Search results for: healthcare waste management

Authors: Samantha Meyerholz

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MSKCC offers patients cutting edge cancer care with the highest quality standards. However, many patients and industry members do not realize that the operations of the Immunology Histology Lab (IHC) are the backbone for carrying out this mission. The IHC lab manufactures blocks and slides containing critical tissue samples that will be read by a Pathologist to diagnose and dictate a patient’s treatment course. The lab processes 200 requests daily, leading to the generation of approximately 2,000 slides and 1,100 blocks each day. Lab material is transported through labeling, cutting, staining and sorting manufacturing stations, while being managed by multiple techs throughout the space. The quality of the stain as well as wait times associated with processing requests, is directly associated with patients receiving rapid treatments and having a wider range of care options. This project aims to improve slide request turnaround time for rush and non-rush cases, while increasing the quality of each request filled (no missing slides or poorly stained items). Rush cases are to be filled in less than 24 hours, while standard cases are allotted a 48 hour time period. Reducing turnaround times enable patients to communicate sooner with their clinical team regarding their diagnosis, ultimately leading faster treatments and potentially better outcomes. Additional project goals included streamlining tech and material workflow, while reducing waste and increasing efficiency. This project followed a DMAIC structure with emphasis on lean and ergonomic principles that could be integrated into an evolving lab culture. Load times and batching processes were analyzed using process mapping, FMEA analysis, waste analysis, engineering observation, 5S and spaghetti diagramming. Reduction of lab technician movement as well as their body position at each workstation was of top concern to pathology leadership. With new equipment being brought into the lab to carry out workflow improvements, screen and tool placement was discussed with the techs in focus groups, to reduce variation and increase comfort throughout the workspace. 5S analysis was completed in two phases in the IHC lab, helping to drive solutions that reduced rework and tech motion. The IHC lab plans to continue utilizing these techniques to further reduce the time gap between tissue analysis and cancer care.

Keywords: engineering, ergonomics, healthcare, lean

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Authors: Amel Ltifi, Ahmed Zouinkhi, Mohamed Salim Bouhlel

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Security and trust management in Vehicular Ad-hoc NETworks (VANET) is a crucial research domain which is the scope of many researches and domains. Although, the majority of the proposed trust management systems for VANET are based on specific road infrastructure, which may not be present in all the roads. Therefore, road security should be managed by vehicles themselves. In this paper, we propose a new Self Organized Trust Management system (SOTM). This system has the responsibility to cut with the spread of false warnings in the network through four principal components: cooperation, trust management, communication and security.

Keywords: ative vehicle, cooperation, trust management, VANET

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Authors: Fatemeh Yazdandoust, Derrick Mirrindi

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The excessive use of non-renewable fossil fuels has led to a pressing energy crisis that demands urgent attention. While renewable sources like solar, wind, and water have gained significant attention as alternatives, we must explore additional avenues. This study takes an interdisciplinary approach, investigating the potential of waste streams from energy production and other untapped natural sources as sustainable energy solutions. Through a review of case studies, this study demonstrates how these alternative sources, including human power, animal body heat, and noise, can seamlessly integrate into architecture and urban planning. This article first discusses passive design strategies integrating alternative energy sources into vernacular architecture. Then, it reviews the waste stream (exergy) and potential energy sources, such as human power, animal body heat, and noise, in contemporary proposals and case studies. It demonstrates how an alternative energy design strategy may easily incorporate these many sources into our architecture and urban planning through passive and active design strategies to increase the energy efficiency of our built environment.

Keywords: alternative energy sources, energy exchange, human and animal power, potential energy sources, waste stream

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Authors: Jaroslav Knapek, Kamila Vavrova, Tomas Kralik, Tereza Humesova

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The treatment and disposal of sewage sludge is one of the most important and critical problems of waste water treatment plants. Currently, 180 thousand tonnes of sludge dry matter are produced in the Czech Republic, which corresponds to approximately 17.8 kg of stabilized sludge dry matter / year per inhabitant of the Czech Republic. Due to the fact that sewage sludge contains a large amount of substances that are not beneficial for human health, the conditions for sludge management will be significantly tightened in the Czech Republic since 2023. One of the tested methods of sludge liquidation is the production of alternative fuel from sludge from sewage treatment plants and paper production. The paper presents an analysis of economic efficiency of alternative fuel production from sludge and its use for fluidized bed boiler with nominal consumption of 5 t of fuel per hour. The evaluation methodology includes the entire logistics chain from sludge extraction, through mechanical moisture reduction to about 40%, transport to the pelletizing line, moisture drying for pelleting and pelleting itself. For economic analysis of sludge pellet production, a time horizon of 10 years corresponding to the expected lifetime of the critical components of the pelletizing line is chosen. The economic analysis of pelleting projects is based on a detailed analysis of reference pelleting technologies suitable for sludge pelleting. The analysis of the economic efficiency of pellet is based on the simulation of cash flows associated with the implementation of the project over the life of the project. For the entered value of return on the invested capital, the price of the resulting product (in EUR / GJ or in EUR / t) is searched to ensure that the net present value of the project is zero over the project lifetime. The investor then realizes the return on the investment in the amount of the discount used to calculate the net present value. The calculations take place in a real business environment (taxes, tax depreciation, inflation, etc.) and the inputs work with market prices. At the same time, the opportunity cost principle is respected; waste disposal for alternative fuels includes the saved costs of waste disposal. The methodology also respects the emission allowances saved due to the displacement of coal by alternative (bio) fuel. Preliminary results of testing of pellet production from sludge show that after suitable modifications of the pelletizer it is possible to produce sufficiently high quality pellets from sludge. A mixture of sludge and paper waste has proved to be a more suitable material for pelleting. At the same time, preliminary results of the analysis of the economic efficiency of this sludge disposal method show that, despite the relatively low calorific value of the fuel produced (about 10-11 MJ / kg), this sludge disposal method is economically competitive. This work has been supported by the Czech Technology Agency within the project TN01000048 Biorefining as circulation technology.

Keywords: Alternative fuel, Economic analysis, Pelleting, Sewage sludge

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

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Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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Authors: Waseem Akram, Hafiz Azhar Ali Khan

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Unplanned urbanization together with change in life from simple to more technologically advanced style with flow of rural masses to urban areas has played a vital role in pilling loads of solid wastes in our environment. The cities and towns have expanded beyond boundaries. Even the uncontrolled population expansion has caused the overall environmental burden. Thus, today the indifference remains as one of the biggest trash that has come up due to the non-responsive behavior of the people. Everyday huge amount of solid waste is thrown in the streets, on the roads, parks, and in all those places that are frequently and often visited by the human beings. This behavior based response in many countries of the world has led to serious health concerns and environmental issues. Over 80% of our products that are sold in the market are packed in plastic bags. None of the bags are later recycled but simply become a permanent environment concern that flies, choke lines or are burnt and release toxic gases in the environment or form dumps of heaps. Lack of classification of the daily waste generated from houses and other places lead to worst clogging of the sewerage lines and formation of ponding areas which ultimately favor vector borne disease and sometimes become a cause of transmission of polio virus. Solid waste heaps were checked at different places of the cities. All of the wastes on visual assessments were classified into plastic bags, papers, broken plastic pots, clay pots, steel boxes, wrappers etc. All solid waste dumping sites in the cities and wastes that were thrown outside of the trash containers usually contained wrappers, plastic bags, and unconsumed food products. Insect populations seen in these sites included the house flies, bugs, cockroaches and mosquito larvae breeding in water filled wrappers, containers or plastic bags. The population of the mosquitoes, cockroaches and houseflies were relatively very high in dumping sites close to human population. This population has been associated with cases like dengue, malaria, dysentery, gastro and also to skin allergies during the monsoon and summer season. Thus, dumping of the huge amount of solid wastes in and near the residential areas results into serious environmental concerns, bad smell circulation, and health related issues. In some places, the same waste is burnt to get rid of mosquitoes through smoke which ultimately releases toxic material in the atmosphere. Therefore, a proper environmental strategy is needed to minimize environmental burden and promote concepts of recycled products and thus, reduce the disease burden.

Keywords: solid waste accumulation, disease burden, mosquitoes, vector borne diseases

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Authors: Everdeanne Javier, Kelvin Louie Abat, Alodia Rizzalynn Cabaya, Chynna Allyson Manzano, Vlasta Sai Espiritu, Raniah May Puzon, Michelle Tobler

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Teledermatology is becoming a more popular form of providing dermatologic healthcare worldwide, and it will almost certainly play a larger role in the future. As the current pandemic continues to worsen, Teledermatology is seen as the primary alternative to face-to-face dermatology consultation; therefore, it needs to be enhanced and developed to become as convenient and reliable as it can be for both patients and doctors. This research paper seeks to know the processes used in teledermatology regarding delivery modalities and proper consultation. This study's research design is a Qualitative Descriptive approach to describe further the processes used by teledermatologists. An online survey questionnaire was used to collect data from Teledermatology Clinics in San Fernando City, La Union. Research showed that patients tend to embrace and be pleased with teledermatology as a way of accessing healthcare. On the other hand, clinicians have usually reported positive outcomes from teledermatology. Furthermore, it is not intended to be used instead of a face-to-face appointment with a dermatologist.

Keywords: teledermatology, online dermatology consultation, dermatology, dermatologist

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Authors: Musa Alhassan, Alhaji Mohammed Mustapha

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Review of studies carried out on the use of bagasse ash in the improvement of deficient soils in Nigeria, with emphasis on lateritic and black cotton soils is presented. Although, the bagasse ash is mostly used as additive to the conventional soil stabilizer (cement and lime), the studies generally showed improvement of geotechnical properties of the soils either modified or stabilized with the ash. This showed the potentials of using this agricultural waste (bagasse ash) in the improvement of geotechnical properties of deficient soils. Thus suggesting that using this material at large scale level, in geotechnical engineering practice could help in the provision of stable and durable structures, reduce cost of soil improvement and also reduces environmental nuisance caused by the unused waste in Nigeria

Keywords: bagasse ash, black cotton soil, deficient soil, laterite, soil improvement

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Authors: Ouaaz Oum Essaad, Melbouci Bachir

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The experimental study conducted has a dual purpose: to valorize the clay material in the road domain and improve the lift of the shape layers by strengthening with plastic waste (in the form of aggregates). To do this, six mixtures of Clay and sand of different percentages were studied: 100% Clay, 95% Clay + 05% Sand, 90% Clay + 10% Sand, 85% Clay + 15% Sand, 80% Clay + 20% Sand, 75% Clay + 25% Sand. Proctor compaction and simple compression tests have been carried out on mixtures (sand + clay + plastic waste). The results obtained show a clear evolution of the characteristics of the Proctor test and the compressive strength of the mixtures according to the different types and percentages of the recycled plastic Plasticity and consistency index are important parameters that play a role in the toughness of plastic soil.

Keywords: valorization, recycling, soil mixture, mechanical tests

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Authors: Ronita Singh, Yaman Pattanaik, Soham Lalwala

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In today’s highly competitive business environment, every organization is striving towards lean manufacturing systems to achieve lower Production Lead Times, lower costs, less inventory and overall improvement in supply chains efficiency. Based on the similar idea, this paper presents the practical application of Value Stream Mapping (VSM) tool and ECRS (Eliminate, Combine, Reduce, and Simplify) technique in the receipt section of the material management center of an oil refinery. A value stream is an assortment of all actions (value added as well as non-value added) that are required to bring a product through the essential flows, starting with raw material and ending with the customer. For drawing current state value stream mapping, all relevant data of the receipt cycle has been collected and analyzed. Then analysis of current state map has been done for determining the type and quantum of waste at every stage which helped in ascertaining as to how far the warehouse is from the concept of lean manufacturing. From the results achieved by current VSM, it was observed that the two processes- Preparation of GRN (Goods Receipt Number) and Preparation of UD (Usage Decision) are both bottle neck operations and have higher cycle time. This root cause analysis of various types of waste helped in designing a strategy for step-wise implementation of lean tools. The future state thus created a lean flow of materials at the warehouse center, reducing the lead time of the receipt cycle from 11 days to 7 days and increasing overall efficiency by 27.27%.

Keywords: current VSM, ECRS, future VSM, receipt cycle, supply chain, VSM

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Authors: Harold Jideofor

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Wastewater treatment consists of applying known technology to improve or upgrade the quality of a wastewater. Usually wastewater treatment will involve collecting the wastewater in a central, segregated location (the Wastewater Treatment Plant) and subjecting the wastewater to various treatment processes. Most often, since large volumes of wastewater are involved, treatment processes are carried out on continuously flowing wastewaters (continuous flow or "open" systems) rather than as "batch" or a series of periodic treatment processes in which treatment is carried out on parcels or "batches" of wastewaters. While most wastewater treatment processes are continuous flow, certain operations, such as vacuum filtration, involving storage of sludge, the addition of chemicals, filtration and removal or disposal of the treated sludge, are routinely handled as periodic batch operations.

Keywords: wastewater treatment, environmental engineering, waste water

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Authors: Boce Zhang, Yaguang Luo

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Ripening of climacteric fruits, such as bananas and avocados, are usually initiated days prior to the retail marketing. However, upon the onset of irreversible ripening, they undergo rapid spoilage if not consumed within a narrow climacteric time window. Controlled ripening of climacteric fruits is a critical step to provide consumers with high-quality products while reducing postharvest losses and food waste. There is a high demand for technologies that can retard the ripening process or enable accelerated ripening immediately before consumption. In this work, metal−organic framework (MOF) was developed as a solid porous matrix to encapsulate gaseous hormone, including ethylene, for subsequent application. The feasibility of the on-demand stimulated ripening of bananas and avocados is also evaluated. MOF was synthesized and loaded with ethylene gas. The MOF−ethylene was placed inside sealed containers with preclimacteric bananas and avocados and stored at 16 °C. The fruits were treated for 24-48 hours, and evaluated for ripening progress. Results indicate that MOF−ethylene treatment significantly accelerated the ripening-related changes of color and textural properties in treated bananas and avocados. The average ripening period for both avocados and bananas were reduced in half by using this method. No significant differences of quality characteristics at respective ripening stages were observed between produce ripened via MOF-ethylene versus exogenously supplied ethylene gas or endogenously produced ethylene. Solid MOF matrices could have multiple advantages compared to existing systems, including easy to transport and safe to use by minimally trained produce handlers and consumers. We envision that this technology can help tackle food waste challenges at the critical retail and consumer stages in the food supply chain.

Keywords: climacteric produce, controllable ripening, food waste challenge, metal organic framework

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Authors: Horng-Wen Wu, Yi Chao, Rong-Fang Horng

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This study is to develop a methanol steam reformer with a heat recovery zone, which recovers heat from exhaust gas of a diesel engine, and to investigate waste heat recovery ratio at the required reaction temperature. The operation conditions of the reformer are reaction temperature (200 °C, 250 °C, and 300 °C), steam to carbonate (S/C) ratio (0.9, 1.1, and 1.3), and N2 volume flow rate (40 cm3/min, 70 cm3/min, and 100 cm3/min). Finally, the hydrogen concentration, the CO, CO2, and N2 concentrations are measured and recorded to calculate methanol conversion efficiency, hydrogen flow rate, and assisting combustion gas and impeding combustion gas ratio. The heat source of this reformer comes from electric heater and waste heat of exhaust gas from diesel engines. The objective is to recover waste heat from the engine and to make more uniform temperature distribution within the reformer. It is beneficial for the reformer to enhance the methanol conversion efficiency and hydrogen-rich gas production. Experimental results show that the highest hydrogen flow rate exists at N2 of the volume rate 40 cm3/min and reforming reaction temperature of 300 °C and the value is 19.6 l/min. With the electric heater and heat recovery from exhaust gas, the maximum heat recovery ratio is 13.18 % occurring at water-methanol (S/C) ratio of 1.3 and the reforming reaction temperature of 300 °C.

Keywords: heat recovery, hydrogen-rich production, methanol steam reformer, methanol conversion efficiency

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Authors: Prateep Wajeetongratana

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The objectives of the research were to examine that how management accounting techniques were perceived and used by companies listed on the stock exchange and to investigate similarities or differences of management accounting practices between companies listed on the stock exchange and Thai SMEs. Descriptive and inferential statistics were employed. The finding found that almost all of the companies used traditional management accounting techniques more than advanced management accounting techniques. Four management accounting techniques having no significant association with business characteristic were standard costing, job order costing, process costing. The barriers that Thai SMEs encountered were a lack of proper accounting system and the insufficient knowledge in management accounting of the accountants. The comparison results revealed that both companies listed on the stock exchange and Thai SMEs used traditional management accounting techniques more than advanced techniques.

Keywords: companies listed on the stock exchange, financial budget, management accounting, operating budget

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Authors: S. Karthikeyan, Naveen Bindra

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Introduction: To update ourselves and understand the concept of latest electronic formats available for Health care providers and how it could be used and developed as per standards. The idea is to correlate between the patients Manual Medical Records keeping and maintaining patients Electronic Information in a Health care setup in this world. Furthermore this stands with adapting to the right technology depending upon the organization and improve our quality and quantity of Healthcare providing skills. Objective: The concept and theory is to explain the terms of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Personal Health Record (PHR) and selecting the best technical among the available Electronic sources and software before implementing. It is to guide and make sure the technology used by the end users without any doubts and difficulties. The idea is to evaluate is to admire the uses and barriers of EMR-EHR-PHR. Aim and Scope: The target is to achieve the health care providers like Physicians, Nurses, Therapists, Medical Bill reimbursements, Insurances and Government to assess the patient’s information on easy and systematic manner without diluting the confidentiality of patient’s information. Method: Health Information Technology can be implemented with the help of Organisations providing with legal guidelines and help to stand by the health care provider. The main objective is to select the correct embedded and affordable database management software and generating large-scale data. The parallel need is to know how the latest software available in the market. Conclusion: The question lies here is implementing the Electronic information system with healthcare providers and organisation. The clinicians are the main users of the technology and manage us to ‘go paperless’. The fact is that day today changing technologically is very sound and up to date. Basically the idea is to tell how to store the data electronically safe and secure. All three exemplifies the fact that an electronic format has its own benefit as well as barriers.

Keywords: medical records, digital records, health information, electronic record system

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Authors: Federico Pittino, Thomas Arnold

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The shredding of waste materials is a key step in the recycling process towards the circular economy. Industrial shredders for waste processing operate in very harsh operating conditions, leading to the need for frequent maintenance of critical components. Maintenance optimization is particularly important also to increase the machine’s efficiency, thereby reducing the operational costs. In this work, a monitoring system has been developed and deployed on an industrial shredder located at a waste recycling plant in Austria. The machine has been monitored for one year, and methods for predictive maintenance have been developed for two key components: the cutting knives and the drive belt. The large amount of collected data is leveraged by statistical machine learning techniques, thereby not requiring very detailed knowledge of the machine or its live operating conditions. The results show that, despite the wide range of operating conditions, a reliable estimate of the optimal time for maintenance can be derived. Moreover, the trade-off between the cost of maintenance and the increase in power consumption due to the wear state of the monitored components of the machine is investigated. This work proves the benefits of real-time monitoring system for the efficient operation of industrial shredders.

Keywords: predictive maintenance, circular economy, industrial shredder, cost optimization, statistical machine learning

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Authors: Gunmala Suri

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The purpose of this study was to investigate the relationship between various dimensions of Knowledge Management and Learning Organizations. On the basis of the dimensions of Learning Organization, Hypothesis were formulated. Knowledge Management (KM) is taken as the independent variable and Learning Organization (LO) as a dependent variable. KM had 5 dimensions and LO had 7. For this study, a total of 92 participants took part and answered the questionnaire. The respondents were selected using Judgemental and Snowball sampling. The respondents were from SMEs in and around Chandigarh. SPSS was used to for the data analysis purposes. The results showed that the dimensions of KM had a positive influence on the dimensions of LO. The hypothesis were accepted.

Keywords: knowledge management leadership, knowledge management, learning organization, knowledge management culture

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Authors: R. F. Vieira, D. Lopes, I. Baptista, S. A. Figueiredo, V. F. Domingues, R. Jorge, C. Delerue-matos, O. M. Freitas

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Odours are generated in municipal solid wastes management plants as a result of decomposition of organic matter, especially when anaerobic degradation occurs. Information was collected about the substances and respective concentration in the surrounding atmosphere of some management plants. The main components which are associated with these unpleasant odours were identified: ammonia, hydrogen sulfide and mercaptans. The first is the most common and the one that presents the highest concentrations, reaching values of 700 mg/m3. Biofiltration, which involves simultaneously biodegradation, absorption and adsorption processes, is a sustainable technology for the treatment of these odour emissions when a natural packing material is used. The packing material should ideally be cheap, durable, and allow the maximum microbiological activity and adsorption/absorption. The presence of nutrients and water is required for biodegradation processes. Adsorption and absorption are enhanced by high specific surface area, high porosity and low density. The main purpose of this work is the exploitation of natural waste materials, locally available, as packing media: heather (Erica lusitanica), chestnut bur (from Castanea sativa), peach pits (from Prunus persica) and eucalyptus bark (from Eucalyptus globulus). Preliminary batch tests of ammonia removal were performed in order to select the most interesting materials for biofiltration, which were then characterized. The following physical and chemical parameters were evaluated: density, moisture, pH, buffer and water retention capacity. The determination of equilibrium isotherms and the adjustment to Langmuir and Freundlich models was also performed. Both models can fit the experimental results. Based both in the material performance as adsorbent and in its physical and chemical characteristics, eucalyptus bark was considered the best material. It presents a maximum adsorption capacity of 0.78±0.45 mol/kg for ammonia. The results from its characterization are: 121 kg/m3 density, 9.8% moisture, pH equal to 5.7, buffer capacity of 0.370 mmol H+/kg of dry matter and water retention capacity of 1.4 g H2O/g of dry matter. The application of natural materials locally available, with little processing, in biofiltration is an economic and sustainable alternative that should be explored.

Keywords: ammonia removal, biofiltration, natural materials, odour control

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Authors: M. Parvez Alam, M. Bilal Khan

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Concrete is the material of choice where strength, performance, durability, impermeability, fire resistance, and abrasion resistance are required. The hunger for the higher strength leads to other materials to achieve the desired results and thus, emerged the contribution of cementitious material for the strength of concrete In present day constructions, concrete is chosen as one of the best choices by civil engineers in construction materials. The concept of sustainability is touching new heights and many pozzolonic materials are tried and tested as partial replacement for the cement. In this paper, comprehensive review of available literatures are studied to evaluate the performance of pozzolonic materials such as ceramic waste powder, copper slag, silica fume on the strength of concrete by the partial replacement of ordinary materials such as cement, fine aggregate and coarse aggregate at different percentage of composition. From the study, we conclude that ceramic wastes are suitable to be used in the construction industry, and more significantly on the making of concrete. Ceramic wastes are found to be suitable for usage as substitution for fine and coarse aggregates and partial substitution in cement production. They were found to be performing better than normal concrete, in properties such as density, durability, permeability, and compressive strength. Copper slag is the waste material of matte smelting and refining of copper such that each ton of copper generates approximately 2.5 tons of copper slag. Copper slag is one of the materials that is considered as a waste which could have a promising future in construction Industry as partial or full substitute of aggregates. Silica fume, also known as micro silica or condensed silica fume, is a relatively new material compared to fly ash, It is another material that is used as an artificial pozzolonic admixture. High strength concrete made with silica fume provides high abrasion/corrosion resistance.

Keywords: concrete, pozzolonic materials, ceramic waste powder, copper slag

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Authors: Patel Darshan Shaileshkumar, M. G. Vanza

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Black cotton soil is problematic soil for any construction work. Black cotton soil contains montmorillonite in its structure. Due to this mineral, black cotton soil will attain maximum swelling and shrinkage. Due to these volume changes, it is necessary to stabilize black cotton soil before the construction of the road. For soil stabilization use of pozzolanic waste is found to be a good solution by some researchers. The palm kernel shell ash (PKSA) is a pozzolanic material that can be used for soil stabilization. Basically, PKSA is a waste material, and it is available at a cheap cost. Palm kernel shell is a waste material generated in palm oil mills. Then palm kernel shell is used in industries instead of coal for power generation. After the burning of a palm kernel shell, ash is formed; the ash is called palm kernel shell ash (PKSA). The PKSA contains a free lime content that will react chemically with the silicate and aluminate of black cotton soil and forms a C-S-H and C-A-H gel which will bines soil particles together and reduce the plasticity of the soil. In this study, the PKSA is added to the soil. It was found that with the addition of PKSA content in the soil, the liquid limit of the soil is decreased, the plastic limit of the soil is increased, and the plasticity of the soil is decreased. The group index value of the soil is evaluated, and it was found that with the addition of PKSA GI value of the soil is decreased, which indicates the strength of the soil is improved.

Keywords: palm kernel shell ash, black cotton soil, liquid limit, group index, plastic limit, plasticity index

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Authors: Maria A. Murtiati, Ancella A. Hermawan

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The objective of this study is to examine whether the firm’s eligibility to get a bank loan is influenced by earnings management. The earnings management is distinguished between accruals and real earnings management. Hypothesis testing is carried out with logistic regression model using sample of 285 companies listed at Indonesian Stock Exchange in 2010. The result provides evidence that a greater magnitude in accruals earnings management increases the firm’s probability to be eligible to get bank loan. In contrast, real earnings management through abnormal cash flow and abnormal discretionary expenses decrease firm’s probability to be eligible to get bank loan, while real management through abnormal production cost increases such probability. The result of this study suggests that if the earnings management is assumed to be opportunistic purpose, the accruals based earnings management can distort the banks credit analysis using financial statements. Real earnings management has more impact on the cash flows, and banks are very concerned on the firm’s cash flow ability. Therefore, this study indicates that banks are more able to detect real earnings management, except abnormal production cost in real earning management.

Keywords: discretionary accruals, real earning management, bank loan, credit worthiness

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Authors: Mukondi Esther Nethavhakone

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In 2020 World Health Organization announced the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as Coronavirus disease 2019 (COVID-19) pandemic. To curb or contain the spread of the novel coronavirus (COVID 19), global governments implemented social distancing and lockdown regulations. Subsequently, it was no longer business as per usual, life as we knew it had changed, and so many aspects of people's lives were negatively affected, including financial and employment stability. Mainly, because companies/businesses had to put their operations on hold, some had to shut down completely, resulting in the loss of income for many people globally. Finances and employment insecurities are some of the issues that exacerbated many social issues that the world was already faced with, such as school drop-outs, teenage pregnancies, sexual assaults, gender-based violence, crime, child abuse, elderly abuse, to name a few. Expectedly the majority of the population's mental health state was threatened. This resulted in an increased number of people seeking mental healthcare services. The increasing need for mental healthcare services in Low and Middle-income countries proves to be a challenge because it is a well-known fact due to financial constraints and not well-established healthcare systems, mental healthcare provision is not as prioritised as the primary healthcare in these countries. It is against this backdrop that the researcher seeks to find viable, cost-effective, and accessible mental health solutions for low and middle-income countries amid the pressures of any pandemic. The researcher will undertake a systematic review of the technology-based mental health solutions that have been implemented/adopted by developed countries during COVID 19 lockdown and social distancing periods. This systematic review study aims to determine if low and middle-income countries can adopt the cost-effective version of digital mental health solutions for the healthcare system to adequately provide mental healthcare services during critical times such as pandemics (when there's an overwhelming diminish in mental health globally). The researcher will undertake a systematic review study through mixed methods. It will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The mixed-methods uses findings from both qualitative and quantitative studies in one review study. It will be beneficial to conduct this kind of study using mixed methods because it is a public health topic that involves social interventions and it is not purely based on medical interventions. Therefore, the meta-ethnographic (qualitative data) analysis will be crucial in understanding why and which digital methods work and for whom does it work, rather than only the meta-analysis (quantitative data) providing what digital mental health methods works. The data collection process will be extensive, involving the development of a database, table of summary of evidence/findings, and quality assessment process lastly, The researcher will ensure that ethical procedures are followed and adhered to, ensuring that sensitive data is protected and the study doesn't pose any harm to the participants.

Keywords: digital, mental health, covid, low and middle-income countries

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Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Fahreza, Yudhi Herliansyah, Harnovinsah

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This study aims to examine how management compensation and auditor reputation effect on corporate tax management in banking using a sample banking companies listed in Indonesia Stock Exchange. At first, this study examines how the influence of management compensation on the implementation of tax management that may be made by management in order to improve the performance of the company. Second, this study also examines the effect of auditor reputation conducting audit on the implementation of the tax management. The population used in this study is the banking companies listed in Indonesia Stock Exchange. The method used was purposive sampling because the samples of this study have certain criteria that are tailored to the purpose of the study. Based on purposive sampling method, the number of samples in this study is 28 samples. Hypothesis tested using multiple regression analysis. The results of this study indicate that on the 5 % significance level, management compensation significantly influenced tax management as measured using the proxy book tax gap. Other result is management compensation does not significantly affect the tax management that measured using a proxy GAAP effective tax rate. In addition the auditor's reputation does significantly influence tax management as measured using the proxy book tax gap and GAAP effective tax rate.

Keywords: tax management, management compensation, auditor reputation, corporate characteristic

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Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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Authors: A. Rosazlin Abdullah, I. Che Fauziah, K. Wan Rasidah, A. B. Rosenani

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The paper industry performs an essential role in the global economy of the world. A study was conducted on the paper mill sludge that is applied on the Khaya senegalensis for 1 year planning period at University Agriculture Park, Puchong, Selangor, Malaysia to determine the growth of Khaya senegalensis, soil properties, nutrients concentrations and effects on the status of heavy metals. Paper Mill Sludge (PMS) and composted Recycled Paper Mill Sludge (RPMS) were used with different rates of nitrogen (0, 150, 300 and 600 kg ha-1) at the ratio of 1:1 (Recycled Paper Mill Sludge (RPMS) : Empty Fruit Brunch (EFB). The growth parameters were measured twice a month for 1 year. Plant nutrients and heavy metal uptake were determined. The paper mill sludge has the potential to be a supplementary N fertilizer as well as a soil amendment. The application of RPMS with N, significantly contributed to the improvement in plant growth parameters such as plant height (4.24 m), basal diameter (10.30 cm), total plant biomass and improved soil physical and chemical properties. The pH, EC, available P and total C in soil were varied among the treatments during the planting period. The treatments with raw and RPM compost had higher pH values than those applied with inorganic fertilizer and control. Nevertheless, there was no salinity problem recorded during the planting period and available P in soil treated with raw and RPMS compost was higher than the control plots that reflects the mineralization of organic P from the decomposition of pulp sludge. The weight of the free and occluded light fractions of carbon concentration was significantly higher in the soils treated with raw and RPMS compost. The application of raw and composted RPMS gave significantly higher concentration of the heavy metals, but the total concentrations of heavy metals in the soils were below the critical values. Hence, the paper mill sludge can be successfully used as soil amendment in acidic soil without any serious threat. The use of paper mill sludge for the soil fertility, shows improvement in land application signifies a unique opportunity to recycle sludge back to the land to alleviate the potential waste management problem.

Keywords: growth, heavy metals, nutrients uptake, production, waste management

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Authors: Devyani Shete, Sudeep Rai

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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

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Authors: Mohieldin Elmashad, Salwa Yassin

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Expansive soils regarded as one of the most problematic unsaturated formations in the Egyptian arid zones and present a great challenge in civil engineering, in general, and geotechnical engineering, in particular. Severe geotechnical complications and consequent structural damages have been arising due to an excessive and differential volumetric change upon wetting and change in water content. Different studies have been carried out concerning the swelling performance of the expansive soils using different additives including phospho-gypsum as an industrial waste product. However, this paper describes the results of a comprehensive testing programme that was carried out to investigate the effect of phospho-gypsum (PG) and sodium chloride (NaCl), as an additive mixture, on the swelling performance of constituent samples of swelling soils. The constituent samples comprise commercial bentonite collected from a natural site, mixed with different percentages of PG-NaCl mixture. The testing programme had been scoped to cover the physical and chemical properties of the constituent samples. In addition, a mineralogical study using x-ray diffraction (XRD) was performed on the collected bentonite and the mixed bentonite with PG-NaCl mixture samples. The obtained results of this study showed significant improvement in the swelling performance of the tested samples with the increase of the proposed PG-NaCl mixture content.

Keywords: expansive soils, industrial waste, mineralogical study, swelling performance, X-ray diffraction

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Authors: Marita Pigłowska, Beata Kurc, Maciej Galiński

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The application of carbon materials in the branches of the electrochemical industry shows an increasing tendency each year due to the many interesting properties they possess. These are, among others, a well-developed specific surface, porosity, high sorption capacity, good adsorption properties, low bulk density, electrical conductivity and chemical resistance. All these properties allow for their effective use, among others in supercapacitors, which can store electric charges of the order of 100 F due to carbon electrodes constituting the capacitor plates. Coals (including expanded graphite, carbon black, graphite carbon fibers, activated carbon) are commonly used in electrochemical methods of removing oil derivatives from water after tanker disasters, e.g. phenols and their derivatives by their electrochemical anodic oxidation. Phenol can occupy practically the entire surface of carbon material and leave the water clean of hydrophobic impurities. Regeneration of such electrodes is also not complicated, it is carried out by electrochemical methods consisting in unblocking the pores and reducing resistances, and thus their reactivation for subsequent adsorption processes. Graphite is commonly used as an anode material in lithium-ion cells, while due to the limited capacity it offers (372 mAh g-1), new solutions are sought that meet both capacitive, efficiency and economic criteria. Increasingly, biodegradable materials, green materials, biomass, waste (including agricultural waste) are used in order to reuse them and reduce greenhouse effects and, above all, to meet the biodegradability criterion necessary for the production of lithium-ion cells as chemical power sources. The most common of these materials are cellulose, starch, wheat, rice, and corn waste, e.g. from agricultural, paper and pharmaceutical production. Such products are subjected to appropriate treatments depending on the desired application (including chemical, thermal, electrochemical). Starch is a biodegradable polysaccharide that consists of polymeric units such as amylose and amylopectin that build an ordered (linear) and amorphous (branched) structure of the polymer. Carbon is also used as a catalyst. Elemental carbon has become available in many nano-structured forms representing the hybridization combinations found in the primary carbon allotropes, and the materials can be enriched with a large number of surface functional groups. There are many examples of catalytic applications of coal in the literature, but the development of this field has been hampered by the lack of a conceptual approach combining structure and function and a lack of understanding of material synthesis. In the context of catalytic applications, the integrity of carbon environmental management properties and parameters such as metal conductivity range and bond sequence management should be characterized. Such data, along with surface and textured information, can form the basis for the provision of network support services.

Keywords: carbon materials, catalysis, BET, capacitors, lithium ion cell

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