Search results for: rapid access clinic
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6254

Search results for: rapid access clinic

5294 An Acyclic Zincgermylene: Rapid H₂ Activation

Authors: Martin Juckel

Abstract:

Probably no other field of inorganic chemistry has undergone such a rapid development in the past two decades than the low oxidation state chemistry of main group elements. This rapid development has only been possible by the development of new bulky ligands. In case of our research group, super-bulky monodentate amido ligands and β-diketiminate ligands have been used to a great success. We first synthesized the unprecedented magnesium(I) dimer [ᴹᵉˢNacnacMg]₂ (ᴹᵉˢNacnac = [(ᴹᵉˢNCMe)₂CH]-; Mes = mesityl, which has since been used both as reducing agent and also for the synthesis of new metal-magnesium bonds. In case of the zinc bromide precursor [L*ZnBr] (L*=(N(Ar*)(SiPri₃); (Ar* = C₆H₂{C(H)Ph₂}₂Me-2,6,4, the reduction with [ᴹᵉˢNacnacMg]₂ led to such a metal-magnesium bond. This [L*ZnMg(ᴹᵉˢNacnac)] compound can be seen as an ‘inorganic Grignard reagent’, which can be used to transfer the metal fragment onto other functional groups or other metal centers; just like the conventional Grignard reagent. By simple addition of (TBoN)GeCl (TBoN = N(SiMe₃){B(DipNCH)₂) to the aforesaid compound, we were able to transfer the amido-zinc fragment to the Ge center of the germylene starting material and to synthesize the first example of a germanium(II)-zinc bond: [:Ge(TBoN)(ZnL*)]. While these reactions typically led to complex product mixture, [:Ge(TBoN)(ZnL*)] could be isolated as dark blue crystals in a good yield. This new compound shows interesting reactivity towards small molecules, especially dihydrogen gas. This is of special interest as dihydrogen is one of the more difficult small molecules to activate, due to its strong (BDE = 108 kcal/mol) and non-polar bond. In this context, the interaction between H₂ σ-bond with the tetrelylene p-Orbital (LUMO), with concomitant donation of the tetrelylene lone pair (HOMO) into the H₂ σ* orbital are responsible for the activation of dihydrogen gas. Accordingly, the narrower the HOMO-LUMO gap of tertelylene, the more reactivity towards H₂ it typically is. The aim of a narrow HOMO-LUMO gap was reached by transferring electropositive substituents respectively metal substituents with relatively low Pauling electronegativity (zinc: 1.65) onto the Ge center (here: the zinc-amido fragment). In consideration of the unprecedented reactivity of [:Ge(TBoN)(ZnL*)], a computational examination of its frontier orbital energies was undertaken. The energy separation between the HOMO, which has significant Ge lone pair character, and the LUMO, which has predominantly Ge p-orbital character, is narrow (40.8 kcal/mol; cf.∆S-T= 24.8 kcal/mol), and comparable to the HOMO-LUMO gaps calculated for other literature known complexes). The calculated very narrow HOMO-LUMO gap for the [:Ge(TBoN)(ZnL*)] complex is consistent with its high reactivity, and is remarkable considering that it incorporates a π-basic amide ligand, which are known to raise the LUMO of germylenes considerably.

Keywords: activation of dihydrogen gas, narrow HOMO-LUMO gap, first germanium(II)-zinc bond, inorganic Grignard reagent

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5293 A Robust Optimization Method for Service Quality Improvement in Health Care Systems under Budget Uncertainty

Authors: H. Ashrafi, S. Ebrahimi, H. Kamalzadeh

Abstract:

With the development of business competition, it is important for healthcare providers to improve their service qualities. In order to improve service quality of a clinic, four important dimensions are defined: tangibles, responsiveness, empathy, and reliability. Moreover, there are several service stages in hospitals such as financial screening and examination. One of the most challenging limitations for improving service quality is budget which impressively affects the service quality. In this paper, we present an approach to address budget uncertainty and provide guidelines for service resource allocation. In this paper, a service quality improvement approach is proposed which can be adopted to multistage service processes to improve service quality, while controlling the costs. A multi-objective function based on the importance of each area and dimension is defined to link operational variables to service quality dimensions. The results demonstrate that our approach is not ultra-conservative and it shows the actual condition very well. Moreover, it is shown that different strategies can affect the number of employees in different stages.

Keywords: allocation, budget uncertainty, healthcare resource, service quality assessment, robust optimization

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5292 Quick off the Mark with Achilles Tendon Rupture

Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

Abstract:

Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

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5291 Case Study: 3000acres Facilitating Urban Agriculture in Melbourne, Australia

Authors: Philippa Anne French

Abstract:

This paper presents a case study of 3000acres, a for-purpose organisation established in 2013 to improve the health of Melbournians by enabling them to grow more of their own food. Over the past four years, the organisation has encountered a number of barriers, both obvious and less obvious, which discourage communities from beginning their own food-growing projects. These include soil contamination, planning policies, public perception and access to land. 3000acres has been working to remove these barriers if possible, or otherwise to find ways around them. Strategies have included the use of removable planter boxes on temporarily vacant land, separating the site soil from above-ground garden beds, writing planning exemptions, developing relationships with land management authorities and recording both the quantitative and qualitative products of food gardens in Melbourne. While creating change in policy and legal requirements will be a gradual process, discernable progress has been made in the attitudes of land management authorities and the establishment of new food gardens is becoming easier. Over the past four years, 3000acres has supported the establishment of 14 food gardens in and around Melbourne, including public community gardens, fenced community gardens and urban farms supplying food to a food relief organisation.

Keywords: case study, community gardens, land access, land contamination, urban agriculture

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5290 Assessing Sexual and Reproductive Health Literacy and Engagement Among Refugee and Immigrant Women in Massachusetts: A Qualitative Community-Based Study

Authors: Leen Al Kassab, Sarah Johns, Helen Noble, Nawal Nour, Elizabeth Janiak, Sarrah Shahawy

Abstract:

Introduction: Immigrant and refugee women experience disparities in sexual and reproductive health (SRH) outcomes, partially as a result of barriers to SRH literacy and to regular healthcare access and engagement. Despite the existing data highlighting growing needs for culturally relevant and structurally competent care, interventions are scarce and not well-documented. Methods: In this IRB-approved study, we used a community-based participatory research approach, with the assistance of a community advisory board, to conduct a qualitative needs assessment of SRH knowledge and service engagement with immigrant and refugee women from Africa or the Middle East and currently residing in Boston. We conducted a total of nine focus group discussions (FGDs) in partnership with medical, community, and religious centers, in six languages: Arabic, English, French, Somali, Pashtu, and Dari. A total of 44 individuals participated. We explored migrant and refugee women’s current and evolving SRH care needs and gaps, specifically related to the development of interventions and clinical best practices targeting SRH literacy, healthcare engagement, and informed decision-making. Recordings of the FGDs were transcribed verbatim and translated by interpreter services. We used open coding with multiple coders who resolved discrepancies through consensus and iteratively refined our codebook while coding data in batches using Dedoose software. Results: Participants reported immigrant adaptation experiences, discrimination, and feelings of trust, autonomy, privacy, and connectedness to family, community, and the healthcare system as factors surrounding SRH knowledge and needs. The context of previously learned SRH knowledge was commonly noted to be in schools, at menstruation, before marriage, from family members, partners, friends, and online search engines. Common themes included empowering strength drawn from religious and cultural communities, difficulties bridging educational gaps with their US- born daughters, and a desire for more SRH education from multiple sources, including family, health care providers, and religious experts & communities. Regarding further SRH education, participants’ preferences varied regarding ideal platform (virtual vs. in-person), location (in religious and community centers or not), smaller group sizes, and the involvement of men. Conclusions: Based on these results, empowering SRH initiatives should include both community and religious center-based, as well as clinic-based, interventions. Interventions should be composed of frequent educational workshops in small groups involving age-grouped women, daughters, and (sometimes) men, tailored SRH messaging, and the promotion of culturally, religiously, and linguistically competent care.

Keywords: community, immigrant, religion, sexual & reproductive health, women's health

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5289 Influence of the Local External Pressure on Measured Parameters of Cutaneous Microcirculation

Authors: Irina Mizeva, Elena Potapova, Viktor Dremin, Mikhail Mezentsev, Valeri Shupletsov

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The local tissue perfusion is regulated by the microvascular tone which is under the control of a number of physiological mechanisms. Laser Doppler flowmetry (LDF) together with wavelet analyses is the most commonly used technique to study the regulatory mechanisms of cutaneous microcirculation. External factors such as temperature, local pressure of the probe on the skin, etc. influence on the blood flow characteristics and are used as physiological tests to evaluate microvascular regulatory mechanisms. Local probe pressure influences on the microcirculation parameters measured by optical methods: diffuse reflectance spectroscopy, fluorescence spectroscopy, and LDF. Therefore, further study of probe pressure effects can be useful to improve the reliability of optical measurement. During pressure tests variation of the mean perfusion measured by means of LDF usually is estimated. An additional information concerning the physiological mechanisms of the vascular tone regulation system in response to local pressure can be obtained using spectral analyses of LDF samples. The aim of the present work was to develop protocol and algorithm of data processing appropriate for study physiological response to the local pressure test. Involving 6 subjects (20±2 years) and providing 5 measurements for every subject we estimated intersubject and-inter group variability of response of both averaged and oscillating parts of the LDF sample on external surface pressure. The final purpose of the work was to find special features which further can be used in wider clinic studies. The cutaneous perfusion measurements were carried out by LAKK-02 (SPE LAZMA Ltd., Russia), the skin loading was provided by the originally designed device which allows one to distribute the pressure around the LDF probe. The probe was installed on the dorsal part of the distal finger of the index figure. We collected measurements continuously for one hour and varied loading from 0 to 180mmHg stepwise with a step duration of 10 minutes. Further, we post-processed the samples using the wavelet transform and traced the energy of oscillations in five frequency bands over time. Weak loading leads to pressure-induced vasodilation, so one should take into account that the perfusion measured under pressure conditions will be overestimated. On the other hand, we revealed a decrease in endothelial associated fluctuations. Further loading (88 mmHg) induces amplification of pulsations in all frequency bands. We assume that such loading leads to a higher number of closed capillaries, higher input of arterioles in the LDF signal and as a consequence more vivid oscillations which mainly are formed in arterioles. External pressure higher than 144 mmHg leads to the decrease of oscillating components, after removing the loading very rapid restore of the tissue perfusion takes place. In this work, we have demonstrated that local skin loading influence on the microcirculation parameters measured by optic technique; this should be taken into account while developing portable electronic devices. The proposed protocol of local loading allows one to evaluate PIV as far as to trace dynamic of blood flow oscillations. This study was supported by the Russian Science Foundation under project N 18-15-00201.

Keywords: blood microcirculation, laser Doppler flowmetry, pressure-induced vasodilation, wavelet analyses blood

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5288 Traffic Forecasting for Open Radio Access Networks Virtualized Network Functions in 5G Networks

Authors: Khalid Ali, Manar Jammal

Abstract:

In order to meet the stringent latency and reliability requirements of the upcoming 5G networks, Open Radio Access Networks (O-RAN) have been proposed. The virtualization of O-RAN has allowed it to be treated as a Network Function Virtualization (NFV) architecture, while its components are considered Virtualized Network Functions (VNFs). Hence, intelligent Machine Learning (ML) based solutions can be utilized to apply different resource management and allocation techniques on O-RAN. However, intelligently allocating resources for O-RAN VNFs can prove challenging due to the dynamicity of traffic in mobile networks. Network providers need to dynamically scale the allocated resources in response to the incoming traffic. Elastically allocating resources can provide a higher level of flexibility in the network in addition to reducing the OPerational EXpenditure (OPEX) and increasing the resources utilization. Most of the existing elastic solutions are reactive in nature, despite the fact that proactive approaches are more agile since they scale instances ahead of time by predicting the incoming traffic. In this work, we propose and evaluate traffic forecasting models based on the ML algorithm. The algorithms aim at predicting future O-RAN traffic by using previous traffic data. Detailed analysis of the traffic data was carried out to validate the quality and applicability of the traffic dataset. Hence, two ML models were proposed and evaluated based on their prediction capabilities.

Keywords: O-RAN, traffic forecasting, NFV, ARIMA, LSTM, elasticity

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5287 Clinical Characteristics of Children Presenting with History of Child Sexual Abuse to a Tertiary Care Centre in India

Authors: T. S. Sowmya Bhaskaran, Shekhar Seshadri

Abstract:

This study aims to study the clinical features of with a history of Child Sexual Abuse (CSA). A chart review of 40 children (<16 years) with history of CSA evaluated at the Department of Child and Adolescent Psychiatry of NIMHANS during a two year period was performed. Results:The most common form of abuse was contact penetrative abuse (65%) followed by non-contact penetrative abuse (32.5%). 75% (N=30) had a psychiatric diagnosis at baseline. 50% of these children had one or more psychiatric comorbidities. Anxiety disorder was the most common diagnosis (27.5%) which included PTSD (11%) followed by Depressive disorder (25.2%). Children abused by multiple perpetrators were found to be more likely to have depression, to having a comorbid psychiatric disorder and more prone to exhibit sexualized behaviour. Children who also experienced physical violence at home were more likely to develop psychiatric illness following child sexual abuse. Psychiatric morbidity is high in clinic population of children with history of CSA. It is important to increase the awareness regarding the consequences of CSA in order to increase help seeking.

Keywords: child sexual abuse, India, tertiary care centre, clinical characteristics

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5286 Effect of Ultrasonic Assisted High Pressure Soaking of Soybean on Soymilk Properties

Authors: Rahul Kumar, Pavuluri Srinivasa Rao

Abstract:

This study investigates the effect of ultrasound-assisted high pressure (HP) treatment on the soaking characteristic of soybeans and extracted soy milk quality. The soybean (variety) was subjected to sonication (US) at ambient temperature for 15 and 30 min followed by HP treatment in the range of 200-400 MPa for dwell times 5-10 min. The bean samples were also compared with HPP samples (200-400 MPa; 5-10 mins), overnight soaked samples(12-15 h) and thermal treated samples (100°C/30 min) followed by overnight soaking for 12-15 h soaking. Rapid soaking within 40 min was achieved by the combined US-HPP treatment, and it reduced the soaking time by about 25 times in comparison to overnight soaking or thermal treatment followed by soaking. Reducing the soaking time of soybeans is expected to suppress the development of undesirable beany flavor of soy milk developed during normal soaking milk extraction. The optimum moisture uptake by the sonicated-pressure treated soybeans was 60-62% (w.b) similar to that obtained after overnight soaking for 12-15 h or thermal treatment followed by overnight soaking. pH of soy milk was not much affected by the different US-HPP treatments and overnight soaking which centered around the range of 6.6-6.7 much like the normal cow milk. For milk extracted from thermally treated soy samples, pH reduced to 6.2. Total soluble solids were found to be maximum for the normal overnight soaked soy samples, and it was in the range of 10.3-10.6. For the HPP treated soy milk, the TSS reduced to 7.4 while sonication further reduced it to 6.2. TSS was found to be getting reduced with increasing time of ultrasonication. Further reduction in TSS to 2.3 was observed in soy milk produced from thermally treated samples following overnight soaking. Our results conclude that thermally treated beans' milk is less stable and more acidic, soaking is very rapid compared to overnight soaking hence milk productivity can be enhanced with less development of undesirable beany flavor.

Keywords: beany flavor, high pressure processing, high pressure, soybean, soaking, milk, ultrasound, wet basis

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5285 Conception and Misconceptions About Mental Health in Gwafan Community of Jos North Nigeria

Authors: Tabitha D. Hussein, Arigu M. Sunday

Abstract:

This paper is an attempt to gauge the conception and misconception of mental health in the Gwafan community, Jos North Plateau State, Nigeria (West Africa), to ascertain which side of the scale the pendulum swings. Mental health education and awareness are necessary for healthy community development. However, in a society such as ours in Nigeria (Africa) that is not knowledge-based, it is easy for people to embrace hearsay, speculations, superstition, and the supernatural. The objectives of this paper are two folds: first, to examine the level of awareness of the people on mental health, or the lack of it; second, to ascertain their access to mental health services and good practices. The methodology adopted is qualitative research, and the instrument used is T-test related. The findings include, first, the fact that a larger population has misconceptions about Mental Health. Second, this misconception is a result of a lack of basic knowledge of Mental Health. Based on the aforementioned, the paper recommends that there is a need for more Mental Health Education among the populace and access to Mental Health services and practices (Preventative and Curative). The paper concludes that in a society that is not knowledgebase, every attempt should be made to shift people’s mindset from superstitious knowledge to evidence-based knowledge, which can empower them to make informed decisions not only on mental Health but on associative Health issues that can aid their wellbeing, livelihood and sustainable development as a whole.

Keywords: conceptions, misconceptions, mental health, knowledge, superstition, service delivery

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5284 Learning the C-A-Bs: Resuscitation Training at Rwanda Military Hospital

Authors: Kathryn Norgang, Sarah Howrath, Auni Idi Muhire, Pacifique Umubyeyi

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Description : A group of nurses address the shortage of trained staff to respond to critical patients at Rwanda Military Hospital (RMH) by developing a training program and a resuscitation response team. Members of the group who received the training when it first launched are now trainer of trainers; all components of the training program are organized and delivered by RMH staff-the clinical mentor only provides adjunct support. This two day training is held quarterly at RMH; basic life support and exposure to interventions for advanced care are included in the test and skills sign off. Seventy staff members have received the training this year alone. An increased number of admission/transfer to ICU due to successful resuscitation attempts is noted. Lessons learned: -Number of staff trained 2012-2014 (to be verified). -Staff who train together practice with greater collaboration during actual resuscitation events. -Staff more likely to initiate BLS if peer support is present-more staff trained equals more support. -More access to Advanced Cardiac Life Support training is necessary now that the cadre of BLS trained staff is growing. Conclusions: Increased access to training, peer support, and collaborative practice are effective strategies to strengthening resuscitation capacity within a hospital.

Keywords: resuscitation, basic life support, capacity building, resuscitation response teams, nurse trainer of trainers

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5283 Mobile Health Apps Can Cause More Harm Due to Health Anxiety Than Good

Authors: Malik Takreem Ahmad, Pablo Lamata, Rasi Mizori

Abstract:

Background: In recent years, mobile health apps have grown in popularity as a means for people to track and manage their health. While there is increasing worry that these applications may potentially contribute to the emergence of health anxiety, they can also help to encourage healthy behaviours and provide access to health information. Objective: The objective of this literature review is to look at available mhealth apps and critically evaluate the compromise between reassurance and anxiety. Methodology: A literature review was carried out to analyse the effects of mhealth apps on the creation of health anxiety within the general population. PubMed and SCOPUS were used to search for relevant articles, and abstracts were screened using inclusion criteria of the terms: mhealth apps; e-Health; healthcare apps; cyberchondria; Health anxiety; illness anxiety disorder. A total of 27 studies were included in the review. Results and discussion: The findings suggest a direct relationship between mobile health app use and health anxiety. The impact of mobile health apps on health anxiety may depend on how they are used - individuals receiving a constant stream of health-related information may trigger unnecessary concern about one's health. The need for more regulation and oversight is identified, which can lead to app quality and safety consistency. There are also concerns about data security and privacy and the resulting "digital gap" for individuals without mobiles or internet access. Conclusion: While health apps can be valuable tools for managing and tracking health, individuals need to use them in a balanced and informed way to avoid increased anxiety.

Keywords: mobile health, mhealth apps, cyberchondria, health anxiety

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5282 A Preliminary Study of the Reconstruction of Urban Residential Public Space in the Context of the “Top-down” Construction Model in China: Based on Research of TianZiFang District in Shanghai and Residential Space in Hangzhou

Authors: Wang Qiaowei, Gao Yujiang

Abstract:

With the economic growth and rapid urbanization after the reform and openness, some of China's fast-growing cities have demolished former dwellings and built modern residential quarters. The blind, incomplete reference to western modern cities and the one-off construction lacking feedback mechanism have intensified such phenomenon, causing the citizen gradually expanded their living scale with the popularization of car traffic, and the peer-to-peer lifestyle gradually settled. The construction of large-scale commercial centers has caused obstacles to small business around the residential areas, leading to space for residents' interaction has been compressed. At the same time, the advocated Central Business District (CBD) model even leads to the unsatisfactory reconstruction of many historical blocks such as the Hangzhou Southern Song Dynasty Imperial Street. However, the popularity of historical spaces such as Wuzhen and Hongcun also indicates the collective memory and needs of the street space for Chinese residents. The evolution of Shanghai TianZiFang also proves the importance of the motivation of space participants in space construction in the context of the “top-down” construction model in China. In fact, there are frequent occurrences of “reconstruction”, which may redefine the space, in various residential areas. If these activities can be selectively controlled and encouraged, it will be beneficial to activate the public space as well as the residents’ intercourse, so that the traditional Chinese street space can be reconstructed in the context of modern cities.

Keywords: rapid urbanization, traditional street space, space re-construction, bottom-up design

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5281 About Some Results of the Determination of Alcohol in Moroccan Gasoline-Alcohol Mixtures

Authors: Mahacine Amrani

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A simple and rapid method for the determination of alcohol in gasoline-alcohol mixtures using density measurements is described. The method can determine a minimum of 1% of alcohol by volume. The precision of the method is ± 3%.The method is more useful for field test in the quality assessment of alcohol blended fuels.

Keywords: gasoline-alcohol, mixture, alcohol determination, density, measurement, Morocco

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5280 Influence of Internal Topologies on Components Produced by Selective Laser Melting: Numerical Analysis

Authors: C. Malça, P. Gonçalves, N. Alves, A. Mateus

Abstract:

Regardless of the manufacturing process used, subtractive or additive, material, purpose and application, produced components are conventionally solid mass with more or less complex shape depending on the production technology selected. Aspects such as reducing the weight of components, associated with the low volume of material required and the almost non-existent material waste, speed and flexibility of production and, primarily, a high mechanical strength combined with high structural performance, are competitive advantages in any industrial sector, from automotive, molds, aviation, aerospace, construction, pharmaceuticals, medicine and more recently in human tissue engineering. Such features, properties and functionalities are attained in metal components produced using the additive technique of Rapid Prototyping from metal powders commonly known as Selective Laser Melting (SLM), with optimized internal topologies and varying densities. In order to produce components with high strength and high structural and functional performance, regardless of the type of application, three different internal topologies were developed and analyzed using numerical computational tools. The developed topologies were numerically submitted to mechanical compression and four point bending testing. Finite Element Analysis results demonstrate how different internal topologies can contribute to improve mechanical properties, even with a high degree of porosity relatively to fully dense components. Results are very promising not only from the point of view of mechanical resistance, but especially through the achievement of considerable variation in density without loss of structural and functional high performance.

Keywords: additive manufacturing, internal topologies, porosity, rapid prototyping, selective laser melting

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5279 Importance of an E-Learning Program in Stress Field for Postgraduate Courses of Doctors

Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau

Abstract:

Background: Preparing in the stress field (SF) is, increasingly, a concern for doctors of different specialties. Aims: The aim was to evaluate the importance of an e-learning program for doctors postgraduate courses, in SF. Methods: Doctors (n= 40 male, 40 female) of different specialties and ages (31-71 years), who attended postgraduate courses in SF, voluntarily responded to a questionnaire that included the following themes: Importance of SF courses for specialty practiced by each respondent doctor (using visual analogue scale, VAS); What SF themes would be indicated as e-learning (EL); Preferred form of SF information assimilation: Classical lectures (CL), EL or a combination of these methods (CL+EL); Which information on the SF course are facilitated by EL model versus CL; In their view which are the first four advantages and the first four disadvantages of EL compared to CL, for SF. Results: To most respondents, the SF courses are important for the specialty they practiced (VAS by an average of 4). The SF themes suggested to be done as EL were: Stress mechanisms; stress factor models for different medical specialties; stress assessment methods; primary stress management methods for different specialties. Preferred form of information assimilation was CL+EL. Aspects of the course facilitated by EL versus CL model: Active reading of theoretical information, with fast access to keywords details; watching documentaries in everyone's favorite order; practice through tests and the rapid control of results. The first four EL advantages, mentioned for SF were: Autonomy in managing the time allocated to the study; saving time for traveling to the venue; the ability to read information in various contexts of time and space; communication with colleagues, in good times for everyone. The first three EL disadvantages, mentioned for SF were: It decreases capabilities for group discussion and mobilization for active participation; EL information accession may depend on electrical source or/and Internet; learning slowdown can appear, by temptation of postponing the implementation. Answering questions was partially influenced by the respondent's age and genre. Conclusions: 1) Post-graduate courses in SF are of interest to doctors of different specialties. 2) The majority of participating doctors preferred EL, but combined with CL (CL+EL). 3) Preference for EL was manifested mainly by young or middle age men doctors. 4) It is important to balance the proper formula for chosen EL, to be the most efficient, interesting, useful and agreeable.

Keywords: stress field, doctors’ postgraduate courses, classical lectures, e-learning lecture

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5278 Quantifying the Rapid Urbanization Impact on Potential Stormwater Runoff of Dhaka City, Bangladesh

Authors: Md. Kumruzzaman, Anutosh Das, Md. Mosharraf Hossain

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Historically, rapid urban growth activities are considered one of the main culprits behind urban floods or waterlogging. The increased unplanned urbanization of many areas of Dhaka has resulted in waterlogging, urban floods, and increasing groundwater depth. To determine potential groundwater recharge from precipitation, the study is being conducted to examine the changes in land use/land cover (LULC) and urban runoff extent based on the NRCS-CN from 2005–2021. Four kinds of land use are used to examine the LULC change: built-up, bare land, vegetation, and water body. These categories are used for the years 2005, 2010, 2015, and 2021. The built-up area is growing at a relatively fast rate: 7.43%, 17.4%, and 5.21%, respectively, between the years 2005 and 2010, 2010 and 2015, and 2015 and 2021. As the amount of impervious surface rose in Dhaka city, stormwater discharge increased from 2005 to 2021. In 2005, 2010, 2015, and 2021, heavy stormwater runoff regions made up around 24.873%, 32.616%, 49.118%, and 55.986% of the entire Dhaka city. Stormwater runoff accounted for around 53.738%, 55.092%, 63.472%, and 67.061% of the total rainfall in 2005, 2010, 2015, and 2021, respectively. Between 2005 and 2021, a significant portion of the natural land cover was altered because of the expanding impervious surface, which also harmed the natural drainage system. Due to careless growth, the potential for stormwater runoff and groundwater recharge in Dhaka city worsens every year. Concerning this situation, a sustainable urban drainage system (SUDS) can be the best possible solution for minimizing the stormwater runoff and groundwater recharge problem.

Keywords: LULC, impervious surface, stormwater runoff, groundwater recharge, SUDS

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5277 Policies and Practice of Refugee Education from Malaysian Perspective: Preliminary Findings

Authors: A. H. A. Hamid, N. A. Zainuddin, M. Y. M. Nor

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Millions of child refugees leave their countries in the hope of better and safer lives particularly in the aspect of education. However, the education access for the child refugees is strongly depending on the policies made by the federal and local governments. Malaysia, in particular, is a country which does not have a specific educational policy that is inclusive of child refugees. Hence, this study explores the feasibility of possible educational policy that specifically caters the needs of child refugees in Malaysia. These are preliminary findings of a case study which involved thirty-five postgraduate students in a local university who undertook Educational Policy coursework and five teachers in a refugee community centre in Kuala Lumpur, Malaysia. Interviews were recorded, transcribed and thematically analysed in relation to issues highlighted in the refugee education literature. The findings showed that most of the informants felt there is an urgent need of a systematic intervention put in place by the local government to cater to the needs of equal education access to the child refugees. A further large scale study is needed in the near future by integrating different perspectives of relevant stakeholders for an effective, efficient and sustainable policy formulation and implementation related to child refugees in Malaysia. The findings may be of interests to the educators, the ministry of education, state education office, district education office, teachers, parents and surrounding communities for their awareness about the needs of refugee education and the feasibility of educational policy for child refugees in the country.

Keywords: child refugees, educational policy, inclusive education, Malaysia

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5276 The Impact of Anxiety on the Access to Phonological Representations in Beginning Readers and Writers

Authors: Regis Pochon, Nicolas Stefaniak, Veronique Baltazart, Pamela Gobin

Abstract:

Anxiety is known to have an impact on working memory. In reasoning or memory tasks, individuals with anxiety tend to show longer response times and poorer performance. Furthermore, there is a memory bias for negative information in anxiety. Given the crucial role of working memory in lexical learning, anxious students may encounter more difficulties in learning to read and spell. Anxiety could even affect an earlier learning, that is the activation of phonological representations, which are decisive for the learning of reading and writing. The aim of this study is to compare the access to phonological representations of beginning readers and writers according to their level of anxiety, using an auditory lexical decision task. Eighty students of 6- to 9-years-old completed the French version of the Revised Children's Manifest Anxiety Scale and were then divided into four anxiety groups according to their total score (Low, Median-Low, Median-High and High). Two set of eighty-one stimuli (words and non-words) have been auditory presented to these students by means of a laptop computer. Stimuli words were selected according to their emotional valence (positive, negative, neutral). Students had to decide as quickly and accurately as possible whether the presented stimulus was a real word or not (lexical decision). Response times and accuracy were recorded automatically on each trial. It was anticipated a) longer response times for the Median-High and High anxiety groups in comparison with the two others groups, b) faster response times for negative-valence words in comparison with positive and neutral-valence words only for the Median-High and High anxiety groups, c) lower response accuracy for Median-High and High anxiety groups in comparison with the two others groups, d) better response accuracy for negative-valence words in comparison with positive and neutral-valence words only for the Median-High and High anxiety groups. Concerning the response times, our results showed no difference between the four groups. Furthermore, inside each group, the average response times was very close regardless the emotional valence. Otherwise, group differences appear when considering the error rates. Median-High and High anxiety groups made significantly more errors in lexical decision than Median-Low and Low groups. Better response accuracy, however, is not found for negative-valence words in comparison with positive and neutral-valence words in the Median-High and High anxiety groups. Thus, these results showed a lower response accuracy for above-median anxiety groups than below-median groups but without specificity for the negative-valence words. This study suggests that anxiety can negatively impact the lexical processing in young students. Although the lexical processing speed seems preserved, the accuracy of this processing may be altered in students with moderate or high level of anxiety. This finding has important implication for the prevention of reading and spelling difficulties. Indeed, during these learnings, if anxiety affects the access to phonological representations, anxious students could be disturbed when they have to match phonological representations with new orthographic representations, because of less efficient lexical representations. This study should be continued in order to precise the impact of anxiety on basic school learning.

Keywords: anxiety, emotional valence, childhood, lexical access

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5275 Implementing Effective Strategies to Improve Teaching and Learning in Higher Education: Balancing the Engagement Acts between Lecturers And Students

Authors: Jeffrey Siphiwe Mkhize

Abstract:

Twelve years of schooling for most South African children, particularly those children from disadvantaged past, are confronted with numerous and diverse challenges. These challenges range from infrastructural limitations, language of teaching, poor resources and varying family backgrounds. Likewise, schools are categorized to signify schools’ geographic location, poverty lines, societal class and type of students that the school are likely to enroll. Such categorization perpetuates particular lines of identities that are indirectly reinforced by the same system that seeks to redress. South African universities prefer point systems to determine students’ suitability to gain access to their programmes. Once students are admitted based on the qualifying points there is an assumed equity in the manner in which they receive tuition. They are assumed as equal; noting the widened access to South African universities as means to redress past inequalities. Given the challenges, inequalities, it is necessary to view higher education as a site for knowledge construction that is accessible to all students. Epistemological access is key to all students irrespective of their socio-economic status. This paper seeks to contribute to the discourse of student engagement using lecturer-student relationship as a lens to understand this phenomenon. Data were generated using South African Survey of Student Engagement, focus group interviews, semi-structured one-on-one-interviews as well as document analysis. The focus was on students registered for the first year of a Bachelor of Education degree as well as lecturers that teach high risk modules in this qualification at the same level. The findings suggest that lecturers are challenged by overcrowded classrooms and over-enrolled modules; this challenge hampers their good intentions to become more efficient and innovative in their teaching. Students lack confidence in approaching lecturers for assistance. Collaborative learning has stronger results and students believe in self-support to deal with their challenges based on their individual strengths. Collaborative learning is key to student academic performance.

Keywords: collaborative learning, consultations, student engagement, student performance

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5274 Willingness to Use Mobile Telephone Technology to Improve Pregnancy Outcomes among Women in Lagos, Nigeria

Authors: O. Onigbogi, M. Onigbogi Jr., O. Ojo

Abstract:

Background: The advances in mobile telephone technology has led to a rise in its use globally which has improved service delivery, empowered businesses and changed the way people access information. The practice of many health professionals has also been affected by the information and communications technology (ICT) revolution because they have better access to information. This study was conducted to assess the willingness to participate in mobile technology interventions to improve pregnancy outcomes in Lagos, Nigeria. Materials and Methods: A total of 238 respondents completed self-administered questionnaires. SPSS version 18 data editor was used to analyze data. Univariate odds ratios and 95% confidence intervals (95 % CI) were used to evaluate the correlates of Willingness to Use (WTU) mobile phones to receive health messages during pregnancy. Results: A total of 107 women (45% of the respondents) reported that they will be willing to receive health-related information on their phones during pregnancy. Greater willingness was associated with higher education (OR = 1.25, 95% CI: 1.13–1.53), involvement with community volunteer organizations (OR = 1.25, 95% CI: 1.05–1.52), monetary incentives (OR = 1.37, 95% CI: 1.14–1.45) and nulliparity (OR = 1.39, 95% CI: 1.02–1.42). Decreased willingness was associated with concerns about wrong interpretation of information (OR = 0.42, 95% CI: 0.21–0.54), poor mobile telephone service by providers (OR = 0.61, 95% CI: 0.52–0.78), increase in number of messages (OR = 0.78, 95% CI: 0.53–0.76). Conclusion: The level of WTU recorded indicates that much work still needs to be done before this novel approach could be used adopted in delivering health-related information. Incentives for would-be subjects should also be a part of the planning to encourage greater participation.

Keywords: mobile, outcomes, pregnancy, technology, telephone

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5273 Digital Immunity System for Healthcare Data Security

Authors: Nihar Bheda

Abstract:

Protecting digital assets such as networks, systems, and data from advanced cyber threats is the aim of Digital Immunity Systems (DIS), which are a subset of cybersecurity. With features like continuous monitoring, coordinated reactions, and long-term adaptation, DIS seeks to mimic biological immunity. This minimizes downtime by automatically identifying and eliminating threats. Traditional security measures, such as firewalls and antivirus software, are insufficient for enterprises, such as healthcare providers, given the rapid evolution of cyber threats. The number of medical record breaches that have occurred in recent years is proof that attackers are finding healthcare data to be an increasingly valuable target. However, obstacles to enhancing security include outdated systems, financial limitations, and a lack of knowledge. DIS is an advancement in cyber defenses designed specifically for healthcare settings. Protection akin to an "immune system" is produced by core capabilities such as anomaly detection, access controls, and policy enforcement. Coordination of responses across IT infrastructure to contain attacks is made possible by automation and orchestration. Massive amounts of data are analyzed by AI and machine learning to find new threats. After an incident, self-healing enables services to resume quickly. The implementation of DIS is consistent with the healthcare industry's urgent requirement for resilient data security in light of evolving risks and strict guidelines. With resilient systems, it can help organizations lower business risk, minimize the effects of breaches, and preserve patient care continuity. DIS will be essential for protecting a variety of environments, including cloud computing and the Internet of medical devices, as healthcare providers quickly adopt new technologies. DIS lowers traditional security overhead for IT departments and offers automated protection, even though it requires an initial investment. In the near future, DIS may prove to be essential for small clinics, blood banks, imaging centers, large hospitals, and other healthcare organizations. Cyber resilience can become attainable for the whole healthcare ecosystem with customized DIS implementations.

Keywords: digital immunity system, cybersecurity, healthcare data, emerging technology

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5272 Role of Tele-health in Expansion of Medical Care

Authors: Garima Singh, Kunal Malhotra

Abstract:

Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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5271 Solution-Processed Threshold Switching Selectors Based on Highly Flexible, Transparent and Scratchable Silver Nanowires Conductive Films

Authors: Peiyuan Guan, Tao Wan, Dewei Chu

Abstract:

With the flash memory approaching its physical limit, the emerging resistive random-access memory (RRAM) has been considered as one of the most promising candidates for the next-generation non-volatile memory. One selector-one resistor configuration has shown the most promising way to resolve the crosstalk issue without affecting the scalability and high-density integration of the RRAM array. By comparison with other candidates of selectors (such as diodes and nonlinear devices), threshold switching selectors dominated by formation/spontaneous rupture of fragile conductive filaments have been proved to possess low voltages, high selectivity, and ultra-low current leakage. However, the flexibility and transparency of selectors are barely mentioned. Therefore, it is a matter of urgency to develop a selector with highly flexible and transparent properties to assist the application of RRAM for a diversity of memory devices. In this work, threshold switching selectors were designed using a facilely solution-processed fabrication on AgNWs@PDMS composite films, which show high flexibility, transparency and scratch resistance. As-fabricated threshold switching selectors also have revealed relatively high selectivity (~107), low operating voltages (Vth < 1 V) and good switching performance.

Keywords: flexible and transparent, resistive random-access memory, silver nanowires, threshold switching selector

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5270 Lucilia Sericata Netrin-A: Secreted by Salivary Gland Larvae as a Potential to Neuroregeneration

Authors: Hamzeh Alipour, Masoumeh Bagheri, Tahereh Karamzadeh, Abbasali Raz, Kourosh Azizi

Abstract:

Netrin-A, a protein identified for conducting commissural axons, has a similar role in angiogenesis. In addition, studies have shown that one of the netrin-A receptors is expressed in the growing cells of small capillaries. It will be interesting to study this new group of molecules because their role in wound healing will become clearer in the future due to angiogenesis. The greenbottle blowfly Luciliasericata (L. sericata) larvae are increasingly used in maggot therapy of chronic wounds. This aim of this was the identification of moleculareatures of Netrin-A in L. sericata larvae. Larvae were reared under standard maggotarium conditions. The nucleic acid sequence of L. sericataNetrin-A (LSN-A) was then identified using Rapid Amplification of cDNA Ends (RACE) and Rapid Amplification of Genomic Ends (RAGE). Parts of the Netrin-A gene, including the middle, 3′-, and 5′-ends were identified, TA cloned in pTG19 plasmid, and transferred into DH5ɑ Escherichia coli. Each part was sequenced and assembled using SeqMan software. This gene structure was further subjected to in silico analysis. The DNA of LSN-A was identified to be 2407 bp, while its mRNA sequence was recognized as 2115 bp by Oligo0.7 software. It translated the Netrin-A protein with 704 amino acid residues. Its molecular weight is estimated to be 78.6 kDa. The 3-D structure ofNetrin-A drawn by SWISS-MODEL revealed its similarity to the Netrin-1 of humans with 66.8% identity. The LSN-A protein conduces to repair the myelin membrane in neuronal cells. Ultimately, it can be an effective candidate in neural regeneration and wound healing. Furthermore, our next attempt is to deplore recombinant proteins for use in medical sciences.

Keywords: maggot therapy, netrin-A, RACE, RAGE, lucilia sericata

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5269 Contribution of Urban Agriculture to the Livelihood of Urban Dwellers in Ilorin West Local Government Area of Kwara State, Nigeria

Authors: Okunola Solomon Olufemi

Abstract:

The study focused on the contribution of urban agriculture to the livelihood of 107 respondents in Kwara State of Nigeria. The study employed structured questionnaire to collect relevant data for the study while descriptive statistics such as frequency distribution and percentage were employed to analyses the objectives. Most respondents (82.9%), were one time or the other in a married state and they had formal education (80.4%) while many of the lot (58.9%) had superior education ranging from OND to Ph.D level. These farmers were either retired government workers or those trying to argument their family income or trying to be food sufficient. Most of the respondents (77.4%) had a farm size of less than or equal to 3 hectares showing that most the urban farmers were smallholders which might be as a result of stiff completion for land resource. Most of the respondents had a relatively large family size of 6 and above members. Most respondents used family labor (59.8%). Respondents in the study area also made use of the cooperatives and daily contributions for loanable funds, while few respondents utilized the formal sector. .Urban agriculture accounted for 84.4% of the Livelihood outcomes of the respondents. While non-farming activities contributed 17.6%.Most of the respondents (31.8%) participated in non-farming activities to generate extra income while their major constraints were shortage of land both in term of access and tenure (34.1%), limited access to resource and agricultural inputs (29.3%), and prohibitive urban policies and regulation (23.2%).

Keywords: poverty throes, urban agriculture, rigors of farming, non-farming, married state

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5268 Rapid, Direct, Real-Time Method for Bacteria Detection on Surfaces

Authors: Evgenia Iakovleva, Juha Koivisto, Pasi Karppinen, J. Inkinen, Mikko Alava

Abstract:

Preventing the spread of infectious diseases throughout the worldwide is one of the most important tasks of modern health care. Infectious diseases not only account for one fifth of the deaths in the world, but also cause many pathological complications for the human health. Touch surfaces pose an important vector for the spread of infections by varying microorganisms, including antimicrobial resistant organisms. Further, antimicrobial resistance is reply of bacteria to the overused or inappropriate used of antibiotics everywhere. The biggest challenges in bacterial detection by existing methods are non-direct determination, long time of analysis, the sample preparation, use of chemicals and expensive equipment, and availability of qualified specialists. Therefore, a high-performance, rapid, real-time detection is demanded in rapid practical bacterial detection and to control the epidemiological hazard. Among the known methods for determining bacteria on the surfaces, Hyperspectral methods can be used as direct and rapid methods for microorganism detection on different kind of surfaces based on fluorescence without sampling, sample preparation and chemicals. The aim of this study was to assess the relevance of such systems to remote sensing of surfaces for microorganisms detection to prevent a global spread of infectious diseases. Bacillus subtilis and Escherichia coli with different concentrations (from 0 to 10x8 cell/100µL) were detected with hyperspectral camera using different filters as visible visualization of bacteria and background spots on the steel plate. A method of internal standards was applied for monitoring the correctness of the analysis results. Distances from sample to hyperspectral camera and light source are 25 cm and 40 cm, respectively. Each sample is optically imaged from the surface by hyperspectral imaging system, utilizing a JAI CM-140GE-UV camera. Light source is BeamZ FLATPAR DMX Tri-light, 3W tri-colour LEDs (red, blue and green). Light colors are changed through DMX USB Pro interface. The developed system was calibrated following a standard procedure of setting exposure and focused for light with λ=525 nm. The filter is ThorLabs KuriousTM hyperspectral filter controller with wavelengths from 420 to 720 nm. All data collection, pro-processing and multivariate analysis was performed using LabVIEW and Python software. The studied human eye visible and invisible bacterial stains clustered apart from a reference steel material by clustering analysis using different light sources and filter wavelengths. The calculation of random and systematic errors of the analysis results proved the applicability of the method in real conditions. Validation experiments have been carried out with photometry and ATP swab-test. The lower detection limit of developed method is several orders of magnitude lower than for both validation methods. All parameters of the experiments were the same, except for the light. Hyperspectral imaging method allows to separate not only bacteria and surfaces, but also different types of bacteria, such as Gram-negative Escherichia coli and Gram-positive Bacillus subtilis. Developed method allows skipping the sample preparation and the use of chemicals, unlike all other microbiological methods. The time of analysis with novel hyperspectral system is a few seconds, which is innovative in the field of microbiological tests.

Keywords: Escherichia coli, Bacillus subtilis, hyperspectral imaging, microorganisms detection

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5267 Mobile Phone Text Reminders and Voice Call Follow-ups Improve Attendance for Community Retail Pharmacy Refills; Learnings from Lango Sub-region in Northern Uganda

Authors: Jonathan Ogwal, Louis H. Kamulegeya, John M. Bwanika, Davis Musinguzi

Abstract:

Introduction: Community retail Pharmacy drug distribution points (CRPDDP) were implemented in the Lango sub-region as part of the Ministry of Health’s response to improving access and adherence to antiretroviral treatment (ART). Clients received their ART refills from nearby local pharmacies; as such, the need for continuous engagement through mobile phone appointment reminders and health messages. We share learnings from the implementation of mobile text reminders and voice call follow-ups among ART clients attending the CRPDDP program in northern Uganda. Methods: A retrospective data review of electronic medical records from four pharmacies allocated for CRPDDP in the Lira and Apac districts of the Lango sub-region in Northern Uganda was done from February to August 2022. The process involved collecting phone contacts of eligible clients from the health facility appointment register and uploading them onto a messaging platform customized by Rapid-pro, an open-source software. Client information, including code name, phone number, next appointment date, and the allocated pharmacy for ART refill, was collected and kept confidential. Contacts received appointment reminder messages and other messages on positive living as an ART client. Routine voice call follow-ups were done to ascertain the picking of ART from the refill pharmacy. Findings: In total, 1,354 clients were reached from the four allocated pharmacies found in urban centers. 972 clients received short message service (SMS) appointment reminders, and 382 were followed up through voice calls. The majority (75%) of the clients returned for refills on the appointed date, 20% returned within four days after the appointment date, and the remaining 5% needed follow-up where they reported that they were not in the district by the appointment date due to other engagements. Conclusion: The use of mobile text reminders and voice call follow-ups improves the attendance of community retail pharmacy refills.

Keywords: antiretroviral treatment, community retail drug distribution points, mobile text reminders, voice call follow-up

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5266 Full-Scale 3D Simulation of the Electroslag Rapid Remelting Process

Authors: E. Karimi-Sibaki, A. Kharicha, M. Wu, A. Ludwig

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The standard electroslag remelting (ESR) process can ideally control the solidification of an ingot and produce homogeneous structure with minimum defects. However, the melt rate of electrode is rather low that makes the whole process uneconomical especially to produce small ingot sizes. In contrast, continuous casting is an economical process to produce small ingots such as billets at high casting speed. Unfortunately, deep liquid melt pool forms in the billet ingot of continuous casting that leads to center porosity and segregation. As such, continuous casting is not suitable to produce segregation prone alloys like tool steel or several super alloys. On the other hand, the electro slag rapid remelting (ESRR) process has advantages of both traditional ESR and continuous casting processes to produce billets. In the ESRR process, a T-shaped mold is used including a graphite ring that takes major amount of current through the mold. There are only a few reports available in the literature discussing about this topic. The research on the ESRR process is currently ongoing aiming to improve the design of the T-shaped mold, to decrease overall heat loss in the process, and to obtain a higher temperature at metal meniscus. In the present study, a 3D model is proposed to investigate the electromagnetic, thermal, and flow fields in the whole process as well as solidification of the billet ingot. We performed a fully coupled numerical simulation to explore the influence of the electromagnetically driven flow (MHD) on the thermal field in the slag and ingot. The main goal is to obtain some fundamental understanding of the formation of melt pool of the solidifying billet ingot in the ESRR process.

Keywords: billet ingot, magnetohydrodynamics (mhd), numerical simulation, remelting, solidification, t-shaped mold.

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5265 Evaluation of Mechanical Properties and Analysis of Rapidly Heat Treated M-42 High Speed Steel

Authors: R. N. Karthik Babu, R. Sarvesh, A. Rajendra Prasad, G. Swaminathan

Abstract:

M42 is a molybdenum-series high-speed alloy steel widely used because of its better hot-hardness and wear resistance. These steels are conventionally heat treated in a salt bath furnace with up to three stages of preheating with predetermined soaking and holding periods. Such methods often involve long periods of processing with a large amount of energy consumed. In this study, the M42 steel samples were heat-treated by rapidly heating the specimens to the austenising temperature of 1260 °C and cooled conventionally by quenching in a neutral salt bath at a temperature of 550 °C with the aid of a hybrid microwave furnace. As metals reflect microwaves, they cannot directly be heated up when placed in a microwave furnace. The technology used herein requires the specimens to be placed in a crucible lined with SiC which is a good absorber of microwaves and the SiC lining heats the metal through radiation which facilitates the volumetric heating of the metal. A sample of similar dimensions was heat treated conventionally and cooled in the same manner. Conventional tempering process was then carried out on both these samples and analysed for various parameters such as micro-hardness, processing time, etc. Microstructure analysis and scanning electron microscopy was also carried out. The objective of the study being that similar or better properties, with substantial time and energy saving and cost cutting are achievable by rapid heat treatment through hybrid microwave furnaces. It is observed that the heat treatment is done with substantial time and energy savings, and also with minute improvement in mechanical properties of the tool steel heat treated.

Keywords: rapid heating, heat treatment, metal processing, microwave heating

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