Search results for: medical technology

Authors: Toktam mehrabani

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Textiles, fashion, and architecture, though seemingly disparate fields, share a deep and evolving relationship. This paper explores the intersection of these disciplines, examining how the tactile, structural, and aesthetic qualities of textiles have influenced both fashion and architecture over time. By investigating historical and contemporary examples, this paper seeks to unravel the ways in which textiles and fashion have not only shaped architectural design but have also acted as a bridge between functionality, art, and human experience in the built environment.Textiles have been integral to human culture since the dawn of civilization. Their presence transcends mere functionality, serving as a medium for artistic expression, cultural identity, and social commentary. Fashion, derived from textiles, has long been associated with personal identity and societal trends, while architecture reflects human needs, environmental context, and cultural values. This paper posits that the relationship between textiles, fashion, and architecture is more interconnected than often perceived, with each influencing and inspiring the other across time. Textiles in Architectural Design: From ancient draperies in temples to tapestries in castles, textiles have adorned structures, softening rigid spaces and adding layers of warmth and luxury. Fabric screens and curtains have also served functional purposes, such as controlling light, acoustics, and temperature. Fashion as Architectural Expression: Renaissance and Baroque fashion used exaggerated forms, corsetry, and layers to mirror the grandiosity of architectural styles of the time. Clothing acted as wearable architecture, with structured garments mirroring the strong lines and curves of buildings..Structural Textiles in Architecture: In the 21st century, textiles are no longer just decorative; they have become integral to architectural innovation. Materials like tensile fabrics and smart textiles are used in creating flexible, lightweight structures. Iconic examples include Frei Otto’s work with tensile membranes, seen in the Munich Olympic Stadium.Technological advancements have drastically transformed the relationship between textiles, fashion, and architecture. Digital tools like 3D printing and laser cutting allow designers in both fields to push the limits of form and structure. Smart textiles that react to environmental stimuli are being explored for use in both wearable technology and adaptable architecture, such as facades that change in response to weather conditions. Textiles, fashion, and architecture are inextricably linked through their shared exploration of form, structure, and expression. This interdisciplinary relationship continues to evolve, driven by technological advancements and a growing emphasis on sustainability. As fashion becomes more architectural in its construction and architecture more fluid in its forms, the lines between these disciplines blur, offering new possibilities for creativity and functionality in both wearable and built environments.

Keywords: textiles in architecture, fashion and architecture, textile architecture, structural textiles, wearable architecture, architectural fashion

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Authors: Aabha Chaubey, Bani Bhattacharya

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Evaluation of the quality of teaching in engineering education in India needs to be conducted on a continuous basis to achieve the best teaching quality in technical education. Quality teaching is an influential factor in technical education which impacts largely on learning outcomes of the students. Present study is not exclusively theory-driven, but it draws on various specific concepts and constructs in the domain of technical education. These include teaching and learning in higher education, teacher effectiveness, and teacher evaluation and performance management in higher education. Student Evaluation of Education Quality (SEEQ) was proposed as one of the evaluation instruments of the quality teaching in engineering education. SEEQ is one of the popular and standard instrument widely utilized all over the world and bears the validity and reliability in educational world. The present study was designed to evaluate the teaching quality through SEEQ in the context of technical education in India, including its validity and reliability based on the collected data. The multiple dimensionality of SEEQ that is present in every teaching and learning process made it quite suitable to collect the feedback of students regarding the quality of instructions and instructor. The SEEQ comprises of 9 original constructs i.e.; learning value, teacher enthusiasm, organization, group interaction, and individual rapport, breadth of coverage, assessment, assignments and overall rating of particular course and instructor with total of 33 items. In the present study, a total of 350 samples comprising first year undergraduate students from Indian Institute of Technology, Kharagpur (IIT, Kharagpur, India) were included for the evaluation of the importance of SEEQ. They belonged to four different courses of different streams of engineering studies. The above studies depicted the validity and reliability of SEEQ was based upon the collected data. This further needs Confirmatory Factor Analysis (CFA) and Analysis of Moment structure (AMOS) for various scaled instrument like SEEQ Cronbach’s alpha which are associated with SPSS for the examination of the internal consistency. The evaluation of the effectiveness of SEEQ in CFA is implemented on the basis of fit indices such as CMIN/df, CFI, GFI, AGFI and RMSEA readings. The major findings of this study showed the fitness indices such as ChiSq = 993.664,df = 390,ChiSq/df = 2.548,GFI = 0.782,AGFI = 0.736,CFI = 0.848,RMSEA = 0.062,TLI = 0.945,RMR = 0.029,PCLOSE = 0.006. The final analysis of the fit indices presented positive construct validity and stability, on the other hand a higher reliability was also depicted which indicated towards internal consistency. Thus, the study suggests the effectivity of SEEQ as the indicator of the quality evaluation instrument in teaching-learning process in engineering education in India. Therefore, it is expected that with the continuation of this research in engineering education there remains a possibility towards the betterment of the quality of the technical education in India. It is also expected that this study will provide an empirical and theoretical logic towards locating a construct or factor related to teaching, which has the greatest impact on teaching and learning process in a particular course or stream in engineering education.

Keywords: confirmatory factor analysis, engineering education, SEEQ, teaching and learning process

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Authors: Emma Plante, Charles Ekwunwa, Diego Illanes

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Introduction: Serum Sickness-Like Reaction (SSLR) is an inflammatory immune response characterized by a rash, polyarthralgias, and fever. SSLR usually occurs in response to a new medication (most commonly antibiotics, anticonvulsants, or antiinflammatory agents) and is believed to involve the formation of drug-specific immune complexes. Here we present a case of a 16-year-old female patient who developed an SSLR in response to the D-mannose-containing over-the-counter supplement, Uqora, used to promote bladder health. Methodology: The methodology for this study included a thorough literature search for other cases of SSLR associated with D-Mannose containing products. Data collection was performed through a review of the patient’s medical record, including history, physical examination, relevant laboratory results, and treatment plan. Findings: A 16-year-old female with a history of overactive bladder and anemia presented with a diffuse urticarial rash, headaches, joint pain, and swelling for three days. Her medications included oral contraceptive pills, iron, mirabegron, UQora, and a probiotic. Physical examination revealed a diffuse urticarial rash, and her musculoskeletal exam revealed swelling and tenderness in her wrists. Her CBC, basic metabolic panel, liver function panel, lyme titers, and urinalysis were all within normal limits. The patient was referred to an allergist, who diagnosed her with SSLR. All medications were discontinued, and she was treated with a 7-day course of prednisone and cetirizine. Her symptoms resolved, and her medications were slowly resumed sequentially over several months. However, UQora triggered a recurrence of her symptoms, and it was identified as the culprit medication. Consequently, UQora was permanently discontinued, and the patient has remained symptom-free. Conclusion: This case report describes the first documented case of SSLR caused by UQora (active ingredient D-mannose). D-Mannose is a monosaccharide found in many plants and fruits, and it is commonly used to prevent urinary tract infections. While the clinical features and timeline, in this case, were typical of SSLR, UQora as the trigger was highly unusual. Clinicians should be aware of the diverse triggers of SSLR and the importance of prompt identification and management to enhance patient safety. It is possible D-mannose was not the trigger, and further research is necessary to better understand the potential therapeutic applications of D-mannose, as well as the potential risks and interactions.

Keywords: serum sickness-like reaction, d-mannose, hypersensitivity reaction, urticaria

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Authors: Lukasz Grabowski, Marcin Szlachetka, Tytus Tulwin

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The main task of the engine cooling system is to maintain its average operating temperatures within strictly defined limits. Too high or too low average temperatures result in accelerated wear or even damage to the engine or its individual components. In order to avoid local overheating or significant temperature gradients, leading to high stresses in the component, the aim is to ensure an even flow of air. In the case of analyses related to heat exchange, one of the main problems is the comparison of temperature fields because standard measuring instruments such as thermocouples or thermistors only provide information about the course of temperature at a given point. Thermal imaging tests can be helpful in this case. With appropriate camera settings and taking into account environmental conditions, we are able to obtain accurate temperature fields in the form of thermograms. Emission of heat from the engine to the engine compartment is an important issue when designing a cooling system. Also, in the case of liquid cooling, the main sources of heat in the form of emissions from the engine block, cylinders, etc. should be identified. It is important to redesign the engine compartment ventilation system. Ensuring proper cooling of aircraft reciprocating engine is difficult not only because of variable operating range but mainly because of different cooling conditions related to the change of speed or altitude of flight. Engine temperature also has a direct and significant impact on the properties of engine oil, which under the influence of this parameter changes, in particular, its viscosity. Too low or too high, its value can be a result of fast wear of engine parts. One of the ways to determine the temperatures occurring on individual parts of the engine is the use of thermal imaging measurements. The article presents the results of preliminary thermal imaging tests of aircraft piston diesel engine with a maximum power of about 100 HP. In order to perform the heat emission tests of the tested engine, the ThermaCAM S65 thermovision monitoring system from FLIR (Forward-Looking Infrared) together with the ThermaCAM Researcher Professional software was used. The measurements were carried out after the engine warm up. The engine speed was 5300 rpm The measurements were taken for the following environmental parameters: air temperature: 17 °C, ambient pressure: 1004 hPa, relative humidity: 38%. The temperatures distribution on the engine cylinder and on the exhaust manifold were analysed. Thermal imaging tests made it possible to relate the results of simulation tests to the real object by measuring the rib temperature of the cylinders. The results obtained are necessary to develop a CFD (Computational Fluid Dynamics) model of heat emission from the engine bay. The project/research was financed in the framework of the project Lublin University of Technology-Regional Excellence Initiative, funded by the Polish Ministry of Science and Higher Education (contract no. 030/RID/2018/19).

Keywords: aircraft, piston engine, heat, emission

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Authors: Chao Li, Lei Zhou, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: In 2016, yellow fever had been first ever discovered in China, soon after the yellow fever epidemic occurred in Angola. After the discovery, China had promptly made the national protocol of control and prevention and strengthened the surveillance on passenger and vector. In this study, a descriptive analysis was conducted to summarize China’s experiences of response towards this import epidemic, in the hope of providing experiences on prevention and control of yellow fever and other similar imported infectious diseases in the future. Methods: The imported cases were discovered and reported by General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) and several hospitals. Each clinically diagnosed yellow fever case was confirmed by real-time reverse transcriptase polymerase chain reaction (RT–PCR). The data of the imported yellow fever cases were collected by local Centers for Disease Control and Prevention (CDC) through field investigations soon after they received the reports. Results: A total of 11 imported cases from Angola were reported in China, during Angola’s yellow fever outbreak. Six cases were discovered by the AQSIQ, among which two with mild symptom were initiative declarations at the time of entry. Except for one death, the remaining 10 cases all had recovered after timely and proper treatment. All cases are Chinese, and lived in Luanda, the capital of Angola. 73% were retailers (8/11) from Fuqing city in Fujian province, and the other three were labors send by companies. 10 cases had experiences of medical treatment in Luanda after onset, among which 8 cases visited the same local Chinese medicine hospital (China Railway four Bureau Hospital). Among the 11 cases, only one case had an effective vaccination. The result of emergency surveillance for mosquito density showed that only 14 containers of water were found positive around places of three cases, and the Breteau Index is 15. Conclusions: Effective response was taken to control and prevent the outbreak of yellow fever in China after discovering the imported cases. However, though the similar origin of Chinese in Angola has provided an easy access for disease detection, information sharing, health education and vaccination on yellow fever; these conveniences were overlooked during previous disease prevention methods. Besides, only one case having effective vaccination revealed the inadequate capacity of immunization service in China. These findings will provide suggestions to improve China’s capacity to deal with not only yellow fever but also other similar imported diseases in China.

Keywords: yellow fever, first import, China, suggestion

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Authors: Josef Uher, Jana Boháčová, Richard Kadeřábek

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In this paper, we present a multi-robot imaging and irradiation research platform referred to as Irradion, with full capabilities of portable arbitrary path computed tomography (CT). Irradion is an imaging and irradiation unit entirely based on robotic arms for research on cancer treatment with ion beams on small animals (mice or rats). The platform comprises two subsystems that combine several imaging modalities, such as 2D X-ray imaging, CT, and particle tracking, with precise positioning of a small animal for imaging and irradiation. Computed Tomography: The CT subsystem of the Irradion platform is equipped with two 6-joint robotic arms that position a photon counting detector and an X-ray tube independently and freely around the scanned specimen and allow image acquisition utilizing computed tomography. Irradiation measures nearly all conventional 2D and 3D trajectories of X-ray imaging with precisely calibrated and repeatable geometrical accuracy leading to a spatial resolution of up to 50 µm. In addition, the photon counting detectors allow X-ray photon energy discrimination, which can suppress scattered radiation, thus improving image contrast. It can also measure absorption spectra and recognize different materials (tissue) types. X-ray video recording and real-time imaging options can be applied for studies of dynamic processes, including in vivo specimens. Moreover, Irradion opens the door to exploring new 2D and 3D X-ray imaging approaches. We demonstrate in this publication various novel scan trajectories and their benefits. Proton Imaging and Particle Tracking: The Irradion platform allows combining several imaging modules with any required number of robots. The proton tracking module comprises another two robots, each holding particle tracking detectors with position, energy, and time-sensitive sensors Timepix3. Timepix3 detectors can track particles entering and exiting the specimen and allow accurate guiding of photon/ion beams for irradiation. In addition, quantifying the energy losses before and after the specimen brings essential information for precise irradiation planning and verification. Work on the small animal research platform Irradion involved advanced software and hardware development that will offer researchers a novel way to investigate new approaches in (i) radiotherapy, (ii) spectral CT, (iii) arbitrary path CT, (iv) particle tracking. The robotic platform for imaging and radiation research developed for the project is an entirely new product on the market. Preclinical research systems with precision robotic irradiation with photon/ion beams combined with multimodality high-resolution imaging do not exist currently. The researched technology can potentially cause a significant leap forward compared to the current, first-generation primary devices.

Keywords: arbitrary path CT, robotic CT, modular, multi-robot, small animal imaging

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Authors: Carlos Tapia Cortez, Serkan Saydam, Jeff Coulton, Claude Sammut

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Strategic mineral commodities (SMC) both energetic and metals have long been fundamental for human beings. There is a strong and long-run relation between the mineral resources industry and society's evolution, with the provision of primary raw materials, becoming one of the most significant drivers of economic growth. Due to mineral resources’ relevance for the entire economy and society, an understanding of the SMC market behaviour to simulate price fluctuations has become crucial for governments and firms. For any human activity, SMC price fluctuations are affected by economic, geopolitical, environmental, technological and psychological issues, where cognition has a major role. Cognition is defined as the capacity to store information in memory, processing and decision making for problem-solving or human adaptation. Thus, it has a significant role in those systems that exhibit dynamic equilibrium through time, such as economic growth. Cognition allows not only understanding past behaviours and trends in SCM markets but also supports future expectations of demand/supply levels and prices, although speculations are unavoidable. Technological developments may also be defined as a cognitive system. Since the Industrial Revolution, technological developments have had a significant influence on SMC production costs and prices, likewise allowing co-integration between commodities and market locations. It suggests a close relation between structural breaks, technology and prices evolution. SCM prices forecasting have been commonly addressed by econometrics and Gaussian-probabilistic models. Econometrics models may incorporate the relationship between variables; however, they are statics that leads to an incomplete approach of prices evolution through time. Gaussian-probabilistic models may evolve through time; however, price fluctuations are addressed by the assumption of random behaviour and normal distribution which seems to be far from the real behaviour of both market and prices. Random fluctuation ignores the evolution of market events and the technical and temporal relation between variables, giving the illusion of controlled future events. Normal distribution underestimates price fluctuations by using restricted ranges, curtailing decisions making into a pre-established space. A proper understanding of SMC's price dynamics taking into account the historical-cognitive relation between economic, technological and psychological factors over time is fundamental in attempting to simulate prices. The aim of this paper is to discuss the SMC market cognition hypothesis and empirically demonstrate its dynamic-cognitive capacity. Three of the largest and traded SMC's: oil, copper and gold, will be assessed to examine the economic, technological and psychological cognition respectively.

Keywords: commodity price simulation, commodity price uncertainties, dynamic-cognition, dynamic systems

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Authors: Teng Teng, Christos Tsinopoulos

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The purpose of this research is to explore the link between IS capabilities, customer connection, and quality performance in the service context, with investigation of the impact of firm’s stable and dynamic environments. The application of Information Systems (IS) has become a significant effect on contemporary service operations. Firms invest in IS with the presumption that they will facilitate operations processes so that their performance will improve. Yet, IS resources by themselves are not sufficiently 'unique' and thus, it would be more useful and theoretically relevant to focus on the processes they affect. One such organisational process, which has attracted a lot of research attention by supply chain management scholars, is the integration of customer connection, where IS-enabled customer connection enhances communication and contact processes, and with such customer resources integration comes greater success for the firm in its abilities to develop a good understanding of customer needs and set accurate customer. Nevertheless, prior studies on IS capabilities have focused on either one specific type of technology or operationalised it as a highly aggregated concept. Moreover, although conceptual frameworks have been identified to show customer integration is valuable in service provision, there is much to learn about the practices of integrating customer resources. In this research, IS capabilities have been broken down into three dimensions based on the framework of Wade and Hulland: IT for supply chain activities (ITSCA), flexible IT infrastructure (ITINF), and IT operations shared knowledge (ITOSK); and focus on their impact on operational performance of firms in services. With this background, this paper addresses the following questions: -How do IS capabilities affect the integration of customer connection and service quality? -What is the relationship between environmental dynamism and the relationship of customer connection and service quality? A survey of 156 service establishments was conducted, and the data analysed to determine the role of customer connection in mediating the effects of IS capabilities on firms’ service quality. Confirmatory factor analysis was used to check convergent validity. There is a good model fit for the structural model. Moderating effect of environmental dynamism on the relationship of customer connection and service quality is analysed. Results show that ITSCA, ITINF, and ITOSK have a positive influence on the degree of the integration of customer connection. In addition, customer connection positively related to service quality; this relationship is further emphasised when firms work in a dynamic environment. This research takes a step towards quelling concerns about the business value of IS, contributing to the development and validation of the measurement of IS capabilities in the service operations context. Additionally, it adds to the emerging body of literature linking customer connection to the operational performance of service firms. Managers of service firms should consider the strength of the mediating role of customer connection when investing in IT-related technologies and policies. Particularly, service firms developing IS capabilities should simultaneously implement processes that encourage supply chain integration.

Keywords: customer connection, environmental dynamism, information systems capabilities, service quality, service supply chain

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Authors: Oliver Chunho Ma, Tszying Chang

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Background: Traditional Chinese Medicine (TCM) has been widely used in the treatment of eczema. However, there is currently a lack of comprehensive research on the overall effectiveness of TCM in treating eczema, particularly using the Eczema Area and Severity Index (EASI) score as an evaluation tool. Meta-analysis can integrate the results of multiple studies to provide more convincing evidence. Objective: To conduct a systematic review and meta-analysis based on the EASI score to evaluate the overall effectiveness of TCM in the treatment of eczema. Specifically, the study will review and analyze published clinical studies that investigate TCM treatments for eczema and use the EASI score as an outcome measure, comparing the differences in improving the severity of eczema between TCM and other treatment modalities, such as conventional Western medicine treatments. Methods: Relevant studies, including randomized controlled trials (RCTs) and non-randomized controlled trials, that involve TCM treatment for eczema and use the EASI score as an outcome measure will be searched in medical literature databases such as PubMed, CNKI, etc. Relevant data will be extracted from the selected studies, including study design, sample size, treatment methods, improvement in EASI score, etc. The methodological quality and risk of bias of the included studies will be assessed using appropriate evaluation tools (such as the Cochrane Handbook). The results of the selected studies will be statistically analyzed, including pooling effect sizes (such as standardized mean differences, relative risks, etc.), subgroup analysis (e.g., different TCM syndromes, different treatment modalities), and sensitivity analysis (e.g., excluding low-quality studies). Based on the results of the statistical analysis and quality assessment, the overall effectiveness of TCM in improving the severity of eczema will be interpreted. Expected outcomes: By integrating the results of multiple studies, we expect to provide more convincing evidence regarding the specific effects of TCM in improving the severity of eczema. Additionally, subgroup analysis and sensitivity analysis can further elucidate whether the effectiveness of TCM treatment is influenced by different factors. Besides, we will compare the results of the meta-analysis with the clinical data from our clinic. For both the clinical data and the meta-analysis results, we will perform descriptive statistics such as means, standard deviations, percentages, etc. and compare the differences between the two using statistical tests such as independent samples t-test or non-parametric tests to assess the statistical differences between them.

Keywords: Eczema, traditional Chinese medicine, EASI, systematic review, meta-analysis

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Authors: Mary Deyo, Zmara Harrison

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This study reports the outcomes of an 8-week experiential learning program for 6 adults with Intellectual and Developmental Disabilities (IDD) at a day habilitation program. The intervention foci for this program include executive function, language learning in the domains of expressive, receptive, and pragmatic language, and quality of life. The interprofessional collaboration aimed at supporting adults with IDD to reach person-centered, functional goals across skill domains is critical. This study is a significant addition to the speech-language pathology literature in that it examines a therapy method that potentially meets this need while targeting domains within the speech-language pathology scope of practice. Communication therapy was provided during highly valued and meaningful hands-on learning experiences, referred to as the Garden Club, which incorporated all aspects of planting and caring for a garden as well as related journaling, sensory, cooking, art, and technology-based activities. Direct care staff and an undergraduate research assistant were trained by SLP to be impactful language guides during their interactions with participants in the Garden Club. SLP also provided direct therapy and modeling during Garden Club. Research methods used in this study included a mixed methods analysis of a literature review, a quasi-experimental implementation of communication therapy in the context of experiential learning activities, Quality of Life participant surveys, quantitative pre- post- data collection and linear mixed model analysis, qualitative data collection with qualitative content analysis and coding for themes. Outcomes indicated overall positive changes in expressive vocabulary, following multi-step directions, sequencing, problem-solving, planning, skills for building and maintaining meaningful social relationships, and participant perception of the Garden Project’s impact on their own quality of life. Implementation of this project also highlighted supports and barriers that must be taken into consideration when planning similar projects. Overall findings support the use of experiential learning projects in day habilitation programs for adults with IDD, as well as additional research to deepen understanding of best practices, supports, and barriers for implementation of experiential learning with this population. This research provides an important contribution to research in the fields of speech-language pathology and other professions serving adults with IDD by describing an interprofessional experiential learning program with positive outcomes for executive function, language learning, and quality of life.

Keywords: experiential learning, adults, intellectual and developmental disabilities, expressive language, receptive language, pragmatic language, executive function, communication therapy, day habilitation, interprofessionalism, quality of life

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Authors: Anietie J. Atangwho, Udeme E. Asibong, Item J. Atangwho, Ndifreke E. Udonwa

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Diabesity, a syndrome where diabetes and obesity occur simultaneously in a single patient, has emerged as a recent challenge to the medical world and is already at epidemic proportion in some countries. Therefore, this study aimed to determine the prevalence of diabesity among adult patients attending the General Outpatient clinic of three healthcare facilities in Calabar in a bid to improve healthcare delivery to patients at risk. A cross-sectional descriptive study design was employed using a mixed method approach that comprised quantitative and qualitative components i.e., Focused Group Discussion (FGD) and Key Informant Interview (KII). One hundred and ninety (190) participants aged 18 to 72 years and body mass index (BMI) ≥ 30kg/m2 were recruited as the study population for the quantitative study using systematic random sampling technique and analysed using SPSS version 25. The qualitative component performed 4 FGDs and 3 KIIs. Results of sociodemographic variables showed respondents aged 35 – 44 as highest in number (37.3%). Of this number, 83.7% were females, 76.8% married, and 3.7% earned USD1,110.00 monthly. Whereas majority of the participants (65.8 %) were within class 1 obesity, only 38% considered themselves obese. Diabesity occurrence was found to be 12.6% (i.e. BMI ≥ 30 to 45.2kg/m2 vs FBS ≥ 7.0 – 14.8mmo/l), with 38% of them being previously undiagnosed. About 48.4 % of the respondents ate two meals only per day; with 90.5% eating between meals. Snacking was predominant, mostly pastries (67.9%), with 58.9% taking cola drinks alongside. Sixty-one percent participated in one form of exercise or the other, with walking/trekking as the most common; 34.4 % had no regular exercise schedule. Only about 39.5% of the participants spent less than an hour on devices like phone, television, and laptops. Additionally, previously known and newly diagnosed hypertensive patients were 27.9% and 7.2%, respectively. Qualitative assessment with KII and FGDs showed eating unhealthy diets and lack of exercise as major factors responsible for diabesity. The bivariate analysis revealed significant association between diabesity with marital status and hypertension (p = 0.007 and p = 0.005, respectively). Also, positive association with diabesity were eating snacking (p = 0.017) and number of times a respondent snacks per day (p = 0.035). Overall, the study has revealed the occurrence of diabesity in Calabar at 12.6 % of the study population, with 38 % of them previously undiagnosed; it identified unhealthy diets and lack of exercise as causative factors as well as hypertension as snacking associatory indicators of diabesity.

Keywords: diabesity, obesity, diabetes, unhealthy diet

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Authors: Bollu Mounica

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Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

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Authors: Manaranjan Pradhan, Shailaja Grover, U. Dinesh Kumar

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Farming community in India, as well as other parts of the world, is one of the highly stressed communities due to reasons such as increasing input costs (cost of seeds, fertilizers, pesticide), droughts, reduced revenue leading to farmer suicides. Lack of integrated farm advisory system in India adds to the farmers problems. Farmers need right information during the early stages of crop’s lifecycle to prevent damage and loss in revenue. In this paper, we use deep learning techniques to develop an early warning system for detection of crop diseases using images taken by farmers using their smart phone. The research work leads to building a smart assistant using analytics and big data which could help the farmers with early diagnosis of the crop diseases and corrective actions. The classical approach for crop disease management has been to identify diseases at crop level. Recently, ImageNet Classification using the convolutional neural network (CNN) has been successfully used to identify diseases at individual plant level. Our model uses convolution filters, max pooling, dense layers and dropouts (to avoid overfitting). The models are built for binary classification (healthy or not healthy) and multi class classification (identifying which disease). Transfer learning is used to modify the weights of parameters learnt through ImageNet dataset and apply them on crop diseases, which reduces number of epochs to learn. One shot learning is used to learn from very few images, while data augmentation techniques are used to improve accuracy with images taken from farms by using techniques such as rotation, zoom, shift and blurred images. Models built using combination of these techniques are more robust for deploying in the real world. Our model is validated using tomato crop. In India, tomato is affected by 10 different diseases. Our model achieves an accuracy of more than 95% in correctly classifying the diseases. The main contribution of our research is to create a personal assistant for farmers for managing plant disease, although the model was validated using tomato crop, it can be easily extended to other crops. The advancement of technology in computing and availability of large data has made possible the success of deep learning applications in computer vision, natural language processing, image recognition, etc. With these robust models and huge smartphone penetration, feasibility of implementation of these models is high resulting in timely advise to the farmers and thus increasing the farmers' income and reducing the input costs.

Keywords: analytics in agriculture, CNN, crop disease detection, data augmentation, image recognition, one shot learning, transfer learning

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Authors: Luis Fernando Calvo Prieto, Raul Herrero Martínez, Mónica Santamarta Llorente, Sergio Paniagua Bermejo

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The project that is presented starts from the questioning about the compartmentalization of knowledge that occurs in university higher education. There are several authors who describe the problems associated with this reality (Rodamillans, M) indicating a lack of integration of the knowledge acquired by students throughout the subjects taken in their university degree. Furthermore, this disintegration is accentuated by the enrollment system of some Faculties and/or Schools of Engineering, which allows the student to take subjects outside the recommended curricular path. This problem is accentuated in an ostentatious way when trying to find an integration between humanistic subjects and the world of experimental sciences or engineering. This abrupt separation between humanities and sciences can be observed in any study plan of Spanish degrees. Except for subjects such as economics or English, in the Faculties of Sciences and the Schools of Engineering, the absence of any humanistic content is striking. At some point it was decided that the only value to take into account when designing their study plans was “usefulness”, considering the humanities systematically useless for their training, and therefore banishing them from the study plans. forgetting the role they have on the capacity of both Leadership and Civic Humanism in our professionals of tomorrow. The teaching guides for the different subjects in the branch of science or engineering do not include any competency, not even transversal, related to leadership capacity or the need, in today's world, for social, civic and humanitarian knowledge part of the people who will offer medical, pharmaceutical, environmental, biotechnological or engineering solutions to a society that is generated thanks to more or less complex relationships based on human relationships and historical events that have occurred so far. If we want professionals who know how to deal effectively and rationally with their leadership tasks and who, in addition, find and develop an ethically civic sense and a humanistic profile in their functions and scientific tasks, we must not leave aside the importance that it has, for the themselves, know the causes, facts and consequences of key events in the history of humanity. The words of the humanist Paul Preston are well known: “he who does not know his history is condemned to repeat the mistakes of the past.” The idea, therefore, that today there can be men of science in the way that the scientists of the Renaissance were, becomes, at the very least, difficult to conceive. To think that a Leonardo da Vinci can be repeated in current times is a more than crazy idea; and although at first it may seem that the specialization of a professional is inevitable but beneficial, there are authors who consider (Sánchez Inarejos) that it has an extremely serious negative side effect: the entrenchment behind the different postulates of each area of knowledge, disdaining everything. what is foreign to it.

Keywords: STEM, higher education, social sciences, history

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Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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Authors: Sarmistha Baruah, Akshai Kumar, Nageswara Rao Peela

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The global energy crisis due to the dependence on fossil fuels and its limited reserves as well as environmental pollution are key concerns to the research communities. However, the implementation of alcohol-based fuel cells such as methanol is anticipated as a reliable source of future energy technology due to their high energy density, environment friendliness, ease of storage, transportation, etc. To drive the anodic methanol oxidation reaction (MOR) in direct methanol fuel cells (DMFCs), an active and long-lasting catalyst is necessary for efficient energy conversion from methanol. Recently, transition metal-zeolite-based materials have been considered versatile catalysts for a variety of industrial and lab-scale processes. Large specific surface area, well-organized micropores, and adjustable acidity/basicity are characteristics of zeolites that make them excellent supports for immobilizing small-sized and highly dispersed metal species. Significant advancement in the production and characterization of well-defined metal clusters encapsulated within zeolite matrix has substantially expanded the library of materials available, and consequently, their catalytic efficacy. In this context, we developed bimetallic Ni-Co catalysts encapsulated within LTA (also known as 4A) zeolite via a method combined with the in-situ encapsulation of metal species using hydrothermal treatment followed by a chemical reduction process. The prepared catalyst was characterized using advanced characterization techniques, such as X-ray diffraction (XRD), field emission transmission electron microscope (FETEM), field emission scanning electron microscope (FESEM), energy dispersive X-ray (EDX), and X-ray photoelectron spectroscopy (XPS). The electrocatalytic activity of the catalyst for MOR was carried out in an alkaline medium at room temperature using techniques such as cyclic voltammetry (CV), and chronoamperometry (CA). The resulting catalyst exhibited better catalytic activity of 12.1 mA cm-2 at 1.12 V vs Ag/AgCl and retained remarkable stability (~77%) even after 1000 cycles CV test for the electro-oxidation of methanol in alkaline media without any significant microstructural changes. The high surface area, better Ni-Co species integration in the zeolite, and the ample amount of surface hydroxyl groups contribute to highly dispersed active sites and quick analyte diffusion, which provide notable MOR kinetics. Thus, this study will open up new possibilities to develop a noble metal-free zeolite-based electrocatalyst due to its simple synthesis steps, large-scale fabrication, improved stability, and efficient activity for DMFC application.

Keywords: alkaline media, bimetallic, encapsulation, methanol oxidation reaction, LTA zeolite.

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Authors: S. R. H. Baqri, T. Shahina, M. T. Hasan

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Pakistan is facing acute shortage of energy and looking for indigenous resources of the energy mix to meet the short fall. After the discovery of huge coal resources in Thar Desert of Sindh province, focus has shifted to coal power generation. The government of Pakistan has planned power generation of 20000 MW on coal by the year 2025. This target will be achieved by mining and power generation in Thar coal Field and on imported coal in different parts of Pakistan. Total indigenous coal production of around 3.0 million tons is being utilized in brick kilns, cement and sugar industry. Coal-based power generation is only limited to three units of 50 MW near Hyderabad from nearby Lakhra Coal field. The purpose of this presentation is to identify and redressal of issues of coal mining and utilization with reference to environmental hazards. Thar coal resource is estimated at 175 billion tons out of a total resource estimate of 184 billion tons in Pakistan. Coal of Pakistan is of Tertiary age (Palaeocene/Eocene) and classified from lignite to sub-bituminous category. Coal characterization has established three main pollutants such as Sulphur, Carbon dioxide and Methane besides some others associated with coal and rock types. The element Sulphur occurs in organic as well as inorganic forms associated with coals as free sulphur and as pyrite, gypsum, respectively. Carbon dioxide, methane and minerals are mostly associated with fractures, joints local faults, seatearth and roof rocks. The abandoned and working coal mines give kerosene odour due to escape of methane in the atmosphere. While the frozen methane/methane ices in organic matter rich sediments have also been reported from the Makran coastal and offshore areas. The Sulphur escapes into the atmosphere during mining and utilization of coal in industry. The natural erosional processes due to rivers, streams, lakes and coastal waves erode over lying sediments allowing pollutants to escape into air and water. Power plants emissions should be controlled through application of appropriate clean coal technology and need to be regularly monitored. Therefore, the systematic and scientific studies will be required to estimate the quantity of methane, carbon dioxide and sulphur at various sites such as abandoned and working coal mines, exploratory wells for coal, oil and gas. Pressure gauges on gas pipes connecting the coal-bearing horizons will be installed on surface to know the quantity of gas. The quality and quantity of gases will be examined according to the defined intervals of times. This will help to design and recommend the methods and procedures to stop the escape of gases into atmosphere. The element of Sulphur can be removed partially by gravity and chemical methods after grinding and before industrial utilization of coal.

Keywords: atmosphere, coal production, energy, pollutants

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Authors: Yuan-Hao Lee, Chia-Wei Lee, Ming-Fang Lin, Tzu-Huei Wu, Chih-Hsiang Ko, Wing P. Chan

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Computed tomography (CT) scan of the head is a good method for investigating cranial lesions. However, radiation-induced oxidative stress can be accumulated in the eyes and promote carcinogenesis and cataract. In this regard, we aimed to protect the eyes with barium sulfate shield(s) during CT scans and investigate the resultant image quality and radiation dose to the eye. Patients who underwent health examinations were selectively enrolled in this study in compliance with the protocol approved by the Ethics Committee of the Joint Institutional Review Board at Taipei Medical University. Participants’ brains were scanned with a water-based marker simultaneously by a multislice CT scanner (SOMATON Definition Flash) under a fixed tube current-time setting or automatic tube current modulation (TCM). The lens dose was measured by Gafchromic films, whose dose response curve was previously fitted using thermoluminescent dosimeters, with or without barium sulfate or bismuth-antimony shield laid above. For the assessment of image quality CT images at slice planes that exhibit the interested regions on the zygomatic, orbital and nasal bones of the head phantom as well as the water-based marker were used for calculating the signal-to-noise and contrast-to-noise ratios. The application of barium sulfate and bismuth-antimony shields decreased 24% and 47% of the lens dose on average, respectively. Under topogram-based TCM, the dose saving power of bismuth-antimony shield was mitigated whereas that of barium sulfate shield was enhanced. On the other hand, the signal-to-noise and contrast-to-noise ratios of DSCT images were decreased separately by barium sulfate and bismuth-antimony shield, resulting in an overall reduction of the CNR. In contrast, the integration of topogram-based TCM elevated signal difference between the ROIs on the zygomatic bones and eyeballs while preferentially decreasing the signal-to-noise ratios upon the use of barium sulfate shield. The results of this study indicate that the balance between eye exposure and image quality can be optimized by combining eye shields with topogram-based TCM on the multislice scanner. Eye shielding could change the photon attenuation characteristics of tissues that are close to the shield. The application of both shields on eye protection hence is not recommended for seeking intraorbital lesions.

Keywords: computed tomography, barium sulfate shield, dose saving, image quality

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Authors: Alessandro Balbo, Gianvito Colucci, Matteo Nicoli, Laura Savoldi

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Hydrogen is expected to become an undisputed player in the ecological transition throughout the next decades. The decarbonization potential offered by this energy vector provides various opportunities for the so-called “hard-to-abate” sectors, including industrial production of iron and steel, glass, refineries and the heavy-duty transport. In this regard, Italy, in the framework of decarbonization plans for the whole European Union, has been considering a wider use of hydrogen to provide an alternative to fossil fuels in hard-to-abate sectors. This work aims to assess and compare different options concerning the pathway to be followed in the development of the future Italian energy system in order to meet decarbonization targets as established by the Paris Agreement and by the European Green Deal, and to infer a techno-economic analysis of the required asset alternatives to be used in that perspective. To accomplish this objective, the Energy System Optimization Model TEMOA-Italy is used, based on the open-source platform TEMOA and developed at PoliTo as a tool to be used for technology assessment and energy scenario analysis. The adopted assessment strategy includes two different scenarios to be compared with a business-as-usual one, which considers the application of current policies in a time horizon up to 2050. The studied scenarios are based on the up-to-date hydrogen-related targets and planned investments included in the National Hydrogen Strategy and in the Italian National Recovery and Resilience Plan, with the purpose of providing a critical assessment of what they propose. One scenario imposes decarbonization objectives for the years 2030, 2040 and 2050, without any other specific target. The second one (inspired to the national objectives on the development of the sector) promotes the deployment of the hydrogen value-chain. These scenarios provide feedback about the applications hydrogen could have in the Italian energy system, including transport, industry and synfuels production. Furthermore, the decarbonization scenario where hydrogen production is not imposed, will make use of this energy vector as well, showing the necessity of its exploitation in order to meet pledged targets by 2050. The distance of the planned policies from the optimal conditions for the achievement of Italian objectives is be clarified, revealing possible improvements of various steps of the decarbonization pathway, which seems to have as a fundamental element Carbon Capture and Utilization technologies for its accomplishment. In line with the European Commission open science guidelines, the transparency and the robustness of the presented results is ensured by the adoption of the open-source open-data model such as the TEMOA-Italy.

Keywords: decarbonization, energy system optimization models, hydrogen, open-source modeling, TEMOA

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Authors: Smriti Rastogi, Narsingh Verma

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Background: A vast body of research exists on the use of oral hypoglycaemic drugs, insulin injections and the like in managing diabetes but no such research exists that has taken into consideration the parameter of time restricted meal intake and its positive effects in managing diabetes. The utility of this project is immense as it offers a solution to the woes of diabetics based on circadian rhythm and normal physiology of the human body. Method: 80 Diabetics, enrolled from the Out Patient Department of Endocrinology, KGMU (King George's Medical University) were randomly divided based on consent to early dinner TRM(time restricted meal) group or not (control group). Follow up was done at six months and 12 months for anthropometric measurement, height, weight, waist-hip ratio, neck size, fasting, postprandial blood sugar, HbA1c, serum urea, serum creatinine, and lipid profile. The patient was given a clear understanding of chronomedicine and how it affects their health. A single intervention was done - the timing of dinner was at or around 7 pm for TRM group. Result: 65% of TRM group and 40 %(non- TRM) had normal HbA1c after 12 months. HbA1c in TRM Group (first visit to second follow up) had a significant p value=0.017. A p value of <0.0001 was observed on comparing the values of blood sugar (fasting) in TRM Group from the first visit and second follow up. The values of blood sugar (postprandial) in TRM Group (first visit and second follow up) showed a p-value <0.0001 (highly significant). Values of the three parameters were non- significant in the control group. Hip size(First Visit to Second Follow Up) TRM Group showed a p-value = 0.0344 (Significant) (Difference between means=2.762 ± 1.261)Detailed results of the above parameters and a few newer ones will be presented at the conference. Conclusion: Time restricted meal intake in diabetics shows promise and is worth exploring further. Time Restricted Meal intake in Type 2 diabetics has a significant effect in controlling and maintaining HbA1c as the reduction in HbA1c value was very significant in the TRM group vs. the control group. Similar highly significant results were obtained in the case of fasting and postprandial values of blood sugar in the TRM group when compared to the control group. The effects of time restricted meal intake in diabetics show promise and are worth exploring further. It is one of the first studies which have been undertaken in Indian diabetics, although the initial data obtained is encouraging yet further research and study are required to corroborate results.

Keywords: chronomedicine, diabetes, endocrinology, time restricted meal intake

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Authors: Beom-Seok Ko, Yoo-Seok Kim, Woo-Sung Lim, Ku-Sang Kim, Hyun-Ah Kim, Jin-Sun Lee, An-Bok Lee, Jin-Gu Bong, Tae-Hyun Kim, Sei-Hyun Ahn

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Background: Breast conserving surgery (BCS) followed by radiation therapy is today standard therapy for early breast cancer. It is safe therapeutic procedure in early breast cancers, because it provides the same level of overall survival as mastectomy. There are a number of different types of incisions used to BCS. Avoiding scars on the breast is women’s desire. Numerous minimal approaches have evolved due to this concern. Periareolar incision is often used when the small tumor relatively close to the nipple. But periareolar incision has a disadvantages include limited exposure of the surgical field. In plastic surgery, various methods such as zigzag incisions have been recommended to achieve satisfactory esthetic results. Periareolar zigzag incision has the advantage of not only good surgical field but also contributed to better surgical scars. The purpose of this study was to evaluate the oncological safety of procedures by studying the status of the surgical margins of the excised tumor specimen and reduces the need for further surgery. Methods: Between January 2016 and September 2016, 148 women with breast cancer underwent BCS or mastectomy by the same surgeon in ASAN medical center. Patients with exclusion criteria were excluded from this study if they had a bilateral breast cancer or underwent resection of the other tumors or taken axillary dissection or performed other incision methods. Periareolar zigzag incision was performed and excision margins of the specimen were identified frozen sections and paraffin-embedded or permanent sections in all patients in this study. We retrospectively analyzed tumor characteristics, the operative time, size of specimen, the distance from the tumor to nipple. Results: A total of 148 patients were reviewed, 72 included in the final analysis, 76 excluded. The mean age of the patients was 52.6 (range 25-19 years), median tumor size was 1.6 cm (range, 0.2-8.8), median tumor distance from the nipple was 4.0 cm (range, 1.0-9.0), median excised specimen sized was 5.1 cm (range, 2.8-15.0), median operation time was 70.0 minute (range, 39-138). All patients were discharged with no sign of infection or skin necrosis. Free resection margin was confirmed by frozen biopsy and permanent biopsy in all samples. There were no patients underwent reoperation. Conclusions: We suggest that periareolar zigzag incision can provide a good surgical field to remove a relatively large tumor and may provide cosmetically good outcomes.

Keywords: periareolar zigzag incision, breast conserving surgery, breast cancer, resection margin

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Authors: Umut Kokbas, Mustafa Nisari

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Immunoglobulins, also known as antibodies, are glycoprotein molecules produced by activated B cells that transform into plasma cells and result in them. Antibodies are critical molecules of the immune response to fight, which help the immune system specifically recognize and destroy antigens such as bacteria, viruses, and toxins. Immunoglobulin classes differ in their biological properties, structures, targets, functions, and distributions. Five major classes of antibodies have been identified in mammals: IgA, IgD, IgE, IgG, and IgM. Evaluation of the immunoglobulin isotype can provide a useful insight into the complex humoral immune response. Evaluation and knowledge of immunoglobulin structure and classes are also important for the selection and preparation of antibodies for immunoassays and other detection applications. The immunoglobulin test measures the level of certain immunoglobulins in the blood. IgA, IgG, and IgM are usually measured together. In this way, they can provide doctors with important information, especially regarding immune deficiency diseases. Hypogammaglobulinemia (HGG) is one of the main groups of primary immunodeficiency disorders. HGG is caused by various defects in B cell lineage or function that result in low levels of immunoglobulins in the bloodstream. This affects the body's immune response, causing a wide range of clinical features, from asymptomatic diseases to severe and recurrent infections, chronic inflammation and autoimmunity Transient infant hypogammaglobulinemia (THGI), IgM deficiency (IgMD), Bruton agammaglobulinemia, IgA deficiency (SIgAD) HGG samples are a few. Most patients can continue their normal lives by taking prophylactic antibiotics. However, patients with severe infections require intravenous immune serum globulin (IVIG) therapy. The IgE level may rise to fight off parasitic infections, as well as a sign that the body is overreacting to allergens. Also, since the immune response can vary with different antigens, measuring specific antibody levels also aids in the interpretation of the immune response after immunization or vaccination. Immune deficiencies usually occur in childhood. In Immunology and Allergy clinics, apart from the classical methods, it will be more useful in terms of diagnosis and follow-up of diseases, if it is fast, reliable and especially in childhood hypogammaglobulinemia, sampling from children with a method that is more convenient and uncomplicated. The antibodies were attached to the electrode surface via the poly hydroxyethyl methacrylamide cysteine nanopolymer. It was used to evaluate the anodic peak results obtained in the electrochemical study. According to the data obtained, immunoglobulin determination can be made with a biosensor. However, in further studies, it will be useful to develop a medical diagnostic kit with biomedical engineering and to increase its sensitivity.

Keywords: biosensor, immunosensor, immunoglobulin, infection

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Authors: Esther Simpson, Evans Addo Tetteh

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One of the most important sectors in Ghana’s economy is the oil and gas sector. Effective supply chain management is required to ensure the timely delivery of these products to the end users, given the rise in nationwide demand for petroleum products. Contrarily, freight forwarding plays a crucial role in facilitating intra- and intra-country trade, particularly the movement of oil goods. Nevertheless, there has not been enough scientific study done on how marketing, supply chain management, and freight forwarding are integrated in the oil business. By highlighting possible areas for development in the supply chain management of petroleum products, this article seeks to close this gap. The study was predominantly qualitative and featured semi-structured interviews with influential figures in the oil and gas sector, such as marketers, distributors, freight forwarders, and regulatory organizations. The purpose of the interviews was to determine the difficulties and possibilities for enhancing the management of the petroleum products supply chain. Thematic analysis was used to examine the data obtained in order to find patterns and themes that arose. The findings from the study revealed that the oil sector faced a number of issues in terms of supply chain management. Inadequate infrastructure, insufficient storage facilities, a lack of cooperation among parties, and an inadequate regulatory framework were among the obstacles. Furthermore, the study indicated significant prospects for enhancing petroleum product supply chain management, such as the integration of more advanced digital technologies, the formation of strategic alliances, and the adoption of sustainable practices in petroleum product supply chain management. The study's conclusions have far-reaching ramifications for the oil and gas sector, freight forwarding, and Ghana’s economy as a whole. Marketing, supply chain management, and freight forwarding has high prospects from being integrated to improve the efficiency of the petroleum product supply chain, resulting in considerable cost savings for the industry. Furthermore, the use of sustainable practices will improve the industry's sustainability and lessen the environmental effect of the petroleum product supply chain. Based on the findings, we propose that stakeholders in Ghana’s oil and gas sector work together and collaborate to enhance petroleum supply chain management. This collaboration should include the use of digital technologies, the formation of strategic alliances, and the implementation of sustainable practices. Moreover, we urge that governments establish suitable rules to guarantee the efficient and sustainable management of petroleum product supply chains. In conclusion, the integration and combination of marketing, supply chain management, and freight forwarding in the oil business gives a tremendous opportunity for enhancing petroleum product supply chain management. The study's conclusions have far-reaching ramifications for the sector, freight forwarding, and the economy as a whole. Using sustainable practices, integrating digital technology, and forming strategic alliances will improve the efficiency and sustainability of the petroleum product supply chain. We expect that this conference paper will encourage more study and collaboration among oil and gas sector stakeholders to improve petroleum supply chain management.

Keywords: collaboration, logistics, sustainability, supply chain management

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Authors: R. Tariq, R. Lee

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Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Elvis Medina, Alejandro Karelovic, Romel Jiménez

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Catalytic ammonia decomposition represents an attractive alternative due to its high H₂ content (17.8% w/w), a product stream free of COₓ, among others; however, challenges need to be addressed for its consolidation as an H₂ chemical storage technology, especially, those focused on the synthesis of efficient bimetallic catalytic systems, as an alternative to the price and scarcity of ruthenium, the most active catalyst reported. In this sense, from the perspective of rational catalyst design, adjusting the main catalytic activity descriptor, a screening of supported catalysts with different compositional settings of cobalt-molybdenum metals is presented to evaluate their effect on the catalytic decomposition rate of ammonia. Subsequently, a kinetic study on the supported monometallic Co and Mo catalysts, as well as on the bimetallic CoMo catalyst with the highest activity is shown. The synthesis of catalysts supported on γ-alumina was carried out using the Charge Enhanced Dry Impregnation (CEDI) method, all with a 5% w/w loading metal. Seeking to maintain uniform dispersion, the catalysts were oxidized and activated (In-situ activation) using a flow of anhydrous air and hydrogen, respectively, under the same conditions: 40 ml min⁻¹ and 5 °C min⁻¹ from room temperature to 600 °C. Catalytic tests were carried out in a fixed-bed reactor, confirming the absence of transport limitations, as well as an Approach to equilibrium (< 1 x 10⁻⁴). The reaction rate on all catalysts was measured between 400 and 500 ºC at 53.09 kPa NH3. The synergy theoretically (DFT) reported for bimetallic catalysts was confirmed experimentally. Specifically, it was observed that the catalyst composed mainly of 75 mol% cobalt proved to be the most active in the experiments, followed by the monometallic cobalt and molybdenum catalysts, in this order of activity as referred to in the literature. A kinetic study was performed at 10.13 – 101.32 kPa NH3 and at four equidistant temperatures between 437 and 475 °C the data were adjusted to an LHHW-type model, which considered the desorption of nitrogen atoms from the active phase surface as the rate determining step (RDS). The regression analysis were carried out under an integral regime, using a minimization algorithm based on SLSQP. The physical meaning of the parameters adjusted in the kinetic model, such as the RDS rate constant (k₅) and the lumped adsorption constant of the quasi-equilibrated steps (α) was confirmed through their Arrhenius and Van't Hoff-type behavior (R² > 0.98), respectively. From an energetic perspective, the activation energy for cobalt, cobalt-molybdenum, and molybdenum was 115.2, 106.8, and 177.5 kJ mol⁻¹, respectively. With this evidence and considering the volcano shape described by the ammonia decomposition rate in relation to the metal composition ratio, the synergistic behavior of the system is clearly observed. However, since characterizations by XRD and TEM were inconclusive, the formation of intermetallic compounds should be still verified using HRTEM-EDS. From this point onwards, our objective is to incorporate parameters into the kinetic expressions that consider both compositional and structural elements and explore how these can maximize or influence H₂ production.

Keywords: CEDI, hydrogen carrier, LHHW, RDS

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Authors: Somnath Bhattacharya, Kamal Sharma, Vaibhav Sonkar

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Composite materials emerged in the middle of the 20th century as a promising class of engineering materials providing new prospects for modern technology. Recently, a new class of composite materials known as functionally graded materials (FGMs) has drawn considerable attention of the scientific community. In general, FGMs are defined as composite materials in which the composition or microstructure or both are locally varied so that a certain variation of the local material properties is achieved. This gradual change in composition and microstructure of material is suitable to get gradient of properties and performances. FGMs are synthesized in such a way that they possess continuous spatial variations in volume fractions of their constituents to yield a predetermined composition. These variations lead to the formation of a non-homogeneous macrostructure with continuously varying mechanical and / or thermal properties in one or more than one direction. Lightweight functionally graded composites with high strength to weight and stiffness to weight ratios have been used successfully in aircraft industry and other engineering applications like in electronics industry and in thermal barrier coatings. In the present work, elastic-plastic crack growth problems (using Ramberg-Osgood Model) in an FGM plate under cyclic load has been explored by extended finite element method. Both edge and centre crack problems have been solved by taking additionally holes, inclusions and minor cracks under plane stress conditions. Both soft and hard inclusions have been implemented in the problems. The validity of linear elastic fracture mechanics theory is limited to the brittle materials. A rectangular plate of functionally graded material of length 100 mm and height 200 mm with 100% copper-nickel alloy on left side and 100% ceramic (alumina) on right side is considered in the problem. Exponential gradation in property is imparted in x-direction. A uniform traction of 100 MPa is applied to the top edge of the rectangular domain along y direction. In some problems, domain contains major crack along with minor cracks or / and holes or / and inclusions. Major crack is located the centre of the left edge or the centre of the domain. The discontinuities, such as minor cracks, holes, and inclusions are added either singly or in combination with each other. On the basis of this study, it is found that effect of minor crack in the domain’s failure crack length is minimum whereas soft inclusions have moderate effect and the effect of holes have maximum effect. It is observed that the crack growth is more before the failure in each case when hard inclusions are present in place of soft inclusions.

Keywords: elastic-plastic, fatigue crack, functionally graded materials, extended finite element method (XFEM)

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Authors: Laila Albughayl

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The purpose of this qualitative case study was to explore Saudi females’ leadership journeys as they navigate the labyrinth of leadership in higher education. To gain a better understanding of how these leaders overcame challenges and accessed support as they progressed through the labyrinth to top positions in Saudi higher education. The significance of this research derived from the premise that leaders need to acquire essential leadership competencies such as knowledge, skills, and practices to effectively lead through economic transformation, growing globalism, and rapidly developing technology in an increasingly diverse world. In addition, understanding Saudi women’s challenges in the labyrinth will encourage policymakers to improve the situation under which these women work. The metaphor ‘labyrinth’ for Eagly and Carli (2007) encapsulates the winding paths, dead ends, and maze-like pathways that are full of challenges and supports that women traverse to access and maintain leadership positions was used. In this study, ‘labyrinth’ was used as the conceptual framework to explore women leaders’ challenges and opportunities in leadership in Saudi higher education. A proposed model for efficient navigation of the labyrinth of leadership was used. This model focused on knowledge, skills, and behaviours (KSB) as the analytical framework for examining responses to the research questions. This research was conducted using an interpretivist qualitative approach. A case study was the methodology used. Semi-structured interviews were the main data collection method. Purposive sampling was used to select ten Saudi leaders in three public universities. In coding, the 6-step framework of thematic analysis for Braun and Clarke was used to identify, analyze, and report themes within the data. NVivo software was also used as a tool to assist with managing and organizing the data. The resultant findings showed that the challenges identified by participants in navigating the labyrinth of leadership in Saudi higher education replicated some of those identified in the literature. The onset findings also revealed that the organizational barriers in Saudi higher education came as the top hindrance to women’s advancement in the labyrinth of leadership, followed by societal barriers. The findings also showed that women’s paths in the labyrinth of leadership in higher education were still convoluted and tedious compared to their male counterparts. In addition, the findings revealed that Saudi women leaders use significant strategies to access leadership posts and effectively navigate the labyrinth; this was not indicated in the literature. In addition, the resultant findings revealed that there are keys that assisted Saudi female leaders in effectively navigating the labyrinth of leadership. For example, the findings indicated that spirituality (religion) was a powerful key that enabled Saudi women leaders to pursue and persist in their leadership paths. Based on participants' experiences, a compass for effective navigation of the labyrinth of leadership in higher education was created for current and aspirant Saudi women leaders to follow. Finally, the findings had several significant implications for practice, policy, theory, and future research.

Keywords: women, leadership, labyrinth, higher education

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Authors: Brajendra S. Sengar, Vivek Garg, Gaurav Siddharth, Nisheka Anadkat, Amitesh Kumar, Shaibal Mukherjee

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The optimal band gap (~ 1 to 1.5 eV) and high absorption coefficient ~104 cm⁻¹ has made Cu₂ZnSn(S,Se)₄ (CZTSSe) films as one of the most promising absorber materials in thin-film photovoltaics. Additionally, CZTSSe consists of elements that are abundant and non-toxic, makes it even more favourable. The CZTSSe thin films are grown at 100 to 500ᵒC substrate temperature (Tsub) on Soda lime glass (SLG) substrate by Elettrorava dual ion beam sputtering (DIBS) system by utilizing a target at 2.43x10⁻⁴ mbar working pressure with RF power of 45 W in argon ambient. The chemical composition, depth profiling, structural properties and optical properties of these CZTSSe thin films prepared on SLG were examined by energy dispersive X-ray spectroscopy (EDX, Oxford Instruments), Hiden secondary ion mass spectroscopy (SIMS) workstation with oxygen ion gun of energy up to 5 keV, X-ray diffraction (XRD) (Rigaku Cu Kα radiation, λ=.154nm) and Spectroscopic Ellipsometry (SE, M-2000D from J. A. Woollam Co., Inc). It is observed that from that, the thin films deposited at Tsub=200 and 300°C show Cu-poor and Zn-rich states (i.e., Cu/(Zn + Sn) < 1 and Zn/Sn > 1), which is not the case for films grown at other Tsub. It has been reported that the CZTSSe thin films with the highest efficiency are typically at Cu-poor and Zn-rich states. The values of band gap in the fundamental absorption region of CZTSSe are found to be in the range of 1.23-1.70 eV depending upon the Cu/(Zn+Sn) ratio. It is also observed that there is a decline in optical band gap with the increase in Cu/(Zn+Sn) ratio (evaluated from EDX measurement). Cu-poor films are found to have higher optical band gap than Cu-rich films. The decrease in the band gap with the increase in Cu content in case of CZTSSe films may be attributed to changes in the extent of p-d hybridization between Cu d-levels and (S, Se) p-levels. CZTSSe thin films with Cu/(Zn+Sn) ratio in the range 0.86–1.5 have been successfully deposited using DIBS. Optical band gap of the films is found to vary from 1.23 to 1.70 eV based on Cu/(Zn+Sn) ratio. CZTSe films with Cu/ (Zn+Sn) ratio of .86 are found to have optical band gap close to the ideal band gap (1.49 eV) for highest theoretical conversion efficiency. Thus by tailoring the value of Cu/(Zn+Sn), CZTSSe thin films with the desired band gap could be obtained. Acknowledgment: We are thankful to DIBS, EDX, and XRD facility equipped at Sophisticated Instrument Centre (SIC) at IIT Indore. The authors B. S. S and A. K. acknowledge CSIR, and V. G. acknowledges UGC, India for their fellowships. B. S. S is thankful to DST and IUSSTF for BASE Internship Award. Prof. Shaibal Mukherjee is thankful to DST and IUSSTF for BASE Fellowship and MEITY YFRF award. This work is partially supported by DAE BRNS, DST CERI, and DST-RFBR Project under India-Russia Programme of Cooperation in Science and Technology. We are thankful to Mukul Gupta for SIMS facility equipped at UGC-DAE Indore.

Keywords: CZTSSe, DIBS, EDX, solar cell

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Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Naziema Begum Jappie

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The internationalization of higher education has become a focal point for academic institutions worldwide, including those in South Africa. This paper explores the multifaceted implications of internationalization on management and practice within the South African higher education landscape. Universities all over the world are increasingly recognizing the challenges of globalization and the pressures towards internationalization. Internationalization in higher education encompasses a range of activities, including academic exchange programs, research collaborations, joint degree programs, and the recruitment of international students and faculty. In South Africa, this process is driven by various factors, including the quest for global competitiveness, the pursuit of academic excellence, and the promotion of cultural diversity. However, while internationalization presents numerous opportunities, it also brings forth significant challenges that require careful consideration by management and practitioners in higher education institutions. Furthermore, the internationalization of higher education in South Africa has significant implications for teaching and learning practices. With an increasingly diverse student body, educators must employ innovative pedagogical approaches that cater to the needs and preferences of a multicultural cohort. This may involve the integration of global perspectives into the curriculum, the use of technology-enhanced learning platforms, and the promotion of intercultural competence among students and faculty. Additionally, the exchange of knowledge and ideas with international partners can enrich research activities and contribute to the advancement of knowledge in various fields. The internationalization of higher education in South Africa has profound implications for management and practice within academic institutions. While it offers opportunities for enhancing academic quality, promoting cultural exchange, and advancing research agendas, it also presents challenges that require strategic planning, resource allocation, and stakeholder engagement. By addressing these challenges proactively and leveraging the opportunities presented by internationalization, South African universities can position themselves as global leaders in higher education while contributing to the socio-economic development of the country and the continent at large. This paper draws together the international experience in South Africa to explore the emerging patterns of strategy and practice in internationalizing Higher Education and will highlight some critical notions of how the concepts of internationalization and globalization in the context of higher education are understood by those who lead universities and what new challenges are being created as universities seek to become more international. Institutions cannot simply have bullet points in the strategic plan for the recruitment of international students; there has to be a complete commitment to a national strategy of inclusivity. This paper will further examine the leadership styles that ensure transformation together with the goals set out for internationalization. Discussions around adding the international relations dimension to the curriculum. Addressing the issues relevant to cross-border delivery of higher education.

Keywords: challenges, higher education, internationalization, strategic focus

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