Search results for: quality assurance and accreditation

Authors: Adiyasa Muda Zannatan

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Cassava (Manihot esculenta) is a plant originating from Brazil. Cassava plants categorized as sixth major food in the world after wheat, rice, corn and potatoes. It has been cultivated on hilly land for 97 years since 1918 at Cireundeu village, West Java Province, Indonesia. Cireundeu traditional village located in the mountain valleys and has a hilly slope up to 38%. Cassava is used as the primary food in that area. Uniquely, Cassava productivity is stable and continues until now. The assessment of soil quality is taking soil samples in the area and analysis the soil in laboratory. The result of analysis that soil in the area is not degraded because it has optimum nutrient, organic matter, and high value of cation exchange capacity in soil even though it has been cultivated in scarp with high slope. Commonly, soil on scarp with high slope has a high rate erosion and poor nutrient. It proved that cassava is able to be an alternative technique of soil conservation in the areas that have a high slope. Beside that, cassava can be utilized as a plant food, feed, fertilizer, and energy. With the utilization of Cassava, the target of Sustainable Development Goals (SDG's) will be achieved with consideration three important components include economy, social, and environment. In economy, Cassava can to be the commercial product like processed food, feed, and alternative energy. In social, it will increase social welfare and will be hereditary. And for environment, Cassava prevents soil from erosion and keeps soil quality.

Keywords: Cassava, local wisdom, conservation, soil quality, sustainable

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Authors: Yi-Jiun Chou, Ying-Hsuan Li, Yi-Jung Liu, Hsin-Yu Chiang, Hsuan-Ching Wang

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Background: Patients received therapeutic hypothermia (TH) after resuscitation from cardiac arrest are more dependent on continue and intensive nursing care. It involves many difficult steps, especially achieving target body temperature. To our best knowledge, there is no consensus or recommended standards on nursing practice of TH. Aim: The aim of this study is to increase the completion rate of nursing care at therapeutic hypothermia. Methods: We took five measures: (1) Amendment of nursing standards of therapeutic hypothermia; (2) Amendment of TH checklist items to nursing records; (3) Establishment of monitor procedure; (4) Design each period of TH care reminder cards; (5) Providing in-service training sections of TH for ICU nursing staff. Outcomes: The completion rate of nursing care at therapeutic hypothermia increased from 78.1% to 89.3%. Conclusion: The project team not only increased the completion rate but also improved patient safety and quality of care.

Keywords: therapeutic hypothermia, nursing, critical care, quality of care

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Authors: Juliana C. Alencar, Monica Ferreira do Amaral Porto

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The blue-green infrastructure in recent years has been pointed out as a possibility to increase the environmental quality of watersheds. The regulation ecosystem services brought by these areas are many, such as the improvement of the air quality of the air, water, soil, microclimate, besides helping to control the peak flows and to promote the quality of life of the population. This study proposes a blue-green infrastructure scenario for the Jaguaré watershed, located in the western zone of the São Paulo city in Brazil. Based on the proposed scenario, it was verified the impact of the adoption of the blue and green infrastructure in the control of the peak flow of the basin, the benefits for the avifauna that are also reflected in the flora and finally, the quantification of the regulation ecosystem services brought by the adoption of the scenario proposed. A survey of existing green areas and potential areas for expansion and connection of these areas to form a network in the watershed was carried out. Based on this proposed new network of green areas, the peak flow for the proposed scenario was calculated with the help of software, ABC6. Finally, a survey of the ecosystem services contemplated in the proposed scenario was made. It was possible to conclude that the blue and green infrastructure would provide several regulation ecosystem services for the watershed, such as the control of the peak flow, the connection frame between the forest fragments that promoted the environmental enrichment of these fragments, improvement of the microclimate and the provision of leisure areas for the population.

Keywords: green and blue infrastructure, sustainable drainage, urban waters, ecosystem services

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Authors: Muhammad Rafiullah Khan, Vanee Chonhenchob

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The effect of sodium alginate (1%) based edible coating incorporated natural essential oils; thymol, carvone and carvacrol as antimicrobial agents at different concentrations (0.1, 0.5 and 1.0 %) on the quality changes of fresh-cut pineapple were investigated. Pineapple dipped in distilled water was served as control. After coating, fruit were sealed in a modified atmosphere package (MAP) using high permeable film; and stored at 5 °C. Gas composition in package headspace, color values (L*, a*, b*, C*), TSS, pH, ethanol, browning, and microbial decay were monitored during storage. Oxygen concentration continuously decreased while carbon dioxide concentration inside all packages continuously increased over time. Color parameters (L*, b*, c*) decreased and a* values increased during storage. All essential oils significantly (p ≤ 0.05) prevented microbial growth than control. A significantly higher (p ≤ 0.05) ethanol content was found in the control than in all other treatments. Visible microbial growth, high ethanol, and low color values limited the shelf life to 6 days in control as compared to 9 days in all other treatments. Among all essential oils, thymol at all concentrations maintained the overall quality of the pineapple and could potentially be used commercially in fresh fruit industries for longer storage.

Keywords: essential oils, antibrowning agents, antimicrobial agents, modified atmosphere packaging, pineapple, microbial decay

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Authors: Muhammad Rafiullah Khan, Vanee Chonhenchob

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The effect of sodium alginate (1%) based edible coating incorporated natural essential oils, thymol, carvone, and carvacrol as antimicrobial agents at different concentrations (0.1, 0.5, and 1.0%) on the quality changes of fresh-cut pineapple was investigated. Pineapple dipped in distilled water was served as control. After coating, the fruit was sealed in a modified atmosphere package (MAP) using high permeable film and stored at 5°C. Gas composition in package headspace, color values (L*, a*, b*, C*), TSS, pH, ethanol, browning, and microbial decay were monitored during storage. Oxygen concentration continuously decreased while carbon dioxide concentration inside all packages continuously increased over time. Color parameters (L*, b*, c*) decreased, and a* values increased during storage. All essential oils significantly (p ≤ 0.05) prevented microbial growth than control. A significantly higher (p ≤ 0.05) ethanol content was found in the control than in all other treatments. Visible microbial growth, high ethanol, and low color values limited the shelf life to 6 days in control as compared to 9 days in all other treatments. Among all essential oils, thymol at all concentrations maintained the overall quality of the pineapple and could potentially be used commercially in fresh fruit industries for longer storage.

Keywords: essential oils, antibrowning agents, antimicrobial agents, modified atmosphere packaging, microbial decay, pineapple

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Authors: Jovian Cheung, Thomas Kwok, Victor Wong

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Buildings are entwined with smart city developments. Building performance relies heavily on electrical and mechanical (E&M) systems and services accounting for about 40 percent of global energy use. By cohering the advancement of technology as well as energy and operation-efficient initiatives into the buildings, people are enabled to raise building performance and enhance the sustainability of the built environment in their daily lives. Digital transformation in the buildings is the profound development of the city to leverage the changes and opportunities of digital technologies To optimize the building performance, intelligent power quality and energy management system is developed for transforming data into actions. The system is formed by interfacing and integrating legacy metering and internet of things technologies in the building and applying big data techniques. It provides operation and energy profile and actionable insights of a building, which enables to optimize the building performance through raising people awareness on E&M services and energy consumption, predicting the operation of E&M systems, benchmarking the building performance, and prioritizing assets and energy management opportunities. The intelligent power quality and energy management system comprises four elements, namely the Integrated Building Performance Map, Building Performance Dashboard, Power Quality Analysis, and Energy Performance Analysis. It provides predictive operation sequence of E&M systems response to the built environment and building activities. The system collects the live operating conditions of E&M systems over time to identify abnormal system performance, predict failure trends and alert users before anticipating system failure. The actionable insights collected can also be used for system design enhancement in future. This paper will illustrate how intelligent power quality and energy management system provides operation and energy profile to optimize the building performance and actionable insights to revitalize an existing building into a smart building. The system is driving building performance optimization and supporting in developing Hong Kong into a suitable smart city to be admired.

Keywords: intelligent buildings, internet of things technologies, big data analytics, predictive operation and maintenance, building performance

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Authors: Seyedeh Fatemeh Nabavi, Hamid Dalir, Anooshiravan Farshidianfar

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Laser welding is pivotal in modern manufacturing, offering unmatched precision, speed, and efficiency. Its versatility in minimizing heat-affected zones, seamlessly joining dissimilar materials, and working with various metals makes it indispensable for crafting intricate automotive components. Integration into automated systems ensures consistent delivery of high-quality welds, thereby enhancing overall production efficiency. Noteworthy are the safety benefits of laser welding, including reduced fumes and consumable materials, which align with industry standards and environmental sustainability goals. As the automotive sector increasingly demands advanced materials and stringent safety and quality standards, laser welding emerges as a cornerstone technology. A comprehensive model encompassing thermal dynamic and characteristics models accurately predicts geometrical, metallurgical, and mechanical aspects of the laser beam welding process. Notably, Model 2 showcases exceptional accuracy, achieving remarkably low error rates in predicting primary and secondary dendrite arm spacing (PDAS and SDAS). These findings underscore the model's reliability and effectiveness, providing invaluable insights and predictive capabilities crucial for optimizing welding processes and ensuring superior productivity, efficiency, and quality in the automotive industry.

Keywords: laser welding process, geometrical characteristics, mechanical characteristics, metallurgical characteristics, comprehensive model, thermal dynamic

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Authors: Javeed Akhtar, R. K. Pandey, Z. R. Azaz Ahmad Azad

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For the purpose of making different uses of food material for the development of extruded foods are produced using single and twin extruders. Extrusion cooking is a useful and economical tool for processing of novel food. This high temperature, short time processing technology causes chemical and physical changes that alter the nutritional and physical quality of the product. Extrusion processing of food ingredients characteristically depends on associating process conditions that influence the product qualities. The process parameters are optimized for extrusion of food material in order to obtain the maximum nutritive value by inactivating the anti-nutritional factors. The processing conditions such as moisture content, temperature and time are controlled to avoid over heating or under heating which otherwise would result in a product of lower nutritional quality.

Keywords: extrusion processing, single and twin extruder, operating condition of extruders and extruded novel foods, food and agricultural engineering

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Authors: Olympia Nisiforou

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The cultural heritage of each country represents a unique and irreplaceable witness of the past. Nevertheless, on many occasions, such heritage is extremely vulnerable to natural disasters and reckless behaviors. Even if such exhibits are now located in Museums, they still receive insufficient protection due to improper environmental conditions. These external changes can negatively affect the conditions of the exhibits and contribute to inefficient maintenance in time. Hence, it is imperative to develop an innovative, low-cost system, to monitor indoor air quality systematically, since conventional methods are quite expensive and time-consuming. The present study gives an insight into the indoor air quality of the National Byzantine Museum of Cyprus. In particular, systematic measurements of particulate matter, bio-aerosols, the concentration of targeted chemical pollutants (including Volatile organic compounds (VOCs), temperature, relative humidity, and lighting conditions as well as microbial counts have been performed using conventional techniques. Measurements showed that most of the monitored physiochemical parameters did not vary significantly within the various sampling locations. Seasonal fluctuations of ammonia were observed, showing higher concentrations in the summer and lower in winter. It was found that the outdoor environment does not significantly affect indoor air quality in terms of VOC and Nitrogen oxides (NOX). A cutting-edge portable Gas Chromatography-Mass Spectrometry (GC-MS) system (TORION T-9) was used to identify and measure the concentrations of specific Volatile and Semi-volatile Organic Compounds. A large number of different VOCs and SVOCs found such as Benzene, Toluene, Xylene, Ethanol, Hexadecane, and Acetic acid, as well as some more complex compounds such as 3-ethyl-2,4-dimethyl-Isopropyl alcohol, 4,4'-biphenylene-bis-(3-aminobenzoate) and trifluoro-2,2-dimethylpropyl ester. Apart from the permanent indoor/outdoor sources (i.e., wooden frames, painted exhibits, carpets, ventilation system and outdoor air) of the above organic compounds, the concentration of some of them within the areas of the museum were found to increase when large groups of visitors were simultaneously present at a specific place within the museum. The high presence of Particulate Matter (PM), fungi and bacteria were found in the museum’s areas where carpets were present but low colonial counts were found in rooms where artworks are exhibited. Measurements mentioned above were used to validate an innovative low-cost air-quality monitoring system that has been developed within the present work. The developed system is able to monitor the average concentrations (on a bidaily basis) of several pollutants and presents several innovative features, including the prompt alerting in case of increased average concentrations of monitored pollutants, i.e., exceeding the limit values defined by the user.

Keywords: exibitions, indoor air quality , VOCs, pollution

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Authors: Bae Yu been, Choi Sung won, Lee Ju yeon, Yang Dan Bi

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The purpose of this study is to develop a self-help therapy program for bipolar disorder (BD). Psychosocial treatment is adjunct to pharmacotherapy for BD, however, it is limited and they demand high costs. Therefore, the objective of the study is to overcome these limitations by developing the self-treatment for BD. The study was examined the efficacy of the self-treatment program for BD. A randomized controlled trial compared the self-help therapy (ST) intervention with a treatment as usual (TAU) group. ST group has conducted the program for 8 weeks (16 sessions). Mood chart, Quality of Life in Bipolar Disorder Questionnaire, Attitudes toward seeking professional help Scale, BIS, CERQ, YMRS, MADRS were used by pre, post, and follow up. The efficacy of the self-help therapy was analyzed by using mixed ANOVAs. There were significant differences in the rate of occurrence of mania or depression between the two groups. ST group reported stable moods on mood chart, and reductions in mood symptoms and improvements in quality of life and treatment adherence. This study was confirmed applicable to BD to the self-help therapy for patients with BD conducted first in Korea.

Keywords: self help therapy, bipolar disorder, self help, self therapy

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Authors: Adithya Nadig

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In the field of production, characterization of surface roughness plays a vital role in assessing the quality of a manufactured product. The defined parameters for this assessment, each, have their own drawbacks in describing a profile surface. From the purview of small-scale and medium-scale industries, an increase in time spent for manual inspection of a product for various parameters adds to the cost of the product. In order to reduce this, a uniform and established standard is necessary for quantifying a profile of a manufactured product. The inspection procedure in the small and medium-scale manufacturing units at Jigani Industrial area, Bangalore, was observed. The parameters currently in use in those industries are described in the paper and a change in the inspection method is proposed.

Keywords: efficiency of quality assessment, manual areal profiling technique, manufacturing in small and medium-scale industries product-oriented inspection, standardization of manual inspection, surface roughness characterization

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Authors: Takahiro Hino, Michiharu Maeda

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Particle swarm optimization (PSO) is an optimization approach that achieves the social model of bird flocking and fish schooling. PSO works in continuous space and can solve continuous optimization problem with high quality. Set-based particle swarm optimization (SPSO) functions in discrete space by using a set. SPSO can solve combinatorial optimization problem with high quality and is successful to apply to the large-scale problem. In this paper, we present an algorithm of SPSO with status memory to decide the position based on the previous position for solving traveling salesman problem (TSP). In order to show the effectiveness of our approach. We examine SPSOSM for TSP compared to the existing algorithms.

Keywords: combinatorial optimization problems, particle swarm optimization, set-based particle swarm optimization, traveling salesman problem

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Authors: Ahmed A. D. Sarhan, S. R. Besharaty, Javad Akbaria, M. Hamdi

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The capability of CNC gantry milling machines in manufacturing long components has caused the expanded use of such machines. On the other hand, the machines’ gantry rigidity can reduce under severe loads or vibration during operation. Indeed, the quality of machining is dependent on the machine’s dynamic behavior throughout the operating process. For this reason, this type of machines has always been used prudently and are non efficient. Therefore, they can usually be employed for rough machining and may not produce adequate surface finishing. In this paper, a CNC gantry milling machine with the potential to produce good surface finish has been designed and analyzed. The lowest natural frequency of this machine is 202 Hz at all motion amplitudes with a full range of suitable frequency responses. Meanwhile, the maximum deformation under dead loads for the gantry machine is 0.565µm, indicating that this machine tool is capable of producing higher product quality.

Keywords: frequency response, finite element, gantry machine, gantry design, static and dynamic analysis

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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: Arslan Ellahi, Syed Amjad Hussain

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Software Testing is a vital process in software development life cycle. We can attain the quality of software after passing it through software testing phase. We have tried to find out automatic test data generation techniques that are a key research area of software testing to achieve test automation that can eventually decrease testing time. In this paper, we review some of the approaches presented in the literature which use evolutionary search based algorithms like Genetic Algorithm, Particle Swarm Optimization (PSO), etc. to validate the test data generation process. We also look into the quality of test data generation which increases or decreases the efficiency of testing. We have proposed test data generation techniques for model-based testing. We have worked on tuning and fitness function of PSO algorithm.

Keywords: search based, evolutionary algorithm, particle swarm optimization, genetic algorithm, test data generation

Procedia PDF Downloads 190

Authors: Q. Niu, X. H. Zhou, W. Liu

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The cooling channels of injection mould play a crucial role in determining the productivity of moulding process and the product quality. It’s not a simple task to design high quality cooling channels. In this paper, an intelligent cooling channels design system including automatic layout of cooling channels, interference checking and assembly of accessories is studied. Automatic layout of cooling channels using genetic algorithm is analyzed. Through integrating experience criteria of designing cooling channels, considering the factors such as the mould temperature and interference checking, the automatic layout of cooling channels is implemented. The method of checking interference based on distance constraint algorithm and the function of automatic and continuous assembly of accessories are developed and integrated into the system. Case studies demonstrate the feasibility and practicality of the intelligent design system.

Keywords: injection mould, cooling channel, intelligent design, automatic layout, interference checking

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Authors: Mahsa Jalili, Trude Johansen, Signe Dille Lovmo, Turid Rustad, Rolf Erik Olsen, Atle M. Bones

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The quality of fish muscle is a key factor in fish industry, and dietary ingredients can influence fish quality. The aim of this study was to examine the impact of krill meal, soybean meal, Bactocell® and butyrate fortified feeds and control diet on characteristics of salmon fillet. Thirty Atlantic salmon (6 per each group) were farmed for 12 weeks. All the fish were killed and frozen immediately. The white muscle from top posterior part of dorsal fin was dissected to analyze fat content, carotenoid content, content of water-soluble and salt-soluble proteins, cathepsin B and cathepsin B-L activities. ANOVA test was used to analyze mean and standard error of mean values at 0.05 significance level. There were significant difference in cathepsin B activity, water-soluble proteins and salt-soluble proteins (p-value= 0.005, 0.009 and 0.002). The mean values of other factors were not significantly different among the groups. Cathepsin B activity was higher in soymeal group. Water-soluble proteins were reported higher in soy meal and krill groups and salt-soluble proteins were significantly higher in soy meal and butyrate rich diets. Although soy meal has proven effect on enteritis, it results in higher percentage of protein in fillets. On the other hand, this feeding may have role in textural deterioration of fillets owing to higher values of endogenous cathepsin B in soymeal group.

Keywords: aquaculture, food quality, Krill protein extract, prebiotics, probiotics, Salmo salar, soy

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Authors: Serge Lacroix

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The proposed study looks at the psychoeducational assessment of bilingual students, in English and French in this case. It will be the opportunity to look at language of assessment and specifically how certain tests can be administered in one language and others in another language. It is also a look into the questioning of the validity of the test scores that are obtained as well as the quality and generalizability of the conclusions that can be drawn. Bilingualism and multiculturalism, although in constant expansion, is not considered in norms development and remains a poorly understood factor when it is at play in the context of a psychoeducational assessment. Student placement, diagnoses, accurate measures of intelligence and achievement are all impacted by the quality of the assessment procedure. The same is true for questionnaires administered to parents and self-reports completed by bilingual students who, more often than not, are assessed in a language that is not their primary one or are compared to monolinguals not dealing with the same challenges or the same skills. Results show that students, when offered to work in a bilingual fashion, chooses to do so in a significant proportion. Recommendations will be offered to support educators aiming at expanding their skills when confronted with multilingual students in an assessment context.

Keywords: psychoeducational assessment, bilingualism, multiculturalism, intelligence, achievement

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Authors: Cesar Augusto Hoil Rosas, José Luis Vázquez Burgos, José Juan Carbajal Hernandez

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White fish (Chirostoma estor estor) is an endemic species that habits in the Patzcuaro Lake, located in Michoacan, Mexico; being an important source of gastronomic and cultural wealth of the area. Actually, it have undergone an immense depopulation of individuals, due to the high fishing, contamination and eutrophication of the lake water, resulting in the possible extinction of this important species. This work proposes a new computational model for monitoring and assessment of critical environmental parameters of the white fish ecosystem. According to an Analytical Hierarchy Process, a mathematical model is built assigning weights to each environmental parameter depending on their water quality importance on the ecosystem. Then, a development of an advanced system for the monitoring, analysis and control of water quality is built using the virtual environment of LabVIEW. As results, we have obtained a global score that indicates the condition level of the water quality in the Chirostoma estor ecosystem (excellent, good, regular and poor), allowing to provide an effective decision making about the environmental parameters that affect the proper culture of the white fish such as temperature, pH and dissolved oxygen. In situ evaluations show regular conditions for a success reproduction and growth rates of this species where the water quality tends to have regular levels. This system emerges as a suitable tool for the water management, where future laws for white fish fishery regulations will result in the reduction of the mortality rate in the early stages of development of the species, which represent the most critical phase. This can guarantees better population sizes than those currently obtained in the aquiculture crop. The main benefit will be seen as a contribution to maintain the cultural and gastronomic wealth of the area and for its inhabitants, since white fish is an important food and economical income of the region, but the species is endangered.

Keywords: Chirostoma estor estor, computational system, lab view, white fish

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Authors: Ribut Alam Malau, Durri Andriani, C. B. Supartomo

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Universitas Terbuka (UT) as a higher education institution implements open and distance education is responsible to provide higher education to all Indonesian citizen wherever they live, including those reside in cultural diversity aras. Operate from Jakarta Head Office and 37 regional centers (ROs), UT is accustomed to the challenge. UT-Kupang and UT-Ambon which oversee East Nusa Tenggara and Maluku have successfully provided quality educational services for students. The two ROs have provided educational facilities which could assist the students to cope with their study in spite of the diversity situations. In order to analyze the effectiveness of the facilities provided, questionnaires focusing on tutorial services were sent to 90 students in the two ROs asking them to assess the facilities which best fulfills students’ needs in terms of their culture diversity. The results showed that UT-Kupang and UT-Ambon have successful in providing education for students in their areas as reflected in more than 80% of respondents aware of the facilities concerning tutorial service except for tutorial mechanism where only 34,5% of respondents aware of. However, despite lower rate of awareness in tutorial mechanism, majority of respondent 90.8% of respondents registered in tutorials and 95.4% will register in tutorials next semester. The majority of respondents showed appreciation for the ROs efforts to provide tutorials on weekdays which could accommodate their beliefs. In addition, conducting tutorials in all islands also perceived highly since students did not have to commute between islands. Efforts done by UT-Kupang and UT-Ambon have proven to be appreciated by students.

Keywords: archipelago, cultural diversity, ODL, service quality, Universitas Terbuka

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Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun

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Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.

Keywords: CABG; MACCEs; quality of life; total arterial revascularisation

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Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: exercise, prostate cancer, quality of life, rehabilitation programme, response shift

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: Jean Pierre Hagenimana, Paulin Ruhato Banguti, Rebecca Lynn Churchill Anderson, Jean de Dieu Tuyishime, Gaston Nyirigira, Eugene Tuyishime

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Background: Little is known regarding the effectiveness of pain protocols and guidelines used in Emergency Departments (ED) in Sub-Saharan Africa (SSA). Therefore, to shed light on this research gap, this study aimed to evaluate the quality of pain management following the implementation of both the WHO pain ladder-based trauma pain management protocol in two Rwandan teaching hospitals. Methods: This was a pre-and post-intervention study. The intervention was a 1-day acute pain course training for ED clinical staff followed by 1 week of mentorship on the use of the WHO pain ladder-based trauma pain management. Results: 261 participants were enrolled in the study (124 before the intervention and 137 after the intervention). The number of patients with undocumented pain scores decreased from 58% to 24% after the intervention (p-value > 0.001), and most patients (62%) had mild pain. In addition, patients who were satisfied with the quality of pain management increased significantly from 42% before the intervention to 80% (p-value > 0.001). Barriers were identified, however, including inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Conclusion: The implementation of the WHO pain ladder-based trauma pain management protocol significantly improved the quality of pain management in both CHUK and CHUB referral Hospital emergency departments. Despite this, some barriers remain, such as inadequate training and experience, shortage of staff, and patient’s reluctance to report pain. Appropriate interventions should be implemented to address the identified barriers and ensure adequate pain management for patients admitted at the emergency departments in referral hospitals in Rwanda.

Keywords: pain management, trauma, emergency departments, Rwanda

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Authors: Yuan-Hao Lee, Chia-Wei Lee, Ming-Fang Lin, Tzu-Huei Wu, Chih-Hsiang Ko, Wing P. Chan

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Computed tomography (CT) scan of the head is a good method for investigating cranial lesions. However, radiation-induced oxidative stress can be accumulated in the eyes and promote carcinogenesis and cataract. In this regard, we aimed to protect the eyes with barium sulfate shield(s) during CT scans and investigate the resultant image quality and radiation dose to the eye. Patients who underwent health examinations were selectively enrolled in this study in compliance with the protocol approved by the Ethics Committee of the Joint Institutional Review Board at Taipei Medical University. Participants’ brains were scanned with a water-based marker simultaneously by a multislice CT scanner (SOMATON Definition Flash) under a fixed tube current-time setting or automatic tube current modulation (TCM). The lens dose was measured by Gafchromic films, whose dose response curve was previously fitted using thermoluminescent dosimeters, with or without barium sulfate or bismuth-antimony shield laid above. For the assessment of image quality CT images at slice planes that exhibit the interested regions on the zygomatic, orbital and nasal bones of the head phantom as well as the water-based marker were used for calculating the signal-to-noise and contrast-to-noise ratios. The application of barium sulfate and bismuth-antimony shields decreased 24% and 47% of the lens dose on average, respectively. Under topogram-based TCM, the dose saving power of bismuth-antimony shield was mitigated whereas that of barium sulfate shield was enhanced. On the other hand, the signal-to-noise and contrast-to-noise ratios of DSCT images were decreased separately by barium sulfate and bismuth-antimony shield, resulting in an overall reduction of the CNR. In contrast, the integration of topogram-based TCM elevated signal difference between the ROIs on the zygomatic bones and eyeballs while preferentially decreasing the signal-to-noise ratios upon the use of barium sulfate shield. The results of this study indicate that the balance between eye exposure and image quality can be optimized by combining eye shields with topogram-based TCM on the multislice scanner. Eye shielding could change the photon attenuation characteristics of tissues that are close to the shield. The application of both shields on eye protection hence is not recommended for seeking intraorbital lesions.

Keywords: computed tomography, barium sulfate shield, dose saving, image quality

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Authors: Nur Atirah Hasmi, Nadia Nisha Musa, Hasnun Nita Ismail, Zulfadli Mahfodz

Abstract:

The effect of water quality parameters on the abundance of aquatic insects has been studied in Batu Berangkai, Dipang, Kuala Woh and Lata Kinjang Rivers, Perak, northern peninsular Malaysia. The focuses are to compare the abundance of aquatic insects in each sampling areas and to investigate the physical and chemical factors (water temperature, depth of water, canopy, water velocity, pH value, and dissolved oxygen) on the abundance of aquatic insects. The samples and data were collected by using aquatic net and multi-probe parameter. Physical parameters; water velocity, water temperature, depth, canopy cover, and two chemical parameters; pH value and dissolved oxygen have been measured in situ and recorded. A total of 631 individuals classified into 6 orders and 18 families of aquatic insects were identified from four sampling sites. The largest percentage of samples collected is from order Plecoptera 35.8%, followed by Ephemeroptera 32.6%, Trichoptera 17.0%, Hemiptera 8.1%, Coleoptera 4.8%, and the least is Odonata 1.7%. The aquatic insects collected from Dipang River have the highest abundance of 273 individuals from 6 orders and 13 families and the least insects trapped at Lata Kinjang which only have 64 individuals from 5 orders and 6 families. There is significant association between different sampling areas and abundance of aquatic insects (p<0.05). High abundance of aquatic insects was found in higher water temperature, low water velocity, deeper water, low pH, high amount of dissolved oxygen, and the area that is not covered by canopy.

Keywords: aquatic insect, physicochemical parameter, river, water quality

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Authors: Hwasuk Jung, Seoi Lee, Dongchoon Ryou, Pyungjong Yoo, Seokmo Lee

Abstract:

The Nakdong River being used as drinking water sources for Pusan metropolitan city has the vulnerability of water management due to the fact that industrial areas are located in the upper Nakdong River. Most citizens of Busan think that the water quality of Nakdong River is not good, so they boil or use home filter to drink tap water, which causes unnecessary individual costs to Busan citizens. We need to diversify water intake to reduce the cost and to change the weak water source. Under this background, this study was carried out for the environmental accounting of Namgang dam water treatment system compared to Nakdong River water treatment system by using emergy analysis method to help making reasonable decision. Emergy analysis method evaluates quantitatively both natural environment and human economic activities as an equal unit of measure. The emergy transformity of Namgang dam’s water was 1.16 times larger than that of Nakdong River’s water. Namgang Dam’s water shows larger emergy transformity than that of Nakdong River’s water due to its good water quality. The emergy used in making 1 m3 tap water from Namgang dam water treatment system was 1.26 times larger than that of Nakdong River water treatment system. Namgang dam water treatment system shows larger emergy input than that of Nakdong river water treatment system due to its construction cost of new pipeline for intaking Namgang daw water. If the Won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.66. If the Em-won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.26. The cost-benefit ratio of Em-won was smaller than that of Won. When we use emergy analysis, which considers the benefit of a natural environment such as good water quality of Namgang dam, Namgang dam water treatment system could be a good alternative for diversifying intake source.

Keywords: emergy, emergy transformity, Em-won, water treatment system

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Authors: Tyler D. Cesarone, Tatiana M. Wugalter

Abstract:

The movement of patients from the Global North to the Global South in pursuit of inexpensive healthcare and touristic experiences dominates the academic discourse on international medical travel (IMT). However, medical travel exists in higher numbers between Global South countries as patients who lack trust in, and feel disenfranchised by, their national healthcare systems seek treatment in nearby countries. Through a review of the existing literature, this paper examines patterns of IMT in the Middle East, Southeast Asia, and Southern Africa, distinguishing North-South medical tourism from South-South intra-regional medical mobility (IRMM). Evidence from these case studies demonstrates that notions of medical distrust and disenfranchisement, rooted in low-resourced and poor quality healthcare systems, are key drivers of IRMM in the Global South. The movement of patients from lower income to proximate higher income countries not only reveals tensions between patients and their healthcare systems but widens gaps in the quality of healthcare between departing and destination countries. In analyzing these cross-regional similarities, the paper moves beyond the current literature’s focus on singular case studies to expose global patterns of South-South IRMM. This presents a shift from the traditional focus on North-South medical tourism, demonstrating how disparities in healthcare systems both influence and are influenced by IRMM.

Keywords: global South, healthcare quality, international medical travel (IMT), intra-regional medical mobility (IRMM), medical disenfranchisement, medical distrust, medical tourism

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Authors: Rajendra Singh, Krishna Mondal, Chandranath Chatterjee

Abstract:

The water, energy, and food (WEF) nexus describes the interconnectedness of these three essential elements of human life. Each of these three sectors depends on the others. India's expanding population, urbanization, and industrialization make WEF nexus management difficult. Coupling and coordination degrees can be used as indicators of a complex system's level of sustainable development. Thus, coupling and coordination of WEF sectors in India are essential for achieving Sustainable Development Goals (SDGs) 2 (zero hunger), 6 (clean water and sanitation), and 7 (affordable and clean energy). This study used a newly developed WEF nexus model and the concept of coupling coordination degree model to examine the coupling and coordination degrees of the WEF nexus at India's sub-national scale (States/Union Territories (UTs)) for the years 2011 and 2021. Results indicate that the WEF nexus coupling degree was reasonably stable among the Indian States/UTs in both years, with all having a coupling degree above 0.90, indicating high-quality coupling. However, the degree of coordination varied spatially and temporally from ‘primary development’ to ‘quality development’ for the Indian States/UTs. In 2021, it went from 53% to 14% intermediate development and 44% to 83% good development compared to 2011. Most Indian States/UTs developed SDG2 more than SDG6 and SDG7. This study also suggests that most States/UTs must implement WEF-related policies and programmes effectively to achieve quality coordinated WEF nexus development. This study may help administrators and policymakers identify States/UTs that need more attention to implement existing or new policies for achieving SDGs 2, 6, and 7.

Keywords: WEF nexus model, Pardee-RAND WEF nexus, sustainable development, policy

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Authors: Reza Vakili

Abstract:

To assess the effect of different levels of soybean oil (SO: 1, 2%) and different types of pellet binders (sodium bentonite (SB), calcium lignosulfonate (Ca-Ls), and plant compounds (PC) on the pellet quality, and broilers’ performance, 480 one-day-old male broiler chickens (Ross 308) were used. The results showed that in the starter diet, the 1-PC group had the highest pellet durability index (PDI) (P<0.05). The PDI of the grower diet containing SB and PC was higher than others (P<0.05). The highest pellet hardness was observed in groups 1-SB, 1-PC, 2-SB, and 2-PC for the starter diet (P<0.05). For the finisher diet, the hardness of pellets containing SB and PC was higher (P<0.05). During the starter phase, the best feed conversion ratio (FCR) was obtained in 1-SB (P<0.05). The lowest and highest daily feed intake was observed in groups 2-PC and 1-SB, respectively, during the finisher phase. During the finisher and whole phases, the most daily body weight gain was observed in the SB group (P<0.05).

Keywords: bentonite, birds, body weight, feed processing, pellet durability, soybean oil

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