Search results for: district general hospital

Authors: Nahla Khatib

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This study investigated several learning difficulties that affected the classroom learning experience of preservice students who are studying general science and methods of teaching science students at Faculty of Educational Studies at the Arab Open University (AOU) in Amman, Jordan. The focus questions for this study were to find answers for the following: 1. What are the main areas of learning difficulty among preservice students towards science education? 2. What are the main aspects of reducing obstacles towards success in science education? To achieve this goal, the researcher prepared a questionnaire which included 30 items to point out the learning difficulties among preservice students towards science education. The questionnaire was distributed among students enrolled in the general science courses 1&2 and methods of teaching science courses at the beginning of the spring semester of year (2013-2014). After collecting the filled questionnaire a descriptive statistical analysis was carried out (means and standard deviation) for the items of the questionnaire. After analyzing the data statistically our findings showed that student control–factors as well as course controlled factor, factors related to the nature of science, and factors related to the role of instructor affected student success toward science education. The study was concluded with a number of recommendations.

Keywords: nature of science, preservice teachers, science education, learning difficulties

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Authors: David C. Ni

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The current efforts for Grand Unification Theory (GUT) can be classified into General Relativity, Quantum Mechanics, String Theory and the related formalisms. In the geometric approaches for extending General Relativity, the efforts are establishing global and local invariance embedded into metric formalisms, thereby additional dimensions are constructed for unifying canonical formulations, such as Hamiltonian and Lagrangian formulations. The approaches of extending Quantum Mechanics adopt symmetry principle to formulate algebra-group theories, which evolved from Maxwell formulation to Yang-Mills non-abelian gauge formulation, and thereafter manifested the Standard model. This thread of efforts has been constructing super-symmetry for mapping fermion and boson as well as gluon and graviton. The efforts of String theory currently have been evolving to so-called gauge/gravity correspondence, particularly the equivalence between type IIB string theory compactified on AdS5 × S5 and N = 4 supersymmetric Yang-Mills theory. Other efforts are also adopting cross-breeding approaches of above three formalisms as well as competing formalisms, nevertheless, the related symmetries, dualities, and correspondences are outlined as principles and techniques even these terminologies are defined diversely and often generally coined as duality. In this paper, we firstly classify these dualities from the perspective of physics. Then examine the hierarchical structure of classes from mathematical perspective referring to Coleman-Mandula theorem, Hidden Local Symmetry, Groupoid-Categorization and others. Based on Fundamental Theorems of Algebra, we argue that rather imposing effective constraints on different algebras and the related extensions, which are mainly constructed by self-breeding or self-mapping methodologies for sustaining invariance, we propose a new addition, momentum-angular momentum duality at the level of electromagnetic duality, for rationalizing the duality algebras, and then characterize this duality numerically with attempt for addressing some unsolved problems in physics and astrophysics.

Keywords: general relativity, quantum mechanics, string theory, duality, symmetry, correspondence, algebra, momentum-angular-momentum

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Authors: Aroona Hashmi

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Student’s success in Mathematics and Science depends upon their learning attitude towards both subjects. It also influences the participation rate of the learner. The present study was based on a survey of high school students about their attitude towards Mathematics and Science at Secondary level. Students of the both gender constitute the population of this study. Sample of the study was 276 students and 20 teachers from 10 Government schools from Lahore District. Questionnaire and interview were selected as tool for data collection. The results showed that Pakistani students’ positive attitude towards learning Mathematics and Science. There was a significance difference between the students’ attitude towards learning Mathematics and no significance difference was found in the students’ attitude towards learning Science at Secondary level.

Keywords: attitude, mathematics, science, secondary level

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Authors: Elisavet Arsenaki

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Paracetamol overdose is associated with significant and possibly permanent consequences including hepatotoxicity, acute and chronic liver failure, and death. This quality improvement project explores the prevalence of accidental iatrogenic paracetamol overdose in hospital patients with a low body weight, defined as <50kg and assesses the impact of educational posters in trying to reduce it. The study included all adult inpatients on the admissions ward, a short stay ward for patients requiring 12-72 hour treatment, and consisted of three cycles. Each cycle consisted of 3 days of data collection in a given month (data collection for cycle 1 occurred in January 2022, February 2022 for cycle 2 and March 2022 for cycle 3). All patients given paracetamol had their prescribed dose checked against their charted weight to identify the percentage of adult inpatients <50kg who were prescribed 1g of paracetamol instead of 500mg. In the first cycle of the audit, data were collected from 83 patients who were prescribed paracetamol on the admissions ward. Subsequently, four A4 educational posters were displayed across the ward, on two separate occasions and with a one-month interval in between each poster display. The aim of this was to remind prescribing doctors of their responsibility to check patient body weight prior to prescribing paracetamol. Data were collected again one week after each round of poster display, from 72 and 70 patients respectively. Over the 3 cycles with a cumulative 225 patients, 15 weighed <50kg (6.67%) and of those, 5 were incorrectly prescribed 1g of paracetamol, yielding a 33.3% prevalence of accidental iatrogenic paracetamol overdose in adult inpatients. In cycle 1 of the project, 3 out of 6 adult patients weighing <50kg were overdosed on paracetamol, meaning that 50% of low weight patients were prescribed the wrong dose of paracetamol for their weight. In the second data collection cycle, 1 out of 5 <50kg patients were overdosed (20%) and in the third cycle, 1 out of 4 (25%). The use of educational posters resulted in a lower prevalence of accidental iatrogenic paracetamol overdose in low body weight adult inpatients. However, the differences observed were statistically insignificant (p value 0.993 and 0.995 respectively). Educational posters did not induce a significant decrease in the prevalence of accidental iatrogenic paracetamol overdose. More robust strategies need to be employed to further decrease paracetamol overdose in patients weighing <50kg.

Keywords: iatrogenic, overdose, paracetamol, patient, safety

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Authors: Kanzumba Kusakana

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The Democratic Republic of Congo (DRC) is currently experiencing a general energy crisis due to lack of proper investment and management in the energy sector. 93, 6% of the country is highly dependent on wood fuels as main source of energy having severe impacts such as deforestation and general degradation of the environment. On the other hand, the major share of the electricity produced mainly from ill-conditioned hydro and thermal power stations is principally used to supply the industrial sector as well as very few urban areas. Nevertheless, DRC possesses huge potential in renewable resources such as hydropower, biomass, methane gas, solar geothermal and moderate wind potential that can be used for energy generation. Recently the country has initiated projects to build decentralized micro hydropower station to supply remotes and isolated areas; to rehabilitate its existent main hydropower plants and transmission lines as well as to extend its current generation capacity by building new hydropower stations able to respond to a major part of the African continent energy needs. This paper presents a comprehensive review of current energy resources as well as of the electricity situation in DRC. Recent energy projects, the energy policy as well as the energy challenges in the DRC are also presented.

Keywords: energy, biomass, hydro power, renewable energy, energy policy, Democratic Republic of Congo

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Authors: Chamaraja Parulli

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Family is an important social institution devoted to the growth of a child, and parents are the important agents of socialization. Mentally challenged children are those who are affected by intellectual disability, which is manifested by limitation in intellectual functioning and adoptive behavior. Intellectual disability affects about 3-4 percentage of the general population. Intellectual disability is caused by genetic condition, problems during pregnancy, problems during childbirth, or illness. Mental retardation is the world’s most complex and challenging issue. The stigmatization of disability results in social and economic marginalization. Parents of the mentally challenged children will have a very high level of parenting stress, which is significantly more than the stress perceived by the parents of the children without disability. The prevalence of severe mental disorder called Schizophrenia is among 1.1 percent of the total population in India. On the other hand, 11 to 12 percent is the overall lifetime occurrence rate of mental disorders. While the government has a separate program for mental health, the segment is marred by lack of adequate doctors and infrastructure. Mentally retarded children have certain limitations in mental functioning and skills, which makes them slow learners in speaking, walking, and taking care of their personal needs such as dressing and eating. Accepting a child with mental handicap becomes difficult for parents and to the whole family, as they have to face many problems, including those of management, finance, deprivation of rest, and leisure. Also, the problems faced by the parents can be seen in different areas like – educational, psychological, social, emotional, financial and family related issues. The study brought out various difficulties and problems faced by the parents as well as family members. The findings revealed that the mental retardation is not only a medico-psychological problem but also a socio-cultural problem. The study results, however, indicate that the quality of life of the family having children with mental retardation can be improved to a greater extent by building up a child-friendly ambience at home. The main aim of the present study is to assess the problems faced by the parents of mentally challenged children, with the help of personal interview data collected from the parents of mentally challenged children, residing in Shimoga District of Karnataka State, India. These individuals were selected using stratified random sampling method. Organizing effective intervention programs for parents, family, society, and educational institutions towards reduction of family stress, augmenting the family’s strengths, increasing child’s competence and enhancing the positive attitudes and values of the society will go a long way for the peaceful existence of the mentally challenged children.

Keywords: mentally challenged children, intellectual disability, special children, social infrastructure, differently abled, psychological stress, marginalization

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Authors: Franck Kem Acho

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The trends of diseases have been changed from the last few years, now the burden of non-communicable diseases is increasing day by day. In all the non-communicable diseases, Hypertension is one of the leading causes of premature death and morbidity worldwide. This disease is a silent killer, it mostly affects the people with no obvious symptoms. Not only the heart it also increases the risk of brain, kidney and other diseases, now a days it is a serious medical problem. Over a billion people near about 1 in 4 men and 1 in 5 women having hypertension. In this case study men and women of ages between 30-80 years with Hypertension were identified in community remote area with their Health status being checked and monitored for one week and Health Education was provided for the importance of regular Health checkup alongside the continuous taking of medications.

Keywords: hypertension, health status, health check up, health education

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Authors: Georgia Mills, Rachel Parsonage

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Thrombocytosis is a platelet count above the upper limit of the normal range. An urgent referral is advised for counts over 1000 x109 and if the count is between 600-1000 x109 with certain conditions/age. A non-urgent referral is warranted when the level is above 450 × 109/L (for more than 3 months) or over 600 × 109/L on at least two occasions (4–6 weeks apart) or within the range 450–600 × 109/L with other haematological abnormalities. The aim of this audit is the assess how well Roseneath's general practice has adhered to the National Institute for Health and Care Excellence (NICE) guidelines for investigations and management of high platelet counts. Through the filtering tool on Vision, all blood results in the surgery were filtered to only show those with a platelet count above 450 x 109 /L. These patients were then analyzed individually to see where they fall on the current NICE guidance pathway for management. The investigations and management of thrombocytosis were generally poor. 60% of those who needed an urgent referral did not have it done. 30% of those who needed a follow-up blood test did not have it done. 60% of those needing a routine referral from complete investigations did not have it done. To improve the knowledge of NICE guidelines within the practice, a teaching session was delivered. Percentages then reached 100% in the 2nd audit. There is a lack of awareness of guidelines and education on thrombocytosis in primary care. Teaching sessions will benefit outcomes greatly

Keywords: platelets, thrombocytosis, management, referral

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Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

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Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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Authors: Charles Bijjah Nkhata, Memory Nekati Mvula, Milton Masautso Kalongonda, Martha Masamba, Isaac Thom Shawa

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Viral Hepatitis is a serious public health concern globally with deaths estimated at 1.4 million annually due to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Hepatitis B and C are the most common viruses that cause liver damage. However, the majority of infected individuals are unaware of their serostatus. Viral Hepatitis has contributed to maternal and neonatal morbidity and mortality. There is no updated data on the Epidemiology of hepatitis B and C among pregnant mothers in Malawi. To assess the epidemiology of Hepatitis B and C viruses among pregnant women at Queen Elizabeth Central Hospital. Specific Objectives • To determine sero-prevalence of HBsAg and Anti-HCV in pregnant women at QECH. • To investigate risk factors associated with HBV and HCV infection in pregnant women. • To determine the distribution of HBsAg and Anti-HCV infection among pregnant women of different age group. A descriptive cross-sectional study was conducted among pregnant women at QECH in last quarter of 2021. Of the 114 pregnant women, 96 participants were consented and enrolled using a convenient sampling technique. 12 participants were dropped due to various reasons; therefore 84 completed the study. A semi-structured questionnaire was used to collect socio-demographic and behavior characteristics to assess the risk of exposure. Serum was processed from venous blood samples and tested for HBsAg and Anti-HCV markers utilizing Rapid screening assays for screening and Enzyme Linked Immunosorbent Assay for confirmatory. A total of 84 pregnant consenting pregnant women participated in the study, with 1.2% (n=1/84) testing positive for HBsAg and nobody had detectable anti-HCV antibodies. There was no significant link between HBV and HCV in any of the socio-demographic data or putative risk variables. The findings indicate a viral hepatitis prevalence lower than the set range by the WHO. This suggests that HBV and HCV are rare in pregnant women at QECH. Nevertheless, accessible screening for all pregnant women should be provided. The prevention of MTCT is key for reduction and prevention of the global burden of chronic viral Hepatitis.

Keywords: viral hepatitis, hepatitis B, hepatitis C, pregnancy, malawi, liver disease, mother to child transmission

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Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

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Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

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Authors: Usharani Rathinam

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Although policies directing inclusion of marginalized were in effect, majority of chronically impoverished in India belonged to schedule caste and schedule tribes. Also, taking into account that poverty is gendered; destitute women belonged to lower social order whose need is not largely highlighted at policy level. This paper discusses on social relations poverty which highlights on how social order that existed structurally in the society can perpetuate chronic poverty, followed by a critical review on social inclusion policies of India, its merits and demerits in addressing chronic poverty. Multiple case study design is utilized to address this concern in four districts of India; Jhansi, Tikamgarh, Cuddalore and Anantapur. These four districts were selected by purposive sampling based on the criteria; the district should either be categorized as a backward district or should have a history of high poverty rate. Qualitative methods including eighty in-depth interviews, six focus group discussions, six social mapping procedures and three key informant interviews were conducted in 2011, at each of the locations. Analysis of the data revealed that irrespective of gender, schedule castes and schedule tribe participants were found to be chronically poor in all districts. Caste based discrimination is exhibited at both micro and macro levels; village and institutional levels. At village level, lower caste respondents had lesser access to public resources. Also, within institutional settings, due to confiscation, unequal access to resources is noticed, especially in fund distribution. This study found that half of the budget intended for schedule caste and schedule tribes were confiscated by upper caste administrative staffs. This implies that power based on social hierarchy marginalize lower caste participants from accessing better economic, social, and political benefits, that had led them to suffer long term poverty. This study also explored the traditional ties between caste, social structure and bonded labour as a cause of long-term poverty. Though equal access is being emphasized in constitutional rights, issues at micro level have not been reflected in formulation of these rights. Therefore, it is significant for a policy to consider the structural complexity and then focus on issues such as equal distribution of assets and infrastructural facilities that will reduce exclusion and foster long-term security in areas such as employment, markets and public distribution.

Keywords: caste, inclusion policies, India, social order

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Authors: Sahar Jahani, Meryem Ayse Yucel, David Boas, Seyed Kamaledin Setarehdan

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Near-infrared spectroscopy allows monitoring of oxy- and deoxy-hemoglobin concentration changes associated with hemodynamic response function (HRF). HRF is usually affected by natural physiological hemodynamic (systemic interferences) which occur in all body tissues including brain tissue. This makes HRF extraction a very challenging task. In this study, we used Kalman filter based on a general linear model (GLM) of brain activity to define the proportion of systemic interference in the brain hemodynamic. The performance of the proposed algorithm is evaluated in terms of the peak to peak error (Ep), mean square error (MSE), and Pearson’s correlation coefficient (R2) criteria between the estimated and the simulated hemodynamic responses. This technique also has the ability of real time estimation of single trial functional activations as it was applied to classify finger tapping versus resting state. The average real-time classification accuracy of 74% over 11 subjects demonstrates the feasibility of developing an effective functional near infrared spectroscopy for brain computer interface purposes (fNIRS-BCI).

Keywords: hemodynamic response function, functional near-infrared spectroscopy, adaptive filter, Kalman filter

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Authors: Aditi Taunk, George Iskander, Kitty Ka Kit Ho, Mark Willcox, Naresh Kumar

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Bacterial infections on biomaterial implants and medical devices accounts for 60-70% of all hospital acquired infections (HAIs). Treatment or removal of these infected devices results in high patient mortality and morbidity along with increased hospital expenses. In addition, with no effective strategies currently available and rapid development of antibacterial resistance has made device-related infections extremely difficult to treat. Therefore, in this project we have developed biomaterial surfaces using antibacterial compounds that inhibit biofilm formation by interfering with the bacterial communication mechanism known as quorum sensing (QS). This study focuses on covalent attachment of potent quorum sensing (QS) inhibiting compounds, halogenated furanones (FUs) and dihydropyrrol-2-ones (DHPs), onto glass surfaces. The FUs were attached by photoactivating the azide groups on the surface, and the acid functionalized DHPs were immobilized on amine surface via EDC/NHS coupling. The modified surfaces were tested in vitro against pathogenic organisms such as Staphylococcus aureus and Pseudomonas aeruginosa using confocal laser scanning microscopy (CLSM). Successful attachment of compounds on the substrates was confirmed by X-ray photoelectron spectroscopy (XPS) and contact angle measurements. The antibacterial efficacy was assessed, and significant reduction in bacterial adhesion and biofilm formation was observed on the FU and DHP coated surfaces. The activity of the coating was dependent upon the type of substituent present on the phenyl group of the DHP compound. For example, the ortho-fluorophenyl DHP (DHP-2) exhibited 79% reduction in bacterial adhesion against S. aureus and para-fluorophenyl DHP (DHP-3) exhibited 70% reduction against P. aeruginosa. The results were found to be comparable to DHP coated surfaces prepared in earlier study via Michael addition reaction. FUs and DHPs were able to retain their in vitro antibacterial efficacy after covalent attachment via azide chemistry. This approach is a promising strategy to develop efficient antibacterial biomaterials to reduce device related infections.

Keywords: antibacterial biomaterials, biomedical device-related infections, quorum sensing, surface functionalization

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Authors: Ismail Sualman, Mohd Khairuddin Othman

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General Election has been the backbone of democracy that permits people to choose their representatives as they deem fit. The support preferences of the voter differ from one to another, particularly in a plural society like Malaysia. The turning up of high numbers of young voters during the Malaysia 14th General Election has been said to have been caused by social media including Facebook, Twitter, WhatsApp, Instagram, YouTube and Telegram, WeChat and SMS/MMs. It has been observed that, besides using social media as an interaction tool among social friends, it is also an important source of information to know about issues, politics and politicians. This paper exhibits the role of social media in providing political information to young voters, before an election and during the election campaign. This study examines how this information is being translated into election support. A total of 799 Malay young respondents in Selangor have been surveyed and interviewed. This study revealed that social media has become the source of political information among Malay young voters. This research suggested that social media had a significant effect on the support during the election. Social media plays an important role in carrying information such as current issues, voting trends, candidate imagery and matters that may influence the view of young voters. The information obtained from social media has been translated into a voting decision.

Keywords: social media, political behaviour, voters’ choice, election.

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Authors: Lamphong Volady

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The primary purpose of this study was to explore the traditional cuisine (local food) of Luangprabang Province in line with the Lao PDR’s One District One Product Policy. Another purpose of the study was to examine channels used to present local food, reasons to preserve and promote local food, as well as local food preservation and promotion strategies. It also aimed at testing correlation hypotheses whether there is a statistically significant relationship between enjoyment of having local food and willingness to promote local cuisines becoming international cuisines, attractiveness to consume local food, preservation and promotion of local food problems, and local people’s occupations. The Convergent Parallel Mixed Methods were employed in this study. The results of the study showed that several local cuisines were found to be local food of Luangprabang Province, namely Jeow Bon (Chilli dipping suace), Or Lam or aw lahm (stew buffalo skin, herbs, Mai sakaan), Kai Pan (River Weed Dry), Tam Mak Houng Luangprabang (Papaya Salad), Nang (Yam Buffalo Skin Dry), Sai Oor (Sausage), Laap Sin Koay Sai Mar-Keua Pao (Beef Salad with Roasted Eggplants), Orm Born (Taro leaves Stew), Oor Nor Mai (Bamboo Shoot Sausage), Jeow Nam Poo (Pickled Crab Chillies), Mok Dok Kae (steaming or roasting a Dok Kae Wrapp), Nor Sa Wan, Kao Noom Kee Noo, Kao Noom Ba Bin. It also depicted that YouTube, Facebook, and TikTok were multiple social channels or platforms which were found to be used to introduce traditional food as well as television, smartphone, word of mouth, Lao food fairs and other provincial events. The study also found that local food should be preserved and promoted since traditional food is not only ancestral, ancient, traditional, and local cuisines, but it is also wisdom, unique, and national cuisine. The study also found that people feel attracted to consuming local food because local food is delicious, unique, clean, nutritious, non-contaminated and natural. The study showed that lack of funds to produce local food, inadequate draw materials, lack material to store products, insufficient place to produce and lack of related organizations engagement were found to be problems for preserving and promoting traditional food. Finally, the result of the study revealed that there is a statistically significant weak relationship between enjoyment of having local food and willingness to promote local cuisines becoming international cuisines (R²= 4.5%), (p-value <0.001). There is a statistically significant moderate relationship between enjoyment of having local food and attractiveness to consume local food (R²= 7.8%), (p-value <0.001). However, there is a statistically insignificant relationship between enjoyment of having local food and preservation and promotion of local food problems (R²= 1.8%), (p-value = 0.086). It was found that there is a statistically insignificant relationship between enjoyment of having local food and local people’s occupations (R²= 0.0%), (p-value = 0.929).

Keywords: local food, preservation, promotion, traditional food, cuisines

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Authors: Paola Molteni, Luigi d’Alonzo

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Background: Sensory issues are now considered one of the key aspects in defining and diagnosing autism, changing the perspectives on behavioural analysis and intervention in mainstream educational services. However, Italian teachers’ training is yet not specific on the topic of autism and its sensory-related effects and this research investigates the teacher’s capability in understanding the student’s needs and his/her challenging behaviours considering sensory perceptions. Objectives: The research aims to analyse mainstream schools teachers’ awareness on students’ sensory perceptions and how this affects classroom inclusion and learning process. The research questions are: i) Are teachers able to identify student’s sensory issues?; ii) Are trained teachers more able to identify sensory problems then untrained ones?; iii) What is the impact of sensory issues on inclusion in mainstream classrooms?; iv) What should teachers know about autistic sensory dimensions? Methods: This research was designed as a pilot study that involves a multi-methods approach, including action and collaborative research methodology. The designed research allows the researcher to catch the complexity of a province school district (from kindergarten to high school) through a deep detailed analysis of selected aspects. The researcher explored the questions described above through 133 questionnaires and 6 focus groups. The qualitative and quantitative data collected during the research were analysed using the Interpretative Phenomenological Analysis (IPA). Results: Mainstream schools teachers are not able to confidently recognise sensory issues of children included in the classroom. The research underlines: how professionals with no specific training on autism are not able to recognise sensory problems in students on the spectrum; how hearing and sight issues have higher impact on classroom inclusion and student’s learning process; how a lack of understanding is often followed by misinterpretations of the impact of sensory issues and challenging behaviours. Conclusions: As this research has shown, promoting and enhancing the importance of understanding sensory issues related to autism is fundamental to enable mainstream schools teachers to define educational and life-long plans able to properly answer the student’s needs and support his/her real inclusion in the classroom. This study is a good example of how the educational research can meet and help the daily practice in working with people on the autism spectrum and support the training design for mainstream school teachers: the emerging need of designed preparation on sensory issues is fundamental to be considered when planning school district in-service training programmes, specifically declined for inclusive services.

Keywords: autism spectrum condition, scholastic inclusion, sensory overload, teacher's training

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Authors: Ali Saeed Alghamdi, Basel Mazen Alsolami, Basel Saeed Alghamdi, Muhanad Saleh Alzahrani Alamri, Salman Anwar Thabet, Abdulhalim J. Kinsara

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Objectives: This study measures the knowledge of the cardiovascular disease among the general population in western regions of Saudi Arabia, and it aimed to increase the level of awareness about cardiovascular diseases among the general population by providing an awareness lecture that included information about the risk factors, major symptoms, and prevention of cardiovascular diseases. The lecture has been attached at the end of the questionnaire. Setting: This study was conducted through an online questionnaire that included our aim and main objectives that targeted the general population in the Western regions of Saudi Arabia (Makkah and Madinah regions). Participants: This study participants were 460 collected through an online questionnaire. Methods: All Saudi citizens and residents who live in the western region of Saudi Arabia aged 18 years and above will be invited to participate voluntarily. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart diseases, with cardiac symptoms and risk factors sections. Results: The majority of respondents were females (74.8%) and Saudis. The knowledge about cardiovascular disease risk factors was weak. Only (18.5%) scores an excellent response regarding risk factors awareness. Lack of exercise, stress, and obesity were the most known risk factors. Regarding cardiovascular disease symptoms, chest pain scores the highest symptom (87.6%) among other symptoms like dyspnea, syncope, and excessive sweating. Participants revealed a poor awareness regarding cardiovascular disease symptoms also (0.9%). However, preventable factors for cardiovascular diseases were more knowledgeable than others categories in this study (60% fall into excellent knowledge). Smoking cessation, normal cholesterol level, and normal blood pressure score the highest preventable methods (92.2%), (88.6%), and (78.7%) respectively. 83.7% of the participant have attended the awareness lecture, and 99 of the attendees reported that the lecture increased their knowledge about cardiovascular disease. Conclusion: This study discussed the level of community awareness of cardiovascular disease in terms of symptoms, risk factors, and protective factors. We found a huge lack of the participant's level of knowledge about the disease and how to prevent it. Moreover, we measure the prevalence of the comorbidities among our participants (diabetes, hypertension, hypercholesterolemia/ hypertriglyceridemia) and their extent of adherence to their medication. In conclusion, this study not only demonstrates awareness of cardiovascular disease risk factors, symptoms, management, and the association between each domain but also provides educational material. Further educational material and campaigns are required to increase awareness and knowledge about cardiovascular diseases.

Keywords: awareness, cardiovascular diseases, education, prevention, risk factors

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Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz

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In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.

Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes

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Authors: Aisha Abdulkarim Aliyu, Alice Sabrina Ismail, Fadhlina Binti Ahmad

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The study's main goal is to improve Afrocentric cultural approaches in Nigerian residential environments (Kano) in terms of physical, aesthetical, and socio-cultural factors. Kano's fast-changing residential settings and city image have been subjected to a significant neoliberal restructuring process in recent decades. Architects have evolved in lockstep with the society they serve, first as an art form, then as a science, and finally as a business that designs structures. Design values have always emphasized a certain building style throughout history. Architects and architectural critics have a different perspective on them than the general public. In fact, a popular style among the general public was taken into consideration. When it comes to the current design, this study examines the values and viewpoints of architects on the usage of an Afrocentric cultural approach to housing. The qualitative data analysis of surveys conducted with Kano housing and planning professionals is used to determine the criteria for using an Afrocentric cultural approach in housing development in order to preserve and restore our cultural heritage, as well as to rank these criteria according to their importance. The professional lens on this subject differs insignificantly across Nigeria, although they do vary to some amount based on the sector of the housing industry, according to the study.

Keywords: architects lens, Afrocentric culture, housing, northern Nigeria

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Authors: Joseph Carl Macalintal, Erlinda Armovit

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Magnesium sulfate has been a mainstay in the management of preeclampsia and is associated with a decreased incidence of morbidity and mortality. The syndrome has an unpredictable course, sometimes rapidly evolving to full-blown disease. In patients with deteriorating status, it is indicated to terminate the pregnancy via cesarean section. The anesthesiologists would prefer to have the procedure done under regional anesthesia; however, there may be cases when neuraxial anesthesia is contraindicated, or a general anesthesia would permit prompt delivery of the fetus. A patient with severe preeclampsia was given magnesium sulfate intrapartum, wherein a primary cesarean section was indicated for arrest in cervical dilatation, and was performed under general anesthesia. The patient developed acute respiratory failure and the causes of this occurrence were investigated in this report. It was later found out that neither the hypermagnesemia nor the muscle relaxant alone caused the patient’s condition but the interaction between the two. The patient was managed expectantly at the intensive care unit (ICU) and was eventually extubated during the 1st post-operative day. Knowledge of this drug interaction would allow obstetricians to advise their patients and their family about the possibility of prolonged intubation and ICU admission. This would also bring to the anesthesiologists’ attention the need to decrease the dose of muscle relaxant and to prepare drugs for immediate decurarisation.

Keywords: eclampsia, magnesium sulfate, preeclampsia, rocuronium bromide

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Authors: Sankara Ganesh Dhoopam, Phaneendra Aduri

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Lattice towers are light weight structures which are primarily governed by the effects of wind loading. Ensuring a precise assessment of wind loads on the tower structure, antennas, and associated equipment is vital for the safety and efficiency of tower design. Earlier, the Indian standards are not available for design of telecom towers. Instead, the industry conventionally relied on the general building wind loading standard for calculating loads on tower components and the transmission line tower design standard for designing the angular members of the towers. Subsequently, the Bureau of Indian Standards (BIS) revised these standards and angular member design standard. While the transmission line towers are designed using the above standard, a full-scale model test will be done to prove the design. Telecom angular towers are also designed using the same with overload factor/factor of safety without full scale tower model testing. General construction in steel design code is available with limit state design approach and is applicable to the design of general structures involving angles and tubes but not used for angle member design of towers. Recently, in response to the evolving industry needs, the Bureau of Indian Standards (BIS) introduced a new standard titled “Isolated Towers, Masts, and Poles using structural steel -Code of practice” for the design of telecom towers. This study focuses on a 40m four legged angular tower to compare loading calculations and member designs between old and new standards. Additionally, a comparative analysis aligning with the new code provisions with international loading and design standards with a specific focus on American standards has been carried out. This paper elaborates code-based provisions used for load and member design calculations, including the influence of "ka" area averaging factor introduced in new wind load case.

Keywords: telecom, angular tower, PLS tower, GSM antenna, microwave antenna, IS 875(Part-3):2015, IS 802(Part-1/sec-2):2016, IS 800:2007, IS 17740:2022, ANSI/TIA-222G, ANSI/TIA-222H.

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Authors: Asmaa Abazaid, Maram Al-Ostah, Nadeen Abu-Zahra, Ruba Bawab, Refaat Abdel-Razek

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Innovation audit is defined as a tool that can be used to reflect on how the innovation is managed in an organization. The aim of this study is to audit innovation in the second top Engineering Firms in the world, and one of the Small Medium Enterprises (SMEs) companies that are working in United Arab Emirates (UAE). The obtained results are then compared with four international companies from China and Brazil. The Diamond model has been used for auditing innovation in the two companies in UAE to evaluate their innovation management and to identify each company’s strengths and weaknesses from an innovation perspective. The results of the comparison between the two companies (Jacobs and Hyper General Contracting) revealed that Jacobs has support for innovation, its innovation processes are well managed, the company is committed to the development of its employees worldwide and the innovation system is flexible. Jacobs was doing best in all innovation management dimensions: strategy, process, organization, linkages and learning, while Hyper General Contracting did not score as Jacobs in any of the innovation dimensions. Furthermore, the audit results of both companies were compared with international companies to examine how well the two construction companies in UAE manage innovation relative to SABIC (Saudi company), Poly Easy and Arnious (Brazilian companies), Huagong tools and Guizohou Yibai (Chinese companies). The results revealed that Jacobs is doing best in learning and organization dimensions, while PolyEasy and Jacobs are equal in the linkage dimension. Huagong Tools scored the highest score in process dimension among all the compared companies. However, the highest score of strategy dimension was given to PolyEasy. On the other hand, Hyper General Contracting scored the lowest in all of the innovation management dimensions. It needs to improve its management of all the innovation management dimensions with special attention to be given to strategy, process, and linkage as they got scores below 4 out of 7 comparing with other dimensions. Jacobs scored the highest in three innovation management dimensions related to the six companies. However, the strategy dimension is considered low, and special attention is needed in this dimension.

Keywords: Brazil, China, innovation audit, innovation evaluation, innovation management, Saudi Arabia, United Arab Emirates

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Authors: Emma Roberts

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The Rome II Regulation has established a uniform regime of conflict of law rules across the European Union (except for Denmark) which determines the law applicable in non-contractual obligations disputes. It marks a significant development towards the Europeanization of private international law and aims to provide the most appropriate connecting factors to achieve both legal certainty and justice in individual cases. Many non-contractual obligations are recognised to present such distinct factors that, to achieve these aims, a special rule is provided for determining the applicable law in cases in respect of product liability and environmental torts, for example. Throughout the legislative process, the European Parliament sought to establish a separate rule for road traffic accidents, recognising that these cases too present such novel situations that a blanket application of a lex loci damni approach would not provide an appropriate answer. Such attempts were rejected and, as a result, cases arising out of road traffic accidents are subject to the Regulation’s general lex loci damni rule along with its escape clause and limited exception. This paper offers a critique of the Regulation’s response to cross-border road traffic accident cases. In England and Wales, there have been few cases that have applied the Regulation’s provisions to date, but significantly the majority of such cases are in respect of road traffic accidents. This paper examines the decisions in those cases and challenges the legislators’ decision not to provide a special rule for such incidences. Owing to the diversity in compensation systems globally, applying the Regulation’s general rule to cases of road traffic accidents – given the breadth of matters that are to be subject to the lex cause – cannot ensure an outcome that provides ‘justice in individual cases’ as is assured by the Regulation's recitals. Not only does this paper suggest that the absence of a special rule for road traffic accidents means that the Regulation fails to achieve one of its principal aims, but it further makes out a compelling case for the legislative body of the European Union to implement a corrective instrument.

Keywords: accidents abroad, applicable law, cross-border torts, non-contractual obligations, road traffic accidents

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

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Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, Antibiotic misuse, Iraq, Prescribing

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Authors: B. Raghu, Shashi Vemuri, Ch. Sreenivasa Rao

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The survey on pesticide use pattern was carried out by interviewing farmers growing chill in open fields and poly houses based on the questionnaire prepared to assess their knowledge and practices on crop cultivation, general awareness on pesticide recommendations and use. Education levels of poly house farmers are high compared to open field farmers, where 57.14% poly house farmers are high school educated, whereas 35% open field farmers are illiterates. Majority farmers use nursery of 35 days and grow in <0.5 acre poly house in summer and rabi and < 1 acre in open field during kharif. Awareness on pesticide related issues is varying among poly house and open field farmers with some commonality, where 28.57% poly house farmers know about recommended pesticides while only 10% open field farmers are aware of this issue. However, in general, all farmers contact pesticide dealer for recommendations, poly house farmers prefer to contact scientists (35.71%) and open field farmers prefer to contact agricultural officers (33.33). Most farmers are unaware about pesticide classification and toxicity symbols on packing. Farmers are aware about endosulfan ban, but only 21.42% poly house and 11.66% open field farmers know about ban of monocrotofos on vegetables. Very few farmers know about pesticide residues and related issues, but know washing helps to reduce contamination.

Keywords: open field, pesticide usage, polyhouses, residues survey

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Authors: Mario Chiasson, Monique Boudreau

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Problem statement: Innovation in education has become a central topic of discussion at various levels, including schools and scholarly literature, driven by the global technological advancements of Industry 4.0. This study aims to contribute to the ongoing dialogue by examining the role of innovation in transforming school culture through the reimagination of traditional structures. The study argues that such a transformation necessitates an understanding and experience of systems leadership. This paper presents the case of the Francophone South School District, where a transformative initiative created an innovative learning environment by engaging students, teachers, and community members collaboratively through eco-communities. Traditional barriers and structures in education were dismantled to facilitate this process. The research component of this paper focuses on the Intr’Appreneur project, a unique initiative launched by the district team in the New Brunswick, Canada to support a system-wide transformation towards progressive and innovative organizational models. Methods This study is part of a larger research project that focuses on the transformation of educational systems in six pilot schools involved in the Intr’Appreneur project. Due to COVID-19 restrictions, the project was downscaled to three schools, and virtual qualitative interviews were conducted with volunteer teachers and administrators. Data was collected from students, teachers, and principals regarding their perceptions of the new learning environment and experiences. The analysis process involved developing categories, establishing codes for emerging themes, and validating the findings. The study emphasizes the importance of system leadership in achieving successful transformation. Results: The findings demonstrate that school principals played a vital role in enabling system-wide change by fostering a dynamic, collaborative, and inclusive culture, coordinating and mobilizing community members, and serving as educational role models who facilitated active and personalized pedagogy among the teaching staff. These qualities align with the characteristics of Leadership 4.0 and are crucial for successful school system transformations. Conclusion: This paper emphasizes the importance of systems leadership in driving educational transformations that extend beyond pedagogical and technological advancements. The research underscores the potential impact of such a leadership approach on teaching, learning, and leading processes in Education 4.0.

Keywords: leadership, system transformation, innovation, innovative learning environment, Education 4.0, system leadership

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Authors: Talib Jan Abasindhi

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Democracy has reached almost every nuke & corner of the globe. It is well embedded in the political systems found in the majority of the countries in the world. Political parties, their manifestos, and programs are educating their people for better democracy and good governance, as well as service delivery in many countries around the globe. Although democracy in Pakistan by itself is in its infancy stage, yet, there is a region consisting of three districts (administrative units) lying in the North of the country where democracy is yet unknown to a wide range of population bounded into a series of mountains from Himalayan and Karakuram ranges. Political parties are struggling now to get their roots in the area while disrupting the traditional and tribal electoral system prevailing in the region. This paper will shed light on an interesting subject of casting lots for nomination as candidatures for general and local bodies’ elections in Kohistani region in Pakistan. The people of wisdom and knowledge in the modern world deem such societies as uncivilized where these practices are found. No one can believe it in today’s world, yet, this practice has been common in Kohistani region over the past many decades, and there have been many reasons for this too. Through this paper, we shall not only make others aware of the process and procedure practiced in casting the lots in elections in democratic Pakistan, but rather we shall also talk about its very basic reasons and suggestions as a solution for this menace to be eliminated.

Keywords: democracy, casting lots, governance, Kohistani region

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Authors: Constant Akama, Frank Kulor, Frederick Agyemang

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All over the world, due to increasing population, electric power distribution companies are looking for more efficient ways of reading electricity meters. In Ghana, the prepaid metering system was introduced in 2007 to replace the manual system of reading which was fraught with inefficiencies. However, the prepaid system in Ghana is not capable of integration with online systems such as e-commerce platforms and remote monitoring systems. In this paper, we present a design framework for an automatic metering system that can be integrated with e-commerce platforms and remote monitoring systems. The meter was designed using ADE 7755 which reads the energy consumption and the reading is processed by a microcontroller connected to Sim900 General Packet Radio Service module containing a GSM chip provisioned with an Access Point Name. The system also has a billing server and a management server located at the premises of the utility company which communicate with the meter over a Virtual Private Network and GPRS. With this system, customers can buy credit online and the credit will be transferred securely to the meter. Also, when a fault is reported, the utility company can log into the meter remotely through the management server to troubleshoot the problem.

Keywords: access point name, general packet radio service, GSM, virtual private network

Procedia PDF Downloads 299

Authors: Masuma Novak, Daniel Novak

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Background: Sweden along with other Nordic countries has the highest incidence of type 1 diabetes mellitus (T1DM) worldwide. The trend is increasing globally. The diagnosis is often given at the emergency clinic when children arrive with cardinal symptom of T1DM. Children with T1DM are known to have an increased risk of microvascular- and macrovascular complications. A family history of cardiovascular complications may further increase their risk. Clinically evident diabetes-related vascular complications are however rarely visible in childhood and adolescence, whereby an intensive diabetes treatment and normoglycemic control is a goal for every child. This study is a risk evaluation of children with T1DM based on their family’s cardiovascular history. Method: Since 2005 the Better Diabetes Diagnosis (BDD) study is a nationwide Swedish prospective cohort study that recruits new-onset T1DM who are less than 18 years old at time of diagnosis. For each newly diagnosed child, blood samples are collected for specific HLA genotyping and islet autoantibody assays and their family’s cardiovascular history is evaluated. As part of the BDD study, during the years 2010-2013 all children diagnosed with T1DM at the Queen Silvia’s Children’s Hospital in Sweden were asked about their family’s cardiovascular history. Questions regarded maternal and paternal high blood pressure, stroke, and myocardial infarction before the age of 55 years, and hyperlipidemia were answered. A maximum risk score of eight was possible. All children are clinically observed prospectively for early functional and structural abnormalities such as protein uremia, blood pressure, and retinopathy. Results: A total of 275 children aged 0 to 18 years were diagnosed with T1DM at the Queen Silvia’s Children’s Hospital emergency clinic during this four year period. The participation rate was 99.7%. 26.4% of the children had no hereditary cardiovascular risk factors. 22.7 % had one risk factor and 18.8% had two risk factors. 14.8% had three risk factors. 9.7% had four risk factors and 7.5% had five risk factors or more. Conclusion: Among children with T1DM in Sweden there is a difference in hereditary cardiovascular risk factors. These results indicate that children with T1DM who also have increased hereditary cardiovascular risk factors should be monitored closely with early screening for functional and structural cardiovascular abnormalities. This is a very preliminary and ongoing study which will be complemented with the cardiovascular risk analysis among children without T1DM.

Keywords: children, type I diabetes, emergency clinic, CVD risk

Procedia PDF Downloads 365