Search results for: daily average gain

Authors: Ahmad Shahfarhat, Ashraf Mohammadzade, Reza Saeedi, Hadi Hesari

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Background: Mothers of infants admitted at NICU are vulnerable to depression (affecting 10 to 20% of mothers during the first year after delivery) As you know, about half of women with prominent postpartum depression (PPD) symptoms are not diagnosed. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD. In this study, we checked EPDS score of 12 or more on the second day (D2), discharge, day 28(D28), and day42 (D42) postpartum to determine the risk factors as well as the prevalence of PPD in a sample of mothers of NICU admitted neonates. Methods: A sample of 682 women used the EPDS on admission and at discharge. An assessment for PPD was performed on D28 and D42 by a telephone interview. Results: On admission, the average score on EPDS was 9.72 (SD = 4.4), and 27.4% of women (187) had an EPDS score ≥12. On Discharge, 4weeks and 6weeks postpartum the average score was ordinary 9.34 (SD = 3.8), 9.12 (SD = 3.7), 8.52(SD = 3.36), and (173)25.4 %,( 141)23.3 %,( 88)15.3% of women presented with PPD. a positive correlation was found between scores on EPDS on admission and D42 (P = 0.001). An analysis shows that mothers of twins (P = 0.001) and higher age mothers (P=0.001) are significantly associated with PPD. Conclusion: Women with EPDS score more than 12 and/or older will benefit from a closer follow-up during the rest of the post-partum period, and it is better to be under psychological support.

Keywords: NICU, depression, pregnancy, mothers

Procedia PDF Downloads 101

Authors: M. Mashiur Rahman, Ulrik Birk Henriksen, Jesper Ahrenfeldt, Maria Puig Arnavat

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Using biomass gasification to make producer gas is one of the promising sustainable energy options available for small scale plant and rural applications for power and electricity. Tar content in producer gas is the main problem if it is used directly as a fuel. A low-tar biomass (LTB) gasifier of approximately 30 kW capacity has been developed to solve this. Moving bed gasifier with internal recirculation of pyrolysis gas has been the basic principle of the LTB gasifier. The gasifier focuses on the concept of mixing the pyrolysis gases with gasifying air and burning the mixture in separate combustion chamber. Five tests were carried out with the use of wood pellets and wood chips separately, with moisture content of 9-34%. The LTB gasifier offers excellent opportunities for handling extremely low-tar in the producer gas. The gasifiers producer gas had an extremely low tar content of 21.2 mg/Nm³ (avg.) and an average lower heating value (LHV) of 4.69 MJ/Nm³. Tar content found in different tests in the ranges of 10.6-29.8 mg/Nm³. This low tar content makes the producer gas suitable for direct use in internal combustion engine. Using mass and energy balances, the average gasifier capacity and cold gas efficiency (CGE) observed 23.1 kW and 82.7% for wood chips, and 33.1 kW and 60.5% for wood pellets, respectively. Average heat loss in term of higher heating value (HHV) observed 3.2% of thermal input for wood chips and 1% for wood pellets, where heat loss was found 1% of thermal input in term of enthalpy. Thus, the LTB gasifier performs better compared to typical gasifiers in term of heat loss. Equivalence ratio (ER) in the range of 0.29 to 0.41 gives better performance in terms of heating value and CGE. The specific gas production yields at the above ER range were in the range of 2.1-3.2 Nm³/kg. Heating value and CGE changes proportionally with the producer gas yield. The average gas compositions (H₂-19%, CO-19%, CO₂-10%, CH₄-0.7% and N₂-51%) obtained for wood chips are higher than the typical producer gas composition. Again, the temperature profile of the LTB gasifier observed relatively low temperature compared to typical moving bed gasifier. The average partial oxidation zone temperature of 970°C observed for wood chips. The use of separate combustor in the partial oxidation zone substantially lowers the bed temperature to 750°C. During the test, the engine was started and operated completely with the producer gas. The engine operated well on the produced gas, and no deposits were observed in the engine afterwards. Part of the producer gas flow was used for engine operation, and corresponding electrical power was found to be 1.5 kW continuously, and maximum power of 2.5 kW was also observed, while maximum generator capacity is 3 kW. A thermodynamic equilibrium model is good agreement with the experimental results and correctly predicts the equilibrium bed temperature, gas composition, LHV of the producer gas and ER with the experimental data, when the heat loss of 4% of the energy input is considered.

Keywords: biomass gasification, low-tar biomass gasifier, tar elimination, engine, deposits, condensate

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Authors: Hamed Mohammadi Mofarah, Mutalifu Abulikemu, Ghassan E. Jabbour

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Personal protective equipment (PPE) is finding increasing interest in incorporating silver nanoparticles (NPs) for various applications including microbial disinfection and shielding against electromagnetic waves. In this venue, we present an in situ reactive coating approach where silver nanoparticles are self-assembled on the surface of cotton yarn. The impacts of a variety of experimental parameters on the average size of the synthesized silver NPs were investigated. These include vacuum conditions, the concentration of the silver salt solution and reducer, temperature, and curing time. Silver NPs with an average size ranging from 10 to 50 nanometers were self-assembled as a result of careful regulation of such reaction conditions. The disinfection efficacy against the COVID surrogate virus of the functional textile reached a rate of 99.99%. On the other hand, the silver NPs decorated textile demonstrated an electromagnetic shielding ranging from 31 dB to 45 dB were achieved for the frequency range 8.2-12.4 GHz.

Keywords: antiviral, COVID, electromagnetic shielding, in-situ reactive coating, SARS CoV 2, silver nanoparticles, smart textile

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Authors: Benachour Karima

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Pollination is a key factor in crop production and the presence of insect pollinators, mainly wild bees, is essential for improving yields. In this work, visiting apoids of two vegetable crops, the turnip (Brassica rapa L.) and the radish (Raphanus sativus L.) (Brassicaceae) were recorded during flowering times of 2003 and 2004 in Constantine area (36°22’N 06°37’E, 660 m). The observations were conducted in a plot of approximately 308 m2 of the Institute of Nutrition, Food and Food Technology (University of Mentouri Brothers). To estimate the density of bees (per 100 flowers or m2), 07 plots (01m2 for each one) are defined from the edge of the culture and in the first two rows. From flowering and every two days, foraging insects are recorded from 09 am until 17 pm (Gmt+1).The purpose of visit (collecting nectar, pollen or both) and pollinating efficiency (estimated by the number of flowers visited per minute and the number of positive visits) were noted for the most abundant bees on flowers. The action of pollinating insects is measured by comparing seed yields of 07 plots covered with tulle with 07 other accessible to pollinators. 04 families of Apoidea: Apidae, Halictidae, Andrenidae and Megachilidae were observed on the two plants. On turnip, the honeybee is the most common visitor (on average 214visites/ m2), it is followed by the Halictidae Lasioglossum mediterraneum whose visits are less intense (20 individuals/m2). Visits by Andrenidae, represented by several species such as Andrena lagopus, A.flavipes, A.agilissima and A.rhypara were episodic. The honeybee collected mainly nectar, its visits were all potentially fertilizing (contact with stigma) and more frequent (on average 14 flowers/min. L.mediterraneum visited only 05 flrs/min, it collected mostly the two products together and all its visits were also positive. On radish, the wild bee Ceratina cucurbitina recorded the highest number of visits (on average 06 individuals/100flo wers), the Halictidae represented mainly by L.mediterraneum, and L.malachurum, L.pauxillum were less abundant. C.cucurbitina visited on average 10 flowers /min and all its visits are positive. Visits of Halictidae were less frequent (05-06 flowers/min) and not all fertilizing. Seed yield of Brassica rapa (average number of pods /plant, seeds/ pods and average weight of 1000 seeds) was significantly higher in the presence of pollinators. Similarly, the pods of caged plants gave a percentage of aborted seeds (10.3%) significantly higher than that obtained on free plants (4.12%), the pods of caged plants also gave a percentage of malformed seeds (1.9%) significantly higher than that of the free plants (0.9%). For radish, the seed yield in the presence and absence of insects are almost similar. Only the percentage of malformed seeds (3.8%) obtained from the pods of caged plants was significantly higher in comparison with pods of free plants (1.9%). Following these results, it is clear that pollinators especially bees are essential for the production and improvement of crop yields and therefore it is necessary to protect this fauna increasingly threatened.

Keywords: foraging behavior, honey bee, radish, seed yield, turnip, wild bee

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Authors: Sepehr Moradi

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This study investigates the contribution of individual Australian Superfine Merino Wool (ASFW) and Inner Mongolia Cashmere (IMC) fibres strength behaviour to the breaking force variation (CVBF) and minimum fibre diameter (CVₘFD) induced by actual single fibre lengths and the combination of length and diameter groups. Mid-side samples were selected for the ASFW (n = 919) and IMC (n = 691) since it is assumed to represent the average of the whole fleece. The average (LₘFD) varied for ASFW and IMC by 36.6 % and 33.3 % from shortest to longest actual single fibre length and -21.2 % and -21.7 % between longest-coarsest and shortest-finest groups, respectively. The tensile properties of single animal fibres were characterised using Single Fibre Analyser (SIFAN 4). After normalising for diversity in fibre diameter at the position of breakage, the parameters, which explain the strength behaviour within actual fibre lengths and combination of length-diameter groups, were the Intrinsic Fibre Strength (IFS) (MPa), Min IFS (MPa), Max IFS (MPa) and Breaking force (BF) (cN). The average strength of single fibres varied extensively within actual length groups and within a combination of length-diameter groups. IFS ranged for ASFW and IMC from 419 to 355 MPa (-15.2 % range) and 353 to 319 (-9.6 % range) and BF from 2.2 to 3.6 (63.6 % range) and 3.2 to 5.3 cN (65.6 % range) from shortest to longest groups, respectively. Single fibre properties showed no differences within actual length groups and within a combination of length-diameter groups, or was there a strong interaction between the strength of single fibre (P > 0.05) within remaining and removing length-diameter groups. Longer-coarser fibre fractionation had a significant effect on BF and IFS and all of the length groups showed a considerable variance in single fibre strength that is accounted for by diversity in the diameter variation along the fibre. There are many concepts for the improvement of the stress-strain properties of animal fibres as a means of raising a single fibre strength by simultaneous changes in fibre length and diameter. Fibre fractionation over a given length directly for single fibre strength or using the variation traits of fibre diameter is an important process used to increase the strength of the single fibre.

Keywords: single animal fibre fractionation, actual length groups, strength variation, length-diameter groups, diameter variation along fibre

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Authors: Anne Allmrodt

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Regions of South-East Europe are characterised by high out-migration for decades. The reasons for leaving range from the hope of a better work situation to a better health care system and beyond. In Serbia, this high out-migration hits the rural areas in particular so that the population number is in the red repeatedly. It might not be hard to guess that this negative population growth has the potential to create different challenges for those who stay in rural areas. So how are they coping with the – statistically proven – high out-migration? Having this in mind, the study is investigating the people‘s individual awareness of the social phenomenon high out-migration and their daily life strategies in rural areas. Furthermore, the study seeks to find out the people’s resilient skills in that context. Is the condition of high out-migration conducive for resilience? The methodology combines a quantitative and a qualitative approach (mixed methods). For the quantitative part, a standardised questionnaire has been developed, including a multiple choice section and a choice experiment. The questionnaire was handed out to people living in rural areas of Serbia only (n = 100). The sheet included questions about people’s awareness of high out-migration, their own daily life strategies or challenges and their social network situation (data about the social network was necessary here since it is supposed to be an influencing variable for resilience). Furthermore, test persons were asked to make different choices of coping with high out-migration in a self-designed choice experiment. Additionally, the study included qualitative interviews asking citizens from rural areas of Serbia. The topics asked during the interview focused on their awareness of high out-migration, their daily life strategies, and challenges as well as their social network situation. Results have shown the following major findings. The awareness of high out-migration is not the same with all test persons. Some declare it as something positive for their own life, others as negative or not effecting at all. The way of coping generally depended – maybe not surprising – on the people’s social network. However – and this might be the most important finding - not everybody with a certain number of contacts had better coping strategies and was, therefore, more resilient. Here the results show that especially people with high affiliation and proximity inside their network were able to cope better and shew higher resilience skills. The study took one step forward in terms of knowledge about societal resilience as well as coping strategies of societies in rural areas. It has shown part of the other side of nowadays migration‘s coin and gives a hint for a more sustainable rural development and community empowerment.

Keywords: coping, out-migration, resilience, rural development, social networks, south-east Europe

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Authors: Ho Sy Nam, Tang Ha Nam Anh

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Background: Rotator cuff tears are a common problem in the aging population. The prevalence of massive rotator cuff tears varies in some studies from 10% to 40%. Of irreparable rotator cuff tears (IRCTs), which are mostly associated with massive tear size, 79% are estimated to have recurrent tears after surgical repair. Recent studies have shown that superior capsule reconstruction (SCR) in massive rotator cuff tears can be an efficient technique with optimistic clinical scores and preservation of stable glenohumeral stability. Superior capsule reconstruction techniques most commonly use either fascia lata autograft or dermal allograft, both of which have their own benefits and drawbacks (such as the potential for donor site issues, allergic reactions, and high cost). We propose a simple technique for superior capsule reconstruction that involves using the long head of the biceps tendon as a local autograft; therefore, the comorbidities related to graft harvesting are eliminated. The long head of the biceps tendon proximal portion is relocated to the footprint and secured as the SCR, serving to both stabilize the glenohumeral joint and maintain vascular supply to aid healing. Objective: The purpose of this study is to assess the clinical outcomes of patients with large to massive RCTs treated by SCR using LHBT. Materials and methods: A study was performed of consecutive patients with large to massive RCTs who were treated by SCR using LHBT between January 2022 and December 2022. We use one double-loaded suture anchor to secure the long head of the biceps to the middle of the footprint. Two more anchors are used to repair the rotator cuff using a single-row technique, which is placed anteriorly and posteriorly on the lateral side of the previously transposed LHBT. Results: The 3 men and 5 women had an average age of 61.25 years (range 48 to 76 years) at the time of surgery. The average follow-up was 8.2 months (6 to 10 months) after surgery. The average preoperative ASES was 45.8, and the average postoperative ASES was 85.83. The average postoperative UCLA score was 29.12. VAS score was improved from 5.9 to 1.12. The mean preoperative ROM of forward flexion and external rotation of the shoulder was 720 ± 160 and 280 ± 80, respectively. The mean postoperative ROM of forward flexion and external rotation were 1310 ± 220 and 630 ± 60, respectively. There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Conclusion: SCR using LHBT is considered a treatment option for patients with large or massive RC tears. It can restore superior glenohumeral stability and function of the shoulder joint and can be an effective procedure for selected patients, helping to avoid progression to cuff tear arthropathy.

Keywords: superior capsule reconstruction, large or massive rotator cuff tears, the long head of the biceps, stabilize the glenohumeral joint

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Authors: Salman Naseer

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One of the main challenges of operating a smart city (SC) is collecting the massive data generated from multiple data sources (DS) and to transmit them to the control units (CU) for further data processing and analysis. These ever-increasing data demands require not only more and more capacity of the transmission channels but also results in resource over-provision to meet the resilience requirements, thus the unavoidable waste because of the data fluctuations throughout the day. In addition, the high energy consumption (EC) and carbon discharges from these data transmissions posing serious issues to the environment we live in. Therefore, to overcome the issues of intensive EC and carbon emissions (CE) of massive data dissemination in Smart Cities, we propose an energy efficient and carbon reduction approach by utilizing the daily mobility of the existing vehicles as an alternative communications channel to accommodate the data dissemination in smart cities. To illustrate the effectiveness and efficiency of our approach, we take the Auckland City in New Zealand as an example, assuming massive data generated by various sources geographically scattered throughout the Auckland region to the control centres located in city centre. The numerical results show that our proposed approach can provide up to 5 times lower delay as transferring the large volume of data by utilizing the existing daily vehicles’ mobility than the conventional transmission network. Moreover, our proposed approach offers about 30% less EC and CE than that of conventional network transmission approach.

Keywords: smart city, delay tolerant network, infrastructure offloading, opportunistic network, vehicular mobility, energy consumption, carbon emission

Procedia PDF Downloads 136

Authors: Suleh Yusufu Godi, Ado Makama Adamu

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Marketing involves all the legal, physical, and economic services which are necessary in moving products from producer to consumers. The more efficient the marketing functions are performed the better the marketing system for the farmers, marketing agents, and the society at large. Rice marketing ensures the flow of product from producers to consumers in the form, time and place of need. Therefore, this study examined profitability of milled rice marketing in Gombe metropolis, Gombe State. Data were collected using structured questionnaires from ninety randomly selected rice marketers in Gombe metropolis. The data were analyzed using descriptive statistics, farm budget technique and regression analysis. The study revealed the total rice marketing cost incurred by rice marketers to be N6, 610,214.70. This gave an average of N73, 446.83 per marketer and N37.30 per Kilogram of rice. The Gross Income for rice marketers in Gombe metropolis was N15, 064,600.00. This value gave an average of N167, 384.44 per rice marketer or N85.00 per kilogram of rice. The study also revealed net income for all rice marketers to be N8, 454,385.30. This gave an average of N93, 937.61 per rice marketer or N47.70 per Kilogram of rice. The study further revealed a marketing margin, marketing efficiency and return per naira invested on rice marketing to be 39.30%, 150.16% and N0.56, respectively. The result of regression analysis shows that age, sex and cost of transportation are positive and significantly affect marketing margin of rice marketers in Gombe Metropolis. However, the main constraints to rice marketing in Gombe metropolis include inadequate electricity, capital, high transportation cost, instability of prices and low patronage among others. The study recommends provision of adequate electrical power supply in the State especially the State capital and also encouraging rice marketers in Gombe metropolis to form cooperative societies so as to have easy access to credit facilities especially from the formal sources.

Keywords: rice marketers, milled rice, cost and return, marketing margin, efficiency, profitability

Procedia PDF Downloads 75

Authors: Abdelghani Qadem, Zouhair Qadem

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Like the countries of the Mediterranean region, Morocco is likely to be at high risk of water scarcity due to climate change. Morocco, which is the subject of this study, is located between two climatic zones, temperate in the North tropical in the South, Morocco is distinguished by four types of climate: humid, sub-humid, semi-arid, and arid. The last decades attest to the progression of the semi-arid climate towards the North of the country. The IPCC projections, which have been made in this direction, show that there is an overall downward trend in rainfall contributions varying on average between 10% and 30% depending on the scenario selected and the region considered, they also show an upward trend in average annual temperatures. These trends will have a real impact on water resources, which will result in a drop in the volume of water resources varying between 7.6% and 40.6%. The present study aims to describe the meteorological conditions of Morocco in order to answer the problem dealing with the effect of climatic fluctuations on water resources and to assess water vulnerability in the face of climate change.

Keywords: morocco, climate change, water resources, impact, water scarcity

Procedia PDF Downloads 77

Authors: Jiaxu Huang

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The melt carbonized blast furnace slag containing TiC was produced by carbothermal reduction of high titanium blast furnace slag. The treatment technology of melt carbonized blast furnace slag with TiC as raw material was studied, including the influence of different cooling methods, crushing atmosphere and sieving particle size on the target product TiC in the slag. The results show that air-cooling and water-cooling have little effect on TiC content of molten carbide blast furnace slag, and have great effect on crystal structure and grain size. TiC content in slag is different when carbide blast furnace slag is crushed in argon atmosphere and air atmosphere. After screening, the difference of TiC content of carbide blast furnace slag with different particle size distribution is obvious. The average TiC content of 100-400 mesh carbide blast furnace slag is 14%. And the average TiC content of carbide blast furnace slag with particle size less than 400 mesh is 10.5%.

Keywords: crushing atmosphere, cooling methods, sieving particle size, TiC

Procedia PDF Downloads 129

Authors: V. Makis, L. Jafari

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In this paper, we develop an optimal Bayesian chart to control the expected number of defects per inspection unit in production processes with long production runs. We formulate this control problem in the optimal stopping framework. The objective is to determine the optimal stopping rule minimizing the long-run expected average cost per unit time considering partial information obtained from the process sampling at regular epochs. We prove the optimality of the control limit policy, i.e., the process is stopped and the search for assignable causes is initiated when the posterior probability that the process is out of control exceeds a control limit. An algorithm in the semi-Markov decision process framework is developed to calculate the optimal control limit and the corresponding average cost. Numerical examples are presented to illustrate the developed optimal control chart and to compare it with the traditional u-chart.

Keywords: Bayesian u-chart, economic design, optimal stopping, semi-Markov decision process, statistical process control

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Authors: Emberga Terhemb Opara Alexander, Selemo Alexader, Onyekwuru Samuel

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The aeromagnetic data have been used to re-evaluate parts of the Upper Benue Trough Nigeria using spectral analysis technique in order to appraise the mineral accumulation potential of the area. The regional field was separated with a first order polynomial using polyfit program. The residual data was subdivided into 24 spectral blocks using OASIS MONTAJ software program. Two prominent magnetic depth source layers were identified. The deeper source depth values obtained ranges from 1.56km to 2.92km with an average depth of 2.37km as the magnetic basement depth while for the shallower sources, the depth values ranges from -1.17km to 0.98km with an average depth of 0.55km. The shallow depth source is attributed to the volcanic rocks that intruded the sedimentary formation and this could possibly be responsible for the mineralization found in parts of the study area.

Keywords: spectral analysis, Upper Benue Trough, magnetic basement depth, aeromagnetic

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Authors: Sandrieli Afornali, Adriano Keijiro Maeda, Renato Fedatto Beraldo, Carlos Alberto Mattozo, Ricardo Nascimento Brito

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BACKGROUND: The most used variety in hydrocephalus treatment is the ventriculoperitoneal shunt (VPS). However, it may fails in 20 to 70% of cases. It makes necessary to have alternative cavities for the implantation of the distal catheter. Ventriculo-atrial shunting (VAS) is described as the second option. To our knowledge, there are 121 reported cases of VGB shunt in children until 2020 and a highly variable success rate, from 25 to 100%, with an average of 63% of patients presenting good long-term results. Our goal is to evaluate the epidemiological profile of patients submitted to ventriculo-gallbladder (VGB) shunt and, through a review of literature, to compare our results with others series. METHODS: a retrospective cross-sectional observational study of a case series of nine patients. The medical records of all patients were reviewed, who underwent VGB shunt at the Hospital Pequeno Príncipe from Curitiba, Paraná, Brazil, from January 2014 to October 2022. The inclusion criteria were: patients under 17 years of age with hydrocephalus of any etiology, currently using or prior to VGB shunt. RESULTS: There were 6 (66,7%) male and 3 (33,3%) female. The average age of 73.6 months or 6.1 years at the time of surgery. They were submitted on average 5.1 VPS reviews previous to VGB shunt. Five (55,5%) had complications of VGB shunt: infection (11.1%), atony (11.1%), hypodrainage due to kinking the distal catheter in the solution (11.1%) and ventriculoenteric fistula (22.2%); all these patients were cured at surgical reapproach, and in 2 of them the VGB shunt was reimplanted. Two patients died (22.2%), and five (55,5%) patients maintained the use of VGB shunt in the follow-up period; and in 4 (44.4%) there was never need for review. CONCLUSION: VGB shunt tends to be underestimated because it is still unconventional and little publicized in literature. Our article shows a lower risk of death and similar risk of complications when compared to others altenatives shunts. We emphasize VGB shunt as a safe procedure to be the second option when VPS fails or has contraindications.

Keywords: hydrocephalus, ventricular-gallbladder shunt, VGB shunt, VPS, ventriculoperitoneal shunt, ventriculoatrial shunt

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Authors: A. Ibovi Mouondayi, S. Zaher, K. Nassar, S. Janani

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Introduction: Osteoarticular ultrasound has become an essential tool for the investigation and monitoring of osteoarticular pathologies for rheumatologists. It is performed in the clinic, cheap to access than other imaging technics. Important anatomical sites of inflammation in inflammatory diseases such as synovium, tendon sheath, and enthesis are easily identifiable on ultrasound. Objective: The objective of this study was to evaluate the importance of ultrasound for rheumatologists in the development of diagnoses of inflammatory rheumatism in cases of uncertain clinical presentation. Material and Methods: This is a retrospective study conducted in our department and carried out over a period of 30 months from January 2020 to June 2022. We included all patients with inflammatory arthralgia without clinical arthritis. Patients' data were collected through a patient operating system. Results: A total of 35 patients were identified, made up of 4 men and 31 women, with a sex ratio M/F of 0.12. The average age of the patients was 48.8 years, with extremes ranging from 17 years to 83 years. All patients had inflammatory polyarthralgia for an average of 9.3 years. Only two patients had suspicious synovitis on clinical examination. 91.43% of patients had a positive inflammatory assessment with an average CRP of 22.2 mg/L. Rheumatoid factor (RF) was present in 45.7% of patients and anti-CCP in 48.57%, with respective averages of 294.43 and 314.63 international units/mL. Radiographic lesions were found in 54% of patients. Osteoarticular ultrasound was performed in all these patients. Subclinical synovitis was found in 60% of patients, including 23% Doppler positive. Tenosynovitis was found in 11% of patients. Enthesitis was objectified in 3% of patients. Rheumatoid arthritis (RA) was retained in 40% of patients; psoriatic arthritis in 6% of patients, hydroxyapatite arthritis, and osteoarthritis in 3% each. Conclusion: Osteoarticular ultrasound has been an essential tool in the practice of rheumatology in recent years. It is for diagnostic purposes in chronic inflammatory rheumatism as well as in degenerative rheumatism and crystal induced arthropathies, but also essential in the follow-up of patients in rheumatology.

Keywords: ultrasound, skeletal, rheumatoid arthritis, arthralgia

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Authors: O. D. Ohijeagbon, Oluseyi O. Ajayi, M. Ogbonnaya, Ahmeh Attabo

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This study analyzed the electricity generation potential from wind at seven sites spread across seven states of the North-Central region of Nigeria. Twenty-one years (1987 to 2007) wind speed data at a height of 10m were assessed from the Nigeria Meteorological Department, Oshodi. The data were subjected to different statistical tests and also compared with the two-parameter Weibull probability density function. The outcome shows that the monthly average wind speeds ranged between 2.2 m/s in November for Bida and 10.1 m/s in December for Jos. The yearly average ranged between 2.1m/s in 1987 for Bida and 11.8 m/s in 2002 for Jos. Also, the power density for each site was determined to range between 29.66 W/m2 for Bida and 864.96 W/m2 for Jos, Two parameters (k and c) of the Weibull distribution were found to range between 2.3 in Lokoja and 6.5 in Jos for k, while c ranged between 2.9 in Bida and 9.9m/s in Jos. These outcomes points to the fact that wind speeds at Jos, Minna, Ilorin, Makurdi and Abuja are compatible with the cut-in speeds of modern wind turbines and hence, may be economically feasible for wind-to-electricity at and above the height of 10 m. The study further assessed the potential and economic viability of standalone wind generation systems for off-grid rural communities located in each of the studied sites. A specific electric load profile was developed to suite hypothetic communities, each consisting of 200 homes, a school and a community health center. Assessment of the design that will optimally meet the daily load demand with a loss of load probability (LOLP) of 0.01 was performed, considering 2 stand-alone applications of wind and diesel. The diesel standalone system (DSS) was taken as the basis of comparison since the experimental locations have no connection to a distribution network. The HOMER® software optimizing tool was utilized to determine the optimal combination of system components that will yield the lowest life cycle cost. Sequel to the analysis for rural community utilization, a Distributed Generation (DG) analysis that considered the possibility of generating wind power in the MW range in order to take advantage of Nigeria’s tariff regime for embedded generation was carried out for each site. The DG design incorporated each community of 200 homes, freely catered for and offset from the excess electrical energy generated above the minimum requirement for sales to a nearby distribution grid. Wind DG systems were found suitable and viable in producing environmentally friendly energy in terms of life cycle cost and levelised value of producing energy at Jos ($0.14/kWh), Minna ($0.12/kWh), Ilorin ($0.09/kWh), Makurdi ($0.09/kWh), and Abuja ($0.04/kWh) at a particluar turbine hub height. These outputs reveal the value retrievable from the project after breakeven point as a function of energy consumed Based on the results, the study demonstrated that including renewable energy in the rural development plan will enhance fast upgrade of the rural communities.

Keywords: wind speed, wind power, distributed generation, cost per kilowatt-hour, clean energy, North-Central Nigeria

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Authors: Christabel Ihedike, John Mooney, Monica Price

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Summary: This study aims to critically evaluate effect of photochemical smog on respiratory health in Nigeria. Cohort of chronic obstructive pulmonary disease (COPD) patients was recruited from two large hospitals in Abuja Nigeria. Respiratory health questionnaires, daily diaries, dyspnoea scale and lung function measurement were used to obtain health data and investigate the relationship with air quality data (principally ozone, NOx and particulate pollution). Concentrations of air pollutants were higher than WHO and Nigerian air quality standard. The result suggests a correlation between measured air quality and exacerbation of respiratory illness. Introduction: Photochemical smog is a significant health challenge in most cities and its effect on respiratory health is well acknowledged. This type of pollution is most harmful to the elderly, children and those with underlying respiratory disease. This study aims to investigate impact of increasing temperature and photo-chemically generated secondary air pollutants on respiratory health in Abuja Nigeria. Method and Result: Health data was collected using spirometry to measure lung function on routine attendance at the clinic, daily diaries kept by patients and information obtained using respiratory questionnaire. Questionnaire responses (obtained using an adapted and internally validated version of St George’s Hospital Respiratory Questionnaire), shows that ‘time of wheeze’ showed an association with participants activities: 30% had worse wheeze in the morning: 10% cannot shop, 15% take long-time to get washed, 25% walk slower, 15% if hurry have to stop and 5% cannot take-bath. There was also a decrease in Forced expiratory volume in the first second and Forced Vital Capacity, and daily change in the afternoon–morning may be associated with the concentration level of pollutants. Also, dyspnoea symptoms recorded that 60% of patients were on grade 3, 25% grade 2 and 15% grade 1. Daily frequency of the number of patients in the cohort that cough /brought sputum is 78%. Air pollution in the city is higher than Nigerian and WHO standards with NOx and PM10 concentrations of 693.59ug/m-3 and 748ugm-3 being measured respectively. The result shows that air pollution may increase occurrence and exacerbation of respiratory disease. Conclusion: High temperature and local climatic conditions in urban Nigeria encourages formation of Ozone, the major constituent of photochemical smog, resulting also in the formation of secondary air pollutants associated with health challenges. In this study we confirm the likely potency of the pattern of secondary air pollution in exacerbating COPD symptoms in vulnerable patient group in urban Nigeria. There is need for better regulation and measures to reduce ozone, particularly when local climatic conditions favour development of photochemical smog in such settings. Climate change and likely increasing temperatures add impetus and urgency for better air quality standards and measures (traffic-restrictions and emissions standards) in developing world settings such as Nigeria.

Keywords: Abuja-Nigeria, effect, photochemical smog, respiratory health

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Authors: Budiman Budiman

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This research aimed at describing and testing whether the students’ ability in writing analytical exposition text is increased by using comic strips at SMAN 12 Pekanbaru. The respondents of this study were the second-grade students, especially XI Science 3 academic year 2011-2012. The total number of students in this class was forty-two (42) students. The quantitative and qualitative data was collected by using writing test and observation sheets. The research finding reveals that there is a significant increase of students’ writing ability in writing analytical exposition text through comic strips. It can be proved by the average score of pre-test was 43.7 and the average score of post-test was 65.37. Besides, the students’ interest and motivation in learning are also improved. These can be seen from the increasing of students’ awareness and activeness in learning process based on observation sheets. The findings draw attention to the use of comic strips in teaching and learning is beneficial for better learning outcome.

Keywords: analytical exposition, comic strips, secondary school students, writing ability

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Authors: Shahed Vahedi, Mohd Salmi Md Noorani

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This paper investigates cluster synchronization phenomena between community networks. We focus on the situation where a variety of dynamics occur in the clusters. In particular, we show that different synchronization states simultaneously occur between the networks. The controller is designed having an adaptive control gain, and theoretical results are derived via Lyapunov stability. Simulations on well-known dynamical systems are provided to elucidate our results.

Keywords: cluster synchronization, adaptive control, community network, simulation

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Authors: Ibrahim Mohammed

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Background: Diabetes mellitus is a chronic disease that can cause devastating secondary complications, reducing the quality and length of life as well as increasing medical costs for the patient and society. The guidelines recommend both clinical and preventive strategies for diabetes management and are regularly updated. The aim of the study is to assess the level of adherence of physicians to American Diabetes Association Guidelines. Method: Observational multicenter retrospective study will be conducted among different hospitals in the central region. Patient data will be collected from the records of the last three years (2017- 2020). Records will be selected randomly after a complete randomized design. The study focuses on the management of type 2 according to ADA not changed in the last three updating; those standards; all patients should be taking Metformin 1500 to 2000 mg/day as recommended dose and should be received a high dose of statin if the high risk to ASCVD or moderate statin if not at risk, patients with hypertension and diabetes should taking ACE or ARBS. Result: The study aimed to evaluate the commitment of physicians in the central region to the ADA. Out of the 153 selected patients, only 17 % were able to control their diabetes with an average A1c below 7. ADA stated that to reach the minimum benefit of using Metformin, the daily dose should be between 1500 and 2000 mg. Results showed that 110 patients were on Metformin, where 68% of them were on the recommended dose. ADA recommended the intake of high statin for diabetic patients with ASCVD risk, while diabetic patients without ASCVD risk should be on a moderate statin. Results showed that 61.5% of patients with ASCVD risk were at high statin while only 36% of patients without ASCVD risk were at moderate statin. Results showed that 89 patients have hypertension, and 80% of them are getting ACE/ARBs as recommended by the ADA. Recommendation: It is necessary to implement periodic training courses for some physicians to enhance and update their knowledge.

Keywords: American Diabetic Association, diabetes mellitus, atherosclerotic cardiovascular disease, ACE inhibitors

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Authors: Sajee A. Gamage, Champa J. Wijesinghe, Patricia Burtner, Ananda R. Wickremasinghe

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Background: Teachers working in the context of special education have an enormous responsibility of enhancing performance skills of children in their classroom settings. Fine Motor Skills (FMS) are essential functional skills for children to gain independence in Activities of Daily Living. Children with Down Syndrome (DS) are predisposed to specific challenges due to deficits in FMS. This study is aimed to determine the teachers’ experience on improving FMS of children with DS in the context of special education of Southern Province, Sri Lanka. Methodology: A cross-sectional study was conducted among all consenting eligible teachers (n=147) working in the context of special education in government schools of Southern Province of Sri Lanka. A self-administered questionnaire was developed based on literature and expert opinion to assess teachers’ experience regarding deficits of FMS, limitations of classroom activity performance and barriers to improve FMS of children with DS. Results: Approximately 93% of the teachers were females with a mean age ( ± SD) of 43.1 ( ± 10.1) years. Thirty percent of the teachers had training in special educationand 83% had children with DS in their classrooms. Major deficits of FMS reported were deficits in grasping (n=116; 79%), in-hand manipulation (n=103; 70%) and bilateral hand use (n=99; 67.3%). Paperwork (n=70; 47.6%), painting (n=58; 39.5%), scissor work (n=50; 34.0%), pencil use for writing (n=45; 30.6%) and use of tools in the classroom (n=41; 27.9%) were identified as major classroom performance limitations of children with DS. Parental factors (n=67; 45.6%), disease specific characteristics (n=58; 39.5%) and classroom factors (n=36; 24.5%), were identified as major barriers to improve FMS in the classroom setting. Lack of resources and standard tools, social stigma and late school admission were also identified as barriers to FMS training. Eighty nine percent of the teachers informed that training fine motor activities in a special education classroom was more successful than work with normal classroom setting. Conclusion: Major areas of FMS deficits were grasping, in-hand manipulation and bilateral hand use; classroom performance limitations included paperwork, painting and scissor work of children with DS. Teachers recommended regular practice of fine motor activities according to individual need. Further research is required to design a culturally specific FMS assessment tool and intervention methods to improve FMS of children with DS in Sri Lanka.

Keywords: classroom activities, Down syndrome, experience, fine motor skills, special education, teachers

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Authors: Ahmed Aisa, Tariq Iqbal

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This letter talks about the ready-to-use design of a solar water heating system because, in Canada, the average consumption of hot water per person is approximately 50 to 75 L per day and the average Canadian household uses 225 L. Therefore, this paper will demonstrate the method of designing a solar water heating system with thermal storage. It highlights the renewable hybrid power system, allowing you to obtain a reliable, independent system with the optimization of the ingredient size and at an improved capital cost. The system can provide hot water for a big building. The main power for the system comes from solar panels. Solar Advisory Model (SAM) and HOMER are used. HOMER and SAM are design models that calculate the consumption of hot water and cost for a house. Some results, obtained through simulation, were for monthly energy production, annual energy production, after tax cash flow, the lifetime of the system and monthly energy usage represented by three types of energy. These are system energy, electricity load electricity and net metering credit.

Keywords: water heating, thermal storage, capital cost solar, consumption

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Authors: Mehmet Yavuz Huseyinca

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The clay beds are located at the south-southeast of Doğanhisar and northwest of Konya in the Central Anatolia. In the scope of preliminary study, three types of samples were investigated including basement phyllite (Bp) overlain by the clay beds, weathered phyllite (Wp) and Doğanhisar clay (Dc). The Chemical Index of Alteration (CIA) values of Dc range from 81 to 88 with an average of 85. This value is higher than that of Post Archean Australian Shale (PAAS) and defines very intense chemical weathering in the source-area. On the other hand, the A-CN-K diagram indicates that Bp underwent high degree post-depositional K-metasomatism. The average reconstructed CIA value of the Bp prior to the K-metasomatism is mainly 81 which overlaps the CIA values of the Wp (83) and Dc (85). Similar CIA values indicate parallel weathering trends. Also, extrapolation of the samples back to the plagioclase-alkali feldspar line in the A-CN-K diagram suggests an identical provenance close to granite in composition. Hereby the weathering background of Dc includes two steps. First one is intense weathering process of a granitic source to Bp with post-depositional K-metasomatism and the latter is progressively weathering of Bp to premetasomatised conditions (formation of Wp) ending with Dc deposition.

Keywords: clay beds, Doganhisar, provenance, weathering

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Authors: Hasanpasha N. Sholapur, Basanagouda M.Patil

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Alcoholic extract of the bark of Moringa oleifera Lam. (MO), (Moringaceae), has been evaluated experimentally in the past for its insulin sensitizing potentials. In order to explore the possibility of the class of phytochemical(s) responsible for this experimental claim, the alcoholic extract was fractionated into non-polar [petroleum ether (PEF)], moderately non-polar [ethyl acetate (EAF)] and polar [aqueous (AQF)] fractions. All the fractions and pioglitazone (PIO) as standard (10mg/kg were p.o., once daily for 11 d) were investigated for their chronic effect on fasting plasma glucose, triglycerides, total cholesterol, insulin, oral glucose tolerance and acute effect on oral glucose tolerance in dexamethasone-induced (1 mg/kg s.c., once daily for 11 d) chronic model and acute model (1 mg/kg i.p., for 4 h) respectively for insulin resistance (IR) in rats. Among all the fractions tested, chronic treatment with EAF (140 mg/kg) and PIO (10 mg/kg) prevented dexamethasone-induced IR, indicated by prevention of hypertriglyceridemia, hyperinsulinemia and oral glucose intolerance, whereas treatment with AQF (95 mg/kg) prevented hepatic IR but not peripheral IR. In acute study single dose treatment with EAF (140 mg/kg) and PIO (10 mg/kg) prevented dexamethasone-induced oral glucose intolerance, fraction PEF did not show any effect on these parameters in both the models. The present study indicates that the triterpenoidal and the phenolic class of phytochemicals detected in EAF of alcoholic extract of MO bark may be responsible for the prevention of dexamethasone-induced insulin resistance in rats.

Keywords: Moringa oleifera, insulin resistance, dexamethasone, serum triglyceride, insulin, oral glucose tolerance test

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Authors: Ami Nkumbuye

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Background: Every year 1.3 million people die due to Road crashes, according to the Global status report. Road crashes remain the greatest killer aged between 15-29 years. Young people are paying an unacceptable price for their own safer mobility. 23,498 students attending class daily from home crossing the roads of 3 districts Kigali and Southern province is showing a similar trend with 40320 cross road daily. As most of them don't have any idea about the safety, they should have when they are crossing roads and traffic rules and signs as well. Despite the high number of mortality related to road crashes in Rwanda, we don't have any approved calendar to teach young people road safety as the most affected age group. Objective: The objective of this study was to identify the causes of road crashes and the outcome of victims after being involved in road crashes over a period of two years, from January 2020 to December 2021, in Huye district and Kigali City. Methods: A retrospective descriptive study with open questions and then data analysis, students were identified from 15 schools in Kigali City and Southern Province and through the Local Action Project supported by Global Youth Coalition for Road Safety and Youth for Road Safety (YOURS), students asked about the cause of road crashes through open and closed question and data analyzed. Result: There were 354 students from 15 schools: 198 males and 156 females. Their age ranged from 10 to 25 years. The commonest cause of road crashes among students attending schools daily was: high speed, lack of education on safe behavior on the road, drinking and driving, and poor road infrastructures, with 47%, 32%, 13% and 8 %, respectively. The hospital admission after road crashes for the victims was 32.3%. In most scenes where road crashes occur, students report that they didn't see any person who could provide post-crash care until the ambulance came, in some cases, resulted in bad outcomes for the victims after road crashes. Conclusion: This study revealed that high speed and lack of education n road safety are the major cause of road crashes among young people in Rwanda. If local Non-Governmental Organization and Decision makers work on these issues like never before, we can see a decrease in road crash among young people and adult as well. We would like to give a recommendation to two institutions: the first is the Rwanda National Police Traffic department to set 30km/m as the maximum speed limit in City and near schools. The second is for the Ministry of Education to put Road Safety and Post Crash Care curricula in both Primary and Secondary schools.

Keywords: road safety, post-crash care, young people, students

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Authors: Baso Hamdani, Arniati Massinai, Jamaluddin Jompa

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Coral diseases are one of the factors affect reef degradation. This research had analysed the progression rate, incidence, and prevalence of Black Band Disease (BBD) on stony coral (Pachyseris sp.) in relation to the environmental parameters (pH, nitrate, phospate, Dissolved Organic Matter (DOM), and turbidity). The incidence of coral disease was measured weekly for 6 weeks using Belt Transect Method. The progression rate of BBD was measured manually. Furthermore, the prevalence and incidence of BBD were calculated each colonies infected. The relationship between environmental parameters and the progression rate, prevalence and incidence of BBD was analysed by Principal Component Analysis (PCA). The results showed the average of progression rate is 0,07 ± 0,02 cm/ hari. The prevalence of BBD increased from 0,92% - 19,73% in 7 weeks observation with the average incidence of new infected colonies coral 0,2 - 0,65 colony/day The environment factors which important were pH, Nitrate, Phospate, DOM, and Turbidity.

Keywords: progression rate, incidence, prevalence, Black Band Disease, Barranglompo

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Authors: Davit Pipoyan, Meline Beglaryan, Nicolò Merendino

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Mining industry is one of the priority sectors of Armenian economy. Along with the solution of some socio-economic development, it brings about numerous environmental problems, especially toxic element pollution, which largely influences the safety of agricultural products. In addition, accumulation of toxic elements in agricultural products, mainly in edible parts of plants represents a direct pathway for their penetration into the human food chain. In Armenia, the share of plant origin food in overall diet is significantly high, so estimation of dietary intakes of toxic trace elements via consumption of selected fruits and vegetables are of great importance for observing the underlying health risks. Therefore, the present study was aimed to assess dietary exposure of potentially toxic trace elements through the intake of locally grown fruits and vegetables in Akhtala community (Armenia), where not only mining industry is developed, but also cultivation of fruits and vegetables. Moreover, this investigation represents one of the very first attempts to estimate human dietary exposure of potentially toxic trace elements in the study area. Samples of some commonly grown fruits and vegetables (fig, cornel, raspberry, grape, apple, plum, maize, bean, potato, cucumber, onion, greens) were randomly collected from several home gardens located near mining areas in Akhtala community. The concentration of Cu, Mo, Ni, Cr, Pb, Zn, Hg, As and Cd in samples were determined by using an atomic absorption spectrophotometer (AAS). Precision and accuracy of analyses were guaranteed by repeated analysis of samples against NIST Standard Reference Materials. For a diet study, individual-based approach was used, so the consumption of selected fruits and vegetables was investigated through food frequency questionnaire (FFQ). Combining concentration data with contamination data, the estimated daily intakes (EDI) and cumulative daily intakes were assessed and compared with health-based guidance values (HBGVs). According to the determined concentrations of the studied trace elements in fruits and vegetables, it can be stressed that some trace elements (Cu, Ni, Pb, Zn) among the majority of samples exceeded maximum allowable limits set by international organizations. Meanwhile, others (Cr, Hg, As, Cd, Mo) either did not exceed these limits or still do not have established allowable limits. The obtained results indicated that only for Cu the EDI values exceeded dietary reference intake (0.01 mg/kg/Bw/day) for some investigated fruits and vegetables in decreasing order of potato > grape > bean > raspberry > fig > greens. In contrast to this, for combined consumption of selected fruits and vegetables estimated cumulative daily intakes exceeded reference doses in the following sequence: Zn > Cu > Ni > Mo > Pb. It may be concluded that habitual and combined consumption of the above mentioned fruits and vegetables can pose a health risk to the local population. Hence, further detailed studies are needed for the overall assessment of potential health implications taking into consideration adverse health effects posed by more than one toxic trace element.

Keywords: daily intake, dietary exposure, fruits, trace elements, vegetables

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Authors: Shiori Ishida, Hiromi Okuno, Hisato Igarashi, Akemi Yamazaki, Hiroko Takahashi

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The purpose of this study was to clarify the differences and similarities regarding the social support of fathers and mothers towards considering increased assistance for the paternity of children with developmental disabilities. Written questionnaires were completed by fathers (n=85) and mothers (n=101) of children using rehabilitation facilities between infancy and 5 years of age. The survey contained multiple-choice questions on four categories: information support (6 items), emotional support (7 items), evaluation support (3 items), and daily living support (3 items). Regarding information support, fathers answered ‘spouse’ as the provider in over 50% of cases for all 6 items, which was significantly different compared with mothers (all p < 0.001). For emotional support, fathers were significantly more likely to get support from the workplace (p < 0.001) and from spouse (p < 0.001). The ‘evaluation support’ did not have significant differences for fathers in all the items, but the most frequent support providers were ‘spouses’. ‘Daily living support’ was significantly different from fathers in the workplace (p < 0.000) in terms of make allowances for work and duties. Thus, it appeared that fathers had fewer social support sources as compared with mothers and limited non-spouse support. The understanding of developmental disabilities, acquisition of methods of rehabilitation, and sources of support might have been inadequately addressed among fathers, which could be a hindrance to the involvement of fathers in the rearing of children with developmental disabilities. On the other hand, we also observed that some fathers were involved in the care of developmentally troubled children while providing mental support for their spouse, cooperating with housework, and adjusting their work life. However, the results on the external and social backgrounds of fathers indicated a necessity for greater empowerment and peer support to improve the paternal care of children with developmental disabilities in the family survey.

Keywords: children with developmental disabilities, family support, father, social support

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Authors: Adekunle Adesina, Dorcas Adesina

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This Research investigated the influence of alcohol consumption on attention in Wister albino rats. It was designed to test whether or not alcohol consumption affected visual and auditory attention. The sample of this study comprise of 3males albino rats and 3 females albino rats which were randomly assigned to 3 (male/female each) groups, 1, 2 and 3. The first group which was experimental Group 1 received 4ml of alcohol ingestion with cannula twice daily (morning and evening). The second group which was experimental group 2 received 2ml of alcohol ingestion with cannula twice daily (morning and evening). Third group which was the control group only received water (placebo), all these happened within a period of 2 days. Three hypotheses were advanced and testedf in the study. Hypothesis 1 stated that there will be no significant difference between the response speed of albino rats that consume alcohol and those that consume water on visual attention using 5-CSRTT. This was confirmed (DF (2, 9) = 0.72, P <.05). Hypothesis 2 stated that albino rats who consumed alcohol will perform better than those who consume water on auditory accuracy using 5-CSRTT. This was also tested but not confirmed (DF (2, 9) = 2.10, P< .05). The third hypothesis which stated that female albino rats who consumed alcohol would not perform better than male albino rats who consumed alcohol on auditory accuracy using 5-CSRTT was tested and not confirmed. (DF (4) = 0.17, P < .05). Data was analyzed using one-way ANOVA and T-test for independent measures. It was therefore recommended that government policies and programs should be directed at reducing to the barest minimum the rate of alcohol consumption especially among males as it is detrimental to the human auditory attentional organ.

Keywords: alcohol, attention, influence, rats, Wistar

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Authors: Dmitriy Chernov, Maria Karavassilis, Suhyoun Youn, Amna Izhar, Devasenan Devendra

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Introduction and Background: A well-structured and comprehensive departmental induction improves patient safety and job satisfaction amongst doctors. The aims of our Project were as follows: 1. Assess the perceived preparedness of junior doctors starting their rotation in Acute Medicine at Watford General Hospital. 2. Develop a supplemental Induction Guide and Pocket reference in the form of an iOS mobile application. 3. To collect feedback after implementing the mobile application following a trial period of 8 weeks with a small cohort of junior doctors. Materials and Methods: A questionnaire was distributed to all new junior trainees starting in the department of Acute Medicine to assess their experience of current induction. A mobile Induction application was developed and trialled over a period of 8 weeks, distributed in addition to the existing didactic induction session. After the trial period, the same questionnaire was distributed to assess improvement in induction experience. Analytics data were collected with users’ consent to gauge user engagement and identify areas of improvement of the application. A feedback survey about the app was also distributed. Results: A total of 32 doctors used the application during the 8-week trial period. The application was accessed 7259 times in total, with the average user spending a cumulative of 37 minutes 22 seconds on the app. The most used section was Clinical Guidelines, accessed 1490 times. The App Feedback survey revealed positive reviews: 100% of participants (n=15/15) responded that the app improved their overall induction experience compared to other placements; 93% (n=14/15) responded that the app improved overall efficiency in completing daily ward jobs compared to previous rotations; and 93% (n=14/15) responded that the app improved patient safety overall. In the Pre-App and Post-App Induction Surveys, participants reported: a 48% improvement in awareness of practical aspects of the job; a 26% improvement of awareness on locating pathways and clinical guidelines; a 40% reduction of feelings of overwhelmingness. Conclusions and recommendations: This study demonstrates the importance of technology in Medical Education and Clinical Induction. The mobile application average engagement time equates to over 20 cumulative hours of on-the-job training delivered to each user, within an 8-week period. The most used and referred to section was clinical guidelines. This shows that there is high demand for an accessible pocket guide for this type of material. This simple mobile application resulted in a significant improvement in feedback about induction in our Department of Acute Medicine, and will likely impact workplace satisfaction. Limitations of the application include: post-app surveys had a small number of participants; the app is currently only available for iPhone users; some useful sections are nested deep within the app, lacks deep search functionality across all sections; lacks real time user feedback; and requires regular review and updates. Future steps for the app include: developing a web app, with an admin dashboard to simplify uploading and editing content; a comprehensive search functionality; and a user feedback and peer ratings system.

Keywords: mobile app, doctor induction, medical education, acute medicine

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