Search results for: transmission of intergenerational trauma

Authors: J. Plocek, P. Holec, S. Kubickova, B. Pacakova, I. Matulkova, A. Mantlikova, I. Němec, D. Niznansky, J. Vejpravova

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This article presents summary on preparation and characterization of zinc, copper, cadmium and cobalt chromite nano crystals, embedded in an amorphous silica matrix. The ZnCr2O4/SiO2, CuCr2O4/SiO2, CdCr2O4/SiO2 and CoCr2O4/SiO2 nano composites were prepared by a conventional sol-gel method under acid catalysis. Final heat treatment of the samples was carried out at temperatures in the range of 900–1200 °C to adjust the phase composition and the crystallite size, respectively. The resulting samples were characterized by Powder X-ray diffraction (PXRD), High Resolution Transmission Electron Microscopy (HRTEM), Raman/FTIR spectroscopy and magnetic measurements. Formation of the spinel phase was confirmed in all samples. The average size of the nano crystals was determined from the PXRD data and by direct particle size observation on HRTEM; both results were correlated. The mean particle size (reviewed by HRTEM) was in the range from ~ 4 to 46 nm. The results showed that the sol-gel method can be effectively used for preparation of the spinel chromite nano particles embedded in the silica matrix and the particle size is driven by the type of the cation A2+ in the spinel structure and the temperature of the final heat treatment. Magnetic properties of the nano crystals were found to be just moderately modified in comparison to the bulk phases.

Keywords: sol-gel method, nanocomposites, Rietveld refinement, Raman spectroscopy, Fourier transform infrared spectroscopy, magnetic properties, spinel, chromite

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Authors: Mohammed Hussein Eltoum Salih

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This study was conducted in four villages, namely: Jadeed, Alandraba, Um Gaar, and EL Shetabe in the White Nile State Sudan, to determine the ecological factors; water vegetations, physical and chemical properties of the water in Snails habitat. Bulinus truncatus, which act as an intermediate host for S. haematobium, were collected from water bodies adjacent to study villages where the residents were suspected to swim, and humans get in contact with water for various purposes. Water samples from the stretches were collected and then measured for parameters that are indicative of the quality of water and sustaining the survival of snails and would confirm even further if the contact between humans and water had taken place. The parameters measured included water conductivity, pH, dissolved oxygen, calcium, and magnesium content. Also, a single water sample from each contact site was collected for microbiological tests. The result revealed that the B. truncatus showed that these animals were fewer and free of infection and their sites of the collection were dense with different plant species making them suitable to harbor snails. Moreover, the results of microbial tests showed that there was higher bacterial contamination. Also, physical and chemical analysis of water sample of contact sites revealed that there were significant differences (p < 0.05) in water pH, calcium, and magnesium content between sites of study villages, and these were discussed in relation to factors suitable for the intermediate hosts and thus for the transmission of the S. haematobium disease.

Keywords: health, parasitology, Schistosoma, snails

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Authors: Emrah Yaliniz, Ali Kalkanli

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ZE41A magnesium alloy has been extensively used in aerospace industry, especially for use in rotorcraft transmission casings. Due to the improved mechanical properties, the latest generation of magnesium casting alloy EV31A-T6 (Elektron 21® specified in AMS 4429) is seen as a potential replacement for ZE41A in terms of strength. Therefore, the necessity of enhancement has been arisen for ZE41A in order to avoid fully replacement. The main element affecting the strength of ZE41A is Zirconium (Zr), which acts as a grain refiner. The specified range of Zr element for ZE41A alloy is between 0.4 wt % and 1.0 wt % (unless otherwise stated by weight percentage after this point) as stated in AMS 4439. This paper investigates the effects of Zr amount on tensile and metallurgical properties of ZE41A magnesium alloy. The Zr alloying amount for the research has been chosen as 0.5 % and 1 %, which are standard amounts in a commercial alloy (average of 0.4-0.6%) and maximum percent in the standard, separately. 1 % Zr amount has been achieved via Zirmax (66.7 Mg-33.3 Zr) master alloy addition. The ultimate tensile strength of ZE41A with 1% Zr has been increased up to about 220-225 MPa in comparison to 200 MPa given in AMS 4439. The reason for the increase in strength with the addition of Zirmax is based on the decrease in grain size, which was measured about 30 µm. Optical microscope, scanning electron microscopy (SEM) and X-ray Diffraction (XRD) were used to detect the change in the microstructural futures via alloying. The zirconium rich coring at the center of the grains was observed in addition to the grain boundary intermetallic phases and bulk Mg-rich matrix. The solidification characteristics were also identified by using the cooling curve obtained from the sand casting mold during cooling of the alloys.

Keywords: aerospace, grain refinement, magnesium, sand casting, ZE41A

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Authors: Qingying Liu, S. Liu, L. Hao, B. Zhang, J. D. Yan

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HVDC technology is becoming increasingly popular due to its simplicity in topology and less power loss over long distance of power transmission, in comparison with HVAC technology. However, the dielectric behavior of insulators in the long term under HVDC stress is completely different from that under HVAC stress as a result of charge accumulation in a constant electric field. Insulators used in practical systems are never perfect in their structural conditions. Over time shallow cracks may develop on their surface. The presence of defects can lead to drastic change in their dielectric behaviour and thus increase the probability of surface flashover. In this contribution, experimental investigations have been carried out on the charge accumulation phenomenon on the surface of a rod insulator made of epoxy that is placed between two disk shaped electrodes at different voltage levels and in different gases (SF6, CO2 and N2). Many results obtained, such as, the two-dimensional electrostatic potential distribution along the insulator surface after the removal of the power source following a pre-defined period of application. The probe has been carefully calibrated before each test. Results show that surface charge distribution near the two disk shaped electrodes is not uniform in the circumferential direction, possibly due to the imperfect electrical connections between the embeded conductor in the insulator and the disk shaped electrodes. The axial length of this non-uniform region is experimentally determined, which provides useful information for shielding design. A charge transport model is also used to explain the formation of the long term electrostatic potential distribution under a constant applied voltage.

Keywords: HVDC, power systems, dielectric behavior, insulation, charge accumulation

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Authors: Askar Kilmametov, Julia Ivanisenko, Boris Straumal, Horst Hahn

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The high-pressure α- to ω-phase transition was discovered in elemental Ti and Zr fifty years ago using static high pressure and then observed to appear between 2 and 12 GPa at room temperature, depending on the experimental technique, the pressure environment, and the sample purity. The fact that ω-phase is retained in a metastable state in ambient condition after the removal of the pressure has been used to check the changes in magnetic and superconductive behavior, electron band structure and mechanical properties. However, the fundamental knowledge on a combination of both mechanical treatment and high applied pressure treatments for ω-phase formation in Ti alloys is currently lacking and has to be studied in relation to improved mechanical properties of bulk nanostructured states. In the present study, nanostructured (α+β) Ti alloys containing β-stabilizing elements such as Co, Fe, Cr, Nb were performed by severe plastic deformation, namely high pressure torsion (HPT) technique. HPT-induced α- to ω-phase transformation was revealed in dependence on applied pressure and shear strains by means of X-ray diffraction, transmission electron microscopy, and differential scanning calorimetry. The transformation kinetics was compared with the kinetics of pressure-induced transition. Orientation relationship between α-, β- and ω-phases was taken into consideration and analyzed according to theoretical calculation proposed earlier. The influence of initial state before HPT appeared to be considerable for subsequent α- to ω-phase transition. Thermal stability of the HPT-induced ω-phase was discussed as well in the frame of mechanical behavior of Ti and Ti-based alloys produced by shear deformation under high applied pressure.

Keywords: bulk nanostructured materials, high pressure phase transitions, severe plastic deformation, titanium alloys

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Authors: Osama K. Abou-Zied, Saba A. Sulaiman

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We studied the spectroscopy of 25-nm diameter gold nanoparticles (AuNPs), coated with human serum albumin (HSA) as a model drug carrier. The morphology and coating of the AuNPs were examined using transmission electron microscopy and dynamic light scattering. Resonance energy transfer from the sole tryptophan of HSA (Trp214) to the AuNPs was observed in which the fluorescence quenching of Trp214 is dominated by a static mechanism. Using fluorescein (FL) to probe the warfarin drug-binding site in HSA revealed the unchanged nature of the binding cavity on the surface of the AuNPs, indicating the stability of the protein structure on the metal surface. The transient absorption results of the surface plasmonic resonance (SPR) band of the AuNPs show three ultrafast dynamics that are involved in the relaxation process after excitation at 460 nm. The three decay components were assigned to the electron-electron (~ 400 fs), electron-phonon (~ 2.0 ps) and phonon-phonon (200–250 ps) interactions. These dynamics were not changed upon coating the AuNPs with HSA which indicates the chemical and physical stability of the AuNPs upon bioconjugation. Binding of FL in HSA did not have any measurable effect on the bleach recovery dynamics of the SPR band, although both FL and AuNPs were excited at 460 nm. The current study is important for a better understanding of the physical and dynamical properties of protein-coated metal nanoparticles which are expected to help in optimizing their properties for critical applications in nanomedicine.

Keywords: gold nanoparticles, human serum albumin, fluorescein, femtosecond transient absorption

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Authors: Z. Kassab, A. Aboulkas, A. Barakat, M. El Achaby

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The red algae are available enormously around the world and their exploitation for the production of agar product has become as an important industry in recent years. However, this industrial processing of red algae generated a large quantity of solid fibrous wastes, which constitute a source of a serious environmental problem. For this reason, the exploitation of this solid waste would help to i) produce new value-added materials and ii) to improve waste disposal from environment. In fact, this solid waste can be fully utilized for the production of cellulose microfibers and nanocrystals because it consists of large amount of cellulose component. For this purpose, the red algae waste was chemically treated via alkali, bleaching and acid hydrolysis treatments with controlled conditions, in order to obtain pure cellulose microfibers and cellulose nanocrystals. The raw product and the as-extracted cellulosic materials were successively characterized using serval analysis techniques, including elemental analysis, X-ray diffraction, thermogravimetric analysis, infrared spectroscopy and transmission electron microscopy. As an application, the as extracted cellulose nanocrystals were used as nanofillers for the production of polymer-based composite films with improved thermal and tensile properties. In these composite materials, the adhesion properties and the large number of functional groups that are presented in the CNC’s surface and the macromolecular chains of the polymer matrix are exploited to improve the interfacial interactions between the both phases, improving the final properties. Consequently, the high performances of these composite materials can be expected to have potential in packaging material applications.

Keywords: cellulose nanowhiskers, food packaging, polymer composites, red algae waste

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Authors: Ali Obeydavi, Majid Rahimi

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This study explores the synthesis and characterization of Fe-Cr-Mo-Co-C-B-Si thin film metallic glasses fabricated using the pulsed laser deposition (PLD) technique on silicon wafer and 304 stainless steel substrates. it systematically varied the laser pulse numbers (20,000; 30,000; 40,000) and energies (130, 165, 190 mJ) to investigate their effects on the microstructural, mechanical, and corrosion properties of the deposited films. Comprehensive characterization techniques, including grazing incidence X-ray diffraction, field emission scanning electron microscopy, atomic force microscopy, and transmission electron microscopy with selected area electron diffraction, were utilized to assess the amorphous structure and surface morphology. Results indicated that increased pulse numbers and laser energies led to enhanced deposition rates and film thicknesses. Nanoindentation tests demonstrated that the hardness and elastic modulus of the amorphous thin films significantly surpassed those of the 304 stainless steel substrate. Additionally, electrochemical polarization and impedance spectroscopy revealed that the Fe-based metallic glass coatings exhibited superior corrosion resistance compared to the stainless steel substrate. The observed improvements in mechanical and corrosion properties are attributed to the unique amorphous structure achieved through the PLD process, highlighting the potential of these materials for protective coatings in aggressive environments.

Keywords: thin film metallic glasses, pulsed laser deposition, mechanical properties, corrosion resistance

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Authors: Nida B. Syed

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Following second wave of the current pandemic COVID-19, education transmission is occurring via both the modes of education, that is, online as well as offline in the college. The aim of the current study was, therefore, to bring forth the comparative analysis of both the modes of education and their impact on the levels of academic stress and states of the mental wellbeing of the students amidst the current pandemic. Measures of the constructs were obtained by the online Google forms, which consist of the Perceptions of Academic Stress Scale (PASS) by and Warwick-Edinburg Mental Well-being Scale, from a sample of 100 undergraduate students aged 19-25 years studying in different colleges of Bengaluru, India. Modes of education were treated as the predictor variables whilst academic stress, and mental wellbeing constituted the criterion variables. Two-way ANOVA was employed. Results show that the levels of academic stress are found to be a bit higher in students attending online classes as compared to those taking offline classes in college (MD = 1.10, df = 98, t = 0.590, p > 0.05), whereas mental wellbeing is found to be low in students attending offline classes in colleges than those taking online classes (MD = 5.180, df = 98, t =2.340, p > 0.05 level). The combined interactional effect of modes of education and academic stress on the states of the mental wellbeing of the students is found to be low (R2 = 0.053), whilst the combined impact of modes of education and mental wellbeing on the levels of academic stress was found to be quite low (R2 = 0.014). It was concluded that modes of education have an impact on levels of academic stress and states of the mental well-being of the students amidst the current pandemic, but it is low.

Keywords: modes of education, online learning, offline learning, pandemic

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Authors: Sarah Kalaouze, Maxine Iannucelli, Kristen Dunfield

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Children’s implicit beliefs regarding intelligence (i.e., intelligence mindsets) influence their motivation, perseverance, and success. Previous research suggests that the way parents perceive failure influences the development of their child’s intelligence mindsets. We invited 151 children-parent dyads (Age= 5–6 years) to complete a series of difficult puzzles over zoom. We assessed parents’ intelligence and failure mindsets using questionnaires and recorded parents’ person/performance-oriented (e.g., “you are smart” or "you were almost able to complete that one) and process-oriented (e.g., “you are trying really hard” or "maybe if you place the bigger pieces first") failure feedback. We were interested in observing the relation between parental mindsets and the type of feedback provided. We found that parents’ intelligence mindsets were not predictive of the feedback they provided children. Failure mindsets, on the other hand, were predictive of failure feedback. Parents who view failure-as-debilitating provided more person-oriented feedback, focusing on performance and personal ability. Whereas parents who view failure-as-enhancing provided process-oriented feedback, focusing on effort and strategies. Taken all together, our results allow us to determine that although parents might already have a growth intelligence mindset, they don’t necessarily have a failure-as-enhancing mindset. Parents adopting a failure-as-enhancing mindset would influence their children to view failure as a learning opportunity, further promoting practice, effort, and perseverance during challenging tasks. The focus placed on a child’s learning, rather than their performance, encourages them to perceive intelligence as malleable (growth mindset) rather than fix (fixed mindset). This implies that parents should not only hold a growth mindset but thoroughly understand their role in the transmission of intelligence beliefs.

Keywords: mindset(s), failure, intelligence, parental feedback, parents

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Authors: M. Ekiert, T. Uhl, A. Mlyniec

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Tendons are the biological soft tissue structures composed of collagen, proteoglycan, glycoproteins, water and cells of extracellular matrix (ECM). Tendons, which primary function is to transfer force generated by the muscles to the bones causing joints movement, are exposed to many micro and macro damages. In fact, tendons and ligaments trauma are one of the most numerous injuries of human musculoskeletal system, causing for many people (particularly for athletes and physically active people), recurring disorders, chronic pain or even inability of movement. The number of tendons reconstruction and transplantation procedures is increasing every year. Therefore, studies on soft tissues storage conditions (influencing i.e. tissue aging) seem to be an extremely important issue. In this study, an atomic-scale investigation on the kinetics of decomposition of two selected tendon components – collagen type I (which forms a 60-85% of a tendon dry mass) and elastin protein (which combine with ECM creates elastic fibers of connective tissues) is presented. A molecular model of collagen and elastin was developed based on crystal structure of triple-helical collagen-like 1QSU peptide and P15502 human elastin protein, respectively. Each model employed 4 linear strands collagen/elastin strands per unit cell, distributed in 2x2 matrix arrangement, placed in simulation box filled with water molecules. A decomposition phenomena was simulated with molecular dynamics (MD) method using ReaxFF force field and periodic boundary conditions. A set of NVT-MD runs was performed for 1000K temperature range in order to obtained temperature-depended rate of production of decomposition by-products. Based on calculated reaction rates activation energies and pre-exponential factors, required to formulate Arrhenius equations describing kinetics of decomposition of tested soft tissue components, were calculated. Moreover, by adjusting a model developed for collagen, system scalability and correct implementation of the periodic boundary conditions were evaluated. An obtained results provide a deeper insight into decomposition of selected tendon components. A developed methodology may also be easily transferred to other connective tissue elements and therefore might be used for further studies on soft tissues aging.

Keywords: decomposition, molecular dynamics, soft tissue, tendons

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Authors: Alexandra Shipley

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Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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Authors: Jiazhen Liao, Xiaolan Zeng

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A series of BiOCl nanoplates with different oxygen vacancies (OVs) concentrations were successfully synthesized via a facile solvothermal method. The concentration of OVs of BiOCl can be tuned by the ratios of water/ethylene glycol. Such nanoplates containing oxygen vacancies served as an efficient visible-light-driven photocatalyst for NO oxidation. Compared with pure BiOCl, the enhanced photocatalytic performance was mainly attributed to the introduction of OVs, which greatly enhanced light absorption, promoted electron transfer, activated oxygen molecules. The present work could provide insights into the understanding of the role of OVs in photocatalysts for reference. Combined with characterization analysis, such as XRD（X-ray diffraction）, XPS（X-ray photoelectron spectroscopy), TEM（Transmission Electron Microscopy）, PL（Fluorescence Spectroscopy）, and DFT (Density Functional Theory) calculations, the effect of vacancies on photoelectrochemical properties of BiOCl photocatalysts are shown. Furthermore, the possible reaction mechanisms of photocatalytic NO oxidation were also revealed. According to the results of in situ DRIFTS （ Diffused Reflectance Infrared Fourier Transform Spectroscopy）, various intermediates were produced during different time intervals of NO photodegradation. The possible pathways are summarized below. First, visible light irradiation induces electron-hole pairs on the surface of OV-BOC (BiOCl with oxygen vacancies). Second, photogenerated electrons form superoxide radical with the contacted oxygen. Then, the NO molecules adsorbed on the surface of OV-BOC are attacked by superoxide radical and form nitrate instead of NO₂ (by-products). Oxygen vacancies greatly improve the photocatalytic oxidation activity of NO and effectively inhibit the production of harmful by-products during the oxidation of NO.

Keywords: OVs-BiOCl nanoplate, oxygen vacancies, NO oxidation, photocatalysis

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Authors: Alaa Sheta

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Economic Load Dispatch (ELD) is one of the vital optimization problems in power system planning. Solving the ELD problems mean finding the best mixture of power unit outputs of all members of the power system network such that the total fuel cost is minimized while sustaining operation requirements limits satisfied across the entire dispatch phases. Many optimization techniques were proposed to solve this problem. A famous one is the Quadratic Programming (QP). QP is a very simple and fast method but it still suffer many problem as gradient methods that might trapped at local minimum solutions and cannot handle complex nonlinear functions. Numbers of metaheuristic algorithms were used to solve this problem such as Genetic Algorithms (GAs) and Particle Swarm Optimization (PSO). In this paper, another meta-heuristic search algorithm named Differential Evolution (DE) is used to solve the ELD problem in power systems planning. The practicality of the proposed DE based algorithm is verified for three and six power generator system test cases. The gained results are compared to existing results based on QP, GAs and PSO. The developed results show that differential evolution is superior in obtaining a combination of power loads that fulfill the problem constraints and minimize the total fuel cost. DE found to be fast in converging to the optimal power generation loads and capable of handling the non-linearity of ELD problem. The proposed DE solution is able to minimize the cost of generated power, minimize the total power loss in the transmission and maximize the reliability of the power provided to the customers.

Keywords: economic load dispatch, power systems, optimization, differential evolution

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Authors: Raana Babadi Fathipour

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Hydrogels are three-dimensional structures formed by the interweaving of polymeric materials, possessing the remarkable ability to imbibe copious amounts of water. Numerous methodologies have been devised for examining and understanding the properties of these synthesized gels. Amongst them, spectroscopic techniques such as ultraviolet/visible (UV/Vis) and Fourier-transform infrared (FTIR) spectroscopy offer a glimpse into molecular and atomic aspects. Additionally, diffraction methods like X-ray diffraction (XRD) enable one to measure crystallinity within the gel's structure, while microscopy tools encompassing scanning electron microscopy (SEM) and transmission electron microscopy (TEM) provide insights into surface texture and morphology. Furthermore, rheology serves as an invaluable tool for unraveling the viscoelastic behavior inherent in hydrogels—a parameter crucial not only to numerous industries, including pharmaceuticals, cosmetics, food processing, agriculture and water treatment, but also pivotal to related fields of research. Likewise, the ultimate configuration of the product is contingent upon its characterization at a microscopic scale in order to comprehend the intricacies of the hydrogel network's structure and interaction dynamics in response to external forces. Within this present scrutiny, our attention has been devoted to unraveling the intricate rheological tendencies exhibited by materials founded on synthetic, natural, and semi-synthetic hydrogels. We also explore their practical utilization within various facets of everyday life from an industrial perspective.

Keywords: rheology, hydrogels characterization, viscoelastic behavior, application

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Authors: Ibrahim Abouelkhir

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Background: Prior to this project, the number of CT aorta requests from our Emergency Department (ED) was reported by the radiology department to be high with a low positive event rate: only 1- 2% of CT aortas performed were positive for acute aortic syndrome. This trend raised concerns about the time required to process and report these scans, potentially impacting the timely reporting of other high-priority imaging, such as trauma-related scans. Other harms identified were unnecessary radiation, patients spending longer in ED contributing to overcrowding, and, most importantly, the patient not getting the right care the first time. The radiology department also raised the problem of reporting bias because they expected our CT aortas to be normal. Aim: The main aim of this project was to reduce the number of unnecessary CT aortas requested, which would be shown by 1. Number of CT aortas requested and 2. Positive event rate. Methodology: This was a quality improvement project carried out in the ED at Frimley Park Hospital, UK. Starting from 1 st January 2024, we recorded the number of days required to reach 35 CT aorta requests. We looked at all patients presenting to the ED over the age of 16 for whom a CT aorta was requested by the ED team. We looked at how many of these scans were positive for acute aortic syndrome. The intervention was a change in practice: all CT aortas should be approved by an ED consultant or ST4+ registrar (5th April 2024). We then reviewed the number of days it took to reach a total of 35 CT aorta requests following the intervention and again reviewed how many were positive. Results: Prior to the intervention, 35 CT Aorta scans were performed over a 20-day period. Following the implementation of the ED senior doctor vetting process, the same number of CT Aorta scan requests was observed over 50 days - more than twice the pre-intervention period. This indicates a significant reduction in the rate of CT Aorta scans being requested. During the pre-intervention phase, there were two positive cases of acute aortic syndrome. In the post-intervention period, there were zero. Conclusion: The mandatory review of CT Aorta scan requested by the ED consultant effectively reduced the number of scans requested. However, this intervention did not lead to an increase in positive scan results. We noted that post-intervention, approximately 50% of scans had been approved by registrar-grade doctors and, only 50% had been approved by ED consultants, and the majority were not in-person reviews. We wonder if restricting the approval to consultant grade only might improve the results, and furthermore, in person reviews should be the gold standard.

Keywords: quality improvement project, CT aorta scans, emergency department, radiology department, aortic dissection, scan request vetting, clinical outcomes, imaging efficiency

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Authors: Diego Abbo

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On February 15, 2012 off the Indian coast of Kerala, in position 091702N-0760180E by the oil tanker Enrica Lexie, flying the Italian flag, bursts of 5.56 x45 caliber shots were fired from assault rifles AR/70 Italian-made Beretta towards the Indian fisher boat St. Anthony. The shots that hit the St. Anthony fishing boat were six, of which two killed the Indian fishermen Ajesh Pink and Valentine Jelestine. From the analysis concerning the kinematic engagement of the two ships and from the autopsy and ballistic results of the Indian judicial authorities it is possible to reconstruct the trajectories of the six aforementioned shots. This essay reconstructs the trajectories of the six shots that cannot be of direct shooting but have undergone a rebound on the water. The investigation carried out scientifically demonstrates the rebound of the blows on the water, the gyrostatic deviation due to the rebound and the tumbling effect always due to the rebound as regards intermediate ballistics. In consideration of the four shots that directly impacted the fishing vessel, the current examination proves, with scientific value, that the trajectories could not be downwards but upwards. Also, the trajectory of two shots that hit to death the two fishermen could not be downwards but only upwards. In fact, this paper demonstrates, with scientific value: The loss of speed of the projectiles due to the rebound on the water; The tumbling effect in the ballistic medium within the two victims; The permanent cavities subject to the injury ballistics and the related ballistic trauma that prevented homeostasis causing bleeding in one case; The thermo-hardening deformation of the bullet found in Valentine Jelestine's skull; The upward and non-downward trajectories. The paper constitutes a tool in forensic ballistics in that it manages to reconstruct, from the final spot of the projectiles fired, all phases of ballistics like the internal one of the weapons that fired, the intermediate one, the terminal one and the penetrative structural one. In general terms the ballistics reconstruction is based on measurable parameters whose entity is contained with certainty within a lower and upper limit. Therefore, quantities that refer to angles, speed, impact energy and firing position of the shooter can be identified within the aforementioned limits. Finally, the investigation into the internal bullet track, obtained from any autopsy examination, offers a significant “lesson learned” but overall a starting point to contain or mitigate bleeding as a rescue from future gunshot wounds.

Keywords: impact physics, intermediate ballistics, terminal ballistics, tumbling effect

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Authors: Shantanu Prakash, Suruchi Shukla, Amita Jain

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Introduction: The hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. Injection drug use and individuals receiving blood and blood products are the primary modes of HCV transmission. Our study aims to establish the prevalent genotypes/ subtypes of HCV circulating in Uttar Pradesh, North India, as reported from a tertiary care hospital. Methods: It is a retrospective observational analysis of consecutive 404 HCV RNA positive cases referred to our hospital during September 2014 to April 2017. The study was approved by an institutional ethics committee. Written informed consent was taken from each participant. Clinical and demographic details of these patients were recorded using predesigned questionnaires. All the laboratory testing was carried on stored serum sample of enrolled cases. Genotyping of all 404 strains was done by Sanger’s sequencing of the core region. The phylogenetic analysis of 179 HCV strains with high -quality sequencing data was performed. Results: The distribution of prevalent genotypes/ subtypes as noted in the present study was; Genotype (GT)1a [n-101(25%)], GT1b [n-12(2.9%)], GT1c [1(0.25%)], GT3a [275(68.07%)], GT3b [9(2.2%)], GT3g [2(0.49%)], GT3i [3(0.74%)], and GT4a [1(0.24%)]. HCV genotypes GT2, GT5 and GT6 were not detected from our region. Sequence analysis showed high genotypic variability in HCV GT3. Phylogenetic analysis showed that HCV GT3 and GT1 circulating in our region were related to Indian strains reported earlier. Conclusions: HCV genotypes 3a and 1a are commonest circulating genotypes in Uttar Pradesh (UP), India.

Keywords: Hepatitis C virus, genetic variation, bioinformatics, genotype, HCV

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Authors: Ellen Kirkpatrick

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Deforestation, toxification, and loss of environmental habitats, accompanied by expanding production and urbanization, are visibly altering planetary life. This is bringing humans and non-human nature into closer contact, resulting in the emergence of infectious diseases such as the Covid-19 virus which, while zoonotic in origin, spread through market relations and networks of local and global production. However, while the pandemic sharply illuminated the role of labour within social transformations, the question remains about the role of labour in transforming ecological relations. Drawing on a historical materialist approach, this paper explores the emergence and transmission of the COVID-19 virus through the Marxist conceptualization of metabolic rift. This allows for a perspective of human and non-human nature, which is in constant motion and dialectical. This negotiates distinctions and binaries between them as humans and non-human nature are taken to mutually constrain, enable and constitute one another. This is particularly significant when considering the ongoing transformations of a climate-changing world and the corresponding effects on social life. To do this, this paper empirically focuses on the Huanan Seafood Wholesale Market in Wuhan, China, where the COVID-19 virus was first detected. It examines how the virus jumped from non-human animals to humans through concrete production operations locally before traveling globally through networks of abstract market relations based on the logic of circulation, trade and exchange. As a mediating relation between human and non-human nature, labour is an analytical tool that can create a dialogue between the concrete and the abstract, as well as the local and global.

Keywords: Marxism, social reproduction, metabolic rift, labour

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Authors: A. Elsayed, M. H. Dewaidar, M. Ghali

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We report on deposition of smooth, pinhole-free, low-surface roughness ( < 4nm) and high optical quality cadmium sulfide (CdS) thin films on glass substrates using our new method based on chemical surface deposition principle. In this method, cadmium acetate and thiourea are used as reactants under special growth conditions for deposition of CdS films. X-ray diffraction (XRD) measurements were used to examine the crystal structure properties of the deposited CdS films. In addition, UV-vis transmittance and low-temperature (4K) photoluminescence (PL) measurements were performed for quantifying optical properties of the deposited films. Interestingly, we found that XRD pattern of the deposited films has dramatically changed when the growth temperature was raised during the reaction. Namely, the XRD measurements reveal a structural change of CdS film from Cubic to Hexagonal phase upon increase in the growth temperature from 75 °C to 200 °C. Furthermore, the deposited films show high optical quality as confirmed from observation of both sharp edge in the transmittance spectra and strong PL intensity at room temperature. Also, we found a strong effect of the growth conditions on the optical band gap of the deposited films; where remarkable red-shift in the absorption edge with temperature is clearly seen in both transmission and PL spectra. Such tuning of both optical band gap and crystal structure of the deposited CdS films; can be utilized for tuning the electronic bands alignments between CdS and other light harvesting materials, like CuInGaSe or CdTe, for potential improvement in the efficiency of all-solution processed solar cells devices based on these heterostructures.

Keywords: thin film, CdS, new method, optical properties

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Authors: Rita Ghosh, Joykrishna Dey

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PEG-based amphiphiles are of tremendous importance for its widespread applications in pharmaceutics, household purposes, and drug delivery. Previously, a number of single PEG-tailed amphiphiles having significant applications have been reported from our group. Therefore, it was of immense interest to explore the properties and application potential of PEG-based double tailed amphiphiles. Herein, for the first time, two novel double PEG-tailed amphiphiles having different PEG chain lengths have been developed. The self-assembly behavior of the newly developed amphiphiles in aqueous buffer (pH 7.0) was thoroughly investigated at 25 oC by a number of techniques including, 1H-NMR, and steady-state and time-dependent fluorescence spectroscopy, dynamic light scattering, transmission electron microscopy, atomic force microscopy, and isothermal titration calorimetry. Despite having two polar PEG chains both molecules were found to have strong tendency to self-assemble in aqueous buffered solution above a very low concentration. Surprisingly, the amphiphiles were shown to form stable vesicles spontaneously at room temperature without any external stimuli. The results of calorimetric measurements showed that the vesicle formation is driven by the hydrophobic effect (positive entropy change) of the system, which is associated with the helix-to-random coil transition of the PEG chain. The spectroscopic data confirmed that the bilayer membrane of the vesicles is constituted by the PEG chains of the amphiphilic molecule. Interestingly, the vesicles were also found to exhibit structural transitions upon addition of salts in solution. These properties of the vesicles enable them as potential candidate for drug delivery.

Keywords: double-tailed amphiphiles, fluorescence, microscopy, PEG, vesicles

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Authors: Deepa S N, Srinivasan a D, Veeramanju K T

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The power transformer is a critical equipment in the transmission and distribution network that must be managed to ensure uninterrupted power service. The liquid insulation is essential for the proper functioning of the transformer, as it serves as both coolant and insulating medium, which influences the transformer’s durability. Further, the insulating state of a power transformer has a significant impact on its reliability. Mineral oil derived from petroleum crude oil has been employed as liquid dielectrics for decades due to its superior functional characteristics, however as a resource for the same are getting depleted over the years. Research is undertaken across the globe to identify a viable substitute for mineral oil. Further, alternate insulating oils are being investigated for better environmental impact, biodegradability and economics. Several combinations of vegetable oil derived natural esters are being inspected by researchers across the globe in these domains. In this work, mineral oil is blended with soyabean oil with various proportions and dielectric properties such as dielectric breakdown voltage, relative permittivity, dissipation factor, viscosity, flash and fire point have been investigated according to international standards. A quantitative comparison is made among various samples and is observed that the blended oil sample of equal proportion of mineral oil and soyabean oil, MO50+SO50 exhibits superior dielectric properties such as breakdown voltage of 65kV, dissipation factor of 0.0044, relative permittivity of 3.1680 that are closer to the range of values recommended for power transformer applications. Also, Breakdown voltage values of all the investigated oil samples obeyed the Weibull and Normal probability distribution.

Keywords: blended oil, dielectric breakdown, liquid insulation, power transformer

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Authors: Kyou Hee Shim, Hwa Sung Shin

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When a thrombolysis agent is administered to treat ischemic stroke, excessive reactive oxygen species are generated due to a sudden provision of oxygen and occurs secondary damage cell necrosis. Thus, it is necessary to administrate adjuvant as well as thrombolysis agent to protect and reduce damaged tissue. As cerebral blood vessels have specific structure called blood-brain barrier (BBB), it is not easy to transfer substances from blood to tissue. Therefore, development of a drug carrier is required to increase drug delivery efficiency to brain tissue. In this study, cyanobacterial pigment from the blue-green algae known for having neuroprotective effect as well as antioxidant effect was nasally administrated for bypassing BBB. In order to deliver cyanobacterial pigment efficiently, the nano-sized liposome was used as a carrier. Liposomes were coated with a positive charge of chitosan since negative residues are present at the nasal mucosa the first gateway of nasal administration. Characteristics of liposome including morphology, size and zeta potential were analyzed by transmission electron microscope (TEM) and zeta analyzer. As a result of cytotoxic test, the liposomes were not harmful. Also, being administered a drug to the ischemic stroke animal model, we could confirm that the pharmacological effect of the pigment delivered by chitosan coated liposome was enhanced compared to that of non-coated liposome. Consequently, chitosan coated liposome could be considered as an optimized drug delivery system for the treatment of acute ischemic stroke.

Keywords: ischemic stroke, cyanobacterial pigment, liposome, chitosan, nasal administration

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Authors: Risikat Oladoyin S. Dauda, Onyebuchi Iwegbu

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This study investigates the response of human development outcomes to selected macroeconomic indicators in Nigeria. Human development outcomes is measured by human development index while the selected macroeconomic variables are inflation rate, real interest rate, government capital expenditure, real exchange rate, current account balance, and savings. Structural Vector Autoregression (SVAR) technique is employed in examining the response of human development index to the macroeconomic shocks. The result from the forecast error variance decomposition and Impulse-Response analysis reveals that fiscal policy (government capital expenditure) shock is the greatest determinant of human development outcomes. This result reiterates the role which the government plays in improving the welfare of the citizenry. The fiscal policy tool is pivotal in human development which comes in the form of investment in education, health, housing, and infrastructure. Further conclusion drawn from this study is that human development outcome positively and significantly responds to shocks from real interest rate, a monetary policy transmission variable and is felt greatly in the short run period. The policy implication of this study is that if capital budget implementation falls below expectations, human development will be engendered. Hence, efforts should be made to ensure that full implementation and appraisal of government capital expenditure is taken sacrosanct as any shock from such plan, engenders human development outcome.

Keywords: human development outcome, macroeconomic outcomes, structural vector autoregression, SVAR

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Authors: Bill D. Geis

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Even with significantly increased spending, suicide rates continue to climb—with alarming increases among traditionally low-risk groups. This has caused clinicians and researchers to call for a complete rethinking of all assumptions about suicide prevention, assessment, and intervention. A form of therapy--Internal Family Systems Therapy--affords tremendous promise in sustained diminishment of lethal suicide risk. Though a form of therapy that is most familiar to trauma therapists, Internal Family Systems Therapy, involving direct work with suicidal parts, is a promising therapy for meaningful and sustained reduction in suicide deaths. Developed by Richard Schwartz, Internal Family Systems Therapy proposes that we are all influenced greatly by internal parts, frozen by development adversities, and these often-contradictory parts contribute invisibly to mood, distress, and behavior. In making research videos of patients from our database and discussing their suicide attempts, it is clear that many persons who attempt suicide are in altered states at the time of their attempt and influenced by factors other than conscious intent. Suicide intervention using this therapy involves direct work with suicidal parts and other interacting parts that generate distress and despair. Internal Family Systems theory posits that deep experiences of pain, fear, aloneness, and distress are defended by a range of different parts that attempt to contain these experiences of pain through various internal activities that unwittingly push forward inhibition, fear, self-doubt, hopelessness, desires to cut and engage in destructive behavior, addictive behavior, and even suicidal actions. These suicidal parts are often created (and “frozen”) at young ages, and these very young parts do not understand the consequences of this influence. Experience suggests that suicidal parts can create impulsive risk behind the scenes when pain is high and emotional support reduced—with significant crisis potential. This understanding of latent suicide risk is consistent with many of our video accounts of serious suicidal acts—compiled in a database of 1104 subjects. Since 2016, consent has been obtained and records kept of 23 highly suicidal patients, with initial Intention-to-Die ratings (0= no intent, 10 = conviction to die) between 5 and 10. In 67% of these cases using IFST parts-work intervention, these highly suicidal patients’ risk was reduced to 0-1, and 83% of cases were reduced to 4 or lower. There were no suicide deaths. Case illustrations will be offered.

Keywords: suicide, internal family systems therapy, crisis management, suicide prevention

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Authors: Ionel Zagan, Vasile Gheorghita Gaitan, Adrian Brezulianu

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This paper presents the contributions in designing a mobile system named Tele-ECG implemented for remote monitoring of cardiac patients. For a better flexibility of this application, the authors chose to implement a local memory and multiple communication interfaces. The project described in this presentation is based on the ARM Cortex M0+ microcontroller and the ADAS1000 dedicated chip necessary for the collection and transmission of Electrocardiogram signals (ECG) from the patient to the microcontroller, without altering the performances and the stability of the system. The novelty brought by this paper is the implementation of a remote monitoring system for cardiac patients, having a real-time behavior and multiple interfaces. The microcontroller is responsible for processing digital signals corresponding to ECG and also for the implementation of communication interface with the main server, using GSM/Bluetooth SIMCOM SIM800C module. This paper translates all the characteristics of the Tele-ECG project representing a feasible implementation in the biomedical field. Acknowledgment: This paper was supported by the project 'Development and integration of a mobile tele-electrocardiograph in the GreenCARDIO© system for patients monitoring and diagnosis - m-GreenCARDIO', Contract no. BG58/30.09.2016, PNCDI III, Bridge Grant 2016, using the infrastructure from the project 'Integrated Center for research, development and innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for fabrication and control', Contract No. 671/09.04.2015, Sectoral Operational Program for Increase of the Economic Competitiveness co-funded from the European Regional Development Fund.

Keywords: Tele-ECG, real-time cardiac monitoring, electrocardiogram, microcontroller

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Authors: Belaynesh Tsegay, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigray. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigray, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigray. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood were collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using ELISA (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the SPSS version 20, and p<0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18–25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15–13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17–7.74, p=0.022) were significantly associated with HBV infections. Conclusion: The seroprevalence of HBV among prisoners was nearly high or borderline, with a very low HCV prevalence. HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, tigray

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Authors: Alex Eldo Simon, Abhishek Yadav

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This study aimed to evaluate the utility of postmortem computed tomography (CT) and heart weight measurements in the assessment of cardiomegaly in cases of sudden death due to cardiac origin by comparing the results of these two diagnostic methods. The study retrospectively analyzed postmortem computed tomography (PMCT) data from 54 cases of sudden natural death and compared the findings with those of the autopsy. The study involved measuring the cardiothoracic ratio (CTR) from coronal computed tomography (CT) images and determining the actual cardiac weight by weighing the heart during the autopsy. The inclusion criteria for the study were cases of sudden death suspected to be caused by cardiac pathology, while exclusion criteria included death due to unnatural causes such as trauma or poisoning, diagnosed natural causes of death related to organs other than the heart, and cases of decomposition. Sensitivity, specificity, and diagnostic accuracy were calculated, and to evaluate the accuracy of using the cardiothoracic ratio (CTR) to detect an enlarged heart, the study generated receiver operating characteristic (ROC) curves. The cardiothoracic ratio (CTR) is a radiological tool used to assess cardiomegaly by measuring the maximum cardiac diameter in relation to the maximum transverse diameter of the chest wall. The clinically used criteria for CTR have been modified from 0.50 to 0.57 for use in postmortem settings, where abnormalities can be detected by comparing CTR values to this threshold. A CTR value of 0.57 or higher is suggestive of hypertrophy but not conclusive. Similarly, heart weight is measured during the traditional autopsy, and a cardiac weight greater than 450 grams is defined as hypertrophy. Of the 54 cases evaluated, 22 (40.7%) had a cardiothoracic ratio (CTR) ranging from > 0.50 to equal 0.57, and 12 cases (22.2%) had a CTR greater than 0.57, which was defined as hypertrophy. The mean CTR was calculated as 0.52 ± 0.06. Among the 54 cases evaluated, the weight of the heart was measured, and the mean was calculated as 369.4 ± 99.9 grams. Out of the 54 cases evaluated, 12 were found to have hypertrophy as defined by PMCT, while only 9 cases were identified with hypertrophy in traditional autopsy. The sensitivity and specificity of the test were calculated as 55.56% and 84.44%, respectively. The sensitivity of the hypertrophy test was found to be 55.56% (95% CI: 26.66, 81.12¹), the specificity was 84.44% (95% CI: 71.22, 92.25¹), and the diagnostic accuracy was 79.63% (95% CI: 67.1, 88.23¹). The limitation of the study was a low sample size of only 54 cases, which may limit the generalizability of the findings. The comparison of the cardiothoracic ratio with heart weight in this study suggests that PMCT may serve as a screening tool for medico-legal autopsies when performed by forensic pathologists. However, it should be noted that the low sensitivity of the test (55.5%) may limit its diagnostic accuracy, and therefore, further studies with larger sample sizes and more diverse populations are needed to validate these findings.

Keywords: PMCT, virtopsy, CTR, cardiothoracic ratio

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Authors: Md. Mahadi Hasan Sany, Mumenunnessa Keya, Sharun Khushbu, Sheikh Abujar

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Since the beginning of China's economic reform, trade between the U.S. and China has grown rapidly, and has increased since China's accession to the World Trade Organization in 2001. The US imports more than it exports from China, reducing the trade war between China and the U.S. for the 2019 trade deficit, but in 2020, the opposite happens. In international and U.S. trade, Washington launched a full-scale trade war against China in March 2016, which occurred a catastrophic epidemic. The main goal of our study is to measure and predict trade relations between China and the U.S., before and after the arrival of the COVID epidemic. The ML model uses different data as input but has no time dimension that is present in the time series models and is only able to predict the future from previously observed data. The LSTM (a well-known Recurrent Neural Network) model is applied as the best time series model for trading forecasting. We have been able to create a sustainable forecasting system in trade between China and the US by closely monitoring a dataset published by the State Website NZ Tatauranga Aotearoa from January 1, 2015, to April 30, 2021. Throughout the survey, we provided a 180-day forecast that outlined what would happen to trade between China and the US during COVID-19. In addition, we have illustrated that the LSTM model provides outstanding outcome in time series data analysis rather than RFR and SVR (e.g., both ML models). The study looks at how the current Covid outbreak affects China-US trade. As a comparative study, RMSE transmission rate is calculated for LSTM, RFR and SVR. From our time series analysis, it can be said that the LSTM model has given very favorable thoughts in terms of China-US trade on the future export situation.

Keywords: RFR, China-U.S. trade war, SVR, LSTM, deep learning, Covid-19, export value, forecasting, time series analysis

Procedia PDF Downloads 198

Authors: Vaikunthan Rajaratnam

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Maintaining continuous professional development among clinicians has been a challenge. Hand surgery is a unique speciality with the coming together of orthopaedics, plastics and trauma surgeons. The requirements for a team-based approach to care with the inclusion of other experts such as occupational, physiotherapist and orthotic and prosthetist provide the impetus for the creation of communities of practice. This study analysed the community of practice in hand surgery that was created through a social networking website for professionals. The main objectives were to discover the usefulness of this community of practice created in the platform of the group function of LinkedIn. The second objective was to determine the usability of this platform for the purposes of continuing professional development among members of this community of practice. The methodology used was one of mixed methods which included a quantitative analysis on the usefulness of the social network website as a community of practice, using the analytics provided by the LinkedIn platform. Further qualitative analysis was performed on the various postings that were generated by the community of practice within the social network website. This was augmented by a respondent driven survey conducted online to assess the usefulness of the platform for continuous professional development. A total of 31 respondents were involved in this study. This study has shown that it is possible to create an engaging and interactive community of practice among hand surgeons using the group function of this professional social networking website LinkedIn. Over three years the group has grown significantly with members from multiple regions and has produced engaging and interactive conversations online. From the results of the respondents’ survey, it can be concluded that there was satisfaction of the functionality and that it was an excellent platform for discussions and collaboration in the community of practice with a 69 % of satisfaction. Case-based discussions were the most useful functions of the community of practice. This platform usability was graded as excellent using the validated usability tool. This study has shown that the social networking site LinkedIn’s group function can be easily used as a community of practice effectively and provides convenience to professionals and has made an impact on their practice and better care for patients. It has also shown that this platform was easy to use and has a high level of usability for the average healthcare professional. This platform provided the improved connectivity among professionals involved in hand surgery care which allowed for the community to grow and with proper support and contribution of relevant material by members allowed for a safe environment for the exchange of knowledge and sharing of experience that is the foundation of a community practice.

Keywords: community of practice, online community, hand surgery, lifelong learning, LinkedIn, social media, continuing professional development

Procedia PDF Downloads 316