Search results for: design improvement

Authors: Bangun F., Crevits B., Bellet T., Banet A., Boy G. A., Katili I.

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This paper seeks the incoherencies in cognitive process during an accident of Powered Two Wheelers (PTW) by understanding the factual sequences of events and causal relations for each case of accident. The principle of this approach is undertaking in-depth investigations on case per case of PTW accidents based on elaborate data acquisitions on accident sites that officially stamped in Police Crash Report (PCRs) 2012 of Medan with criteria, involved at least one PTW and resulted in serious injury and fatalities. The analysis takes into account four modules: accident chronologies, perpetrator, and victims, injury surveillance, vehicles and road infrastructures, comprising of traffic facilities, road geometry, road alignments and weather. The proposal for improvement could have provided a favorable influence on the chain of functional processes and events leading to collision. Decision Aiding Processes (DAP) assists in structuring different entities at different decisional levels, as each of these entities has its own objectives and constraints. The entities (A) are classified into 6 groups of accidents: solo PTW accidents; PTW vs. PTW; PTW vs. pedestrian; PTW vs. motor-trishaw; and PTW vs. other vehicles and consecutive crashes. The entities are also distinguished into 4 decisional levels: level of road users and street systems; operational level (crash-attended police officers or CAPO and road engineers), tactical level (Regional Traffic Police, Department of Transportation, and Department of Public Work), and strategic level (Traffic Police Headquarters (TCPHI)), parliament, Ministry of Transportation and Ministry of Public Work). These classifications will lead to conceptualization of Problem Situations (P) and Problem Formulations (I) in DAP context. The DAP concerns the sequences process of the incidents until the time the accident occurs, which can be modelled in terms of five activities of procedural rationality: identification on initial human features (IHF), investigation on proponents attributes (PrAT), on Injury Surveillance (IS), on the interaction between IHF and PrAt and IS (intercorrelation), then unravel the sequences of incidents; filtering and disclosure, which include: what needs to activate, modify or change or remove, what is new and what is priority. These can relate to the activation or modification or new establishment of law. The PrAt encompasses the problems of environmental, road infrastructure, road and traffic facilities, and road geometry. The evaluation model (MP) is generated to bridge P and I since MP is produced by the intercorrelations among IHF, PrAT and IS extracted from the PCRs 2012 of Medan. There are 7 findings of incoherences: lack of knowledge and awareness on the traffic regulations and the risks of accidents, especially when riding between 0 < x < 10 km from house, riding between 22 p.m.–05.30 a.m.; lack of engagements on procurement of IHF Data by CAPO; lack of competency of CAPO on data procurement in accident-sites; no intercorrelation among IHF and PrAt and IS in the database systems of PCRs; lack of maintenance and supervision on the availabilities and the capacities of traffic facilities and road infrastructure; instrumental bias with wash-back impacts towards the TCPHI; technical robustness with wash-back impacts towards the CAPO and TCPHI.

Keywords: decision aiding processes, evaluation model, PTW accidents, police crash reports

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Authors: Mulubrhan Berihu

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Due to the design versatility, availability, and cost efficiency, concrete continues to be the most used construction material on earth. However, the production of Portland cement, the primary component of concrete mix is causing to have a serious effect on environmental and economic impacts. This shows there is a need to study using of supplementary cementitious materials (SCMs). The most commonly used supplementary cementitious materials are wastes, and the use of these industrial waste products has technical, economic, and environmental benefits besides the reduction of CO2 emission from cement production. This paper aims to document the effect on the strength property of concrete due to the use of low cement by maximizing supplementary cementitious materials like fly ash. The amount of cement content was below 250 kg/m3, and in all the mixes, the quantity of powder (cement + fly ash) is almost kept at about 500 kg. According to this, seven different cement content (250 kg/m3, 195 kg/m3, 150 kg/m3, 125 kg/m3, 100 kg/m3, 85 kg/m3, 70 kg/m3) with different amount of replacement of SCMs was conducted. The mix proportion was prepared by keeping the water content constant and varying the cement content, SCMs, and water-to-binder ratio. Based on the different mix proportions of fly ash, a range of mix designs was formulated. The test results showed that using up to 85 kg/m3 of cement is possible for plain concrete works like hollow block concrete to achieve 9.8 Mpa, and the experimental results indicate that strength is a function of w/b. The experiment result shows a big difference in gaining of compressive strength from 7 days to 28 days and this obviously shows the slow rate of hydration of fly ash concrete. As the w/b ratio increases, the strength decreases significantly. At the same time, higher permeability was seen in the specimens which were tested for three hours than one hour.

Keywords: efficiency factor, cement content, compressive strength, mix proportion, w/c ratio, water permeability, SCMs

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Authors: Subir Gupta, Subhas Ganguly

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In this paper, we demonstrate the new area of application of image processing in metallurgical images to develop the more opportunity for structure-property correlation based approaches of alloy design. The present exercise focuses on the development of image processing tools suitable for phrase segmentation, grain boundary detection and recognition of micro-constituents in SEM micrographs of ferrite and pearlite steels. A comprehensive data of micrographs have been experimentally developed encompassing the variation of ferrite and pearlite volume fractions and taking images at different magnification (500X, 1000X, 15000X, 2000X, 3000X and 5000X) under scanning electron microscope. The variation in the volume fraction has been achieved using four different plain carbon steel containing 0.1, 0.22, 0.35 and 0.48 wt% C heat treated under annealing and normalizing treatments. The obtained data pool of micrographs arbitrarily divided into two parts to developing training and testing sets of micrographs. The statistical recognition features for ferrite and pearlite constituents have been developed by learning from training set of micrographs. The obtained features for microstructure pattern recognition are applied to test set of micrographs. The analysis of the result shows that the developed strategy can successfully detect the micro constitutes across the wide range of magnification and variation of volume fractions of the constituents in the structure with an accuracy of about +/- 5%.

Keywords: SEM micrograph, metallurgical image processing, ferrite pearlite steel, microstructure

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Authors: Merav Ben Natan, Heba Igbarin, Arwa Watted

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Introduction: The rising prevalence of autism spectrum disorders (ASD) has heightened the need to understand the challenges faced by children with ASD and their families in emergency departments (EDs). Children with ASD often experience additional health issues and heightened anxiety in the chaotic ED environment, which can impact their care and parental satisfaction. Purpose: This study aimed to examine factors identified by mothers as affecting their satisfaction with the care provided to their children in the ED, among mothers of children with ASD in comparison to mothers of children without ASD. Design and methods: In this correlational quantitative study, 128 Israeli mothers – 59 (46%) mothers of children with ASD and 69 (54%) of children without ASD - completed an online survey based on a Ministry of Health national survey of patient experience. Results: Mothers of children with ASD expressed lower satisfaction with the care provided. The difference was particularly evident concerning waiting times for examination of the child by nurses and physicians in the ED, whether the nurses were attentive and responsive to the mother's questions and concerns, whether the ED staff demonstrated coordination and cooperation with regard to medical care of the child, and whether work in the ED was conducted in an orderly and organized manner. The presence of communication difficulties in children predicted mothers' satisfaction with care. Conclusions: These findings suggest that certain needs of mothers and/or their children with ASD do not receive an appropriate response in the ED. Practice implications: It is important to raise the awareness of healthcare providers in EDs regarding the needs of children with ASD and their parents, especially children with communication difficulties. Strategies should be implemented to improve the experience of children with ASD and their parents in the ED.

Keywords: autism spectrum disorder, emergency department, parental satisfaction, healthcare challenges

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Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl

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Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.

Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method

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Authors: Jose A. Alvarez Aldegunde, Adrian Fernandez Sanchez, Matthew D. Menden, Bernardo Vila Rodriguez

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Up to five statistical pre-processings have been carried out considering the pollutant records of the stations present in Cartagena de Indias, Colombia, also taking into account the childhood asthma incidence surveys conducted in hospitals in the city by the Health Ministry of Colombia for this study. These pre-processings have consisted of different techniques such as the determination of the quality of data collection, determination of the quality of the registration network, identification and debugging of errors in data collection, completion of missing data and purified data, as well as the improvement of the time scale of records. The characterization of the quality of the data has been conducted by means of density analysis of the pollutant registration stations using ArcGis Software and through mass balance techniques, making it possible to determine inconsistencies in the records relating the registration data between stations following the linear regression. The results obtained in this process have highlighted the positive quality in the pollutant registration process. Consequently, debugging of errors has allowed us to identify certain data as statistically non-significant in the incidence and series of contamination. This data, together with certain missing records in the series recorded by the measuring stations, have been completed by statistical imputation equations. Following the application of these prior processes, the basic series of incidence data for respiratory disease and pollutant records have allowed the characterization of the influence of pollutants on respiratory diseases such as, for example, childhood asthma. This characterization has been carried out using statistical correlation methods, including visual correlation, simple linear regression correlation and spectral analysis with PAST Software which identifies maximum periodicity cycles and minimums under the formula of the Lomb periodgram. In relation to part of the results obtained, up to eleven maximums and minimums considered contemporary between the incidence records and the particles have been identified taking into account the visual comparison. The spectral analyses that have been performed on the incidence and the PM2.5 have returned a series of similar maximum periods in both registers, which are at a maximum during a period of one year and another every 25 days (0.9 and 0.07 years). The bivariate analysis has managed to characterize the variable "Daily Vehicular Flow" in the ninth position of importance of a total of 55 variables. However, the statistical correlation has not obtained a favorable result, having obtained a low value of the R2 coefficient. The series of analyses conducted has demonstrated the importance of the influence of pollutants such as PM2.5 in the development of childhood asthma in Cartagena. The quantification of the influence of the variables has been able to determine that there is a 56% probability of dependence between PM2.5 and childhood respiratory asthma in Cartagena. Considering this justification, the study could be completed through the application of the BenMap Software, throwing a series of spatial results of interpolated values of the pollutant contamination records that exceeded the established legal limits (represented by homogeneous units up to the neighborhood level) and results of the impact on the exacerbation of pediatric asthma. As a final result, an economic estimate (in Colombian Pesos) of the monthly and individual savings derived from the percentage reduction of the influence of pollutants in relation to visits to the Hospital Emergency Room due to asthma exacerbation in pediatric patients has been granted.

Keywords: Asthma Incidence, BenMap, PM2.5, Statistical Analysis

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Authors: Narottam Puri, Gurvinder Kaur

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Background: The National Accreditation Board for Hospitals & Healthcare Providers (NABH) is India’s apex standard setting accrediting body in health care which evaluates and accredits healthcare organizations. NABH requires accredited organizations to become reaccredited every three years. It is often though that once the initial accreditation is complete, the foundation is set and reaccreditation is a much simpler process. Fortis Hospital, Shalimar Bagh, a part of the Fortis Healthcare group is a 262 bed, multi-specialty tertiary care hospital. The hospital was successfully accredited in the year 2012. On completion of its first cycle, the hospital underwent a reaccreditation assessment in the year 2015. This paper aims to gain a better understanding of the challenges that accredited hospitals face when preparing for a renewal of their accreditations. Methods: The study was conducted using a cross-sectional mixed methods approach; semi-structured interviews were conducted with senior leadership team and staff members including doctors and nurses. Documents collated by the QA team while preparing for the re-assessment like the data on quality indicators: the method of collection, analysis, trending, continual incremental improvements made over time, minutes of the meetings, amendments made to the existing policies and new policies drafted was reviewed to understand the challenges. Results: The senior leadership had a concern about the cost of accreditation and its impact on the quality of health care services considering the staff effort and time consumed it. The management was however in favor of continuing with the accreditation since it offered competitive advantage, strengthened community confidence besides better pay rates from the payors. The clinicians regarded it as an increased non-clinical workload. Doctors felt accountable within a professional framework, to themselves, the patient and family, their peers and to their profession; but not to accreditation bodies and raised concerns on how the quality indicators were measured. The departmental leaders had a positive perception of accreditation. They agreed that it ensured high standards of care and improved management of their functional areas. However, they were reluctant in sparing people for the QA activities due to staffing issues. With staff turnover, a lot of work was lost as sticky knowledge and had to be redone. Listing the continual quality improvement initiatives over the last 3 years was a challenge in itself. Conclusion: The success of any quality assurance reaccreditation program depends almost entirely on the commitment and interest of the administrators, nurses, paramedical staff, and clinicians. The leader of the Quality Movement is critical in propelling and building momentum. Leaders need to recognize skepticism and resistance and consider ways in which staff can become positively engaged. Involvement of all the functional owners is the start point towards building ownership and accountability for standards compliance. Creativity plays a very valuable role. Communication by Mail Series, WhatsApp groups, Quizzes, Events, and any and every form helps. Leaders must be able to generate interest and commitment without burdening clinical and administrative staff with an activity they neither understand nor believe in.

Keywords: NABH, reaccreditation, quality assurance, quality indicators

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Authors: S. Schröder, P. Ennen, T. Langer, S. Müller, M. Shehadeh, M. Haberstroh, F. Hees

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Since a bit over a year ago, Festo AG and Co. KG, Festo Didactic SE, robomotion GmbH, the researchers of the Cybernetics-Lab IMA/ZLW and IfU, as well as the Human-Computer Interaction Center at the RWTH Aachen University, have been working together in the focal point of assembly competences to realize different scenarios in the field of human-machine interaction (HMI). In the framework of project ARIZ, questions concerning the future of production within the fourth industrial revolution are dealt with. There are many perspectives of human-robot collaboration that consist Industry 4.0 on an individual, organization and enterprise level, and these will be addressed in ARIZ. The aim of the ARIZ projects is to link AI-Approaches to assembly problems and to implement them as prototypes in demonstrators. To do so, island and flow based production scenarios will be simulated and realized as prototypes. These prototypes will serve as applications of flexible robotics as well as AI-based planning and control of production process. Using the demonstrators, human interaction strategies will be examined with an information system on one hand, and a robotic system on the other. During the tests, prototypes of workspaces that illustrate prospective production work forms will be represented. The human being will remain a central element in future productions and will increasingly be in charge of managerial tasks. Questions thus arise within the overall perspective, primarily concerning the role of humans within these technological revolutions, as well as their ability to act and design respectively to the acceptance of such systems. Roles, such as the 'Trainer' of intelligent systems may become a possibility in such assembly scenarios.

Keywords: human-machine interaction, information technology, island based production, assembly competences

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Authors: Kalpana Jamdhade, Anita Chorey, Bharti Tijare, V. M. Bhale

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A field experiment was conducted during summer season of 2011 at Agronomy research farm, Dr. PDKV, Akola, to study the effect of irrigation regime and nitrogen levels on growth and productivity of summer sesame. The experiment was laid out in split plot Design in which three irrigation scheduling on the basis of IW/CPE ratio viz., irrigation at 0.6, 0.8 and 1.0 IW/CPE ratios (I1, I2 and I3, respectively) and one irrigation scheduling based on critical growth stages of sesame (I4), in main plot and three nitrogen levels 0, 30 and 60 kg N ha-1 (N0, N1 and N2, respectively) in subplot. The result showed that plant height, number of leaves plant-1, leaf area and dry matter accumulation were maximum in irrigation scheduling at 1.0 IW/CPE ratio, which significantly superior over 0.6 IW/CPE ratio and irrigation at critical growth stages but were statistically at par with irrigation at 0.8 IW/CPE ratio. Nitrogen levels, application of 60 kg N ha-1 was recorded significantly superior all growth parameters over treatment 30 kg N ha-1 and 0 kg N ha-1. In case of yield attributes viz., No. of capsules plant-1, Test wt., grain yield and Stalk yield (qha-1) were maximum in irrigation scheduling at 1.0 IW/CPE ratio and were significantly superior over 0.8 IW/CPE ratio, 0.6 IW/CPE ratio and irrigation at critical growth stages. Application of 60 kg N ha-1 increased all yield attributing characters over application of 30 and 0 kg N ha-1. In case of economics of crop same trend was found and the highest B:C ration was obtained in irrigation scheduling at 1.0 IW/CPE ratio. Whereas, application of 30 kg N ha-1 was recorded highest B:C ration over application of 60 and 0 kg N ha-1. Interaction effect of irrigation and nitrogen levels were found to be non significant in summer season.

Keywords: irrigation regimes, nitrogen levels, summer sesame, agricultural technology

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Authors: Vimal O. Kumar, C. K. Muthukumaran, P. Rakesh

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Liquid rocket engine (LRE) combustion chamber is subjected to pressure oscillation during the combustion process. The combustion noise (acoustic noise) is a broad band, small amplitude, high frequency component pressure oscillation. They constitute only a minor fraction ( < 1%) of the entire combustion process. However, this high frequency oscillation is huge concern during the design phase of LRE combustion chamber as it would cause catastrophic failure of the chamber. Depends on the chamber geometry, certain frequencies form standing wave pattern, and they resonate with high amplitude and are known as Eigen modes. These Eigen modes could cause failures unless it is suppressed to be within safe limits. These modes are categorized into radial, tangential, and azimuthal modes, and their structure inside the combustion chamber is of interest to the researchers. In the present proposal, experimental as well as numerical simulation will be performed to obtain the frequency-amplitude characteristics of the model combustion chamber for different baffle configuration. The main objective of this study is to find effect of baffle configuration that would provide better suppression of acoustic modes. The experimental study aims at measuring the frequency amplitude characteristics at certain points in the chamber wall. The experimental measurement will be also used for scheme used in numerical simulation. In addition to experiments, numerical simulation would provide detailed structure of the Eigenmodes exhibited and their level of suppression with the aid of different baffle configurations.

Keywords: baffle, instability, liquid rocket engine, pressure response of chamber

Procedia PDF Downloads 116

Authors: Tianyou Wang

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Students' own intrinsic motivation is the main source of energy for learning activities, and their self-efficacy becomes a key factor affecting the learning effect. In today's increasingly common situation of online vocal music teaching, virtualized teaching scenarios have brought a considerable impact on students' personal efficacy. Since personal efficacy is the result of the interaction between environmental factors and subject characteristics, an empirical study was conducted to investigate the changes in students' self-efficacy, influencing factors, and characteristics in online vocal teaching scenarios based on the three dimensions of teachers, students, and technology. One hundred valid questionnaires were studied through a quantitative survey. The results showed that students' personal efficacy was significantly lower in online learning environments compared to offline vocal teaching and showed significant differences due to factors such as gender and class type; students' self-efficacy in online vocal teaching was significantly affected by factors such as technological environment, teaching style, and information technology ability. Based on the results of the study, it is recommended to pay attention to inquiry and practice in the teaching design, use singing projects as the teaching organization, grasp the learning process with the orientation of problem-solving, push the applicable vocal music teaching resources in time, lead students to explore and refine the problems and push students to learn independently according to the goals and plans.

Keywords: vocal pedagogy, self-efficacy, online learning, intrinsic motivation, information technology

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Authors: Naohiro Nakamura

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Analysis methods to accurately estimate the behavior of buildings when earthquakes occur is very important for improving the seismic safety of such buildings. Recently, the use of damping devices has increased significantly and there is a particular need to appropriately evaluate the behavior of buildings with such devices during earthquakes in the design stage. At present, however, the accuracy of the analysis evaluations is not sufficient. One reason is that the accuracy of current analysis methods has not been appropriately verified because there is very limited data on the behavior of actual buildings during earthquakes. Many types of shaking table test of large structures are performed at the '3-Dimensional Full-Scale Earthquake Testing Facility' (nicknamed 'E-Defense') operated by the National Research Institute of Earth Science and Disaster Prevention (NIED). In this study, simulations using 3- dimensional analysis models were conducted on shaking table test of a 5-story steel-frame structure with dampers. The results of the analysis correspond favorably to the test results announced afterward by the committee. However, the suitability of the parameters and models used in the analysis and the influence they had on the responses remain unclear. Hence, we conducted additional analysis and studies on these models and parameters. In this paper, outlines of the test are shown and the utilized analysis model is explained. Next, the analysis results are compared with the test results. Then, the additional analyses, concerning with the hysteresis curve of the dampers and the beam-end stiffness of the frame, are investigated.

Keywords: three-dimensional analysis, E-defense, full-scale experimen, vibration control damper

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Authors: Goodness Onwuka, Khaled Abou-El-Hossein

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Borosilicate-crown (BK7) glass has found broad application in the optic and automotive industries and the growing demands for nanometric surface finishes is becoming a necessity in such applications. Thus, it has become paramount to optimize the parameters influencing the surface roughness of this precision lens. The research was carried out on a 4-axes Nanoform 250 precision lathe machine with an ultra-high precision grinding spindle. The experiment varied the machining parameters of feed rate, wheel speed and depth of cut at three levels for different combinations using Box Behnken design of experiment and the resulting surface roughness values were measured using a Taylor Hobson Dimension XL optical profiler. Acoustic emission monitoring technique was applied at a high sampling rate to monitor the machining process while further signal processing and feature extraction methods were implemented to generate the input to a neural network algorithm. This paper highlights the training and development of a back propagation neural network prediction algorithm through careful selection of parameters and the result show a better classification accuracy when compared to a previously developed response surface model with very similar machining parameters. Hence artificial neural network algorithms provide better surface roughness prediction accuracy in the ultra-high precision grinding of BK7 glass.

Keywords: acoustic emission technique, artificial neural network, surface roughness, ultra-high precision grinding

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Authors: Alemayehu Ambaw, Matia Mukama, Umezuruike Linus Opara

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This study introduces a comprehensive method for designing ventilated corrugated fiberboard carton for fresh fruit packaging utilising virtual prototyping. The technique efficiently assesses and analyses the mechanical and thermal capabilities of fresh fruit packing boxes prior to making production investments. Comprehensive structural, aerodynamic, and thermodynamic data from designs were collected and evaluated in comparison to real-world packaging needs. Physical prototypes of potential designs were created and evaluated afterward. The virtual prototype is created with computer-aided graphics, computational structural dynamics, and computational fluid dynamics technologies. The virtual prototyping quickly generated data on carton compression strength, airflow resistance, produce cooling rate, spatiotemporal temperature, and product quality map in the cold chain within a few hours. Six distinct designs were analysed. All the various carton designs showed similar effectiveness in preserving the quality of the goods. The innovative packaging box design is more compact, resulting in a higher freight density of 1720 kg more fruit per reefer compared to the commercial counterpart. The precooling process was improved, resulting in a 17% increase in throughput and a 30% reduction in power usage.

Keywords: postharvest, container logistics, space/volume usage, computational method, packaging technology

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Authors: Ainura Tursunalieva, Irene Hudson

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Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

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Authors: R. Suresh, Pavan Kumar Nimmagadda, Ming Zo Tan, Shane Hart, Sharp Ugwuocha

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Polycrystalline diamond compact (PDC) drill bits are extensively used in the oil and gas industry as well as the mining industry. Industry engineers continually improve upon PDC drill bit designs and hydraulic conditions. Optimized injection nozzles play a key role in improving the drilling performance and efficiency of these ever changing PDC drill bits. In the first part of this study, computational fluid dynamics (CFD) modelling is performed to investigate the hydrodynamic characteristics of drilling fluid flow around the PDC drill bit. An Open-source CFD software – OpenFOAM simulates the flow around the drill bit, based on the field input data. A specifically developed console application integrates the entire CFD process including, domain extraction, meshing, and solving governing equations and post-processing. The results from the OpenFOAM solver are then compared with that of the ANSYS Fluent software. The data from both software programs agree. The second part of the paper describes the parametric study of the PDC drill bit nozzle to determine the effect of parameters such as number of nozzles, nozzle velocity, nozzle radial position and orientations on the flow field characteristics and bit washing patterns. After analyzing a series of nozzle configurations, the best configuration is identified and recommendations are made for modifying the PDC bit design.

Keywords: ANSYS Fluent, computational fluid dynamics, nozzle configuration, OpenFOAM, PDC dill bit

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Authors: Maximiliano K. Pagliarini, Ana Carolina T. Malavolta, Isabela M. Morita, Regina Maria M. Castilho

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Among the ornamental plants, the Amaryllis (Hippeastrum X hybridum Hort.) is one of the most cultivated plants in Brazil because of their large and showy flowers. Thus, the consumer market wants better quality plants or to flourish more in less time. One of the devices that can make such improvements or accelerate the flowering process is the use of growth regulators. The objective of this research was to evaluate the use of different Stimulate® growth regulator doses and its constituents separately in the development and flowering of Hippeastrum X hybridum Hort. Cv Orange Souvereign. The experiment was conducted in a Pad & Fan greenhouse at UNESP, São Paulo State, Brazil from August to October 2014. The bulbs were placed in black vases of 1.2 L filled with commercial substrate and divided into 9 treatments: T1 – 10 mL L-1 of Stimulate®, T2 – 5 mL L-1 of Stimulate®, T3 – 0.5 mg L-1 of gibberellic acid (GA), T4 – 0.25 mg L-1 of GA, T5 – 0.45 mg L-1 of kinetin, T6 – 0.9 mg L-1 of kinetin, T7 – 0.5 mg L-1 of indolbutiric acid (IBA), T8 – 0.25 mg L-1 of IBA and T9 – distilled water (control). All treatments were diluted in water. The used design was completely randomized with six repetitions and two vessels, totalling 12 vessels per treatment. The evaluated characteristics were: number of leaves, length of leaf, number of rods, maximum height of rods, maximum diameter of rods, maximum number of flowers, beginning of flowering, flowering duration, and weight of bulbs. The results showed that the Stimulate® was not efficient in the conducted experiment conditions. However, the best treatment was 0.5 mg L-1 of IBA.

Keywords: bulbs, gibberellic acid, indolbutiric acid, kinetin, ornamental plants

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Authors: Mahlet Nigussie Worku

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The main purpose of this study was to examine the effects of different leadership styles on employee engagement in Ethiopian Airlines headquarters located in Addis Ababa. Specific objectives of the study were stated to examine the effects of five leadership styles, namely transformational, transactional, democratic, lassies fair and autocratic leadership styles on employees’ engagement. The study was conducted on 288 sample sizes, and a simple random sampling technique was employed. The quantitative findings were presented and analyzed by table, ANOVA, bivariate correlation and regression model through SPSS software version 23. Out of 288 total distributed questionnaires, 280 were returned, and 8 of the returned were rejected due to missing data, while the remaining 280 responses were used for data analysis. Data was analyzed using the Statistical Package for Social Sciences (SPSS). The study employed both descriptive and explanatory research design. Correlation and regression were used to analyze the relationship and its effect between leadership Style and employee engagement. The regression results showed that transformational, transactional and democratic leadership Styles have significant contributions to employee engagement. Similarly, the transformational, transactional land democratic leadership style had a positive and strong correlation with employee engagement. However, lassies-fair and autocratic leadership styles showed a negative and insignificant effect on employee engagement. Finally, based on the findings, workable recommendations and implications for further studies were forwarded.

Keywords: leadership, autocratic leadership style, democratic leadership style, employee engagement

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Authors: Oriyomi M. Okeyinka, David A. Oloke, Jamal M. Khatib

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Large quantities of solid wastes being generated worldwide from sources such as household, domestic, industrial, commercial and construction demolition activities, leads to environmental concerns. Utilization of these wastes in making building construction materials can reduce the magnitude of the associated problems. When these waste products are used in place of other conventional materials, natural resources and energy are preserved and expensive and/or potentially harmful waste disposal is avoided. Recycling which is regarded as the third most preferred waste disposal option, with its numerous environmental benefits, stand as a viable option to offset the environmental impact associated with the construction industry. This paper reviews the results of laboratory tests and important research findings, and the potential of using these wastes in building construction materials with focus on sustainable development. Research gaps, which includes; the need to develop standard mix design for solid waste based building materials; the need to develop energy efficient method of processing solid waste use in concrete; the need to study the actual behavior or performance of such building materials in practical application and the limited real life application of such building materials have also been identified. Therefore a research is being proposed to develop an environmentally friendly, lightweight building block from recycled waste paper, without the use of cement, and with properties suitable for use as walling unit. This proposed research intends to incorporate, laboratory experimentation and modeling to address the identified research gaps.

Keywords: recycling, solid wastes, construction, building materials

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Authors: Jeremiah Madzimure

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In order to stay competitive in business and improve performance, Small and Medium Enterprises (SMEs) need to make use of business networking and logistics integration. Strategic networking and logistics integration in business companies have become critical as they allow supplier partnering, exchange of vital information/ access to valuable resources allowing innovation, gaining access to additional resources, sharing risks and costs which is required for enhancing company performance. The purpose of this study was to examine the influence of strategic networks and logistics integration on company performance: the case of small and medium enterprises in South Africa. A quantitative research design was adopted in this study, and 137 SMEs owners and managers completed and returned the survey questionnaire. Confirmatory Factor Analysis (CFA) was conducted using the Analysis of Moment Structures (AMOS), version 24.0 to assess psychometric properties of the measurement scales. Path modelling techniques were used to test the proposed hypothesis. Three research hypotheses were postulated. The results indicate that strategic networks had a positive and significant influence on logistics integration and company performance. As well logistics integration had a strong positive and significant influence on company performance. This study provides a useful model for analysing the relationship between strategic networks and logistics integration on company performance. Moreover, the findings of the study provide useful insights into how SMEs should benefit from business networking and logistics integration so as to improve their performance. The implications of the study are discussed, and finally, limitations and recommendations are indicated.

Keywords: strategic networking, logistics integration, company performance, SMEs

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Authors: Aleksandras Velykis, Antanas Satkus

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Clay loam and clay soils are typical for northern Lithuania. These soils are susceptible to physical degradation in the case of intensive use of heavy machinery for field operations. However, clayey soils having poor physical properties by origin require more intensive tillage to maintain proper physical condition for grown crops. Therefore not only choice of suitable tillage system is very important for these soils in the region, but also additional search of other measures is essential for good soil physical state maintenance. Research objective: To evaluate the long-term effects of different intensity tillage as well as its combinations with supplementary agronomic practices on improvement of soil physical conditions and environmental sustainability. The experiment examined the influence of deep and shallow ploughing, ploughless tillage, combinations of ploughless tillage with incorporation of lime sludge and cover crop for green manure and application of the same cover crop for mulch without autumn tillage under spring and winter crop growing conditions on clay loam (27% clay, 50% silt, 23% sand) Endocalcaric Endogleyic Cambisol. Methods: The indicators characterizing the impact of investigated measures were determined using the following methods and devices: Soil dry bulk density – by Eijkelkamp cylinder (100 cm3), soil water content – by weighing, soil structure – by Retsch sieve shaker, aggregate stability – by Eijkelkamp wet sieving apparatus, soil mineral nitrogen – in 1 N KCL extract using colorimetric method. Results: Clay loam soil physical state (dry bulk density, structure, aggregate stability, water content) depends on tillage system and its combination with additional practices used. Application of cover crop winter mulch without tillage in autumn, ploughless tillage and shallow ploughing causes the compaction of bottom (15-25 cm) topsoil layer. However, due to ploughless tillage the soil dry bulk density in subsoil (25-35 cm) layer is less compared to deep ploughing. Soil structure in the upper (0-15 cm) topsoil layer and in the seedbed (0-5 cm), prepared for spring crops is usually worse when applying the ploughless tillage or cover crop mulch without autumn tillage. Application of lime sludge under ploughless tillage conditions helped to avoid the compaction and structure worsening in upper topsoil layer, as well as increase aggregate stability. Application of reduced tillage increased soil water content at upper topsoil layer directly after spring crop sowing. However, due to reduced tillage the water content in all topsoil markedly decreased when droughty periods lasted for a long time. Combination of reduced tillage with cover crop for green manure and winter mulch is significant for preserving the environment. Such application of cover crops reduces the leaching of mineral nitrogen into the deeper soil layers and environmental pollution. This work was supported by the National Science Program ‘The effect of long-term, different-intensity management of resources on the soils of different genesis and on other components of the agro-ecosystems’ [grant number SIT-9/2015] funded by the Research Council of Lithuania.

Keywords: clay loam, endocalcaric endogleyic cambisol, mineral nitrogen, physical state

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Authors: Rania E. Ramadan

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Dental esthetics is subjective, can be reported by the dentist and not noticed by the patient. However, if there is any imperfection seen by both the dentist and the patient, it is considered as an unesthetic like white and/or brown spot lesions. Many patients nowadays have been concerned about dental esthetics. Esthetic rehabilitation of anterior teeth and even maxillary premolars aid a lot in patients’ satisfaction of their smile consequently, gaining positive psychological impact for the patients. Many cases need esthetic rehabilitation such as diastema closure, spaced teeth and masking discolored teeth. Dental fluorosis and enamel hypo calcification can be presented as white and/or brown spot lesions. There are many treatment options for the management of these spotted teeth. Treatment options range from bleaching, microabrasion, direct composite restorations, porcelain veneers, and complete coverage crowns. The selection of certain options depends on many factors: the patient’s age, socioeconomic status and the severity of the lesion. In this clinical report, a 22-year-old male patient has been presented to the Department of Prosthodontics in Alexandria University, Egypt. His chief complaint was, “I was unpleased by white and brown spots in my teeth and I want to close the space between the two maxillary central.” Upon medical history, clinical examination, diagnostic photographs, and digital smile design by Exocad software, lithium disilicate veneers were chosen as the treatment of choice in maxillary anterior and first premolars.

Keywords: flourosis, ceramic veneers, case report, diastema closure

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Authors: Ferit Çakıcı, M. Kemal Leblebicioğlu

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In this study, characteristics and flight test analysis of a fixed-wing unmanned aerial vehicle (UAV) with hover capability is analyzed. The base platform is chosen as a conventional airplane with throttle, ailerons, elevator and rudder control surfaces, that inherently allows level flight. Then this aircraft is mechanically modified by the integration of vertical propellers as in multi rotors in order to provide hover capability. The aircraft is modeled using basic aerodynamical principles and linear models are constructed utilizing small perturbation theory for trim conditions. Flight characteristics are analyzed by benefiting from linear control theory’s state space approach. Distinctive features of the aircraft are discussed based on analysis results with comparison to conventional aircraft platform types. A hybrid control system is proposed in order to reveal unique flight characteristics. The main approach includes design of different controllers for different modes of operation and a hand-over logic that makes flight in an enlarged flight envelope viable. Simulation tests are performed on mathematical models that verify asserted algorithms. Flight tests conducted in real world revealed the applicability of the proposed methods in exploiting fixed-wing and rotary wing characteristics of the aircraft, which provide agility, survivability and functionality.

Keywords: flight test, flight characteristics, hybrid aircraft, unmanned aerial vehicle

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Authors: A. Khodabakhshi, A. Mortazavi

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Accurate determination of rock mass deformation modulus, as an important design parameter, is one of the most controversial issues in most engineering projects. A 3D numerical model of standard plate load test (PLT) using the FLAC3D code was carried to investigate the mechanism governing the test process. Five objectives were the focus of this study. The first goal was to employ 3D modeling in the interpretation of PLT conducted at the Bazoft dam site, Iran. The second objective was to investigate the effect of displacements measuring depth from the loading plates on the calculated moduli. The magnitude of rock mass deformation modulus calculated from PLT depends on anchor depth, and in practice, this may be a cause of error in the selection of realistic deformation modulus for the rock mass. The third goal of the study was to investigate the effect of testing plate diameter on the calculated modulus. Moreover, a comparison of the calculated modulus from ISRM formula, numerical modeling and calculated modulus from the actual PLT carried out at right abutment of the Bazoft dam site was another objective of the study. Finally, the effect of plastic strains on the calculated moduli in each of the loading-unloading cycles for three loading plates was investigated. The geometry, material properties, and boundary conditions on the constructed 3D model were selected based on the in-situ conditions of PLT at Bazoft dam site. A good agreement was achieved between numerical model results and the field tests results.

Keywords: deformation modulus, numerical model, plate loading test, rock mass

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Authors: Tzyy-Rong Jinn, Sheng-Kuo Hsieh, Yi-Ching Chung, Feng-Chia Hsieh

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In this study, we attempted to develop a recombinant oleosin-based fusion expression strategy in Escherichia coli (E. coli) and coupled with the artificial oil bodies (AOB)-cyanogen bromide technology platform to produce bioactive mastoparan B (MP-B). As reported, the oleosin in AOB system plays a carrier (fusion with target protein), since oleosin possess two amphipathic regions (at the N-terminus and C-terminus), which result in the N-terminus and C-terminus of oleosin could be arranged on the surface of AOB. Thus, the target protein fused to the N-terminus or C-terminus of oleosin which also is exposed on the surface of AOB, and this process will greatly facilitate the subsequent separation and purification of target protein from AOB. In addition, oleosin, a unique structural protein of seed oil bodies, has the added advantage of helping the fused MP-B expressed in inclusion bodies, which can protect from proteolytic degradation. In this work, MP-B was fused to the C-terminus of oleosin and then was expressed in E. coli as an insoluble recombinant protein. As a consequence, we successfully developed a reliable recombinant oleosin-based fusion expression strategy in Escherichia coli and coupled with the artificial oil bodies (AOB)-cyanogen bromide technology platform to produce the small peptide, MP-B. Take together, this platform provides an insight into the production of active MP-B, which will facilitate studies and applications of this peptide in the future.

Keywords: artificial oil bodies, Escherichia coli, Oleosin-fusion protein, Mastoparan-B

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Authors: Farhan E Shafrin, Khandaker Shabbir Ahmed

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Natural ventilation strategies continue to be a key alternative to costly mechanical ventilation systems, especially in healthcare facilities, due to increasing energy issues in developing countries, including Bangladesh. Besides, overcrowding and insufficient ventilation strategies remain significant causes of thermal discomfort and hospital infection in Bangladesh. With the proper location of inlet and outlet windows, uniform flow is possible in the occupancy area to achieve thermal comfort. It also determines the airflow pattern of the ward that decreases the movement of the contaminated air. This paper aims to establish a relationship between the location of the windows and the thermal comfort of the occupants in a naturally ventilated hospital ward. It defines the openings and ventilation variables that are interrelated in a way that enhances or limits the health and thermal comfort of occupants. The study conducts a full-scale experiment in one of the naturally ventilated wards in a primary health care hospital in Manikganj, Dhaka. CFD simulation is used to explore the performance of various opening positions in ventilation efficiency and thermal comfort in the study area. The results indicate that the opening located in the hospital ward has a significant impact on the thermal comfort of the occupants and the airflow pattern inside the ward. The findings can contribute to design the naturally ventilated hospital wards by identifying and predicting future solutions when it comes to relationships with the occupants' thermal comforts.

Keywords: CFD simulation, hospital ward, natural ventilation, thermal comfort, window location

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Authors: Pitigalage Chamath Chandira Peiris

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A widely researched domain in the field of image processing in recent times has been single image super-resolution, which tries to restore a high-resolution image from a single low-resolution image. Many more single image super-resolution efforts have been completed utilizing equally traditional and deep learning methodologies, as well as a variety of other methodologies. Deep learning-based super-resolution methods, in particular, have received significant interest. As of now, the most advanced image restoration approaches are based on convolutional neural networks; nevertheless, only a few efforts have been performed using Transformers, which have demonstrated excellent performance on high-level vision tasks. The effectiveness of CNN-based algorithms in image super-resolution has been impressive. However, these methods cannot completely capture the non-local features of the data. Enhancer is a simple yet powerful Transformer-based approach for enhancing the resolution of images. A method for single image super-resolution was developed in this study, which utilized an efficient and effective transformer design. This proposed architecture makes use of a locally enhanced window transformer block to alleviate the enormous computational load associated with non-overlapping window-based self-attention. Additionally, it incorporates depth-wise convolution in the feed-forward network to enhance its ability to capture local context. This study is assessed by comparing the results obtained for popular datasets to those obtained by other techniques in the domain.

Keywords: single image super resolution, computer vision, vision transformers, image restoration

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Authors: Sayed Ahmed El Sayed, Osama M. Mesalhy, Mohamed A. Abdelatief

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A numerical study has been conducted to clarify fluid flow characteristics, pressure distributions, and skin friction coefficient over a wing-shaped tubes bundle in staggered arrangement with the placement of longitudinal fins (LF) at downstream position of the tube. The air-side Rea were at 1.8 x 103 to 9.7 x 103. The tubes bundle were employed with various fin height [hf] and fin thickness (δ) from (2 mm ≤ hf ≤ 12 mm) and (1.5 mm ≤ δ ≤ 3.5 mm) respectively at the considered Rea range. The flow pattern around the staggered wing-shaped tubes bundle was predicted using the commercial CFD FLUENT 6.3.26 software package. The distribution of average skin friction coefficient around wing-shaped tubes bundle is studied. Correlation of pressure drop coefficient Pdc and skin friction coefficient (Cf) in terms of Rea, design parameters for the studied cases were presented. Results indicated that the values of Pdc for hf = 6 mm are lower than these of NOF and hf = 2 mm by about 11 % and 13 % respectively for considered Rea range. Cf decreases as Rea increases. LFTH with hf = 6 mm offers lower form drag than that with hf = 12 mm and that of NOF. The lowest values of the pumping power are achieved for arrangements of hf = 6 mm for the considered Rea range. δ has negligible effect on skin friction coefficient, while has a slightly variation in ∆Pa. The wing-shaped tubes bundle heat exchanger with hf = 6 mm has the lowest values of ∆Pa, Pdc, Cf, and pumping power and hence the best performance comparing with the other bundles. Comparisons between the experimental and numerical results of the present study and those obtained by similar previous studies showed good agreements.

Keywords: longitudinal fins, skin friction, flow characteristics, FLUENT, wing-shaped tubes

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Authors: Margareth S. Zanchetta, Kateryna Metersky, Valerie Tan, Charissa Cordon, Stephanie Lucchese, Yana Siganevich, Prasha Sivasundaram, Truong Binh Nguyen, Imran Qureshi

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Due to a new area of practice, Canadian nurses possess knowledge gaps regarding the use of cannabis-based therapies by clients/patients. Education related to medical cannabis (MC) and recreational cannabis (RC) is required to promote nurses’ competency and confidence in supporting clients/patients using MC/RC toward the improvement of health outcomes. A team composed of nursing researchers and undergraduate/graduate students implemented a national survey to explore this theme with the population of undergraduate, graduate (MN and NP), and Post-Diploma (RN Bridging) nursing students enrolled in Canadian Universities Nursing Programs. Upon Research Ethics Board approval, survey recruitment was supported by major nursing stakeholders. The research questions were : (a) Which are the most preferred sources of information on MC/RC for nursing students? (b) Which are the factors and preferred learning modalities that could increase interest in learning about MC/RC, and (c) What are the future career plans among nursing students, and how would they consider the prospective use of cannabis in their practice? The survey was available from Sept. 2022 to Feb. 2023, hosted by a remote platform. An original questionnaire (English-French) was composed of 18 multiple choice questions and 2 open-ended questions. Sociodemographic information and closed-ended responses were compiled as descriptive statistics, while narrative accounts will be analysed through thematic analysis. Respondents (n=153) were from 7 Canadian provinces, national (99%) and international students (1%); the majority of respondents (61%) were in the age range of 21-30 years old. Results indicated that respondents perceive a gap in the undergraduate curriculum on the topics of MC/RC (91%) and that their learning needs include regulations (90%), data on effectiveness (88%), dosing best practices (86%), contraindications (83%), and clinical and medical indications (76%). Respondents reported motivation to learn more about MC/RC through online lectures/videos (65%), e-learning modules or online interactive training (61%), workshops (51%), webinars (36%), and social media (35%). Their primary career-related motivations regarding MC/RC knowledge include enhancing nursing practice (76%), learning about this growing scope of practice (61%), keeping up-to-date responding to scientific curiosity (59%), learning about evidence-based practice (59%), and utilizing alternative forms of medical treatment (37%). Respondents indicated that the integration of topics on cannabis in any course in the undergraduate and/or graduate curriculum would increase their desire to learn about MC/RC as equally as exposure within a clinical setting (75%). The emerging trend in the set of narrative responses (n=130) suggests that respondents believe educational MC/RC content should be integrated into core nursing courses. Respondents also urged educators to be well-informed about evidence-based practice related to MC/RC and to reflect upon stigma and biases surrounding its use. Future knowledge dissemination and translation activities include scholarly products and presentations to stimulate discussion amongst nursing faculty and students, as well as nurses in clinical settings. The goal is to mobilise talents and build collaboration for the development of a socially responsive curriculum on MC/RC competency to address the education-related expectations of all these social actors.

Keywords: Canada, medical cannabis, nursing education, nursing graduate student, nursing undergraduate student, online survey, recreational cannabis

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Authors: Lamia Bouzgarrou, Irtyah Merchaoui, Amira Omrane, Salma Kammoun, Amine Daafa, Neila Chaari

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Backgrounds: Currently, low back pain (LBP) is one of the most prevalent public health problems, which caused severe morbidity among a large portion of the adult population. It is also associated with heavy direct and indirect costs, in particular, related to absenteeism and early retirement. Health care workers are one of most occupational groups concerned by LBP, especially because of biomechanical and psycho-organizational risk factors. Our current study aims to investigate risk factors associated with chronic low back pain among Tunisian caregivers in university-hospitals. Methods: Cross-sectional study conducted over a period of 14 months, with a representative sample of caregivers, matched according to age, sex and work department, in two university-hospitals in Tunisia. Data collection included items related to socio-professional characteristics, the evaluation of the working capacity index (WAI), the occupational stress (Karazek job strain questionnaire); the quality of life (SF12), the musculoskeletal disorders Nordic questionnaire, and the examination of the spine flexibility (distance finger-ground, sit-stand maneuver and equilibrium test). Results: Totally, 293 caregivers were included with a mean age equal to 42.64 ± 11.65 years. A body mass index (BMI) exceeding 30, was noted in 20.82% of cases. Moreover, no regular physical activity was practiced in 51.9% of cases. In contrast, domestic activity equal or exceeding 20 hours per week, was reported by 38.22%. Job strain was noted in 19.79 % of cases and the work capacity was 'low' to 'average' among 27.64% of subjects. During the 12 months previous to the investigation, 65% of caregivers complained of LBP, with pain rated as 'severe' or 'extremely severe' in 54.4% of cases and with a frequency of discomfort exceeding one episode per week in 58.52% of cases. During physical examination, the mean distance finger-ground was 7.10 ± 7.5cm. Caregivers assigned to 'high workload' services had the highest prevalence of LBP (77.4%) compared to other categories of hospital services, with no statistically significant relationship (P = 0.125). LBP prevalence was statistically correlated with female gender (p = 0.01) and impaired work capacity (p < 10⁻³). Moreover, the increase of the distance finger-ground was statistically associated with LBP (p = 0.05), advanced age (p < 10⁻³), professional seniority (p < 10⁻³) and the BMI ≥ 25 (p = 0.001). Furthermore, others physical tests of spine flexibility were underperformed among LBP suffering workers with a statistically significant difference (sit-stand maneuver (p = 0.03); equilibrium test (p = 0.01)). According to the multivariate analysis, only the domestic activity exceeding 20H/week, the degraded quality of physical life, and the presence of neck pain were significantly corelated to LBP. The final model explains 36.7% of the variability of this complaint. Conclusion: Our results highlighted the elevate prevalence of LBP among caregivers in Tunisian public hospital and identified both professional and individual predisposing factors. The preliminary analysis supports the necessity of a multidimensional approach to prevent this critical occupational and public health problem. The preventive strategy should be based both on the improvement of working conditions, and also on lifestyle modifications, and reinforcement of healthy behaviors in these active populations.

Keywords: health care workers, low back pain, prevention, risk factor

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