Search results for: Occupational safety

Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

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Authors: Manoj Sarda, Abhishek Agarwal, Juhi Kaushik, Vatsal Sanjay, Arup Kumar Das

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Railways in India remain primary mode of transport having one of the largest networks in the world and catering to billions of transits yearly. Catastrophic economic damage and loss to life is encountered over the past few decades due to fire to locomotives. Study of fire dynamics and fire propagation plays an important role in evacuation planning and reducing losses. Simulation based study of propagation of fire and soot inside an air conditioned coach of Indian locomotive is done in this paper. Finite difference based solver, Fire Dynamic Simulator (FDS) version 6 has been used for analysis. A single air conditioned 3 tier coupe closed to ambient surroundings by glass windows having occupancy for 8 people is the basic unit of the domain. A system of three such coupes combined is taken to be fundamental unit for the entire study to resemble effect to an entire coach. Analysis of flame and soot contours and concentrations is done corresponding to variations in heat release rate per unit volume (HRRPUA) of fire source, variations in conditioned air velocity being circulated inside coupes by vents and an alternate fire initiation and propagation mechanism via ducts. Quantitative results of fractional area in top and front view of the three coupes under fire and smoke are obtained using MATLAB (IMT). Present simulations and its findings will be useful for organizations like Commission of Railway Safety and others in designing and implementing safety and evacuation measures.

Keywords: air conditioned coaches, fire propagation, flame contour, soot flow, train fire

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Authors: A. Robak, M. Pieńko, E. Błazik-Borowa, J. Bęc, I. Szer

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The analyzes and classifications presented in the article were based on the research carried out in year 2016 and 2017 on a group of nearly one hundred scaffoldings assembled and used on construction sites in different parts of Poland. During scaffolding selection process efforts were made to maintain diversification in terms of parameters such as scaffolding size, investment size, type of investment, location and nature of conducted works. This resulted in the research being carried out on scaffoldings used for church renovation in a small town or attached to the facades of classic apartment blocks, as well as on scaffoldings used during construction of skyscrapers or facilities of the largest power plants. This variety allows to formulate general conclusions about the technical condition of used frame scaffoldings. Exploitation damages of the frame scaffolding elements were divided into three groups. The first group includes damages to the main structural components, which reduce the strength of the scaffolding elements and hence the whole structure. The qualitative analysis of these damages was made on the basis of numerical models that take into account the geometry of the damage and on the basis of computational nonlinear static analyzes. The second group focuses on exploitation damages such as the lack of a pin on the guardrail bolt which may cause an imminent threat to people using scaffolding. These are local damages that do not affect the bearing capacity and stability of the whole structure but are very important for safe use. The last group consider damages that reduce only aesthetic values and do not have direct impact on bearing capacity and safety of use. Apart from qualitative analyzes the article will present quantitative analyzes showing how frequently given type of damage occurs.

Keywords: scaffolding, damage, safety, numerical analysis

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Authors: Mark McGuire, Eric Shannon, John Parmigiani

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Timber harvesting increasingly involves mechanized equipment. This has increased the efficiency of harvesting, but has also introduced worker-safety concerns. One such concern arises from the use of harvesters. During operation, harvesters subject saw chain to large dynamic mechanical stresses. These stresses can, under certain conditions, cause the saw chain to fracture. The high speed of harvester saw chain can cause the resulting open chain loop to fracture a second time due to the dynamic loads placed upon it as it travels through space. If a second fracture occurs, it can result in a projectile consisting of one-to-several chain links. This projectile is referred to as a chain shot. It has speeds similar to a bullet but typically has greater mass and is a significant safety concern. Numerous examples exist of chain shots penetrating bullet-proof barriers and causing severe injury and death. Improved harvester-cab barriers can help prevent injury however a comprehensive scientific understanding of chain shot is required to consistently reduce or prevent it. Obtaining this understanding requires a test machine with the capability to cause chain shot to occur under carefully controlled conditions and accurately measure the response. Worldwide few such test machine exist. Those that do focus on validating the ability of barriers to withstand a chain shot impact rather than obtaining a scientific understanding of the chain shot event itself. The purpose of this paper is to describe the design, fabrication, and use of a test machine capable of a comprehensive scientific investigation of chain shot. The capabilities of this machine are to test all commercially-available saw chains and bars at chain tensions and speeds meeting and exceeding those typically encountered in harvester use and accurately measure the corresponding key technical parameters. The test machine was constructed inside of a standard shipping container. This provides space for both an operator station and a test chamber. In order to contain the chain shot under any possible test conditions, the test chamber was lined with a base layer of AR500 steel followed by an overlay of HDPE. To accommodate varying bar orientations and fracture-initiation sites, the entire saw chain drive unit and bar mounting system is modular and capable of being located anywhere in the test chamber. The drive unit consists of a high-speed electric motor with a flywheel. Standard Ponsse harvester head components are used to bar mounting and chain tensioning. Chain lubrication is provided by a separate peristaltic pump. Chain fracture is initiated through ISO standard 11837. Measure parameters include shaft speed, motor vibration, bearing temperatures, motor temperature, motor current draw, hydraulic fluid pressure, chain force at fracture, and high-speed camera images. Results show that the machine is capable of consistently causing chain shot. Measurement output shows fracture location and the force associated with fracture as a function of saw chain speed and tension. Use of this machine will result in a scientific understanding of chain shot and consequently improved products and greater harvester operator safety.

Keywords: chain shot, safety, testing, timber harvesters

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Authors: Sujith Gunawardhana

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The circular economy is a system in which resources and energy are derived from renewable sources, utilized efficiently, recycled, and reused to reduce waste, reduce nonrenewable resource consumption, and mitigate negative environmental impacts. However, it poses moral questions about sustainability, the environment, and societal issues. Many societies face challenges when implementing the circular economy, as the concept is still young. The equitable distribution of the advantages and costs of circularity should be ensured during implementation, as some communities, particularly disadvantaged or marginalized ones, may suffer unfairly disproportionately from the harmful effects of production and recycling facilities. Prioritizing the health and safety of workers, communities, and the environment is essential, and strict rules must be implemented to guard against harm. However, most underdeveloped countries need a legal safeguard for this situation. The ultimate objective of the circular economy is to improve social, environmental, and economic performance, but its implementation also requires consideration of the ethics of care and non-epistemic values. Those are often hindered in underdeveloped countries, as the availability of infrastructure and technology, affordability, and legislative framework are poor. To achieve long-term success in the circular economy, evaluating implementation steps and considering health, safety, environmental, and social risks is crucial. To implement the circular economy, respect ethics of care and non-epistemic values. Adopt Kantian Ethics and control technology design to ensure equal benefits for all involved. Ethical gaps may lead underdeveloped countries to generate social pressure against the circular economy.

Keywords: circular economy, ethics, values, sustainability

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Authors: Shinhao Yang, Hsiao-Chien Huang, Chin-Hsiang Luo

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The leakage of protective clothing is an important issue in the occupational health field. There is no quantitative method for measuring the leakage of personal protective equipment. This work aims to measure the quantitative leakage of the personal protective equipment by using the fluorochrome aerosol tracer. The fluorescent aerosols were employed as airborne particulates in a controlled chamber with ultraviolet (UV) light-detectable stickers. After an exposure-and-leakage test, the protective equipment was removed and photographed with UV-scanning to evaluate areas, color depth ratio, and aerosol deposition and shielding effects of the areas where fluorescent aerosols had adhered to the body through the protective equipment. Thus, this work built a calculation software for quantitative leakage ratio of protective clothing based on fluorescent illumination depth/aerosol concentration ratio, illumination/Fa ratio, aerosol deposition and shielding effects, and the leakage area ratio on the segmentation. The results indicated that the two-repetition total leakage rate of the X, Y, and Z type protective clothing for subject T were about 3.05, 4.21, and 3.52 (mg/m2). For five-repetition, the leakage rate of T were about 4.12, 4.52, and 5.11 (mg/m2).

Keywords: fluorochrome, deposition, shielding effects, digital image processing, leakage ratio, personal protective equipment

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Authors: Jeffrey Ho, Scott Joing, Paul Nystrom, William Heegaard, Danielle Hart, David Plummer, James Miner

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Body-Worn Cameras (BWCs) are used in public safety to record encounters. They are shown to enhance the accuracy of documentation in virtually every situation. They are not widely used in medical encounters in part because of concern for patient acceptance. The goal of this pilot study was to determine if BWC use is acceptable to the patient. This was a prospective, observational study of the AXON Flex BWC (TASER International, Scottsdale, AZ) conducted at an urban, Level 1 Trauma Center Emergency Department (ED). The BWC was worn by Emergency Physicians (EPs) on their shifts during a 30-day period. The BWC was worn at eye-level mounted on a pair of clear safety glasses. Patients seen by the EP were enrolled in the study by a trained research associate. Patients who were <18 years old, who were with other people in the exam room, did not speak English, were critically ill, had chief complaints involving genitalia or sexual assault, were considered to be vulnerable adults, or with an altered mental status were excluded. Consented patients were given a survey after the encounter to determine their perception of the BWC. The questions asked involved the patients’ perceptions of a BWC being present during their interaction with their EP. Data were analyzed with descriptive statistics. There were 417 patients enrolled in the study. 3/417 (0.7%) patients were intimidated by the BWC, 1/417 (0.2%) was nervous because of the BWC, 0/417 (0%) were inhibited from telling the EP certain things because of the BWC, 57/417 (13.7%) patients did not notice the device, and 305/417 (73.1%) patients were had a favorable perception about the BWC being used during their encounter. The use of BWCs appears feasible in the ED, with largely favorable perceptions and acceptance of the device by the patients. Further study is needed to determine the best use and practices of BWCs during ED patient encounters.

Keywords: body-worn camera, documentation, patient satisfaction, video

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Authors: Goran Baloevic, Jure Radnic, Nikola Grgic

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The application of frames with masonry or panel infill is common in the engineering practice. In these cases, a frame is often considered to be a primary structure, while an infill is considered to be a secondary structure. In past calculations, the infill was rarely included in the design of frame structures in terms of their bearing capacity and safety. Recent calculations of such structures necessarily include the effect of infill since it contributes to stiffness and bearing capacity of overall system, especially under horizontal loads. In certain cases, if the infill is not included in the seismic design of frame structures, the result can be lower design safety. However, since the different configuration of the infill through the building’s height can be made, it is possible that contribution of such infill to the overall bearing capacity can be lower and seismic forces on the building can be increased due to greater stiffness of the structure. So far, many experimental and numerical researches on the behavior of infilled frames under horizontal static forces and earthquake have been performed. In this paper, several masonry-infilled concrete and steel frames under horizontal static forces and earthquake are analysed. The experimental results by shake-table and numerical results are compared in terms of the bearing capacity of bare and infilled frames. Herein, the stiffness of frames and infill were varied, with different position of the infill and different types of openings. Cases with positive and negative effects of the infill to the bearing capacity of the frames were considered. Finally, main conclusions and recommendations for practical application and design of masonry-infilled concrete and steel frames are given.

Keywords: bearing capacity, infilled frame, numerical model, shake table

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Authors: Ema Vitória Fonseca Lavrador

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In this work, we intend to explore the impact that the film "Lightyear" (2022) had on the social context of its production, distribution, and reception. This film, produced by Walt Disney Animation Studios and Pixar Animation Studios, depicts the story of Buzz Lightyear, a Space Ranger from which the character of the same name in the "Toy Story" film franchise is based. This prequel was predicted to be the blockbuster of the year, but it was a financial fiasco and the subject of numerous controversies, which also caused it to be drowned out by the film "Minions: The Rise of Gru" (2022). The reason for its failure is not based on the film's narrative or quality but on its controversial context for being a commitment to LGBTQIA+ representation in an unexpected way, by featuring a same-sex couple and showing a kiss shared by them. This representation cost Disney distribution in countries against LGBTQIA+ representation in media and involved Disney in major disagreements with fans and politicians, especially for being a direct opposition to the Florida House Bill 1557, also called the “Don't Say Gay” bill. Many major companies have taken a stand against this law because it jeopardizes the safety of the LGBTQIA+ community, and, although Disney initially cut the kiss off the film, pressure from the staff and audience resulted in unprecedented progress. For featuring a brief homosexual kiss, its exhibition was banned in several countries and discouraged by the same public that was previously the focus of Disney's attention, as this is a conservative “family-friendly” branded company. We believe it is relevant to study the case of "Lightyear" because it is a work that raises awareness and promotes representation of communities affected during the dark times while less legislation is being approved to protect the rights and safety of queer people.

Keywords: Don’t Say Gay” bill, gender stereotypes, LGBTQIA+ representation, lightyear, Disney/Pixar

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Authors: Byung Keun Yang, Jae Eun Ku, Young Seon Joo, Je Sung You, Sung Phil Chung, Hahn Shick Lee

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The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication. PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs. 11 days) in case of delayed extracorporeal therapy. Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

Keywords: carnitine, overdose, poisoning, renal dialysis, valproic acid

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Authors: Kumari Kajal, Muthu Kumar Sampath, Hare Ram Singh

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In this context, the formulation and characterization of collagen silver lipid nanoparticles (CSLNs) were studied for their capacity to serve as fillers/matrix materials used in cosmeceutical applications. The CSLNs were prepared following a series of studies, such as X-ray diffraction (XRD), field-emission scanning electron microscopy (FESEM) coupled with energy-dispersive X-ray spectroscopy (EDS), Fourier-transform infrared spectroscopy FT-IR; thermogravimetric analysis (TGA); and differential scanning calorimetry (DSC). The studies confirmed the structural integrity of nanoparticles, their cargo and thermal stability. The biological functionality of CSLNs was studied by carrying out in vitro & in vivo studies. The antibacterial effect, hemocompatibility and anti-inflammatory characteristics of these fibers were systematically investigated. The toxicological assays included oral toxicity in mice and aquatic life tests with the fish Danio rerio model. The morphology of the nanoparticles was confirmed using high-resolution transmission electron microscopy (HR-TEM). The report found that CSLNs had strong antimicrobial effects, unmatched hemocompatibility, and low or absent inflammatory reactions, which makes them perfect candidates for cosmeceutical applications. The toxicological evaluations evinced a good safety record without any significant adverse effects in both murine and Danio rerio models. This research reveals the efficient way of CSLNs to the efficacy and safety of dermaceuticals.

Keywords: collagen silver lipid nanoparticles (CSLNs), cosmeceuticals, antimicrobial activity, hemocompatibility, in vitro assessment, in vivo assessment.

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Authors: Raad Nari, Maura Moriaty, Maha T. Barakat

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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.

Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection

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Authors: Sudhir Kumar Singh, Debashish Chakravarty

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Slope stability analysis is an important aspect in the field of geotechnical engineering. It is also important from safety, and economic point of view as any slope failure leads to loss of valuable lives and damage to property worth millions. This paper aims at mitigating the risk of slope failure by studying the effect of different joint sets on the stability of mine pit slopes under the influence of various external factors, namely degree of saturation, rainfall intensity, and seismic coefficients. Supervised machine learning approach has been utilized for making accurate and reliable predictions regarding the stability of slopes based on the value of Factor of Safety. Numerous cases have been studied for analyzing the stability of slopes using the popular Finite Element Method, and the data thus obtained has been used as training data for the supervised machine learning models. The input data has been trained on different supervised machine learning models, namely Random Forest, Decision Tree, Support vector Machine, and XGBoost. Distinct test data that is not present in training data has been used for measuring the performance and accuracy of different models. Although all models have performed well on the test dataset but Random Forest stands out from others due to its high accuracy of greater than 95%, thus helping us by providing a valuable tool at our disposition which is neither computationally expensive nor time consuming and in good accordance with the numerical analysis result.

Keywords: finite element method, geotechnical engineering, machine learning, slope stability

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Authors: Dorota Kobus-Ostrowska

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Work for everyone, especially for person with disability is a condition in independence; it secures basic needs and develops manual and intellectual capabilities. The work is a source of income, and it builds and strengthens of self-esteem and competence. The purpose of this article is to identify work as an important factor in everyone’s life, despite Polish disabled persons rarely having the chance to undertake a job. In order to achieve this purpose, two methods were used: comparative and qualitative. The theoretical part of this article is based on studies of a wide range of Polish and foreign literature devoted to the issue of the occupational development of people with disabilities. The article was also enriched with the institutional and legal analysis types of support for people with disabilities in Poland. Currently, a Polish person with disability who wants to enter or return to the labor market is under a special protection. Those entities employing workers with disabilities may obtain a subsidy for the salary of a person with disabilities. Unfortunately, people with disability in Poland rarely participate in the workforce. The factors that contribute to this include the difficulty in obtaining work, the uncertainty of keeping it, and the low salary offered. Despite that domestic and foreign literature highlight the important role of disabled people as a workforce, very few people with disability in Poland are economically active.

Keywords: disabled person, employer, rehabilitation, work

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Authors: A. Sekhar, N. Ramakrishna Raju

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This paper is a result of ground improvement using deep vibro techniques with combination of sand and stone columns performed on a highly liquefaction susceptible site (70 to 80% sand strata and balance silt) with low bearing capacities due to high settlements located (earth quake zone V as per IS code) at Madhepura, Bihar state in northern part of India. Initially, it was envisaged with bored cast in-situ/precast piles, stone/sand columns. However, after detail analysis to address both liquefaction and improve bearing capacities simultaneously, it was analyzed the deep vibro techniques with combination of sand and stone columns is excellent solution for given site condition which may be first time in India. First after detail soil investigation, pre eCPT test was conducted to evaluate the potential depth of liquefaction to densify silty sandy soils to improve factor of safety against liquefaction. Then trail test were being carried out at site by deep vibro compaction technique with sand and stone columns combination with different spacings of columns in triangular shape with different timings during each lift of vibro up to ground level. Different spacings and timing was done to obtain the most effective spacing and timing with vibro compaction technique to achieve maximum densification of saturated loose silty sandy soils uniformly for complete treated area. Then again, post eCPT test and plate load tests were conducted at all trail locations of different spacings and timing of sand and stone columns to evaluate the best results for obtaining the required factor of safety against liquefaction and the desired bearing capacities with reduced settlements for construction of industrial structures. After reviewing these results, it was noticed that the ground layers are densified more than the expected with improved factor of safety against liquefaction and achieved good bearing capacities for a given settlements as per IS codal provisions. It was also worked out for cost-effectiveness of lightly loaded single storied structures by using deep vibro technique with sand column avoiding stone. The results were observed satisfactory for resting the lightly loaded foundations. In this technique, the most important is to mitigating liquefaction with improved bearing capacities and reduced settlements to acceptable limits as per IS: 1904-1986 simultaneously up to a depth of 19M. To our best knowledge it was executed first time in India.

Keywords: ground improvement, deep vibro techniques, liquefaction, bearing capacity, settlement

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Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

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Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

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Authors: Lian Zeng

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Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.

Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma

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Authors: Anam Layla, Qamar Abbas Syed, Tahir Zahoor, Muhammad Shahid

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Brassicaceae sprouts are promising candidates for functional food because of their unique phytochemistry and high nutrient density compared to their seeds and matured vegetables. Despite being admired for their health-promoting properties, white cabbage sprouts have been least explored for their nutritional significance and behavior to lactic acid fermentation. This study aimed to investigate the role of lactic acid fermentation i.e., inoculum vs. spontaneous, in reducing intrinsic toxicants load and improving nutrients delivering potential of the white cabbage sprouts. White cabbage sprouts with a 5 – 7 cm average size were processed as raw, blanched, Lactiplantibacillus plantarum inoculated fermentation and spontaneous fermentation. Plant material was dehydrated at 40˚C and evaluated for microbiological quality, macronutrients, minerals, and anti-nutrient contents. The results indicate L. plantarum inoculum fermentation of blanched cabbage sprouts (IF-BCS) to increase lactic acid bacteria count of the sprouts from 0.97 to 8.47 log CFU/g. Compared with the raw cabbage sprouts (RCS), inoculum fermented-raw cabbage sprouts (IF-RCS), and spontaneous fermented-raw cabbage sprouts (SF-RCS), the highest content of Ca (447 mg/ 100g d.w.), Mg (204 mg/100g d.w.), Fe (9.3 mg/100g d.w.), Zn (5 mg/100g d.w.) and Cu (0.5 mg/100g d.w.) were recorded in IF-BCS. L. plantarum led fermentation of BCS demonstrated a reduction in phytates, tannins, and oxalates contents at a rate of 42%, 66%, and 53%, respectively, while standalone lactic acid fermentation of the raw sprouts reduced the burden of anti-nutrients in a range between 32 to 56%. The results suggest L. plantarum led lactic acid fermentation coupled with sprouts blanching is the most promising way to improve the nutritional quality and safety of the white cabbage sprouts.

Keywords: lactic acid fermentation, anti-nutrients, mineral content, nutritional quality

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Authors: Kevin Giraldo, Juan A. Gallego, Uriel Zapata, Fanny L. Casado

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Compliant mechanisms are designed to deform in a controlled manner in response to external forces, utilizing the flexibility of their components to store potential elastic energy during deformation, gradually releasing it upon returning to its original form. This article explores the design of a knee orthosis intended to assist users during stand-up motion. The orthosis makes use of a compliant mechanism to balance the user’s weight, thereby minimizing the strain on leg muscles during standup motion. The primary function of the compliant mechanism is to store and exchange potential energy, so when coupled with the gravitational potential of the user, the total potential energy variation is minimized. The design process for the semi-rigid knee orthosis involved material selection and the development of a numerical model for the compliant mechanism seen as a spring. Geometric properties are obtained through the numerical modeling of the spring once the desired stiffness and safety factor values have been attained. Subsequently, a 3D finite element analysis was conducted. The study demonstrates a strong correlation between the maximum stress in the mathematical model (250.22 MPa) and the simulation (239.8 MPa), with a 4.16% error. Both analyses safety factors: 1.02 for the mathematical approach and 1.1 for the simulation, with a consistent 7.84% margin of error. The spring’s stiffness, calculated at 90.82 Nm/rad analytically and 85.71 Nm/rad in the simulation, exhibits a 5.62% difference. These results suggest significant potential for the proposed device in assisting patients with knee orthopedic restrictions, contributing to ongoing efforts in advancing the understanding and treatment of knee osteoarthritis.

Keywords: biomechanics, complaint mechanisms, gonarthrosis, orthoses

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Authors: Margarida Porfírio Tomás, Paula Pereira, José Manuel Palma Oliveira

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The decline in employment rates across sectors like industry and construction is exacerbated by an aging workforce. This has far-reaching implications for the economy, including skills gaps, labour shortages, productivity challenges due to physical limitations, and workplace safety concerns. To sustain the workforce and pension systems, technology plays a pivotal role. Robots provide valuable support to human workers, and effective human-robot interaction is essential. FORTIS, a Horizon project, aims to address these challenges by creating a comprehensive Human-Robot Interaction (HRI) solution. This solution focuses on multi-modal communication and multi-aspect interaction, with a primary goal of maintaining a human-centric approach. By meeting the needs of both human workers and robots, FORTIS aims to facilitate efficient and safe collaboration. The project encompasses three key activities: 1) A Human-Centric Approach involving data collection, annotation, understanding human behavioural cognition, and contextual human-robot information exchange. 2) A Robotic-Centric Focus addressing the unique requirements of robots during the perception and evaluation of human behaviour. 3) Ensuring Human-Robot Trustworthiness through measures such as human-robot digital twins, safety protocols, and resource allocation. Factor Social, a project partner, will analyse psycho-physiological signals that influence human factors, particularly in hazardous working conditions. The analysis will be conducted using a combination of case studies, structured interviews, questionnaires, and a comprehensive literature review. However, the adoption of novel technologies, particularly those involving human-robot interaction, often faces hurdles related to acceptance. To address this challenge, FORTIS will draw upon insights from Social Sciences and Humanities (SSH), including risk perception and technology acceptance models. Throughout its lifecycle, FORTIS will uphold a human-centric approach, leveraging SSH methodologies to inform the design and development of solutions. This project received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No 101135707 (FORTIS).

Keywords: skills gaps, productivity challenges, workplace safety, human-robot interaction, human-centric approach, social sciences and humanities, risk perception

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Authors: Arul Aram, Vishnu Priya, Monicka Karunanithi

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In India, in particular, festivals are the occasions of celebrations. They create beautiful moments to cherish. Mostly, people pay a visit to their native places to celebrate with their loved ones. So are wedding celebrations. The Covid-19 pandemic came upon us unexpectedly, and to fight it, the festivals and weddings are celebrated unusually. Crowded places are deserted. Mass gatherings are avoided, changes and alterations are made in our rituals and celebrations. The warmth usually people have at their heart during any festival and wedding has disappeared. Some aspects of the celebrations become virtual/digital rather than real -- for instance, digital greetings/invitations, digital conduct of ceremonies by priests, YouTube worship, online/digital cash gifts, and digital audience for weddings. Each festival has different rituals which are followed with the divine nature in every family, but the pandemic warranted some compromises on the traditions. Likewise, a marriage is a beautiful bond between two families where a lot of traditional customs are followed. The wedding ceremonies are colorful and celebrations may extend for several days. People in India spend financial resources to prepare and celebrate weddings. The bride's and the groom's homes are fully decorated with colors, balloons and other decorations. The wedding rituals and celebrations vary by religion, region, preference and the resources of the groom, bride and their families. They can range from one day to multiple-days events. But the Covid-19 pandemic situation changes the mindset of people over ceremonies. This lockdown has affected those weddings and industries that support them and make the people postpone or at times advance without fanfare their 'big day.' People now adopt the protocols, guidelines and safety measures to reduce the risk and minimize the fear during celebrations. The study shall look into: how the pandemic shattered the expectations of people celebrating; problems faced economically by people/service providers who are benefited by the celebrations; and identify the alterations made in the rituals or the practices of our culture for the safety of families. The study shall employ questionnaires, interviews and visual ethnography to collect data. The study found that during a complete lockdown, people have not bought new clothes, sweets, or snacks, as they generally do before a pandemic. Almost all of them kept their celebrations low-key, and some did not celebrate at all. Digital media played a role in keeping the celebration alive, as people used it to wish their friends and families virtually. During partial unlock, the situation was under control, and people began to go out and see a few family and friends. They went shopping and bought new clothes and needs, but they did it while following safety precautions. There is also an equal percentage of people who shopped online. Although people continue to remain disappointed, they were less stressed up as life was returning to normal.

Keywords: covid-19, digital, festivals, India, wedding

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Authors: Sara D. Garduno-Diaz, Philippe Y. Garduno-Diaz

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To date, one of the few comprehensive indicators for the measurement of food security is the Global Food Security Index. This index is a dynamic quantitative and qualitative bench marking model, constructed from 28 unique indicators, that measures drivers of food security across both developing and developed countries. Whereas the Global Food Security Index has been calculated across a set of 109 countries, in this paper we aim to present and compare, for the Middle East and North Africa (MENA), 1) the Food Security Index scores achieved and 2) the data available on affordability, availability, and quality of food. The data for this work was taken from the latest (2014) report published by the creators of the GFSI, which in turn used information from national and international statistical sources. According to the 2014 Global Food Security Index, MENA countries rank from place 17/109 (Israel, although with resent political turmoil this is likely to have changed) to place 91/109 (Yemen) with household expenditure spent in food ranging from 15.5% (Israel) to 60% (Egypt). Lower spending on food as a share of household consumption in most countries and better food safety net programs in the MENA have contributed to a notable increase in food affordability. The region has also however experienced a decline in food availability, owing to more limited food supplies and higher volatility of agricultural production. In terms of food quality and safety the MENA has the top ranking country (Israel). The most frequent challenges faced by the countries of the MENA include public expenditure on agricultural research and development as well as volatility of agricultural production. Food security is a complex phenomenon that interacts with many other indicators of a country’s well-being; in the MENA it is slowly but markedly improving.

Keywords: diet, food insecurity, global food security index, nutrition, sustainability

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Authors: A. Poukens, I. Sluyts, A. Krings, J. Swartenbroekx, D. Geeroms, J. Poukens

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Introduction and Objectives: It has been known for many years that with the administration of intravenous medication, a rather significant part of the planned to be administered infusion solution, the residual volume ( the volume that remains in the IV line and or infusion bag), does not reach the patient and is wasted. This could possibly result in under dosage and diminished therapeutic effect. Despite the important impact on the patient, the reduction of residual volume lacks attention. An optimized and clearly stated protocol concerning the reduction of residual volume in an IV line is necessary for each hospital. As described in my Master’s thesis, acquiring the degree of Master in Hospital Pharmacy, administration of intravenous medication can be optimized by reduction of the residual volume. Herewith effectiveness, user-friendliness, cost efficiency and safety were taken into account. Material and Methods: By usage of a literature study and an online questionnaire sent out to all Flemish hospitals and hospitals in the Netherlands (province Limburg), current flush methods could be mapped out. In laboratory research, possible flush methods aiming to reduce the residual volume were measured. Furthermore, a self-developed experimental method to reduce the residual volume was added to the study. The current flush methods and the self-developed experimental method were compared to each other based on cost efficiency, user-friendliness and safety. Results: There is a major difference between the Flemish and the hospitals in the Netherlands (Province Limburg) concerning the approach and method of flushing IV lines after administration of intravenous medication. The residual volumes were measured and laboratory research showed that if flushing was done minimally 1-time equivalent to the residual volume, 95 percent of glucose would be flushed through. Based on the comparison, it became clear that flushing by use of a pre-filled syringe would be the most cost-efficient, user-friendly and safest method. According to laboratory research, the self-developed experimental method is feasible and has the advantage that the remaining fraction of the medication can be administered to the patient in unchanged concentration without dilution. Furthermore, this technique can be applied regardless of the level of the residual volume. Conclusion and Recommendations: It is recommendable to revise the current infusion systems and flushing methods in most hospitals. Aside from education of the hospital staff and alignment on a uniform substantiated protocol, an optimized and clear policy on the reduction of residual volume is necessary for each hospital. It is recommended to flush all IV lines with rinsing fluid with at least the equivalent volume of the residual volume. Further laboratory and clinical research for the self-developed experimental method are needed before this method can be implemented clinically in a broader setting.

Keywords: intravenous medication, infusion therapy, IV flushing, residual volume

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Authors: Emmanuel Larbi Offei, Felix Agyei-Sasu, Maura Naa Densua Ashong

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Ghana has 26 universal banks and several banking and non-banking financial institutions operating in the country. The growing number of banks has heightened competition among banks to attract and retain customers more customers to ensure sustainability. Hence the need to identify and understand factors that influences customers’ choice of banks cannot be overemphasised. This study investigates the determinants of bank selection criteria by banking customers in Ghana. Four banks were purposively sampled for this study namely Barclays, Standard Chartered, Sahel Sahara and Unibank. Convenience sampling was then used to select 114 bank customers in Accra and interviewed. Questionnaires were used to collect data that were analysed in tables and charts with the use of STATA software. The findings of the study revealed that quick/prompt services and complaint handling, safety of funds, networked branches, easy access to functional Automated Teller Machines (ATMs) and low/moderate service charges were the major determinants of customers’ choice of banks. The results further show that 89.5 percent of all deposits are held in either current or savings accounts. About 22.1 percent of the respondents indicated that they have plans of changing their banks in the near future because they are not satisfied with their banks. A gender analysis of the choice criteria showed differences between the choice criteria of the male as compared to the female. The study recommends that banks in Ghana should focus on products and policies that will not compromise on the safety of funds of their customers. Again, banks must address customer complaints and dissatisfactions as promptly as possible by taking pragmatic steps to address administrative bureaucracies and infrastructural challenges that prolong the duration of banking transactions.

Keywords: Ghana, banks, determinants, customers’ choice, competition

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Authors: N. Cetinkaya

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The objective of the present study is to determine the critical control points during the production, transportation and storage conditions of compound feeds to be used in the Hazard Analysis Critical Control Point (HACCP) feed safety management system. A total of 40 feed samples were taken after 20 and 40 days of storage periods from the 10 dairy and 10 beef cattle farms following the transportation of the compound feeds from the factory. In addition, before transporting the feeds from factory immediately after production of dairy and beef cattle compound feeds, 10 from each total 20 samples were taken as 0 day. In all feed samples, chemical composition and total aflatoxin levels were determined. The aflatoxin levels in all feed samples with the exception of 2 dairy cattle feeds were below the maximum acceptable level. With the increase in storage period in dairy feeds, the aflatoxin levels were increased to 4.96 ppb only in a BS8 dairy farm. This value is below the maximum permissible level (10 ppb) in beef cattle feed. The aflatoxin levels of dairy feed samples taken after production varied between 0.44 and 2.01 ppb. Aflatoxin levels were found to be between 0.89 and 3.01 ppb in dairy cattle feeds taken on the 20^th day of storage at 10 dairy cattle farm. On the 40^th day, feed aflatoxin levels in the same dairy cattle farm were found between 1.12 and 7.83 ppb. The aflatoxin levels were increased to 7.83 and 6.31 ppb in 2 dairy farms, after a storage period of 40 days. These obtained aflatoxin values are above the maximum permissible level in dairy cattle feeds. The 40 days storage in pellet form in the HACCP feed safety management system can be considered as a critical control point.

Keywords: aflatoxin, beef cattle feed, compound feed, dairy cattle feed, HACCP

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Authors: Armana Huq

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Railway networks have a significant role in the economy of any country. Similar to other transportation modes, many lives suffer from fatalities or injuries caused by accidents related to the railway. Railway accidents are not as common as roadway accidents yet they are more devastating and damaging than other roadway accidents. Despite that, issues related to railway accidents are not taken into consideration with significant attention as a major threat because of their less frequency compared to other accident categories perhaps. However, the Federal Railroad Administration reported nearly twelve thousand train accidents related to the railroad in the year 2014, resulting in more than eight hundred fatalities and thousands of injuries in the United States alone of which nearly one third fatalities resulted from railway crossing accidents. From an analysis of railway accident data of six years (2005-2010), it has been revealed that 344 numbers of the collision were occurred resulting 200 people dead and 443 people injured in Bangladesh. This paper includes a comprehensive overview of the railway safety situation in Bangladesh from 1998 to 2015. Each year on average, eight fatalities are reported in at-grade level crossings due to railway accidents in Bangladesh. In this paper, the number of railway accidents that occurred in Bangladesh has been presented and a fatality rate of 58.62% has been estimated as the percentage of total at-grade railway level crossing accidents. For this study, analysis of railway accidents in Bangladesh for the period 1998 to 2015 was obtained from the police reported accident database using MAAP (Microcomputer Accident Analysis Package). Investigation of the major contributing factors to the railway accidents has been performed using the Multinomial Logit model. Furthermore, hotspot analysis has been conducted using ArcGIS. Eventually, some suggestions have been provided to mitigate those accidents.

Keywords: safety, human factors, multinomial logit model, railway

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Authors: Hong Geng, Zaiyu Fan

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With the acceleration of urbanization and motorization in China, the scale of cities and the travel distance of residents are constantly expanding, and the number of cars is continuously increasing, so the urban traffic problem is more and more serious. Traffic congestion, environmental pollution, energy consumption, travel safety and direct interference between traffic and other urban activities are increasingly prominent problems brought about by motorized development. This not only has a serious impact on the lives of the residents but also has a major impact on the healthy development of the city. The paper found that, in order to solve the development of motorization, a number of problems will arise; urban planning and traffic planning and design in residential planning often take into account the development of motorized traffic but neglects the demand for street life. This kind of planning has resulted in the destruction of the traditional communication space of the residential area, the pollution of noise and exhaust gas, and the potential safety risks of the residential area, which has disturbed the previously quiet and comfortable life of the residential area, resulting in the inconvenience of residents' life and the loss of street vitality. Based on these facts, this paper takes a residential area in Wuhan as the research object, through the actual investigation and research, from the perspective of micro-transformation analysis, combined with the concept of traffic micro-reconstruction governance. And research puts forward the residential traffic optimization strategies such as strengthening the interaction and connection between the residential area and the urban street system, street traffic classification and organization.

Keywords: micro-transformation, residential traffic, residents demand, traffic microcirculation

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Bidya Dhar Sahu, Meghana Koneru, R. Shyam Sunder, Ramakrishna Sistla

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Environmental and occupational exposure to hexavalent chromium [Cr(VI)] via textile manufacture, metallurgy, spray paints, stainless steel industries, drinking water containing chromium are often known to cause acute renal injury in humans and animals. Nephrotoxicity is the major effect of chromium poisoning. In the present study, we investigated the potential renoprotective effect and underlying mechanisms of carvedilol using rat model of potassium dichromate (K2Cr2O7)-induced nephrotoxicity. Exploration of the underlying mechanisms of carvedilol revealed that carvedilol attenuated nuclear translocation and DNA binding activity of NF-κB (p65), restored antioxidant and mitochondrial respiratory enzyme activities and attenuated apoptosis related protein expressions in kidney tissues. The serum levels of TNF-α, the renal iNOS and myeloperoxidase activity were significantly decreased in carvedilol pre-treated K2Cr2O7-induced nephrotoxic rats. These results were further supported and confirmed by histological findings. In conclusion, the findings of the present study demonstrated that carvedilol is an effective chemoprotectant against K2Cr2O7-induced nephrotoxicity in rats.

Keywords: apoptosis, carvedilol, inflammation, potassium dichromate-induced nephrotoxicity, applied pharmacology

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Authors: S. Asplund, J. Åhlin, S. Åström, B. M. Lindgren

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The aim of this qualitative study was to describe experiences of work-related stress among highly stressed municipal employees in rural northern Sweden. We interviewed 15 employees in the municipal sector in rural northern Sweden using a semi-structured guide and subjected the interviews to qualitative content analysis. Under the main theme of Suffering Though Endless Chaos, we summarized four themes: facing incompatible interests and high demands due to lack of time and resources; feeling powerless, trapped, and ignored due to lack of control; feeling insufficient, insecure, and guilty due to challenging relations and high expectations; and struggling with consequences such as health problems, spillover effects on family life, and difficulty coping. Findings from this study suggest the importance of acknowledging suffering among municipal employees in a stressful work environment. An imbalance between job demands and resources is affecting both the health and family lives of employees and also their ability to work. It seems important to improve the work environment through supportive leadership, job control, and reasonable job demands to prevent stress, reduce suffering, and create a healthy organization.

Keywords: manager, municipal sector, occupational health, qualitative content analysis

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