Search results for: Intensive Care

Authors: Jihene Jlassi, Ahmed Frikha, Wazna Kortli

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The objectives of Nurse-Patient Assignment are the minimization of the overall hospital cost and the maximization of nurses ‘preferences. This paper aims to assess nurses' satisfaction related to the implementation of patient acuity tool-based assignments. So, we used an integer linear program that assigns patients to nurses while balancing nurse workloads. Then, the proposed model is applied to the Paediatrics Department at Kasserine Hospital Tunisia. Where patients need special acuities and high-level nursing skills and care. Hence, numerical results suggested that proposed nurse-patient assignment models can achieve a balanced assignment

Keywords: nurse-patient assignment, mathematical model, logistics, pediatrics department, balanced assignment

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Authors: Salman Naseer

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One of the main challenges of operating a smart city (SC) is collecting the massive data generated from multiple data sources (DS) and to transmit them to the control units (CU) for further data processing and analysis. These ever-increasing data demands require not only more and more capacity of the transmission channels but also results in resource over-provision to meet the resilience requirements, thus the unavoidable waste because of the data fluctuations throughout the day. In addition, the high energy consumption (EC) and carbon discharges from these data transmissions posing serious issues to the environment we live in. Therefore, to overcome the issues of intensive EC and carbon emissions (CE) of massive data dissemination in Smart Cities, we propose an energy efficient and carbon reduction approach by utilizing the daily mobility of the existing vehicles as an alternative communications channel to accommodate the data dissemination in smart cities. To illustrate the effectiveness and efficiency of our approach, we take the Auckland City in New Zealand as an example, assuming massive data generated by various sources geographically scattered throughout the Auckland region to the control centres located in city centre. The numerical results show that our proposed approach can provide up to 5 times lower delay as transferring the large volume of data by utilizing the existing daily vehicles’ mobility than the conventional transmission network. Moreover, our proposed approach offers about 30% less EC and CE than that of conventional network transmission approach.

Keywords: smart city, delay tolerant network, infrastructure offloading, opportunistic network, vehicular mobility, energy consumption, carbon emission

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Authors: Emna Bahri Hammami, Zammouri Mounira, Tarhouni Jamila

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The Nadhour Saouaf Sisseb El Alem (NSSA) system comprises some of the most intensively exploited aquifers in central Tunisia. Since the 1970s, the growth in economic productivity linked to intensive agriculture in this semiarid region has been sustained by increasing pumping rates of the system’s groundwater. Exploitation of these aquifers has increased rapidly, ultimately causing their depletion. With the aim to better understand the behavior of the aquifer system and to predict its evolution, the paper presents a finite difference model of the groundwater flow and solute transport. The model is based on the Groundwater Modeling System (GMS) and was calibrated using data from 1970 to 2010. Groundwater levels observed in 1970 were used for the steady-state calibration. Groundwater levels observed from 1971 to 2010 served to calibrate the transient state. The impact of pumping discharge on the evolution of groundwater levels was studied through three hypothetical pumping scenarios. The first two scenarios replicated the approximate drawdown in the aquifer heads (about 17 m in scenario 1 and 23 m in scenario 2 in the center of NSSA) following an increase in pumping rates by 30% and 50% from their current values, respectively. In addition, pumping was stopped in the third scenario, which could increase groundwater reserves by about 7 Mm3/year. NSSA groundwater reserves could be improved considerably if the pumping rules were taken seriously.

Keywords: pumping, depletion, groundwater modeling system GMS, Nadhour Saouaf

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Authors: Suzanne L. Stewart, Sarah J. Ponton, Mikaela D. Gabriel, Roy Strebel, Xinyi Lu

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Indigenous Peoples have faced unique barriers to accessing and receiving culturally safe and appropriate mental health care while also facing daunting rates of mental health diagnoses and comorbidities. Indigenous researchers and clinicians have well established the connection of the current mental health issues in Indigenous communities as a direct result of colonization by way of intergenerational trauma throughout Canada’s colonial history. Such mental health barriers and challenges have become exacerbated during the COVID-19 pandemic. Throughout the pandemic, access to mental health, cultural, ceremonial, and community services were severely impacted and restricted; however, it is these same cultural activities and community resources that are key to supporting Indigenous mental health from a traditional and community-based perspective. This research employed a unique combination of a thorough, analytical scoping review of the existent mental health literature of Indigenous mental health in the COVID-19 pandemic, alongside narrative interviews employing an oral storytelling tradition methodology with key community informants that provide comprehensive cultural services to the Indigenous community of Toronto, as well as across Canada. These key informant interviews provided a wealth of insights into virtual transitions of Indigenous care and mental health support; intersections of historical underfunding and current financial navigation in technology infrastructure; accessibility and connection with Indigenous youth in remote locations; as well as maintaining community involvement and traditional practices in a current pandemic. Both the scoping review and narrative interviews were meticulously analyzed for overarching narrative themes to best explore the extent of the literature on Indigenous mental health and services during COVID-19; identify gaps in this literature; identify barriers and supports for the Indigenous community, and explore the intersection of community and cultural impacts to mental health. Themes of the scoping review included: Historical Context; Challenges in Culturally-Based Services; and Strengths in Culturally-Based Services. Meta themes across narrative interviews included: Virtual Transitions; Financial Support for Indigenous Services; Health Service Delivery & Wellbeing; and Culture & Community Connection. The results of this scoping review and narrative interviews provide wide application and contribution to the mental health literature, as well as recommendations for policy, service provision, autonomy in Indigenous health and wellbeing, and crucial insights into the present and enduring mental health needs of Indigenous Peoples throughout the COVID-19 pandemic.

Keywords: indigenous community services, indigenous mental health, indigenous scoping review, indigenous peoples and Covid-19

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Shantol McIntosh

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Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

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Authors: Anne Hovgaard Jorgensen

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This study investigates how Muslim fathers in Denmark are struggling to overcome notions of mistrust from teachers and educators. Starting from school-home-cooperation (parent conferences, school-home communication, etc.), the study finds that many Muslim fathers do not feel acknowledged as a resource in the upbringing of their children. To explain these experiences further, the study suggest the notion of ‘mistrusted masculinity’ to grasp the controlling image these fathers meet in various schools and child-care-institutions in the Danish Welfare state. The paper is based on 9 months of fieldwork in a Danish school, a social housing area and in various ‘father groups’ in Denmark. Additional, 50 interviews were conducted with fathers, children, mothers, schoolteachers, and educators. By using Connell's concepts 'hegemonic' and 'marginalized' masculinity as steppingstones, the paper argues that these concepts might entail a too static and dualistic picture of gender. By applying the concepts of 'emergent masculinity' and 'emergent fatherhood' the paper brings along a long needed discussion of how Muslim men in Denmark are struggling to overcome and change the controlling images of them as patriarchal and/or ignorant fathers regarding the upbringing of their children. As such, the paper shows how Muslim fathers are taking action to change this controlling image, e.g. through various ‘father groups’. The paper is inspired by the phenomenological notions of ‘experience´ and in the light of this notion, the paper tells the fathers’ stories about their upbringing of their children and aspirations for fatherhood. These stories share light on how these fathers take care of their children in everyday life. The study also shows that the controlling image of these fathers have affected how some Muslim fathers are actually being fathers. The study shows that fear of family-interventions from teachers or social workers e.g. have left some Muslim fathers in a limbo, being afraid of scolding their children, and being confused of ‘what good parenting in Denmark is’. This seems to have led to a more lassie fair upbringing than these fathers actually wanted. This study is important since anthropologists generally have underexposed the notion of fatherhood, and how fathers engage in the upbringing of their children. Over more, the vast majority of qualitative studies of fatherhood have been on white middleclass fathers, living in nuclear families. In addition, this study is crucial at this very moment due to the major refugee crisis in Denmark and in the Western world in general. A crisis, which has resulted in a vast number of scare campaigns against Islam from different nationalistic political parties, which enforces the negative controlling image of Muslim fathers.

Keywords: fatherhood, Muslim fathers, mistrust, education

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Authors: S. Benessam, T. H. Debieche, A. Drouiche, F. Zahi, S. Mahdid

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The intensive use of the chemical fertilizers and the pesticides in agriculture often produces a contamination of the groundwater by organic pollutants. The irrigation and/or rainwater transport the pollutants towards groundwater or water surface. Among these pollutants, one finds the nitrogen, often observed in the agricultural zones in the nitrate form. In order to understand the form and chemical mobility of nitrogen in groundwater, this study was conducted. A two-monthly monitoring of the parameters physicochemical and chemistry of water of the alluvial plain of Nil river (North-eastern Algerian) were carried out during the period from November 2013 to January 2015 as well as an in-situ investigation of the various chemical products used by the farmers. The results show a raise concentration of nitrates in the wells (depth < 20 m) of the plain, which the concentrations arrive at 50 mg/L (standard of potable water). On the other hand in drillings (depth > 20 m), one observes two behaviors. The first in the upstream part, where the aquifer is unconfined and the medium is oxidizing, one observes the weak nitrate concentrations, indicating its absorption by the ground during the infiltration of water towards the groundwater. The second in the central and downstream parts, where the groundwater is locally confined and the reducing medium, one observes an absence of nitrates and the appearance of nitrites and ammonium, indicating the reduction of nitrates. The projection of the analyses on diagrams Eh-pH of nitrogen has enabled to us to determine the intervals of variation of the nitrogen forms. This study also highlighted the effect of the rains, the pumping and the nature of the geological formations in the form and the mobility of nitrogen in the plain.

Keywords: groundwater, nitrogen, mobility, speciation

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Authors: Jessica Gladden

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This study explored the perceived benefits of trauma-sensitive yoga programs. Participants attended one of two six-week trauma-sensitive yoga programs utilizing the G.R.A.C.E model, a format developed based on Emerson’s trauma-sensitive yoga guidelines and modified by the instructors. Participants in this study completed surveys on their experiences. The results of the surveys indicated that participants perceived improvements in self-care, embodiment, and mood. These results show that trauma-sensitive yoga may have benefits beyond the treatment of specific diagnoses that could be applied to a variety of populations. Reflections from one of the researchers who teaches in this program, as well as qualitative statements from the participants, will be shared to support the continued use of this method.

Keywords: yoga, trauma-sensitive, yoga therapy, trauma

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Authors: Gabriela Smeckova

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The entire world is becoming more and more diverse. The reasons why people migrate are different and unique for each family /individual. Professionals delivering services (including speech-language pathologists) must be prepared to work with clients coming from different cultural and/or linguistic backgrounds. Well-educated speech-language pathologists will consider many factors when delivering services. Some of them will be discussed during the presentation (language spoken, beliefs about health care and disabilities, reasons for immigration, etc.). The communication styles of the client can be different than the styles of the speech-language pathologist. The goal is to become culturally responsive in service delivery.

Keywords: culture, cultural competence, culturallly responsive practices, speech-language pathologist, cultural and linguistical variables, communication styles

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Authors: Dušan Bojović, Wei Huang, Zdravko Stojanović, Jovan Ilić

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In an era of ever-growing electricity generation from renewable energy sources, namely wind and solar, a need for reliable energy storage and intensive balancing of the electric power system gains significance. For decades, pump storage hydroelectric power plants have proven to be an important asset regarding the storage of generated electricity. However, with the increasing overall share of wind and solar in electric systems at large, the importance of electric grid stability keeps growing. A large pump storage project, the Bistrica Pump Storage Plant (PSP), is currently under development in Serbia. The Bistrica PSP will be designed as a 600+ MW power plant, which is envisaged as a significant contributor to the Serbian power grid stability as more and more renewable energy sources are implemented over time. PSP Bistrica is seen as a strategically important project on the green agenda path of the Electric Power Industry of Serbia as a necessary pre-condition for the safe implementation of other renewable energy sources. The importance of such a plant would also play an important role in reducing the electricity production from coal, i.e., thermoelectric power plants. During the project’s development, various techniques and technologies are evaluated for the purpose of determining the optimum (the most profitable) solution. Over the course of this paper, these technologies – such as frequency-regulated pump turbines and ternary sets will be presented, with a detailed explanation of their possible application within the Bistrica PSP project and their relative advantages/disadvantages in this particular case.

Keywords: hydraulic turbines, pumped storage, renewable energy, competing technologies

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Iqraq Kamal, Akmal Razif, Sivadas Chandra Sekaran, Ahmad Syazwan Hisaburi

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Painting plays a crucial role in the aerospace manufacturing industry, serving both protective and cosmetic purposes for components. However, the traditional manual painting method is time-consuming and labor-intensive, posing challenges for the sector in achieving higher efficiency. Additionally, the current automated robot path planning has been a bottleneck for spray painting processes, as typical manual teaching methods are time-consuming, error-prone, and skill-dependent. Therefore, it is essential to develop automated tool path planning methods to replace manual ones, reducing costs and improving product quality. Focusing on flat panel painting in aerospace manufacturing, this study aims to address issues related to unreliable part identification techniques caused by the high-mixture, low-volume nature of the industry. The proposed solution involves using a spray gun and a UR10 robotic arm with a vision system that utilizes one-shot object detection (OS2D) to identify parts accurately. Additionally, the research optimizes path planning by concentrating on the region of interest—specifically, the identified part, rather than uniformly covering the entire painting tray.

Keywords: aerospace manufacturing, one-shot object detection, automated spray painting, vision-based path optimization, deep learning, automation, robotic arm

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

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Authors: Lingfei Sun

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Based on the significant value of ecology, the strategic planning for ecological civilization construction was mentioned in the 17th and 18th National Congress of the Communist Party of China. How to generate economic value based on the environmental capacity is not only an economic decision but also a political decision to make. Boshan took the full use of “Ecology” and transformed it as an inexhaustible green resource to benefit people, reflecting the sustainable value of new agriculture development mode. The Strawberry Harvest Festival and Blueberry Harvest Festival hosted approximately 96,000 and 54,000 leisure tourists respectively in 2014. For the Kiwi Harvest Festival in August 2014, in average, it attracted about 4600 tourists per day, which generated daily kiwi sales of 50,000 lbs and 3 million RMB (About 476,000 USD) of daily revenue. The purpose of this study is to elaborate the modes of agritourism development, by analyzing the cases in rural area of Boshan, China. Interviews with the local government officers were applied to discover operation mode of agritourism operation. The financial data was used to demonstrate the strength of government policy and improvement of the income of rural people. The result indicated that there are mainly three types of modes: the Intensive Mode, the Model Mode and the Mixed Mode, supported by case study respectively. With the boom of tourism, the development of agritourism in Boshan relies on the agriculture encouraging policy of China and the effort of local government; meanwhile, large scale of cultivation and the product differentiation are the crucial elements for the success of rural agritourism projects.

Keywords: agriculture, agritourism, economy, rural area development

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Authors: Abdulrahman Algaeed

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The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

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Authors: Tamar Lazariashvili

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There are a number of factors that determine the growth and development of the country's economy; however, trade and economic relations with other countries are the most important of all these factors. The paper analyzes the trade and economic relations between Georgia and Germany, identifies the impediments caused by the Covid pandemic, and substantiates the need for further economic cooperation between the countries. Research objectives. The objective of the research is to develop recommendations and reveal the prospects of further cooperation between Georgia and Germany based on identifying the problems in the field of trade and economy in the post-crisis situation. The research object is Georgian German economic relations. Germany is Georgia's largest trading partner in the European Union. Georgia and Germany actively cooperate within the framework of international organizations as well. The paper analyzes the multilateral and intensive economic relations between Germany and Georgia; evaluates the investments of German companies in Georgia and the activities of Georgian companies in Germany. Research methods. The paper uses general and specific research methods; in particular, analysis, synthesis, induction, deduction, comparison, statistical (selection, grouping, observation, trend), and other research methods.SWOT analysis is used to determine development opportunities between countries. As a result of the research economic ranking of Georgia and Germany are determined according to the above criteria, the causes of the impediments due to the pandemic are studied; the main problems in the field of trade and economy are identified. The paper provides conclusions on the problems in the trade relations between Georgia and Germany and suggests recommendations regarding the prospects for improving these relations.

Keywords: georgia-germany, trade and economic relations, economic ranking, perspective directions

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Authors: Abuzar Baloach

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Spinal cord stimulators (SCS) are increasingly used for managing chronic pain, but their presence requires careful anesthetic planning. This review explores critical anesthetic considerations for patients with SCS, encompassing preoperative, intraoperative, and acute pain management, as well as specific considerations for obstetric and out-of-operating-room procedures. Preoperative Evaluation: Thorough assessment is essential, including a detailed medical history of the SCS device, such as type, manufacturer, and settings. Additionally, a complete pain history and a physical exam are necessary to understand the patient’s baseline neurological function and assess mobility, which can impact anesthesia management. Intraoperative Considerations: Electrocautery poses a risk for patients with SCS due to potential interference. Monopolar electrocautery is discouraged, but if needed, the grounding pad should be positioned away from the device, and the device itself should be turned off. The SCS device can introduce ECG artifacts and potentially interfere with pacemakers and defibrillators (ICD), which may result in inappropriate pacing or shocks. Precautions, including baseline ECG and interrogation, are recommended if both devices are present. Furthermore, lithotripsy, though generally avoided, can be performed under certain conditions with caution. Obstetric Anesthesia: While SCS devices are generally turned off during pregnancy, they have shown no interference with fetal cardiotocography, and epidural placement can be safely achieved with a sterile technique below the SCS leads. Acute Pain Considerations: SCS placement is taken into account in pain management plans, especially with neuraxial anesthesia, as potential risks include infection, limited spread due to fibrous sheaths, and damage to the SCS leads. Out-of-Operating Room Procedures: MRI, previously contraindicated, is now conditionally safe with SCS devices, depending on manufacturer specifications. CT scans are generally safe, though radiation should be minimized to prevent device malfunction. For radiation therapy, specific safety measures are recommended, such as keeping the beam at least 1 cm away from the device and limiting the dose to prevent damage. In conclusion, anesthetic management for SCS patients requires meticulous planning across all stages of care. By understanding the unique interactions and potential risks associated with SCS and other devices, healthcare providers can enhance patient safety and improve outcomes. Further research and the establishment of standardized guidelines are essential to optimize perioperative care for this growing patient population.

Keywords: anesthesia, chronic pain, spinal cord stimulator, SCS

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Authors: Tiffany Wicks

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Queer patients can face issues with self-advocating due to the factors of implicit provider bias, lack of tools and resources to self-advocate, and lack of comfortability in self-advocating based on prior experiences. In this study, five participants who identify as queer discussed their interactions with their healthcare providers. This exploratory study revealed that there is a need for healthcare provider education to reduce implicit bias and judgments about queer patients. There is also an important need for peer advocates in order to further inform healthcare promotion and decision-making before and during provider visits in an effort for a better outcome. Through this exploration, queer patients voiced their experiences and concerns to inform a need for change in healthcare collaboration between providers and patients in the queer community.

Keywords: queer, LGBT, patient, self-advocacy, healthcare

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Authors: Sharon Ganzer

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Older adults want choices about where they ‘age-in-place’ and express the desire to remain in their home for as long as possible because it maintains feelings of independence and autonomy, perpetuates a sense of identity, enable people to have space for their belongings and supports connections and social engagement. When circumstances change, and alternative living arrangements are required, more and more older adults are considering a transition to a retirement village – the liminal space between home and residential care. This qualitative study explores the lived experience of older adults who relocate to a retirement village in Queensland, Australia, and the role that material culture plays in this process.

Keywords: material culture, social gerontology, concepts of home, retirement villages

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Authors: N. J. M. Yusof, T. Sabir, J. McLoughlin

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Garment manufacturing industry involves sequential processes that are subjected to uncontrollable variations. The industry depends on the skill of labour in handling the varieties of fabrics and accessories, machines, and also a complicated sewing operation. Due to these reasons, garment manufacturers created systems to monitor and control the product’s quality regularly by conducting quality approaches to minimize variation. The aims of this research were to ascertain the quality approaches deployed by Malaysian garment manufacturers in three key areas-quality systems and tools; quality control and types of inspection; sampling procedures chosen for garment inspection. The focus of this research also aimed to distinguish quality approaches used by companies that supplied the finished garments to both domestic and international markets. The feedback from each of company’s representatives was obtained using the online survey, which comprised of five sections and 44 questions on the organizational profile and quality approaches used in the garment industry. The results revealed that almost all companies had established their own mechanism of process control by conducting a series of quality inspection for daily production either it was formally been set up or vice versa. Quality inspection was the predominant quality control activity in the garment manufacturing and the level of complexity of these activities was substantially dictated by the customers. AQL-based sampling was utilized by companies dealing with the export market, whilst almost all the companies that only concentrated on the domestic market were comfortable using their own sampling procedures for garment inspection. This research provides an insight into the implementation of quality approaches that were perceived as important and useful in the garment manufacturing sector, which is truly labour-intensive.

Keywords: garment manufacturing, quality approaches, quality control, inspection, Acceptance Quality Limit (AQL), sampling

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Authors: Gauranga Das

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People in cities have prosperity but there is immense pollution, chaos in the mind, anxiety and turbulence. People in the villages experience pristine pure environment but they also experience poverty. There is a need to find out ways by which the cities and the villages can complement each other through their strengths and take care of each other’s weaknesses. In order to do this, the case study of Govardhan Ecovillage has been explored in this paper. All its environment, social and economic initiatives along with eco-tourism and wellness features are being analyzed. The analysis shows that Govardhan Ecovillage is successfully able to harmonize its different initiatives and provide a package which has created a win-win solution for the city people and also the villagers. Such kind of Eco-tourism initiatives should be supported and replicated in other places in the world to benefit everyone.

Keywords: sustainability, ecotourism, ecology, rural development, wellness, biodiversity

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Authors: Marina Kapsali, John S. Anagnostopoulos

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Greek islands’ interconnection (IC) with larger power systems, such as the mainland grid, is a crucial issue that has attracted a lot of interest; however, the recent economic recession that the country undergoes together with the highly capital intensive nature of this kind of projects have stalled or sifted the development of many of those on a more long-term basis. On the other hand, most of Greek islands are still heavily dependent on the lengthy and costly supply chain of oil imports whilst the majority of them exhibit excellent potential for wind energy (WE) applications. In this respect, the main purpose of the present work is to investigate −through a parametric study which varies both in wind farm (WF) and submarine IC capacities− the impact of large-scale WE development on the IC of the third in size island of Greece (Lesbos) with the mainland system. The energy and economic performance of the system is simulated over a 25-year evaluation period assuming two possible scenarios, i.e. S(a): without the contribution of the local Thermal Power Plant (TPP) and S(b): the TPP is maintained to ensure electrification of the island. The economic feasibility of the two options is investigated in terms of determining their Levelized Cost of Energy (LCOE) including also a sensitivity analysis on the worst/reference/best Cases. According to the results, Lesbos island IC presents considerable economic interest for covering part of island’s future electrification needs with WE having a vital role in this challenging venture.

Keywords: electricity generation cost, levelized cost of energy, mainland grid, wind energy rejection

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Authors: Jacintha Menezes, Ramalingam Dharmalingam, Palaiahnakote Shivakumara

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In the recent years, Omani acid lime cultivation and production has been affected by Citrus greening or Huanglongbing (HLB) disease. HLB disease is one of the most destructive diseases for citrus, with no remedies or countermeasures to stop the disease. Currently used Polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) HLB detection tests require lengthy and labor-intensive laboratory procedures. Furthermore, the equipment and staff needed to carry out the laboratory procedures are frequently specialized hence making them a less optimal solution for the detection of the disease. The current research uses hyperspectral imaging technology for automatic detection of citrus trees with HLB disease. Omani citrus tree leaf images were captured through portable Specim IQ hyperspectral camera. The research considered healthy, nutrition deficient, and HLB infected leaf samples based on the Polymerase chain reaction (PCR) test. The highresolution image samples were sliced to into sub cubes. The sub cubes were further processed to obtain RGB images with spatial features. Similarly, RGB spectral slices were obtained through a moving window on the wavelength. The resized spectral-Spatial RGB images were given to Convolution Neural Networks for deep features extraction. The current research was able to classify a given sample to the appropriate class with 92.86% accuracy indicating the effectiveness of the proposed techniques. The significant bands with a difference in three types of leaves are found to be 560nm, 678nm, 726 nm and 750nm.

Keywords: huanglongbing (HLB), hyperspectral imaging (HSI), · omani citrus, CNN

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Authors: Hung-Jen Lin, Chien-Hao Wang, Chien-Peng Huang, Yu-Sheng Tseng, En-Cheng Yang, Joe-Air Jiang

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Bees’ incoming and outgoing behavior is a decisive index which can indicate the health condition of a colony. Traditional methods for monitoring the behavior of honey bees (Apis mellifera) take too much time and are highly labor-intensive, and the lack of automation and synchronization disables researchers and beekeepers from obtaining real-time information of beehives. To solve these problems, this study proposes to use an Internet of Things (IoT)-based system for counting honey bees’ incoming and outgoing activities using an infrared interruption technique, while environmental factors are recorded simultaneously. The accuracy of the established system is verified by comparing the counting results with the outcomes of manual counting. Moreover, this highly -accurate device is appropriate for providing quantitative information regarding honey bees’ incoming and outgoing behavior. Different statistical analysis methods, including one-way ANOVA and two-way ANOVA, are used to investigate the influence of environmental factors, such as temperature, humidity, illumination and ambient pressure, on bees’ incoming and outgoing behavior. With the real-time data, a standard model is established using the outcomes from analyzing the relationship between environmental factors and bees’ incoming and outgoing behavior. In the future, smart control systems, such as a temperature control system, can also be combined with the proposed system to create an appropriate colony environment. It is expected that the proposed system will make a considerable contribution to the apiculture and researchers.

Keywords: ANOVA, environmental factors, honey bee, incoming and outgoing behavior

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Authors: Rafeza Begum, Mohammad Mokhlesur Rahman, Safikul Moula, Rafiqul Islam

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Potassium (K) is crucial for healthy soil and plant growth. However, K fertilization is either disregarded or poorly underutilized in Bangladesh agriculture, despite the great demand for crops. This could eventually result in a significant depletion of the soil's potassium reserves, irreversible alteration of the minerals that contain potassium, and detrimental effects on crop productivity. Soil K mining in Bangladesh is a worrying problem, and we need to evaluate it thoroughly and find remedies. A pot culture experiment was conducted in the greenhouse of Bangladesh Institute of Nuclear Agriculture (BINA) using eleven soil series of Bangladesh in order to see the depletion behaviour of potassium (K) by continuous cropping using rice (var. Iratom-24) as the test crop. The soil series were Ranishankhail, Kaonia. Sonatala, Silmondi, Gopalpur, Ishurdi, Sara, Kongsha, Nunni, Lauta and Amnura on which four successive rice plants (45 days duration) were raised with (100 ppm K) or without addition of potassium. Nitrogen, phosphorus, sulfur and zinc were applied as basal to all pots. Potassium application resulted in higher dry matter yield, increased K concentration and uptake in all the soils compared with no K treatment; which gradually decreased in the subsequent harvests. Furthermore, plant takes up K not only from exchangeable pool but also from non-exchangeable sites and a minimum replenishment of K from the soil reserve was observed. Continuous cropping has resulted in the depletion of available K of the soil. The result indicated that in order to sustain higher crop yield under intensive cultivation, the addition of potash fertilizer is necessary.

Keywords: potassium, exchangeable pool, depletion behavior., Soil series

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Authors: Ayat N. El-Shazly, Dina Magdy Abdo, Hamdy Maamoun Abdel-Ghafar, Xiangju Song, Heqing Jiang

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Product water recovery and draw solution (DS) reuse is the most energy-intensive stage in forwarding osmosis (FO) technology. Sucrose solution is the most suitable DS for FO application in food and beverages. However, sucrose DS recovery by conventional pressure-driven or thermal-driven concentration techniques consumes high energy. Herein, we developed a spontaneous and sustainable solar-driven evaporation process based on a photothermal membrane for the concentration and recovery of sucrose solution. The photothermal membrane is composed of multi-walled carbon nanotubes (f-MWCNTs)photothermal layer on a hydrophilic polyvinylidene fluoride (PVDF) substrate. The f-MWCNTs photothermal layer with a rough surface and interconnected network structures not only improves the light-harvesting and light-to-heat conversion performance but also facilitates the transport of water molecules. The hydrophilic PVDF substrate can promote the rapid transport of water for adequate water supply to the photothermal layer. As a result, the optimized f-MWCNTs/PVDF photothermal membrane exhibits an excellent light absorption of 95%, and a high surface temperature of 74 °C at 1 kW m−2 . Besides, it realizes an evaporation rate of 1.17 kg m−2 h−1 for 5% (w/v) of sucrose solution, which is about 5 times higher than that of the natural evaporation. The designed photothermal evaporation process is capable of concentrating sucrose solution efficiently from 5% to 75% (w/v), which has great potential in FO process and juice concentration.

Keywords: solar, pothothermal, membrane, MWCNT

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Authors: N. Hedayat, E. Karamifar

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Sustainable food and fiber production is emerging as an irresistible option in agrarian planning. Although one should not underestimate the successes of the Green Revolution in enhancing crop production, its adverse environmental and ecosystem consequences have also been remarkable. The aim of this paper is to identify ways of improving crop production to ensure agricultural sustainability and environmental integrity. Systematic observations are used for data collection on intensive farming, deforestation and the environmental implications of industrial pollutants on agricultural sustainability at national and international levels. These were achieved within a comparative analytical model of data interpretation. Results show that while multiple factors enhance yield, they have a simultaneous effect in undermining the ecosystem and environmental integrity. Results show that application of excessive agrichemical have been one of the major cause of polluting the surface and underground water bodies as well as soil layers in affected croplands. Results consider rapid deforestation in the tropical regions has been the underlying cause of impairing the integrity of biodiversity and oxygen-generation regime. These, coupled with production of greenhouse gasses, have contributed to global warming and hydrological irregularities. Continuous production of pollutants and effluents has affected marine and land biodiversity arising from acid rains generated by modern farming and deforestation. Continuous production of greenhouse gases has also been instrumental in affecting climatic behavior manifested in recurring draughts and contraction of lakes and ponds as well as emergence of potential flooding of waterways and floodplains in the future.

Keywords: agricultural sustainability, environmental integrity, pollution, eco-system

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Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

Abstract:

Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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Authors: Wardoyo, Humairoh

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In global competition nowadays, the world economy heavily depends upon high technology and capital intensive industries that are mainly owned by well-established economic and developed countries, such as United States of America, United Kingdom, Japan, and South Korea. Indonesia as a developing country is building its economic activities towards industrial country as well, although a slightly different approach was implemented. For example, similar to the concept of one village one product (OVOP) implemented in Japan, Indonesia also adopted this concept by promoting local traditional products to improve incomes of village people and to enhance local economic activities. Analysis on how OVOP program increase local people’s income and influence customer satisfaction were the objective of this paper. Behavioral intention to purchase and re-purchase, customer satisfaction and promotion are key factors for local products to play significant roles in improving local income and economy of the region. The concepts of OVOP and key factors that influence economic activities of local people and the region will be described and explained in the paper. Results of research, in a case study based on 300 respondents, customers of a local restaurant at Tangerang City, Banten Province of Indonesia, indicated that local product, service quality and behavioral intention individually have significant influence to customer satisfaction; whereas simultaneous tests to the variables indicated positive and significant influence to the behavioral intention through customer satisfaction as the intervening variable.

Keywords: behavioral intention, customer satisfaction, local products, one village one product (OVOP)

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