760 kW, 200 kWh of the necessary quantity of lead-acid storage, and a somewhat lower COE of $0.309/kWh. Different scenarios that account for fluctuations in the gasified biomass generator's production of electricity have been simulated, and various strategies to guarantee the balance between generation and consumption have been investigated. The technological optimization of the same system has been finished and is being reviewed in a recent paper study.

Keywords: battery, corrosion, diesel, economic planning optimization, hybrid energy system, lead-acid battery, multi-year planning, microgrid, price forecast, PV, total net present cost

Procedia PDF Downloads 86

Authors: Priya Jaswal, Vivek, S. K. Sinha

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One of the most important and complicated factors influencing the functional performance of unpaved roads is traffic loading. The complexity of traffic loading is caused by the variable magnitude and frequency of load, which causes unpaved roads to fail prematurely. Unpaved roads are low-volume roads, and as peri-urbanization increases, unpaved roads act as a means to boost the rural economy. This has also increased traffic on unpaved roads, intensifying the issue of settlement, rutting, and fatigue failure. This is a major concern for unpaved roads built on poor subgrade soil, as excessive rutting caused by heavy loads can cause driver discomfort, vehicle damage, and an increase in maintenance costs. Some researchers discovered that when a consistent static load is exerted as opposed to a rapidly changing load, the rate of deformation of unpaved roads increases. Previously, some of the most common methods for overcoming the problem of rutting and fatigue failure included chemical stabilisation, fibre reinforcement, and so on. However, due to their high cost, engineers' attention has shifted to geotextiles which are used as reinforcement in unpaved roads. Geotextiles perform the function of filtration, lateral confinement of base material, vertical restraint of subgrade soil, and the tension membrane effect. The use of geotextiles in unpaved roads increases the strength of unpaved roads and is an economically viable method because it reduces the required aggregate thickness, which would need less earthwork, and is thus recommended for unpaved road applications. The majority of geotextiles used previously were polymeric, but with a growing awareness of sustainable development to preserve the environment, researchers' focus has shifted to natural fibres. Coir is one such natural fibre that possesses the advantage of having a higher tensile strength than other bast fibres, being eco-friendly, low in cost, and biodegradable. However, various researchers have discovered that the surface of coir fibre is covered with various impurities, voids, and cracks, which act as a plane of weakness and limit the potential application of coir geotextiles. To overcome this limitation, chemical surface modification of coir geotextiles is widely accepted by researchers because it improves the mechanical properties of coir geotextiles. The current paper reviews the effect of using treated coir geotextiles as reinforcement on the load-deformation behaviour of a two-layered unpaved road model.

Keywords: coir, geotextile, treated, unpaved

Procedia PDF Downloads 91

Authors: Ahmed Abdulfatah Yusuf, Collins Oduor Ondiek

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The automation of farming activities can have a transformational impact on the agricultural sector, especially from the emerging new technologies such as the Internet of Things (IoT). The system uses water level sensors and soil moisture sensors that measure the content of water in the soil as the values generated from the sensors enable the system to use an appropriate quantity of water, which avoids over or under irrigation. Due to the increase in the world’s population, there is a need to increase food production. With this demand in place, it is difficult to increase crop yield using the traditional manual approaches that lead to the wastage of water, thus affecting crop production. Food insecurity has become a scourge greatly affecting the developing countries and agriculture is an essential part of human life and tends to be the mainstay of the economy in most developing nations. Thus, without the provision of adequate food supplies, the population of those living in poverty is likely to multiply. The project’s main objective is to design and develop an IoT (Internet of Things) microcontroller-based Smart Irrigation System. In addition, the specific research objectives are to find out the challenges with traditional irrigation approaches and to determine the benefits of IoT-based smart irrigation systems. Furthermore, the system includes Arduino, a website and a database that works simultaneously in collecting and storing the data. The system is designed to pave the way in attaining the Sustainable Development Goal (SDG 1), which aims to end extreme poverty in all forms by 2030. The research design aimed at this project is a descriptive research design. Data was gathered through online questionnaires that used both quantitative and qualitative in order to triangulate the data. Out of the 32 questionnaires sent, there were 32 responses leading to a 100% response rate. In terms of sampling, the target group of this project is urban farmers, which account for about 25% of the population of Nairobi. From the findings of the research carried out, it is evident that there is a need to move away from manual irrigation approaches due to the high wastage of water to the use of smart irrigation systems that propose a better way of conserving water while maintaining the quality and moisture of the soil. The research also found out that urban farmers are willing to adopt this system to better their farming practices. However, this system can be improved in the future by incorporating it with other features and deploying it to a larger geographical area.

Keywords: crop production, food security, smart irrigation system, sustainable development goal

Procedia PDF Downloads 150

Authors: Lin Po-Hsi, Sheu Ming-Thau

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Urea cycle disorders (UCD) are rare genetic metabolic disorders that compromise the body's urea cycle. Sodium phenylbutyrate (SPB) is a medication commonly administered in tablet or powder form to lower ammonia levels. Nonetheless, its high sodium content poses risks to sodium-sensitive UCD patients. This necessitates the creation of an alternative drug formulation to mitigate sodium load and optimize drug delivery for UCD patients. This study focused on crafting a novel oral drug formulation for UCD, leveraging choline bicarbonate and phenylbutyric acid. The active pharmaceutical ingredient-ionic liquids (API-ILs) and therapeutic deep eutectic systems (THEDES) were formed by combining these with choline chloride. These systems display characteristics like maintaining a liquid state at room temperature and exhibiting enhanced solubility. This in turn amplifies drug dissolution rate, permeability, and ultimately oral bioavailability. Incorporating choline-based phenylbutyric acid as a substitute for traditional SPB can effectively curtail the sodium load in UCD patients. Our in vitro dissolution experiments revealed that the ILs and DESs, synthesized using choline bicarbonate and choline chloride with phenylbutyric acid, surpassed commercial tablets in dissolution speed. Pharmacokinetic evaluations in SD rats indicated a notable uptick in the oral bioavailability of phenylbutyric acid, underscoring the efficacy of choline salt ILs in augmenting its bioavailability. Additional in vitro intestinal permeability tests on SD rats authenticated that the ILs, formulated with choline bicarbonate and phenylbutyric acid, demonstrate superior permeability compared to their sodium and acid counterparts. To conclude, choline salt ILs developed from choline bicarbonate and phenylbutyric acid present a promising avenue for UCD treatment, with the added benefit of reduced sodium load. They also hold merit in formulation engineering. The sustained-release capabilities of DESs position them favorably for drug delivery, while the low toxicity and cost-effectiveness of choline chloride signal potential in formulation engineering. Overall, this drug formulation heralds a prospective therapeutic avenue for UCD patients.

Keywords: phenylbutyric acid, sodium phenylbutyrate, choline salt, ionic liquids, deep eutectic systems, oral bioavailability

Procedia PDF Downloads 113

Authors: Karolina Mazur, Stanislaw Kuciel

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Polylactides (PLA) and polyhydroxyalkanoates (PHA) are the two groups of biodegradable and biocompatible thermoplastic polymers most commonly utilised in medicine and rehabilitation. The aim of this work is to determine the changes in the strength properties and the microstructures taking place in biodegradable polymer composites during their long-term storage in a highly cooled environment (i.e. a freezer at -24ºC) and to initially assess the durability of such biocomposites when used as single-use elements of rehabilitation or medical equipment. It is difficult to find any information relating to the feasibility of long-term storage of technical products made of PLA or PHA, but nonetheless, when using these materials to make products such as casings of hair dryers, laptops or mobile phones, it is safe to assume that without storing in optimal conditions their degradation time might last even several years. SEM images and the assessment of the strength properties (tensile, bending and impact testing) were carried out and the density and water sorption of two polymers, PLA and PHA (NaturePlast PLE 001 and PHE 001), filled with cellulose fibres (corncob grain – Rehofix MK100, Rettenmaier&Sohne) up to 10 and 20% mass were determined. The biocomposites had been stored at a temperature of -24ºC for 4 years. In order to find out the changes in the strength properties and the microstructure taking place after such a long time of storage, the results of the assessment have been compared with the results of the same research carried out 4 years before. Results shows a significant change in the manner of fractures – from ductile with developed surface for the PHA composite with corncob grain when the tensile testing was performed directly after the injection into a more brittle state after 4 years of storage, which is confirmed by the strength tests, where a decrease of deformation is observed at point of fracture. The research showed that there is a way of storing medical devices made out of PLA or PHA for a reasonably long time, as long as the required temperature of storage is met. The decrease of mechanical properties found during tensile testing and bending for PLA was less than 10% of the tensile strength, while the modulus of elasticity and deformation at fracturing slightly rose, which may implicate the beginning of degradation processes. The strength properties of PHA are even higher after 4 years of storage, although in that case the decrease of deformation at fracturing is significant, reaching even 40%, which suggests its degradation rate is higher than that of PLA. The addition of natural particles in both cases only slightly increases the biodegradation.

Keywords: biocomposites, PLA, PHA, storage

Procedia PDF Downloads 264

Authors: Hailemariam Getachew, John Sandi, Isata Dumbuya, Patricia Efe.Azikiwe, Evaline Nginge, Moses Mugisha, Eseoghene Dase, Foday Mandaray, Grace Moore

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Enhanced recovery after cesarean section (ERAC) is a standardized peri- operative care program that comprises the multidisciplinary team's collective efforts working in collaboration throughout the peri-operative period with the principal goal to improve quality of surgical care, decrease surgical related complications, and increasing patient satisfaction. Objective: The main objective of this project is to improve the implementation of enhanced recovery after cesarean section at Koidu Government hospital. Identified gap: Even though the hospital is providing comprehensive maternal and child care service, there are gaps in the implementation of ERAC. According to our survey, we found that there is low (13.3%) utilization of WHO surgical safety checklist, only limited (15.9%) patients get opioid free analgesia, pain was not recorded as a vital sign, there is no standardized checklist for hand over to and from Post Anesthesia care Unit(PACU). Furthermore, there is inconsistent evidence based post-operative care and there is no local consensus protocol and guideline as well. Implementation plan: we aimed at designing standardized protocol, checklist and guideline, provide training, build staff capacity, document pain as vital sign, perform regional analgesia, and provide evidence based post-operative care, monitoring and evaluation. Result: Data from 389 cesarean mothers showed that, Utilization of the WHO surgical safety check list found to be 95%, and pain assessment and documentation was done for all surgical patients. Oral feeding, ambulation and catheter removal was performed as per the ERAC standard for all patients. Postoperative complications drastically decreased from 13.6% to 8.1%. While, the rate of readmission was kept below 1%. Furthermore, the duration of hospital stay decreased from 4.64 days to 3.12 days. Conclusion The successful implementation of ERAC protocols demonstrates through this Quality Improvement Project that, the effectiveness of the protocols in improving recovery and patient outcome following cesarean section.

Keywords: cesarean delivery, enhanced recovery, quality improvement, patient outcome

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Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

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Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

Procedia PDF Downloads 131

Authors: M. Bhattarai, B. B. Rana, M. Kamimukai, I. Takamure, T. Kawano, M. Murai

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The sd1-d allele at the sd1 locus on chromosome 1, originating from Taiwanese variety Dee-geo-woo-gen, has been playing important role for developing short-culm and lodging-resistant indica varieties such as IR36 in rice. The dominant allele SD1 for long culm at the locus is differentiated into SD1-in and SD1-ja which are harbored in indica and japonica subspecies’s, respectively. The sd1-d of an indica variety IR36 was substituted with SD1-in or SD1-ja by recurrent backcrosses of 17 times with IR36, and two isogenic tall lines regarding the respective dominant alleles were developed by using an indica variety IR5867 and a japonica one ‘Koshihikari’ as donors, which were denoted by '5867-36' and 'Koshi-36', respectively. The present study was conducted to examine the effect of sd1-d on yield and related traits as compared with SD1-in and SD1-ja, by using the two isogenic tall lines. Seedlings of IR36 and the two isogenic lines were transplanted on an experimental field of Kochi University, by the planting distance of 30 cm × 15 cm with two seedlings per hill, on May 3, 2017. Chemical fertilizers were supplied by basal application and top-dressing at a rate of 8.00, 6.57 and 7.52 g/m², respectively, for N, P₂O₅ and K₂O in total. Yield, yield components, and other traits were measured. Culm length (cm) was in the order of 5867-36 (101.9) > Koshi-36 (80.1) > IR36 (60.0), where '>' indicates statistically significant difference at the 5% level. Accordingly, sd1-d reduced culm by 41.9 and 20.1 cm, compared with SD1-in and SD1-ja, respectively, and the effect of elongating culm was higher in the former allele than in the latter one. Total brown rice yield (g/m²), including unripened grains, was in the order of IR36 (611) ≧ 5867-36 (586) ≧ Koshi-36 (572), indicating non-significant differences among them. Yield-1.5mm sieve (g/m²) was in the order of IR36 (596) ≧ 5867-36 (575) ≧ Koshi-36 (558). Spikelet number per panicle was in the order of 5867-36 (89.2) ≧ IR36 (84.7) ≧ Koshi-36 (79.8), and 5867-36 > Koshi-36. Panicle number per m² was in the order of IR36 (428) ≧ Koshi-36 (403) ≧ 5867-36 (353), and IR36 > 5867-36, suggesting that sd1-d increased number of panicles compared with SD1-in. Ripened-grain percentage-1.5mm sieve was in the order of Koshi-36 (86.0) ≧ 5867-36 (85.0) ≧ IR36 (82.7), and Koshi-36 > IR36. Thousand brown-rice-grain weight-1.5mm sieve (g) was in the order of 5867-36 (21.5) > Koshi-36 (20.2) ≧ IR36 (19.9). Total dry weight at maturity (g/m²) was in the order of 5867-36 (1404 ) ≧ IR36 (1310) ≧ Kosihi-36 (1290). Harvest index of total brown rice (%) was in the order of IR36 (39.6) > Koshi-36 (37.7) > 5867-36 (35.5). Hence, sd1-d did not exert significant effect on yield in indica genetic background. However, lodging was observed from the late stage of maturity in 5867-36 and Koshi-36, particularly in the former, which was principally due to their long culms. Consequently, sd1-d enables higher yield with higher fertilizer application, by enhancing lodging resistance, particularly in indica subspecies.

Keywords: rice, dwarfing gene, sd1-d, SD1-in, SD1-ja, yield

Procedia PDF Downloads 167

Authors: Ajay Mandal, Jitendar Kumar Tiwari, N. Sathish, A. K. Srivastava

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A fundamental investigation is performed on the development of graphene (Gr) reinforced stainless steel 316L (SS 316L) metal matrix composite via selective laser melting (SLM) in order to improve specific strength and wear resistance property of SS 316L. Firstly, SS 316L powder and graphene were mixed in a fixed ratio using low energy planetary ball milling. The milled powder is then subjected to the SLM process to fabricate composite samples at a laser power of 320 W and exposure time of 100 µs. The prepared composite was mechanically tested (hardness and tensile test) at ambient temperature, and obtained results indicate that the properties of the composite increased significantly with the addition of 0.2 wt. % Gr. Increment of about 25% (from 194 to 242 HV) and 70% (from 502 to 850 MPa) is obtained in hardness and yield strength of composite, respectively. Raman mapping and XRD were performed to see the distribution of Gr in the matrix and its effect on the formation of carbide, respectively. Results of Raman mapping show the uniform distribution of graphene inside the matrix. Electron back scatter diffraction (EBSD) map of the prepared composite was analyzed under FESEM in order to understand the microstructure and grain orientation. Due to thermal gradient, elongated grains were observed along the building direction, and grains get finer with the addition of Gr. Most of the mechanical components are subjected to several types of wear conditions. Therefore, it is very necessary to improve the wear property of the component, and hence apart from strength and hardness, a tribological property of composite was also measured under dry sliding condition. Solid lubrication property of Gr plays an important role during the sliding process due to which the wear rate of composite reduces up to 58%. Also, the surface roughness of worn surface reduces up to 70% as measured by 3D surface profilometry. Finally, it can be concluded that SLM is an efficient method of fabricating cutting edge metal matrix nano-composite having Gr like reinforcement, which was very difficult to fabricate through conventional manufacturing techniques. Prepared composite has superior mechanical and tribological properties and can be used for a wide variety of engineering applications. However, due to the unavailability of a considerable amount of literature in a similar domain, more experimental works need to perform, such as thermal property analysis, and is a part of ongoing study.

Keywords: selective laser melting, graphene, composite, mechanical property, tribological property

Procedia PDF Downloads 135

Authors: Asli Tiktas, Huseyin Gunerhan, Arif Hepbasli

Abstract:

Solar energy, with its abundant and clean features, is one of the prominent renewable energy sources in multigeneration energy systems where various outputs, especially power generation, are produced together. In the literature, concentrated solar energy systems, which are an expensive technology, are mostly used in solar power plants where medium-high capacity production outputs are achieved. In addition, although different methods have been developed and proposed for solar energy-supported integrated power generation systems by different investigators, absorption technology, which is one of the key points of the present study, has been used extensively in cooling systems in these studies. Unlike these common uses mentioned in the literature, this study designs a system in which a flat plate solar collector (FPSC), Rankine cycle, absorption heat transformer (AHT), and cooling systems (ACS) are integrated. The system proposed within the scope of this study aims to produce medium-high-capacity electricity, heating, and cooling outputs using a technique different from the literature, with lower production costs than existing systems. With the proposed integrated system design, the average production costs based on electricity, heating, and cooling load production for similar scale systems are 5-10% of the average production costs of 0.685 USD/kWh, 0.247 USD/kWh, and 0.342 USD/kWh. In the proposed integrated system design, this will be achieved by increasing the outlet temperature of the AHT and FPSC system first, expanding the high-temperature steam coming out of the absorber of the AHT system in the turbine up to the condenser temperature of the ACS system, and next directly integrating it into the evaporator of this system and then completing the AHT cycle. Through this proposed system, heating and cooling will be carried out by completing the AHT and ACS cycles, respectively, while power generation will be provided because of the expansion of the turbine. Using only a single generator in the production of these three outputs together, the costs of additional boilers and the need for a heat source are also saved. In order to demonstrate that the system proposed in this study offers a more optimum solution, the techno-economic parameters obtained based on energy, exergy, economic, and environmental analysis were compared with the parameters of similar scale systems in the literature. The design parameters of the proposed system were determined through a parametric optimization study to exceed the maximum efficiency and effectiveness and reduce the production cost rate values of the compared systems.

Keywords: solar energy, absorption technology, Rankine cycle, multigeneration energy system

Procedia PDF Downloads 55

Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz

Abstract:

Objective: Serratia species are identified as aerobic, motile Gram negative rods. The species Serratia marcescens (S. marcescens) causes both opportunistic and nosocomial infections. The genus Providencia is Gram-negative bacilli and includes urease-producing that is responsible for a wide range of human infections. Although most Providencia infections involve the urinary tract, they are also associated with gastroenteritis, wound infections, and bacteremia. The aim of this study was evaluate the antimicrobial resistance rates of S. marcescens and Providencia spp. strains which had been isolated from various clinical materials obtained from different patients who belongs to intensive care units (ICU) and inpatient clinics. Methods: A total of 35 S. marcescens and Providencia spp. strains isolated from various clinical samples admitted to Medical Microbiology Laboratory, ANS Research and Practice Hospital, Afyon Kocatepe University between October 2013 and September 2015 were included in the study. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bio-Merieux, Marcy l’etoile, France) was used additionally. Antibacterial resistance tests were performed by using Kirby Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: The distribution of clinical samples were as follows: upper and lower respiratory tract samples 26, 74.2 % wound specimen 6, 17.1 % blood cultures 3, 8.5%. Of the 35 S. marcescens and Providencia spp. strains; 28, 80% were isolated from clinical samples sent from ICU. The resistance rates of S. marcescens strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 8.5 %, 22.8 %, 11.4 %, 2.8 %, 17.1 %, 40 %, 28.5 % and 5.7 % respectively. Resistance rates of Providencia spp. strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 10.2 %, 33,3 %, 18.7 %, 8.7 %, 13.2 %, 38.6 %, 26.7%, and 11.8 % respectively. Conclusion: S. marcescens is usually resistant to ampicillin, amoxicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefuroxime, cephamycins, nitrofurantoin, and colistin. The most effective antibiotic on the total of S. marcescens strains was found to be gentamicin 2.8 %, of the totally tested strains the highest resistance rate found against to ceftazidime 40 %. The lowest and highest resistance rates were found against gentamiycin and ceftazidime with the rates of 8.7 % and 38.6 % for Providencia spp.

Keywords: Serratia marcescens, Providencia spp., antibiotic resistance, intensive care unit

Procedia PDF Downloads 243