Search results for: hypereutectic high chromium cast iron

Authors: Anne Klimesch, Alejandra Martinez, Martin HäRter, Isabelle Scholl, Paulina Bravo

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Patient-centered care (PCC) is a key principle of high-quality healthcare. In Latin America, research on and promotion of PCC have taken place in the past. However, thorough implementation of PCC in practice is still missing. In Germany, an integrative model of patient-centeredness has been developed by synthesis of diverse concepts of PCC. The model could serve as a point of reference for further research on the implementation of PCC. However, it is predominantly based on research from Europe and North America. This scoping review, therefore, aims to accumulate research on PCC in Latin America in the past 15 years and analyse how PCC has been conceptualized. The resulting overview of PCC in Latin America will be a foundation for a subsequent study aiming at the adaptation of the integrative model of patient-centeredness to the Latin American health care context. Scientific databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science, SCIELO, Redalyc.) will be searched, and reference and citation tracking will be performed. Studies will be included if they were carried out in Latin America, investigated PCC in any clinical and community setting (public and private), and were published in English, Spanish, French, or Portuguese since 2006. Furthermore, any theoretical framework or conceptual model to guide how PCC is conceptualized in Latin America will be included. Two reviewers will be responsible for the identification of articles, screening of records, and full-text assessment. The results of the scoping review will be used in the development of a mixed-methods study with the aim to understand the needs for PCC, as well as barriers and facilitators in Latin America. Based on the outcomes, the integrative model of PCC will be translated to Spanish and adapted to the Latin American context. The integrative model will enable the dissemination of the concept of PCC in Latin America and will provide a common ground for further research on the topic. The project will thereby make an important contribution to an evidence-based implementation of PCC in Latin America.

Keywords: conceptual framework, integrative model of PCC, Latin America, patient-centered care

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Authors: Marlen Acosta Alamo, Lisa Manne, Richard Veit

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Habitat loss due to land use change is one of the leading causes of biodiversity loss worldwide. This form of habitat loss is a non-random phenomenon since the same environmental factors that make an area suitable for supporting high local biodiversity overlap with those that make it attractive for urban development. We aimed to compare the effect of two non-random habitat loss predictors on the richness, abundance, and rarity of nature-affiliated and human-affiliated North American breeding birds. For each group of birds, we simulated the non-random habitat loss using two predictors: the House Price Index as a measure of the attractiveness of an area for humans and the Normalized Difference Vegetation Index as a proxy for primary productivity. We compared the results of the two non-random simulation sets and one set of random habitat loss simulations using an analysis of variance and followed up with a Tukey-Kramer test when appropriate. The attractiveness of an area for humans predicted estimates of richness loss and increase of rarity higher than primary productivity and random habitat loss for nature-affiliated and human-affiliated birds. For example, at 50% of habitat loss, the attractiveness of an area for humans produced estimates of richness at least 5% lower and of a rarity at least 40% higher than primary productivity and random habitat loss for both groups of birds. Only for the species abundance of nature-affiliated birds, the attractiveness of an area for humans did not outperform primary productivity as a predictor of biodiversity following habitat loss. We demonstrated the value of the House Price Index, which can be used in conservation assessments as an index of the risks of habitat loss for natural communities. Thus, our results have relevant implications for sustainable urban land-use planning practices and can guide stakeholders and developers in their efforts to conserve local biodiversity.

Keywords: biodiversity loss, bird biodiversity, house price index, non-random habitat loss

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Authors: Andrew Kanzunguze, Sopani Sichinga, Paston Simkoko, George Nxumayo, Cosmas, V. B. Dambo

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Early detection of plant invasions is a necessary prerequisite for effective invasive plant management in protected areas. This study was conducted to determine the distribution and abundance of alien invasive trees in Nyika National Park (NNP). Data on species' presence and abundance were collected from belt transects (n=31) in a 100 square kilometer area on the central plateau. The data were tested for normality using the Shapiro-Wilk test; Mann-Whitney test was carried out to compare frequencies and abundances between the species, and geographical information systems were used for spatial analyses. Results revealed that Black Wattle (Acacia mearnsii), Mexican Pine (Pinus patula) and Himalayan Raspberry (Rubus ellipticus) were the main alien invasive trees on the plateau. A. mearnsii was localized in the areas where it was first introduced, whereas P. patula and R. ellipticus were spread out beyond original points of introduction. R. ellipticus occurred as dense, extensive (up to 50 meters) thickets on the margins of forest patches and pine stands, whilst P. patula trees were frequent in the valleys, occurring most densely (up to 39 stems per 100 square meters) south-west of Chelinda camp on the central plateau with high variation in tree heights. Additionally, there were no significant differences in abundance between R. ellipticus (48) and P. patula (48) in the study area (p > 0.05) It was concluded that R. ellipticus and P. patula require more attention as compared to A. mearnsii. Howbeit, further studies into the invasion ecology of both P. patula and R. ellipticus on the Nyika plateau are highly recommended so as to assess the threat posed by the species on biodiversity, and recommend appropriate conservation measures in the national park.

Keywords: alien-invasive trees, Himalayan raspberry, Nyika National Park, Mexican pine

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Authors: Joana Margarida Bôto, Belmira Neto, Vera Miguéis, Manuela Meireles, Ada Rocha

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The Mediterranean diet has been recognized as a sustainable model of living with benefits for the environment and human health. However, a complete assessment of its sustainability, encompassing all dimensions and aspects, to our best knowledge, has not yet been realized. This systematic literature review aimed to fill this gap by identifying and describing the indicators used to assess the sustainability of the Mediterranean diet, looking at several dimensions, and presenting the results from their application. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines methodology was used, and searches were conducted in PubMed, Scopus, Web of Science, and GreenFile. There were identified thirty-two articles evaluating the sustainability of the Mediterranean diet. The environmental impact was quantified in twenty-five of these studies, the nutritional quality was evaluated in seven studies, and the daily cost of the diet was assessed in twelve studies. A total of thirty-three indicators were identified and separated by four dimensions of sustainability, specifically, the environmental dimension (ten indicators, namely carbon, water, and ecological footprint), the nutritional dimension (eight indicators, namely Health score and Nutrient Rich Food Index), the economic dimension (one indicator, the dietary cost), the sociocultural dimension (six indicators – with no results). Only eight of the studies used combined indicators. The Mediterranean diet was considered in all articles as a sustainable dietary pattern with a lower impact than Western diets. The carbon footprint ranged between 0.9 and 6.88 kg CO₂/d per capita, the water footprint between 600 and 5280 m³/d per capita, and the ecological footprint between 2.8 and 53.42 m²/d per capita. The nutritional quality was high, obtaining 122 points using the Health score and 12.95 to 90.6 points using the Nutrient Rich Food Index. The cost of the Mediterranean diet did not significantly differ from other diets and varied between 3.33 and 14.42€/d per capita. A diverse approach to evaluating the sustainability of the Mediterranean diet was found.

Keywords: Mediterranean diet, sustainability, environmental indicators, nutritional indicators

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Authors: Cristian Moisa, Andreea Lupitu, Adriana Csakvari, Dana G. Radu, Leonard Marian Olariu, Georgeta Pop, Dorina Chambre, Lucian Copolovici, Dana Copolovici

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Green synthesis of nanoparticles (NPs) represents a promising, accessible, eco-friendly, and safe process with significant applications in biotechnology, pharmaceutical sciences, and farming. The aim of our study was to obtain silver nanoparticles, using plant wastes extracts resulted in the essential oils extraction process: Thymus vulgaris L., Origanum vulgare L., Lavandula angustifolia L., and in hemp processing for seed and fibre, Cannabis sativa. Firstly, we obtained aqueous extracts of thyme, oregano, lavender, and hemp (two monoicous and one dioicous varieties), all harvested in western part of Romania. Then, we determined the chemical composition of the extracts by liquid-chromatography coupled with diode array and mass spectrometer detectors. The compounds identified in the extracts were in agreement with earlier published data, and the determination of the antioxidant activity of the obtained extracts by DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) assays confirmed their antioxidant activity due to their total polyphenolic content evaluated by Folin-Ciocalteu assay. Then, the silver nanoparticles (AgNPs) were successfully biosynthesised, as was demonstrated by UV-VIS, FT-IR spectroscopies, and SEM, by reacting AgNO₃ solution and plant extracts. AgNPs were spherical in shape, with less than 30 nm in diameter, and had a good bactericidal activity against Gram-positive (Staphylococcus aureus) and Gram-negative bacteria (Escherichia coli, Klebsiella pneumoniae, Pseudomonas fluorescens).

Keywords: plant wastes extracts, chemical composition, high performance liquid chromatography mass spectrometer, HPLC-MS, scanning electron microscopy, SEM, silver nanoparticles

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Authors: Mimoza Canga, Irene Malagnino, Ruzhdie Qafmolla, Vergjini Mulo, Gresa Baboci, Vito Antonio Malagnino

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Background: Dental caries represents the most widespread pathology in childhood. The prevalence of dental caries varies with age, gender, socio economic status, geographical location, nutrition habits, and oral hygiene. Objective: The objective of the present longitudinal study is to show clearly the prevalence of dental caries in the children of age 6 and 7 years old in Vlore, Albania, in a two year time period with controls done every 6 months. Materials and methods: The present study was conducted on 530 children, with a controlled sample for a time period of 24 months from September 2019- September 2021. The children in the study had different economic and social backgrounds. The teeth controls were done by the dentists who work at the hospital of the city. The present study was conducted in accordance with Helsinki declaration. Permissions were obtained in written form, which allowed us to perform the observations. Parents had the right to withdraw their children at any time. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: The data of the present study showed that the age group of 6 years old had 139 or 52.3% of the children with dental caries and 127 or 47.7% of them had no dental caries, while at the age of 7 there were 184 or 69.7% of the children with dental caries problems in the permanent molars and 80 or 30.3% of them had no dental caries. In the present study, it was observed that there is a statistically significant association between age group and presence of caries. Children 7 years old had higher presence of dental caries (χ2 = 16.934 (df 1) p-value < 0.001). According to the present research, there is a statistically significant correlation between period of time and the presence of dental caries. Furthermore, in the actual research, it was established that in the time 18-24 months, the prevalence of dental caries was high (χ2=15,318 (df 1) p-value = 0.004). Conclusion: According to the results of the present study performed in Albania in a two year time period with controls done every 6 months, it is proved that the prevalence of dental caries was 17.4 percent higher among children 7 years old in comparison with the children 6 years old.

Keywords: age, children, dental caries, permanent molars

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Authors: Shu-Yu Chung, Ying-Fang Wang, Shih-Min Wang

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To conduct long-term exposure assessments are important for workers exposed to chemicals with chronic effects. However, it usually encounters with several constrains, including cost, workers' willingness, and interference to work practice, etc., leading to inadequate long-term exposure data in the real world. In this study, an integrated approach was developed for conducting long-term exposure assessment for welding workers in a shipbuilding factory. A laboratory study was conducted to yield the fume generation rates under various operating conditions. The results and the measured environmental conditions were applied to the near field/far field (NF/FF) model for predicting long term fume exposures via the Monte Carlo simulation. Then, the predicted long-term concentrations were used to determine the prior distribution in Bayesian decision analysis (BDA). Finally, the resultant posterior distributions were used to assess the long-term exposure and serve as basis for initiating control strategies for shipbuilding workers. Results show that the NF/FF model was a suitable for predicting the exposures of metal contents containing in welding fume. The resultant posterior distributions could effectively assess the long-term exposures of shipbuilding welders. Welders' long-term Fe, Mn and Pb exposures were found with high possibilities to exceed the action level indicating preventive measures should be taken for reducing welders' exposures immediately. Though the resultant posterior distribution can only be regarded as the best solution based on the currently available predicting and monitoring data, the proposed integrated approach can be regarded as a possible solution for conducting long term exposure assessment in the field.

Keywords: Bayesian decision analysis, exposure assessment, near field and far field model, shipbuilding industry, welding fume

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Authors: Mirzaii Khadigeh

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Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

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Authors: Kwok W. Mui, Ling T. Wong, Tsz W. Tsang

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Many Hong Kong people nowadays spend most of their lifetime working indoor. Since poor Indoor Air Quality (IAQ) potentially leads to discomfort, ill health, low productivity and even absenteeism in workplaces, a call for establishing statutory IAQ control to safeguard the well-being of residents is urgently required. Although policies, strategies, and guidelines for workplace IAQ diagnosis have been developed elsewhere and followed with remedial works, some of those workplaces or buildings have relatively late stage of the IAQ problems when the investigation or remedial work started. Screening for IAQ problems should be initiated as it will provide information as a minimum provision of IAQ baseline requisite to the resolution of the problems. It is not practical to sample all air pollutants that exit. Nevertheless, as a statutory control, reliable, rapid screening is essential in accordance with a compromise strategy, which balances costs against detection of key pollutants. This study investigates the feasibility of using an IAQ index as a parameter of IAQ control in Hong Kong. The index is a screening parameter to identify the unsatisfactory workplace IAQ and will highlight where a fully effective IAQ monitoring and assessment is needed for an intensive diagnosis. There already exist a number of representative common indoor pollutants based on some extensive IAQ assessments. The selection of pollutants is surrogate to IAQ control consists of dilution, mitigation, and emission control. The IAQ Index and assessment will look at high fractional quantities of these common measurement parameters. With the support of the existing comprehensive regional IAQ database and the IAQ Index by the research team as the pre-assessment probability, and the unsatisfactory IAQ prevalence as the post-assessment probability from this study, thresholds of maintaining the current measures and performing a further IAQ test or IAQ remedial measures will be proposed. With justified resources, the proposed IAQ Index and assessment protocol might be a useful tool for setting up a practical public IAQ surveillance programme and policy in Hong Kong.

Keywords: assessment, index, indoor air quality, surveillance programme

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Authors: Ragi Poyyara, Vijaya Patnana, Mohammed Alam

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When acid is pumped into damaged reservoirs for damage removal/stimulation, distorted inflow of acid into the formation occurs caused by acid preferentially traveling into highly permeable regions over low permeable regions, or (in general) into the path of least resistance. This can lead to poor zonal coverage and hence warrants diversion to carry out an effective placement of acid. Diversion is desirably a reversible technique of temporarily reducing the permeability of high perm zones, thereby forcing the acid into lower perm zones. The uniqueness of each reservoir can pose several challenges to engineers attempting to devise optimum and effective diversion strategies. Diversion techniques include mechanical placement and/or chemical diversion of treatment fluids, further sub-classified into ball sealers, bridge plugs, packers, particulate diverters, viscous gels, crosslinked gels, relative permeability modifiers (RPMs), foams, and/or the use of placement techniques, such as coiled tubing (CT) and the maximum pressure difference and injection rate (MAPDIR) methodology. It is not always realized that the effectiveness of diverters greatly depends on reservoir properties, such as formation type, temperature, reservoir permeability, heterogeneity, and physical well characteristics (e.g., completion type, well deviation, length of treatment interval, multiple intervals, etc.). This paper reviews the mechanisms by which each variety of diverter functions and discusses the effect of various reservoir properties on the efficiency of diversion techniques. Guidelines are recommended to help enhance productivity from zones of interest by choosing the best methods of diversion while pumping an optimized amount of treatment fluid. The success of an overall acid treatment often depends on the effectiveness of the diverting agents.

Keywords: diversion, reservoir, zonal coverage, carbonate, sandstone

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Authors: Boshra Mozaffar, Arash Ardavani, Iskandar Idris

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Food taste and flavor affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect taste which can result in reduced appetite, weight loss and psychological problems, but the efficacy of Zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. We searched four electronic bibliographical databases; Ovid MEDLINE, Ovid Embase, Ovid AMAD and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. To facilitate the collection and identification of all available and relevant articles published before 7 December 2020, there were no restrictions on the publication date. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. In total, we included 12 randomized controlled trials with 938 subjects. Intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc and acetate); the pooled results of the meta-analysis indicate that improvements in taste disorder occurred more frequently in the intervention group compared to the control group (RR = 1.8; 95% CI:1.27 -2.57, p=0.009). The doses are equivalent to 17 mg- 86.7 mg of elemental zin for three to six months. Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency or idiopathic taste disorders when given in high doses ranging from 68–86.7 mg/d for up to three months. However, we did not find sufficient evidence to determine the effectiveness of zinc supplementation in patients with taste disorders induced by chronic renal failure.

Keywords: taste change, taste disorder, zinc, zinc sulfate or Zn, deficiency, supplementation.

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Authors: Rohin Rameswarapu, Sameer Valsangkar

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Background: Globally, musculoskeletal disorders are the largest single cause of work-related illnesses accounting for over 33% of all newly reported occupational illnesses. Risk factors for MSD need to be delineated to suggest means for amelioration. Material and methods: In this current cross-sectional study, the prevalence of MSDs among workers in an electrical company assembly line, the socio-demographic and job characteristics associated with MSD were obtained through a semi-structured questionnaire. A quantitative assessment of the physical risk factors through the Rapid Upper Limb Assessment (RULA) tool, and measurement of psychosocial risk factors through a Likert scale was obtained. Statistical analysis was conducted using Epi-info software and descriptive and inferential statistics including chi-square and unpaired t test were obtained. Results: A total of 263 workers consented and participated in the study. Among these workers, 200 (76%) suffered from MSD. Most of the workers were aged between 18–27 years and majority of the workers were women with 198 (75.2%) of the 263 workers being women. A chi square test was significant for association between male gender and MSD with a P value of 0.007. Among the MSD positive group, 4 (2%) had a grand score of 5, 10 (5%) had a grand score of 6 and 186 (93%) had a grand score of 7 on RULA. There were significant differences between the non-MSD and MSD group on five out of the seven psychosocial domains, namely job demand, job monotony, co-worker support, decision control and family and environment domains. Discussion: The current cross-sectional study demonstrates a high prevalence of MSD among assembly line works with inherent physical and psychosocial risk factors and recommends that not only physical risk factors, addressing psychosocial risk factors through proper ergonomic means is also essential to the well-being of the employee.

Keywords: musculoskeletal disorders, India, occupational health, Rapid Upper Limb Assessment (RULA)

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Authors: Meera Shanker

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Excellent education and financial need have encouraged Indian women to go out and work in well-paid and high-status occupations. In the era of cutthroat competition, women are expected to work hard to produce the desired result; hence, workload and expectations haveincreased. At home, they are anticipated to take care of family members, children, and household work. Women are stretching themselves mechanically to remain in the job competition and try to give their best at home. Consequentially, they are under tremendous pressure, stressed, and having issues related to physical-mental wellness. Mental healthcare is often ignored and not accepted due to a lack of awareness and cultural barriers. These further compounds the problem, resulting in decreased productivity in economic terms and an increase in stress-related physical-mental ailments. The main objective of the study was to find out the impact of stress on the physical-mental wellbeing of working women in India, along with their awareness and acceptability related to mental health. Six hundred and one woman working at various levels took part in this study, responding to the items related to stress and physical-mental illness. Finally, 21 items were retained under four meaningful factors measuring stress dimensions along with 17 items with three factors measuring physical-mental wellbeing. Confirmatory Factor Analysis (CFA), path analysis, in Structural Equation Modeling (SEM), was used to get a relationship, validity of the instruments. The psychometric properties of items and Cronbach’s Alpha reliabilities calculated for the subscales were relatively acceptable. The subscale correlations, regression, and path analysis of stress dimensions with physical-mental illness were found to be positive, indicating the growing stress among working women in India, which is impacting their physical-mental health. Single item analysis revealed that 77 percent of women have never visited psychologists. However, 70 percent of working women were not ready to seek the help of a psychologist.

Keywords: working women, stress, physical-mental well-being, confirmatory factor analysis

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Authors: Ibrahim Obeidat

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Reaching a fully-connected network of mobile nodes in rural areas got a great attention between network researchers. This attention rose due to the complexity and high costs while setting up the needed infrastructures for these networks, in addition to the low transmission range these nodes has. Terranet technology, as an example, employs ad-hoc mesh network where each node has a transmission range not exceed one kilometer, this means that every two nodes are able to communicate with each other if they are just one kilometer far from each other, otherwise a third-party will play the role of the “relay”. In Terranet, and as an idea to reduce network setup cost, every node in the network will be considered as a router that is responsible of forwarding data between other nodes which result in a decentralized collaborative environment. Most researches on Terranet presents the idea of how to encourage mobile nodes to become more cooperative by letting their devices in “ON” state as long as possible while accepting to play the role of relay (router). This research presents the issue of finding the percentage of nodes in ad-hoc mesh network within rural areas that should play the role of relay at every time slot, relating to what is the actual area coverage of nodes in order to have the network reach the fully-connectivity. Far from our knowledge, till now there is no current researches discussed this issue. The research is done by making an implementation that depends on building adjacency matrix as an indicator to the connectivity between network members. This matrix is continually updated until each value in it refers to the number of hubs that should be followed to reach from one node to another. After repeating the algorithm on different area sizes, different coverage percentages for each size, and different relay percentages for several times, results extracted shows that for area coverage less than 5% we need to have 40% of the nodes to be relays, where 10% percentage is enough for areas with node coverage greater than 5%.

Keywords: ad-hoc mesh networks, network connectivity, mobile ad-hoc networks, Terranet, adjacency matrix, simulator, wireless sensor networks, peer to peer networks, vehicular Ad hoc networks, relay

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Authors: Kathryn Strachan, Sameer Otoom, Amal AL-Gallaf, Ahmed Al Ansari

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Introduction: Introducing a reliable method to select graduates for an award in higher education can be challenging but is not impossible. Multisource feedback (MSF) is a popular assessment tool that relies on evaluations of different groups of people, including physicians and non-physicians. It is useful for assessing several domains, including professionalism, communication and collaboration and may be useful for selecting the best interns to receive a University award. Methods: 16 graduates responded to an invitation to participate in the student award, which was conducted by the Royal College of Surgeons of Ireland-Bahrain Medical University of Bahrain (RCSI Bahrain) using the MSF process. Five individuals from the following categories rated each participant: physicians, nurses, and fellow students. RCSI Bahrain graduates were assessed in the following domains; professionalism, communication, and collaboration. Mean and standard deviation were calculated and the award was given to the graduate who scored the highest among his/her colleagues. Cronbach’s coefficient was used to determine the questionnaire’s internal consistency and reliability. Factor analysis was conducted to examine for the construct validity. Results: 16 graduates participated in the RCSI-Bahrain interns’ award based on the MSF process, giving us a 16.5% response rate. The instrument was found to be suitable for factor analysis and showed 3 factor solutions representing 79.3% of the total variance. Reliability analysis using Cronbach’s α reliability of internal consistency indicated that the full scale of the instrument had high internal consistency (Cronbach’s α 0.98). Conclusion: This study found the MSF process to be reliable and valid for selecting the best graduates for the interns’ awards. However, the low response rates may suggest that the process is not feasible for allowing the majority of the students to participate in the selection process. Further research studies may be required to support the feasibility of the MSF process in selecting graduates for the university award.

Keywords: MSF, RCSI, validity, Bahrain

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Authors: Abhishek Pandey

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Ibuprofen and Acetaminophen is widely used as prescription & non-prescription medicine. Ibuprofen mainly used in the treatment of mild to moderate pain related to headache, migraine, postoperative condition and in the management of spondylitis, osteoarthritis and rheumatoid arthritis. Acetaminophen is used as an analgesic and antipyretic drug. Ibuprofen having high tendency of sticking to punches of tablet punching machine while Acetaminophen is not ordinarily compressible to tablet formulation because Acetaminophen crystals are very hard and brittle in nature and fracture very easily when compressed producing capping and laminating tablet defects therefore wet granulation method is used to make them compressible. The aim of study was to prepare Ibuprofen and Acetaminophen tablets by direct compression and top spray granulation technique. In this Investigation tablets were prepared by using directly compressible grade excipients. Dibasic calcium phosphate, lactose anhydrous (DCL21), microcrystalline cellulose (Avicel PH 101). In order to obtain best or optimized formulation, nine different formulations were generated among them batch F7, F8, F9 shows good results and within the acceptable limit. Formulation (F7) selected as optimize product on the basis of dissolution study. Furtherly, directly compressible granules of both drugs were prepared by using top spray granulation technique in fluidized bed processor equipment and compressed .In order to obtain best product process optimization was carried out by performing four trials in which various parameters like inlet air temperature, spray rate, peristaltic pump rpm, % LOD, properties of granules, blending time and hardness were optimized. Batch T3 coined as optimized batch on the basis physical & chemical evaluation. Finally formulations prepared by both techniques were compared.

Keywords: direct compression, top spray granulation, process optimization, blending time

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Authors: Amit Kaushik

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Equus kiang kiang is an indigenous large-bodied herbivore species, and in India, it is restricted to limited geographies of Ladakh. One of such areas is the Tsokar Basin. With the rise in global pashmina demand, the livestock numbers have grown significantly. Previous studies have reported conflict between a nomadic pastoral community, the Changpas, and kiang. Absentee pastoralism (in lieu of pure pastoralism) and tourism are two major economic activities among the local people. However, the social, economic, political, and ecological changes are inevitable in such a contemporary system. The study examines several factors influencing the local pastoral economy and focuses on the presence of two non-human cohabitants, kiang, and the wolf. This study used semi-structured interviews and vehicle count method in four different seasons. The results show that people perceived kiang as a threat but also reveal a level of tolerance towards them. The locals predicted high kiang numbers ranging from 200-3000 in the basin and contrastingly ranked them behind wolves, which are very few in numbers. Due to a lack of scientific pieces of evidence, the kiang population status remains obscure, and local peoples’ concerns remain unaddressed. But how this competitive dysfunctionality does take place? On one side, the rural development or the animal husbandry department aims at developing the area by providing stall-feed and tourism, whereas, on another side, the wildlife department emphasizes wildlife conservation. Therefore, the managers and planners may need to be cautious about the local socio-ecological complexities and may require inter-departmental communications. The study concludes that an interdisciplinary inquiry may be an important tool in understanding such a precarious situation and may be used in the policy-making processes.

Keywords: coexistence, human-livestock-wildlife interactions, interdisciplinary approach, kiang, policymaking, tsokar.

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Authors: Jou-An Chung

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The purpose of this study is to investigate the verb bias of the Mandarin verbs in children’s reading materials and provide the criteria for categorization. Verb bias varies cross-linguistically. As Mandarin and English are typological different, this study hopes to shed light on Mandarin verb bias with the use of corpus and provide thorough and detailed criteria for analysis. Moreover, this study focuses on children’s reading materials since it is a significant issue in understanding children’s sentence processing. Therefore, investigating verb bias of Mandarin verbs in children’s reading materials is also an important issue and can provide further insights into children’s sentence processing. The small corpus is built up for this study. The corpus consists of the collection of school textbooks and Mandarin Daily News for children. The files are then segmented and POS tagged by JiebaR (Chinese segmentation with R). For the ease of analysis, the one-word character verbs and intransitive verbs are excluded beforehand. The total of 20 high frequency verbs are hand-coded and are further categorized into one of the three types, namely DO type, SC type and other category. If the frequency of taking Other Type exceeds the threshold of 25%, the verb is excluded from the study. The results show that 10 verbs are direct object bias verbs, and six verbs are sentential complement bias verbs. The paired T-test was done to assure the statistical significance (p = 0.0001062 for DO bias verb, p=0.001149 for SC bias verb). The result has shown that in children’s reading materials, the DO biased verbs are used more than the SC bias verbs since the simplest structure of sentences is easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child's reading materials but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context. Sentences are easier for children’s sentence comprehension or processing. In sum, this study not only discussed verb bias in child corpus, but also provided basic coding criteria for verb bias analysis in Mandarin and underscored the role of context.

Keywords: corpus linguistics, verb bias, child language, psycholinguistics

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Authors: Hasan Türe, Kader Terzioglu, Evren Tunca

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Contamination of aqueous environment by heavy metal ions is a serious and complex problem, owing to their hazards to human being and ecological systems. The treatment methods utilized for removing metal ions from aqueous solution include membrane separation, ion exchange and chemical precipitation. However, these methods are limited by high operational cost. Recently, biobased beads are considered as promising biosorbent to remove heavy metal ions from water. The aim of present study was to characterize the alginate/perlite composite beads and to investigate the adsorption performance of obtained beads for removing Pb (II) from aqueous solution. Alginate beads were synthesized by ionic gelation methods and different amount of perlite (aljinate:perlite=1, 2, 3, 4, 5 wt./wt.) was incorporated into alginate beads. Samples were characterized by means of X-ray diffraction (XRD), thermogravimetric analysis (TGA), scanning electron microscopy (SEM). The effects of perlite level, the initial concentration of Pb (II), initial pH value of Pb(II) solution and effect of contact time on the adsorption capacity of beads were investigated by using batch method. XRD analysis indicated that perlite includes silicon or silicon and aluminum bearing crystalline phase. The diffraction pattern of perlite containing beads is similar to that of that perlite powder with reduced intensity. SEM analysis revealed that perlite was embedded into alginate polymer and SEM-EDX (Energy-Dispersive X-ray) showed that composite beads (aljinate:perlite=1) composed of C (41.93 wt.%,), O (43.64 wt.%), Na (10.20 wt.%), Al (0.74 wt.%), Si (2.72 wt.%) ve K (0.77 wt.%). According to TGA analysis, incorporation of perlite into beads significantly improved the thermal stability of the samples. Batch experiment indicated that optimum pH value for Pb (II) adsorption was found at pH=7 with 1 hour contact time. It was also found that the adsorption capacity of beads decreased with increases in perlite concentration. The results implied that alginate/perlite composite beads could be used as promising adsorbents for the removal of Pb (II) from wastewater. Acknowledgement: This study was supported by TUBITAK (Project No: 214Z146).

Keywords: alginate, adsorption, beads, perlite

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Authors: Siddhant Yadav, Ann Vincent, Sanjeev Nanda, Karen M. Fischer, Jessica A. Wright

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Statement of the Problem: Despite the growing popularity of cannabis in the general population, there are several unknowns regarding its use, specific reasons for use, patient’s choice of products, health benefits, and adverse effects. The aim of our study was to evaluate patient-reported information related to cannabis use that was recorded in the electronic medical records. Methodology & Theoretical Orientation: We manually reviewed the electronic medical records of cannabis users who were part of a large pharmacogenomic study. Data abstracted included demographics, level of education, concurrent alcohol and tobacco use, type of cannabis utilized, formulation, indication, symptomatic improvement, or adverse effects reported. Following this, we did a descriptive statistical analysis. Findings: Our sample of 164 cannabis users were predominantly female (73.2%); 66% of users reported using cannabis for medical indications. Of the 109 patients who recorded information pertaining to alcohol/tobacco use, two-thirds of cannabis users reported concurrent use of alcohol, and about half of them were former or current tobacco users. The mean age of cannabis use was 66 years. Regarding the type of cannabis, 34.1% reported using marijuana, 32.3% reported CBD use, 1.8% reported using THC, and 1.2% reported using Marinol. Oral formulations (capsules, oils, suspensions, brownies, cakes, and tea) were the most common route (44 %). Indications for use included chronic pain (n=76), anxiety (n=9), counteracting side effects of chemotherapy (n=4), and palliative reasons (n=2). Fifty-eight of the 76 users endorsed improvement in chronic pain (80%), 5 users reported improvement in anxiety, and 2 reported improvement in side effects of chemotherapy. Conclusion & Significance: The majority of our cannabis users were Caucasian females, and there was a high likelihood of coinciding use of alcohol/tobacco in patients using cannabis. Most of our patients used the oral formulation for chronic pain. Importantly, a considerable number of patients reported improvements in chronic pain, anxiety, and side effects of chemotherapy.

Keywords: cannabis use, adverse effects, medical practice, indications

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Authors: Benbelkacem Ouerdia

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Heterotrophic denitrification has been proven to be one of the most feasible processes for removing nitrate from wastewater and drinking water. In this process, heterotrophic bacteria use organic carbon for both growth and as an electron source. Underground water pollution by nitrates become alarming in Algeria. A survey carried out revealed that the nitrate concentration is in continual increase. Studies in some region revealed contamination exceeding the recommended permissible dose which is 50 mg/L. Worrying values in the regions of Mascara, Ouled saber, El Eulma, Bouira and Algiers are respectively 72 mg/L, 75 mg/L, 97 mg/L, 102 mg/L, and 158 mg/L. High concentration of nitrate in drinking water is associated with serious health risks. Research on nitrate removal technologies from municipal water supplies is increasing because of nitrate contamination. Biological denitrification enables the transformation of oxidized nitrogen compounds by a wide spectrum of heterotrophic bacteria into harmless nitrogen gas with accompanying carbon removal. Globally, denitrification is commonly employed in biological nitrogen removal processes to enhance water quality The study investigated the valorization of a vegetable residue as a carbon source (dates nodes) in water treatment using the denitrification process. Throughout the study, the effect of inoculums addition, pH, and initial concentration of nitrates was also investigated. In this research, a natural organic substance: dates nodes were investigated as a carbon source in the biological denitrification of drinking water. This material acts as a solid substrate and bio-film carrier. The experiments were carried out in batch processes. Complete denitrification was achieved varied between 80 and 100% according to the type of process used. It was found that the nitrate removal rate based on our results, we concluded that the removal of organic matter and nitrogen compounds depended mainly on the initial concentration of nitrate. The effluent pH was mainly affected by the C/N ratio, where a decrease increases pH.

Keywords: biofilm, carbon source, dates nodes, heterotrophic denitrification, nitrate, nitrite

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Authors: Said Moqeem Sadat, Saito Takahiro, Inuzuka Norikazu, Sugiyama Ikuo

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Kabul city is the capital of Afghanistan with a population of about 4.0 million in 2009 and 6.5 million in 2025. It is geographically located in a narrow plain valley along the Kabul River and is surrounded by high mountains. Due to its sharp geological condition, the city has been suffering from floods caused by storm water and snow melting water in the rainy season. Meanwhile, potable water resources are becoming a critical issue as the underground water table is decreasing falling rapidly due to domestic usage, industrial and agricultural activities usage especially in the dry season. This paper focuses on flood water management in Kabul including suburban agricultural area considering not only for flood protection but also: 1. To reserve the quality underground water for the future population growth. 2. To irrigate farming area in dry season using storm water ponds in rainy season. 3. To discharge city contaminated flood water to the downstream safely using existing channels/new pipes. Cost and benefit is considered in this study to find out a suitable flood protection method both in rural area and city center from a view point of 1 to 3 mentioned above. In this analysis, cost mainly consists of lost opportunity to develop lands due to flood ponds in addition to construction and maintenance one including connecting channels for water collecting/discharging. Benefit mainly consists of damage reduction of flood loss due to counter measures (this is corresponding cost) in addition to the contribution to agricultural crops. As far as reservation of the ground water for the future city growth is concerned, future demand and supply are compared in case that the pumping amount is limited by this irrigation system.

Keywords: cost-benefit, hydrological modeling, water management, water quality

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Authors: Deybith Venegas-Rojas, Jens Budde, Dominik Nörz, Manfred Jücker, Hoc Khiem Trieu

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Microfluidics is a promising approach for biomedicine cell culture experiments with microfluidic bioreactors (MBR), which can provide high precision in volume and time control over mass transport and microenvironments in small-scale studies. Nevertheless, shear stress and oxygen concentration are important factors that affect the microenvironment and then the cell culture. It is presented a novel MBR design in which differences in geometry, shear stress, and oxygen concentration were studied and optimized for cell culture. The aim is to mimic the in vivo condition with biocompatible materials and continuous perfusion of nutrients, a healthy shear stress, and oxygen concentration. The design consists of a capture system of PDMS micropillars which keep cells in place, so it is not necessary any hydrogel or complicated scaffolds for cells immobilization. Besides, the design allows continuous supply with nutrients or even any other chemical for cell experimentation. Finite element method simulations were used to study and optimize the effect of parameters such as flow rate, shear stress, oxygen concentration, micropillars shape, and dimensions. The micropillars device was fabricated with microsystem technology such as soft-lithography, deep reactive ion etching, self-assembled monolayer, replica molding, and oxygen plasma bonding. Eight different geometries were fabricated and tested, with different flow rates according to the simulations. During the experiments, it was observed the effect of micropillars size, shape, and configuration for stability and shear stress control when increasing flow rate. The device was tested with several successful HepG2 3D cell cultures. With this MBR, the aforementioned parameters can be controlled in order to keep a healthy microenvironment according to specific necessities of different cell types, with no need of hydrogels and can be used for a wide range of experiments with cells.

Keywords: cell culture, micro-bioreactor, microfluidics, micropillars, oxygen concentration, shear stress

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Authors: Riky Tri Hartagung, Mohammad Syamsu Rosid

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The lithology prediction process, as well as the fluid content is the most important part in the reservoir characterization. One of the methods used in this process is the simultaneous seismic inversion method. In the Posseidon field, Browse Basin, Australia, the parameters generated through simultaneous seismic inversion are not able to characterize the reservoir accurately because of the overlapping impedance values between hydrocarbon sand, water sand, and shale, which causes a high level of ambiguity in the interpretation. The Poisson Impedance inversion provides a solution to this problem by rotating the impedance a few degrees, which is obtained through the coefficient c. Coefficient c is obtained through the Target Correlation Coefficient Analysis (TCCA) by finding the optimum correlation coefficient between Poisson Impedance and the target log, namely gamma ray, effective porosity, and resistivity. Correlation of each of these target logs will produce Lithology Impedance (LI) which is sensitive to lithology sand, Porosity Impedance (ϕI) which is sensitive to porous sand, and Fluid Impedance (FI) which is sensitive to fluid content. The results show that PI gives better results in separating hydrocarbon saturated reservoir zones. Based on the results of the LI-GR crossplot, the ϕI-effective porosity crossplot, and the FI-Sw crossplot with optimum correlations of 0.74, 0.91, and 0.82 respectively, it shows that the lithology of hidrocarbon-saturated porous sand is at the value of LI ≤ 2800 (m/s)(g *cc), ϕI ≤ 5500 (m/s)(g*cc), and FI ≤ 4000 (m/s)(g*cc). The presence of low values of LI, ϕI, and FI correlates accurately with the presence of hydrocarbons in the well. Each value of c is then applied to the seismic data. The results show that the PI inversion gives a good distribution of Hydrocarbon-saturated porous sand lithology. The distribution of hydrocarbon saturated porous sand on the seismic inversion section is seen in the northeast – southwest direction, which is estimated as the direction of gas distribution.

Keywords: reservoir characterization, poisson impedance, browse basin, poseidon field

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Authors: Ying-Hsiang Ho, Hsiao-Tseng Lin

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Mudan Township is a remote mountainous area in Taiwan. In recent years, due to the migration of the population, inconvenient transportation, digital divide, and low production, agricultural products marketing have become a major issue. This research aims to develop the marketing strategy suitable for the agricultural products of the rural areas. The main objective of this work is to conduct in-depth interviews with scholars and experts in the marketing field, combined with the marketing 4P combination, to analyze and summarize the possible marketing strategies for agricultural products for remote districts. The interviews consist of seven experts from industry who have practical experience in producing, marketing, and selling agricultural products and three professors that have experience in teaching marketing management. The in-depth interviews are conducted for about an hour using a pre-drafted interview outline. The results of the interviews are summarized by semantic analysis and presented in a marketing 4P combination. The results indicate that in terms of products, high-quality products with original characteristics can be added through the implementation of production history, organic certification, and cultural packaging. In the place part, we found that the use of emerging communities, the emphasis on cross-industry alliances, the improvement of information application capabilities of rural households, production and marketing group, and contractual farming system are the development priorities. In terms of promotion, it should be an emphasis on the management of internet social media and word-of-mouth marketing. Mudan Township may consider promoting agricultural products through special festivals such as farmer's market, wild ginger flower season and hot spring season. This research also proposes relevant recommendations for the government's public sector and related industry reference for the promotion of agricultural products for remote area.

Keywords: marketing strategy, remote districts, agricultural products, in-depth interviews

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Authors: Lixin Tian, Wei Xue

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Many jobs in society go underground, such as mine mining, tunnel construction and subways, which are vital to the development of society. Once accidents occur in these places, the interruption of traditional wired communication is not conducive to the development of rescue work. In order to realize the positioning, early warning and command functions of underground personnel and improve rescue efficiency, it is necessary to develop and design an emergency ground communication system. It is easy to be subjected to narrowband interference when performing conventional underground communication. Spreading communication can be used for this problem. However, general spread spectrum methods such as direct spread communication are inefficient, so it is proposed to use parallel combined spread spectrum (PCSS) communication to improve efficiency. The PCSS communication not only has the anti-interference ability and the good concealment of the traditional spread spectrum system, but also has a relatively high frequency band utilization rate and a strong information transmission capability. So, this technology has been widely used in practice. This paper presents a PCSS communication model-multiple detection parallel combined spread spectrum (MDPCSS) communication system. In this paper, the principle of MDPCSS communication system is described, that is, the sequence at the transmitting end is processed in blocks and cyclically shifted to facilitate multiple detection at the receiving end. The block diagrams of the transmitter and receiver of the MDPCSS communication system are introduced. At the same time, the calculation formula of the system bit error rate (BER) is introduced, and the simulation and analysis of the BER of the system are completed. By comparing with the common parallel PCSS communication, we can draw a conclusion that it is indeed possible to reduce the BER and improve the system performance. Furthermore, the influence of different pseudo-code lengths selected on the system BER is simulated and analyzed, and the conclusion is that the larger the pseudo-code length is, the smaller the system error rate is.

Keywords: cyclic shift, multiple detection, parallel combined spread spectrum, PN code

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Authors: Jhe-Hao Huang, Kun-Da Wu, Wei-Cheng Shih, Jui-Pin Hung

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This study presented the investigation on the dynamic characteristics of a spindle tool system by experimental and finite element modeling approaches. As well known facts, the machining stability is greatly determined by the dynamic characteristics of the spindle tool system. Therefore, understanding the factors affecting dynamic behavior of a spindle tooling system is a prerequisite in dominating the final machining performance of machine tool system. To this purpose, a physical spindle unit was employed to assess the dynamic characteristics by vibration tests. Then, a three-dimensional finite element model of a high-speed spindle system integrated with tool holder was created to simulate the dynamic behaviors. For modeling the angular contact bearings, a series of spring elements were introduced between the inner and outer rings. The spring constant can be represented by the contact stiffness of the rolling bearing based on Hertz theory. The interface characteristic between spindle nose and tool holder taper can be quantified from the comparison of the measurements and predictions. According to the results obtained from experiments and finite element predictions, the vibration behavior of the spindle is dominated by the bending deformation of the spindle shaft in different modes, which is further determined by the stiffness of the bearings in spindle housing. Also, the spindle unit with tool holder shows a different dynamic behavior from that of spindle without tool holder. This indicates the interface property between tool holder and spindle nose plays an dominance on the dynamic characteristics the spindle tool system. Overall, the dynamic behaviors the spindle with and without tool holder can be successfully investigated through the finite element model proposed in this study. The prediction accuracy is determined by the modeling of the rolling interface of ball bearings in spindles and the interface characteristics between tool holder and spindle nose. Besides, identifications of the interface characteristics of a ball bearing and spindle tool holder are important for the refinement of the spindle tooling system to achieve the optimum machining performance.

Keywords: contact stiffness, dynamic characteristics, spindle, tool holder interface

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Authors: Yan Wang, Guowei Chen, Gang Wang

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Soil microbial diversity is one of the important parameters to assess the soil fertility and soil health, even stability of the ecosystem. In this paper, we aim to reveal the soil microbial difference in rhizosphere and root zone, even to pick the special biomarkers influenced by the long term tillage practices, which included four treatments of no-tillage, ridge tillage, continuous cropping with corn and crop rotation with corn and soybean. Here, high-throughput sequencing was performed to investigate the difference of bacteria in rhizosphere and root zone. The results showed a very significant difference of species richness between rhizosphere and root zone soil at the same crop rotation system (p < 0.01), and also significant difference of species richness was found between continuous cropping with corn and corn-soybean rotation treatment in the rhizosphere statement, no-tillage and ridge tillage in root zone soils. Implied by further beta diversity analysis, both tillage methods and crop rotation systems influence the soil microbial diversity and community structure in varying degree. The composition and community structure of microbes in rhizosphere and root zone soils were clustered distinctly by the beta diversity (p < 0.05). Linear discriminant analysis coupled with effect size (LEfSe) analysis of total taxa in rhizosphere picked more than 100 bacterial taxa, which were significantly more abundant than that in root zone soils, whereas the number of biomarkers was lower between the continuous cropping with corn and crop rotation treatment, the same pattern was found at no-tillage and ridge tillage treatment. Bacterial communities were greatly influenced by main environmental factors in large scale, which is the result of biological adaptation and acclimation, hence it is beneficial for optimizing agricultural practices.

Keywords: tillage methods, biomarker, biodiversity, rhizosphere

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Authors: Brian Connett, Bryan O'Halloran

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Systems assets within critical infrastructures were seemingly safe from the exploitation or attack by nefarious cyberspace actors. Now, critical infrastructure is a target and the resources to exploit the cyber physical systems exist. These resources are characterized in terms of patience, stealth, replication-ability and extraordinary robustness. System owners are obligated to maintain a high level of protection measures. The difficulty lies in knowing when to fortify a critical infrastructure against an impending attack. Models currently exist that demonstrate the value of knowing the attacker’s capabilities in the cyber realm and the strength of the target. The shortcomings of these models are that they are not designed to respond to the inherent fast timing of an attack, an impetus that can be derived based on open-source reporting, common knowledge of exploits of and the physical architecture of the infrastructure. A useful model will inform systems owners how to align infrastructure architecture in a manner that is responsive to the capability, willingness and timing of the attacker. This research group has used an existing theoretical model for estimating parameters, and through analysis, to develop a decision tool for would-be target owners. The continuation of the research develops further this model by estimating the variable parameters. Understanding these parameter estimations will uniquely position the decision maker to posture having revealed the vulnerabilities of an attacker’s, persistence and stealth. This research explores different approaches to improve on current attacker-defender models that focus on cyber threats. An existing foundational model takes the point of view of an attacker who must decide what cyber resource to use and when to use it to exploit a system vulnerability. It is valuable for estimating parameters for the model, and through analysis, develop a decision tool for would-be target owners.

Keywords: critical infrastructure, cyber physical systems, modeling, exploitation

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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