Search results for: integrated audit quality model

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Dali Gaganidze, Ekaterine Abashidze

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Potato is one of the main agricultural crops in Georgia. Georgia produces early and late potato varieties in almost all regions. In traditional potato growing regions (Svaneti, Samckhet javaheti and Tsalka), the yield is higher than 30-35 t/ha. Among the plant pests that limit potato production and quality, the potato cyst nematodes (PCN) are harmful around the world. Yield losses caused by PCN are estimated up to 30%. Rout surveys conducted in two geographically distinct regions of Georgia producing potatoes - Samtskhe - Javakheti and Svaneti revealed potato cyst nematode Globodera rostochiensi. The aim of the study was the Phylogenetic analyses of Globodera rostochiensi revealed in Georgia by the amplification and sequencing of 28S gen in the D3 region and intergenic ITS1-15.8S-ITS2 region. Identification of all the samples from the two Globodera populations (Samtskhe - Javakheti and Svaneti), i.e., G. rostochiensis (20 isolates) were confirmed by conventional multiplex PCR with ITS 5 universal and PITSp4, PITSr3 specific primers of the cyst nematodes’ (G. pallida, G. rostochiensis). The size of PCR fragment 434 bp confirms that PCN samples from two populations, Samtskhe- Javakheti and Svaneti, belong to G. rostochiensi . The ITS1–5.8S-ITS2 regions were amplified using prime pairs: rDNA1 ( 5’ -TTGATTACGTCCCTGCCCTTT-3’ and rDNA2( 5’ TTTCACTCGCCGTTACTAAGG-3’), D3 expansion regions were amplified using primer pairs: D3A (5’ GACCCCTCTTGAAACACGGA-3’) and D3B (5’-TCGGAAGGAACCAGCTACTA-3’. PCR products of each region were cleaned up and sequenced using an ABI 3500xL Genetic Analyzer. Obtained sequencing results were analyzed by computer program BLASTN (https://blast.ncbi.nlm.nih.gov/Blast.cg). Phylogenetic analyses to resolve the relationships between the isolates were conducted in MEGA7 using both distance- and character-based methods. Based on analysis of G.rostochiensis isolate`s D3 expansion regions are grouped in three major clades (A, B and C) on the phylogenetic tree. Clade A is divided into three subclades; clade C is divided into two subclades. Isolates from the Samtckhet-javakheti population are in subclade 1 of clade A and isolates in subclade 1 of clade C. Isolates) from Svaneti populations are in subclade 2 of clade A and in clad B. In Clade C, subclade two is presented by three isolates from Svaneti and by one isolate (GL17) from Samckhet-Javakheti. . Based on analysis of G.rostochiensis isolate`s ITS1–5.8S-ITS2 regions are grouped in two main clades, the first contained 20 Georgian isolates of Globodera rostochiensis from Svaneti . The second clade contained 15 isolates of Globodera rostochiensis from Samckhet javakheti. Our investigation showed of high genetic variation of D3 and ITS1–5.8S-ITS2 region of rDNA of the isolates of G. rostochiensis from different geographic origins (Svameti, Samckhet-Javakheti) of Georgia. Acknowledgement: The research has been supported by the Shota Rustaveli National Scientific Foundation of Georgia : Project # FR17_235

Keywords: globodera rostochiensi, PCR, phylogenetic tree, sequencing

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Authors: Nashed Atef Nashed Farag

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Introduction: Reporting adverse events following vaccination remains a challenge. WHO has mandated pharmacovigilance centers around the world to submit Adverse Events Following Immunization (AEFI) reports from different countries to a large electronic database of adverse drug event data called Vigibase. Despite sufficient information about AEFIs on Vigibase, they are not available to the general public. However, the WHO has an alternative website called VigiAccess, an open-access website that serves as an archive for reported adverse reactions and AEFIs. The aim of the study was to establish a reporting model for a number of commonly used vaccines in the VigiAccess system. Methods: On February 5, 2018, VigiAccess comprehensively searched for ESSI reports on the measles vaccine, oral polio vaccine (OPV), yellow fever vaccine, pneumococcal vaccine, rotavirus vaccine, meningococcal vaccine, tetanus vaccine, and tuberculosis vaccine (BCG). These are reports from all pharmacovigilance centers around the world since they joined the WHO Drug Monitoring Program. Results: After an extensive search, VigiAccess found 9,062 AEFIs from the measles vaccine, 185,829 AEFIs from the OPV vaccine, 24,577 AEFIs from the yellow fever vaccine, 317,208 AEFIs from the pneumococcal vaccine, 73,513 AEFIs from the rotavirus vaccine, and 145,447 AEFIs from meningococcal cal vaccine, 22,781 EI FI vaccines against tetanus and 35,556 BCG vaccines against AEFI. Conclusion: The study found that among the eight vaccines examined, pneumococcal vaccines were associated with the highest number of AEFIs, while measles vaccines were associated with the fewest AEFIs.

Keywords: surgical approach, anatomical approach, decompression, axillary nerve, quadrangular space adverse events following immunization, cameroon, COVID-19 vaccines, nOPV, ODK vaccines, adverse reactions, VigiAccess, adverse event reporting

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Authors: Asma Shaheen, Javed Iqbal

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The water resources are depleting due to an intrusion of industrial pollution. There are clusters of industries including leather tanning, textiles, batteries, and chemical causing contamination. These industries use bulk quantity of water and discharge it with toxic effluents. The penetration of heavy metals through irrigation from industrial effluent has toxic effect on soil and groundwater. There was strong positive significant correlation between all the heavy metals in three media of industrial effluent, soil and groundwater (P < 0.001). The metal to the metal association was supported by dendrograms using cluster analysis. The geospatial variability was assessed by using geographically weighted regression (GWR) and pollution model to identify the simulation of carcinogenic elements in soil and groundwater. The principal component analysis identified the metals source, 48.8% variation in factor 1 have significant loading for sodium (Na), calcium (Ca), magnesium (Mg), iron (Fe), chromium (Cr), nickel (Ni), lead (Pb) and zinc (Zn) of tannery effluent-based process. In soil and groundwater, the metals have significant loading in factor 1 representing more than half of the total variation with 51.3 % and 53.6 % respectively which showed that pollutants in soil and water were driven by industrial effluent. The cumulative eigen values for the three media were also found to be greater than 1 representing significant clustering of related heavy metals. The results showed that heavy metals from industrial processes are seeping up toxic trace metals in the soil and groundwater. The poisonous pollutants from heavy metals turned the fresh resources of groundwater into unusable water. The availability of fresh water for irrigation and domestic use is being alarming.

Keywords: groundwater, geostatistical, heavy metals, industrial effluent

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Authors: Ali Mortazavi

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The main objective of this research project is to delve into a multitude of geomechanical risks associated with various mining methods employed within the underground mining industry. Controlling geotechnical design parameters and operational factors affecting the selection of suitable mining techniques for a given underground mining condition will be considered from a risk assessment point of view. Important geomechanical challenges will be investigated as appropriate and relevant to the commonly used underground mining methods. Given the complicated nature of rock mass in-situ and complicated boundary conditions and operational complexities associated with various underground mining methods, the selection of a safe and economic mining operation is of paramount significance. Rock failure at varying scales within the underground mining openings is always a threat to mining operations and causes human and capital losses worldwide. Geotechnical design is a major design component of all underground mines and basically dominates the safety of an underground mine. With regard to uncertainties that exist in rock characterization prior to mine development, there are always risks associated with inappropriate design as a function of mining conditions and the selected mining method. Uncertainty often results from the inherent variability of rock masse, which in turn is a function of both geological materials and rock mass in-situ conditions. The focus of this research is on developing a methodology which enables a geomechanical risk assessment of given underground mining conditions. The outcome of this research is a geotechnical risk analysis algorithm, which can be used as an aid in selecting the appropriate mining method as a function of mine design parameters (e.g., rock in-situ properties, design method, governing boundary conditions such as in-situ stress and groundwater, etc.).

Keywords: geomechanical risk assessment, rock mechanics, underground mining, rock engineering

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Authors: Franklin Nantui Mabe, Samuel A. Donkoh, Seidu Al-Hassan

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Rice yields among agro-ecological zones are heterogeneous. Farmers, researchers and policy makers are making frantic efforts to bridge rice yield gaps between agro-ecological zones through the promotion of improved agricultural technologies (IATs). Farmers are also modifying these IATs and blending them with indigenous farming practices (IFPs) to form farmer innovation systems (FISs). Also, different metafrontier models have been used in estimating productivity performances and their drivers. This study used the two-step stochastic metafrontier model to estimate the productivity performances of rice farmers and their determining factors in GSZ, FSTZ and CSZ. The study used both primary and secondary data. Farmers in CSZ are the most technically efficient. Technical inefficiencies of farmers are negatively influenced by age, sex, household size, education years, extension visits, contract farming, access to improved seeds, access to irrigation, high rainfall amount, less lodging of rice, and well-coordinated and synergized adoption of technologies. Albeit farmers in CSZ are doing well in terms of rice yield, they still have the highest potential of increasing rice yield since they had the lowest TGR. It is recommended that government through the ministry of food and agriculture, development partners and individual private companies promote the adoption of IATs as well as educate farmers on how to coordinate and synergize the adoption of the whole package. Contract farming concept and agricultural extension intensification should be vigorously pursued to the latter.

Keywords: efficiency, farmer innovation systems, improved agricultural technologies, two-step stochastic metafrontier approach

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Authors: Silindile Gumede, Amir Hossein Mohammadi, Mbuyu Germain Ntunka

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Goal 12 of the 17 Sustainable Development Goals (SDGs) encourages sustainable consumption and production patterns. This necessitates achieving the environmentally safe management of chemicals and all wastes throughout their life cycle and the proper disposal of pollutants and toxic waste. Fluid catalytic cracking (FCC) catalysts are widely used in the refinery to convert heavy feedstocks to lighter ones. During the refining processes, the catalysts are deactivated and discarded as hazardous toxic solid waste. Spent catalysts (SC) contain high-cost metal, and the recovery of metals from SCs is a tactical plan for supplying part of the demand for these substances and minimizing the environmental impacts. Leaching followed by solvent extraction, has been found to be the most efficient method to recover valuable metals with high purity from spent catalysts. However, the use of inorganic acids during the leaching process causes a secondary environmental issue. Therefore, it is necessary to explore other alternative efficient leaching agents that are economical and environmentally friendly. In this study, the waste catalyst was collected from a domestic refinery and was characterised using XRD, ICP, XRF, and SEM. Response surface methodology (RSM) and Box Behnken design were used to model and optimize the influence of some parameters affecting the acidic leaching process. The parameters selected in this investigation were the acid concentration, temperature, and leaching time. From the characterisation results, it was found that the spent catalyst consists of high concentrations of Vanadium (V) and Nickel (Ni); hence this study focuses on the leaching of Ni and V using a biodegradable acid to eliminate the formation of the secondary pollution.

Keywords: eco-friendly leaching, optimization, metal recovery, leaching

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Authors: David Ryan, Martin Breugst, Turlough Downes, Peter A. Byrne, Gerard P. McGlacken

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An ambident nucleophile is a nucleophile that possesses two or more distinct nucleophilic sites that are linked through resonance and are effectively “in competition” for reaction with an electrophile. Examples include enolates, pyridone anions, and nitrite anions, among many others. Reactions of ambident nucleophiles and electrophiles are extremely prevalent at all levels of organic synthesis. The principle of hard and soft acids and bases (the “HSAB principle”) is most commonly cited in the explanation of selectivities in such reactions. Although this rationale is pervasive in any discussion on ambident reactivity, the HSAB principle has received considerable criticism. As a result, the principle’s supplantation has become an area of active interest in recent years. This project focuses on developing a model for rationalizing ambident reactivity. Presented here is an approach that incorporates computational calculations and experimental kinetic data to construct Gibbs energy profile diagrams. The preferred site of alkylation of nitrite anion with a range of ‘hard’ and ‘soft’ alkylating agents was established by ¹H NMR spectroscopy. Pseudo-first-order rate constants were measured directly by ¹H NMR reaction monitoring, and the corresponding second-order constants and Gibbs energies of activation were derived. These, in combination with computationally derived standard Gibbs energies of reaction, were sufficient to construct Gibbs energy wells. By representing the ambident system as a series of overlapping Gibbs energy wells, a more intuitive picture of ambident reactivity emerges. Here, previously unexplained switches in reactivity in reactions involving closely related electrophiles are elucidated.

Keywords: ambident, Gibbs, nucleophile, rates

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Authors: Jing Chen, Jun-E Liu, Peng Yue

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Objective: The objective of this study was to develop a psychological adjustment and adaptation status scale for breast cancer survivors, and to examine the reliability and validity of the scale. Method: 37 breast cancer survivors were recruited in qualitative research; a five-subject theoretical framework and an item pool of 150 items of the scale were derived from the interview data. In order to evaluate and select items and reach a preliminary validity and reliability for the original scale, the suggestions of study group members, experts and breast cancer survivors were taken, and statistical methods were used step by step in a sample of 457 breast cancer survivors. Results: An original 24-item scale was developed. The five dimensions “domestic affections”, “interpersonal relationship”, “attitude of life”, “health awareness”, “self-control/self-efficacy” explained 58.053% of the total variance. The content validity was assessed by experts, the CVI was 0.92. The construct validity was examined in a sample of 264 breast cancer survivors. The fitting indexes of confirmatory factor analysis (CFA) showed good fitting of the five dimensions model. The criterion-related validity of the total scale with PTGI was satisfactory (r=0.564, p<0.001). The internal consistency reliability and test-retest reliability were tested. Cronbach’s alpha value (0.911) showed a good internal consistency reliability, and the intraclass correlation coefficient (ICC=0.925, p<0.001) showed a satisfactory test-retest reliability. Conclusions: The scale was brief and easy to understand, was suitable for breast cancer patients whose physical strength and energy were limited.

Keywords: breast cancer survivors, rehabilitation, psychological adaption and adjustment, development of scale

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Authors: Alae El Fahsi

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This study explores the ‘Tajawob’ app's role in urban development, demonstrating how mobile applications can empower citizens and facilitate urban planning. Tajawob serves as a digital platform for community feedback, engagement, and participatory governance, addressing urban challenges through innovative tech solutions. This research synthesizes data from a variety of sources, including user feedback, engagement metrics, and interviews with city officials, to assess the app’s impact on citizen participation in urban development in Morocco. By integrating advanced data analytics and user experience design, Tajawob has bridged the communication gap between citizens and government officials, fostering a more collaborative and transparent urban planning process. The findings reveal a significant increase in civic engagement, with users actively contributing to urban management decisions, thereby enhancing the responsiveness and inclusivity of urban governance. Challenges such as digital literacy, infrastructure limitations, and privacy concerns are also discussed, providing a comprehensive overview of the obstacles and opportunities presented by mobile app-based citizen engagement platforms. The study concludes with strategic recommendations for scaling the Tajawob model to other contexts, emphasizing the importance of adaptive technology solutions in meeting the evolving needs of urban populations. This research contributes to the burgeoning field of smart city innovations, offering key insights into the role of digital tools in facilitating more democratic and participatory urban environments.

Keywords: smart cities, digital governance, urban planning, strategic design

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Authors: K. N. Kiran, S. Anish

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It is well known that secondary flow loses account about one third of the total loss in any axial turbine. Modern gas turbine height is smaller and have longer chord length, which might lead to increase in secondary flow. In order to improve the efficiency of the turbine, it is important to understand the behavior of secondary flow and device mechanisms to curtail these losses. The objective of the present work is to understand the effect of a stream wise end-wall fence on the aerodynamics of a linear turbine cascade. The study is carried out computationally by using commercial software ANSYS CFX. The effect of end-wall on the flow field are calculated based on RANS simulation by using SST transition turbulence model. Durham cascade which is similar to high-pressure axial flow turbine for simulation is used. The aim of fencing in blade passage is to get the maximum benefit from flow deviation and destroying the passage vortex in terms of loss reduction. It is observed that, for the present analysis, fence in the blade passage helps reducing the strength of horseshoe vortex and is capable of restraining the flow along the blade passage. Fence in the blade passage helps in reducing the under turning by 7⁰ in comparison with base case. Fence on end-wall is effective in preventing the movement of pressure side leg of horseshoe vortex and helps in breaking the passage vortex. Computations are carried for different fence height whose curvature is different from the blade camber. The optimum fence geometry and location reduces the loss coefficient by 15.6% in comparison with base case.

Keywords: boundary layer fence, horseshoe vortex, linear cascade, passage vortex, secondary flow

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Authors: Doni Dermawan

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Modern sports competition as a consequence of the increase in the value of the business and entertainment in the field of sport has been demanding athletes to always have excellent physical endurance performance. Physical exercise is done in a long time, and intensive may pose a risk of muscle tissue damage caused by the increase of the enzyme creatine kinase. Branched Chain Amino Acids (BCAA) is an essential amino acid that is composed of leucine, isoleucine, and valine which serves to maintain muscle tissue, keeping the immune system, and prevent further loss of coordination and muscle pain. Pea (Pisum sativum L.) is a kind of leguminous plants that are rich in Branched Chain Amino Acids (BCAA) where every one gram of protein pea contains 82.7 mg of leucine; 56.3 mg isoleucine; and 56.0 mg of valine. This research aims to develop Branched Chain Amino Acids (BCAA) from pea extract is applied in dosage forms Gel PVP Kinesio Tape technology using Ultrasound-assisted Extraction. The method used in the writing of this paper is the Cochrane Collaboration Review that includes literature studies, testing the quality of the study, the characteristics of the data collection, analysis, interpretation of results, and clinical trials as well as recommendations for further research. Extraction of BCAA in pea done using ultrasound-assisted extraction technology with optimization variables includes the type of solvent extraction (NaOH 0.1%), temperature (20-250C), time (15-30 minutes) power (80 watt) and ultrasonic frequency (35 KHz). The advantages of this extraction method are the level of penetration of the solvent into the membrane of the cell is high and can increase the transfer period so that the BCAA substance separation process more efficient. BCAA extraction results are then applied to the polymer PVP (Polyvinylpyrrolidone) Gel powder composed of PVP K30 and K100 HPMC dissolved in 10 mL of water-methanol (1: 1) v / v. Preparations Kinesio Tape Gel PVP is the BCAA in the gel are absorbed into the muscle tissue, and joints through tensile force then provides stimulation to the muscle circulation with variable pressure so that the muscle can increase the biomechanical movement and prevent damage to the muscle enzyme creatine kinase. Analysis and evaluation of test preparation include interaction, thickness, weight uniformity, humidity, water vapor permeability, the levels of the active substance, content uniformity, percentage elongation, stability testing, release profile, permeation in vitro and in vivo skin irritation testing.

Keywords: branched chain amino acid, BCAA, Kinesio tape, pea, PVP gel, ultrasound-assisted extraction

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Authors: Bing-Fang Lee, Srinivasan Periasamy, Ming-Yie Liu

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Shift work sleep disorder is a common problem in industrialized world. It is a type of circadian rhythmic sleep disorders characterized by insomnia and sleep deprivation. Lack of sleep in workers may lead to poor health conditions such as hepatic dysfunction. Melatonin is a hormone secreted by the pineal gland to alleviate insomnia. Moreover, it is a powerful antioxidant and may prevent acute liver injury. Therefore, workers take in melatonin to deal with sleep-related health is an important issue. The aim of this study was to investigate the effect of melatonin on an acute hepatic injury model sinusoidal obstruction syndrome (SOS) in mice. Male C57BL/6 mice were injected with a single dose (500 mg/kg) of monocrotaline (MCT) to induce SOS. Melatonin (1, 3, 10 and 30 mg/kg) was injected 1 h before MCT treatment. After 24 h of MCT treatment, mice were sacrificed. The blood and liver were collected. Organ damage was evaluated by serum biochemistry, hematology analyzer, and histological examination. Low doses of melatonin (1 and 3 mg/kg) had no protective effect on SOS. However, high doses (10 and 30 mg/kg) exacerbated SOS. In addition, it not only increased serum glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and extended liver damage indicated by histological examination but also decreased platelet levels, lymphocyte ratio, and glutathione level; it had no effect on malondialdehyde and nitric oxide level in SOS mice. To conclude, melatonin may exacerbate MCT-induced SOS in mice. Furthermore, melatonin might have a synergistic action with SOS. Usage of melatonin for insomnia by people working in long shift must be cautioned; it might cause acute hepatic injury.

Keywords: acute liver injury, melatonin, shift work, sleep deprivation

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Authors: Sujan Tyata, Alison Shilpakar, Nayan Bakhadyo, Kushal K. C., Abhas Maskey

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The Koshi River, acknowledged as the "Sorrow of Bihar," poses intricate challenges characterized by recurrent flooding. Within the Koshi Basin, floods have historically inflicted damage on infrastructure, agriculture, and settlements. The Koshi River exhibits a highly braided pattern across a 48 km stretch to the south of Chatara. The devastating flood from the Koshi River, which began in Nepal's Sunsari District in 2008, led to significant casualties and the destruction of agricultural areas.The catastrophe was exacerbated by a levee breach, underscoring the vulnerability of the region's flood defenses. A comprehensive understanding of environmental changes in the area is unveiled through satellite imagery analysis. This analysis facilitates the identification of high-risk zones and their contributing factors. Employing remote sensing, the analysis specifically pinpoints locations vulnerable to levee breaches. Topographical features of the area along with longitudinal and cross sectional profiles of the river and levee obtained from digital elevation model are used in the hydrological analysis for assessment of flood. To mitigate the impact of floods, the strategy involves the establishment of reservoirs upstream. Leveraging satellite data, optimal locations for water storage are identified. This approach presents a dual opportunity to not only alleviate flood risks but also catalyze the implementation of pumped storage hydropower initiatives. This holistic approach addresses environmental challenges while championing sustainable energy solutions.

Keywords: flood mitigation, levee, remote sensing, satellite imagery analysis, sustainable energy solutions

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Authors: Jalil Salimi, Mandana Asadi, Naser Fathi

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Urmia Lake (UL) has undergone a significant decline in water levels, resulting in severe environmental, socioeconomic, and health-related challenges. This paper examines the restoration process of UL from a water governance perspective. By applying a water governance model, the study evaluates the process based on six selected principles: stakeholder engagement, transparency and accountability, effectiveness, equitable water use, adaptation capacity, and water usage efficiency. The dominance of structural and physicalist approaches to water governance has led to a weak understanding of social and environmental issues, contributing to social crises. Urgent efforts are required to address the water crisis and reform water governance in the country, making water-related issues a top national priority. The UL restoration process has achieved significant milestones, including stakeholder consensus, scientific and participatory planning, environmental vision, intergenerational justice considerations, improved institutional environment for NGOs, investments in water infrastructure, transparency promotion, environmental effectiveness, and local issue resolutions. However, challenges remain, such as power distribution imbalances, bureaucratic administration, weak conflict resolution mechanisms, financial constraints, accountability issues, limited attention to social concerns, overreliance on structural solutions, legislative shortcomings, program inflexibility, and uncertainty management weaknesses. Addressing these weaknesses and challenges is crucial for the successful restoration and sustainable governance of UL.

Keywords: evaluation, restoration process, Urmia Lake, water governance, water resource management

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Authors: Mohamed Ghorab

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Local generated and distributed system for thermal and electrical energy is sighted in the near future to reduce transmission losses instead of the centralized system. Distributed Energy Resources (DER) is designed at different sizes (small and medium) and it is incorporated in energy distribution between the hubs. The energy generated from each technology at each hub should meet the local energy demands. Economic and environmental enhancement can be achieved when there are interaction and energy exchange between the hubs. Network energy system and CO₂ optimization between different six hubs presented Canadian community level are investigated in this study. Three different scenarios of technology systems are studied to meet both thermal and electrical demand loads for the six hubs. The conventional system is used as the first technology system and a reference case study. The conventional system includes boiler to provide the thermal energy, but the electrical energy is imported from the utility grid. The second technology system includes combined heat and power (CHP) system to meet the thermal demand loads and part of the electrical demand load. The third scenario has integration systems of CHP and Organic Rankine Cycle (ORC) where the thermal waste energy from the CHP system is used by ORC to generate electricity. General Algebraic Modeling System (GAMS) is used to model DER system optimization based on energy economics and CO₂ emission analyses. The results are compared with the conventional energy system. The results show that scenarios 2 and 3 provide an annual total cost saving of 21.3% and 32.3 %, respectively compared to the conventional system (scenario 1). Additionally, Scenario 3 (CHP & ORC systems) provides 32.5% saving in CO₂ emission compared to conventional system subsequent case 2 (CHP system) with a value of 9.3%.  

Keywords: distributed energy resources, network energy system, optimization, microgeneration system

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Authors: Wissam Aljundi, Loay Daas, Yaser Abu Dail, Barbara Käsmann-Kellner, Berthold Seitz, Alaa Din Abdin

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Purpose: To investigate the effectiveness of nonsteroidal anti-inflammatory eye drops (NSAIDs) combined with oral acetazolamide for postoperative macular edema (PME) after uncomplicated phacoemulsification (PE) and to identify predictors of non-response. Methods: We analyzed data of uncomplicated PE and identified eyes with PME. First-line therapy included topical NSAIDs combined with oral acetazolamide. In case of non-response, triamcinolone was administered subtenonally. Outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: 94 eyes out of 9750 uncomplicated PE developed PME, of which 60 eyes were included. Follow-ups occurred 6.4±1.8, 12.5±3.7, and 18.6±6.0 weeks after diagnosis. BCVA and CMT improved significantly in all follow-ups. 40 eyes showed response to first-line therapy at first follow-up (G1). The remaining 20 eyes showed no response and required subtenon triamcinolone (G2), of which 11 eyes showed complete regression at the second follow-up and 4 eyes at the third follow-up. 5 eyes showed no response and required intravitreal injection. Multivariate linear regression model showed that diabetes mellitus (DM) and increased cumulative dissipated energy (CDE) are predictors of non-response. Conclusion: Topical NSAIDs with acetazolamide resulted in complete regression of PME in 67% of all cases. DM and increased CDE might be considered as predictors of nonresponse to this treatment.

Keywords: postoperative macular edema, intravitreal injection, cumulative energy, irvine gass syndrome, pseudophakie

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Authors: Anit S. Malhotra, Ajay Duseja, Neelam Chadha

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Endothelial dysfunction is a precursor to atherosclerosis, and flow-mediated dilatation (FMD) in the brachial artery is the commonest method to evaluate endothelial function in humans. Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver disorders encountered in clinical practice. An earlier meta-analysis had quantitatively assessed the degree of endothelial dysfunction using FMD. However, the largest study investigating the relation of FMD with NAFLD was published after that meta-analysis. In addition, that meta-analysis did not include some studies, including one from our centre. Therefore, an updating the previous meta-analysis was considered important. We searched PubMed, Cochrane Library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify observational studies evaluating endothelial function using FMD in patients with non-alcoholic fatty liver disease. Data was analyzed using MedCalc. Fourteen studies were found eligible for inclusion in the meta-analysis. Patients with NAFLD had lower brachial artery FMD as compared to controls, standardized mean difference (random effects model) being –1.279%; 95% confidence interval (CI), –1.478 to –0.914. The effect size became smaller after addition of the recent study with the largest sample size was included compared with the earlier meta-analysis. In conclusion, patients with NAFLD had low FMD values indicating that they are at a higher risk of cardiovascular disease although our results suggest the effect size is not as large as reported previously.

Keywords: endothelial dysfunction, flow-mediated dilatation, meta-analysis, non-alcoholic fatty liver disease

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Authors: Rebin Mzhda Mohammed, Hoshmand Ali Hama Agha

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Excess skin, often consequential to substantial weight loss or the aging process, introduces physical discomfort, obstructs daily activities, and undermines an individual's self-esteem. As these challenges become increasingly prevalent, the need to explore viable solutions grows in significance. Extra skin removal surgery, colloquially known as body contouring surgery, has emerged as a compelling intervention to ameliorate the physical and psychological burdens of excess skin. This study undertakes a comprehensive review to illuminate the intricacies of extra skin removal surgery, encompassing its diverse procedures, associated risks, benefits, and psychological implications on patients. The methodological approach adopted involves a systematic and exhaustive review of pertinent scholarly literature sourced from reputable databases, including PubMed, Google Scholar, and specialized cosmetic surgery journals. Articles are meticulously curated based on their relevance, credibility, and recency. Subsequently, data from these sources are synthesized and categorized, facilitating a comprehensive understanding of the subject matter. Qualitative analysis serves to unravel the nuanced psychological effects, while quantitative data, where available, are harnessed to underpin the study's conclusions. In terms of major findings, the research underscores the manifold advantages of extra skin removal surgery. Patients experience a notable improvement in physical comfort, amplified mobility, enhanced self-confidence, and a newfound ability to don clothing comfortably. Nonetheless, the benefits are juxtaposed with potential risks, encompassing infection, scarring, hematoma, delayed healing, and the challenge of achieving symmetry. A salient discovery is the profound psychological impact of the surgery, as patients consistently report elevated body image satisfaction, heightened self-esteem, and a substantial enhancement in overall quality of life. In summation, this research accentuates the pivotal role of extra skin removal surgery in ameliorating the intricate interplay of physical and psychological difficulties posed by excess skin. By elucidating the diverse procedures, associated risks, and psychological outcomes, the study contributes to a comprehensive and informed comprehension of the surgery's multifaceted effects. Therefore, individuals contemplating this transformative surgical option are equipped with comprehensive insights, ultimately fostering informed decision-making, guided by the expertise of medical professionals.

Keywords: extra skin removal surgery, body contouring, abdominoplasty, brachioplasty, thigh lift, body lift, benefits, risks, psychological effects

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Authors: Firas Alfwaress, Abdelraheem Bebers Abdelhadi Hamasha, Maha Abu Awaad

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Objectives: The aim of the present study was to investigate the effect of Palatal Lift Prosthesis (PLP) on speech clarity in patients with Flaccid Dysarthria. Five speech measures were investigated including Nasalance Scores, Diadchokinetic (DDK), Vowel Duration, airflow, and Sound Intensity. Participants: Twelve (7 Males and 5 females) native speakers of Jordanian Arabic with Flaccid Dysarthria following stroke, traumatic brain injury, and amyotrophic lateral sclerosis were included. The age of the participants ranged from 8–65 years with an average of 31.75 years. Design: Nasalance Scores, Diadchokinetic rate, Vowel Duration, and Sound Intensity were obtained using the Nasometer II, Model 6450 in three conditions. The first condition included obtaining the five measures without wearing the customized Palatal Lift Prosthesis. The second and third conditions included obtaining the five measures immediately after wearing the Palatal Lift Prosthesis and three months later. Results: Palatal lift prosthesis was found to be effective in individuals with flaccid dysarthria. Results showed decrease in the Nasalance Scores for the syllable repetition tasks and vowel prolongation tasks when comparing the means in the pre PLP with the post PLP at p≤0.001 except for the /m/ prolongation task. Results showed increased DDK repetition task, airflow amount, and sound intensity, and a decrease in vowel length at p≤0.001. Conclusions: The use of palatal lift prosthesis is effective in improving the speech of patients with flaccid dysarthria.

Keywords: palatal lift prosthesis, flaccid dysarthria, hypernasality, speech clarity, diadchokinetic rate

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Authors: Ester Ato, Maria Angeles Fernández-Vilar, Maria Dolores Galián

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The aim of this work was to analyze the relation between children´s effortful control, marital adjustment and parenting practices in a sample of 345 Spanish children aged between 6 and 8 years. Traditionally, the literature confirms that a higher level of marital conflict has been associated with less effective and less positive parenting, but there are few studies that include the effect that children´s effortful control exert to this relation. To measure marital adjustment, parenting practices and children’s temperament, parents were given the Marital Adjustment Test (MAT), the Spanish version of the PCRI (Parent-Child Relationship Inventory), and the TMCQ (Temperament in Middle Childhood Questionnaire). The results confirmed that higher marital satisfaction predicted more positive parenting practices, whereas lower marital adjustment scores predicted less parenting support and control. Using a statistical modeling approach, we tested a moderation model that revealed the moderating role of effortful control in the relation between marital adjustment and parenting. Concretely, higher marital satisfaction predicts higher parenting communication and involvement, but only in children with low levels of effortful control. Therefore, a difficult temperament interferes in a less negative way in the family system when parents are satisfied and united. And a better self-regulated child predicts more effective parenting practice regardless of the parents´ marital satisfaction. The clinical implications of the present findings should be considered. Specifically, difficult children must be detected and evaluated in community settings, such as school or community programs, in order to take into account the marital adjustment and parenting practices of their parents, and to be able to design adequate family interventions and prevent future pathologizing patterns.

Keywords: effortful control, marital adjustment, parenting, moderation

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Authors: Todd Enslen

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In order to attract more international students to study for undergraduate degrees in Japan, many universities have been developing English-Medium Instruction degree programs. This means that many faculty members must now teach their courses in English, which raises a number of concerns. A common misconception of English-Medium Instruction (EMI) is that teaching in English is simply a matter of translating materials. Since much of the teaching in Japan still relies on a more traditional, teachercentered, approach, continuing with this style in an EMI environment that targets international students can cause a clash between what is happening and what students expect in the classroom, not to mention what the Scholarship of Teaching and Learning (SoTL) has shown is effective teaching. A variety of considerations need to be taken into account in EMI classrooms such as varying English abilities of the students, modifying input material, and assuring comprehension through interactional checks. This paper analyzes the effectiveness of the English-Medium Instruction (EMI) undergraduate degree programs in engineering, agriculture, and science at a large research university in Japan by presenting the results from student surveys regarding the areas where perceived improvements need to be made. The students were the most dissatisfied with communication with their teachers in English, communication with Japanese students in English, adherence to only English being used in the classes, and the quality of the education they received. In addition, the results of a needs analysis survey of Japanese teachers having to teach in English showed that they believed they were most in need of English vocabulary and expressions to use in the classroom and teaching methods for teaching in English. The result from the student survey and the faculty survey show similar concerns between the two groups. By helping the teachers to understand student-centered teaching and the benefits for learning that it provides, teachers may begin to incorporate more student-centered approaches that in turn help to alleviate the dissatisfaction students are currently experiencing. Through analyzing the current environment in Japanese higher education against established best practices in teaching and EMI, three areas that need to be addressed in professional development workshops were identified. These were “culture” as it relates to the English language, “classroom management techniques” and ways to incorporate them into classes, and “language” issues. Materials used to help faculty better understand best practices as they relate to these specific areas will be provided to help practitioners begin the process of helping EMI faculty build awareness of better teaching practices. Finally, the results from faculty development workshops participants’ surveys will show the impact that these workshops can have. Almost all of the participants indicated that they learned something new and would like to incorporate the ideas from the workshop into their teaching. In addition, the vast majority of the participants felt the workshop provided them with new information, and they would like more workshops like these.

Keywords: English-medium instruction, materials development, professional development, teaching effectiveness

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Authors: N. Garrós, P. Bustos, N. Beirampour, R. Mohammadi, M. Mallandrich, A.C. Calpena, H. Colom

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Atopic dermatitis (AD) is a persistent skin condition characterized by chronic inflammation caused by an autoimmune response. It is a prevalent clinical issue that requires continual treatment to enhance the patient's quality of life. Systemic therapy often involves the use of glucocorticoids or immunosuppressants to manage symptoms. Our objective was to create and assess topical liposomal formulations containing Baricitinib (BNB), a reversible inhibitor of Janus-associated kinase (JAK), which is involved in various immune responses. These formulations were intended to address flare-ups and improve treatment outcomes for AD. We created three distinct liposomal formulations by combining different amounts of 1-palmitoyl-2-oleoyl-glycero-3-phosphocholine (POPC), cholesterol (CHOL), and ceramide (CER): (i) pure POPC, (ii) POPC mixed with CHOL (at a ratio of 8:2, mol/mol), and (iii) POPC mixed with CHOL and CER (at a ratio of 3.6:2.4:4.0 mol/mol/mol). We conducted various tests to determine the formulations' skin tolerance, irritancy capacity, and their ability to cause erythema and edema on altered skin. We also assessed the transepidermal water loss (TEWL) and skin hydration of rabbits to evaluate the efficacy of the formulations. Histological analysis, the HET-CAM test, and the modified Draize test were all used in the evaluation process. The histological analysis revealed that liposome POPC and POPC:CHOL avoided any damage to the tissues structures. The HET-CAM test showed no irritation effect caused by any of the three liposomes, and the modified Draize test showed a good Draize score for erythema and edema. Liposome POPC effectively counteracted the impact of xylol on the skin, and no erythema or edema was observed during the study. TEWL values were constant for all the liposomes with similar values to the negative control (within the range 8 - 15 g/h·m2, which means a healthy value for rabbits), whereas the positive control showed a significant increase. The skin hydration values were constant and followed the trend of the negative control, while the positive control showed a steady increase during the tolerance study. In conclusion, the developed formulations containing BNB exhibited no harmful or irritating effects, they did not demonstrate any irritant potential in the HET-CAM test and liposomes POPC and POPC:CHOL did not cause any structural alteration according to the histological analysis. These positive findings suggest that additional research is necessary to evaluate the efficacy of these liposomal formulations in animal models of the disease, including mutant animals. Furthermore, before proceeding to clinical trials, biochemical investigations should be conducted to better understand the mechanisms of action involved in these formulations.

Keywords: baricitinib, HET-CAM test, histological study, JAK inhibitor, liposomes, modified draize test

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Authors: Jiří F. Urbánek, Alena Oulehlová, Hana Malachová, Jiří J. Urbánek Jr.

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Crisis situations investigation and modelling are introduced and made within the complex system of energetic critical infrastructure, operating on peril´s environments. Every crisis situations and perils has an origin in the emergency/ crisis event occurrence and they need critical/ crisis interfaces assessment. Here, the emergency events can be expected - then crisis scenarios can be pre-prepared by pertinent organizational crisis management authorities towards their coping; or it may be unexpected - without pre-prepared scenario of event. But the both need operational coping by means of crisis management as well. The operation, forms, characteristics, behaviour and utilization of crisis management have various qualities, depending on real critical infrastructure organization perils, and prevention training processes. An aim is always - better security and continuity of the organization, which successful obtainment needs to find and investigate critical/ crisis zones and functions in critical infrastructure organization models, operating in pertinent perils environment. Our DYVELOP (Dynamic Vector Logistics of Processes) method is disposables for it. Here, it is necessary to derive and create identification algorithm of critical/ crisis interfaces. The locations of critical/ crisis interfaces are the flags of crisis situation in organization of critical infrastructure models. Then, the model of crisis situation will be displayed at real organization of Czech energetic crisis infrastructure subject in real peril environment. These efficient measures are necessary for the infrastructure protection. They will be derived for peril mitigation, crisis situation coping and for environmentally friendly organization survival, continuity and its sustainable development advanced possibilities.

Keywords: algorithms, energetic infrastructure complex system, modelling, peril´s environment

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Authors: Daniel Murrant, Andrew Quinn, Lee Chapman

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A growing population has led to increasing global water and energy demand. This demand, combined with the effects of climate change and an increasing need to maintain and protect the natural environment, represents a potentially severe threat to many national infrastructure systems. This has resulted in a considerable quantity of published material on the interdependencies that exist between the supply of water and the thermal generation of electricity, often known as the water-energy nexus. Focusing specifically on the UK, there is a growing concern that the future availability of water may at times constrain thermal electricity generation, and therefore hinder the UK in meeting its increasing demand for a secure, and affordable supply of low carbon electricity. To provide further information on the threat the water-energy nexus may pose to the UK’s energy system, this paper models the regional water demand of UK thermal electricity generation in 2030 and 2050. It uses the strategically important Energy Systems Modelling Environment model developed by the Energy Technologies Institute. Unlike previous research, this paper was able to use abstraction and consumption factors specific to UK power stations. It finds that by 2050 the South East, Yorkshire and Humber, the West Midlands and North West regions are those with the greatest freshwater demand and therefore most likely to suffer from a lack of resource. However, it finds that by 2050 it is the East, South West and East Midlands regions with the greatest total water (fresh, estuarine and seawater) demand and the most likely to be constrained by environmental standards.

Keywords: climate change, power station cooling, UK water-energy nexus, water abstraction, water resources

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Authors: M. K. Wijayarathna, S. M. Buddika Harshanath

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Monitoring student engagement has become a crucial part of the educational process and a reliable indicator of the capacity to retain information. As online learning classrooms are now more common these days, students' attention levels have become increasingly important, making it more difficult to check each student's concentration level in an online classroom setting. To profile student attention to various gradients of engagement, a study is a plan to conduct using machine learning models. Using a convolutional neural network, the findings and confidence score of the high accuracy model are obtained. In this research, convolutional neural networks are using to help discover essential emotions that are critical in defining various levels of participation. Students' attention levels were shown to be influenced by emotions such as calm, enjoyment, surprise, and fear. An improved virtual learning system was created as a result of these data, which allowed teachers to focus their support and advise on those students who needed it. Student participation has formed as a crucial component of the learning technique and a consistent predictor of a student's capacity to retain material in the classroom. Convolutional neural networks have a plan to implement the platform. As a preliminary step, a video of the pupil would be taken. In the end, researchers used a convolutional neural network utilizing the Keras toolkit to take pictures of the recordings. Two convolutional neural network methods are planned to use to determine the pupils' attention level. Finally, those predicted student attention level results plan to display on the graphical user interface of the System.

Keywords: HTML5, JavaScript, Python flask framework, AI, graphical user

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Authors: Tarnveer Kaur

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Amino acids, as fundamental structural units of peptides and proteins, have an important role in biological systems by affecting solubility, denaturation, and activity of biomolecules. A study of these effects on thermophysical properties of model compounds in the presence of electrolytes solutions provides information about solute-solvent and solute-solute interactions on biomolecules. Ionic liquids (ILs) as organic electrolytes and green solvents are composed of an organic cation and an inorganic anion, which are liquid at ambient conditions. In the past decade, extensive investigations showed that the use of ILs as reaction media for processes involving biologically relevant compounds is promising in view of their successful application in kinetic resolution, biocatalysis, biosynthesis, separation, and purification processes. The scope of this information is valuable to explore the interactions of amino acids in ILs. To reach this purpose, apparent molar volumes of glycine/L-alanine in aqueous solutions of 1-butyl-3-methylimidazolium bromide/chloride were determined from precise density measurements at temperatures T = (288.15-318.15) K and at atmospheric pressure. Positive values for all the studied amino acids indicate the dominance of hydrophilic-ionic interactions between amino acids and Ionic liquids. The effect of temperature on volumetric properties of glycine/L-alanine in solutions has been determined from the partial molar expansibility and second-order partial molar expansibility. Further, volumetric interaction parameters and hydration number have been calculated, which have been interpreted in terms of possible solute-solvent interactions.

Keywords: ILs, amino acids, volumetric properties, hydration numbers

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Authors: Zhipeng Feng, Huanhuan Qi, Pingchuan Shen, Fenggang Zang, Yixiong Zhang

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Numerical simulations of vortex-induced vibration of a three-dimensional flexible tube under uniform turbulent flow are calculated when Reynolds number is 1.35×10⁴. In order to achieve the vortex-induced vibration, the three-dimensional unsteady, viscous, incompressible Navier-Stokes equation and LES turbulence model are solved with the finite volume approach, the tube is discretized according to the finite element theory, and its dynamic equilibrium equations are solved by the Newmark method. The fluid-tube interaction is realized by utilizing the diffusion-based smooth dynamic mesh method. Considering the vortex-induced vibration system, the variety trends of lift coefficient, drag coefficient, displacement, vertex shedding frequency, phase difference angle of tube are analyzed under different frequency ratios. The nonlinear phenomena of locked-in, phase-switch are captured successfully. Meanwhile, the limit cycle and bifurcation of lift coefficient and displacement are analyzed by using trajectory, phase portrait, and Poincaré sections. The results reveal that: when drag coefficient reaches its minimum value, the transverse amplitude reaches its maximum, and the “lock-in” begins simultaneously. In the range of lock-in, amplitude decreases gradually with increasing of frequency ratio. When lift coefficient reaches its minimum value, the phase difference undergoes a suddenly change from the “out-of-phase” to the “in-phase” mode.

Keywords: vortex induced vibration, limit cycle, LES, CFD, FEM

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Authors: Ekpeti Bukola Grace, Mahmoudi Sabar Esmail, Chaer Issa

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Global energy consumption has been increasing steadily over the last half - century, and this trend is projected to continue. As energy demand rises in many countries throughout the world due to population growth, natural ventilation in buildings has been identified as a viable option for lowering these demands, saving costs, and also lowering CO2 emissions. However, natural ventilation is driven by forces that are generally unpredictable in nature thus, it is important to manage the resulting airflow in order to maintain pleasant indoor conditions, making it a complex system that necessitates specific control approaches. The effective application of fuzzy logic technique amidst other intelligent systems is one of the best ways to bridge this gap, as its control dynamics relates more to human reasoning and linguistic descriptions. This article reviewed existing literature and presented practical solutions by applying fuzzy logic control with optimized techniques, selected input parameters, and expert rules to design a more effective control system. The control monitors used indoor temperature, outdoor temperature, carbon-dioxide levels, wind velocity, and rain as input variables to the system, while the output variable remains the control of window opening. This is achieved through the use of fuzzy logic control tool box in MATLAB and running simulations on SIMULINK to validate the effectiveness of the proposed system. Comparison analysis model via simulation is carried out, and with the data obtained, an improvement in control actions and energy savings was recorded.

Keywords: fuzzy logic, intelligent control systems, natural ventilation, optimization

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Authors: Xuan Zheng

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China is home to one of the world’s largest Deaf and Hard of Hearing (DHH) populations. In the 1980s, the concept of inclusive education was introduced, giving rise to a unique “learning in regular class (随班就读)” model tailored to local contexts. China’s inclusive education for DHH students is diversifying with innovative models like special education classes at regular schools, regular classes at regular schools, resource classrooms, satellite classes, and bilingual-bimodal projects. The scope extends to preschool and higher education programs. However, the inclusive development of DHH students faces challenges. The prevailing pathological viewpoint on disabilities persists, emphasizing the necessity for favorable auditory and speech rehabilitation outcomes before DHH students can integrate into regular classes. In addition, inadequate support systems in inclusive schools result in poor academic performance and increased psychological disorders among the group, prompting a notable return to special education schools. Looking ahead, China’s inclusive education for DHH students needs a substantial shift from “learning in regular class” to “sharing equal regular education.” Particular attention should be devoted to the effective integration of DHH students who employ sign language into mainstream educational settings. It is crucial to strengthen regulatory frameworks and institutional safeguards, advance the professional development of educators specializing in inclusive education for DHH students, and consistently enhance resources tailored to this demographic. Furthermore, the establishment of a robust, multidimensional, and collaborative support network, engaging both families and educational institutions, is also a pivotal facet.

Keywords: deaf, hard of hearing, inclusive education, China

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