Search results for: intensive Care

Authors: Sawarni Hasibuan, Rudi Effendi Listyanto

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The industrial sector is the largest consumer of energy consumption in Indonesia. The ceramics industry includes one of seven industries categorized as an energy-intensive industry. Energy costs on the ceramic floor production process reached 40 percent of the total production cost. The kiln is one of the machines in the ceramic industry that consumes the most gas energy reach 51 percent of gas consumption in ceramic production. The purpose of this research is to make improvement of energy consumption in kiln machine part with the innovation of burner tube to support the sustainability of Indonesian ceramics industry. The tube burner is technically designed to be able to raise the temperature and stabilize the air pressure in the burner so as to facilitate the combustion process in the kiln machine which implies the efficiency of gas consumption required. The innovation of the burner tube also has an impact on the decrease of the combustion chamber pressure in the kiln and managed to keep the pressure of the combustion chamber according to the operational standard of the kiln; consequently, the smoke fan motor power can be lowered and the kiln electric energy consumption is also more efficient. The innovation of burner tube succeeded in saving consume of gas and electricity respectively by 0.0654 GJ and 1,693 x 10-3 GJ for every ton of ceramics produced. Improvement of this energy consumption not only implies the cost savings of production but also supports the sustainability of the Indonesian ceramics industry.

Keywords: sustainable ceramic industry, burner tube, kiln, energy efficiency

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Authors: Musoke Ivan, Birungi Racheal

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The construction trend is characterized by increased use of modern methods yet traditional methods are cheaper in terms of costs, in addition to the benefits it offers to the construction sector, like providing more jobs that could have been worked with the intensive machines. The purpose of this research was to assess the influence of using Traditional methods of construction (TMC) on the costs and quality of building structures and determine the different ways. Traditional methods of construction (TMC) can be applicable and integrated into the construction trend, and propose ways how this can be a success. The study adopted a quantitative method approach targeting various construction professionals like Architects, Quantity surveyors, Engineers, and Construction Managers. Questionnaires and analyses of literature were used to obtain research data and findings. Simple random sampling was used to select 40 construction professionals to which questionnaires were administered. The data was then analyzed using Microsoft Excel. The findings of the research indicate that Traditional methods of construction (TMCs) in Uganda are cheaper in terms of costs, but the quality is still low. This is attributed to a lack of skilled labour and efficient supervision while undertaking tasks leading to low quality. The study identifies strategies that would improve Traditional methods of construction (TMC), which include the employment of skilled manpower and effective supervision. It also identifies the need by stakeholders like the government, clients, and professionals to appreciate Traditional methods of construction (TMCs) and allow for a levelled ground for Traditional Methods of Construction and Modern methods of construction (MMCs).

Keywords: traditional methods of construction, integration, cost, quality

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Authors: B. Rusyidi

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Since 2009, the Indonesian Ministry of Social Affairs has been implementing Program Kesejahteraan Sosial Anak (PKSA) (Child Welfare Program) a conditional cash transfer program that targets neglected children, children with disabilities, street children, children in conflict with the law, and children in need of special protection, all from poor households. PKSA integrates three elements: Transfer of cash, care and social services through social workers, and institutional childcare assistance. This qualitative study analyzed the roles and the challenges of social workers in implementing PKSA and lays out recommendations to inform policy changes. Data were collected in late 2014 from national and local government and non-government child welfare agencies, social workers, and childcare institution representatives through interviews and Focused Group Discussions (FGDs). Field work took place in six districts in the provinces of Jakarta, Central Java and South Sulawesi. The study found that the social workers’ role was significant in facilitating cash transfer, providing education and guidance, and linking children and families to basic social services. This improved utilization of basic social services enhanced children and families’ behaviors and contributed to the well being of the children. However, only a small number of childcare institutions have social workers, leaving many children and families without care and social service linkages, depriving them of rehabilitative components to help them regain their social functions. Some social workers reported their struggles with heavy workloads, lack of professional competencies and training, limited job security, and inadequate professional acknowledgment from other professions. Parts of those challenges were due to the centralized nature of the program and the lack of shared vision and commitment about the child protection system among related government agencies both at the national and local levels. The study highlights the necessity to implement an integrated child protection system, decentralize the PKSA program, and increase the number, competence, case management, and management and monitoring of social workers. The most recent progress of the program and its impacts on social workers are also discussed.

Keywords: child protection, conditional cash transfer, program decentralization, social worker, working conditions

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Authors: Yulistiani Yulistiani, Zamrotul Izzah, Lintang Bismantara, Wenny Putri Nilamsari, Arif Bachtiar, Budi Suprapti

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Interferon-gamma (IFN-γ) and interleukin-6 (IL-6) are pro-inflammatory cytokines, which have the protective immune response against Tuberculosis (TB). Indeed, pro-inflammatory cytokines Mycobacterium tuberculosis antigen-specific CD4+ and CD8+ T cells and NK cells increase the level of production of IFN-γ, a cytokine critical for augmenting the microbicidal activity of phagocytes. On the other hand, M. tuberculosis reduces the effects of IFN-γ by inhibiting the transcription of IFN-γ- responsive genes and by inducing the secretion of IL-6, which inhibits IFN-γ signaling. Probiotics Lactobacillus sp. and Bifidobacterium sp. were known to increase IFN-γ production in vivo, while vitamin B1, B6, and B12 worked on macrophages and releasing cytokines. Therefore, the present study was to evaluate the effect of probiotics and vitamin B supplement on changes of plasma cytokine levels in active pulmonary TB. From October to November 2016, twelve M. tuberculosis-infected patients starting anti-TB drugs were recruited, then divided into two groups. Seven patients were given a combination of probiotics and vitamin B, while five patients were in the control group. Plasma IFN-γ and IL-6 levels were measured by the ELISA kit before and a month after treatment. IFN-γ levels raised in four patients receiving the supplement (P = 0.743), while IL-6 increased in three patients in this group until day 30 of treatment (P = 0.298). Taken together, these results show the promising effect of probiotics and vitamin B on stimulation of IFN-γ and IL-6 production during intensive therapy of TB.

Keywords: interferon-gamma, interleukin-6, probiotic, tuberculosis

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Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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Authors: Sanja O. Podunavac-Kuzmanović, Lidija R. Jevrić, Strahinja Z. Kovačević

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In last decade, metal-organic complexes have captured intensive attention because of their wide range of biological activities such as antibacterial, antifungal, anticancerous, antimicrobial and antiHIV. Therefore, it is of great importance for the development of coordination chemistry to explore the assembly of functional organic ligands with metal ion and to investigate the relationship between the structure and property. In view of our studies, we reasoned that benzimidazoles complexed to metal ions could act as a potent antibacterial agents. Thus, we have bioassayed the inhibitory potency of benzimidazoles and their metal salts (Co or Ni) against Gram negative bacteria Escherichia coli. In order to validate our in vitro study, we performed in silico studies using molecular docking software’s. The investigated compounds and their metal complexes (Co, Ni) showed good antibacterial activity against Escherichia coli. In silico docking studies of the synthesized compounds suggested that complexed benzimidazoles have a greater binding affinity and enhanced antibacterial activity in comparison with noncomplexed ligands. In view of their enhanced inhibitory properties we propose that the studied complexes can be used as potential pharmaceuticals. This study is financially supported by COST action CM1306 and the project No. 114-451-347/2015-02, financially supported by the Provincial Secretariat for Science and Technological Development of Vojvodina.

Keywords: benzimidazoles, complexes, antibacterial, Escherichia coli, metal

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Authors: Ali A. Alshahrani

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This study aims to identify Saudi English as a Foreign Language (EFL) students' perspectives towards using the English language in their studies. The study explores students' self-confident and its association with students' actual performance in English courses in their different academic programs. A multimodal methodology was used to fulfill the research purpose and answer the research questions. A 25-item survey questionnaire and final examination grades were used to collect data. Two hundred forty-one students agreed to participate in the study. They completed the questionnaire and agreed to release their final grades to be a part of the collected data. The data were coded and analyzed by SPSS software. The findings indicated a significant difference in students' performance in English courses between participants' academic programs on the one hand. Students' self-confidence in their English language skills, on the other hand, was not significantly different between participants' academic programs. Data analysis also revealed no correlational relationship between students' self-confidence level and their language skills and their performance. The study raises more questions about other vital factors such as course instructors' views of the materials, faculty members of the target department, family belief in the usefulness of the program, potential employers. These views and beliefs shape the student's preparation process and, therefore, should be explored further.

Keywords: English language intensive program, language proficiency, performance, self-confidence

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Authors: Farjina Malek, Julie King, Niki Edwards

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Across the globe more than a billion people live with a disability and a further billion people, mostly carers, are indirectly impacted. While prevalence data is problematic, it is estimated that more than 15% of the population in Bangladesh live with a disability. Disability service infrastructure in Bangladesh is under-developed; and consequently, the onus of care falls on family, especially on mothers. Within the caring role, mothers encounter many challenging experiences which are not only due to the lack of support delivered through the Bangladeshi health care system but also related to the existence of stigma and perception around disability in the Bangladeshi society. Within this perception, the causes of disability are mostly associated with 'God’s will'; 'possession of ghosts on the disabled person'; and 'karma or the result of past sins of the family members especially the mothers'. These beliefs are likely to have a significant impact on the well-being of mothers and their caring experience of children with disability. This is an ongoing qualitative study which is conducting in-depth interviews with 30 mothers from five districts (Dhaka, Mymensingh, Manikganj, Tangail, and Gazipur) of Bangladesh with the aim to explore the impact of social perception and stigma around physical disability on the caring role of the mothers of children with physical disability. The major findings of this study show that the social perception around disability and the social expectation from a mother regarding her caring role have a huge impact on the well-being of mothers. Mothers are mostly expected to take their child on their lap to prove that they are ‘good mother’. These practices of lifting their children with physical disability and keeping them on the lap for a long time often cause chronic back pain of the mothers. Existing social beliefs consider disability as a ‘curse’ and punishment for the ‘sins’ of the family members, most often by the mother. Mothers are blamed if they give birth to ‘abnormal’ children. This social construction creates stigma, and thus, the caring responsibility of mothers become more challenging. It also encourages the family and mothers to hide their children from the society and to avoid seeking accessible disability services. The mothers also compromise their careers and social interaction as they have to stay with their children at home, and that has a significant impact on personal wellbeing, income, and empowerment of the mothers. The research is informed by intersectional theory and employed an interpretive phenomenological methodology to explore mothers’ experience of caring their children with physical disability, and the contribution and impact of key relationships within the family and the intersection with community and services.

Keywords: mother, family carer, physical disability, children, social stigma, key relationship

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Authors: Sabrina Yulianti

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This study aims to explain the identity struggles of local religious communities in Indonesia. Local religion in Indonesia is not recognized by the government and is not incorporated into the official religion in Indonesia. This makes the local religions in Indonesia experienced the challenges and obstacles in fulfilling their rights as citizens of Indonesia. Challenges and barriers they experience such as: difficulty in making of the birth certificate and marriage. It is as experienced by one of the local religions namely Parmalim which located in North Sumatra. Not only difficulty in taking care of the bureaucracy as a citizen, but the local religion is seen as a minority and sometimes regarded as follower of deviate religion.

Keywords: local religion, faith, struggles, civilization, discrimination

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Authors: N. Mansouri, A. Asadi

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Data Grid is a geographically distributed environment that deals with data intensive application in scientific and enterprise computing. Data replication is a common method used to achieve efficient and fault-tolerant data access in Grids. In this paper, a dynamic data replication strategy, called Enhanced Latest Access Largest Weight (ELALW) is proposed. This strategy is an enhanced version of Latest Access Largest Weight strategy. However, replication should be used wisely because the storage capacity of each Grid site is limited. Thus, it is important to design an effective strategy for the replication replacement task. ELALW replaces replicas based on the number of requests in future, the size of the replica, and the number of copies of the file. It also improves access latency by selecting the best replica when various sites hold replicas. The proposed replica selection selects the best replica location from among the many replicas based on response time that can be determined by considering the data transfer time, the storage access latency, the replica requests that waiting in the storage queue and the distance between nodes. Simulation results utilizing the OptorSim show our replication strategy achieve better performance overall than other strategies in terms of job execution time, effective network usage and storage resource usage.

Keywords: data grid, data replication, simulation, replica selection, replica placement

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Authors: Maryam Enteshari, Kooshan Nayebzadeh, Abdorreza Mohammadi

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In this study, the oxidative stability of soybean oil under different storage temperatures (4 and 25˚C) and during 6-month shelf-life was investigated by various analytical methods and headspace-liquid phase microextraction (HS-LPME) coupled to gas chromatography-mass spectrometry (GC-MS). Oxidation changes were monitored by analytical parameters consisted of acid value (AV), peroxide value (PV), p-Anisidine value (p-AV), thiobarbituric acid value (TBA), fatty acids profile, iodine value (IV), and oxidative stability index (OSI). In addition, concentrations of hexanal and heptanal as secondary volatile oxidation compounds were determined by HS-LPME/GC-MS technique. Rate of oxidation in soybean oil which stored at 25˚C was so higher. The AV, p-AV, and TBA were gradually increased during 6 months while the amount of unsaturated fatty acids, IV, and OSI decreased. Other parameters included concentrations of both hexanal and heptanal, and PV exhibited increasing trend during primitive months of storage; then, at the end of third and fourth months a sudden decrement was understood for the concentrations of hexanal and heptanal and the amount of PV, simultaneously. The latter parameters increased again until the end of shelf-time. As a result, the temperature and time were effective factors in oxidative stability of soybean oil. Also intensive correlations were found for soybean oil at 4 ˚C between AV and TBA (r2=0.96), PV and p-AV (r2=0.9), IV and TBA (-r2=0.9), and for soybean oil stored at 4˚C between p-AV and TBA (r2=0.99).

Keywords: headspace-liquid phase microextraction, oxidation, shelf-life, soybean oil

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Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

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Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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Authors: K. Bresilla, L. Manfrini, B. Morandi, A. Boini, G. Perulli, L. C. Grappadelli

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Image/video processing for fruit in the tree using hard-coded feature extraction algorithms have shown high accuracy during recent years. While accurate, these approaches even with high-end hardware are computationally intensive and too slow for real-time systems. This paper details the use of deep convolution neural networks (CNNs), specifically an algorithm (YOLO - You Only Look Once) with 24+2 convolution layers. Using deep-learning techniques eliminated the need for hard-code specific features for specific fruit shapes, color and/or other attributes. This CNN is trained on more than 5000 images of apple and pear fruits on 960 cores GPU (Graphical Processing Unit). Testing set showed an accuracy of 90%. After this, trained data were transferred to an embedded device (Raspberry Pi gen.3) with camera for more portability. Based on correlation between number of visible fruits or detected fruits on one frame and the real number of fruits on one tree, a model was created to accommodate this error rate. Speed of processing and detection of the whole platform was higher than 40 frames per second. This speed is fast enough for any grasping/harvesting robotic arm or other real-time applications.

Keywords: artificial intelligence, computer vision, deep learning, fruit recognition, harvesting robot, precision agriculture

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

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Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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Authors: Shubham Tandon, Rajni Goel

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The prime objective of our review paper is to study the quantitative psychology impact on our daily life. Quantitative techniques have been studied with the aim of discovering solutions in an advanced way. To get the unbiased and correct results, statistics and other useful mathematical aspects have been reviewed. So, many psychologists use quantitative techniques while working in the area of psychology with the aim of discovering solutions in an advanced way. This ensures their accurate outcomes as those will make use of precise criteria in knowing the minds and conditions of any person. Also, proper experimentation and observational tools are taken care of to avoid some possibilities of invalid data.

Keywords: quantitative psychology, psychologists, statistics, person, results, minds

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Authors: Yusuf Ali Abdulle, Azhar Uddin Keerio

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Background: Protein elicitors play a key role in signaling or displaying plant defense mechanisms and emerging as vital tools for bio-control of insects. This study was aimed at the characterization of the novel protein elicitor isolated from entomopathogenic fungi Lecanicillium lecanii (V3) strain and its activity against Whitefly, Bemisia tabaci in cotton. The sequence of purified elicitor protein showed 100% similarity with hypothetical protein LEL_00878 [Cordyceps confragosa RCEF 1005], GenBank no (OAA81333.1). This novel protein elicitor has 253 amino acid residues and 762bp with a molecular mass of 29 kDa. The protein recombinant was expressed in Escherichia coli using pET‐28a (+) plasmid. Effects of purified novel protein elicitor on Bemisia tabaci were determined at three concentrations of protein (i.e., 58.32, 41.22, 35.41 μg mL⁻¹) on cotton plants and were exposed to newly molted adult B.tabaci. Bioassay results showed a significant effect of the exogenous application of novel protein elicitor on B. tabaci in cotton. In addition, the gene expression analysis found a significant up-regulation of the major genes associated with salicylic acid (SA) and jasmonic acid (JA) linked plant defense pathways in elicitor protein-treated plants. Our results suggested the potential application of a novel protein elicitor derived from Lecanicillium lecanii as a future bio-intensive controlling approach against the whitefly, Bemisia tabaci.

Keywords: resistance, Lecanicillium lecanii, secondary metabolites, whitefly

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Authors: Anamika Devi

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Based on Vygotsky’s cultural, historical theory and Hedegaard’s concept of transition, this study aims to investigate to propose strategies to maintain digital wellbeing of children and parents during and post COVID pandemic. Due COVID 19 pandemic, children and families have been facing new challenges and sudden changes in their everyday life. While children are juggling to adjust themselves in new circumstance of onsite and online learning settings, parents are juggling with their work-life balance. A number of papers have identified that the COVID-19 pandemic has affected the lives of many families around the world in many ways, for example, the stress level of many parents increased, families faced financial difficulties, uncertainty impacted on long term effects on their emotional and social wellbeing. After searching and doing an intensive literature review from 2020 and 2021, this study has found some scholarly articles provided solution or strategies of reducing stress levels of parents and children in this unprecedented time. However, most of them are not underpinned by proper theoretical lens to ensure they validity and success. Therefore, this study has proposed strategies that are underpinned by theoretical lens to ensure their impact on children’s and parents' emotional wellbeing during and post COVID-19 era. The strategies will highlight on activities for positive coping strategies to the best use of family values and digital technologies.

Keywords: onsite and online learning, strategies, emotional wellbeing, tips, and strategies, COVID19

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Authors: Ricardo Andrés Márquez Ortiz

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Objective: The objective of this literature review is to compile updated information from studies that have addressed the association between dental pathologies and agriculture. Materials and method: The research carried out corresponds to a documentary study of ex post facto retrospective, historiographic, and bibliometric design. An exhaustive bibliographic review search was carried out in databases and the Internet, books and articles on dental anthropology, archeology, and dentistry, on the relationship between dental pathologies and agriculture in prehistoric and current populations from different parts of the world. Subsequently, data collection was carried out through the ATLAS.ti computer program. Conclusions: In an influential article by Turner, which addresses the correlation between caries and the way of subsistence of both prehistoric and modern populations (hunting and gathering, mixed and agricultural economies), an average of 1.3% was found in hunter-gatherer societies, and 10.4% in agricultural societies. Sreebny compared global grain supply data (rice, wheat and corn) with DMF (spoiled, lost and blocked) rates. He concluded that rice has no association with dental caries, corn has a negative correlation, and wheat has a positive correlation. Additionally, intensive monoculture agricultural production systems cause an increase in dental pathologies. Meanwhile, polyculture agriculture, which leads to a more varied diet, generates a better state of dental health.

Keywords: dental pathologies, agricultural production systems, extensive agriculture, dental anthropology

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Authors: M. Eckert, M. Oliveira, A. Bettencourt Ribeiro

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The intensive use of natural aggregate, near the towns, associated to the increase of the global population, leads to its depletion and increases the transport distances. The uncontrolled deposition of construction and demolition waste in landfills and city outskirts, causes pollution and take up space for noblest purposes. The main problem of recycled aggregate lies in its high water absorption, what is due to the porosity of the materials which constitute this type of aggregate. When the aggregates are dry, water flows from the inside to the engaging cement paste matrix, and when they are saturated an inverse process occurs. This water flow breaks the aggregate-cement paste bonds and the greater water concentration, in the inter-facial transition zone, degrades the concrete properties in its fresh and hardened state. Based on the water absorption over time, it was optimized an staged mixing method, to regulate the said flow and manufacture recycled aggregate concrete with levels of work-ability, strength and shrinkage equivalent to those of conventional concrete.The physical, mechanical and geometrical properties of the aggregates where related to the properties of concrete in its fresh and hardened state. Three types of commercial recycled aggregates and two types of natural aggregates where evaluated. Six compositions with different percentages of recycled coarse aggregate where tested.

Keywords: recycled aggregate, water absorption, interfacial transition zone, compressive-strength, shrinkage

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Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

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Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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Authors: Wing Chi Wong

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Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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Authors: Guanhao Tong, Li Li, Ben David

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This study aims to provide an explanatory account of how the leisure tourist experience emerges from tourists and their surroundings through a critical realist lens. This was achieved by applying Archer’s realist social theory as the underlying theoretical ground to unpack the interplays between the external (tourism system or structure) and the internal (tourists or agency). This theory argues that social phenomena can be analyzed in three domains - structure, agency, and culture (SAC), and along three phases – structure conditioning, sociocultural interactions, and structure elaboration. From the realist perspective, the world is an open system; events and discourses are irreducible to present individuals and collectivities. Therefore, identifying the processes or mechanisms is key to help researchers understand how social reality is brought about. Based on the contextual nature of the tourist experience, the research focuses on Chinese tourists (from mainland China) to London as a destination and British culture conveyed through the concept of the destination image. This study uses an intensive approach based on Archer’s M/M approach to discover the mechanisms/processes of the emergence of the tourist experience. Individual interviews were conducted to reveal the underlying causes of lived experiences of the tourists. Secondary data was also collected to understand how British destinations are portrayed to Chinese tourists.

Keywords: Chinese tourists, destination image, M/M approach, realist social theory, social mechanisms, tourist experience

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Authors: Narottam Puri, Bishnu Panigrahi, Narayan Pendse

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Background: Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from the patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving the quality of patient care. In 2012, International Consortium Of HealthCare Outcome Measurement (ICHOM) was founded which has defined global Standard Sets for measuring the outcome of various treatments. Method: Monitoring of Clinical Outcomes was identified as a pillar of Fortis’ core value of Patient Centricity. The project was started as an in-house developed Clinical Outcomes Reporting Portal by the Fortis Medical IT team. Standard sets of Outcome measurement developed by ICHOM were used. A pilot was run at Fortis Escorts Heart Institute from Aug’13 – Dec’13.Starting Jan’14, it was implemented across 11 hospitals of the group. The scope was hospital-wide and major clinical specialties: Cardiac Sciences, Orthopedics & Joint Replacement were covered. The internally developed portal had its limitations of report generation and also capturing of Patient related outcomes was restricted. A year later, the company provisioned for an ICHOM Certified Software product which could provide a platform for data capturing and reporting to ensure compliance with all ICHOM requirements. Post a year of the launch of the software; Fortis Healthcare has become the 1st Healthcare Provider in Asia to publish Clinical Outcomes data for the Coronary Artery Disease Standard Set comprising of Coronary Artery Bypass Graft and Percutaneous Coronary Interventions) in the public domain. (Jan 2016). Results: This project has helped in firmly establishing a culture of monitoring and reporting Clinical Outcomes across Fortis Hospitals. Given the diverse nature of the healthcare delivery model at Fortis Network, which comprises of hospitals of varying size and specialty-mix and practically covering the entire span of the country, standardization of data collection and reporting methodology is a huge achievement in itself. 95% case reporting was achieved with more than 90% data completion at the end of Phase 1 (March 2016). Post implementation the group now has one year of data from its own hospitals. This has helped identify the gaps and plan towards ways to bridge them and also establish internal benchmarks for continual improvement. Besides the value created for the group includes: 1. Entire Fortis community has been sensitized on the importance of Clinical Outcomes monitoring for patient centric care. Initial skepticism and cynicism has been countered by effective stakeholder engagement and automation of processes. 2. Measuring quality is the first step in improving quality. Data analysis has helped compare clinical results with best-in-class hospitals and identify improvement opportunities. 3. Clinical fraternity is extremely pleased to be part of this initiative and has taken ownership of the project. Conclusion: Fortis Healthcare is the pioneer in the monitoring of Clinical Outcomes. Implementation of ICHOM standards has helped Fortis Clinical Excellence Program in improving patient engagement and strengthening its commitment to its core value of Patient Centricity. Validation and certification of the Clinical Outcomes data by an ICHOM Certified Supplier adds confidence to its claim of being leaders in this space.

Keywords: clinical outcomes, healthcare delivery, patient centricity, ICHOM

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Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen

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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.

Keywords: anesthesia nurses, burnout, job, turnover intention

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Authors: T. P. Singh, Vijay Gautam

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Gladiolus is an important cash crop and is grown mainly for its elegant spikes. Traditionally the gladiolus corms are planted manually which is very tedious, time consuming and labor intensive operation. So far, there is no planter available for planting of gladiolus corms. With a view to mechanize the planting operation of this horticultural crop, a prototype of 4-row gladiolus planter was developed and its performance was evaluated in-situ condition. Cup-chain type metering device was used to singulate the gladiolus corms while planting. Three levels of corm spacing viz 15, 20 and 25 cm and four levels of forward speed viz 1.0, 1.5, 2.0 and 2.5 km/h was taken as evaluation parameter for the planter. The performance indicators namely corm spacing in each row, coefficient of uniformity, missing index, multiple index, quality of feed index, number of corms per meter length, mechanical damage to the corms etc. were determined during the field test. The data was statistically analyzed using Completely Randomized Design (CRD) for testing the significance of the parameters. The result indicated that planter was able to drop the corms at required nominal spacing with minor variations. The highest deviation from the mean corm spacing was observed as 3.53 cm with maximum coefficient of variation as 13.88%. The highest missing and quality of feed indexes were observed as 6.33% and 97.45% respectively with no multiples. The performance of the planter was observed better at lower forward speed and wider corm spacing. The field capacity of the planter was found as 0.103 ha/h with an observed field efficiency of 76.57%.

Keywords: coefficient of uniformity, corm spacing, gladiolus planter, mechanization

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Authors: Rubai M. Ochieng

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Cancer, which accounts for 7 percent of deaths per year in Kenya, is the third highest cause of death after infectious and cardiovascular diseases. Awareness Campaigns have tended to focus on leading cancers including breast and cervical for women as well as prostrate and Esophageal for men. Consequently, less common cancers such as Acute Myeloid Leukemia (AML) are rarely properly understood by the general population and a section of the medical fraternity. Diagnoses of AML in patients who may not have heard about it sometimes results in shock, denial and confusion not just to the diagnosed, but also to their family and friends. The diagnosed and caregivers are bound to receive a lot of contradicting information about prognosis, care and treatment of AML. This information, which often comes from diverse sources including doctors, friends, internet and social media platforms, causes further confusion and panic. The situation is handled differently by different people. Religious people sometimes resort to prayer. This paper, written from the perspective of a care giver, is based on data collected from a case of Acute Myeloid Leukemia diagnosed in a 32 year old male who lost his life within six weeks of diagnosis. The sample constitutes of 16 people who participated in prayers. Out of this total, 5 were males including the diagnosed and 11 were females. All the 16 were Christians of protestant orientation including Anglicans, Quakers and Church of God members. Data was collected by the researcher herself through participant of observation. Findings discuss how the 16 participants prayed individually at different times, together in an overnight prayer meeting and every morning through a group social media platform. They shared songs and words of encouragement from the bible. The group prayed for healing, peace and strength to the diagnosed and family, financial breakthrough and doctors’ work and decisions, among other challenges that came with the situation. The paper reveals the immense benefits of prayer to the diagnosed and his close relatives and friends. They include acceptance of the condition and a positive attitude in handling the challenges that arose from the disease and treatment processes. The challenges arising from the prayer approach of handling the situation are also discussed. The paper concludes that prayer as therapy goes a long way in cancer management.

Keywords: acute myeloid leukemia, Kenya, participant observation, prayer

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Authors: Majdi Al Shdifat, Juan Chiachio, Esther Puertas, María L. Jalón, Álvaro Blanca-Hoyos

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In recent years, the world has begun to adopt more sustainable practices in response to today's environmental and climate challenges. The construction sector is one of the most resource-intensive among others, so researchers are testing different types of materials with different processes and methodologies to achieve more environmentally and sustainably friendly buildings. Plastic is one of the most harmful materials for the environment. The global production of plastics has increased dramatically in recent decades, and it is one of the most widely used materials. However, plastic waste is not biodegradable and has a chemical composition that is stable for many years in the environment, both on land and in water bodies. Recycled plastics have been tested to be used in construction in many ways to reduce the amount of plastic in the environment and the use of raw materials in construction. In this context, the main objective of this research is to test the use of plastic fibers with one of the most promising materials to replace cement, which is rammed earth. In fact, rammed earth is considered one of the most environmentally friendly materials due to its use of local raw materials, recyclability, and low embodied energy. In this research, three different types of plastic fibers were used. Then, the blends were evaluated by considering their mechanical properties, including compressive strength and tensile strength. In addition, the non-destructive ultrasonic wave velocity was measured. The result shows excellent potential for the use of plastic fibers in rammed earth, especially in terms of compressive strength.

Keywords: mechanical characterization, plastic fibers reinforcement, rammed earth, sustainable material

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Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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Authors: Ian M. Grey, Bryan Roche, Anna Dillon, Justin Thomas, Sarah Cassidy, Dylan Colbert, Ian Stewart

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This paper presents findings from a study conducted in two schools in Abu Dhabi. The hypothesis is that teaching young children to derive various relations between stimuli leads to increases in full-scale IQ scores of typically developing children. In the experimental group, sixteen 6-7-year-old children were exposed over six weeks to an intensive training intervention designed specifically for their age group. This training intervention, presented on a tablet, aimed to improve their understanding of the relations Same, Opposite, Different, contextual control over the concept of Sameness and Difference, and purely arbitrary derived relational responding for Sameness and Difference. In the control group, sixteen 6-7-year-old children interacted with KIBO robotics over six weeks. KIBO purports to improve cognitive skills through engagement with STEAM activities. Increases in full-scale IQ were recorded for most children in the experimental group, while no increases in full-scale IQ were recorded for the control group. These findings support the hypothesis that relational skills underlie many aspects of general cognitive ability.

Keywords: early childhood, derived relational responding, intelligence, relational frame theory, relational skills

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