Search results for: clinical quality and safety

Authors: Kejal Joshi Reddy, Sirimavo Nair

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Micronutrient malnutrition affects pregnant women and children extremely with reference to growth manifestations in gestation as well as after birth. Early fetal development affected by iodine and iron deficiency leads to poor life quality. Various researchers have found interesting interrelations between iron and iodine. A few studies on impact assessment of DFS supplementation during pregnancy have been reported in India. Aim To provide meaningful contribution by assessing the efficacy of DFS supplementation on iodine and iron status of pregnant women. Design An interventional study. Setting A semi government hospital of urban Vadodara. Subjects Pregnant women (n=150) enrolled during first trimester (< 12 weeks) and followed up till the end of gestation, n=75 were divided in experimental (DFS supplemented) and control (Non supplemented) group. Results Impact on iron and iodine status was assessed by Hb concentration and UIE respectively. Mean Hb improved significantly (p < 0.001) (+0.42 g/dl) in experimental group and reduced non significantly (-0.20 g/dl) in control group at the end, since DFS provided additional 93 mg of iron within 6 months. Median UIE improved non significantly (278.6 to 299.01µg/L) in experimental group and decreased significantly (p < 0.05) (376.59 to 288.66 µg/L) in control group. Conclusion DFS could improve iron and iodine status of experimental group compared to control group. It is an effective measure to control two essential micronutrient deficiencies together.

Keywords: DFS supplementation, anemia, pregnancy, iodine deficiency, iron

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Authors: Theodore Gautier Le Jeune Bikoko, Jean Claude Tchamba, Sofiane Amziane

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This study focuses on the problem of collapsed buildings within the city of Douala over the past ten years, and more precisely, within the period from 2011 to 2020. It was carried out in a bid to ascertain the real causes of this phenomenon, which has become recurrent in the leading economic city of Cameroon. To achieve this, it was first necessary to review some works dealing with construction materials and technology as well as some case histories of structural collapse within the city. Thereafter, a statistical study was carried out on the results obtained. It was found that the causes of building collapses in the city of Douala are: Neglect of administrative procedures, use of poor quality materials, poor composition and confectioning of concrete, lack of Geotechnical study, lack of structural analysis and design, corrosion of the reinforcement bars, poor maintenance in buildings, and other causes. Out of the 46 cases of structural failure of buildings within the city of Douala, 7 of these were identified to have had no geotechnical study carried out, giving a percentage of 15.22%. It was also observed that out of the 46 cases of structural failure, 6 were as a result of lack of proper structural analysis and design, giving a percentage of 13.04%. Subsequently, recommendations and suggestions are made in a bid to placing particular emphasis on the choice of materials, the manufacture and casting of concrete, as well as the placement of the required reinforcements. All this guarantees the stability of a building.

Keywords: collapse buildings, Douala, structural collapse, Cameroon

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Authors: Maria C. Proença, Marco Aniceto, Pedro N. Santos, José C. Freitas

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A methodology based on wavelets is proposed for the automatic location and delimitation of defects in limestone plates. Natural defects include dark colored spots, crystal zones trapped in the stone, areas of abnormal contrast colors, cracks or fracture lines, and fossil patterns. Although some of these may or may not be considered as defects according to the intended use of the plate, the goal is to pair each stone with a map of defects that can be overlaid on a computer display. These layers of defects constitute a database that will allow the preliminary selection of matching tiles of a particular variety, with specific dimensions, for a requirement of N square meters, to be done on a desktop computer rather than by a two-hour search in the storage park, with human operators manipulating stone plates as large as 3 m x 2 m, weighing about one ton. Accident risks and work times are reduced, with a consequent increase in productivity. The base for the algorithm is wavelet decomposition executed in two instances of the original image, to detect both hypotheses – dark and clear defects. The existence and/or size of these defects are the gauge to classify the quality grade of the stone products. The tuning of parameters that are possible in the framework of the wavelets corresponds to different levels of accuracy in the drawing of the contours and selection of the defects size, which allows for the use of the map of defects to cut a selected stone into tiles with minimum waste, according the dimension of defects allowed.

Keywords: automatic detection, defects, fracture lines, wavelets

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Authors: Abdel-Monem Sayed Mohamed

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Lake Aswan is one of the largest man-made reservoirs in the world. The reservoir began to fill in 1964 and the level rose gradually, with annual irrigation cycles, until it reached a maximum water level of 181.5 m in November 1999, with a capacity of 160 km3. The filling of such large reservoir changes the stress system either through increasing vertical compressional stress by loading and/or increased pore pressure through the decrease of the effective normal stress. The resulted effect on fault zones changes stability depending strongly on the orientation of pre-existing stress and geometry of the reservoir/fault system. The main earthquake occurred on November 14, 1981, with magnitude 5.5. This event occurred after 17 years of the reservoir began to fill, along the active part of the Kalabsha fault and located not far from the High Dam. Numerous of small earthquakes follow this earthquake and continue till now. For this reason, 13 seismograph stations (radio-telemetry network short-period seismometers) were installed around the northern part of Lake Aswan. The main purpose of the network is to monitor the earthquake activity continuously within Aswan region. The data described here are obtained from the continuous record of earthquake activity and lake-water level variation through the period from 1982 to 2015. The seismicity is concentrated in the Kalabsha area, where there is an intersection of the easterly trending Kalabsha fault with the northerly trending faults. The earthquake foci are distributed in two seismic zones, shallow and deep in the crust. Shallow events have focal depths of less than 12 km while deep events extend from 12 to 28 km. Correlation between the seismicity and the water level variation in the lake provides great suggestion to distinguish the micro-earthquakes, particularly, those in shallow seismic zone in the reservoir–triggered seismicity category. The water loading is one factor from several factors, as an activating medium in triggering earthquakes. The common factors for all cases of induced seismicity seem to be the presence of specific geological conditions, the tectonic setting and water loading. The role of the water loading is as a supplementary source of earthquake events. So, the earthquake activity in the area originated tectonically (ML ≥ 4) and the water factor works as an activating medium in triggering small earthquakes (ML ≤ 3). Study of the inducing seismicity from the water level variation in Aswan Lake is of great importance and play great roles necessity for the safety of the High Dam body and its economic resources.

Keywords: Aswan lake, Aswan seismic network, seismicity, water level variation

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Authors: Kimberly Winnie Achieng Otieno

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The Nairobi Hospital plays a pivotal role in healthcare provision in East and Central Africa, yet it faces challenges in providing accessible dialysis care. This paper explores strategic interventions to enhance dialysis care, improve access and streamline health information management, with an aim of fostering an integrated and patient-centered healthcare system in our region. Challenges at The Nairobi Hospital The Nairobi Hospital currently grapples with insufficient dialysis machines which results in extended turn around times. This issue stems from both staffing bottle necks and infrastructural limitations given our growing demand for renal care services. Our Paper-based record keeping system and fragmented flow of information downstream hinders the hospital’s ability to manage health data effectively. There is also a need for investment in expanding The Nairobi Hospital dialysis facilities to far reaching communities. Setting up satellite clinics that are closer to people who live in areas far from the main hospital will ensure better access to underserved areas. Community Outreach and Education Implementing education programs on kidney health within local communities is vital for early detection and prevention. Collaborating with local leaders and organizations can establish a proactive approach to renal health hence reducing the demand for acute dialysis interventions. We can amplify this effort by expanding The Nairobi Hospital’s corporate social responsibility outreach program with weekend engagement activities such as walks, awareness classes and fund drives. Enhancing Efficiency in Dialysis Care Demand for dialysis services continues to rise due to an aging Kenyan population and the increasing prevalence of chronic kidney disease (CKD). Present at this years International Nursing Conference are a diverse group of caregivers from around the world who can share with us their process optimization strategies, patient engagement techniques and resource utilization efficiencies to catapult The Nairobi Hospital to the 21st century and beyond. Plans are underway to offer ongoing education opportunities to keep staff updated on best practices and emerging technologies in addition to utilizing a patient feedback mechanisms to identify areas for improvement and enhance satisfaction. Staff empowerment and suggestion boxes address The Nairobi Hospital’s organizational challenges. Current financial constraints may limit a leapfrog in technology integration such as the acquisition of new dialysis machines and an investment in predictive analytics to forecast patient needs and optimize resource allocation. Streamlining Health Information Management Fully embracing a shift to 100% Electronic Health Records (EHRs) is a transformative step toward efficient health information management. Shared information promotes a holistic understanding of patients’ medical history, minimizing redundancies and enhancing overall care quality. To manage the transition to community-based care and EHRs effectively, a phased implementation approach is recommended. Conclusion By strategically enhancing dialysis care access and streamlining health information management, The Nairobi Hospital can strengthen its position as a leading healthcare institution in both East and Central Africa. This comprehensive approach aligns with the hospital’s commitment to providing high-quality, accessible, and patient-centered care in an evolving landscape of healthcare delivery.

Keywords: Africa, urology, diaylsis, healthcare

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Authors: Johannes Mertl

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Our surrounding air contains various particles. Besides typical representatives of inorganic dust, such as soot and ash, also particles originating from animals, microorganisms or plants are floating through the air, so-called bioaerosols. The group of bioaerosols consists of a broad spectrum of particles of different size, including fungi, bacteria, viruses, spores, or tree, flower and grass pollen that are of high relevance for allergy sufferers. In dependence of the environmental climate and the actual season, these allergenic particles can be found in enormous numbers in the air and are inhaled by humans via the respiration tract, with a potential for inflammatory diseases of the airways, such as asthma or allergic rhinitis. As a consequence air filter systems of ventilation and air conditioning devices are required to meet very high standards to prevent, or at least lower the number of allergens and airborne germs entering the indoor air. Still, filter systems are merely classified for their separation rates using well-defined mineral test dust, while no appropriate sufficiently standardized test methods for bioaerosols exist. However, determined separation rates for mineral test particles of a certain size cannot simply be transferred to bioaerosols, as separation efficiency of particularly fine and respirable particles (< 10 microns) is dependent not only on their shape and particle diameter, but also defined by their density and physicochemical properties. For this reason, the OFI developed a test method, which directly enables a testing of filters and filter media for their separation rates on bioaerosols, as well as a classification of filters. Besides allergens from an intact or fractured tree or grass pollen, allergenic proteins bound to particulates, as well as allergenic fungal spores (e.g. Cladosporium cladosporioides), or bacteria can be used to classify filters regarding their separation rates. Allergens passing through the filter can then be detected by highly sensitive immunological assays (ELISA) or in the case of fungal spores by microbiological methods, which allow for the detection of even one single spore passing the filter. The test procedure, which is carried out in laboratory scale, was furthermore validated regarding its sufficiency to cover real life situations by upscaling using air conditioning devices showing great conformity in terms of separation rates. Additionally, a clinical study with allergy sufferers was performed to verify analytical results. Several different air conditioning filters from the car industry have been tested, showing significant differences in their separation rates.

Keywords: airborne germs, allergens, classification of filters, fine dust

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Authors: Ningombam Linthoingambi Devi, Amrendra Kumar

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The long term sampling at one of the most populated city in Indo-Gangetic region shows higher mass concentration of atmospheric aerosol (PM₂.₅) during spring season (144.70µg/m³), summer season (91.96 µg/m³), the autumn season (266.48µg/m³) and winter season (367.09 µg/m³) respectively. The concentration of PM₂.₅ in Patna across the year shows much higher than the limit fixed by the national ambient air quality level fixed by central pollution control board India (CPCB, India) and World Health Organization (WHO). Different water-soluble cation (Na⁺, K⁺, Ca²⁺, NH₄⁺ , and Mg²⁺) and anion (Cl⁻, NO₃⁻ , and SO₄²⁻) species were detected in PM₂.₅. Results show the significantly higher loaded of water-soluble ions during winter and spring seasons. The acidity of the atmosphere was revealed and calculated using selected major cations (K⁺, Ca²⁺ , and NH₄⁺) and anions (SO₄²⁻, and NO₃⁻). A regression correlation was analyzed to check the significant linkage between the acidity and alkalinity ions. During the winter season (r² = 0.79) and spring season (r² = 0.64) shows good significant correlation between the cations and anions. The ratio of NO₃⁻/SO₄²⁻ indicates the sources of secondary pollutants were mainly influenced by industrial and vehicular emission however SO₄²⁻ mostly emitted from industries during the winter season.

Keywords: aerosols, inorganic species, source apportionment, Indo-Gangetic region

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Authors: Rangoli Goyal, Rama Bhargava

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The triple diffusive boundary layer flow of nanofluid under the action of constant magnetic field over a non-linear stretching sheet has been investigated numerically. The model includes the effect of Brownian motion, thermophoresis, and cross-diffusion; slip mechanisms which are primarily responsible for the enhancement of the convective features of nanofluid. The governing partial differential equations are transformed into a system of ordinary differential equations (by using group theory transformations) and solved numerically by using variational finite element method. The effects of various controlling parameters, such as the magnetic influence number, thermophoresis parameter, Brownian motion parameter, modified Dufour parameter, and Dufour solutal Lewis number, on the fluid flow as well as on heat and mass transfer coefficients (both of solute and nanofluid) are presented graphically and discussed quantitatively. The present study has industrial applications in aerodynamic extrusion of plastic sheets, coating and suspensions, melt spinning, hot rolling, wire drawing, glass-fibre production, and manufacture of polymer and rubber sheets, where the quality of the desired product depends on the stretching rate as well as external field including magnetic effects.

Keywords: FEM, thermophoresis, diffusiophoresis, Brownian motion

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Authors: Haveesha Buddhdev

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The most important right for a human being in a society is the freedom of expression as stated by Article 18 and 19 of the Universal Declaration of Human rights pledged by member states of United Nations. Will it be fair to expect him/her to be of sound mental health if this right is taken away? Religion as a primary social institution controls many rights, freedoms and duties of people in a society. It does so by imposing certain values and beliefs on people which would either enhance quality of life or curb their freedom adversely thus affecting individual mental health. This paper aims to study the positive and negative role that religion plays in influencing one’s freedom of expression. This paper will focus on reviewing existing studies on the positive and negative impacts of religion on mental health. It will also contain data collected by the researcher about the impacts of religion on freedom of expression which will be obtained by surveying a sample of 30 adolescents and young adults. The researcher will use a Likert scale for these purpose, with response options ranging from strongly disagree to strongly agree and quantify it accordingly. Descriptive statistics would be used to analyse the data. Such research would help to identify possible problems faced by adolescents and young adults when it comes to religio-cultural ethos and also facilitate further researches to study the role that religion plays in mental health.

Keywords: cultural Ethos, freedom of expression, adolescent mental health, social science

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Authors: Asma Salman, Brian Gabbitas, Peng Cao, Deliang Zhang

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The performance of a coating is strongly dependent upon its microstructure, which in turn is dependent on the characteristics of the feedstock powder. This study involves the evaluation and performance of a titanium-based composite coating produced by the HVOF (high-velocity oxygen fuel) spraying method. The feedstock for making the composite coating was produced using high energy mechanical milling of TiO2 and Al powders followed by a combustion reaction. The characteristics of the feedstock powder were improved by treating it with an organic binder. Two types of coatings were produced using treated and untreated feedstock powders. The microstructures and characteristics of both types of coatings were studied, and their thermal shock resistance was accessed by dipping into molten aluminum. The results of this study showed that feedstock treatment did not have a significant effect on the microstructure of the coatings. However, it did affect the uniformity, thickness and surface roughness of the coating on the steel substrate. A coating produced by an untreated feedstock showed better thermal shock resistance in molten aluminum compared with the one produced by PVA (polyvinyl alcohol) treatment.

Keywords: coating, feedstock, powder processing, thermal shock resistance, thermally spraying

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Authors: Rufat Nuriyev

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Located in the eastern part of the Republic of Azerbaijan and on the western shore of the Caspian Sea, Gobustan National Reserve was inscribed as Gobustan Rock Art Cultural Landscape into the World Heritage List in 2007. Gobustan is an outstanding rock art landscape, where over 6000 rock engravings were found and registered, since the end of Upper Paleolithic up to the Middle Ages. Being a rock art center, the Gobustan seeks to stimulate public awareness and disseminate knowledge of prehistoric art to enrich educational, cultural and artistic communities regionally, nationally and internationally. Due to the Decree of the President of the Republic of Azerbaijan and the “Action Plan” , planned actions started to realize. Some of them implemented before of stipulated date. For the attraction of visitors and improvement of service quality in the museum-reserve, various activities are organized. The building of a new museum center at the foot of the Beyukdash Mountain has been completed in 2011. Main aims of the new museum building and exhibition was to provide better understanding of the importance of this monument for local community, Azerbaijanian culture and the world. In the Petroglyph Museum at Gobustan, digital and traditional media are closely integrated to reveal the complexity of historical, cultural and artistic meaning of prehistoric rock carvings of Gobustan. Alongside with electronic devices, the visitor gets opportunity of direct contact with artifacts and ancient rock carvings.

Keywords: Azerbaijan, Gobustan, rock art, museum

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Authors: Michael Louis Sunaris, Robby Yussac Tallar

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The concept of sustainable river is evolving in Indonesia today. Many rivers condition in Indonesia have decreased by quality and quantity. The degradation of this condition is caused by rapid land use change as a result of increased population growth and human activity. It brings the degradation of the existing watersheds including some types of land use that an important factor in determining the status of river sustainability. Therefore, an evaluation method is required to determine the sustainability status of waterbody within watershed. The purpose of this study is to analyze various types of land use in determining the status of river sustainability. This study takes the watersheds of Citarum Upstream as a study area. The results of the analysis prove the index of sustainability status of the river that changes from good to bad or average in the rivers in the study area. The rapid and uncontrolled changes of land use especially in the upper watersheds area are the main causes that happened over time. It was indicated that the cumulative runoff coefficients were increased significantly. These situations indicated that the damage of watersheds has an impact on the water surplus or deficit problem yearly. Therefore, the rivers in Indonesia should be protected and conserved. The sustainability index of the rivers is an index to indicate the condition of watersheds by defining status of rivers in order to achieve sustainable water resource management.

Keywords: land use change, runoff coefficient, a simple index, sustainable river

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Authors: Crin N. Marcean, Mihaela A. Alexandru, Eugenia S. Cristescu

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By definition, nursing means caring. It is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain or recover optimal health and quality of life. However, there is a subtle difference between the two: nursing is widely considered as an art and a science, wherein caring forms the theoretical framework of nursing. Nursing and caring are grounded in a relational understanding, unity, and connection between the professional nurse and the patient. Task-oriented approaches challenge nurses in keeping care in nursing. This challenge is on-going as professional nurses strive to maintain the concept, art, and act of caring as the moral centre of the nursing profession. Keeping the care in nursing involves the application of art and science through theoretical concepts, scientific research, conscious commitment to the art of caring as an identity of nursing, and purposeful efforts to include caring behaviours during each nurse-patient interaction. The competencies, abilities, as well as the psycho-motor, cognitive, and relational skills necessary for the nursing practice are conveyed and improved by the nursing teachers’ art of teaching. They must select and use the teaching methods which shape the personalities of the trainers or students, enabling them to provide individualized, personalized care in real-world context of health problems. They have the ultimate responsibility of shaping the future health care system by educating skilful nurses.

Keywords: art of nursing, health care, teacher-student relationship, teaching innovations

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Authors: Aftab Hameed Memon, Shadab Noor, Muhammad Akram Akhund

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Lean construction is a philosophy adopted in the construction industry to increase the value of a project by reducing waste and improving construction productivity. Lean emphasizes on maximizing the value of a project with less expenditure. Globally, lean philosophy has received wider popularity in construction sector. Lean construction has supported the practitioners with several tools and techniques to implement at various stages of a construction project. Following the global trends, this study has investigated the lean practice in Pakistan. The level of implementation of different lean tools and techniques altogether with potential benefits experienced by its implementation in construction projects of Pakistan is analyzed. To achieve the targets, the opinion was sought by the practitioners involved in handling construction projects representing four stakeholders that are a client, consultant, contractors and material suppliers through a structured questionnaire. A total of 34 completed questionnaires were collected and then statistically analyzed. The findings of the analysis have highlighted that pull approach, work standardization, just in time, increase visualization tools, integrated project delivery method and fail-safe for quality are common lean techniques implemented in the local construction industry. While reduction in waste, client’s satisfaction, improved communication, visual control and proper task management are major benefits of the lean construction application.

Keywords: lean construction, lean tools and techniques, lean benefits, waste reduction, Pakistan

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Authors: Georges Bou Ghantous

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This literature review examines the transformative impact of Artificial Intelligence (AI) on higher education, highlighting both the potential benefits and challenges associated with its adoption. The review reveals that AI significantly enhances personalized learning by tailoring educational experiences to individual student needs, thereby boosting engagement and learning outcomes. Automated grading systems streamline assessment processes, allowing educators to focus on improving instructional quality and student interaction. AI's data-driven insights provide valuable analytics, helping educators identify trends in at-risk students and refine teaching strategies. Moreover, AI promotes enhanced instructional innovation through the adoption of advanced teaching methods and technologies, enriching the educational environment. Administrative efficiency is also improved as AI automates routine tasks, freeing up time for educators to engage in research and curriculum development. However, the review also addresses the challenges that accompany AI integration, such as data privacy concerns, algorithmic bias, dependency on technology, reduced human interaction, and ethical dilemmas. This balanced exploration underscores the need for careful consideration of both the advantages and potential hurdles in the implementation of AI in higher education.

Keywords: administrative efficiency, data-driven insights, data privacy, ethical dilemmas, higher education, personalized learning

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Authors: Muhammad Zia Ullah Baig, Atiq Uz Zama

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The motivation of the project is to facilitate the governance body, as well as the common man in his/her daily life consuming product rates, to easily monitor the expense, to control the budget with the help of single SMS (message), e-mail facility, and to manage governance body by task management system. The system will also be capable of finding irregularities being done by the concerned department in mitigating the complaints generated by the customer and also provide a solution to overcome problems. We are building a system that easily controls the price control system of any country, we will feeling proud to give this system free of cost to Indian Government also. The system is able to easily manage and control the price control department of government all over the country. Price control department run in different cities under City District Government, so the system easily run in different cities with different SMS Code and decentralize Database ensure the non-functional requirement of system (scalability, reliability, availability, security, safety). The customer request for the government official price list with respect to his/her city SMS code (price list of all city available on website or application), the server will forward the price list through a SMS, if the product is not available according to the price list the customer generate a complaint through an SMS or using website/smartphone application, complaint is registered in complaint database and forward to inspection department when the complaint is entertained, the inspection department will forward a message about the complaint to customer. Inspection department physically checks the seller who does not follow the price list, but the major issue of the system is corruption, may be inspection officer will take a bribe and resolve the complaint (complaint is fake) in that case the customer will not use the system. The major issue of the system is to distinguish the fake and real complain and fight for corruption in the department. To counter the corruption, our strategy is to rank the complain if the same type of complaint is generated the complaint is in high rank and the higher authority will also notify about that complain, now the higher authority of department have reviewed the complaint and its history, the officer who resolve that complaint in past and the action against the complaint, these data will help in decision-making process, if the complaint was resolved because the officer takes bribe, the higher authority will take action against that officer. When the price of any good is decided the market/former representative is also there, with the mutual understanding of both party the price is decided, the system facilitate the decision-making process. The system shows the price history of any goods, inflation rate, available supply, demand, and the gap between supply and demand, these data will help to allot for the decision-making process.

Keywords: price control, goods, government, inspection, department, customer, employees

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Authors: Brock Liden, Eric Janowitz

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Introduction: Diabetic peripheral neuropathy (DPN) affects 70% of individuals with diabetes1. DPN causes a loss of protective sensation, which can lead to tissue damage and diabetic foot ulcer (DFU) formation2. These ulcers can result in infections and lower-extremity amputations of toes, the entire foot, and the lower leg. Even after a DFU is healed, recurrence is common, with 49% of DFU patients developing another ulcer within a year and 68% within 5 years3. This case series examines the use of sensory insoles and newly available plantar data (pressure, temperature, step count, adherence) and remote patient monitoring in patients at risk of DFU. Methods: Participants were provided with custom-made sensory insoles to monitor plantar pressure, temperature, step count, and daily use and were provided with real-time cues for pressure offloading as they went about their daily activities. The sensory insoles were used to track subject compliance, ulceration, and response to feedback from real-time alerts. Patients were remotely monitored by a qualified healthcare professional and were contacted when areas of concern were seen and provided coaching on reducing risk factors and overall support to improve foot health. Results: Of the 40 participants provided with the sensory insole system, 4 presented with a DFU. Based on flags generated from the available plantar data, patients were contacted by the remote monitor to address potential concerns. A standard clinical escalation protocol detailed when and how concerns should be escalated to the provider by the remote monitor. Upon escalation to the provider, patients were brought into the clinic as needed, allowing for any issues to be addressed before more serious complications might arise. Conclusion: This case series explores the use of innovative sensory technology to collect plantar data (pressure, temperature, step count, and adherence) for DFU detection and early intervention. The results from this case series suggest the importance of sensory technology and remote patient monitoring in providing proactive, preventative care for patients at risk of DFU. This robust plantar data, with the addition of remote patient monitoring, allow for patients to be seen in the clinic when concerns arise, giving providers the opportunity to intervene early and prevent more serious complications, such as wounds, from occurring.

Keywords: diabetic foot ulcer, DFU prevention, digital therapeutics, remote patient monitoring

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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: Prakash Singh

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The aim of this study was to investigate the extent of teachers’ experiences of tobephobia (TBP) in their heterogeneous classrooms and what impact this had on their emotions and job satisfaction. The expansive and continuously changing demands for quality and equal education for all students in educational organisations that have limited resources connotes that the negative effects of TBP cannot be simply ignored as being non-existent in the educational environment. As this quantitative study reveals, teachers disliking their job with low expectations, lack of motivation in their workplace and pessimism, result in their low self-esteem. When there is pessimism in the workplace, then the employees’ self-esteem will inevitably be low, as pointed out by 97.1% of the respondents in this study. Self-esteem is a reliable indicator of whether employees are happy or not in their jobs and the majority of the respondents in this study agreed that their experiences of TBP negatively impacted on their self-esteem. Hence, this exploratory study strongly indicates that productivity in the workplace is directly linked to the employees’ expectations, self-confidence and their self-esteem. It is therefore inconceivable for teachers to be productive in their regular classrooms if their genuine professional concerns, anxieties, and curriculum challenges are not adequately addressed. This empirical study contributes to our knowledge on TBP because it clearly outlines some of the teaching problems that we are grappling with and constantly experience in our schools in this century. Therefore, it is imperative that the tobephobic experiences of teachers are not merely documented, but appropriately addressed with relevant action by every stakeholder associated with education so that our teachers’ emotions and job satisfaction needs are fully taken care of.

Keywords: demotivated teachers' pessimism, low expectations of teachers' job satisfaction, self-esteem, tobephobia

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Authors: Khin Thandar Soe, Mark Stephen Pulham

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Ballistic building materials play a crucial role in ensuring the safety of the occupants within protective structures. Traditional options like Ordinary Portland Cement (OPC)-based walls, including reinforced concrete walls, precast concrete walls, masonry walls, and concrete blocks, are frequently employed for ballistic protection, but they have several drawbacks such as being thick, heavy, costly, and challenging to construct. On the other hand, glass and composite materials offer lightweight and easier construction alternatives, but they come with a high price tag. There has been no reported test data on magnesium-based ballistic wall panels or modular wall systems so far. This paper presents groundbreaking small arms test data related to the development of the world’s first magnesia cement ballistic wall panels and modular wall system. Non-hydraulic magnesia cement exhibits several superior properties, such as lighter weight, flexibility, acoustics, and fire performance, compared to the traditional Portland Cement. However, magnesia cement is hydrophilic and may degrade in prolonged contact with water. In this research, modified magnesia cement for water resistant and durability from UBIQ Technology is applied. The specimens are made of a modified magnesia cement formula and prepared in the Laboratory of UBIQ Technology Pty Ltd. The specimens vary in thickness, and the tests cover various small arms threats in compliance with standards AS/NZS2343 and UL752 and are performed up to the maximum threat level of Classification R2 (NATO) and UL-Level 8(NATO) by the Accredited Test Centre, BMT (Ballistic and Mechanical Testing, VIC, Australia). In addition, the results of the test conducted on the specimens subjected to the small 12mm diameter steel ball projectile impact generated by a gas gun are also presented and discussed in this paper. Gas gun tests were performed in UNSW@ADFA, Canberra, Australia. The tested results of the magnesia panels and wall systems are compared with one of concrete and other wall panels documented in the literature. The conclusion drawn is that magnesia panels and wall systems exhibit several advantages over traditional OPC-based wall systems, and they include being lighter, thinner, and easier to construct, all while providing equivalent protection against threats. This makes magnesia cement-based materials a compelling choice of application where efficiency and performance are critical to create a protective environment.

Keywords: ballistics, small arms, gas gun, projectile, impact, wall panels, modular, magnesia cement

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Authors: Jamilah Halina Abdul Halim, Norsiah Hassan, Azlina Aziz, Norhayati Mat Wajid, Mohd Saipul Asrafi

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There are various types of vertical greenery system (VGS) in Malaysia, but none is installed at government buildings, although the government is looking into energy efficient building design. This is due to lack of technical information that focus on the maintenance and care, issues, and challenges face by vertical greenery system under tropical climate conditions. This research aim to identify issues in implementation of vertical greenery system on existing government building in Malaysia. The methodology used are literature reviews (desktop study), observation on sites, and case studies. Initial findings indicates that design and maintenance issues of vertical greenery system are the main challenges faced mainly by designer, especially those who involved in decision-making process. It can be concluded that orientation, openings, maintenance, performance, longevity, structural load, access, wind resistance, design failure, system failure, and lack of maintenance foresight are the main factors that need to be considered. These factors should be holistically aligned towards the economic cost, effective time, and quality design in implementation of vertical greenery system on existing government building. A comprehensive implementation of vertical greenery system will lead to greater sustainable investment for government buildings and responsive action to climate change.

Keywords: issues, government building, maintenance, vertical greenery system

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Authors: W. E. Igwegbe, B. C. Okoro, J. C. Osuagwu

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The study was aimed at assessing the effectiveness of reducing the concentrations of heavy metals in waste water using Pawpaw (Carica papaya) wood as a bio-sorbent. The heavy metals considered include; zinc, cadmium, lead, copper, iron, selenium, nickel, and manganese. The physiochemical properties of carica papaya stem were studied. The experimental sample was obtained from a felled trunk of matured pawpaw tree. Waste water for experimental use was prepared by dissolving soil samples collected from a dump site at Owerri, Imo state in water. The concentration of each metal remaining in solution as residual metal after bio-sorption was determined using Atomic absorption Spectrometer. The effects of ph, contact time and initial heavy metal concentration were studied in a batch reactor. The results of Spectrometer test showed that there were different functional groups detected in the carica papaya stem biomass. Optimum bio-sorption occurred at pH 5.9 with 5g/100ml solution of bio-sorbent. The results of the study showed that the treated wastewater is fit for irrigation purpose based on Canada wastewater quality guideline for the protection of Agricultural standard. This approach thus provides a cost effective and environmentally friendly option for treating waste water.

Keywords: biomass, bio-sorption, Carica papaya, heavy metal, wastewater

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Authors: S. El Hasini, M. El Azzouzi, M. De Nobili, K. Azim, A. Zouahri

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Soil salinization is one of the most severe environmental hazards which threaten sustainable agriculture in arid and semi-arid regions, including Morocco. In this regard the application of organic matter to saline soil has confirmed its effectiveness. The present study was aimed to examine the effect of humic acid which represent, among others, the important component of organic matter that contributes to reduce soil salinity. In fact, different composts taken from Agadir (Morocco), with different C/N ratio, were tested. After extraction and purification of humic acid, the interaction with Na2CO3 was carried out. The reduction of salinity is calculated as a value expressed in mg Na2CO3 equivalent/g HA. The results showed that humic acid had generally a significant effect on salinity. In that respect, the hypothesis proposed that carboxylic groups of humic acid create bonds with excess sodium in the soil to form a coherent complex which descends by leaching operation. The comparison between composts was based on C/N ratio, it showed that the compost with the lower ratio C/N had the most important effect on salinity reduction, whereas the compost with higher C/N ratio was less effective. The study is attended also to evaluate the quality of each compost by determining the humification index, we noticed that the compost which have the lowest C/N (20) ratio was relatively less stable, where a greater predominance of the humified substances, when the compost with C/N ratio is 35 exhibited higher stability.

Keywords: compost, humic acid, organic matter, salinity

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Authors: Christopher R. Triggle, Hong Ding, Khaled Machaca, Gnanapragasam Arunachalam

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The antidiabetic drug, metformin, has been in clinical use for over 50 years and remains the first choice drug for the treatment of type two diabetes. In addition to its effectiveness as an oral anti-hyperglycaemic drug metformin also possesses vasculoprotective effects that are assumed to be secondary to its ability to reduce insulin resistance and control glycated hemoglobin levels; however, recent data from our laboratory indicate that metformin also has direct vasoprotective effects that are mediated, at least in part, via the anti-ageing gene, SIRT1. Diabetes is a major risk factor for the development of cardiovascular disease (CVD) and it is also well established that tobacco use further enhances the risk of CVD; however, it is not known whether treatment with metformin can offset the negative effects of diabetes and tobacco use on cardiac function. The current study was therefore designed to investigate 1: the effects of hyperglycaemia (HG) either alone or in the presence of elevated fatty acids (palmitate) and nicotine on the protein expression levels of the deacetylase sirtuin 1 (the protein product of SIRT1), anti-apoptotic Bcl-2, pro-apoptotic BIM and the pro-apoptotic, tumour suppressor protein, acetylated p53 in cardiomyocytes. 2: the ability of metformin to prevent the detrimental effects of HG, palmitate and nicotine on cardiomyocyte survival. Cell culture protocols were designed using a rat cardiomyocyte cell line, H9c2, either under normal glycaemic (NG) conditions of 5.5mM glucose, or hyperglycaemic conditions (HG) of 25mM glucose with, or without, added palmitate (250μM) or nicotine (1.0mM) for 24h. Immuno-blotting was used to detect the expression of sirtuin 1, Bcl-2, BIM, acetylated (Ac)-p53, p53 with β-actin used as the reference protein. Exposure to HG, palmitate, or nicotine alone significantly reduced expression of sirtuin1, Bcl-2 and raised the expression levels of acetylated p53 and BIM; however, the combination of HG, palmitate and nicotine had a synergistic effect to significantly suppress the expression levels of sirtuin 1 and Bcl-2, but further enhanced the expression of Ac-p53, and BIM. The inclusion of 1000μM, but not 50μM, metformin in the H9c2 cell culture protocol prevented the effects of HG, palmitate and nicotine on the pro-apoptotic pathways. Collectively these data indicate that metformin, in addition to its anti-hyperglycaemic and vasculoprotective properties, also has direct cardioprotective actions that offset the negative effects of hyerglycaemia, elevated free fatty acids and nicotine on cardiac cell survival. These data are of particular significance for the treatment of patients with diabetes who are also smokers as the inclusion of metformin in their therapeutic treatment plan should help reduce cardiac-related morbidity and mortality.

Keywords: apoptosis, cardiac muscle, diabetes, metformin, nicotine

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Authors: Emir H. Pernet, Jeimy J. Cano

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Maturity models, used descriptively to explain changes in reality or normatively to guide managers to make interventions to make organizations more effective and efficient, are based on the principles of statistical quality control promulgated by Shewhart in the years 30, and on the principles of PDCA continuous improvement (Plan, Do, Check, Act) developed by Deming and Juran. Some frameworks developed over the concept of maturity models includes COBIT, CMM, and ITIL. This paper presents some limitations of traditional maturity models, most of them based on points of reflection and analysis done by some authors. Almost all limitations are related to the mechanistic and reductionist approach of the principles over those models are built. As Systems Theory helps the understanding of the dynamics of organizations and organizational change, the development of a systemic maturity model can help to overcome some of those limitations. This document proposes a systemic maturity model, based on a systemic conceptualization of organizations, focused on the study of the functioning of the parties, the relationships among them, and their behavior as a whole. The concept of maturity from the system theory perspective is conceptually defined as an emergent property of the organization, which arises from as a result of the degree of alignment and integration of their processes. This concept is operationalized through a systemic function that measures the maturity of an organization, and finally validated by the measuring of maturity in organizations. For its operationalization and validation, the model was applied to measure the maturity of organizational Governance, Risk and Compliance (GRC) processes.

Keywords: GRC, maturity model, systems theory, viable system model

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Authors: Zhihui Liu, Dongmei Hao, Qian Qiu, Yang An, Lin Yang, Song Zhang, Yimin Yang, Xuwen Li, Dingchang Zheng

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Premature birth, defined as birth before 37 completed weeks of gestation is a leading cause of neonatal morbidity and mortality and has long-term adverse consequences for health. It has recently been reported that the worldwide preterm birth rate is around 10%. The existing measurement techniques for diagnosing preterm delivery include tocodynamometer, ultrasound and fetal fibronectin. However, they are subjective, or suffer from high measurement variability and inaccurate diagnosis and prediction of preterm labor. Electrohysterography (EHG) method based on recording of uterine electrical activity by electrodes attached to maternal abdomen, is a promising method to assess uterine activity and diagnose preterm labor. The purpose of this study is to analyze the difference of EHG signal features between term labor and preterm labor. Free access database was used with 300 signals acquired in two groups of pregnant women who delivered at term (262 cases) and preterm (38 cases). Among them, EHG signals from 38 term labor and 38 preterm labor were preprocessed with band-pass Butterworth filters of 0.08–4Hz. Then, EHG signal features were extracted, which comprised classical time domain description including root mean square and zero-crossing number, spectral parameters including peak frequency, mean frequency and median frequency, wavelet packet coefficients, autoregression (AR) model coefficients, and nonlinear measures including maximal Lyapunov exponent, sample entropy and correlation dimension. Their statistical significance for recognition of two groups of recordings was provided. The results showed that mean frequency of preterm labor was significantly smaller than term labor (p < 0.05). 5 coefficients of AR model showed significant difference between term labor and preterm labor. The maximal Lyapunov exponent of early preterm (time of recording < the 26th week of gestation) was significantly smaller than early term. The sample entropy of late preterm (time of recording > the 26th week of gestation) was significantly smaller than late term. There was no significant difference for other features between the term labor and preterm labor groups. Any future work regarding classification should therefore focus on using multiple techniques, with the mean frequency, AR coefficients, maximal Lyapunov exponent and the sample entropy being among the prime candidates. Even if these methods are not yet useful for clinical practice, they do bring the most promising indicators for the preterm labor.

Keywords: electrohysterogram, feature, preterm labor, term labor

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Authors: Sebastian Leal-Arenas

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TikTok’s influence on contemporary society is undeniable. The impact of the mobile app transcends entertainment, as shown by the growing presence of specialized accounts dedicated to providing educational content, particularly as it pertains to language learning. However, the prevailing trend on the platform is vocabulary and grammar acquisition, neglecting a critical component: pronunciation. This study examines English pronunciation materials available on TikTok by taking a comprehensive approach that incorporates established assessment tools, such as the Learning Object Review Instrument and the Framework for Language Learning App Evaluation. Furthermore, novel evaluation categories are introduced to provide a more holistic assessment of these educational resources. 60 English pronunciation videos were part of the analysis. The findings reveal that these audio-visual materials present clear audio bolstered by high-quality video content and automatically generated closed captions. These three components enhance the comprehensibility of the input, making these concise videos valuable assets for language learners. Nevertheless, certain deficiencies are observed, such as the lack of emphasis on specific segments and their relationship with articulators. Improvements and refinements are discussed, as well as their potential utility within the language classroom. This study contributes to the ongoing investigation of multimedia materials used for language teaching and emphasizes the need to adapt pronunciation instruction methods to today’s technology.

Keywords: pronunciation, segments, teaching materials, technology

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Authors: Tina Melkoshvili

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Drastic development of information and communication technologies in Georgia has led to the necessity of launching conceptually new, effective, flexible, transparent and society oriented form of government that is e-government. Through applying information technologies, the electronic system enables to raise the efficacy of state governance and increase citizens’ participation in the process. Focusing on the topic of e-government allows us to analyze success stories, attributed benefits and, at the same time, observes challenges hampering the government development process. There are number of methodologies elaborated to study the conditions in the field of electronic governance. They enable us to find out if the government is ready to apply broad opportunities of information and communication technologies and if the government is apt to improve the accessibility and quality of delivering mainly social services. This article seeks to provide comparative analysis of widely spread methodologies used for Electronic government projects’ assessment. It has been concluded that applying current methods of assessment in Georgia is related to difficulties due to inaccessible data and the necessity of involving number of experts. The article presents new indicators for e-government development assessment that reflect efficacy of e-government conception realization in the regions of Georgia and enables to provide quantitative evaluation of regional e-government projects including all significant aspects of development.

Keywords: development methodology, e-government in Georgia, information and communication technologies, regional government

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Authors: Prakash Singh

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The focus of this exploratory study is on whether teachers demonstrate emphatic concern for their learners in planning, implementing and assessing learning outcomes in their regular classrooms. Empathy must be shown to all learners equally and not only for high-risk learners at the expense of other ability learners. Empathy demonstrated by teachers allows them to build a stronger bond with all their learners. This bond based on trust leads to positive outcomes for learners to be able to excel in their work. Empathic teachers must make every effort to simplify the subject matter for high risk learners so that these learners not only enjoy their learning activities but are also successful like their more able peers. A total of 87.5% of the participants agreed that empathy allows teachers to demonstrate humanistic values in their choice of learning materials for learners of different abilities. It is therefore important for teachers to select content and instructional materials that will contribute to the learners’ success in the mainstream of education. It is also imperative for teachers to demonstrate empathic skills and consequently, to be attuned to the emotions and emotional needs of their learners. Schools need to be reformed, not by simply lengthening the school day or by simply adding more content in the curriculum, but by making school more satisfying to learners. This must be consistent with their diverse learning needs and interests so that they gain a sense of power, fulfillment, and importance in their regular classrooms. Hence, teacher - pupil relationships based on empathic concern for the latter’s educational needs lays the foundation for quality education to be offered.

Keywords: emotional intelligence, empathy, learners’ emotional needs, teachers’ empathic skills

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Authors: Jacob Schwartz, Maxim Durach, Aniruddha Mitra, Abbas Rashidi, Glen Sage, Atin Adhikari

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NIOSH (National Institute for Occupational Safety and Health) approved N95 respirators are commonly used by workers in construction sites where there is a large amount of dust being produced from sawing, grinding, blasting, welding, etc., both electrostatically charged and not. A significant portion of airborne particles in construction sites could be nanoparticles created beside coarse particles. The penetration of the particles through the masks may differ depending on the size and charge of the individual particle. In field experiments relevant to this current study, we found that nanoparticles of medium size ranges are penetrating more frequently than nanoparticles of smaller and larger sizes. For example, penetration percentages of nanoparticles of 11.5 – 27.4 nm into a sealed N95 respirator on a manikin head ranged from 0.59 to 6.59%, whereas nanoparticles of 36.5 – 86.6 nm ranged from 7.34 to 16.04%. The possible causes behind this increased penetration of mid-size nanoparticles through mask filters are not yet explored. The objective of this study is to identify causes behind this unusual behavior of mid-size nanoparticles. We have considered such physical factors as Boltzmann distribution of the particles in thermal equilibrium with the air, kinetic energy of the particles at impact on the mask, Stoke’s drag force, and electrostatic forces in the mask stopping the particles. When the particles collide with the mask, only the particles that have enough kinetic energy to overcome the energy loss due to the electrostatic forces and the Stokes’ drag in the mask can pass through the mask. To understand this process, the following assumptions were made: (1) the effect of Stoke’s drag depends on the particles’ velocity at entry into the mask; (2) the electrostatic force is proportional to the charge on the particles, which in turn is proportional to the surface area of the particles; (3) the general dependence on electrostatic charge and thickness means that for stronger electrostatic resistance in the masks and thicker the masks’ fiber layers the penetration of particles is reduced, which is a sensible conclusion. In sampling situations where one mask was soaked in alcohol eliminating electrostatic interaction the penetration was much larger in the mid-range than the same mask with electrostatic interaction. The smaller nanoparticles showed almost zero penetration most likely because of the small kinetic energy, while the larger sized nanoparticles showed almost negligible penetration most likely due to the interaction of the particle with its own drag force. If there is no electrostatic force the fraction for larger particles grows. But if the electrostatic force is added the fraction for larger particles goes down, so diminished penetration for larger particles should be due to increased electrostatic repulsion, may be due to increased surface area and therefore larger charge on average. We have also explored the effect of ambient temperature on nanoparticle penetrations and determined that the dependence of the penetration of particles on the temperature is weak in the range of temperatures in the measurements 37-42°C, since the factor changes in the range from 3.17 10-3K-1 to 3.22 10-3K-1.

Keywords: respiratory protection, industrial hygiene, aerosol, electrostatic force

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