Search results for: Douglas Dunn

Authors: Alvin Han, Reema Shafi, Alishba Afaq, Jennifer Gommerman, Valeria Ramaglia, Shannon E. Dunn

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Adolescents engaged in contact-sports can suffer from recurrent brain concussions with no loss of consciousness and no need for hospitalization, yet they face the possibility of long-term neurocognitive problems. Recent studies suggest that head concussive injuries during adolescence can also predispose individuals to multiple sclerosis (MS). The underlying mechanisms of how brain concussions predispose to MS is not understood. Here, we hypothesize that: (1) recurrent brain concussions prime microglial cells, the tissue resident myeloid cells of the brain, setting them up for exacerbated responses when exposed to additional challenges later in life; and (2) brain concussions lead to the sensitization of myelin-specific T cells in the peripheral lymphoid organs. Towards addressing these hypotheses, we implemented a mouse model of closed head injury that uses a weight-drop device. First, we calibrated the model in male 12 week-old mice and established that a weight drop from a 3 cm height induced mild neurological symptoms (mean neurological score of 1.6+0.4 at 1 hour post-injury) from which the mice fully recovered by 72 hours post-trauma. Then, we performed immunohistochemistry on the brain of concussed mice at 72 hours post-trauma. Despite mice having recovered from all neurological symptoms, immunostaining for leukocytes (CD45) and IBA-1 revealed no peripheral immune infiltration, but an increase in the intensity of IBA1+ staining compared to uninjured controls, suggesting that resident microglia had acquired a more active phenotype. This microglia activation was most apparent in the white matter tracts in the brain and in the olfactory bulb. Immunostaining for the microglia-specific homeostatic marker TMEM119, showed a reduction in TMEM119+ area in the brain of concussed mice compared to uninjured controls, confirming a loss of this homeostatic signal by microglia after injury. Future studies will test whether single or repetitive concussive injury can worsen or accelerate autoimmunity in male and female mice. Understanding these mechanisms will guide the development of timed and targeted therapies to prevent MS from getting started in people at risk.

Keywords: concussion, microglia, microglial priming, multiple sclerosis

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Authors: Douglas Nyathi, Mxolisi Sibanda, Joram Ndlovuu, Thulani Dube, Innocent T. Mahiya

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Communication of sexual matters between the parents and adolescents has been seen as one of the strategies that could play a cardinal role in encouraging adolescents to be responsible and delay sexual debut or avoid unprotected sexual intercourse. The increasing rate of teenage pregnancies and new HIV/AIDS infections among adolescents in Sub-Saharan Africa makes the phenomenon worth analysis. The purpose of this paper is to interrogate the dynamics of parent-adolescent communication on sexual and reproductive health in Sub-Sahara. Specifically the paper focuses on barriers to communication between parents and adolescents on sexual and reproductive health and its policy implications. It emanates from the paper that communication on sexual and reproductive health at household level is triggered by death of a relative from a sexual related illness, suspicion on sexual activity, radio programmes and in some instances fliers. Literature engagement reveals that communication between parents and adolescents on sexual and reproductive health is made difficult by economic factors (poverty, lack of privacy and low self-esteem), household demographics (age, sex, class, death), socio-cultural factors (beliefs and religious values) as well as social media. We argue that there is need to use broadcast mediato come up with radio and television programmes that create family environments in which sexual and reproductive health issues are discussed. We also recommend that government departments and Non-Governmental Organisations concerned with sexuality issues need to undertake studies that can help dismantle taboos, prejudices and stereotypes that impede sexual and reproductive health communication between parents and adolescents.

Keywords: parent, adolecsent, communication, sexual and reproductive health

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Authors: Zhihao Zhao, Ali El-Nagger, Johnson Kau, Chris Olson, Douglas Tomlinson, Scott X. Chang

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One strategy to reduce CO₂ emissions from cement production is to reduce the amount of Portland cement produced by replacing it with supplementary cementitious materials (SCMs). Biochar is a potential SCM that is an eco-friendly and stable porous pyrolytic material. However, the effects of biochar addition on the performances of Portland cement composites are not fully understood. This meta-analysis investigated the impact of biochar addition on the 7- and 28-day compressive strength of Portland cement composites based on 606 paired observations. Biochar feedstock type, pyrolysis conditions, pre-treatments and modifications, biochar dosage, and curing type all influenced the compressive strength of Portland cement composites. Biochars obtained from plant-based feedstocks (except rice and hardwood) improved the 28-day compressive strength of Portland cement composites by 3-13%. Biochars produced at pyrolysis temperatures higher than 450 °C, with a heating rate of around 10 °C/min, increased the 28-day compressive strength more effectively. Furthermore, the addition of biochars with small particle sizes increased the compressive strength of Portland cement composites by 2-7% compared to those without biochar addition. Biochar dosage of < 2.5% of the binder weight enhanced both compressive strengths and common curing methods maintained the effect of biochar addition. However, when mixing the cement, adding fine and coarse aggregates such as sand and gravel affects the concrete and mortar's compressive strength, diminishing the effect of biochar addition and making the biochar effect nonsignificant. We conclude that appropriate biochar addition could maintain or enhance the mechanical performance of Portland cement composites, and future research should explore the mechanisms of biochar effects on the performance of cement composites.

Keywords: biochar, Portland cement, constructure, compressive strength, meta-analysis

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Authors: Juni C. Kim, Anna R. Robuck, Douglas I. Walker

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The human exposome, which includes chemical exposures over the lifetime and their effects, is now recognized as an important measure for understanding human health; however, the complexity of the data makes the identification of environmental chemicals challenging. The goal of our project was to establish a computational workflow for the improved identification of environmental pollutants containing chlorine or bromine. Using the “pattern. search” function available in the R package NonTarget, we wrote a multifunctional script that searches mass spectral clusters from untargeted gas-chromatography high-resolution mass spectrometry (GC-HRMS) for the presence of spectra consistent with chlorine and bromine-containing organic compounds. The “pattern. search” function was incorporated into a different function that allows the evaluation of clusters containing multiple analyte fragments, has multi-core support, and provides a simplified output identifying listing compounds containing chlorine and/or bromine. The new function was able to process 46,000 spectral clusters in under 8 seconds and identified over 150 potential halogenated spectra. We next applied our function to a deidentified dataset from patients diagnosed with primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and healthy controls. Twenty-two spectra corresponded to potential halogenated compounds in the PSC and PBC dataset, including six significantly different in PBC patients, while four differed in PSC patients. We have developed an improved algorithm for detecting halogenated compounds in GC-HRMS data, providing a strategy for prioritizing exposures in the study of human disease.

Keywords: exposome, metabolome, computational metabolomics, high-resolution mass spectrometry, exposure, pollutants

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Nour Mohamad Fayad

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Complex and extensively researched, the impact of corruption on economic growth seems to be intricate. Many experts believe that corruption reduces economic development. However, counterarguments have suggested that corruption either promotes growth and development or has no significant impact on economic performance. Clearly, there is no consensus in the economics literature regarding the possible relationship between corruption and economic development. Corruption's complex and clandestine nature, which makes it difficult to define and measure, is one of the obstacles that must be overcome when investigating its effect on an economy. In an attempt to contribute to the ongoing debate, this study examines the impact of corruption on economic growth in the Middle East and North Africa (MENA) region between 2000 and 2021 using a Customized Corruption Index-CCI and panel data on MENA countries. These countries were selected because they are understudied in the economic literature, and despite the World Bank's recent emphasis on corruption in the developing world, the MENA countries have received little attention. The researcher used Cobb-Douglas functional form to test corruption in MENA using a customized index known as Customized Corruption Index-CCI to track corruption over almost 20 years, then used the dynamic panel data. The findings indicate that there is a positive correlation between corruption and economic growth, but this is not consistent across all MENA nations. First, the relatively recent lack of data from MENA nations. This issue is related to the inaccessibility of data for many MENA countries, particularly regarding the returns on resources, private malfeasance, and other variables in Gulf countries. In addition, the researcher encountered several restrictions, such as electricity and internet outages, due to the fact that he is from Lebanon, a country whose citizens have endured difficult living conditions since the Lebanese crisis began in 2019. Demonstrating a customized index known as Customized Corruption Index-CCI that suits the characteristics of MENA countries to peculiarly measure corruption in this region, the outcome of the Customized Corruption Index-CCI is then compared to the Corruption Perception Index-CPI and Control of Corruption from World Governance Indicator-CC from WGI.

Keywords: corruption, economic growth, corruption measurements, empirical review, impact of corruption

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Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

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bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

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Authors: Riaz A. Agha, Ishani Barai, Shivanchan Rajmohan, Seon Lee, Mohammed O. Anwar, Alex J. Fowler, Dennis P. Orgill, Douglas G. Altman

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Introduction: Medical knowledge is growing fast. Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. Methods: A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results were compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. Results: 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047 to 8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the journals (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). Conclusion: The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. This will allow peer-reviewers to focus on what is present, not what is missing, raising the level of scholarly discourse between authors and the scientific community and reducing frustration amongst readers.

Keywords: CONSORT, guide for authors, PRISMA, reporting guidelines, journal impact factor, citation analysis

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Authors: Riaz A. Agha, Alexander J. Fowler, Seon-Young Lee, Buket Gundogan, Katharine Whitehurst, Harkiran K. Sagoo, Kyung Jin Lee Jeong, Douglas G. Altman, Dennis P. Orgill

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Introduction: Case Series are an important and common study type. Currently, no guideline exists for reporting case series and there is evidence of key data being missed from such reports. We propose to develop a reporting guideline for case series using a methodologically robust technique. The first step in this process is a systematic review of literature relevant to the reporting deficiencies of case series. Methods: A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, EMBASE, Cochrane Methods Register, Science Citation index and Conference Proceedings Citation index, from the start of indexing until 5th November 2014. Independent screening, eligibility assessments and data extraction was performed. Included articles were analyzed for five areas of deficiency: failure to use standardized definitions missing or selective data transparency or incomplete reporting whether alternate study designs were considered. Results: The database searching identified 2,205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequency of methodological and reporting issues identified was a failure to use standardized definitions (57%), missing or selective data (66%), transparency, or incomplete reporting (70%), whether alternate study designs were considered (11%) and other issues (52%). Conclusion: The methodological and reporting quality of surgical case series needs improvement. Our data shows that clear evidence-based guidelines for the conduct and reporting of a case series may be useful to those planning or conducting them.

Keywords: case series, reporting quality, surgery, systematic review

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Authors: Fabio R. Pires, Paulo R. C. C. Ribeiro, Douglas G. Viana, Robson Bonomo, Fernando B. Egreja Filho, Alberto Cargnelutti Filho, Luiz F. Martins, Leila B. S. Cruz, Mauro C. P. Nascimento

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The use of barite (BaSO₄) as a weighting agent in drilling fluids for oil and gas activities makes barium a potential contaminant in the case of spills onto flooded soils, where barium sulfate solubility is increased due to low redox conditions. In order to select plants able to remove barium in such scenarios, seven plant species were evaluated on barium phytoextraction capacity: Brachiaria arrecta; Cyperus cf. papyrus; Eleocharis acutangula; Eleocharis interstincta; Nephrolepsis cf. rivularis; Paspalum conspersum and Typha domingensis. Plants were grown in pots with 13 kg of soil each, and exposed to six barium concentrations (established with BaCl₂): 0; 2.5; 5.0; 10.0; 30.0; 65.0 mg kg-1. To simulate flooding conditions, every pot was manteined with a thin irrigation water depth over soil surface (~1.0 cm). Treatments were carried out in triplicate, and pots were distributed randomly inside the greenhouse. Biometric and chemical analyses were performed throughout the experiment, including Ba²⁺ accumulation in shoots and roots. The highest amount of barium was observed in T. domingensis biomass, followed by C. cf. papyrus. However, the latter exported most of the barium to shoot, especially in higher BaCl₂ doses, while the former accumulated barium preferentially in roots. Thus, barium removal with C. cf. papyrus could be achieved by simply harvesting aerial biomass. The amount of barium in C. cf. papyrus was a consequence of high biomass production rather than barium concentration in plant tissues, whereas T. domingensis showed high barium concentration in plant tissues and high biomass production as well. These results make T. domingensis and C. cf. papyrus potential candidates to be applied in phytoremediation schemes to remove barium from flooded soils.

Keywords: barium sulfate, cyperus, drilling fluids, phytoextraction, Typha

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Authors: Getinet Gezahegn Gebre

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The study examined the impact of gender differences on Crop productivity in Decha woreda of southwest Kafa zone, located 140 Km from Jimma Town and 460 km southwest of Addis Ababa, between Bonga town and Omo River. The specific objectives were to assess the extent to which the agricultural production system is gender oriented, to examine access and control over productive resources, and to estimate men’s and women’s productivity in agriculture. Cross-sectional data collected from a total of 140 respondents were used in this study, whereby 65 were female-headed and 75 were male-headed households. The data were analyzed by using Statistical Package for Social Science (SPSS). Descriptive statistics such as frequency, mean, percentage, t-test and chi-square were used to summarize and compare the information between the two groups. Moreover, Cobb-Douglas(CD) production function was used to estimate the productivity difference in agriculture between male and female-headed households. Results of the study showed that male-headed households (MHH) own more productive resources such as land, livestock, labor and other agricultural inputs as compared to female-headed households (FHH). Moreover, the estimate of CD production function shows that livestock, herbicide use, land size and male labor were statistically significant for MHH, while livestock, land size, herbicides use and female labor were significant variables for FHH. The crop productivity difference between MHH and FHH was about 68.83% in the study area. However, if FHH had equal access to the inputs as MHH, the gross value of the output would be higher by 23.58% for FHH. This might suggest that FHH would be more productive than MHH if they had equal access to inputs as MHH. Based on the results obtained, the following policy implication can be drawn: accessing FHH to inputs that increase the productivity of agriculture, such as herbicides, livestock and male labor; increasing the productivity of land; and introducing technologies that reduce the time and energy of women, especially for enset processing.

Keywords: gender difference, crop productivity, GDP, efficiency

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Authors: Niharika Keot, Manabendra Sarma

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A thorough investigation of Ln3+ complexes with more than one inner-sphere water molecule is crucial for designing high relaxivity contrast agents (CAs) used in magnetic resonance imaging (MRI). This study accomplished a comparative stability analysis of two hexadentate (H3cbda and H3dpaa) and two heptadentate (H4peada and H3tpaa) ligands with Ln3+ ions. The higher stability of the hexadentate H3cbda and heptadentate H4peada ligands has been confirmed by the binding affinity and Gibbs free energy analysis in aqueous solution. In addition, energy decomposition analysis (EDA) reveals the higher binding affinity of the peada4− ligand than the cbda3− ligand towards Ln3+ ions due to the higher charge density of the peada4− ligand. Moreover, a mechanistic overview of water exchange kinetics has been carried out based on the strength of the metal–water bond. The strength of the metal–water bond follows the trend Gd–O47 (w) > Gd–O39 (w) > Gd–O36 (w) in the case of the tris-aquated [Gd(cbda)(H2O)3] and Gd–O43 (w) > Gd–O40 (w) for the bis-aquated [Gd(peada)(H2O)2]− complex, which was confirmed by bond length, electron density (ρ), and electron localization function (ELF) at the corresponding bond critical points. Our analysis also predicts that the activation energy barrier decreases with the decrease in bond strength; hence kex increases. The 17O and 1H hyperfine coupling constant values of all the coordinated water molecules were different, calculated by using the second-order Douglas–Kroll–Hess (DKH2) approach. Furthermore, the ionic nature of the bonding in the metal–ligand (M–L) bond was confirmed by the Quantum Theory of Atoms-In-Molecules (QTAIM) and ELF along with energy decomposition analysis (EDA). We hope that the results can be used as a basis for the design of highly efficient Gd(III)-based high relaxivity MRI contrast agents for medical applications.

Keywords: MRI contrast agents, lanthanide chemistry, thermodynamic stability, water exchange kinetics

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Authors: Getinet Gezahegn Gebre

Abstract:

The study examined the impact of gender differences on Crop productivity in Decha woreda of south west Kafa zone, located 140 Km from Jimma Town and 460 km south west of Addis Ababa, between Bonga town and Omo River. The specific objectives were to assess the extent to which the agricultural production system is gender oriented, to examine access and control over productive resources, and to estimate men’s and women’s productivity in agriculture. Cross-sectional data collected from a total of 140 respondents were used in this study, whereby 65 were female headed and 75 were male headed households. The data were analyzed by using Statistical Package for Social Science (SPSS). Descriptive statistics such as frequency, mean, percentage, t-test, and chi-square were used to summarize and compare the information between the two groups. Moreover, Cobb-Douglas(CD) production function was to estimate the productivity difference in agriculture between male and female headed households. Results of the study showed that male headed households (MHH) own more productive resources such as land, livestock, labor, and other agricultural inputs as compared to female headed households (FHH). Moreover, the estimate of CD production function shows that livestock, herbicide use, land size, and male labor were statistically significant for MHH, while livestock, land size, herbicides use and female labor were significant variables for FHH. The crop productivity difference between MHH and FHH was about 68.83% in the study area. However, if FHH had equal access to the inputs as MHH, the gross value of the output would be higher by 23.58% for FHH. This might suggest that FHH would be more productive than MHH if they had equal access to inputs as MHH. Based on the results obtained, the following policy implication can be drawn: accessing FHH to inputs that increase the productivity of agriculture, such as herbicides, livestock, and male labor; increasing the productivity of land; and introducing technologies that reduce the time and energy of women, especially for inset processing.

Keywords: gender difference, crop, productivity, efficiency

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Authors: Eva Filová, Jana Daňková, Věra Sovková, Matej Daniel

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Titanium alloys are biocompatible metals that are widely used in clinical practice as load bearing implants. The chemical modification may influence cell adhesion, proliferation, and differentiation as well as stiffness of the material. The aim of the study was to evaluate the adhesion, growth and differentiation of pig mesenchymal stem cells on the novel beta titanium alloy Ti36Nb6Ta compared to standard medical titanium alloy Ti6Al4V. Discs of Ti36Nb6Ta and Ti6Al4V alloy were sterilized by ethanol, put in 48-well plates, and seeded by pig mesenchymal stem cells at the density of 60×103/cm2 and cultured in Minimum essential medium (Sigma) supplemented with 10% fetal bovine serum and penicillin/streptomycin. Cell viability was evaluated using MTS assay (CellTiter 96® AQueous One Solution Cell Proliferation Assay;Promega), cell proliferation using Quant-iT™ ds DNA Assay Kit (Life Technologies). Cells were stained immunohistochemically using monoclonal antibody beta-actin, and secondary antibody conjugated with AlexaFluor®488 and subsequently the spread area of cells was measured. Cell differentiation was evaluated by alkaline phosphatase assay using p-nitrophenyl phosphate (pNPP) as a substrate; the reaction was stopped by NaOH, and the absorbance was measured at 405 nm. Osteocalcin, specific bone marker was stained immunohistochemically and subsequently visualized using confocal microscopy; the fluorescence intensity was analyzed and quantified. Moreover, gene expression of osteogenic markers osteocalcin and type I collagen was evaluated by real-time reverse transcription-PCR (qRT-PCR). For statistical evaluation, One-way ANOVA followed by Student-Newman-Keuls Method was used. For qRT-PCR, the nonparametric Kruskal-Wallis Test and Dunn's Multiple Comparison Test were used. The absorbance in MTS assay was significantly higher on titanium alloy Ti6Al4V compared to beta titanium alloy Ti36Nb6Ta on days 7 and 14. Mesenchymal stem cells were well spread on both alloys, but no difference in spread area was found. No differences in alkaline phosphatase assay, fluorescence intensity of osteocalcin as well as the expression of type I collagen, and osteocalcin genes were observed. Higher expression of type I collagen compared to osteocalcin was observed for cells on both alloys. Both beta titanium alloy Ti36Nb6Ta and titanium alloy Ti6Al4V Ti36Nb6Ta supported mesenchymal stem cellsˈ adhesion, proliferation and osteogenic differentiation. Novel beta titanium alloys Ti36Nb6Ta is a promising material for bone implantation. The project was supported by the Czech Science Foundation: grant No. 16-14758S, the Grant Agency of the Charles University, grant No. 1246314 and by the Ministry of Education, Youth and Sports NPU I: LO1309.

Keywords: beta titanium, cell growth, mesenchymal stem cells, titanium alloy, implant

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Authors: Shaibu Baanni Azumah, William Adzawla

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Rice is an important staple crop, with current demand higher than the domestic supply in Ghana. This has led to a high and unfavourable import bill. Therefore, recent policies and interventions in the agricultural sub-sector aim at promoting various improved agricultural technologies in order to improve domestic production and reduce the importation of rice. In this study, we examined the effect of the adoption of Urea Deep Placement (UDP) technology by rice farmers on the position of the production frontier. This involved 200 farmers selected through a multi stage sampling technique in the Northern region of Ghana. A Cobb-Douglas stochastic frontier model was fitted. The result showed that the adoption of UDP technology shifts the output frontier outward and also move the farmers closer to the frontier. Farmers were also operating under diminishing returns to scale which calls for redress. Other factors that significantly influenced rice production were farm size, labour, use of certified seeds and NPK fertilizer. Although there was an opportunity for improvement, the farmers were highly efficient (92%), compared to previous studies. Farmers’ efficiency was improved through increased education, household size, experience, access to credit, and lack of extension service provision by MoFA. The study recommends the revision of Ghana’s agricultural policy to include the UDP technology. Agricultural Extension officers of the Ministry of Food and Agriculture (MoFA) should be trained on the UDP technology to support IFDC’s drive to improve adoption by rice farmers. Rice farmers are also encouraged to expand their farm lands, improve plant population, and also increase the usage of fertilizer to improve yields. Mechanisms through which credit can be made easily accessible and effectively utilised should be identified and promoted.

Keywords: efficiency, rice farmers, stochastic frontier, UDP technology

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Authors: Sumanta Das, Miroslav Gašparík, Tomáš Kytka, Anil Kumar Sethy

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In this modern century, Cross-laminated timber (CLT) evolved as an excellent material for building and high load-bearing structural applications worldwide. CLT is produced mainly from softwoods such as Norway spruce, White fir, Scots pine, European larch, Douglas fir, and Swiss stone pine. The use of hardwoods in CLT production is still at an early stage, and the utilization of hardwoods is expected to provide the opportunity for obtaining higher bending stiffness and shear resistance to CLT panels. In load-bearing structures like CLT, bonding is an important character that is needed to evaluate. One particular issue with using hardwood lumber in CLT panels is that it is often more challenging to achieve a strong, durable adhesive bond. Several researches in the past years have already evaluated the bonding properties of CLT panels from hardwood both from higher and lower densities. This research aims to identify the effect of pressure and glue spread and evaluate which poplar lumber characteristics affect adhesive bond quality. Three-layered CLT panels were prepared from poplar wood with one-component polyurethane (PUR) adhesive by applying pressure of 0.6 N/mm2 and 1 N/mm2 with a glue spread rate of 160 and 180 g/m2. The delamination and block shear tests were carried out as per EN 16351:2015, and the wood failure percentage was also evaluated. The results revealed that glue spread rate and applied pressure significantly influenced both the shear bond strength and wood failure percentage of the CLT. However, samples with lower pressure 0.6 N/mm2 and less glue spread rate showed delamination, and in samples with higher pressure 1 N/mm2 and higher glue spread rate, no delamination was observed. All the properties determined by this study met the minimum requirement mentioned in EN 16351:2015 standard.

Keywords: cross-laminated timber, delamination, glue spread rate, poplar, pressure, PUR, shear strength, wood failure percentage

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Authors: Austin P. Hopkins, R. Daren Harmel, Jim A Ippolito, P. J. A. Kleinman, D. Sahoo

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Field-scale runoff and water quality data are critical to understanding the fate and transport of nutrients applied to agricultural lands and minimizing their off-site transport because it is at that scale that agricultural management decisions are typically made based on hydrologic, soil, and land use factors. However, regional influences such as precipitation, temperature, and prevailing cropping systems and land use patterns also impact nutrient runoff. In the present study, the recently-updated MANAGE (Measured Annual Nutrient loads from Agricultural Environments) database was used to conduct an ecoregion-level analysis of nitrogen and phosphorus runoff from agricultural lands in the North America. Specifically, annual N and P runoff loads for cropland and grasslands in North American Level II EPA ecoregions were presented, and the impact of factors such as land use, tillage, and fertilizer timing and placement on N and P runoff were analyzed. Specifically we compiled annual N and P runoff load data (i.e., dissolved, particulate, and total N and P, kg/ha/yr) for each Level 2 EPA ecoregion and for various agricultural management practices (i.e., land use, tillage, fertilizer timing, fertilizer placement) within each ecoregion to showcase the analyses possible with the data in MANAGE. Potential differences in N and P runoff loads were evaluated between and within ecoregions with statistical and graphical approaches. Non-parametric analyses, mainly Mann-Whitney tests were conducted on median values weighted by the site years of data utilizing R because the data were not normally distributed, and we used Dunn tests and box and whisker plots to visually and statistically evaluate significant differences. Out of the 50 total North American Ecoregions, 11 were found that had significant data and site years to be utilized in the analysis. When examining ecoregions alone, it was observed that ER 9.2 temperate prairies had a significantly higher total N at 11.7 kg/ha/yr than ER 9.4 South Central Semi Arid Prairies with a total N of 2.4. When examining total P it was observed that ER 8.5 Mississippi Alluvial and Southeast USA Coastal Plains had a higher load at 3.0 kg/ha/yr than ER 8.2 Southeastern USA Plains with a load of 0.25 kg/ha/yr. Tillage and Land Use had severe impacts on nutrient loads. In ER 9.2 Temperate Prairies, conventional tillage had a total N load of 36.0 kg/ha/yr while conservation tillage had a total N load of 4.8 kg/ha/yr. In all relevant ecoregions, when corn was the predominant land use, total N levels significantly increased compared to grassland or other grains. In ER 8.4 Ozark-Ouachita, Corn had a total N of 22.1 kg/ha/yr while grazed grassland had a total N of 2.9 kg/ha/yr. There are further intricacies of the interactions that agricultural management practices have on one another combined with ecological conditions and their impacts on the continental aquatic nutrient loads that still need to be explored. This research provides a stepping stone to further understanding of land and resource stewardship and best management practices.

Keywords: water quality, ecoregions, nitrogen, phosphorus, agriculture, best management practices, land use

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Authors: Douglas F. Prawitt, Nathan Y. Sharp, David A. Wood

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Consistent with prior experimental and survey studies, we find that IAFs that spend more time directly assisting the external auditor is associated with lower external audit fees. Interestingly, we do not find evidence that external auditors reduce fees based on work previously performed by the IAF. We also find that the time spent assisting the external auditor has a greater negative effect on external audit fees than the time spent performing tasks upon which the auditor may rely but that are not performed as direct assistance to the external audit. Our results also show that previous proxies used to measure this relation is either not associated with or are negatively associated with our direct measures of how the IAF can contribute to the external audit and are highly positively associated with the size and the complexity of the organization. Thus, we conclude the disparate experimental and archival results may be attributable to issues surrounding the construct validity of measures used in previous archival studies and that when measures similar to those used in experimental studies are employed in archival tests, the archival results are consistent with experimental findings. Our research makes four primary contributions to the literature. First, we provide evidence that internal auditing contributes to a reduction in external audit fees. Second, we replicate and provide an explanation for why previous archival studies find that internal auditing has either no association with external audit fees or is associated with an increase in those fees: prior studies generally use proxies of internal audit contribution that do not adequately capture the intended construct. Third, our research expands on survey-based research (e.g., Oil Libya sh.co.) by separately examining the impact on the audit fee of the internal auditors’ work, indirectly assisting external auditors and internal auditors’ prior work upon which external auditors can rely. Finally, we extend prior research by using a new, independent data source to validate and extend prior studies. This data set also allows for a sample of examining the impact of internal auditing on the external audit fee and the use of a more comprehensive external audit fee model that better controls for determinants of the external audit fee.

Keywords: internal audit, contribution, external audit, function

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Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

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Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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Authors: Douglas MacCutcheon, Florian Pausch, Robert Ljung, Lorna Halliday, Stuart Rosen

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Contemporary classrooms are increasingly inclusive of children with mild to moderate disabilities and children from different language backgrounds (bilinguals, multilinguals), but classroom environments and standards have not yet been adapted adequately to meet these challenges brought about by this inclusivity. Additionally, classrooms are becoming noisier as a learner-centered as opposed to teacher-centered teaching paradigm is adopted, which prioritizes group work and peer-to-peer learning. Challenging listening conditions with distracting sound sources and background noise are known to have potentially negative effects on children, particularly those that are prone to struggle with speech perception in noise. Therefore, this research investigates two groups vulnerable to these environmental effects, namely children with a mild to moderate hearing loss (MMHLs) and sequential bilinguals learning in their second language. In the MMHL study, this group was assessed on speech-in-noise perception, and a number of receptive language and cognitive measures (auditory working memory, auditory attention) and correlations were evaluated. Speech reception thresholds were found to be predictive of language and cognitive ability, and the nature of correlations is discussed. In the bilinguals study, sequential bilingual children’s listening comprehension, speech-in-noise perception, listening effort and release from masking was evaluated under a number of different ecologically valid acoustic scenarios in order to pinpoint the extent of the ‘native language benefit’ for Swedish children learning in English, their second language. Scene manipulations included target-to-distractor ratios and introducing spatially separated noise. This research will contribute to the body of findings from which educational institutions can draw when designing or adapting educational environments in inclusive schools.

Keywords: sequential bilinguals, classroom acoustics, mild to moderate hearing loss, speech-in-noise, release from masking

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Authors: Amanda T. Badaró, Douglas F. Barbin, Sofia T. Garcia, Maria Teresa P. S. Clerici, Amanda R. Ferreira

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Food fortification is the intentional addition of a nutrient in a food matrix and has been widely used to overcome the lack of nutrients in the diet or increasing the nutritional value of food. Fortified food must meet the demand of the population, taking into account their habits and risks that these foods may cause. Wheat and its by-products, such as semolina, has been strongly indicated to be used as a food vehicle since it is widely consumed and used in the production of other foods. These products have been strategically used to add some nutrients, such as fibers. Methods of analysis and quantification of these kinds of components are destructive and require lengthy sample preparation and analysis. Therefore, the industry has searched for faster and less invasive methods, such as Near-Infrared Spectroscopy (NIR). NIR is a rapid and cost-effective method, however, it is based on indirect measurements, yielding high amount of data. Therefore, NIR spectroscopy requires calibration with mathematical and statistical tools (Chemometrics) to extract analytical information from the corresponding spectra, as Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA). PCA is well suited for NIR, once it can handle many spectra at a time and be used for non-supervised classification. Advantages of the PCA, which is also a data reduction technique, is that it reduces the data spectra to a smaller number of latent variables for further interpretation. On the other hand, LDA is a supervised method that searches the Canonical Variables (CV) with the maximum separation among different categories. In LDA, the first CV is the direction of maximum ratio between inter and intra-class variances. The present work used a portable infrared spectrometer (NIR) for identification and classification of pure and fiber-fortified semolina samples. The fiber was added to semolina in two different concentrations, and after the spectra acquisition, the data was used for PCA and LDA to identify and discriminate the samples. The results showed that NIR spectroscopy associate to PCA was very effective in identifying pure and fiber-fortified semolina. Additionally, the classification range of the samples using LDA was between 78.3% and 95% for calibration and 75% and 95% for cross-validation. Thus, after the multivariate analysis such as PCA and LDA, it was possible to verify that NIR associated to chemometric methods is able to identify and classify the different samples in a fast and non-destructive way.

Keywords: Chemometrics, fiber, linear discriminant analysis, near-infrared spectroscopy, principal component analysis, semolina

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Authors: Ubon Asuquo Essien, Okwudili Bismark Ibeagwa, Daberechi Peace Ubabuko

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The Broiler Poultry subsector is dominated by small scale production with low aggregate output. The high cost of inputs currently experienced in Nigeria tends to aggravate the situation; hence many broiler farmers struggle to break-even. This study was designed to examine income and input factors in small scale deep liter broiler production in Imo state, Nigeria. Specifically, the study examined; socio-economic characteristics of small scale deep liter broiler producing Poultry farmers; estimate cost and returns of broiler production in the area; analyze input factors in broiler production in the area and examined marketability, age and profitability of the enterprise. A multi-stage sampling technique was adopted in selecting 60 small scale broiler farmers who use deep liter system from 6 communities through the use of structured questionnaire. The socioeconomic characteristics of the broiler farmers and the profitability/ marketability age of the birds were described using descriptive statistical tools such as frequencies, means and percentages. Gross margin analysis was used to analyze the cost and returns to broiler production, while Cobb Douglas production function was employed to analyze input factors in broiler production. The result of the study revealed that the cost of feed (P<0.1), deep liter material (P<0.05) and medication (P<0.05) had a significant positive relationship with the gross return of broiler farmers in the study area, while cost of labour, fuel and day old chicks were not significant. Furthermore, Gross profit margin of the farmers who market their broiler at the 8th week of rearing was 80.7%; and 78.7% and 60.8% for farmers who market at the 10th week and 12th week of rearing, respectively. The business is, therefore, profitable but at varying degree. Government and Development partners should make deliberate efforts to curb the current rise in the prices of poultry feeds, drugs and timber materials used as bedding so as to widen the profit margin and encourage more farmers to go into the business. The farmers equally need more technical assistance from extension agents with regards to timely and profitable marketing.

Keywords: broilers, factor analysis, income, small scale

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Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman

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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.

Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis

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Authors: A. Drelick, T. Sondergeld, M. Decarlo-Tecce, K. McGinley

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In 1975, a free, appropriate public education (FAPE) was granted for all students in the United States regardless of their disabilities. As a result, the special education landscape has been reshaped through new policies and legislation. Progress monitoring, a specific component of an Individual Education Program (IEP) calls, for the use of data collection to determine the appropriateness of services provided to students with disabilities. The recent US Supreme Court ruling in Endrew F. v. Douglas County warrants giving increased attention to student progress, specifically pertaining to improving functional, or non-academic, skills that are addressed outside the general education curriculum. While using technology to enhance data collection has become a common practice for measuring academic growth, its application for non-academic IEP goals is uncertain. A mixed-methods study examined current practices and rationales for implementing technology-based progress monitoring focused on non-academic IEP goals. Fifty-seven participants responded to an online survey regarding their progress monitoring programs for non-academic goals. After isolated analysis and interpretation of quantitative and qualitative results, data were synthesized to produce meta-inferences that drew broader conclusions on the topic. For the purpose of this paper, specific focus will be placed on the perceived barriers and benefits of implementing technology-based progress monitoring protocols for non-academic IEP goals. The findings of this study highlight facts impacting the use of technology-based progress monitoring. Perceived barriers to implementation include: (1) lack of training, (2) access to technology, (3) outdated or inoperable technology, (4) reluctance to change, (5) cost, (6) lack of individualization within technology-based programs, and (7) legal issues in special education; while perceived benefits include: (1) overall ease of use, (2) accessibility, (3) organization, (4) potential for improved presentation of data, (5) streamlining the progress-monitoring process, and (6) legal issues in special education. Based on these conclusions, recommendations are made to IEP teams, school districts, and software developers to improve the progress-monitoring process for functional skills.

Keywords: special education, progress monitoring, functional skills, technology

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Murray L. Ireland, Kevin J. Worrall, Rebecca Mackenzie, Thaleia Flessa, Euan McGookin, Douglas Thomson

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Robotic rovers which are designed to work in extra-terrestrial environments present a unique challenge in terms of the reliability and availability of systems throughout the mission. Should some fault occur, with the nearest human potentially millions of kilometres away, detection and identification of the fault must be performed solely by the robot and its subsystems. Faults in the system sensors are relatively straightforward to detect, through the residuals produced by comparison of the system output with that of a simple model. However, faults in the input, that is, the actuators of the system, are harder to detect. A step change in the input signal, caused potentially by the loss of an actuator, can propagate through the system, resulting in complex residuals in multiple outputs. These residuals can be difficult to isolate or distinguish from residuals caused by environmental disturbances. While a more complex fault detection method or additional sensors could be used to solve these issues, an alternative is presented here. Using inverse simulation (InvSim), the inputs and outputs of the mathematical model of the rover system are reversed. Thus, for a desired trajectory, the corresponding actuator inputs are obtained. A step fault near the input then manifests itself as a step change in the residual between the system inputs and the input trajectory obtained through inverse simulation. This approach avoids the need for additional hardware on a mass- and power-critical system such as the rover. The InvSim fault detection method is applied to a simple four-wheeled rover in simulation. Additive system faults and an external disturbance force and are applied to the vehicle in turn, such that the dynamic response and sensor output of the rover are impacted. Basic model-based fault detection is then employed to provide output residuals which may be analysed to provide information on the fault/disturbance. InvSim-based fault detection is then employed, similarly providing input residuals which provide further information on the fault/disturbance. The input residuals are shown to provide clearer information on the location and magnitude of an input fault than the output residuals. Additionally, they can allow faults to be more clearly discriminated from environmental disturbances.

Keywords: fault detection, ground robot, inverse simulation, rover

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Authors: Margarita Dufresne

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This study devoted to development TPS for small space re-usable launchers. We have used SIRIUS design for S1 prototype. Multiphysics coupling for hypersonic reactive flow and thermos-structural analysis with and without ablation is provided by -CCM+ and COMSOL Multiphysics and FASTRAN and ACE+. Flow around hypersonic flight vehicles is the interaction of multiple shocks and the interaction of shocks with boundary layers. These interactions can have a very strong impact on the aeroheating experienced by the flight vehicle. A real gas implies the existence of a gas in equilibrium, non-equilibrium. Mach number ranged from 5 to 10 for first stage flight.The goals of this effort are to provide validation of the iterative coupling of hypersonic physics models in STAR-CCM+ and FASTRAN with COMSOL Multiphysics and ACE+. COMSOL Multiphysics and ACE+ are used for thermal structure analysis to simulate Conjugate Heat Transfer, with Conduction, Free Convection and Radiation to simulate Heat Flux from hypersonic flow. The reactive simulations involve an air chemical model of five species: N, N2, NO, O and O2. Seventeen chemical reactions, involving dissociation and recombination probabilities calculation include in the Dunn/Kang mechanism. Forward reaction rate coefficients based on a modified Arrhenius equation are computed for each reaction. The algorithms employed to solve the reactive equations used the second-order numerical scheme is obtained by a “MUSCL” (Monotone Upstream-cantered Schemes for Conservation Laws) extrapolation process in the structured case. Coupled inviscid flux: AUSM+ flux-vector splitting The MUSCL third-order scheme in STAR-CCM+ provides third-order spatial accuracy, except in the vicinity of strong shocks, where, due to limiting, the spatial accuracy is reduced to second-order and provides improved (i.e., reduced) dissipation compared to the second-order discretization scheme. initial unstructured mesh is refined made using this initial pressure gradient technique for the shock/shock interaction test case. The suggested by NASA turbulence models are the K-Omega SST with a1 = 0.355 and QCR (quadratic) as the constitutive option. Specified k and omega explicitly in initial conditions and in regions – k = 1E-6 *Uinf^2 and omega = 5*Uinf/ (mean aerodynamic chord or characteristic length). We put into practice modelling tips for hypersonic flow as automatic coupled solver, adaptative mesh refinement to capture and refine shock front, using advancing Layer Mesher and larger prism layer thickness to capture shock front on blunt surfaces. The temperature range from 300K to 30 000 K and pressure between 1e-4 and 100 atm. FASTRAN and ACE+ are coupled to provide high-fidelity solution for hot hypersonic reactive flow and Conjugate Heat Transfer. The results of both approaches meet the CIRCA wind tunnel results.

Keywords: hypersonic, first stage, high speed compressible flow, shock wave, aerodynamic heating, conugate heat transfer, conduction, free convection, radiation, fastran, ace+, comsol multiphysics, star-ccm+, thermal protection system (tps), space launcher, wind tunnel

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Authors: Vanda Ferreira Ribeiro, Daiane Tomacheski, Douglas Naue Simões, Michele Pitto, Ruth Marlene Campomanes Santana

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Indoor environments, such as car cabins and public transportation vehicles are places where users are subject to air quality. Microorganisms (bacteria, fungi, yeasts) enter these environments through windows, ventilation systems and may use the organic particles present as a growth substrate. In addition, atmospheric pollutants can act as potential carbon and nitrogen sources for some microorganisms. Compounds base SEBS copolymers, poly(styrene-b-(ethylene-co-butylene)-b-styrene, are a class of thermoplastic elastomers (TPEs), fully recyclable and largely used in automotive parts. Metals, such as cooper and silver, have biocidal activities and the production of the SEBS compounds by melting blending with these agents can be a good option for producing compounds for use in plastic parts of ventilation systems and automotive air-conditioning, in order to minimize the problems caused by growth of pathogenic microorganisms. In this sense, the aim of this work was to evaluate the effect of copper microparticles as antimicrobial agent in compositions based on SEBS/PP/oil/calcite. Copper microparticles were used in weight proportion of 0%, 1%, 2% and 4%. The compounds were prepared using a co-rotating double screw extruder (L/D ratio of 40/1 and 16 mm screw diameter). The processing parameters were 300 rpm of screw rotation rate, with a temperature profile between 150 to 190°C. SEBS based TPE compounds were injection molded. The compounds emission were characterized by gravimetric fogging test. Compounds were characterized by physical (density and staining by contact), mechanical (hardness and tension properties) and rheological properties (melt volume rate – MVR). Antibacterial properties were evaluated against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) strains. To avaluate the abilities toward the fungi have been chosen Aspergillus niger (A. niger), Candida albicans (C. albicans), Cladosporium cladosporioides (C. cladosporioides) and Penicillium chrysogenum (P. chrysogenum). The results of biological tests showed a reduction on bacteria in up to 88% in E.coli and up to 93% in S. aureus. The tests with fungi showed no conclusive results because the sample without copper also demonstrated inhibition of the development of these microorganisms. The copper addition did not cause significant variations in mechanical properties, in the MVR and the emission behavior of the compounds. The density increases with the increment of copper in compounds.

Keywords: air conditioner, antimicrobial, cooper, SEBS

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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