Search results for: process safety management

Authors: Everard van Kemenade

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Many quality improvement activities are planned. Leaders are strongly involved in missions, visions and strategic planning. They use, consciously or unconsciously, the PDCA-cycle, also know as the Deming cycle. After the planning, the plans are carried out and the results or effects are measured. If the results show that the goals in the plan have not been achieved, adjustments are made in the next plan or in the execution of the processes. Then, the cycle is run through again. Traditionally, the PDCA-cycle is advocated as a means to an end. However, PDCA is especially fit for planned, ordered, certain contexts. It fits with the empirical and referential quality paradigm. For uncertain, unordered, unplanned processes, something else might be needed instead of Plan-Do-Check-Act. Due to the complexity of our society, the influence of the context, and the uncertainty in our world nowadays, not every activity can be planned anymore. At the same time organisations need to be more innovative than ever. That provides leaders with ‘wicked tendencies’. However, that raises the question how one can innovate without being able to plan? Complexity science studies the interactions of a diverse group of agents that bring about change in times of uncertainty, e.g. when radical innovation is co-created. This process is called emergence. This research study explores the role of leadership in the emergence paradigm. Aim of the article is to study the way that leadership can support the emergence of innovation in a complex context. First, clarity is given on the concepts used in the research question: complexity, emergence, innovation and leadership. Thereafter a literature search is conducted to answer the research question. The topics ‘emergent leadership’ or ‘complexity leadership’ are chosen for an exploratory search in Google and Google Scholar using the berry picking method. Exclusion criterion is emergence in other disciplines than organizational development or in the meaning of ‘arising’. The literature search conducted gave 45 hits. Twenty-seven articles were excluded after reading the title and abstract because they did not research the topic of emergent leadership and complexity. After reading the remaining articles as a whole one more was excluded because the article used emergent in the limited meaning of ‗arising‘ and eight more were excluded because the topic did not match the research question of this article. That brings the total of the search to 17 articles. The useful conclusions from the articles are merged and grouped together under overarching topics, using thematic analysis. The findings are that 5 topics prevail when looking at possibilities for leadership to facilitate innovation: enabling, sharing values, dreaming, interacting, context sensitivity and adaptivity. Together they form In Dutch the acronym Medusa.

Keywords: complexity science, emergence, leadership in the emergence paradigm, innovation, the Medusa principles

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Authors: Priya Kulkarni, Soumya Koppikar, Narendrakumar Wagh, Dhanshri Ingle, Onkar Lande, Abhay Harsulkar

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Cartilage is an extracellular matrix composed of aggrecan, which imparts it with a great tensile strength, stiffness and resilience. Disruption in cartilage metabolism leading to progressive degeneration is a characteristic feature of Osteoarthritis (OA). The process involves enzymatic depolymerisation of cartilage specific proteoglycan, releasing free glycosaminoglycan (GAG). This released GAG in synovial fluid (SF) of knee joint serves as a direct measure of cartilage loss, however, limited due to its invasive nature. Western Ontario and McMaster Universities Arthritis Index (WOMAC) is widely used for assessing pain, stiffness and physical-functions in OA patients. The scale is comprised of three subscales namely, pain, stiffness and physical-function, intends to measure patient’s perspective of disease severity as well as efficacy of prescribed treatment. Twenty SF samples obtained from OA patients were analysed for their GAG values in SF using DMMB based assay. LK 1.0 vernacular version was used to attain WOMAC scale. The results were evaluated using SAS University software (Edition 1.0) for statistical significance. All OA patients revealed higher GAG values compared to the control value of 78.4±30.1µg/ml (obtained from our non-OA patients). Average WOMAC calculated was 51.3 while pain, stiffness and function estimated were 9.7, 3.9 and 37.7, respectively. Interestingly, a strong statistical correlation was established between WOMAC function subscale and GAG (p = 0.0102). This subscale is based on day-to-day activities like stair-use, bending, walking, getting in/out of car, rising from bed. However, pain and stiffness subscale did not show correlation with any of the studied markers and endorsed the atypical inflammation in OA pathology. On one side, where knee pain showed poor correlation with GAG, it is often noted that radiography is insensitive to cartilage degenerative changes; thus OA remains undiagnosed for long. Moreover, active cartilage degradation phase remains elusive to both, patient and clinician. Through analysis of large number of OA patients we have established a close association of Kellgren-Lawrence grades and increased cartilage loss. A direct attempt to correlate WOMAC and radiographic progression of OA with various biomarkers has not been attempted so far. We found a good correlation in GAG levels in SF and the function subscale.

Keywords: cartilage, Glycosaminoglycan, synovial fluid, western ontario and McMaster Universities Arthritis Index

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Authors: Anggun Yuliana Putri, Melisa Rahmadini

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The Ministry of National Development Planning in Indonesia has reported that more than eight million Indonesian children are still malnourished. Based on national statistics, and a recent ranking from NGO Save the Children, Indonesia is one of 15 countries making the fastest gains in cutting child malnutrition among 165 developing countries. According to a United Nations Children’s Fund, at least 7.6 million Indonesian children under the age of 5 or one out of every three suffer from stunted growth, a primary manifestation of malnutrition in early childhood, the report ranked Indonesia as having the fifth largest number of children under 5 suffering from stunted growth worldwide. Addressing the problem of malnutrition in Indonesia, Aksi Cepat Tanggap (ACT) Foundation, a humanitarian organization working with Carrefour, acts as donor and pursues several solutions to the problem, especially of malnourished children and infants in South Tangerang area, Indonesia. The objective of this study was to examine the community empowerment driven by ACT Foundation in order to maintain the good status continuity of child and toddler after the children malnutrition recovered. Research was conducted using qualitative approach through in-depth interview and observation to find out how the Bengkel Gizi Terpadu (Integrated Nutrion Workshop) programs make people empowered. Bengkel Gizi Terpadu (BGT) is divided into 3 sequences of activities, there were: integrated malnutrition rehabilitation; provision of health education to mothers of infants and young children; and family economic empowerment to head of household. Results showed that after empowerment process has been done through training and provision of knowledge to the mothers and families about the important of nutrition and health, there were 30 of 100 mothers who participated actively. Then, there were 45 of 100 heads of household who participated in business training were able to open a business on their own which provided and controlled by ACT as stakeholder in this program. The further findings revealed that BGT programs are able to form community health workers and provide employment opportunities to community. This study believes that integrated nutrition workshop program is the solution to maintain good nutrition among children in South Tangerang, through empowerment of parents and community members, via education and business training program. Both programs prepared parents with economic sustenance and necessary information, a pre-requisite to end malnutrition in children.

Keywords: community, empowerment, malnutrition, training

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Authors: Jawaher Bakheet Almudarra

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The Saudi Arabian educational system shared the philosophical principles, in its foundation, which concentrated on the achievement of goals, thereby taking up authoritative styles of leadership. However, organisations are beginning to be more liberal in today’s environment than in the 1940s and 1950s, and appealing to emotional intelligence as a tool and skill are needed for effective leadership. In the Saudi Arabian case, such developments are characterised by changes such as that of the educational supervisor having the role redefined to that of a director. This review tracks several parts: the first section helps western reader to understand the subtleties, complexities, and intricacies of the Saudi Arabia education system and its approach to leadership system of education, history, culture and political contribution. This can lead to the larger extent understand if emotional intelligence is a provocation for better leadership of Saudi Arabian education sector or not. The second part is the growth of educational supervision in Saudi Arabia, focusing on the education system, and evaluates the impact of emotional intelligence as a necessary skill in leadership. The third section looks at emotions and emotional intelligence, gender roles, and contributions by emotional intelligence in the education system. The education system of Saudi Arabia has undergone significant transformation. To fully understand the current climate of Saudi Arabia, it is essential to review this process of transformation in terms of the historical, cultural, political and social positions and transformations. Over the years, the education system in Saudi Arabia has undergone significant metamorphosis. The Saudi government has instituted a wide range of reforms in an attempt to improve education standards and outcomes, facilitate improvements and ensure that high standards of education standards are upheld to keep pace with the global environment and knowledge economy. Leadership itself has become an increasingly prominent aspect of educational reform worldwide. Emotional intelligence is often considered a significant aspect of leadership, but it is in its early stages in Saudi Arabia. Its recognition and adoption may improve leadership practices, particularly among educational supervisors and contribute to national and international understandings of leadership in Saudi Arabia. Studying leadership in the Saudi Arabian context is imperative as the new generation of leaders need to cultivate pertinent skills that will allow them to become fundamentally and positively involved in the regions’ decision making processes in order to impact the progression of the Saudi Arabian education system. Understanding leadership in the education context will allow for suitable inculcation of leadership skills. These skills include goal-setting, sound decision-making as well as problem-solving within the education system of Saudi Arabia.

Keywords: educational supervision, educational administration, emotional intelligence, educational leadership

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Authors: W. Mohammedsaeed, A. J. Mcbain, S. M. Cruickshank, C. A. O’Neill

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Many studies have demonstrated the importance of probiotics and their potential therapeutic effects within the gut. Recently, the possible therapeutic effects of probiotics in other tissues have also begun to be investigated. Comparatively few studies have evaluated the use of topical probiotics in relation to the skin. In this study, we have conducted preliminary investigations into whether a well-known probiotic, Lactobacillus rhamnosus GG (LGG), can increase the rate of re-epithelialization in a model wound. Full-thickness skin was obtained from individuals undergoing elective cosmetic surgery. This skin was wounded using excisional punch and cultured using a serum-free medium, either in the presence or absence of L. rhamnosus GG lysate. Histological staining of the sections was performed with Haematoxylin& Eosin E to quantify “epithelial tongue length”. This is the length of the new epithelial ‘tongue’ that grows and covers the exposed dermis at the inner wound edges. The length of the new epithelial ‘tongue’ was compared in untreated section and section treated with and L. rhamnosus GG made using108CFU/ml bacterial cells. L. rhamnosus GG lysate enhanced significantly the re-epithelialisation of treated wounds compared with that of untreated wounds (P=0.005, n=3). Tongue length, at day 1 was 7.55μm 0.15, at day 3 it was 18.5μm 0.25 and at day 7 was 22.9μm 0.35. These results can be compared with untreated cultures in which tongue length was 3.25μm 0.35, day 3 was 9.65μm 0.25 and day 7 was 13.5μm 0.15 post-wounding. In ex-vivo proliferation and migration cells were measured by determining the expression of nuclear proliferation marker Ki-67 and the expression of Phosphorylated cortactin respectively demonstrated that L. rhamnosus GG significantly increased NHEK proliferation and migration rates relative to controls. However, the dominant mechanism was migration because in ex-vivo skin treated with the L. rhamnosus GG up-regulated the gene expression of the chemokine receptor and ligands CXCR2 and CXCL2 comparing with controls (P=0.02, P=0.03 respectively, n=3). High levels of CXCL2/CXCL2 have already been implicated in multiple aspects of stimulation of wound healing through activation of keratinocyte migration. These data demonstrate that lysates from Lactobacillus rhamnosus GG increase re-epithelialization by stimulation of keratinocyte migration. The current study identifies the partial mechanism that contribute to stimulating the wound-healing process ex vivo in response to L. rhamnosus GG lysate is an increase in the production of CXCL2/ CXCR2 in ex vivo models. The use of probiotic lysates potentially offers new options to develop treatments that could improve wound healing.

Keywords: Lactobacillus rhamnosus GG, wounds, migration, lysate

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Authors: Murray Anderson, Galina Freed, Karli Jahn

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Trauma is increasingly recognized as an important construct that has health implications for those who struggle with various mental health issues. For those individuals who meet the criteria for a diagnosis of hoarding disorder (HD), many have experienced some form of trauma. Further, some of the therapeutic interventions for those with HD can further perpetuate or magnify the experience of trauma. Therefore, the aim of this scoping review is to identify and document the nature and extent of research evidence related to trauma as it connects with HD. This review was guided by the questions, ‘How can our understanding of the trauma cycle help us to better appreciate the experiences of individuals who hoard, and how will a trauma informed lens inform the interventions for hoarding disorder? A comprehensive literature search was performed to identify original studies that contained the words “hoarding” and “trauma.” PsychINFO”,''EBSCO host,” “CINAHL” and “PubMed” were searched between January 2005 and April 2021. Articles were screened by three reviewers. Data extracted included publication date, demographics, study design, type of analysis, and noted connections between hoarding and trauma. Of the 329 articles, all duplicates, articles on hoardings of animals, articles not in English, and those without full-text availability were removed. Five categories were found in the remaining 45 articles, including (a) traumatic and stressful life events; (b) the link between posttraumatic stress disorder, trauma, and hoarding; (c) the relationships between different comorbidities, trauma, and hoarding; (d) the lack of early emotional expression and other forms of parental deprivation; and (e) the role of attachment. Lastly, the literature explains how the links between hoarding and trauma are difficult to study due to the highly stigmatized identities with this population. The review provided strong support for the connections between the experience of trauma and HD. What is missing from the literature is the use of a trauma-informed lens to better account for the ways in which hoarding disorder is understood. Other missing pieces in the literature are the potential uses of a trauma-informed lens to enhance the therapeutic process, to understand and reduce treatment attrition, and to improve treatment outcomes. The application of a trauma informed lens could improve our understanding of effective interactions among clients, families, and communities and improve the education around hoarding-related matters. Exploring the connections between trauma and HD can improve therapeutic delivery and destigmatize the experience of dealing with clutter and hoarding concerns. This awareness can also provide health care professionals with both the language and skills to liberate them from a reductionist view on HD.

Keywords: hoarding, attachment, parental deprivation, trauma

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Authors: Janani Selvaraj, M. Prashanthi Devi, P. B. Harathi

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Epidemiologic studies conducted over several decades have provided evidence to suggest that long-term exposure to elevated ambient levels of particulate air pollution is associated with increased mortality. Air quality risk management is significant in developing countries and it highlights the need to understand the role of ecologic covariates in the association between air pollution and mortality. Several new methods show promise in exploring the geographical distribution of disease and the identification of high risk areas using epidemiological maps. However, the addition of the temporal attribute would further give us an in depth idea of the disease burden with respect to forecasting measures. In recent years, new methods developed in the reanalysis were useful for exploring the spatial structure of the data and the impact of spatial autocorrelation on estimates of risk associated with exposure to air pollution. Based on this, our present study aims to explore the spatial and temporal distribution of the lung cancer cases in the Coimbatore district of Tamil Nadu in relation to air pollution risk areas. A spatio temporal moving average method was computed using the CrimeStat software and visualized in ArcGIS 10.1 to document the spatio temporal movement of the disease in the study region. The random walk analysis performed showed the progress of the peak cancer incidences in the intersection regions of the Coimbatore North and South taluks that include major commercial and residential regions like Gandhipuram, Peelamedu, Ganapathy, etc. Our study shows evidence that daily exposure to high air pollutant concentration zones may lead to the risk of lung cancer. The observations from the present study will be useful in delineating high risk zones of environmental exposure that contribute to the increase of cancer among daily commuters. Through our study we suggest that spatially resolved exposure models in relevant time frames will produce higher risks zones rather than solely on statistical theory about the impact of measurement error and the empirical findings.

Keywords: air pollution, cancer, spatio-temporal analysis, India

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Authors: Jihane Saad, Thomas Lendormi, Caroline Le Marechal, Anne-marie Pourcher, Céline Druilhe, Jean-louis Lanoiselle

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Agricultural anaerobic digestion consists in the conversion of animal slurry and manure into biogas and digestate. They need, however, to be treated at 70 ºC during 60 min before anaerobic digestion according to the European regulation (EC n°1069/2009 & EU n°142/2011). The impact of such heat treatment on the outcome of bacteria has been poorly studied up to now. Moreover, a recent study¹ has shown that enterococci and clostridia are still detected despite the application of such thermal treatment, questioning the relevance of this approach for the hygienisation of digestate. The aim of this study is to establish the heat inactivation kinetics of two species of enterococci (Enterococcus faecalis and Enterococcus faecium) and two species of clostridia (Clostridioides difficile and Clostridium novyi as a non-toxic model for Clostridium botulinum of group III). A pure culture of each strain was prepared in a specific sterile medium at concentration of 10⁴ – 10⁷ MPN / mL (Most Probable number), depending on the bacterial species. Bacterial suspensions were then filled in sterilized capillary tubes and placed in a water or oil bath at desired temperature for a specific period of time. Each bacterial suspension was enumerated using a MPN approach, and tests were repeated three times for each temperature/time couple. The inactivation kinetics of the four indicator bacteria is described using the Weibull model and the classical Bigelow model of first-order kinetics. The Weibull model takes biological variation, with respect to thermal inactivation, into account and is basically a statistical model of distribution of inactivation times as the classical first-order approach is a special case of the Weibull model. The heat treatment at 70 ºC / 60 min contributes to a reduction greater than 5 log10 for E. faecium and E. faecalis. However, it results only in a reduction of about 0.7 log10 for C. difficile and an increase of 0.5 log10 for C. novyi. Application of treatments at higher temperatures is required to reach a reduction greater or equal to 3 log10 for C. novyi (such as 30 min / 100 ºC, 13 min / 105 ºC, 3 min / 110 ºC, and 1 min / 115 ºC), raising the question of the relevance of the application of heat treatment at 70 ºC / 60 min for these spore-forming bacteria. To conclude, the heat treatment (70 ºC / 60 min) defined by the European regulation is sufficient to inactivate non-sporulating bacteria. Higher temperatures (> 100 ºC) are required as far as spore-forming bacteria concerns to reach a 3 log10 reduction (sporicidal activity).

Keywords: heat treatment, enterococci, clostridia, inactivation kinetics

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Authors: Dany I. Doughan, Nizam S. Najd

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Different governments in today’s global pandemic are approaching the challenging and complex issue of mitigating the spread of the SARS-CoV-2 virus differently while simultaneously considering their national economic and operational bottom lines. One of the most notable successes has been Taiwan's multifaceted virus containment approach, which resulted in a substantially lower incidence rate compared to Sweden’s chief mitigation tactic of herd immunity. From a classic Swiss Cheese Model perspective, integrating more fail-safe layers of defense against the virus in Taiwan’s approach compared to Sweden’s meant that in Taiwan, the government did not have to resort to extreme measures like the national lockdown Sweden is currently contemplating. From an optimized virus spread mitigation solution development standpoint using the Solutions Principle, the Taiwanese and Swedish solutions were desirable economically by businesses that remained open and non-economically or socially by individuals who enjoyed fewer disruptions from what they considered normal before the pandemic. Out of the two, the Taiwanese approach was more feasible long-term from a workforce management and quality control perspective for healthcare facilities and their professionals who were able to provide better, longer, more attentive care to the fewer new positive COVID-19 cases. Furthermore, the Taiwanese approach was more applicable as an overall model to emulate thanks in part to its short-term and long-term multilayered approach, which allows for the kind of flexibility needed by other governments to fully or partially adapt or adopt said, model. The Swedish approach, on the other hand, ignored the biochemical nature of the virus and relied heavily on short-term personal behavioral adjustments and conduct modifications, which are not as reliable as establishing required societal norms and awareness programs. The available international data on COVID-19 cases and the published governmental approaches to control the spread of the coronavirus support a better fit into the Solutions Principle of Taiwan’s Swiss Cheese Model success story compared to Sweden’s.

Keywords: coronavirus containment and mitigation, solutions principle, Swiss Cheese Model, viral mutation

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Authors: B. Orser, A. Riding, Y. Li

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To inform government about how gender gaps in SME ( small and medium-sized enterprise) contracting might be redressed, the research question was: What are the key obstacles to, and response strategies for, increasing the engagement of women business owners among SME suppliers to the government of Canada? Thirty-five interviews with senior policymakers, supplier diversity organization executives, and expert witnesses to the Canadian House of Commons, Standing Committee on Government Operations and Estimates. Qualitative data were conducted and analysed using N’Vivo 11 software. High order response categories included: (a) SME risk mitigation strategies, (b) SME procurement program design, and (c) performance measures. Primary obstacles cited were government red tape and long and complicated requests for proposals (RFPs). The majority of 'common' complaints occur when SMEs have questions about the federal procurement process. Witness responses included use of outcome-based rather than prescriptive procurement practices, more agile procurement, simplified RFPs, making payment within 30 days a procurement priority. Risk mitigation strategies included provision of procurement officers to assess risks and opportunities for businesses and development of more agile procurement procedures and processes. Recommendations to enhance program design included: improved definitional consistency of qualifiers and selection criteria, better co-ordination across agencies; clarification about how SME suppliers benefit from federal contracting; goal setting; specification of categories that are most suitable for women-owned businesses; and, increasing primary contractor awareness about the importance of subcontract relationships. Recommendations also included third-party certification of eligible firms and the need to enhance SMEs’ financial literacy to reduce financial errors. Finally, there remains the need for clear and consistent pre-program statistics to establish baselines (by sector, issuing department) performance measures, targets based on percentage of contracts granted, value of contract, percentage of target employee (women, indigenous), and community benefits including hiring local employees. The study advances strategies to enhance federal procurement programs to facilitate socio-economic policy objectives.

Keywords: procurement, small business, policy, women

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Authors: M. J. Gibbons, A. J. Robinson

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Increasing expectations on small form factor electronics to be more compact while increasing performance has driven conventional cooling technologies to a thermal management threshold. An emerging solution to this problem is electrospray (ES) cooling. ES cooling enables two phase cooling by utilising Coulomb forces for energy efficient fluid atomization. Generated charged droplets are accelerated to the grounded target surface by the applied electric field and surrounding gravitational force. While in transit the like charged droplets enable plume dispersion and inhibit droplet coalescence. If the electric field is increased in the cone-jet regime, a subsequent increase in the plume spray angle has been shown. Droplet segregation in the spray plume has been observed, with primary droplets in the plume core and satellite droplets positioned on the periphery of the plume. This segregation is facilitated by inertial and electrostatic effects. This result has been corroborated by numerous authors. These satellite droplets are usually more densely charged and move at a lower relative velocity to that of the spray core due to the radial decay of the electric field. Previous experimental research by Gomez and Tang has shown that the number of droplets deposited on the periphery can be up to twice that of the spray core. This result has been substantiated by a numerical models derived by Wilhelm et al., Oh et al. and Yang et al. Yang et al. showed from their numerical model, that by varying the extractor potential the dispersion radius of the plume also varies proportionally. This research aims to investigate this dispersion density and the role it plays in the local heat transfer coefficient profile (h) of ES cooling. This will be carried out for different extractor – target separation heights (H2), working fluid flow rates (Q), and extractor applied potential (V2). The plume dispersion will be recorded by spraying a 25 µm thick, joule heated steel foil and by recording the thermal footprint of the ES plume using a Flir A-40 thermal imaging camera. The recorded results will then be analysed by in-house developed MATLAB code.

Keywords: electronic cooling, electrospray, electrospray plume dispersion, spray cooling

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Authors: Esther Cabezas-Rivas

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Ordinary differential equations (ODE) are a fundamental part of the curriculum for most engineering degrees, and students typically have difficulties in the subsequent abstract mathematical calculations. To enhance their motivation and profit that they are digital natives, we propose a teamwork project that includes the creation of a video. It should explain how to model mathematically a real-world problem transforming it into an ODE, which should then be solved using the tools learned in the lectures. This idea was indeed implemented with first-year students of a BSc in Engineering and Management during the period of online learning caused by the outbreak of COVID-19 in Spain. Each group of 4 students was assigned a different topic: model a hot water heater, search for the shortest path, design the quickest route for delivery, cooling a computer chip, the shape of the hanging cables of the Golden Gate, detecting land mines, rocket trajectories, etc. These topics should be worked out through two complementary channels: a written report describing the problem and a 10-15 min video on the subject. The report includes the following items: description of the problem to be modeled, detailed obtention of the ODE that models the problem, its complete solution, and interpretation in the context of the original problem. We report the outcomes of this teaching in context and active learning experience, including the feedback received by the students. They highlighted the encouragement of creativity and originality, which are skills that they do not typically relate to mathematics. Additionally, the video format (unlike a common presentation) has the advantage of allowing them to critically review and self-assess the recording, repeating some parts until the result is satisfactory. As a side effect, they felt more confident about their oral abilities. In short, students agreed that they had fun preparing the video. They recognized that it was tricky to combine deep mathematical contents with entertainment since, without the latter, it is impossible to engage people to view the video till the end. Despite this difficulty, after the activity, they claimed to understand better the material, and they enjoyed showing the videos to family and friends during and after the project.

Keywords: active learning, contextual teaching, models in differential equations, student-produced videos

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Authors: Woldegerima G. Medhin, Tadele Araya

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Background: Rabies is acute viral encephalitis affecting mainly carnivores and insectivorous but can affect any mammal. Case fatality rate is 100% once clinical signs appear. Rabies has a worldwide distribution in continental regions of Asia and Africa. Globally, rabies is responsible for more than 61000 human deaths annually. An estimation of human mortality rabies in Asia and Africa annually exceed 35172 and 21476 respectively. Ethiopia approximately 2900 people were estimated to die of rabies annually, Tigary region approximately 98 people were estimated to die annually. The aim of this study is to analyze trends, describe, and evaluate the ten years rabies data in Tigray, Ethiopia. Methods: We conducted descriptive epidemiological study from 15-30 February, 2023 of rabies exposure and death in humans by reviewing the health management information system report from Tigray Regional Health Bureau and vaccination coverage of dog population from 2013 to 2022. We used case definition, suspected cases are those bitten by the dogs displaying clinical signs consistent with rabies and confirmed cases were deaths from rabies at time of the exposure. Results: A total 21031 dog bites and 375 deaths report of rabies and 18222 post exposure treatments for humans in Tigray region were used. A suspected rabies patients had shown an increasing trend from 2013 to 2015 and 2018 to 2019. Overall mortality rate was 19/1000 in Tigray. Majority of suspected patients (45%) were age <15 years old. An estimated by Agriculture Bureau of Tigray Region about 12000 owned and 2500 stray dogs are available in the region, but yearly dog vaccination remains low (50%). Conclusion: Rabies is a public health problem in Tigray region. It is highly recommended to vaccinate individually owned dogs and concerned sectors should eliminate stray dogs. Surveillance system should strengthen for estimating the real magnitude, launch preventive and control measures.

Keywords: rabies, Virus, transmision, prevalence

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Authors: Bruno Cossu, Elio Carlo

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The invention (patent pending) relates to the field of devices aimed to harness wave energy (WEC) especially for artificial upwelling, forced downwelling, production of compressed air. In its basic form, the pump consists of a hydro-pneumatic machine, driven by wave energy, characterised by the fact that it has no moving mechanical parts, and is made up of only two structural components: an hollow body, which is open at the bottom to the sea and partially immersed in sea water, and a tube, both joined together to form a single body. The shape of the hollow body is like a mushroom whose cap and stem are hollow; the stem is open at both ends and the lower part of its surface is crossed by holes; the tube is external and coaxial to the stem and is joined to it so as to form a single body. This shape of the hollow body and the type of connection to the tube allows the pump to operate simultaneously as an air compressor (OWC) on the cap side, and as an airlift on the stem side. The pump can be implemented in four versions, each of which provides different variants and methods of implementation: 1) firstly, for the artificial upwelling of cold, deep ocean water; 2) secondly, for the lifting and transfer of these waters to the place of use (above all, fish farming plants), even if kilometres away; 3) thirdly, for the forced downwelling of surface sea water; 4) fourthly, for the forced downwelling of surface water, its oxygenation, and the simultaneous production of compressed air. The transfer of the deep water or the downwelling of the raised surface water (as for pump versions indicated in points 2 and 3 above), is obtained by making the water raised by the airlift flow into the upper inlet of another pipe, internal or adjoined to the airlift; the downwelling of raised surface water, oxygenation, and the simultaneous production of compressed air (as for the pump version indicated in point 4), is obtained by installing a venturi tube on the upper end of the pipe, whose restricted section is connected to the external atmosphere, so that it also operates like a hydraulic air compressor (trompe). Furthermore, by combining one or more pumps for the upwelling of cold, deep water, with one or more pumps for the downwelling of the warm surface water, the system can be used in an Ocean Thermal Energy Conversion plant to supply the cold and the warm water required for the operation of the same, thus allowing to use, without increased costs, in addition to the mechanical energy of the waves, for the purposes indicated in points 1 to 4, the thermal one of the marine water treated in the process.

Keywords: air lifted upwelling, fish farming plant, hydraulic air compressor, wave energy converter

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Authors: Rawia M. Khalil, Ghada Abd-Elbary, Mona Basha, Ghada E. A. Awad, Hadeer A. Elhashemy

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Background: Bacterial infections of the eye are the clinical conditions responsible for ocular morbidity and blindness. Conjunctivitis is an inflammation of the conjunctiva, due to Staphylococcus aureus. Lomefloxacin HCl (LXN) is a third generation flouroquinolone antibiotic with a broad spectrum against wide range of bacteria and very effective against Staph infections especially in conjunctiva (conjunctivitis). The present study aims to develop and evaluate novel ocular proniosomal gels of Lomefloxacin Hcl (LXN); in order to improve its ocular bioavailability for the management of bacterial conjunctivitis. Materials and methods: Proniosomes were prepared by coacervation phase separation method using different types of nonionic surfactants (Span 60,40,20,Tween 20,40,60,80,Brij 35,98,72) solely and as mixtures with Span® 60. The formed gels were characterized for entrapment efficiency, vesicle size and in vitro drug release. The optimum proniosomal gel; P-LXN 7 were characterized for pH measurement, transmission electron microscopy (TEM) and differential scanning calorimetry (DSC) as well as Stability study and microbiological evaluation .The results revealed that only Span 60 was able to form stable LXN proniosomal gel when used individually while the other nonionic surfactants formed gels only in combination with Span 60 at different ratios. The optimum proniosomal gel; P-LXN 7 (Span60:Tween60, 9:1) appeared as spherical shaped vesicles having high entrapment efficiency (>80 %), appropriate vesicle size (187 nm) as well as controlled drug release over 12h. DSC confirmed the amorphous nature and the uniformity of LXN inclusion within the vesicles. Physical stability study did not show any significant changes in appearance or entrapment efficiency or vesicle size after storage for 3 months at 4°C. Ocular irritancy test revealed that P-LXN 7 was safe, well tolerable and suitable for ocular delivery. In vivo antibacterial activity of P-LXN 7 evaluated using the susceptibility test and topical therapy of induced ocular conjunctivitis confirmed the enhanced antibacterial therapeutic efficacy of the LXN-proniosomal gel compared to the commercially available LXN eye drops; Orchacin®. Conclusions: Our results suggest that proniosomal gels could provide a promising carrier of LXN for efficient ocular treatment of bacterial conjunctivitis.

Keywords: bacterial conjunctivitis, lomefloxacin HCl, ocular drug delivery, proniosomes

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Authors: Yuanyuan Liu, Yuanqing Wang, Di Li

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Carbon dioxide (CO2) emissions mitigation from road construction activities is one of the potential pathways to deal with climate change due to its higher use of materials, machinery energy consumption, and high quantity of vehicle and equipment fuels for transportation and on-site construction activities. Aiming to assess the environmental impact of the road infrastructure construction activities and to identify hotspots of emissions sources, this study developed a life-cycle CO2 emissions assessment framework covering three stages of material production, to-site and on-site transportation under the guidance of the principle of LCA ISO14040. Then streamlined inventory analysis on sub-processes of each stage was conducted based on the budget files from cases of highway projects in China. The calculation results were normalized into functional unit represented as ton per km per lane. Then a comparison between the amount of emissions from each stage, and sub-process was made to identify the major contributor in the whole highway lifecycle. In addition, the calculating results were used to be compared with results in other countries for understanding the level of CO2 emissions associated with Chinese road infrastructure in the world. The results showed that materials production stage produces the most of the CO2 emissions (for more than 80%), and the production of cement and steel accounts for large quantities of carbon emissions. Life cycle CO2 emissions of fuel and electric energy associated with to-site and on-site transportation vehicle and equipment are a minor component of total life cycle CO2 emissions from highway project construction activities. Bridges and tunnels are dominant large carbon contributor compared to the road segments. The life cycle CO2 emissions of road segment in highway project in China are slightly higher than the estimation results of highways in European countries and USA, about 1500 ton per km per lane. In particularly, the life cycle CO2 emissions of road pavement in majority cities all over the world are about 500 ton per km per lane. However, there is obvious difference between the cities when the estimation on life cycle CO2 emissions of highway projects included bridge and tunnel. The findings of the study could offer decision makers a more comprehensive reference to understand the contribution of road infrastructure to climate change, especially understand the contribution from road infrastructure construction activities in China. In addition, the identified hotspots of emissions sources provide the insights of how to reduce road carbon emissions for development of sustainable transportation.

Keywords: carbon dioxide emissions, construction activities, highway, life cycle assessment

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Authors: Remy Kulagowski, Tobias Sturm, Audrey Leopold, Aurelie Metay, Josephine Peigne, Alexis Thoumazeau, Alain Brauman, Bruno Fogliani, Florent Tivet

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A major challenge for agriculture is to enhance productivity while limiting the impact on the environment. Conservation agriculture (CA) is one strategy whereby both sustainability and productivity can be achieved by preserving and improving the soil quality. Soils provide and regulate a large number of ecosystem services (ES) such as agricultural productivity and climate change adaptation and mitigation. The aim of this study is to assess the impacts of contrasted CA crop management on soil functions for maize (Zea mays L.) cultivation in an eight years field experiment (2010-2018). The study included two CA practices: direct seeding in dead mulch (DM) and living mulch (LM), and conventional plough-based tillage (CT) practices on a fluvisol in New Caledonia (French Archipelago in the South Pacific). In 2018, soil quality of the cropping systems were evaluated with the Biofunctool® set of indicators, that consists in twelve integrative, in-field, and low-tech indicators assessing the biological, physical and chemical properties of soils. Main soil functions were evaluated including (i) carbon transformation, (ii) structure maintenance, and (iii) nutrient cycling in the ten first soil centimeters. The results showed significant higher score for soil structure maintenance (e.g., aggregate stability, water infiltration) and carbon transformation function (e.g., soil respiration, labile carbon) under CA in DM and LM when compared with CT. Score of carbon transformation index was higher in DM compared with LM. However, no significant effect of cropping systems was observed on nutrient cycling (i.e., nitrogen and phosphorus). In conclusion, the aggregated synthetic scores of soil multi-functions evaluated with Biofunctool® demonstrate that CA cropping systems lead to a better soil functioning. Further analysis of the results with agronomic performance of the soil-crop systems would allow to better understand the links between soil functioning and production ES of CA.

Keywords: conservation agriculture, cropping systems, ecosystem services, soil functions

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Authors: Fiona Wahr, Sitalakshmi Venkatraman

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Industry employers require new graduates to bring with them a range of knowledge, skills and abilities which mean these new employees can immediately make valuable work contributions. These will be a combination of discipline and professional knowledge, skills and abilities which give graduates the technical capabilities to solve practical problems whilst interacting with a range of stakeholders. Underpinning the development of these disciplines and professional knowledge, skills and abilities, are “enabling” knowledge, skills and abilities which assist students to engage in learning. These are academic and learning skills which are essential to common starting points for both the learning process of students entering the course as well as forming the foundation for the fully developed graduate knowledge, skills and abilities. This paper reports on a project created to introduce and strengthen these enabling skills into the first semester of a Bachelor of Information Technology degree in an Australian polytechnic. The project uses an action research approach in the context of ongoing continuous improvement for the course to enhance the overall learning experience, learning sequencing, graduate outcomes, and most importantly, in the first semester, student engagement and retention. The focus of this is implementing the new curriculum in first semester subjects of the course with the aim of developing the “enabling” learning skills, such as literacy, research and numeracy based knowledge, skills and abilities (KSAs). The approach used for the introduction and embedding of these KSAs, (as both enablers of learning and to underpin graduate attribute development), is presented. Building on previous publications which reported different aspects of this longitudinal study, this paper recaps on the rationale for the curriculum redevelopment and then presents the quantitative findings of entering students’ reading literacy and numeracy knowledge and skills degree as well as their perceived research ability. The paper presents the methodology and findings for this stage of the research. Overall, the cohort exhibits mixed KSA levels in these areas, with a relatively low aggregated score. In addition, the paper describes the considerations for adjusting the design and delivery of the new subjects with a targeted learning experience, in response to the feedback gained through continuous monitoring. Such a strategy is aimed at accommodating the changing learning needs of the students and serves to support them towards achieving the enabling learning goals starting from day one of their higher education studies.

Keywords: enabling skills, student retention, embedded learning support, continuous improvement

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Authors: El Hatka Hicham, Hafidi Youssef, Saghiri Khalid, Ittobane Najim

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Flexible polyurethane foam (FPUF) is a low-density cellular material generally used as a cushioning material in many applications such as furniture, bedding, packaging, etc. It is commercially produced during a continuous process, where a reactive mixture of foam chemicals is poured onto a moving conveyor. FPUFs are produced by the catalytic balancing of two reactions involved, the blowing reaction (isocyanate-water) and the gelation reaction (isocyanate-polyol). The microstructure of FPUF is generally composed of soft phases (polyol phases) and rigid domains that separate into two domains of different sizes: the rigid polyurea microdomains and the macrodomains (larger aggregates). The morphological features of FPUF are strongly influenced by the phase separation morphology that plays a key role in determining the global FPUF properties. This phase-separated morphology results from a thermodynamic incompatibility between soft segments derived from aliphatic polyether and hard segments derived from the commonly used aromatic isocyanate. In order to improve the properties of FPUF against the different stresses faced by this material during its use, we report in this work a study of the phase separation phenomenon in FPUF that has been examined using SAXS WAXS and FTIR. Indeed, we have studied with these techniques the effect of water, isocyanates, and alkaline chlorides on the phase separation behavior. SAXS was used to study the morphology of the microphase separated, WAXS to examine the nature of the hard segment packing, and FTIR to investigate the hydrogen bonding characteristics of the materials studied. The prepared foams were shown to have different levels of urea phase connectivity; the increase in water content in the FPUF formulation leads to an increase in the amount of urea formed and consequently the increase of the size of urea aggregates formed. Alkali chlorides (NaCl, KCl, and LiCl) incorporated into FPUF formulations show that is the ability to prevent hydrogen bond formation and subsequently alter the rigid domains. FPUFs prepared by different isocyanate structures showed that urea aggregates are difficult to be formed in foams prepared by asymmetric diisocyanate, while are more easily formed in foams prepared by symmetric and aliphatic diisocyanate.

Keywords: flexible polyurethane foam, hard segments, phase separation, soft segments

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Authors: K. Mondal, S. Talapatra, M. Terrones, S. Pokhrel, C. Frizzel, B. Sumpter, V. Meunier, A. L. Elias

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Worldwide energy independence is reliant on the ability to leverage locally available resources for fuel production. Recently, syngas produced through gasification of carbonaceous materials provided a gateway to a host of processes for the production of various chemicals including transportation fuels. The basis of the production of gasoline and diesel-like fuels is the Fischer Tropsch Synthesis (FTS) process: A catalyzed chemical reaction that converts a mixture of carbon monoxide (CO) and hydrogen (H₂) into long chain hydrocarbons. Until now, it has been argued that only transition metal catalysts (usually Co or Fe) are active toward the CO hydrogenation and subsequent chain growth in the presence of hydrogen. In this paper, we demonstrate that carbon nanotube (CNT) surfaces are also capable of hydro-deoxygenating CO and producing long chain hydrocarbons similar to that obtained through the FTS but with orders of magnitude higher conversion efficiencies than the present state-of-the-art FTS catalysts. We have used advanced experimental tools such as XPS and microscopy techniques to characterize CNTs and identify C-O functional groups as the active sites for the enhanced catalytic activity. Furthermore, we have conducted quantum Density Functional Theory (DFT) calculations to confirm that C-O groups (inherent on CNT surfaces) could indeed be catalytically active towards reduction of CO with H₂, and capable of sustaining chain growth. The DFT calculations have shown that the kinetically and thermodynamically feasible route for CO insertion and hydro-deoxygenation are different from that on transition metal catalysts. Experiments on a continuous flow tubular reactor with various nearly metal-free CNTs have been carried out and the products have been analyzed. CNTs functionalized by various methods were evaluated under different conditions. Reactor tests revealed that the hydrogen pre-treatment reduced the activity of the catalysts to negligible levels. Without the pretreatment, the activity for CO conversion as found to be 7 µmol CO/g CNT/s. The O-functionalized samples showed very activities greater than 85 µmol CO/g CNT/s with nearly 100% conversion. Analyses show that CO hydro-deoxygenation occurred at the C-O/O-H functional groups. It was found that while the products were similar to FT products, differences in selectivities were observed which, in turn, was a result of a different catalytic mechanism. These findings now open a new paradigm for CNT-based hydrogenation catalysts and constitute a defining point for obtaining clean, earth abundant, alternative fuels through the use of efficient and renewable catalyst.

Keywords: CNT, CO Hydrodeoxygenation, DFT, liquid fuels, XPS, XTL

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Authors: Justin Fu, Thomas Mazzuchi, Shahram Sarkani

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A key factor in technological immaturity in defense weapons acquisition is lack of understanding critical integrations at the subsystem and component level. To address this shortfall, recent research in integration readiness level (IRL) combines with technology readiness level (TRL) to form a system readiness level (SRL). SRL can be enriched with more robust quantitative methods to provide the program manager a useful tool prior to committing to major weapons acquisition programs. This research harnesses previous mathematical models based on graph theory, Petri nets, and tropical algebra and proposes a modification of the desirable SRL mathematical properties such that a tightly integrated (multitude of interfaces) subsystem can display a lower SRL than an inherently less coupled subsystem. The synthesis of these methods informs an improved decision tool for the program manager to commit to expensive technology development. This research ties the separately developed manufacturing readiness level (MRL) into the network representation of the system and addresses shortfalls in previous frameworks, including the lack of integration weighting and the over-importance of a single extremely immature component. Tropical algebra (based on the minimum of a set of TRLs or IRLs) allows one low IRL or TRL value to diminish the SRL of the entire system, which may not be reflective of actuality if that component is not critical or tightly coupled. Integration connections can be weighted according to importance and readiness levels are modified to be a cardinal scale (based on an analytic hierarchy process). Integration arcs’ importance are dependent on the connected nodes and the additional integrations arcs connected to those nodes. Lack of integration is not represented by zero, but by a perfect integration maturity value. Naturally, the importance (or weight) of such an arc would be zero. To further explore the impact of grouping subsystems, a multi-objective genetic algorithm is then used to find various clusters or communities that can be optimized for the most representative subsystem SRL. This novel calculation is then benchmarked through simulation and using past defense acquisition program data, focusing on the newly introduced Middle Tier of Acquisition (rapidly field prototypes). The model remains a relatively simple, accessible tool, but at higher fidelity and validated with past data for the program manager to decide major defense acquisition program milestones.

Keywords: readiness, maturity, system, integration

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Authors: A. P. Attanayake, K. A. P. W. Jayatilaka, L. K. B. Mudduwa, C. Pathirana

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Triggering of β-cell regeneration is a recognized therapeutic strategy for the treatment of type 1 diabetes mellitus. One such approach to foster restoration and regeneration of β-cells is from exogenous natural extracts. The aim of the present study was to investigate and compare the β-cell regenerative potentials of the extracts of Spondias pinnata (Linn. f.) Kurz, Coccinia grandis (L.) Voigt and Gmelina arborea Roxb. in alloxan induced diabetic rats. Wistar rats were divided in to six groups (n=6); healthy untreated rats, alloxan induced diabetic untreated rats (150 mg/kg, ip), diabetic rats receiving the extracts of S. pinnata (1.0 g/kg), C. grandis (0.75 g/kg), G. arobrea (1.00 g/kg) and diabetic rats receiving glibenclamide (0.5 mg/kg) for 30 days. The assessment of selected biochemical parameters, histopathology and immunohistochemistry in the pancreatic tissue were done on the 30th day. The reduction in the percentage of HbA1C was in the decreasing order of C. grandis (35%), G. arborea (31%) and S. pinnata (29%) in alloxan induced diabetic rats (p< 0.05). The concentration of serum fructosamine, insulin and C-peptide were decreased significantly in a decreasing order of C. grandis (30%, 72%, 51%), G. arborea (25%, 44%, 44%) and S. pinnata (27%, 34%, 24%) in alloxan induced diabetic rats (p < 0.05). The extent of β-cell regeneration was in the decreasing order of C. grandis, G. arborea, S. pinnata reflected through the increased percentage of insulin secreting β-cells in alloxan induced diabetic rats. The extract of C. grandis produced the highest degree of β-cell regeneration demonstrated through an increase in the number of islets and percentage of the insulin secreting β-cells (75%) in the pancreas of diabetic rats (p < 0.05). Further the C. grandis extract produced a significant increase in mean profile diameter in small (118%), average (10%), and large (13%) islets as compared with diabetic control rats respectively. However, statistically significant increase in the islet profile diameter was shown only in average (2%) and large (5%) islets in the G. arborea extract treated rats and large islets (5%) in S. pinnata extract treated diabetic rats (p < 0.05). The β-cell regeneration potency was in the decreasing order of C. grandis (0.75 g/kg), G. arborea (1.00 g/kg) and S. pinnata (1.00 g/kg) in alloxan induced diabetic rats. The three plant extracts may be useful as natural agents of triggering the β-cell regeneration in the management of type 1 diabetes mellitus.

Keywords: alloxan-induced diabetic rats, β-cell regeneration, histopathology, immunohistochemistry

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Authors: Rinku Dhanker, Suman Chaudhary, Tanvi Bhatia, Sneh Goyal

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Municipal Solid Waste (MSW), being a rich source of organic materials, can be used for agricultural applications as an important source of nutrients for soil and plants. This is also an alternative beneficial management practice for MSW generated in developing countries. In the present study, MSW treated soil samples from last four to six years at farmer’s field in Rohtak and Gurgaon states (Haryana, India) were collected. The samples were analyzed for all-important agricultural parameters and compared with the control untreated soil samples. The treated soil at farmer’s field showed increase in total N by 48 to 68%, P by 45.7 to 51.3%, and K by 60 to 67% compared to untreated soil samples. Application of sewage sludge at different sites led to increase in microbial biomass C by 60 to 68% compared to untreated soil. There was significant increase in total Cu, Cr, Ni, Fe, Pb, and Zn in all sewage sludge amended soil samples; however, concentration of all the metals were still below the current permitted (EU) limits. To study the adverse effect of heavy metals accumulation on various soil microbial activities, the sewage sludge samples (from wastewater treatment plant at Gurgaon) were artificially contaminated with heavy metal concentration above the EU limits. They were then applied to soil samples with different rates (0.5 to 4.0%) and incubated for 90 days under laboratory conditions. The samples were drawn at different intervals and analyzed for various parameters like pH, EC, total N, P, K, microbial biomass C, carbon mineralization, and diethylenetriaminepentaacetic acid (DTPA) exactable heavy metals. The results were compared to the uncontaminated sewage sludge. The increasing level of sewage sludge from 0.5 to 4% led to build of organic C and total N, P and K content at the early stages of incubation. But, organic C was decreased after 90 days because of decomposition of organic matter. Biomass production was significantly increased in both contaminated and uncontaminated sewage soil samples, but also led to slight increases in metal accumulation and their bioavailability in soil. The maximum metal concentrations were found in treatment with 4% of contaminated sewage sludge amendment.

Keywords: heavy metal, municipal sewage sludge, sustainable agriculture, soil fertility and quality

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Authors: E. Menga, S. Hernandez

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Finite Element Models (FEMs) are widely used in order to study and predict the dynamic properties of structures and usually, the prediction can be obtained with much more accuracy in the case of a single component than in the case of assemblies. Especially for structural dynamics studies, in the low and middle frequency range, most complex FEMs can be seen as assemblies made by linear components joined together at interfaces. From a modelling and computational point of view, these types of joints can be seen as localized sources of stiffness and damping and can be modelled as lumped spring/damper elements, most of time, characterized by nonlinear constitutive laws. On the other side, most of FE programs are able to run nonlinear analysis in time-domain. They treat the whole structure as nonlinear, even if there is one nonlinear degree of freedom (DOF) out of thousands of linear ones, making the analysis unnecessarily expensive from a computational point of view. In this work, a methodology in order to obtain the nonlinear frequency response of structures, whose nonlinearities can be considered as localized sources, is presented. The work extends the well-known Structural Dynamic Modification Method (SDMM) to a nonlinear set of modifications, and allows getting the Nonlinear Frequency Response Functions (NLFRFs), through an ‘updating’ process of the Linear Frequency Response Functions (LFRFs). A brief summary of the analytical concepts is given, starting from the linear formulation and understanding what the implications of the nonlinear one, are. The response of the system is formulated in both: time and frequency domain. First the Modal Database is extracted and the linear response is calculated. Secondly the nonlinear response is obtained thru the NL SDMM, by updating the underlying linear behavior of the system. The methodology, implemented in MATLAB, has been successfully applied to estimate the nonlinear frequency response of two systems. The first one is a two DOFs spring-mass-damper system, and the second example takes into account a full aircraft FE Model. In spite of the different levels of complexity, both examples show the reliability and effectiveness of the method. The results highlight a feasible and robust procedure, which allows a quick estimation of the effect of localized nonlinearities on the dynamic behavior. The method is particularly powerful when most of the FE Model can be considered as acting linearly and the nonlinear behavior is restricted to few degrees of freedom. The procedure is very attractive from a computational point of view because the FEM needs to be run just once, which allows faster nonlinear sensitivity analysis and easier implementation of optimization procedures for the calibration of nonlinear models.

Keywords: frequency response, nonlinear dynamics, structural dynamic modification, softening effect, rubber

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Authors: Ibrahim M Hassan, Lorna Que, Michael Rutland

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Type I SOD is usually diagnosed by anatomical imaging such as ultrasound, CT and MRCP. However, the types II and III SOD yield negative results despite the presence of significant symptoms. In particular, the type III is difficult to diagnose due to the absence of significant biochemical or anatomical abnormalities. Nuclear Medicine can aid in this diagnostic dilemma by demonstrating functional changes in the bile flow. Low dose Morphine (0.04mg/Kg) stimulates the tone of the sphincter of Oddi (SO) and its usefulness has been shown in diagnosing SOD by causing a delay in bile flow when compared to a non morphine provoked - baseline scan. This work expands on that process by using sublingual GTN at 60 minutes post tracer and morphine injection to relax the SO and induce an improvement in bile outflow, and in some cases show immediate relief of morphine induced abdominal pain. The criteria for positive SOD are as follows: if during the first hour of the morphine provocation showed (1) delayed intrahepatic biliary ducts tracer accumulation; plus (2) delayed appearance but persistent retention of activity in the common bile duct, and (3) delayed bile flow into the duodenum. In addition, patients who required GTN within the first hour to relieve abdominal pain were regarded as highly supportive of the diagnosis. Retrospective analysis of 85 patients (pts) (78F and 6M) referred for suspected SOD (type III) who had been intensively investigated because of recurrent right upper quadrant or abdominal pain post cholecystectomy. 99mTc-HIDA scan with morphine-provocation is performed followed by GTN at 60 minutes post tracer injection and a further thirty minutes of dynamic imaging are acquired. 30 pts were negative. 55 pts were regarded as positive for SOD and 38/55 (60%) of these patients with an abnormal result were further evaluated with a baseline 99mTc-HIDA. As expected, all 38 pts showed better bile flow characteristics than during the morphine provocation. 20/55 (36%) patients were treated by ERCP sphincterotomy and the rest were managed conservatively by medical therapy. In all cases regarded as positive for SOD, the sublingual GTN at 60 minutes showed immediate improvement in bile flow. 11/55(20%) who developed severe post-morphine abdominal pain were relieved by GTN almost instantaneously. We propose that GTN is a useful agent in the diagnosis of SOD when performing 99mTc-HIDA scan and that the satisfactory response to the sublingual GTN could offer additional information in patients who have severe pain at the time the procedure or when presenting to the emergency unit because of biliary pain. And also in determining whether a trial of medical therapy may be used before considering surgery.

Keywords: GTN, HIDA, MORPHINE, SOD

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Authors: Hsing Yuan Liu

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Background: Considerable theoretical and empirical work has identified a relationship between collaboration interactions and creativity in an organizational context. The mechanisms underlying this link, however, are not well understood in healthcare education. Objectives: The aims of this study were to explore the impact of collaboration interactions on team creativity and its underlying mechanism and to verify a moderated mediation model. Design, setting, and participants: This study utilized a cross-sectional, quantitative, descriptive design. The survey data were collected from 177 nursing students who enrolled in 18-week capstone courses of small interdisciplinary groups collaborating to design healthcare products in Taiwan during 2018 and 2019. Methods: Questionnaires assessed the nursing students' perceptions about their teams' swift trust (of cognition- and affect-based), conflicts (of task, process, and relationship), interaction behaviors (constructive controversy, helping behaviors, and spontaneous communication), and creativity. This study used descriptive statistics to compare demographics, swift trust scores, conflict scores, interaction behavior scores, and creativity scores for interdisciplinary teams. Data were analyzed using Pearson’s correlation coefficient and simple and hierarchical multiple regression models. Results: Pearson’s correlation analysis showed the cognition-based team swift trust was positively correlated with team creativity. The mediation model indicated constructive controversy fully mediated the effect of cognition-based team swift trust on student teams’ creativity. The moderated mediation model indicated that task conflict negatively moderates the mediating effect of the constructive controversy on the link between cognition-based team swift trust and team creativity. Conclusion: Our findings suggest nursing student teams’ interaction behaviors and task conflict are crucial mediating and moderated mediation variables on the relationship between collaboration interactions and team creativity, respectively. The empirical data confirms the validity of our proposed moderated mediation models of team creativity. Therefore, this study's validated moderated mediation model could provide guidance for nursing educators to improve collaboration interaction outcomes and creativity on nursing student teams.

Keywords: team swift trust, team conflict, team interaction behavior, moderated mediating effects, interdisciplinary education, nursing students

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Authors: Diogo Prosdocimi, Don Ross, Matthew Townshend

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Road authorities are mandated within limited budgets to both deliver improved access to basic services and facilitate economic growth. This responsibility is further complicated if maintenance backlogs and funding shortfalls exist, as evident in many countries including South Africa. These conditions require authorities to make difficult prioritisation decisions, with the effect that Road Asset Management Systems with a one-dimensional focus on traffic volumes may overlook the maintenance of low-volume roads that provide isolated communities with vital access to basic services. Given these challenges, this paper overlays the full South African road network with geo-referenced information for population, primary and secondary schools, and healthcare facilities to identify the network of connective roads between communities and basic service centres. This connective network is then rationalised according to the Gross Value Added and number of jobs per mesozone, administrative and functional road classifications, speed limit, and road length, location, and name to estimate the Basic Access Road Network. A two-step floating catchment area (2SFCA) method, capturing a weighted assessment of drive-time to service centres and the ratio of people within a catchment area to teachers and healthcare workers, is subsequently applied to generate a Multivariate Road Index. This Index is used to assign higher maintenance priority to roads within the Basic Access Road Network that provide more people with better access to services. The relatively limited incidence of Basic Access Roads indicates that authorities could maintain the entire estimated network without exhausting the available road budget before practical economic considerations get any purchase. Despite this fact, a final case study modelling exercise is performed for the Namakwa District Municipality to demonstrate the extent to which optimal relocation of schools and healthcare facilities could minimise the Basic Access Road Network and thereby release budget for investment in roads that best promote GDP growth.

Keywords: basic access roads, multivariate road index, road prioritisation, two-step floating catchment area method

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Authors: Andrea S. Badillo-Perez, Alexis D. Mitchell, Sara M. Levens

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Overeating, and obesity have been associated with addictive behavior, primarily due to behaviors like reward-based eating, the tendency to overeat due to factors such as lack of control, preoccupation over food, and lack of satiation. Temporal discounting (TD), the ability to select future rewards over short term gains, and mindfulness, the process of maintaining present moment awareness, have been suggested to have significant, differential impacts on health-related behaviors. An individual’s health locus of control, the degree to which they feel that they have control over their health is also known to have an impact on health outcomes. The goal of this study was to investigate the relationship between health locus of control and reward-based eating, as well as the relation between TD and mindfulness in a sample (N = 126) of overweight or obese participants from larger health-focused study. Through the use of questionnaires (including the Five Facet Mindfulness Questionnaire (FFMQ), Reward-Based Eating Drive (RED), and Multidimensional Health Locus of Control (MHLOC)), anthropometric measurements, and a computerized TD task, a series of regressions tested the association between subscales of these measures. Results revealed differences in how the mindfulness subscales are associated with TD measures. Specifically the ‘Observing’ (beta =-.203) and ‘Describing’ (beta =.26) subscales were associated with lower TD rates and a longer subjective devaluation time-frame respectively. In contrast, the ‘Acting with Awareness’ subscale was associated with a shorter subjective devaluation timeframe (beta =-.23). These findings suggest that the reflective perspective initiated through the observing and describing components of mindfulness may facilitate delay of gratification, whereas the acting with awareness component of mindfulness, which focuses on the present moment, may make delay of gratification more challenging. Results also indicated that a higher degree of reward-based eating was associated with a higher degree of an external health locus of control based on the power of chance (beta =.10). However, an external locus of control based on the power of others had no significant association with reward-based eating. This finding implies that the belief that health is due to chance is associated with greater reward-based eating behavior, suggesting that interventions that focus on locus of control may be helpful. Overall, findings demonstrate that weight loss interventions may benefit from health locus of control and mindfulness exercises, but caution should be taken as the components of mindfulness appear to have different effects on increasing or decreasing delay of gratification.

Keywords: health locus of control, mindfulness, obesity, reward-based eating, temporal discounting

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Authors: M. Nadeem, S. Nasir, K. A. Moazzam, R. Kashif

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The remarkable growth and evolution in information and communication technology (ICT) in the past few decades has transformed modern society in almost every aspect of life. The impact and application of ICT have been observed in almost all walks of life including science, arts, business, health, management, engineering, sports, and education. ICT in education is being used extensively for student learning, creativity, interaction, and knowledge sharing and as a valuable source of teaching instrument. Apart from the student’s perspective, it plays a vital role for teacher education, instructional methods and curriculum development. There is a significant difference in growth of ICT enabled education in developing countries compared to developed nations and according to research, this gap is widening. ICT gradually infiltrate in almost every aspect of life. It has a deep and profound impact on our social, economic, health, environment, development, work, learning, and education environments. ICT provides very effective and dominant tools for information and knowledge processing. It is firmly believed that the coming generation should be proficient and confident in the use of ICT to cope with the existing international standards. This is only possible if schools can provide basic ICT infrastructure to students and to develop an ICT-integrated curriculum which covers all aspects of learning and creativity in students. However, there is a digital divide and steps must be taken to reduce this digital divide considerably to have the profound impact of ICT in education all around the globe. This study is based on theoretical approach and an extensive literature review is being conducted to see the successful implementations of ICT integration in education and to identify technologies and models which have been used in education in developed countries. This paper deals with the modern applications of ICT in schools for both teachers and students to uplift the learning and creativity amongst the students. A brief history of technology in education is presented and discussed are some important ICT tools for both student and teacher’s perspective. Basic ICT-based infrastructure for academic institutions is presented. The overall conclusion leads to the positive impact of ICT in education by providing an interactive, collaborative and challenging environment to students and teachers for knowledge sharing, learning and critical thinking.

Keywords: information and communication technology, ICT, education, ICT infrastructure, learning

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Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey

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Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.

Keywords: biopsy, medical imaging, nephrology, radiology

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