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Authors: Q. Ni, J. A. Serna, D. Holland, X. Wang

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The objective of this study is to develop Nuclear Magnetic Resonance (NMR) techniques to enhance bone related research applied on normal and disuse (Biglycan knockout) mice bone in vitro by using both low-field and high-field NMR simultaneously. It is known that the total amplitude of T₂ relaxation envelopes, measured by the Carr-Purcell-Meiboom-Gill NMR spin echo train (CPMG), is a representation of the liquid phase inside the pores. Therefore, the NMR CPMG magnetization amplitude can be transferred to the volume of water after calibration with the NMR signal amplitude of the known volume of the selected water. In this study, the distribution of mobile water, porosity that can be determined by using low-field (20 MHz) CPMG relaxation technique, and the pore size distributions can be determined by a computational inversion relaxation method. It is also known that the total proton intensity of magnetization from the NMR free induction decay (FID) signal is due to the water present inside the pores (mobile water), the water that has undergone hydration with the bone (bound water), and the protons in the collagen and mineral matter (solid-like protons). Therefore, the components of total mobile and bound water within bone that can be determined by low-field NMR free induction decay technique. Furthermore, the bound water in solid phase (mineral and organic constituents), especially, the dominated component of calcium hydroxyapatite (Ca₁₀(OH)₂(PO₄)₆) can be determined by using high-field (400 MHz) magic angle spinning (MAS) NMR. With MAS technique reducing NMR spectral linewidth inhomogeneous broadening and susceptibility broadening of liquid-solid mix, in particular, we can conduct further research into the ¹H and ³¹P elements and environments of bone materials to identify the locations of bound water such as OH- group within minerals and bone architecture. We hypothesize that with low-field and high-field magic angle spinning NMR can provide a more complete interpretation of water distribution, particularly, in bound water, and these data are important to access bone quality and predict the mechanical behavior of bone.

Keywords: bone, mice bone, NMR, water in bone

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Authors: Johanna Renny Octavia, Kamila Okta Saarah

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Smartphone nowadays is widely used by many people all over the world. However, people with vision impairment may experience difficulties that interfere with the proper usage of the smartphone. In Indonesia, the population of visually impaired is about 13 million people (estimated 285 million people worldwide). There are a number of mobile applications developed to enhance the use of smartphone by visually impaired. This paper discusses the usability evaluation of a mobile application, namely Ray Vision, designed to help visually impaired in using smartphone. A series of usability testing with a number of Indonesian visually impaired revealed 28 usability problems in the mobile application that led to 14 design recommendations. The redesigned application was then re-evaluated through another usability testing series. The results showed that all five usability criteria assessed were increased (usefulness by 13%, effectiveness by 27%, efficiency by 27%, satisfaction by 23%, and learnability by 12%). The System Usability Score (SUS) was also increased by 14.92%.

Keywords: mobile application, smartphone, usability evaluation, vision impaired

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Authors: Hala M. El-hanbuli, Mohammed F. Darweesh

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The incidence rates of any tumor vary hugely with geographical location. Basal Cell Carcinoma (BCC) is one of the most common skin cancer that has many histopathologic subtypes. Objective: The aim was to study the histopathological features of BCC cases that were received in the Pathology Department, Kasr El-Aini hospital, Cairo University, Egypt during the period from Jan 2004 to Dec 2013 and to evaluate the clinical characters through the patient data available in the request sheets. Methods: Slides and data of BCC cases were collected from the archives of the pathology department, Kasr El-Aini hospital. Revision of all available slides and histological classification of BCC according to WHO (2006) was done. Results: A total number of 310 cases of BCC representing about 65% from the total number of malignant skin tumors examined during the 10-years duration in the department. The age ranged from 8 to 84 years, the mean age was (55.7 ± 15.5). Most of the patients (85%) were above the age of 40 years. There was a slight male predominance (55%). Ulcerated BCC was the most common gross picture (60%), followed by nodular lesion (30%) and finally the ulcerated nodule (10%). Most of the lesions situated in the high-risk sites (77%) where the nose was the most common site (35%) followed by the periocular area (22%), then periauricular (15%) and finally perioral (5%). No lesion was reported outside the head. The tumor size was less than 2 centimeters in 65% of cases, and from 2-5 centimeters in the lesions' greatest dimension in the rest of cases. Histopathological reclassification revealed that the nodular BCC was the most common (68%) followed by the pigmented nodular (18.75%). The histologic high-risk groups represented (7.5%) about half of them (3.75%) being basosquamous carcinoma. The total incidence for multiple BCC and 2nd primary was 12%. Recurrent BCC represented 8%. All of the recurrent lesions of BCC belonged to the histologic high-risk group. Conclusion: Basal Cell Carcinoma is the most common skin cancer in the 10-year survey. Histopathological diagnosis and classification of BCC cases are essential for the determination of the tumor type and its biological behavior.

Keywords: basal cell carcinoma, high risk, histopathological features, statistical analysis

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Authors: A. Albaridi Najla

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Flaxseed (Linum usitatissimum) is well known to have beneficial effect on health. The seeds are rich in protein, α-linolenic fatty acid and dietary fiber. Bakery products are important part of our daily meals. Functional food recently received considerable attention among consumers. The increase in bread daily consumption leads to the production of breads with functional ingredients such as flaxseed The aim of this Study was to improve the nutritional value of bread by adding flaxseed flour and assessing the effect of adding 0, 5, 10 and 15% flaxseed on whole wheat bread rheological and sensorial properties. The total consumer's acceptability of the flaxseed bread was assessed. Dough characteristics were determined using Farinograph (C.W. Brabender® Instruments, Inc). The result shows no change was observed in water absorption between the stander dough (without flaxseed) and the bread with flaxseed (67%). An Increase in the peak time and dough stickiness was observed with the increase in flaxseed level. Further, breads were evaluated for sensory parameters, colour and texture. High flaxseed level increased the bread crumb softness. Bread with 5% flaxseed was optimized for total sensory evaluation. Overall, flaxseed bread produced in this study was highly acceptable for daily consumption as a functional foods with a potentially health benefits.

Keywords: bread, flaxseed, rheological properties, whole-wheat bread

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Authors: Y. Long, L. Liu, K. V. Branin

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One challenge faced by procurement decision-maker during the acquisition process is how to compare similar products from different suppliers and allocate orders among different products or services. This work focuses on allocating orders among multiple suppliers considering rebate. The objective function is to minimize the total acquisition cost including purchasing cost and rebate benefit. Rebate benefit is complex and difficult to estimate at the ordering step. Rebate rules vary for different suppliers and usually change over time. In this work, we developed a system to collect the rebate policies, standardized the rebate policies and developed two-stage optimization models for ordering allocation. Rebate policy with multi-tiers is considered in modeling. The discontinuous cost function of rebate benefit is formulated for different scenarios. A piecewise linear function is used to approximate the discontinuous cost function of rebate benefit. And a Mixed Integer Programing (MIP) model is built for order allocation problem with multi-tier rebate. A case study is presented and it shows that our optimization model can reduce the total acquisition cost by considering rebate rules.

Keywords: discontinuous cost function, mixed integer programming, optimization, procurement, rebate

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Authors: A. T. Ramachandra Naik, H. Shivananda Murthy, H. n. Anjanayappa

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The freshwater prawn, Macrobrachium rosenbergii is a more popular crustacean cultured widely in monoculture system in India. It has got high nutritional value in the human diet. Hence, understanding its enzymatic and body composition is important in order to judge its flesh quality. Fish oil specially derived from Indian oil sardine is a good source of highly unsaturated fatty acid and lipid source in fish/prawn diet. A 35% crude protein diet with graded levels of Sardine oil as a source of fat was incorporated at four levels viz, 2.07, 4.07, 6.07 and 8.07% maintaining a total lipid level of feed at 8.11, 10.24, 12.28 and 14.33% respectively. Diet without sardine oil (6.05% total lipid) was served as basal treatment. The giant freshwater prawn, Macrobrachium rosenbergii was used as test animal and the experiment was lost for 112 days. Significantly, higher gain in weight of prawn was recorded in the treatment with 6.07% sardine oil incorporation followed by higher specific growth rate, food conversion rate and protein efficiency ratio. The 8.07% sardine oil diet produced the highest RNA: DNA ratio in the prawn muscle. Digestive enzyme analyses in the digestive tract and mid-gut gland showed the greatest activity in prawns fed the 8.07% diet.

Keywords: digestive enzyme, fish diet, Macrobrachium rosenbergii, sardine oil

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Authors: Lara Marie Pangan Lo, Soo Im Chung, Yao Cheng Zhang, Xingyue Jin, Mi Young Kang

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Being the world’s most consumed grain crop, rice (Oryza sativa L.) demands’ have increase and this prompted the development of new rice cultivars with high bio-functional properties than the commonly used white rice. Ordinary rice variety is already known to be a potential source for a number of nutritional as well as bioactive compounds. To further enhance the rice’s nutritive values, germination is done in addition to making it more tasty and palatable when cooked. Pigmented rice, on the other hand, has become increasingly popular in the recent years for their greater antioxidant potential and other nutraceutical properties which can help alleviate the occurrence of the increasing incidence of metabolic diseases. Combining these two (2) parameters, this research study is sought to quantitatively determine the pre-germinated and germinated quantities of the major bioactive compounds of South Korea’s newly developed purplish pigmented rice grain cultivar Superjami (SJ) and red pigmented rice grain Superhongmi (SH) and compare them against the non-pigmented Normal Brown (NB) rice variety. Powdered rice grain cultivars were subjected to 72-hour germination period and the quantities of GABA, γ-oryzanol, ferulic acid, tocopherol and tocotrienol homologues were compared against their pre-germinated condition using γ- amino butyric acid (GABA) analysis and High Performance Liquid Chromatography (HPLC). Results revealed the effectiveness of germination in enhancing the bioactive components in all rice samples. GABA contents in germinated rice cultivars increased by more than 10-fold following the order: SJ >SH >NB. In addition, purple rice variety (SJ) has higher total γ-oryzanol and ferulic acid contents which increased by > 2-fold after germination followed by the red cultivar SH then the control, NB. Germinated varieties also possess higher total tocotrienol content than their pre-germinated state. As for the total tocopherol content, SJ has higher quantity, but the red-pigmented SH (0.16 mg/kg) is shown to have lower total tocopherol content than the control rice NB (0.86 mg/kg). However, all tocopherol and tocotrienol homologues were present only in small amounts ( < 3.0 mg/kg) in all pre-germinated and germinated samples. In general, all of the analyzed pigmented rice cultivars were found to possess higher bioactive compounds than the control NB rice variety. Also, regardless of their strain, germinated rice samples have higher bioactive compounds than their pre-germinated counterparts. This only shows the effectiveness of germinating rice in enhancing bioactive constituents. Overall, these results suggest the potential of the pigmented rice varieties as natural source of nutraceuticals in bio-functional food development.

Keywords: bioactive compounds, germinated rice, superhongmi, superjami

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Authors: Abdulwahab Alalyani, Mahbub Rashid

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Urban Open Space (UOS) a central role to promotes community health, including daily activities, but these resources may not available, accessible enough, and or equitably be distributed. This paper measures and compares spatial equity of the availability and accessibility UOS among low, middle, and high-income neighborhoods in Riyadh city. The measurement mothdulgy for the UOSavailability was by calculating the total of UOS with respect to the population total (m2/inhabitant) and the accessibility indicted by using walking distance of a 0.25 mi (0.4 km) buffering streets network.All UOS were mapped and measured using geographical information systems. To evaluate the significant differences in UOS availability and accessibility across low, medium, and high-income Riyadh neighborhoods, we used a One-way ANOVA analysis of covariance to test the differences.The findings are as follows; finding, UOSavailability was lower than global standers. Riyadh has only 1.13 m2 per capita of UOS, and the coverage accessible area by walking distance to UOS was lower than 50%. The final finding, spatial equity of the availability and accessibility, were significantly different among Riyadh neighborhoods based on socioeconomic status. The future development of UOS should be focused on increasing Urban park availability and should be given priority to those low-income and unhealthy communities.

Keywords: distribution urban open space, urban open space accessibility, spatial equity, riyadh city

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Authors: Mindaye Teshome, Nesibu Yahya, Carlos Moreira Miquelino Eleto Torres, Pedro Manuel Villaa, Mehari Alebachew

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Arbagugu forest is one of the remnant dry Afromontane forests under severe anthropogenic disturbances in central Ethiopia. Despite this fact, up-to-date information is lacking about the status of the forest and its role in climate change mitigation. In this study, we evaluated the woody species composition, structure, biomass, and carbon stock in this forest. We employed a systematic random sampling design and established fifty-three sample plots (20 × 100 m) to collect the vegetation data. A total of 37 woody species belonging to 25 families were recorded. The density of seedlings, saplings, and matured trees were 1174, 101, and 84 stems ha-1, respectively. The total basal area of trees with DBH (diameter at breast height) ≥ 2 cm was 21.3 m2 ha-1. The characteristic trees of dry Afromontane Forest such as Podocarpus falcatus, Juniperus procera, and Olea europaea subsp. cuspidata exhibited a fair regeneration status. On the contrary, the least abundant species Lepidotrichilia volkensii, Canthium oligocarpum, Dovyalis verrucosa, Calpurnia aurea, and Maesa lanceolata exhibited good regeneration status. Some tree species such as Polyscias fulva, Schefflera abyssinica, Erythrina brucei, and Apodytes dimidiata lack regeneration. The total carbon stored in the forest ranged between 6.3 Mg C ha-1 and 835.6 Mg C ha-1. This value is equivalent to 639.6 Mg C ha-1. The forest had a very low number of woody species composition and diversity. The regeneration study also revealed that a significant number of tree species had unsatisfactory regeneration status. Besides, the forest had a lower carbon stock density compared with other dry Afromontane forests. This implies the urgent need for forest conservation and restoration activities by the local government, conservation practitioners, and other concerned bodies to maintain the forest and sustain the various ecosystem goods and services provided by the Arbagugu forest.

Keywords: aboveground biomass, forest regeneration, climate change, biodiversity conservation, restoration

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Authors: Lazhar Belkhiri, Ammar Tiri, Lotfi Mouni, Fatma Elhadj Lakouas

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This research aims to present a surface water quality assessment of hydrochemical parameters in the Kebir Rhumel Basin, Algeria. The water quality index (WQI), Mann–Kendall (MK) test, and hierarchical cluster analysis (HCA) were used in oder to understand the spatio-temporal distribution of the surface water quality in the study area. Eleven hydrochemical parameters were measured monthly at eight stations from January 2016 to December 2020. The dominant cation in the surface water was found to be calcium, followed by sodium, and the dominant anion was sulfate, followed by chloride. In terms of WQI, a significant percentage of surface water samples at stations Ain Smara (AS), Beni Haroune (BH), Grarem (GR), and Sidi Khlifa (SK) exhibited poor water quality, with approximately 89.5%, 90.6%, 78.2%, and 62.7%, respectively, falling into this category. Mann–Kendall trend analysis revealed a significantly increasing trend in WQI values at stations Oued Boumerzoug (ON) and SK, indicating that the temporal variation of WQI in these stations is significant. Hierarchical clustering analysis classified the data into three clusters. The first cluster contained approximately 22% of the total number of months, the second cluster included about 30%, and the third cluster had the highest representation, approximately 48% of the total number of months. Within these clusters, certain stations exhibited higher WQI values. In the first cluster, stations GR and ON had the highest WQI values. In the second cluster, stations Oued Boumerzoug (OB) and SK showed the highest WQI values, while in the last cluster, stations AS, BH, El Milia (EM), and Hammam Grouz (HG) had the highest mean WQI values. Also, approximately 38%, 41%, and 38% of the total water samples in the first, second, and third clusters, respectively, were classified as having poor water quality. The findings of this study can serve as a scientific basis for decision-makers to formulate strategies for surface water quality restoration and management in the region.

Keywords: surface water, water quality index (WQI), Mann Kendall (MK) test, hierarchical cluster analysis (HCA), spatial-temporal distribution, Kebir Rhumel Basin

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Authors: Donya Ashtiani Haghighi, Amirali Baniasadi

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Coronavirus (COVID-19) disease has spread abruptly all over the world since the end of 2019. Computed tomography (CT) scans and X-ray images are used to detect this disease. Different Deep Neural Network (DNN)-based diagnosis solutions have been developed, mainly based on Convolutional Neural Networks (CNNs), to accelerate the identification of COVID-19 cases. However, CNNs lose important information in intermediate layers and require large datasets. In this paper, Capsule Network (CapsNet) is used. Capsule Network performs better than CNNs for small datasets. Accuracy of 0.9885, f1-score of 0.9883, precision of 0.9859, recall of 0.9908, and Area Under the Curve (AUC) of 0.9948 are achieved on the Capsule-based framework with hyperparameter tuning. Moreover, different dropout rates are investigated to decrease overfitting. Accordingly, a dropout rate of 0.1 shows the best results. Finally, we remove one convolution layer and decrease the number of trainable parameters to 146,752, which is a promising result.

Keywords: capsule network, dropout, hyperparameter tuning, classification

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Authors: A. Suresh, Sreehari Rao Patri, K. S. R. Krishnaprasad

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An ultra low power capacitor less low-dropout voltage regulator with improved transient response using gain enhanced feed forward path compensation is presented in this paper. It is based on a cascade of a voltage amplifier and a transconductor stage in the feed forward path with regular error amplifier to form a composite gain-enhanced feed forward stage. It broadens the gain bandwidth and thus improves the transient response without substantial increase in power consumption. The proposed LDO, designed for a maximum output current of 100 mA in UMC 180 nm, requires a quiescent current of 69 µA. An undershoot of 153.79mV for a load current changes from 0mA to 100mA and an overshoot of 196.24mV for current change of 100mA to 0mA. The settling time is approximately 1.1 µs for the output voltage undershoot case. The load regulation is of 2.77 µV/mA at load current of 100mA. Reference voltage is generated by using an accurate band gap reference circuit of 0.8V.The costly features of SOC such as total chip area and power consumption is drastically reduced by the use of only a total compensation capacitance of 6pF while consuming power consumption of 0.096 mW.

Keywords: capacitor-less LDO, frequency compensation, transient response, latch, self-biased differential amplifier

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Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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Authors: Ghorbanali Mohammadi

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Background: Due to the widespread outbreak of the COVID-19 virus, a large number of people become infected with the disease every day and go to hospitals. The acute condition of this disease has caused the death of many people. Since all the stages of treatment for these people happen in the hospitals, nurses are at the forefront of the fight against this virus. This causes nurses to suffer from physical and mental health problems. Methods: Physical and mental problems in nurses were assessed using the Depression, Anxiety and Stress Scale (DASS-42) of Lovibond (1995) and the Nordic Questionnaire. Results: 90 nurses from emergency, intensive care, and coronary care units were examined, and a total of 180 questionnaires were collected and evaluated. It was found that 37.78%, 47.78%, and 21.11% of nurses have symptoms of depression, anxiety, and stress, respectively. 40% of the nurses had physical problems. In total, 65.17% of them were involved in one or more mental or physical illnesses. Conclusions: Of the three units surveyed, the nurses in intensive care, emergency room, and coronary care units worked more than ten hours a day. Examining the interaction of physical and mental health problems indicated that physical problems can aggravate mental problems.

Keywords: depression anxiety and stress scale of Lovibond, nordic questionnaire, mental health of nurses, physical health problems in nurses

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Authors: E. Wairimu Mwangi, Daniel Sarpong

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Background: Access to effective antiretroviral therapy in the United States has resulted in the rise in longevity in people living with HIV (PLHIV). Despite the progress, women living with HIV (WLWH) experience increasing rates of cardiometabolic disorders compared with their HIV-negative counterparts. Studies focusing on the predictors of metabolic disorders in this population have largely focused on the composite measure of metabolic syndrome (METs). This study seeks to identify the predictors of composite and individual METs factors in a nationally representative sample of WLWH. In particular, the study also examines the role of food security in predicting METs. Methods: The study comprised 1800 women, a subset of participants from the Women’s Interagency HIV Study (WIHS). The primary exposure variable, food security, was measured using the U.S. 10-item Household Food Security Survey Module. The outcome measures are the five metabolic syndrome indicators (elevated blood pressure [systolic BP > 130 mmHg and diastolic BP ≥ 85 mmHg], elevated fasting glucose [≥ 110 mg/dL], elevated fasting triglyceride [≥ 150 mg/dL], reduced HDL cholesterol [< 50 mg/dL], and waist circumference > 88 cm) and the composite measure - Metabolic Syndrome (METs) Status. Each metabolic syndrome indicator was coded one if yes and 0 otherwise. The values of the five indicators were summed, and participants with a total score of 3 or greater were classified as having metabolic syndrome. Participants classified as having metabolic syndrome were assigned a code of 1 and 0 otherwise for analysis. The covariates accounted for in this study fell into sociodemographic factors and behavioral and health characteristics. Results: The participants' mean (SD) age was 47.1 (9.1) years, with 71.4% Blacks and 10.9% Whites. About a third (33.1%) had less than a high school (HS) diploma, 60.4% were married, 32.8% were employed, and 53.7% were low-income. The prevalence of worst dietary diversity, low, moderate, and high food security were 24.1%, 26.6%, 17.0%, and 56.4%, respectively. The correlate profile of the five individual METs factors plus the composite measure of METs differ significantly, with METs based on HDL having the most correlates (Age, Education, Drinking Status, Low Income, Body Mass Index, and Health Perception). Additionally, metabolic syndrome based on waist circumference was the only metabolic factor where food security was significantly correlated (Food Security, Age, and Body Mass Index). Age was a significant predictor of all five individual METs factors plus the composite METs measure. Except for METs based on Fasting Triglycerides, body mass index (BMI) was a significant correlate of the various measures of metabolic syndrome. Conclusion: High-density Lipoprotein (HDL) cholesterol significantly correlated with most predictors. BMI was a significant predictor of all METs factors except Fasting Triglycerides. Food insecurity, the primary predictor, was only significantly associated with waist circumference.

Keywords: blood pressure, food insecurity, fasting glucose, fasting triglyceride, high-density lipoprotein, metabolic syndrome, waist circumference, women living with HIV

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Authors: Jadwiga Fila, Mateusz Jezowski, Pawel Poszytek

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The outbreak of the global COVID-19 pandemic started the times of crisis full of uncertainty, especially in the field of transnational cooperation projects based on the international mobility of their participants. This is notably the case of Erasmus+ Program for higher education, which is the flagship European initiative boosting cooperation between educational institutions, businesses, and other actors, enabling students and staff mobility, as well as strategic partnerships between different parties. The aim of this abstract is to study whether competences 4.0 are able to empower Erasmus+ project leaders in sustaining their international cooperation in times of global crisis, widespread online learning, and common project disruption or cancellation. The concept of competences 4.0 emerged from the notion of the industry 4.0, and it relates to skills that are fundamental for the current labor market. For the aim of the study presented in this abstract, four main 4.0 competences were distinguished: digital, managerial, social, and cognitive competence. The hypothesis for the study stipulated that the above-mentioned highly-developed competences may act as a protective shield against the pandemic challenges in terms of projects’ sustainability and continuation. The objective of the research was to assess to what extent individual competences are useful in managing projects in times of crisis. For this purpose, the study was conducted, involving, among others, 141 Polish higher education project leaders who were running their cooperation projects during the peak of the COVID-19 pandemic (Mar-Nov 2020). The research explored the self-perception of the above-mentioned competences among Erasmus+ project leaders and the contextual data regarding the sustainability of the projects. The quantitative character of data permitted validation of scales (Cronbach’s Alfa measure), and the use of factor analysis made it possible to create a distinctive variable for each competence and its dimensions. Finally, logistic regression was used to examine the association of competences and other factors on project status. The study shows that the project leaders’ competence profile attributed the highest score to digital competence (4.36 on the 1-5 scale). Slightly lower values were obtained for cognitive competence (3.96) and managerial competence (3.82). The lowest score was accorded to one specific dimension of social competence: adaptability and ability to manage stress (1.74), which proves that the pandemic was a real challenge which had to be faced by project coordinators. For higher education projects, 10% were suspended or prolonged because of the COVID-19 pandemic, whereas 90% were undisrupted (continued or already successfully finished). The quantitative analysis showed a positive relationship between the leaders’ levels of competences and the projects status. In the case of all competences, the scores were higher for project leaders who finished projects successfully than for leaders who suspended or prolonged their projects. The research demonstrated that, in the demanding times of the COVID-19 pandemic, competences 4.0, to a certain extent, do play a significant role in the successful management of Erasmus+ projects. The implementation and sustainability of international educational projects, despite mobility and sanitary obstacles, depended, among other factors, on the level of leaders’ competences.

Keywords: Competences 4.0, COVID-19 pandemic, Erasmus+ Program, international education, project sustainability

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Authors: Ayse Berivan Bakan, Senay Karadag Arli, Ela Varol

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Objective: The present study aims to identify nursing students’ attitudes toward older people. Methods: This descriptive study was conducted with 166 nursing department students enrolled in a four-year undergraduate program in a university located in Eastern Turkey. The participants were chosen using convenience sampling method, and the data were collected through the Descriptive Characteristics Form and Turkish version of Kogan's Attitudes toward Old People Scale (KAOP). Results: It was found that the students participating in the study had positive attitudes toward old people, and the mean scores of those who wanted to work with old people after graduation were significantly high (p<0.05). Scale mean scores according to receiving Gerontology Nursing course showed that the score difference between the two groups was not statistically significant. Conclusion: This study found that nursing students’ attitudes toward older people were positive. Cultural features of the region where the study was conducted are considered to contribute to this result.

Keywords: older people, attitudes, gerontology, nursing students, Turkey

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Authors: Angela O. Ugwu, Sunday Ocheni

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Background: Cancer-associated thrombosis (CAT) is a cause of morbidity and mortality among cancer patients. Several risk factors for developing venous thromboembolism (VTE) also coexist with cancer patients, such as chemotherapy and immobilization, thus contributing to the higher risk of VTE in cancer patients when compared to non-cancer patients. This study aimed to determine if there is any correlation between levels of some inflammatory cytokines/haematological parameters and Khorana scores of newly diagnosed chemotherapy naïve ambulatory cancer patients (CNACP). Methods: This was a cross-sectional analytical study carried out from June 2021 to May 2022. Eligible newly diagnosed cancer patients 18 years and above (case group) were enrolled consecutively from the adult Oncology Clinics of the University of Nigeria Teaching Hospital, Ituku/Ozalla (UNTH). The control group was blood donors at UNTH Ituku/Ozalla, Enugu blood bank, and healthy members of the Medical and Dental Consultants Association of Nigeria (MDCAN), UNTH Chapter. Blood samples collected from the participants were assayed for IL-6, TNF-Alpha, and haematological parameters such as haemoglobin, white blood cell count (WBC), and platelet count. Data were entered into an Excel worksheet and were then analyzed using Statistical Package for Social Sciences (SPSS) computer software version 21.0 for windows. A P value of < 0.05 was considered statistically significant. Results: A total of 200 participants (100 cases and 100 controls) were included in the study. The overall mean age of the participants was 47.42 ±15.1 (range 20-76). The sociodemographic characteristics of the two groups, including age, sex, educational level, body mass index (BMI), and occupation, were similar (P > 0.05). Following One Way ANOVA, there were significant differences between the mean levels of interleukin-6 (IL-6) (p = 0.036) and tumor necrotic factor-α (TNF-α) (p = 0.001) in the three Khorana score groups of the case group. Pearson’s correlation analysis showed a significant positive correlation between the Khorana scores and IL-6 (r=0.28, p = 0.031), TNF-α (r= 0.254, p= 0.011), and PLR (r= 0.240, p=0.016). The mean serum levels of IL-6 were significantly higher in CNACP than in the healthy controls [8.98 (8-12) pg/ml vs. 8.43 (2-10) pg/ml, P=0.0005]. There were also significant differences in the mean levels of the haemoglobin (Hb) level (P < 0.001)); white blood cell (WBC) count ((P < 0.001), and platelet (PL) count (P = 0.005) between the two groups of participants. Conclusion: There is a significant positive correlation between the serum levels of IL-6, TNF-α, and PLR and the Khorana scores of CNACP. The mean serum levels of IL-6, TNF-α, PLR, WBC, and PL count were significantly higher in CNACP than in the healthy controls. Ambulatory cancer patients with high-risk Khorana scores may benefit from anti-inflammatory drugs because of the positive correlation with inflammatory cytokines. Recommendations: Ambulatory cancer patients with 2 Khorana scores may benefit from thromboprophylaxis since they have higher Khorana scores. A multicenter study with a heterogeneous population and larger sample size is recommended in the future to further elucidate the relationship between IL-6, TNF-α, PLR, and the Khorana scores among cancer patients in the Nigerian population.

Keywords: thromboprophylaxis, cancer, Khorana scores, inflammatory cytokines, haematological parameters

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Authors: Mary A. Bisi-Johnson, Kehinde A. Adediran, Saheed A. Akinola, Hamzat A. Oyelade

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Some of the main problems man contends with are the quantity (source and amount) and quality of water in Nigeria. Scarcity leads to water being obtained from various sources and microbiological contaminations of the water may thus occur between the collection point and the point of usage. Thus, this study aims to assess the general and microbiological quality of domestic water sources and household stored water used within selected areas in Ile-Ife, South-Western part of Nigeria for microbial contaminants. Physicochemical and microbiological examination were carried out on 45 source and stored water samples collected from well and spring in three different local government areas i.e. Ife east, Ife-south, and Ife-north. Physicochemical analysis included pH value, temperature, total dissolved solid, dissolved oxygen, and biochemical oxygen demand. Microbiology involved most probable number analysis, total coliform, heterotrophic plate, faecal coliform, and streptococcus count. The result of the physicochemical analysis of samples showed anomalies compared to acceptable standards with the pH value of 7.20-8.60 for stored and 6.50-7.80 for source samples as the total dissolved solids (TDS of stored 20-70mg/L, source 352-691mg/L), dissolved oxygen (DO of stored 1.60-9.60mg/L, source 1.60-4.80mg/L), biochemical oxygen demand (BOD stored 0.80-3.60mg/L, source 0.60-5.40mg/L). General microbiological quality indicated that both stored and source samples with the exception of a sample were not within acceptable range as indicated by analysis of the MPN/100ml which ranges (stored 290-1100mg/L, source 9-1100mg/L). Apart from high counts, most samples did not meet the World Health Organization standard for drinking water with the presence of some pathogenic bacteria and fungi such as Salmonella and Aspergillus spp. To annul these constraints, standard treatment methods should be adopted to make water free from contaminants. This will help identify common and likely water related infection origin within the communities and thus help guide in terms of interventions required to prevent the general populace from such infections.

Keywords: domestic, microbiology, physicochemical, quality, water

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Authors: Mikko Salminen, Simo Järvelä, Niklas Ravaja

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One of the central models of emotional intelligence (EI) is that of Mayer and Salovey’s, which includes ability to monitor own feelings and emotions and those of others, ability to discriminate different emotions, and to use this information to guide thinking and actions. There is vast amount of previous research where positive links between EI and, for example, leadership successfulness, work outcomes, work wellbeing and organizational climate have been reported. EI has also a role in the effectiveness of work teams, and the effects of EI are especially prominent in jobs requiring emotional labor. Thus, also the organizational context must be taken into account when considering the effects of EI on work outcomes. Based on previous research, it is suggested that EI can also protect managers from the negative consequences of stress. Stress may have many detrimental effects on the manager’s performance in essential work tasks. Previous studies have highlighted the effects of stress on, not only health, but also, for example, on cognitive tasks such as decision-making, which is important in managerial work. The motivation for the current study came from the notion that, unfortunately, many stressed individuals may not be aware of the circumstance; periods of stress-induced physiological arousal may be prolonged if there is not enough time for recovery. To tackle this problem, physiological stress levels of managers were collected using recording of heart rate variability (HRV). The goal was to use this data to provide the managers with feedback on their stress levels. The managers could access this feedback using a www-based learning environment. In the learning environment, in addition to the feedback on stress level and other collected data, also developmental tasks were provided. For example, those with high stress levels were sent instructions for mindfulness exercises. The current study focuses on the relation between the measured physiological stress levels and EI of the managers. In a pilot study, 33 managers from various fields wore the Firstbeat Bodyguard HRV measurement devices for three consecutive days and nights. From the collected HRV data periods (minutes) of stress and recovery were detected using dedicated software. The effects of EI on HRV-calculated stress indexes were studied using Linear Mixed Models procedure in SPSS. There was a statistically significant effect of total EI, defined as an average score of Schutte’s emotional intelligence test, on the percentage of stress minutes during the whole measurement period (p=.025). More stress minutes were detected on those managers who had lower emotional intelligence. It is suggested, that high EI provided managers with better tools to cope with stress. Managing of own emotions helps the manager in controlling possible negative emotions evoked by, e.g., critical feedback or increasing workload. High EI managers may also be more competent in detecting emotions of others, which would lead to smoother interactions and less conflicts. Given the recent trend to different quantified-self applications, it is suggested that monitoring of bio-signals would prove to be a fruitful direction to further develop new tools for managerial and leadership coaching.

Keywords: emotional intelligence, leadership, heart rate variability, personality, stress

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Authors: S. Oladoyinbo, A. A. Tijani

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Multilevel inverters (MLI) are used at high power application based on their operation. There are 3 main types of multilevel inverters (MLI); diode clamped, flying capacitor and cascaded MLI. A cascaded MLI requires the least number of components to achieve same number of voltage levels when compared to other types of MLI while the flying capacitor has the minimum harmonic distortion. However, maximizing the advantage of cascaded H-bridge MLI and flying capacitor MLI, an improved MLI can be achieved with fewer components and better performance. In this paper an improved MLI is presented by asymmetrically integrating a flying capacitor to a cascaded H-bridge MLI also integrating an auxiliary transformer to the main transformer to decrease the total harmonics distortion (THD) with increased number of output voltage levels. Furthermore, the system is incorporated with a hybrid time and climate based solar panel cleaner and power selector which intelligently manage the input of the MLI and clean the solar panel weekly ensuring the environmental factor effect on the panel is reduced to minimum.

Keywords: multilevel inverter, total harmonics distortion, cascaded h-bridge inverter, flying capacitor

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Authors: Safi Haider

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This work seeks to understand the fundamental mourning ceremonies termed azadari in the tristate Shi’i community. Azadari, a name derived from the Arabic aza (mourning) and the Persian dari (commemoration) as it exists in the Tri-State Shi'i community has a unique relation to the hearts and minds of its adherents. It shows the development of the community from the various perspective offered by the participants of this work. This work seeks to analyze Azadari in the light of the Tri-State Shi'i community, which is a deeply diverse community, consisting of immigrants from various other countries, including Pakistan, India, Iran, and the Arab communities. At its heart, this work is an ethnography, it seeks to know the experience of those who are a part of the Muharram commemorations and it seek to see what the underlying psychological and the social foundations of Azadari are. Five people from each of the four communities were interviewed, and the aim was to have at least two men, two women, two youth, two elders, and one person from either of these categories. What was found was that the Shi’i community is scarcely a monolith in its mourning practices, and there is a great difference not only when comparing one cultural community to another, but also within the communities as well. This work seeks to analyze azadari from the various perspective of the Shi’i community in the tri-state area. This work seeks to analyze interviews from twenty people in total: two men, two women, two youth, and two adults from each of the communities of the Shi’i of the tristate area, for a total of twenty people. Two Priests were also interviewed for the sake of the paper as well.

Keywords: Ashura, Imam Husayn, Islam, Muharram, Shi'i

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Authors: Shahin Mirshekari, Mohammadreza Moradi, Hossein Jafari, Mehdi Jafari, Mohammad Ensaf

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This research employs Gaussian Process Regression (GPR) with an ensemble kernel, integrating Exponential Squared, Revised Matern, and Rational Quadratic kernels to analyze pharmaceutical sales data. Bayesian optimization was used to identify optimal kernel weights: 0.76 for Exponential Squared, 0.21 for Revised Matern, and 0.13 for Rational Quadratic. The ensemble kernel demonstrated superior performance in predictive accuracy, achieving an R² score near 1.0, and significantly lower values in MSE, MAE, and RMSE. These findings highlight the efficacy of ensemble kernels in GPR for predictive analytics in complex pharmaceutical sales datasets.

Keywords: Gaussian process regression, ensemble kernels, bayesian optimization, pharmaceutical sales analysis, time series forecasting, data analysis

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Authors: Hadriana Bansi, Elizabeth Wina, Toto Toharmat

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Acacia villosa is thornless shrub legume which contents high crude protein. However, the utilization of A. villosa as ruminant feed is limited by its secondary compounds. The aim of this article is to find out the maximum of substitution A. villosa in sheep ration. The nutritional evaluation consisted of in vitro two stages, in vivo, and in vitro gas production trials. The secondary compounds of A. villosa also were analyzed. Evaluating digestibility of increasing level of substitution A. villosa replacing Pennisetum purpureum was using in vitro two stages. The substitution of 30% A. villosa was compared to 100% P. purpureum by in vitro gas production technique and in vivo digestibility. The results of two stages in vitro showed that total phenol, condensed tannin, and non-protein amino acid (NPAA) were high. Substitution 15% A. villosa reached the highest digestibility for both dry matter (DM) and crude protein (CP) which were 67% and 86% respectively, but it was shown that DM and CP digestibility of substitution 30% of A. villosa was still high which were 61.82% and 75-67% respectively. The pattern of gas production showed that first 8 hours total gas production substitution of 30% A. villosa was higher than 100% P. purpureum and declined after 10 hours incubation. In vivo trials showed that substitution of 30% A. villosa significantly increased CP intake, CP digestibility, and nitrogen retention. It can be concluded that substitution A. villosa until 30% still gave the good impact even though it has high secondary compounds.

Keywords: Acacia villosa, digestibility, gas production, secondary compounds

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Authors: Eman Abdullah Morsi, Hend Okasha, Heba Abdel Hady, Mortada El-Sayed, Mohamed Abbas Shemis

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Context: Linum usitatissimum (Linn), known as Flaxseed, is one of the most important medicinal plants traditionally used for various health as nutritional purposes. Objective: Estimation of total phenolic and flavonoid contents as well as evaluate the antioxidant using α, α-diphenyl-β-picrylhydrazyl (DPPH), 2-2'azinobis (3-ethylbenzthiazoline-6-sulphonic acid (ABTS) and total antioxidant capacity (TAC) assay and investigation of anti-inflammatory by Bovine serum albumin (BSA) and anticancer activities of hepatocellular carcinoma cell line (HepG2) and breast cancer cell line (MCF7) have been applied on hexane, ethyl acetate, n-butanol and methanol extracts and also, fractions of methonal extract (hexane, ethyl acetate and n-butanol). Materials and Methods: Phenolic and flavonoid contents were detected using spectrophotometric and colorimetric assays. Antioxidant and anti-inflammatory activities were estimated in-vitro. Anticancer activity of extracts and fractions of methanolic extract were tested on (HepG2) and (MCF7). Results: Methanolic extract and its ethyl acetate fraction contain higher contents of total phenols and flavonoids. In addition, methanolic extract had higher antioxidant activity. Butanolic and ethyl acetate fractions yielded higher percent of inhibition of protein denaturation. Meanwhile, ethyl acetate fraction and methanolic extract had anticancer activity against HepG2 and MCF7 (IC50=60 ± 0.24 and 29.4 ± 0.12µg.mL⁻¹) and (IC50=94.7 ± 0.21 and 227 ± 0.48µg.mL⁻¹), respectively. In Gas chromatography-mass spectrometry (GC-MS) analysis, methanolic extract has 32 compounds, whereas; ethyl acetate and butanol fractions contain 40 and 36 compounds, respectively. Conclusion: Flaxseed contains totally different biologically active compounds that have been found to possess good variable activities, which can protect human body against several diseases.

Keywords: phenolic content, flavonoid content, HepG2, MCF7, hemolysis-assay, flaxseed

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Authors: Ali Kazemi

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The digital evolution of financial services, while offering unprecedented convenience and accessibility, has also escalated the vulnerabilities to fraudulent activities. In this study, we introduce a distinct approach to real-time anomaly detection in financial transactions, aiming to fortify the defenses of banking and financial institutions against such threats. Utilizing unsupervised machine learning algorithms, specifically autoencoders and isolation forests, our research focuses on identifying irregular patterns indicative of fraud within transactional data, thus enabling immediate action to prevent financial loss. The data we used in this study included the monetary value of each transaction. This is a crucial feature as fraudulent transactions may have distributions of different amounts than legitimate ones, such as timestamps indicating when transactions occurred. Analyzing transactions' temporal patterns can reveal anomalies (e.g., unusual activity in the middle of the night). Also, the sector or category of the merchant where the transaction occurred, such as retail, groceries, online services, etc. Specific categories may be more prone to fraud. Moreover, the type of payment used (e.g., credit, debit, online payment systems). Different payment methods have varying risk levels associated with fraud. This dataset, anonymized to ensure privacy, reflects a wide array of transactions typical of a global banking institution, ranging from small-scale retail purchases to large wire transfers, embodying the diverse nature of potentially fraudulent activities. By engineering features that capture the essence of transactions, including normalized amounts and encoded categorical variables, we tailor our data to enhance model sensitivity to anomalies. The autoencoder model leverages its reconstruction error mechanism to flag transactions that deviate significantly from the learned normal pattern, while the isolation forest identifies anomalies based on their susceptibility to isolation from the dataset's majority. Our experimental results, validated through techniques such as k-fold cross-validation, are evaluated using precision, recall, and the F1 score alongside the area under the receiver operating characteristic (ROC) curve. Our models achieved an F1 score of 0.85 and a ROC AUC of 0.93, indicating high accuracy in detecting fraudulent transactions without excessive false positives. This study contributes to the academic discourse on financial fraud detection and provides a practical framework for banking institutions seeking to implement real-time anomaly detection systems. By demonstrating the effectiveness of unsupervised learning techniques in a real-world context, our research offers a pathway to significantly reduce the incidence of financial fraud, thereby enhancing the security and trustworthiness of digital financial services.

Keywords: anomaly detection, financial fraud, machine learning, autoencoders, isolation forest, transactional data analysis

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Authors: Indra Bahadur Chand

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This paper will focus on the need for development and application of global protocols and policy in planning, designing, development, and management of systems of eco-towns and eco-villages so that sustainable development will be assured from the perspective of environmental, economical, peace, and harmonized social dynamics. This perspective is essential for the development of civilized and eco-friendly human settlements in the town and rural areas of the nation that will be a milestone for developing a happy and sustainable lifestyle of rural and urban communities of the nation. The urban population of most of the town of developing economies has been tremendously increasing, whereas rural people have been tremendously migrating for the past three decades. Consequently, the urban lifestyle in most towns has stressed in terms of environmental pollution, water crisis, congested traffic, energy crisis, food crisis, and unemployment. Eco-towns and villages should be developed where lifestyle of all residents is sustainable and happy. Built up environment of settlement should reduce and minimize the problems of non ecological CO2 emissions, unbalanced utilization of natural resources, environmental degradation, natural calamities, ecological imbalance, energy crisis, water scarcity, waste management, food crisis, unemployment, deterioration of cultural heritage, social, the ratio among the public and private land ownership, ratio of land covered with vegetation and area of settlement, the ratio of people in the vehicles and foot, the ratio of people employed outside of town and village, ratio of resources recycling of waste materials, water consumption level, the ratio of people and vehicles, ratio of the length of the road network and area of town/villages, a ratio of renewable energy consumption with total energy, a ratio of religious/recreational area out of the total built-up area, the ratio of annual suicide case out of total people, a ratio of annual injured and death out of total people from a traffic accident, a ratio of production of agro foods within town out of total food consumption will be used to assist in designing and monitoring of each eco-towns and villages. An eco-town and villages should be planned and developed to offer sustainable infrastructure and utilities that maintain CO2 level in individual homes and settlements, home energy use, transport, food and consumer goods, water supply, waste management, conservation of historical heritages, healthy neighborhood, conservation of natural landscape, conserving bio-diversity and developing green infrastructures. Eco-towns and villages should be developed on the basis of master planning and architecture that affect and define the settlement and its form. Master planning and engineering should focus in delivering the sustainability criteria of eco towns and eco village. This will involve working with specific landscape and natural resources of locality.

Keywords: eco-town, ecological habitation, master plan, sustainable development

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Authors: Kwestan Salimi, Jenna Jacoby, Michelle Basham, Amy Cerato

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The extreme annual weather patterns of the central United States have increased the need for underground shelters for protection from destructive tornadic activity. However, very few residential homes have basements due to the added construction expense and the prevalence of expansive soils covering the central portion of the United States. These expansive soils shrink and swell, increasing earth pressure on basement walls. To mitigate the effect of expansive soils on basement walls, this study performed bench-scale tests using a common natural expansive soil mitigated with a backfill layer of crumb rubber. The results revealed that at 80% soil compaction, a 1:6 backfill height to total height ratio produced a 66% reduction in swell pressure. However, this percent reduction decreased to 27% for 90% soil compaction. It was also found that there is a strong linear correlation between compaction percentage and reduction in swell pressure when using the same backfill height to total height ratio. Using this correlation and extrapolating to 95% compaction, the percent reduction in swell pressure was approximately 12%.

Keywords: expansive soils, swell/shrink, swell pressure, stabilization, crumb rubber

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Authors: Akram Salah Eddine Belaidi, Said Kenai, El-Hadj Kadri, Benchaâ Benabed, Hamza Soualhi

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Self-compacting concrete (SCC) was developed in the middle of the 1980’s in Japan. SCC flows alone under its dead weight and consolidates itself without any entry of additional compaction energy and without segregation. As an integral part of a SCC, self-compacting mortars (SCM) may serve as a basis for the mix design of concrete since the measurement of the rheological properties of SCCs. This paper discusses the effect of using natural pozzolana (PZ) and marble powder (MP) in two alternative systems ratios PZ/MP = 1 and 1/3 of the performance of the SCC. A total of 11 SCC’s were prepared having a constant water-binder (w/b) ratio of 0.40 and total cementitious materials content of 475 kg/m3. Then, the fresh properties of the mortars were tested for mini-slump flow diameter and mini-V-funnel flow time for SCMs and Slumps flow test, L-Box height ratio, V-Funnel flow time and sieve stability for SCC. Moreover, the development in the compressive strength was determined at 3, 7, 28, 56, and 90 days. Test results have shown that using of ternary blends improved the fresh properties of the mixtures. The compressive strength of SCC at 90 days with 30% of PZ and MP was similar to those of ordinary concrete use in situ.

Keywords: self-compacting mortar, self-compacting concrete, natural pozzolana, marble powder, rheology, compressive strength

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Authors: S. M. C. Kelly, M. Goulden

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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

Procedia PDF Downloads 135