Search results for: pollution risk assessment

Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

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Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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Authors: Joshua Loiselle

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This paper discusses the challenges engineering teams face in conducting Failure Modes and Effects Analysis (FMEA) studies. This paper focuses on the specific topic of improving the efficiency and effectiveness of FMEA studies. Modern economic needs and increased business competition require engineers to constantly develop newer and better solutions within shorter timeframes and tighter margins. In addition, documentation requirements for meeting standards/regulatory compliance and customer needs are becoming increasingly complex and verbose. Managing open actions and continuous improvement activities across all projects, product variations, and processes in addition to daily engineering tasks is cumbersome, time consuming, and is susceptible to errors, omissions, and non-conformances. FMEA studies are proven methods for improving products and processes while subsequently reducing engineering workload and improving machine and resource availability through a pre-emptive, systematic approach of identifying, analyzing, and improving high-risk components. If implemented correctly, FMEA studies significantly reduce costs and improve productivity. However, the value of an effective FMEA is often shrouded by a lack of clarity and structure, misconceptions, and previous experiences and, as such, FMEA studies are frequently grouped with the other required information and documented retrospectively in preparation of customer requirements or audits. Performing studies in this way only adds cost to a project and perpetuates the misnomer that FMEA studies are not value-added activities. This paper discusses the benefits of effective FMEA studies, the challenges related to conducting FMEA studies, best practices for efficiently overcoming challenges via structure and automation, and the benefits of implementing those practices.

Keywords: FMEA, quality, APQP, PPAP

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Authors: Sayed Ali Garossi, Azar Heidarizadi, Shahla Mohammad Ganji

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Context: Colorectal cancer is the second type of cancer-related mortality globally. Expression of cas8 (caspase 8) is closely connected to growth and metastasis of colorectal cancer.Cas8/Rip1 plays a vital role in the apoptosis pathway and resistance to chemotherapy. The aim of the present study is to investigate the pattern of gene expression in colorectal cancer and compare the differences using Real-Time PCR to find a potential biomarker candidate for colorectal cancer. Methodology: This study conducted real-time PCR to evaluate gene expression of Cas8 in colorectal cancer patients. The gene-specific primer sequences exon–exon junction was designed by OLIGO7 software for the expression of the gene under investigation. Forty-six patient samples without any chemotherapy were selected, including tumoral tissue and adjacent normal tissue samples. The age of the patients was 50 and the size of the tumors was 5.5 cm. The categories were before and after age 50. Findings: Here, we found that Caspase 8 was overexpressed in CRC tissues compared to corresponding adjacent colon tissues (Cas8: 5.2 vs. 1 ratio); high expression of Cas8 was associated with poor overall survival and independent risk factors for the prognosis of CRC patients. Conclusion: In conclusion, our study pioneered the reporting of high Casp8 expression as a predictor of poor prognosis and chemical resistance in CRC patients.Cas8 overexpression suppressed Cas 8 / Rip1-dependent apoptosis and activated the proliferation of tumor cells by activating necroptosis. The necroptosis pathway has also emerged as a new approach to anti-tumor in cancer treatment.

Keywords: Cas8, necroptosis, apoptosis, Real-Time PCR

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le, Chi V. Phan

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Wilson’s disease (WD) is an autosomal recessive disorder of the copper metabolism, which is caused by a mutation in the copper-transporting P-type ATPase (ATP7B). The mechanism of this disease is the failure of hepatic excretion of copper to bile, and leads to copper deposits in the liver and other organs. The ATP7B gene is located on the long arm of chromosome 13 (13q14.3). This study aimed to investigate the gene mutation in the Vietnamese patients with WD, and make a presymptomatic diagnosis for their familial members. Forty-three WD patients and their 65 siblings were identified as having ATP7B gene mutations. Genomic DNA was extracted from peripheral blood samples; 21 exons and exon-intron boundaries of the ATP7B gene were analyzed by direct sequencing. We recognized four mutations ([R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G) in the sum of 20 detectable mutations, accounting for 87.2% of the total. Mutation S105* was determined to have a high rate (32.6%) in this study. The hotspot regions of ATP7B were found at exons 2, 16, and 8, and intron 14, in 39.6 %, 11.6 %, 9.3%, and 7 % of patients, respectively. Among nine homozygote/compound heterozygote siblings of the patients with WD, three individuals were determined as asymptomatic by screening mutations of the probands. They would begin treatment after diagnosis. In conclusion, 20 different mutations were detected in 43 WD patients. Of this number, four novel mutations were explored, including [R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G. The mutation S105* is the most prevalent and has been considered as a biomarker that can be used in a rapid detection assay for diagnosis of WD patients. Exons 2, 8, and 16, and intron 14 should be screened initially for WD patients in Vietnam. Based on risk profile for WD, genetic testing for presymptomatic patients is also useful in diagnosis and treatment.

Keywords: ATP7B gene, mutation detection, presymptomatic diagnosis, Vietnamese Wilson’s disease

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Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

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Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

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Authors: Muhammad Arslan Usman, Muhammad Rehan Usman, Soo Young Shin

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Live video streaming is one of the most widely used service among end users, yet it is a big challenge for the network operators in terms of quality. The only way to provide excellent Quality of Experience (QoE) to the end users is continuous monitoring of live video streaming. For this purpose, there are several objective algorithms available that monitor the quality of the video in a live stream. Subjective tests play a very important role in fine tuning the results of objective algorithms. As human perception is considered to be the most reliable source for assessing the quality of a video stream, subjective tests are conducted in order to develop more reliable objective algorithms. Temporal impairments in a live video stream can have a negative impact on the end users. In this paper we have conducted subjective evaluation tests on a set of video sequences containing temporal impairment known as frame freezing. Frame Freezing is considered as a transmission error as well as a hardware error which can result in loss of video frames on the reception side of a transmission system. In our subjective tests, we have performed tests on videos that contain a single freezing event and also for videos that contain multiple freezing events. We have recorded our subjective test results for all the videos in order to give a comparison on the available No Reference (NR) objective algorithms. Finally, we have shown the performance of no reference algorithms used for objective evaluation of videos and suggested the algorithm that works better. The outcome of this study shows the importance of QoE and its effect on human perception. The results for the subjective evaluation can serve the purpose for validating objective algorithms.

Keywords: objective evaluation, subjective evaluation, quality of experience (QoE), video quality assessment (VQA)

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Authors: Dirk Winkler, Leon Koevener, Lamees AlHayary

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This paper contributes to the improvement of the municipal wastewater systems in Jordan. An important goal is increased energy efficiency in wastewater treatment plants and therefore lower expenses due to reduced electricity consumption. The chosen way to achieve this goal is through the implementation of Technical Sustainable Management adapted to the Jordanian context. Three wastewater treatment plants in Jordan have been chosen as a case study for the investigation. These choices were supported by the fact that the three treatment plants are suitable for average performance and size. Beyond that, an energy assessment has been recently conducted in those facilities. The project succeeded in proving the following hypothesis: Energy efficiency in wastewater treatment plants can be improved by implementing principles of Technical Sustainable Management adapted to the Jordanian context. With this case study, a significant increase in energy efficiency can be achieved by optimization of operational performance, identifying and eliminating shortcomings and appropriate plant management. Implementing Technical Sustainable Management as a low-cost tool with a comparable little workload, provides several additional benefits supplementing increased energy efficiency, including compliance with all legal and technical requirements, process optimization, but also increased work safety and convenient working conditions. The research in the chosen field continues because there are indications for possible integration of the adapted tool into other regions and sectors. The concept of Technical Sustainable Management adapted to the Jordanian context could be extended to other wastewater treatment plants in all regions of Jordan but also into other sectors including water treatment, water distribution, wastewater network, desalination, or chemical industry.

Keywords: energy efficiency, quality management system, technical sustainable management, wastewater treatment

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Authors: Wee Akina Sia Seng Lee, Shabeshan Rengasamy, Lim Boon Hooi, Chandrakalavaratharajoo, Mohd Ibrahim K. Azeez

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This study was conducted to examine the effectiveness of Teaching Games For Understanding (TGFU) in improving the hockey tactical skills and state self-confidence among 16-year-old students. Two hundred fifty nine (259) school students were selected for the study based on the intact sampling method. One class was used as the control group (Boys=60, Girls=70), while another as the treatment group (Boys=60, Girls=69) underwent intervention with TGFU in physical education class conducted twice a week for four weeks. The Games Performance Assessment Instrument was used to observe the hockey tactical skills and The State Self-Confidence Inventory was used to determine the state of self-confidence among the students. After four weeks, ANCOVA analysis indicated the treatment groups had significant improvement in hockey tactical skills with F (1, 118) =313.37, p < .05 for school boys, and F (1, 136) =92.62, p < .05 for school girls. The Mann Whitney U test also showed the treatment groups had significant improvement in state self-confidence with U=428.50, z= -7.22, p < .05, r=.06 for school boys. ANCOVA analysis also showed the treatment group had significant improvement in state self-confidence with F (1, 136) =74.40, p < .05 for school girls. This indicates that TGFU in a 40 minute physical education class conducted twice a week for four weeks can significantly improve the hockey tactical skills and state self-confidence among 16-year-old students. The findings give new knowledge to PE teachers to implement the TGFU method as it enhances the hockey tactical skills and state self-confidence among 16-year-old students. Some recommendation was suggested for future research.

Keywords: Teaching Games For Understanding (TGFU), traditional teaching, hockey tactical skills, state self-confidence

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Authors: David Cobham

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In higher education, a great degree of importance is placed on the internationalization of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks and connections, and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment through learning approaches, assessment methods, and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country, either to study, to work, to volunteer or to gain cultural and social enhancement, has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience, and adopting collaborative online projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learned and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways and that they will persist beyond the present to become part of the 'new normal' for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Keywords: higher education management, internationalization, transnational education, virtual mobility

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Authors: Parvin Goli, Amirhosein Kefayat, Rezvan Goli

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Background: It is well established that parents can influence their offspring's neurodevelopment. It is shown that paternal environment and lifestyle is beneficial for the progeny's fitness and might affect their metabolic mechanisms; however, the effects of paternal exercise on the brain in the offspring have not been explored in detail. Objective: This study aims to review the impact of paternal physical exercise on memory and learning, neuroplasticity, as well as DNA methylation levels in the off-spring's hippocampus. Study design: In this systematic review and meta-analysis, an electronic literature search was conducted in databases including PubMed, Scopus, and Web of Science. Eligible studies were those with an experimental design, including an exercise intervention arm, with the assessment of any type of memory function, learning ability, or any type of brain plasticity as the outcome measures. Standardized mean difference (SMD) and 95% confidence intervals (CI) were computed as effect size. Results: The systematic review revealed the important role of environmental enrichment in the behavioral development of the next generation. Also, offspring of exercised fathers displayed higher levels of memory ability and lower level of brain-derived neurotrophic factor. A significant effect of paternal exercise on the hippocampal volume was also reported in the few available studies. Conclusion: These results suggest an intergenerational effect of paternal physical activity on cognitive benefit, which may be associated with hippocampal epigenetic programming in offspring. However, the biological mechanisms of this modulation remain to be determined.

Keywords: hippocampal plasticity, learning ability, memory, parental exercise

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Authors: Atiq U. Zaman, Juliet Arnott

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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.

Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management

Procedia PDF Downloads 183

Authors: Sohrab Jafarpour, Hamed Farokhi, Mohammad Rahmati, Alireza Gholipour

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In the current study, a nonlinear fluid-structure interaction (FSI) biomechanical model of atherosclerosis in the left anterior descending (LAD) coronary artery is developed to perform a detailed sensitivity analysis of the geometrical features of an atheroma plaque. In the development of the numerical model, first, a 3D geometry of the diseased artery is developed based on patient-specific dimensions obtained from the experimental studies. The geometry includes four influential geometric characteristics: stenosis ratio, plaque shoulder-length, fibrous cap thickness, and eccentricity intensity. Then, a suitable strain energy density function (SEDF) is proposed based on the detailed material stability analysis to accurately model the hyperelasticity of the arterial walls. The time-varying inlet velocity and outlet pressure profiles are adopted from experimental measurements to incorporate the pulsatile nature of the blood flow. In addition, a computationally efficient type of structural boundary condition is imposed on the arterial walls. Finally, a non-Newtonian viscosity model is implemented to model the shear-thinning behaviour of the blood flow. According to the results, the structural responses in terms of the maximum principal stress (MPS) are affected more compared to the fluid responses in terms of wall shear stress (WSS) as the geometrical characteristics are varying. The extent of these changes is critical in the vulnerability assessment of an atheroma plaque.

Keywords: atherosclerosis, fluid-Structure interaction modeling, material stability analysis, and nonlinear biomechanics

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Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito

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There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.

Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia

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Authors: Odey Moses Ogah, Felix Terhemba Ikyereve

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The study was carried out to analyzed risks in financing agriculture by agricultural cooperatives in Benue State, Nigeria. The study made use of research questionnaires for data collection. A multistage sampling technique was used to select a sample of 210 respondents from 21 agricultural cooperatives. Both descriptive and inferential statistics were employed in data analysis. Loan defaulting (66.7%) and reduction in savings by members (51.4%) were the major causes of risks faced by agricultural cooperatives in financing agriculture in the study area. Other causes include adverse changes in commodity prices (48.6%), disaster (45.7%), among others. It was found that risks adversely influence the profitability and competition of agricultural cooperatives (82.9%). Multiple regression analysis results showed that the coefficient of multiple determinations was 0.67, implying that the explanatory variables included in the model accounted for 67% of the variation in the level of profitability of agricultural cooperatives. The number of loans, average amount of loan and the interest rate were significant and important determinants of profitability of the cooperatives. The majority of the respondents (88.6%) made use of loan guarantors as a strategy of managing loan default/no repayment. It was found that the majority (70%) of the respondents were faced with the challenge of lack of insurance cover. The study recommends that agricultural cooperative officials should be encouraged to undergo formal training and education to easily acquire administrative skills in the management of agricultural loans; Farmer's loan size should be increased and released on time to enable them to use it effectively. Policies that enhance insuring farm activities should be put in place to discourage farmers from risk aversion.

Keywords: agriculture, analysis, cooperative, finance, risks

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Authors: Amel Osman, Stewart McKenna

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Aim: Fever may present as the sole sign of a serious underlying infection in young infants. Febrile Infants aged less than 90 days are at an elevated susceptibility to invasive bacterial infections, thus presenting a challenge in ensuring the appropriate management of these cases. This study aims to ensure strict adherence to NICE guidelines for the management of fever in infants between 0 and 90 days presenting to Tallaght Hospital ED. A comprehensive audit, followed by a re-audit, was conducted to enhance the quality of care delivered to these patients. In accordance with NICE guidelines, all febrile infants should undergo blood tests. Additionally, LP should be performed in all neonates under 28 days, infants displaying signs of illness, and those with WCC below 5 or above 15. Method: A retrospective case review was performed, encompassing all patients aged between 0 to 90 days who presented with fever at Tallaght ED. Data retrieval was conducted from electronic records on two separate occasions, six months apart. The evaluation encompassed the assessment of body temperature as well as both partial and full septic workups. Results: Over the study period, 150 infants presented to the ED with fever in the initial audit, and 120 in the re-audit. In the first study, 81 patients warranted a full septic workup as per NICE, but only 48 received it. Conversely, 40 patients met criteria for a partial septic workup, with 12 undergoing blood tests. In the second study, 73 patients qualified for a full septic workup, of which 52 were completed. Additionally, 27 patients were indicated for a partial workup, with 20 undergoing blood tests. Conclusion: Managing febrile infants under three months of age presenting to Tallaght ED remains a persistent challenge, underscoring the need for continuous educational initiatives to guarantee that these patients receive the requisite assessments and treatments.

Keywords: infants, fever, septic workup, tallaght

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: Venuste Kayinamura, V. Iyamuremye, A. Ngirabakunzi

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Anti-retroviral therapy (ART) for HIV patient can cause a deficiency in glucose metabolism by promoting insulin resistance, glucose intolerance, and diabetes, diabetes mellitus keep increasing among HIV-infected patients worldwide but there is limited data on levels of blood glucose and its relationship with antiretroviral drugs (ARVs) and HIV-infection worldwide, particularly in Rwanda. A convenient sampling strategy was used in this study and it involved 323 HIV patients (n=323). Patients who are HIV positive under ARVs were involved in this study. The patient’s blood glucose was analyzed using an automated machine or glucometer (COBAS C 311). Data were analyzed using Microsoft Excel and SPSS V. 20.0 and presented in percentages. The highest diabetes mellitus prevalence was 93.33 % in people aged >40 years while the lowest diabetes mellitus prevalence was 6.67% in people aged between 21-and 40 years. The P-value was (0.021). Thus, there is a significant association between age and diabetes occurrence. The highest diabetes mellitus prevalence was 28.2% in patients under ART treatment for more than 10 years, 16.7% were <5years while 20% of patients were on ART treatment between 5-10 years. The P-value here is (0.03), thus the incidence of diabetes is associated with long-term ART use in HIV-infected patients. This study assessed the prevalence of diabetes among HIV-infected patients under ARVs attending the University Teaching Hospital of Butare (CHUB), it shows that the prevalence of diabetes is high in HIV-infected patients under ARTs. This study found no significant relationship between gender and diabetes mellitus growth. Therefore, regular assessment of diabetes mellitus especially among HIV-infected patients under ARVs is highly recommended to control other health issues caused by diabetes mellitus.

Keywords: anti-retroviral, diabetes mellitus, antiretroviral therapy, human immune deficiency virus

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Authors: Zhaopeng Zhu, Xianzhi Song, Gensheng Li, Shuo Zhu, Shiming Duan, Xuezhe Yao

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Accurate calculation of wellbore pressure is of great significance to prevent wellbore risk during drilling. The traditional mechanism model needs a lot of iterative solving procedures in the calculation process, which reduces the calculation efficiency and is difficult to meet the demand of dynamic control of wellbore pressure. In recent years, many scholars have introduced artificial intelligence algorithms into wellbore pressure calculation, which significantly improves the calculation efficiency and accuracy of wellbore pressure. However, due to the ‘black box’ property of intelligent algorithm, the existing intelligent calculation model of wellbore pressure is difficult to play a role outside the scope of training data and overreacts to data noise, often resulting in abnormal calculation results. In this study, the multi-phase flow mechanism is embedded into the objective function of the neural network model as a constraint condition, and an intelligent prediction model of wellbore pressure under the constraint condition is established based on more than 400,000 sets of pressure measurement while drilling (MPD) data. The constraint of the multi-phase flow mechanism makes the prediction results of the neural network model more consistent with the distribution law of wellbore pressure, which overcomes the black-box attribute of the neural network model to some extent. The main performance is that the accuracy of the independent test data set is further improved, and the abnormal calculation values basically disappear. This method is a prediction method driven by MPD data and multi-phase flow mechanism, and it is the main way to predict wellbore pressure accurately and efficiently in the future.

Keywords: multiphase flow mechanism, pressure while drilling data, wellbore pressure, mechanism constraints, combined drive

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Authors: Charles Amoo, Joshua New, Bill Eckman

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Buildings in the United States account for a significant proportion of energy consumption and greenhouse gas (GHG) emissions, and this trend is expected to continue as well as rise in the near future. Low-income households, in particular, bear a disproportionate burden of high building energy consumption and spending due to high energy costs. Energy efficiency improvements need to reach an average of 4% per year in this decade in order to meet global net zero emissions target by 2050, but less than 1 % of U.S. buildings are improved each year. The government has recognized the importance of technology in addressing this issue, and energy efficiency programs have been developed to tackle the problem. The Weatherization Assistance Program (WAP), the largest residential whole-house energy efficiency program in the U.S., is specifically designed to reduce energy costs for low-income households. Under the WAP, energy auditors must follow specific audit procedures and use Department of Energy (DOE) approved energy audit tools or software. This article proposes an expanded framework of factors that should be considered in energy audit software that is approved for use in energy efficiency programs, particularly for low-income households. The framework includes more than 50 factors organized under 14 assessment criteria and can be used to qualitatively and quantitatively score different energy audit software to determine their suitability for specific energy efficiency programs. While the tool can be useful for developers to build new tools and improve existing software, as well as for energy efficiency program administrators to approve or certify tools for use, there are limitations to the model, such as the lack of flexibility that allows continuous scoring to accommodate variability and subjectivity. These limitations can be addressed by using aggregate scores of each criterion as weights that could be combined with value function and direct rating scores in a multicriteria decision analysis for a more flexible scoring.

Keywords: buildings, energy efficiency, energy audit, software

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Authors: Maxwell Ladogo Abilla

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As evidence from the 2007–2008 and 2010 global food and financial crises revealed that food systems were under stress, the idea of sustainable food systems rose to prominence in the discussion of food security. The idea suggests moving away from a conception of food security that emphasizes production in favor of one that is more socially and environmentally conscious and interested in tackling a wide range of issues that have rendered the food system dysfunctional. This study evaluates the efforts made by international development organizations to increase food security in the area, taking into account the persistence of poverty and food insecurity in northern Ghana, utilizing the idea of sustainable food systems as the evaluation criterion. The study used triangulation to address the research questions by combining qualitative interview data with documentary analysis. To better comprehend the concept of sustainability, a variety of discourses and concepts are used, which results in the development of eight doable objectives for attaining sustainable food systems. The study finds that the food system in northern Ghana is unsustainable because of three kinds of barriers, with the practical objectives of developing sustainable food systems serving as the assessment criteria (natural, cultural and economic, and institutional). According to an evaluation of the World Food Programme's development support in northern Ghana, regional challenges to attaining sustainable food systems continue to be unaddressed by global development initiatives. Due to institutional constraints, WFP's interventions fell short of their promise. By demonstrating the need for development partners to enhance institutional efficiency and coordination, enable marginalized communities to access their rights, and prioritize agricultural irrigation in the area, the study makes a contribution to development policy and practice in northern Ghana.

Keywords: sustainable, food security, development, institutional

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Authors: Maia Kukhaleishvili, Ekaterine Bulauri, Iveta Megrelishvili, Tamar Shamatava, Tamar Chipashvili

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Plant viruses can cause loss of yield and quality in a lot of important crops. Symptoms of pathogens are variable depending on the cultivars and virus strain. Selection of resistant potato varieties would reduce the risk of virus transmission and significant economic impact. Other way to avoid reduced harvest yields is regular potato seed production sampling and testing for viral infection. The aim of this study was to determine the occurrence and distribution of viral diseases according potato cultivars for further selection of virus-free material in Georgia. During the summer 2015- 2016, 5 potato cultivars (Sante, Laura, Jelly, Red Sonia, Anushka) at 5 different farms located in Akhalkalaki were tested for 6 different potato viruses: Potato virus A (PVA), Potato virus M (PVM), Potato virus S (PVS), Potato virus X (PVX), Potato virus Y (PVY) and potato leaf roll virus (PLRV). A serological method, Double Antibody Sandwich-Enzyme linked Immunosorbent Assay (DASELISA) was used at the laboratory to analyze the results. The result showed that PVY (21.4%) and PLRV (19.7%) virus presence in collected samples was relatively high compared to others. Researched potato cultivars except Jelly and Laura were infected by PVY with different concentrations. PLRV was found only in three potato cultivars (Sante, Jelly, Red Sonia) and PVM virus (3.12%) was characterized with low prevalence. PVX, PVA and PVS virus infection was not reported. It would be noted that 7.9% of samples were containing PVY/PLRV mix infection. Based on the results it can be concluded that PVY and PLRV infections are dominant in all research cultivars. Therefore significant yield losses are expected. Systematic, long-term control of potato viral infection, especially seed-potatoes, must be regarded as the most important factor to increase seed productivity.

Keywords: virus, potato, infection, diseases

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Authors: Ana Maria Carmen Ilie, Carmela Vaccaro

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Gas migration through wellbore failure, in particular from abandoned wells, is repeatedly identified as the highest risk mechanism. The vadose zone was subject to monitoring system close to the wellbore in Minerbio, methane storage site. The new technology has been well-developed and used with the purpose to provide reliable estimates of leakage parameters. Of these techniques, soil flux sampling at the soil surface, via the accumulation chamber method and soil flux sampling at the depths of 100cm below the ground surface, have been an important technique for characterizing the gas concentrations at the gas storage site. We present results of soil Radon Bq/m3, CO2%, CH4% and O2% concentration gases. Measurements have been taken for radon concentrations with an Durridge RAD7 Company, Inc., USA, instrument. We used for air and soil quality an Biogas ETG instrument monitoring system, with NDIR CO2, CH4 gas sensor and electrochemical O2 gas sensor. The measurements started in September-October 2015, where no outliers have been identified. The measurements have continued in March-April-July-August-September 2016, almost at the same time in the same place around the gas storage site, values measured 15 minutes for each sampling, to determine their concentration, their distribution and to understand the relationship among gases and atmospheric conditions. At a depth of 100 cm, the maximum soil radon gas concentrations were found to be 1770 ±±582 Bq/m3, the soil consists of 64.31% sand, 20.75% silt and 14.94% clay, and with 0.526 ppm of Uranium. The maximum concentration (September 2016), in soil at 100cm below the ground surface, with 83% sand, 8.96% silt and 7.89% clay, was about 0.06% CH4, and in atmosphere 0.06% CH4 at 40°C (T). In the other months the values have been on the range of 0.01% to 0.03% CH4. Since we did not have outliers in the gas storage site, soil-gas samples for isotopic analysis have not been done.

Keywords: leakage gas monitoring, lithology, soil gas, methane

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Authors: Massimiliano Frezza, Sergio Bianchi, Augusto Pianese

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Introduced by Shannon in 1948 in the field of information theory as the average rate at which information is produced by a stochastic set of data, the concept of entropy has gained much attention as a measure of uncertainty and unpredictability associated with a dynamical system, eventually depicted by a stochastic process. In particular, the Shannon entropy measures the degree of order/disorder of a given signal and provides useful information about the underlying dynamical process. It has found widespread application in a variety of fields, such as, for example, cryptography, statistical physics and finance. In this regard, many contributions have employed different measures of entropy in an attempt to characterize the financial time series in terms of market efficiency, market crashes and/or financial crises. The Shannon entropy has also been considered as a measure of the risk of a portfolio or as a tool in asset pricing. This work investigates the theoretical link between the Shannon entropy and the multifractional Brownian motion (mBm), stochastic process which recently is the focus of a renewed interest in finance as a driving model of stochastic volatility. In particular, after exploring the current state of research in this area and highlighting some of the key results and open questions that remain, we show a well-defined relationship between the Shannon (log)entropy and the memory function H(t) of the mBm. In details, we allow both the length of time series and time scale to change over analysis to study how the relation modify itself. On the one hand, applications are developed after generating surrogates of mBm trajectories based on different memory functions; on the other hand, an empirical analysis of several international stock indexes, which confirms the previous results, concludes the work.

Keywords: Shannon entropy, multifractional Brownian motion, Hurst–Holder exponent, stock indexes

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Authors: Ian Omung'a

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Breast cancer remains to be one of the deadliest cancers for women worldwide, with the risk of developing tumors being as high as 50 percent in Sub-Saharan African countries like Kenya. With as many as 42 percent of these cases set to be diagnosed late when cancer has metastasized and or the prognosis has become terminal, Full Field Digital [FFD] Mammography remains an effective screening technique that leads to early detection where in most cases, successful interventions can be made to control or eliminate the tumors altogether. FFD Mammograms have been proven to multiply more effective when used together with Computer-Aided Detection and Diagnosis [CADe] systems, relying on algorithmic implementations of Deep Learning techniques in Computer Vision to carry out deep pattern recognition that is comparable to the level of a human radiologist and decipher whether specific areas of interest in the mammogram scan image portray abnormalities if any and whether these abnormalities are indicative of a benign or malignant tumor. Within this paper, we review emergent Deep Learning techniques that will prove relevant to the development of State-of-The-Art FFD Mammogram CADe systems. These techniques will span self-supervised learning for context-encoded occlusion, self-supervised learning for pre-processing and labeling automation, as well as the creation of a standardized large-scale mammography dataset as a benchmark for CADe systems' evaluation. Finally, comparisons are drawn between existing practices that pre-date these techniques and how the development of CADe systems that incorporate them will be different.

Keywords: breast cancer diagnosis, computer aided detection and diagnosis, deep learning, whole mammogram classfication, ultrasound classification, computer vision

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Authors: Yung-Hui Tang, Yan-Chiou Ku, Li-Chi Huang

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Aim: The aim of this study is to explore the effect of the Humanoid Diagram Teaching (HDT) strategy on novice nurses’ care ability and retention rate. Methods: This study was a quasi-experimental study using two groups concurrently with repeat measurements sample consisted of 24 novice nurses (12 in each experimental and control group) in a medical center in southern Taiwan. Both groups all received regular training program (nursing standard techniques and practices, concept map, mini-CEX, CbD, and clinical education and training), and experimental group added the HDT program. The HDT strategy includes the contents of patients’ body humanoid drawing and discussion for 30 minutes each time, three times a week, and continually for four weeks. The effectiveness of ＨDT was evaluated by mini-CEX, CbD and clinical assessment and retention rate at the 3rd month and 6th month. Results: The novice nurses' care ability were examined, only CbD score in the control group was improved in the 3rd month and with statistical difference, p = .003. The mini-CEX and CbD in the experimental group were significantly improved in both the first and third month with statistical differences p = .00. Although mini-CEX and CbD in the experimental group were higher than the control group, but there was no significant difference p > .05. Retention rate of the experimental group in the third month and sixth month was significantly higher than the control group, and there was a statistically significant difference p < .05. Conclusions: The study reveals that HDT strategy can help novice nurses learning, enhancing their knowledge and technical capability, analytical skills in case-based caring, and retention. The HDT strategy can be served as an effective strategy for novice training for better nurse retention rate.

Keywords: humanoid diagram teaching strategy, novice nurses retention, teaching strategy of nurse retention, visual learning mode

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Authors: Mahesh K. Jat, Ankan Jana, Mahender Choudhary

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Rapid population and economic growth resulted in changes in large-scale land use land cover (LULC) changes. Changes in the biophysical properties of the Earth's surface and its impact on climate are of primary concern nowadays. Different approaches, ranging from location-based relationships or modelling earth surface - atmospheric interaction through modelling techniques like surface energy balance (SEB) are used in the recent past to examine the relationship between changes in Earth surface land cover and climatic characteristics like temperature and precipitation. A remote sensing-based model i.e., Surface Energy Balance Algorithm for Land (SEBAL), has been used to estimate the surface heat fluxes over Mahi Bajaj Sagar catchment (India) from 2001 to 2020. Landsat ETM and OLI satellite data are used to model the SEB of the area. Changes in observed precipitation and temperature, obtained from India Meteorological Department (IMD) have been correlated with changes in surface heat fluxes to understand the relative contributions of LULC change in changing these climatic variables. Results indicate a noticeable impact of LULC changes on climatic variables, which are aligned with respective changes in SEB components. Results suggest that precipitation increases at a rate of 20 mm/year. The maximum and minimum temperature decreases and increases at 0.007 ℃ /year and 0.02 ℃ /year, respectively. The average temperature increases at 0.009 ℃ /year. Changes in latent heat flux and sensible heat flux positively correlate with precipitation and temperature, respectively. Variation in surface heat fluxes influences the climate parameters and is an adequate reason for climate change. So, SEB modelling is helpful to understand the LULC change and its impact on climate.

Keywords: LULC, sensible heat flux, latent heat flux, SEBAL, landsat, precipitation, temperature

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Authors: Hiba T. Allah ALtieb Gusm ALsied, Amna Beshir Medani Ahmed, Ikram Mohamed ELtayeb, Saad Mohamed Hussein Ayoub

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This study was carried out to determine the hepatoactivity and the antioxidant activity of Coiradrum sativum L. aerial part and fruit extracts against CCL4 induced acute liver damages in Wistar rats. The aerial parts and fruits part of the plant were extracted 96% ethanol with soxhlet apparatus. Hepatic injury was achieved by subcutaneous injection of 3 ml/kg of CCL4 diluted with olive oil with ratio 1:1. The extracts were mixed together 1:1 ratio and given in different doses 100,200,400 mg/kg/day for 5 days under CCL4 induction at 3rd day. The significance of differences between means by using T-test was compared among the groups. The mixture of the two extracts didn’t show any significant result in protecting liver injury (antagonistic effects), it shows high level of liver enzyme like alkaline phosphatase (ALP), glutamate oxaloacetate transaminase (SGOT) and glutamate pyruvate transaminase (SGPT). Serological studies further confirmed the results. The results obtained were compared with silymarin (70 mg/kg/day) orally, the standard drug for hepatoprotection which show recovery close to normalization almost like that of silymarin; therefore, further studies on this plant with different ratios especially in isolated tissue to spot more light on antagonistic effects of the two extracts. Antioxidant activity of the extracts was determined by the DPPH method. The results obtained show high anti-oxidant activity for fruits extract while slight or moderate antioxidant activity to aerial extracts.

Keywords: antioxidant, aerial part, Coriadrum sativum L., fruity, hepatoprotection, Silymarin, phytochemical screening

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Authors: Damien Rinsant, Eugen Andreiadis, Michael Carboni, Daniel Meyer

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Different types of materials have been developed for the solid/liquid uranium extraction processes, such as functionalized organic polymers, hybrid silica or inorganic adsorbents. In general, these materials exhibit a moderate affinity for uranyl ions and poor selectivity against impurities like iron, vanadium or molybdenum. Moreover, the structural organization deficiency of these materials generates ion diffusion issues inside the material. Therefore, the aim of our study is to developed efficient and organized materials, stable in the acid media encountered in uranium extraction processes. Metal organic frameworks (MOFs) are hybrid crystalline materials consisting of an inorganic part (cluster or metal ions) and tailored organic linkers connected via coordination bonds. These hierarchical materials have exceptional surface area, thermal stability and a large variety of tunable structures. However, due to the reversibility of constitutive coordination bonds, MOFs have moderate stability in strongly complexing or acidic media. Only few of them are known to be stable in aqueous media and only one example is described in strong acidic media. However, these conditions are very often encountered in the environmental pollution remediation of mine wastewaters. To tackle the challenge of developing MOFs adapted for uranium extraction from acid mine waters, we have investigated the stability of several materials. To ensure a good stability we have synthetized and characterized different materials based on highly coordinated metal clusters, such as LnOFs and Zirconium based materials. Among the latter, the UiO family shows a great stability in sulfuric acid media even in the presence of 1.4 M sodium sulfate at pH 2. However, the stability in phosphoric media is reduced due to the high affinity between zirconium and phosphate ligand. Based on these results, we have developed a tertiary amine functionalized MOF denoted UiO-68-NMe2 particularly adapted for the extraction of anionic uranyl (VI) sulfate complexes mainly present in the acid mine solutions. The adsorption capacity of the material has been determined upon varying total sulfate concentration, contact time and uranium concentration. The extraction tests put in evidence different phenomena due to the complexity of the extraction media and the interaction between the MOF and sulfate anion. Finally, the extraction mechanisms and the interaction between uranyl and the MOF structure have been investigated. The functionalized material UiO-68-NMe2 has been characterized in the presence and absence of uranium by FT-IR, UV and Raman techniques. Moreover, the stability of the protonated amino functionalized MOF has been evaluated. The synthesis, characterization and evaluation of this type of hybrid material, particularly adapted for uranium extraction in sulfuric acid media by an anionic exchange mechanism, paved the way for the development of metal organic frameworks functionalized by different other chelating motifs, such as bifunctional ligands showing an enhanced affinity and selectivity for uranium in acid and complexing media. Work in this direction is currently in progress.

Keywords: extraction, MOF, ligand, uranium

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Authors: Carlos Rios Llamas

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Urban health challenges, like the obesity epidemic, need to be studied from a dialogue between different disciplines and geographical conditions. Public health uses quantitative analysis and local samples, but qualitative data and multisite analysis would help to better understand how obesity has become a health problem. In the last decades, obesity rates have increased in most of the countries, especially in the Western World. Concerned about the problem, the American Medical Association has recently voted obesity as a disease. Suddenly, a ‘war on obesity’ attracted scientists from different disciplines to explore various ways to control and even reverse the trends. Medical sciences have taken the advance with quantitative methodologies focused on individual behaviors. Only a few scientist have extended their studies to the environment where obesity is produced as social risk, and less of them have taken into consideration the political and cultural aspects. This paper presents a multisite ethnography in South Bronx, USA, La Courneuve, France, and Lomas del Sur, Mexico, where obesity rates are as relevant as urban degradation. The comparative ethnography offers a possibility to unveil the mechanisms producing health risks from the urban tissue. The analysis considers three main categories: 1) built environment and access to food and physical activity, 2) biocultural construction of the healthy body, 3) urban inequalities related to health and body size. Major findings from a comparative ethnography on obesogenic environments, refer to the anthropological values related to food and body image, as well as the multidimensional oppression expressed in fat people who live in stigmatized urban zones. At the end, obesity, like many other diseases, is the result of political and cultural constructions structured in urbanization processes.

Keywords: comparative ethnography, urban health, obesogenic cities, biopolitics

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