Search results for: Scalar dissipation rate

Authors: Melkamu A. Zeru, Aweke A. Mitiku, Endashaw Amuka

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Background: Under-five mortality is the likelihood that a baby will pass away before turning exactly 5 years old, represented as a percentage per 1,000 live births. Exploring the spatial distribution and identifying the temporal pattern is important to reducing under-five child mortality globally, including in Ethiopia. Thus, this study aimed to identify the risk factors of under-five mortality and the spatiotemporal variation in Ethiopian administrative zones. Method: This study used the 2000-2016 Ethiopian Demographic and Health Survey (EDHS) data, which were collected using a two-stage sampling method. A total of 43,029 (10,873 in 2000, 9,861 in 2005, 11,654 in 2011, and 10,641 in 2016) weighted sample under-five child mortality was used. The space-time dynamic model was employed to account for spatial and time effects in 65 administrative zones in Ethiopia. Results: From the result of a general nesting spatial-temporal dynamic model, there was a significant space-time interaction effect [γ = -0.1444, 95 % CI (-0.6680, -0.1355)] for under-five mortality. The increase in the percentages of mothers illiteracy [𝛽 = 0.4501, 95% CI (0.2442, 0.6559)], not vaccinated[𝛽= 0.7681, 95% CI (0.5683, 0.9678)], unimproved water[𝛽= 0.5801, CI (0.3793, 0.7808)] were increased death rates for under five children while increased percentage of contraceptive use [𝛽= -0.6609, 95% CI (-0.8636, -0.4582)] and ANC visit > 4 times [𝛽= -0.1585, 95% CI(-0.1812, -0.1357)] were contributed to the decreased under-five mortality rate at the zone in Ethiopia. Conclusions: Even though the mortality rate for children under five has decreased over time, still there is still higher in different zones of Ethiopia. There exists spatial and temporal variation in under-five mortality among zones. Therefore, it is very important to consider spatial neighbourhoods and temporal context when aiming to avoid under-five mortality.

Keywords: under-five children mortality, space-time dynamic, spatiotemporal, Ethiopia

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Authors: Miguel A. Figueroa, José A. Lara-Ramos, Miguel A. Mueses

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Pharmaceutical residues are a section of emerging contaminants of anthropogenic origin that are present in a myriad of waters with which human beings interact daily and are starting to affect the ecosystem directly. Conventional waste-water treatment systems are not capable of degrading these pharmaceutical effluents because their designs cannot handle the intermediate products and biological effects occurring during its treatment. That is why it is necessary to hybridize conventional waste-water systems with non-conventional processes. In the specific case of an ozonation process, its efficiency highly depends on a perfect dispersion of ozone, long times of interaction of the gas-liquid phases and the size of the ozone bubbles formed through-out the reaction system. In order to increase the efficiency of these parameters, the use of a modified flotation cell has been proposed recently as a reactive system, which is used at an industrial level to facilitate the suspension of particles and spreading gas bubbles through the reactor volume at a high rate. The objective of the present work is the development of a mathematical model that can closely predict the kinetic rates of reactions taking place in the flotation cell at an experimental scale by means of identifying proper reaction mechanisms that take into account the modified chemical and hydrodynamic factors in the FeO-catalyzed Ozonation of Diclofenac aqueous solutions in a flotation cell. The methodology is comprised of three steps: an experimental phase where a modified flotation cell reactor is used to analyze the effects of ozone concentration and loading catalyst over the degradation of Diclofenac aqueous solutions. The performance is evaluated through an index of utilized ozone, which relates the amount of ozone supplied to the system per milligram of degraded pollutant. Next, a theoretical phase where the reaction mechanisms taking place during the experiments must be identified and proposed that details the multiple direct and indirect reactions the system goes through. Finally, a kinetic model is obtained that can mathematically represent the reaction mechanisms with adjustable parameters that can be fitted to the experimental results and give the model a proper physical meaning. The expected results are a robust reaction rate law that can simulate the improved results of Diclofenac mineralization on water using the modified flotation cell reactor. By means of this methodology, the following results were obtained: A robust reaction pathways mechanism showcasing the intermediates, free-radicals and products of the reaction, Optimal values of reaction rate constants that simulated Hatta numbers lower than 3 for the system modeled, degradation percentages of 100%, TOC (Total organic carbon) removal percentage of 69.9 only requiring an optimal value of FeO catalyst of 0.3 g/L. These results showed that a flotation cell could be used as a reactor in ozonation, catalytic ozonation and photocatalytic ozonation processes, since it produces high reaction rate constants and reduces mass transfer limitations (Ha > 3) by producing microbubbles and maintaining a good catalyst distribution.

Keywords: advanced oxidation technologies, iron oxide, emergent contaminants, AOTS intensification

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Authors: Jawad Zakir, Syed Irtiza Ali Shah, Rana Shaharyar, Sidra Mahmood

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Y-force equation comprises aerodynamic forces, drag and side force with side slip angle β and weight component along with the coupled roll (φ) and pitch angles (θ). This research deals with the linearization of Y-force equation using Small Disturbance theory assuming equilibrium flight conditions for different state variables of aircraft. By using assumptions of Small Disturbance theory in non-linear Y-force equation, finally reached at linearized lateral rigid body equation of motion; which says that in linearized Y-force equation, the lateral acceleration is dependent on the other different aerodynamic and propulsive forces like vertical tail, change in roll rate (Δp) from equilibrium, change in yaw rate (Δr) from equilibrium, change in lateral velocity due to side force, drag and side force components due to side slip, and the lateral equation from coupled rotating frame to decoupled rotating frame. This paper describes implementation of this lateral linearized equation for aircraft control systems. Another significant parameter considered on which y-force equation depends is ‘c’ which shows that any change bought in the weight of aircrafts wing will cause Δφ and cause lateral force i.e. Y_c. This simplification also leads to lateral static and dynamic stability. The linearization of equations is required because much of mathematics control system design for aircraft is based on linear equations. This technique is simple and eases the linearization of the rigid body equations of motion without using any high-speed computers.

Keywords: Y-force linearization, small disturbance theory, side slip, aerodynamic force drag, lateral rigid body equation of motion

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Authors: L. C. Nwosu, C. O. Adedire, M. O. Ashamo, E. O. Ogunwolu

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The maize weevil, Sitophilus zeamais Motschulsky is a notorious pest of stored maize (Zea mays L.). The development of resistant maize varieties to manage weevils is a major breeding objective. The study investigated the parameters and mechanisms that confer resistance on a maize variety to S. zeamais infestation using twenty elite maize varieties. Detailed morphological, physical and chemical studies were conducted on whole-maize grain and the grain pericarp. Resistance was assessed at 33, 56, and 90 days post infestation using weevil mortality rate, weevil survival rate, percent grain damage, percent grain weight loss, weight of grain powder, oviposition rate and index of susceptibility as indices rated on a scale developed by the present study and on Dobie’s modified scale. Linear regression models that can predict maize grain damage in relation to the duration of storage were developed and applied. The resistant varieties identified particularly 2000 SYNEE-WSTR and TZBRELD3C5 with very high degree of resistance should be used singly or best in an integrated pest management system for the control of S. zeamais infestation in stored maize. Though increases in the physical properties of grain hardness, weight, length, and width increased varietal resistance, it was found that the bases of resistance were increased chemical attributes of phenolic acid, trypsin inhibitor and crude fibre while the bases of susceptibility were increased protein, starch, magnesium, calcium, sodium, phosphorus, manganese, iron, cobalt and zinc, the role of potassium requiring further investigation. Characters that conferred resistance on the test varieties were found distributed in the pericarp and the endosperm of the grains. Increases in grain phenolic acid, crude fibre, and trypsin inhibitor adversely and significantly affected the bionomics of the weevil on further assessment. The flat side of a maize grain at the point of penetration was significantly preferred by the weevil. Why the south area of the flattened side of a maize grain was significantly preferred by the weevil is clearly unknown, even though grain-face-type seemed to be a contributor in the study. The preference shown to the south area of the grain flat side has implications for seed viability. The study identified antibiosis, preference, antixenosis, and host evasion as the mechanisms of maize post harvest resistance to Sitophilus zeamais infestation.

Keywords: maize weevil, resistant, parameters, mechanisms, preference

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Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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Authors: Ogbuagu Josephat Okechukwu, Okeke Abuchi Princewill, Arinze Rosemary Uche, Tabugbo Ifeyinwa Blessing, Ogbuagu Adaora Stellamaris

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Phthalates or Phthalate esters (PAEs), categorized as an endocrine disruptor and persistent organic pollutants, are known for their environmental contamination and toxicological effects. In this study, the concentration of selected phthalates was determined across the sampling site to investigate their occurrence and the ecological and health risk assessment they pose to the environment. Water and sediment samples were collected following standard procedures. Solid phase and ultrasonic methods were used to extract seven different PAEs, which were analyzed by Gas Chromatography with Mass Detector (GCMS). The analytical average recovery was found to be within the range of s83.4% ± 2.3%. The results showed that PAEs were detected in six out of seven samples with a high percentage of detection rate in water. Di-n-butyl phthalate (DPB) and diisobutyl phthalates (DiBP) showed greater detection rate compared to other PAEs monomers. The concentration of PEs was found to be higher in the sediment samples compared to the water samples due to the fact that sediments serve as a sink for most persistent organic pollutants. The concentrations of PAEs in water samples and sediments ranged from 0.03 ± 0.01 to 0.29 ± 0.002 ppm and 3.99 ± 0.43 to 6.04 ± 1.25 ppm, respectively. Ecological risk assessment using the risk quotient method (RQ) reveals that the estimated environmental risk caused by phthalates lies within the moderate level as RQ ranges from 0.1 to 1.0, whereas the health risk assessment caused by phthalates on estimating the average daily dose reveals that the ingestion of phthalates was found to be high which can cause serious carcinogenic occurrence in the human system with time due to excess accumulation.

Keywords: phthaletes, assessment, marine pollution, endocrine

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Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

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Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

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Authors: Rukayya Ibrahim Muazu, Aiduan Li Borrion, Julia A. Stegemann

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Biomass briquette gasification is regarded as a promising route for efficient briquette use in energy generation, fuels and other useful chemicals, however, previous research work has focused on briquette gasification in fixed bed gasifiers such as updraft and downdraft gasifiers. Fluidised bed gasifier has the potential to be effectively sized for medium or large scale. This study investigated the use of fuel briquettes produced from blends of rice husks and corn cobs biomass residues, in a bubbling fluidised bed gasifier. The study adopted a combination of numerical equations and Aspen Plus simulation software to predict the product gas (syngas) composition based on briquette's density and biomass composition (blend ratio of rice husks to corn cobs). The Aspen Plus model was based on an experimentally validated model from the literature. The results based on a briquette size of 32 mm diameter and relaxed density range of 500 to 650 kg/m3 indicated that fluidisation air required in the gasifier increased with an increase in briquette density, and the fluidisation air showed to be the controlling factor compared with the actual air required for gasification of the biomass briquettes. The mass flowrate of CO2 in the predicted syngas composition, increased with an increase in the air flow rate, while CO production decreased and H2 was almost constant. The H2/CO ratio for various blends of rice husks and corn cobs did not significantly change at the designed process air, but a significant difference of 1.0 for H2/CO ratio was observed at higher air flow rate, and between 10/90 to 90/10 blend ratio of rice husks to corn cobs. This implies the need for further understanding of biomass variability and hydrodynamic parameters on syngas composition in biomass briquette gasification.

Keywords: aspen plus, briquettes, fluidised bed, gasification, syngas

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Authors: Nkwanyang L. Takem, Christopher M. Agyingi

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Background and aim: An integrated interpretation of wireline logs and lithology of two selected wells (KF-1 and KF-2) of Kribi oil field within the southeastern offshore Douala/Kribi Campo Basin was carried out for sequence stratigraphic analysis of sediments penetrated by the wells. Methods: The stratigraphic units within the wells were subdivided into depositional sequences using characteristic well log patterns that were deposited between Tertiary Miocene to lower Cretaceous. Results: Nine (9) and eight (8) depositional sequences were identified respectively for KF-1 and KF-2. The sequences comprise LST (progradational packages), TSTs (retrogradational packages) and HSTs (aggradational packages), which reflect depositional systems deposited during different phases of base-level changes. The (LST) consists of Basin Floor Fans (BFF), Slope Fans and Channel Sands deposited when sea level was low and accommodation space lower than rate of sediment influx. TST consists of retrogradational marine shales deposited during high relative sea levels and when accommodation space was higher than rate of sediment influx. HST consisted of shoreface sands displaying mostly aggradational to progradational stacking patterns. Conclusion: The rapid facies changes between successive systems tracts provide potential stratigraphic traps. Reservoir stratification and continuity vary greatly between systems tracts and this enhanced development of stratigraphic traps in the area. Basin floor fans comprise sandstone of good reservoir quality, thus huge accumulation of HC can be trapped in this reservoirs.

Keywords: Douala-Kribi-Campo Basin, reservoirs, sequence strastigraphyy, system tracks

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Authors: Otgonjargal Damdinbaljir

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Background: Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. In 2010, Mongolia used WHO 2008 edition of Indicators for assessing infant and young child feeding practices for the first time. Objective: To evaluate the feeding status of infants and young children under 2 years old in Mongolia. Materials and Methods: The study was conducted by cluster random sampling. The data on breastfeeding and complementary food supplement of the 350 infants and young children aged 0-23 months in 21 provinces of the 4 economic regions of the country and capital Ulaanbaatar city were collected through questionnaires. The feeding status was analyzed according to the WHO 2008 edition of Indicators for assessing infant and young child feeding practices. Analysis of data: Survey data was analysed using the PASW statistics 18.0 and EPI INFO 2000 software. For calculation of overall measures for the entire survey sample, analyses were stratified by region. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and socio demographic factors as independent variables. Simple proportions were calculated for each IYCF indicator. The differences in the feeding practices between sexes and age-groups, if any, were noted using chi-square test. Ethics: The Ethics Committee under the auspices of the Ministry of Health approved the study. Results: A total of 350 children aged 0-23 months were investigated. The rate of ever breastfeeding of children aged 0-23 months reached up to 98.2%, while the percentage of early initiation of breastfeeding was only 85.5%. The rates of exclusive breastfeeding under 6 months, continued breastfeeding for 1 year, and continued breastfeeding for 2 years were 71.3%, 74% and 54.6%, respectively. The median time of giving complementary food was the 6th month and the weaning time was the 9th month. The rate of complementary food supplemented from 6th-8th month in time was 80.3%. The rates of minimum dietary diversity, minimum meal frequency, and consumption of iron-rich or iron-fortified foods among children aged 6-23 months were 52.1%, 80.8% (663/813) and 30.1%, respectively. Conclusions: The main problems revealed from the study were inadequate category and frequency of complementary food, and the low rate of consumption of iron-rich or iron-fortified foods were the main issues to be concerned on infant feeding in Mongolia. Our findings have highlighted the need to encourage mothers to enrich their traditional wheat- based complementary foods add more animal source foods and vegetables.

Keywords: complementary feeding, early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency

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Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

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Authors: M. E. Razipoor, T. Masunaga, K. Sato, M. S. Saboory

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Estimation of soil erosion is economically and environmentally important in Herat, Afghanistan. Degradation of soil has negative impact (decreased soil fertility, destroyed soil structure, and consequently soil sealing and crusting) on life of Herat residents. Water and wind are the main erosive factors causing soil erosion in Herat. Furthermore, scarce vegetation cover, exacerbated by socioeconomic constraint, and steep slopes accelerate soil erosion. To sustain soil productivity and reduce soil erosion impact on human life, due to sustaining agricultural production and auditing the environment, it is needed to quantify the magnitude and extent of soil erosion in a spatial domain. Thus, this study aims to estimate soil loss potential and its spatial distribution in Herat, Afghanistan by applying RUSLE in GIS environment. The rainfall erosivity factor ranged between values of 125 and 612 (MJ mm ha-1 h-1 year-1). Soil erodibility factor varied from 0.036 to 0.073 (Mg h MJ-1 mm-1). Slope length and steepness factor (LS) values were between 0.03 and 31.4. The vegetation cover factor (C), derived from NDVI analysis of Landsat-8 OLI scenes, resulting in range of 0.03 to 1. Support practice factor (P) were assigned to a value of 1, since there is not significant mitigation practices in the study area. Soil erosion potential map was the product of these factors. Mean soil erosion rate of Herat Province was 29 Mg ha-1 year-1 that ranged from 0.024 Mg ha-1 year-1 in flat areas with dense vegetation cover to 778 Mg ha-1 year-1 in sharp slopes with high rainfall but least vegetation cover. Based on land cover map of Afghanistan, areas with soil loss rate higher than soil loss tolerance (8 Mg ha-1 year-1) occupies 98% of Forests, 81% rangelands, 64% barren lands, 60% rainfed lands, 28% urban area and 18% irrigated Lands.

Keywords: Afghanistan, erosion, GIS, Herat, RUSLE

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Authors: Enyia James Diwa, Dodeye Ina Igbong, Archibong Archibong Eso

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Gas turbine operators have been faced with the dramatic financial setback resulting from compressor fouling. In a highly deregulated power industry where there is stiffness in the market competition, has made it imperative to improvise means of reducing maintenance cost in other to yield maximum profit. Compressor fouling results from the deposition of contaminants in the presence of oil and moisture on the compressor blade or annulus surfaces, which leads to a loss in flow capacity and compressor efficiency. These combined effects reduce power output, increase heat rate and cause creep life reduction. This paper also contains a model of two gas turbine engines via Cranfield University software known as TURBOMATCH, which is simulation software for detecting engine fouling rate. The model engines are of different configurations and capacities, and are operating in two different modes of constant output power and turbine inlet temperature for a two and three stage filter system. The idea is to investigate the more economically viable filtration systems by gas turbine users based on performance only. It has been demonstrated in the results that the two spool engine is a little more beneficial compared to the single spool. This is as a result of a higher pressure ratio of the two spools as well as the deceleration of the high-pressure compressor and high-pressure turbine speed in a constant TET. Meanwhile, the inlet filtration system was properly designed and balanced with a well-timed and economical compressor washing regime/scheme to control compressor fouling. The different technologies of inlet air filtration and compressor washing are considered and an attempt at optimization with respect to the cost of a combination of both control measures are made.

Keywords: inlet filtration, pressure loss, single spool, two spool

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Authors: Juan C. Torrado, Javier Gomez, Guadalupe Montero, German Montoro, M. Dolores Villalba

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One of the most challenging aspects of the executive dysfunction of people with Autism Spectrum Disorders is the behavior control. This is related to a deficit in their ability to regulate, recognize and manage their own emotions. Some researchers have developed applications for tablets and smartphones to practice strategies of relaxation and emotion recognition. However, they cannot be applied to the very moment of temper outbursts, anger episodes or anxiety, since they require to carry the device, start the application and be helped by caretakers. Also, some of these systems are developed for either obsolete technologies (old versions of tablet devices, PDAs, outdated operative systems of smartphones) or specific devices (self-developed or proprietary ones) that create differentiation between the users and the rest of the individuals in their context. For this project we selected smartwatches. Focusing on emergent technologies ensures a wide lifespan of the developed products, because the derived products are intended to be available in the same moment the very technology gets popularized, not later. We also focused our research in commercial versions of smartwatches, since this way differentiation is easily avoided, so the users’ abandonment rate lowers. We have developed a smartwatch system along with a smartphone authoring tool to display self-regulation strategies. These micro-prompting strategies are conformed of pictograms, animations and temporizers, and they are designed by means of the authoring tool: When both devices synchronize their data, the smartwatch holds the self-regulation strategies, which are triggered when the smartwatch sensors detect a remarkable rise of heart rate and movement. The system is being currently tested in an educational center of people with ASD of Madrid, Spain.

Keywords: assistive technologies, emotion regulation, human-computer interaction, smartwatches

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Authors: Yasmin Sayed, Hala Hamdy, Hafez Bazaraa, Hanaa Rady, Sherif Elanwary

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Intravenous and inhaled magnesium sulfate (MgSO₄) had been recently used as an adjuvant therapy in cases suffering from the wheezy chest. Objective: We aimed to determine the possible change in the hemodynamic state in cases received intravenous or inhaled MgSO₄ in comparison to cases received standard treatment in critically ill infants and children with the wheezy chest. Methods: A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSO₄ was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSO₄. The hemodynamic state was determined by assessment of blood pressure, heart rate, capillary refill time and the need for shock therapy or inotropic support just before and 24 hours after receiving treatment in 3 groups. Results: There was no significant difference in the hemodynamic state of the studied groups before and after treatment. Means of blood pressure were 102.2/63.2, 105.1/64.8 before and after inhaled MgSO₄; respectively. Means of blood pressure were 105.5/64.2, 104.1/64.9 before and after intravenous MgSO₄; respectively. Means of blood pressure were 107.4/62.8, 104.4/62.1 before and after standard treatment, respectively. There was a statistically insignificant reduction of the means of the heart rate in group A and group B after treatment rather than group C. There was no associated prolongation in capillary refill time and/or the need for inotropic support or shock therapy after treatment in the studied groups. Conclusion: MgSO₄ is a safe adjuvant therapy and not associated with significant alteration in the hemodynamic state in critically ill infants and children with the wheezy chest.

Keywords: critically ill infants and children, inhaled MgSO₄, intravenous MgSO₄, wheezy chest

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Authors: Rajinikanth Siddalingam, Poonguzhali Subramanian

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The present study aims to prepare and evaluate the self-nano emulsifying drug delivery (SNEDDS) system to enhance the dissolution rate of a poorly soluble drug dutasteride. The formulation was prepared using capryol PGMC, Cremophor EL, and polyethylene glycol (PEG) 400 as oil, surfactant and co-surfactant, respectively. The pseudo-ternary phase diagrams with presence and absence of drug were plotted to find out the nano emulsification range and also to evaluate the effect of dutasteride on the emulsification behavior of the phases. Prepared SNEDDS formulations were evaluated for its particle size distribution, nano emulsifying properties, robustness to dilution, self-emulsification time, turbidity measurement, drug content and in-vitro dissolution. The optimized formulations are further evaluated for heating cooling cycle, centrifugation studies, freeze-thaw cycling, particle size distribution and zeta potential were carried out to confirm the stability of the formed SNEDDS formulations. The particle size, zeta potential and polydispersity index of the optimized formulation found to be 35.45 nm, -15.45 and 0.19, respectively. The in vitro results are revealed that the prepared formulation enhanced the dissolution rate of dutasteride significantly as compared with pure drug. The in vivo studies in was conducted using rats and the results are revealed that SNEDDS formulation has enhanced the bioavailability of dutasteride drug significantly as compared with raw drug. Based the results, it was concluded that the dutasteride-loaded SNEDDS shows potential to enhance the dissolution of dutasteride, thus improving the bioavailability and therapeutic effects.

Keywords: self-emulsifying drug delivery system, dutasteride, enhancement of bioavailability, dissolution enhancement

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Authors: Guerich Mohamed, Assaf Samir

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The application of viscoelastic materials in the form of constrained layers in mechanical structures is an efficient and cost-effective technique for solving noise and vibration problems. This technique requires a design tool to select the best location, type, and thickness of the damping treatment. This paper presents a finite element model for the vibration of beams partially or fully covered with a constrained viscoelastic damping material. The model is based on Bernoulli-Euler theory for the faces and Timoshenko beam theory for the core. It uses four variables: the through-thickness constant deflection, the axial displacements of the faces, and the bending rotation of the beam. The sandwich beam finite element is compatible with the conventional C1 finite element for homogenous beams. To validate the proposed model, several free vibration analyses of fully or partially covered beams, with different locations of the damping patches and different percent coverage, are studied. The results show that the proposed approach can be used as an effective tool to study the influence of the location and treatment size on the natural frequencies and the associated modal loss factors. Then, a parametric study regarding the variation in the damping characteristics of partially covered beams has been conducted. In these studies, the effect of core shear modulus value, the effect of patch size variation, the thickness of constraining layer, and the core and the locations of the patches are considered. In partial coverage, the spatial distribution of additive damping by using viscoelastic material is as important as the thickness and material properties of the viscoelastic layer and the constraining layer. Indeed, to limit added mass and to attain maximum damping, the damping patches should be placed at optimum locations. These locations are often selected using the modal strain energy indicator. Following this approach, the damping patches are applied over regions of the base structure with the highest modal strain energy to target specific modes of vibration. In the present study, a more efficient indicator is proposed, which consists of placing the damping patches over regions of high energy dissipation through the viscoelastic layer of the fully covered sandwich beam. The presented approach is used in an optimization method to select the best location for the damping patches as well as the material thicknesses and material properties of the layers that will yield optimal damping with the minimum area of coverage.

Keywords: finite element model, damping treatment, viscoelastic materials, sandwich beam

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Authors: Yilin Ma, Zhaomiao Liu, Xiang Wang, Yan Pang

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Microscale droplets play an increasingly important role in various applications, including medical diagnostics, material synthesis, chemical engineering, and cell research due to features of high surface-to-volume ratio and tiny scale, which can significantly improve reaction rates, enhance heat transfer efficiency, enable high-throughput parallel studies as well as reduce reagent usage. As a mature technique to manipulate small amounts of liquids, droplet microfluidics could achieve the precise control of droplet parameters such as size, uniformity, structure, and thus has been widely adopted in the engineering and scientific research of multiple fields. Necking processes of the droplet in the cross junction microchannels are experimentally and theoretically investigated and dynamic mechanisms of the neck thinning in two different regimes are revealed. According to evolutions of the minimum neck width and the thinning rate, the necking process is further divided into different stages and the main driving force during each stage is confirmed. Effects of the flow rates and the cross-sectional aspect ratio on the necking process as well as the neck profile at different stages are provided in detail. The distinct features of the two regimes in the squeezing stage are well captured by the theoretical estimations of the effective flow rate and the variations of the actual flow rates in different channels are reasonably reflected by the channel width ratio. In the collapsing stage, the quantitative relation between the minimum neck width and the remaining time is constructed to identify the physical mechanism.

Keywords: cross junction, neck thinning, force analysis, inertial mechanism

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Authors: Mahmoud A Rabah, Sabah M. Abelbasir

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Lead-calcium alloy containing up to 0.10% calcium was recovered from spent rechargeable sealed acid lead batteries. Two techniques were investigated to explore the effect of flux salts on the extent and quality of the recovered alloy, pyro-metallurgical and electrochemical methods. About 10 kg of the spent batteries were collected for testing. The sample was washed with hot water and dried. The plastic cases of the batteries were mechanically cut, and the contents were dismantled manually, the plastic containers were shredded for recycling. The electrode plates were freed from the loose powder and placed in SiC crucible and covered with alkali chloride salts. The loaded crucible was heated in an electronically controlled chamber furnace type Nabertherm C3 at temperatures up to 800 °C. The obtained metals were analyzed. The effect of temperature, rate of heating, atmospheric conditions, composition of the flux salts on the extent and quality of the recovered products were studied. Results revealed that the spent rechargeable batteries contain 6 blocks of 6 plates of Pb-Ca alloy each. Direct heating of these plates in a silicon carbide crucible under ambient conditions produces lead metal poor in calcium content ( < 0.07%) due to partial oxidation of the alloying calcium element. Rate of temperature increase has a considerable effect on the yield of the lead alloy extraction. Flux salts composition benefits the recovery process. Sodium salts are more powerful as compared to potassium salts. Lead calcium alloy meeting the standard specification was successfully recovered from the spent rechargeable acid lead batteries with a very competitive cost to the same alloy prepared from primary resources.

Keywords: rechargeable lead batteries, lead-calcium alloy, waste recovery, flux salts, thermal recovery

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Authors: Turki Adnan Kamal, Abdulmajeed Ahmad Alsofiany, Nemer Khidhran Husain Alghamdi, Ali Eissa Hassan Al-Rajhi

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Background:- Health care workers are ranked as one of the most vulnerable groups experiencing violence and aggressive behavior compared to other occupational groups. Objectives:- To estimate the prevalence rate and characteristics and assess the avoidance measures, and notification of the violence among medical staff working in primary health care centers in Taif city. Subject and methods:- A cross-sectional study design was applied among all physicians and a representative sample of nurses working in primary health care centers affiliated with the Ministry of Health (MOH) in Taif city. A predesigned Arabic/English validated self-administered questionnaire was used. Results:- In this study, 56 physicians and 145 nurses responded, giving a response rate of 77.6%. Their age ranged from 25 and 60 years (36.2±8.2), with 59.7% of them aged between 25 and 35 years. Males represent 55.7% of them. More than half of them (52.2%) were Saudis. The prevalence of workplace violence was 30.3%. Verbal abuse was the commonest reported type (86.9%). The absence of security, training on the procedures that must be followed and special uniforms at the workplace were significantly associated with workplace violence. We concluded that workplace violence is a significant problem facing a considerable proportion of HCWs in primary health care centers in Taif, Saudi Arabia. Most violence incidents were verbal. Conclusion:- Findings of this study revealed that HCWs who were dealing with male patients only were at high risk of workplace violence and the absence of measures to avoid workplace violence, particularly security, training on the procedures that must be followed and special uniform at the workplace was significantly associated with workplace violence.

Keywords: violence, workplace, primary health care, prevalence, avoidance

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Authors: N. Ayob, N. C. Nkosi, R. P. Burger, S. J. Piketh, F. Letlaila, O. Maphosa

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South African higher tertiary institution have been faced with high dropout rates. About 50 to 60% of first years drop out to due to various reasons one being inadequate academic support. Geography 111 (GEOG 111) module is historically known for having below 50% pass rate, high dropout rate and identified as a first year risk module. For the first time GEOG 111 (2021) on the Mahikeng Campus admitted 150 students pursuing more than 6 different qualifications (BA and BSc) from the Humanities Faculty and FNAS. First year students had difficulties transitioning from secondary to tertiary institutions as we shifted to remote learning while we navigate through the Covid-19 pandemic. The traditional method of teaching does not encourage students to help each other. With remote learning we do not have control over what the students share and perhaps this can be a learning opportunity to embrace peer learning and change the manner in which we assess the students. The purpose of this pilot study was to assist GEOG111 students with academic challenges whilst improving their University experience. This was a qualitative study open to all GEOG111, repeaters, students who are not confident in their Geographical knowledge and never did Geography at high school level. The selected 9 Golden Key International Honour Society Geography mentors attended an academic mentor training program with module lecturers. About 17.6% of the mentees did not have a geography background however, 94% of the mentees passed, 1 mentee had a mark of 38%. 11 of the participants had a mark >60% with one student that excelled 70%. It is evident that mentorship helped students reach their academic potential. Peer learning and mentoring are associated with improved academic performance and allows the students to take charge of their learning and academic experience. Thus an important element as we transform pedagogies at higher learning institutions.

Keywords: geography, risk module, peer mentoring, peer learning

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Authors: Ping Zhou, Dawu Xiao, Chunli Jiang, Ge Sang

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Deformation twinning plays an important role in the mechanical properties of Ti which has high specific strength and excellent corrosion resistance ability. To investigate the twinning behavior of Ti under high strain rate compression, the split Hopkinson pressure bar (SHPB) was adopted to deform samples to different strains at room temperature. In addition, twinning behaviors under varied temperatures of 373K, 573K and 873K were also investigated. The cylindrical-shaped samples with purity 99.995% were annealed at 1073K for 1 hour in vacuum before compression. All the deformation twins were identified by electron backscatter diffraction (EBSD) techniques. The mechanical behavior showed three-stage work hardening in stress-strain curves for samples deformed at temperature 573K and 873K, while only two stages were observed for those deformed at room temperature. For samples compressed at room temperature, the predominant twin types are {10-12}<10-11> (E1), {11-21}<11-26> (E2) and {11-21}<11-23> (C1). The secondary and tertiary twinning was observed inside some E1, E2 and C1 twins. Most of the twin boundaries of E2 acted as the nucleate sites of E1. The densities of twins increase remarkably with increment of strains. For samples compressed at relatively higher temperatures, the migration of twin boundaries of E1, E2 and C1 was observed. All the twin lamellas shorten with temperature, and nearly disappeared at 873K except some remaining E1 twins. Polygonizations of grain boundaries were observed above 573K. The microstructure intended to have a texture with c-axes parallel to compression direction with temperature increment. Factors affecting the dynamic recovery and re-crystallization were discussed.

Keywords: deformation twins, EBSD, mechanical behavior, high strain rate, titanium

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Authors: Preetinder Kaur Randhawa

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The rural areas can be differentiated from urban areas in terms of their economic activities as rural areas are primarily involved in agricultural sector and provide natural resources whereas, urban areas are primarily involved in infrastructure sector and provide manufacturing services. Census of India defines a Census Town as an area which satisfies the following three criteria i.e. population exceeds 5000, at least 75 percent of male population engaged in non-agricultural sector and minimum population density of 400 persons per square kilometers. Urban areas can be attributed to the improvement of transport facilities, the massive decline in agricultural, especially male workers and workers shift to non-agricultural activities. This study examines the pattern, process of rural areas transformed into urban areas/ census town. The study has analyzed the various factors which are responsible for land transformation as well as the socio-economic transformation of the village population. Nilpur (CT) which belongs to Rajpura Tehsil in Patiala district, Punjab has been selected for the present study. The methodology adopted includes qualitative and quantitative research design, methods based on secondary data. Secondary data has been collected from unpublished revenue record office of Rajpura Tehsil and Primary Census Abstract of Patiala district, Census of India 2011. The results have showed that rate of transformation of a village to census town in Rajpura Tehsil has been one of highest among other villages. The census town has evolved through the evolutionary process of human settlement which grows in size, population and physical development. There must be a complete economic transformation and attainment of high level of technological development. Urban design and construction of buildings and infrastructure can be carried out better and faster and can be used to aid human habitation with the enhancement of quality of life. The study has concluded that in the selected area i.e Nilpur (CT) literacy rate has increased to 72.1 percent in year 2011 from 67.6 percent in year 2001. Similarly non-agricultural work force has increased to 95.2 percent in year 2011 from 81.1 percent in year 2001. It is very much clear that the increased literacy rate has put a positive impact on the involvement of non-agricultural workers have enhanced. The study has concluded that rural-urban linkages are important tools for understanding complexities of people livelihood and their strategies which involve mobility migration and the diversification of income sources and occupations.

Keywords: Census Town, India, Nilpur, Punjab

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Authors: Prakash Singh

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Employees who are satisfied at their place of work rate their leaders’ intrapersonal competencies as being high. They also believe that a leader’s intrapersonal competencies influence their sense of job satisfaction. Employees who indicate that they are unhappy at their place of work rate their leaders’ intrapersonal competencies as being low. They also believe that a leader’s intrapersonal intelligence influence their feeling of job satisfaction. The leader’s appropriate intrapersonal competencies are crucial to the creation of a motivated and satisfied employee team. In this study, the quantitative research method was used to determine the employees’ perceptions of their leaders’ intrapersonal competencies and their influence on their job satisfaction; the six competencies being self-awareness, self-confidence, self-expression, self-control, adaptability, and optimism. All the competencies of leaders identified in this quantitative study can therefore be described as intervening variables that influence an employee’s sense of job satisfaction. The number of responses that indicate that each of the intrapersonal competencies of a leader that will have an influence on an employee’s sense of job satisfaction, ranges from 93% (a leader’s sense of self-awareness) to 99% (a leader’s ability to be adaptable). As the responses are significantly similar, it can be stated that the respondents indicate that all the intrapersonal competencies of a leader can influence an employee’s sense of job satisfaction. The findings of this study strongly suggest that in order to be satisfied at work, employees prefer to be led by leaders who are confident in their leadership roles; who send out clear, unambiguous messages; who maintain self-control; who are adaptable and flexible;, who face the future with optimism and who support the establishment of a collegial working environment. Evidently, the findings corroborate the hypothesis that employees believe that the intrapersonal competencies of leaders have a positive influence on the employees’ sense of job satisfaction. This study’s findings, therefore, confirm that the key to the leaders’ self-knowledge is access to their own feelings and the ability to discriminate among them and draw upon them to guide behaviour in their organisations. This exploratory study makes a contribution to the emerging research being accomplished on leaders’ intrapersonal intelligence with more research still needing to be attempted to determine to what extent these competencies of leaders can reshape the organizational climate and culture.

Keywords: emotional intelligence, employees’ job satisfaction, leaders’ intrapersonal competencies, leaders’ self-knowledge

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Authors: D. Amaranatha Reddy

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Highly efficient and stable co-catalysts materials is of great important for boosting photo charge carrier’s separation, transportation efficiency, and accelerating the catalytic reactive sites of semiconductor photocatalysts. As a result, it is of decisive importance to fabricate low price noble metal free co-catalysts with high catalytic reactivity, but it remains very challenging. Considering this challenge here, dual metal organic frame work derived N-Doped Fe3C nanocages have been rationally designed and decorated with ultrathin ZnIn2S4 nanosheets for efficient photocatalytic hydrogen generation. The fabrication strategy precisely integrates co-catalyst nanocages with ultrathin two-dimensional (2D) semiconductor nanosheets by providing tightly interconnected nano-junctions and helps to suppress the charge carrier’s recombination rate. Furthermore, constructed highly porous hybrid structures expose ample active sites for catalytic reduction reactions and harvest visible light more effectively by light scattering. As a result, fabricated nanostructures exhibit superior solar driven hydrogen evolution rate (9600 µmol/g/h) with an apparent quantum efficiency of 3.6 %, which is relatively higher than the Pt noble metal co-catalyst systems and earlier reported ZnIn2S4 based nanohybrids. We believe that the present work promotes the application of sulfide based nanostructures in solar driven hydrogen production.

Keywords: photocatalysis, water splitting, hydrogen fuel production, solar-driven hydrogen

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Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

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Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

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Authors: Sameer Gupta, Prant Gupta

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Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

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Authors: S. Y. Lin, C. H. Kuan, C. H. She, W. T. Wang

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In this study, ultrasonic assisted machining (UAM) technique is applied in side-surface milling experiment for glass-ceramic workpiece material. The tungsten carbide cutting-tool with diamond coating is used in conjunction with two kinds of cooling/lubrication mediums such as water-soluble (WS) cutting fluid and minimum quantity lubricant (MQL). Full factorial process parameter combinations on the milling experiments are planned to investigate the effect of process parameters on cutting performance. From the experimental results, it tries to search for the better process parameter combination which the edge-indentation and the surface roughness are acceptable. In the machining experiments, ultrasonic oscillator was used to excite a cutting-tool along the radial direction producing a very small amplitude of vibration frequency of 20KHz to assist the machining process. After processing, toolmaker microscope was used to detect the side-surface morphology, edge-indentation and cutting tool wear under different combination of cutting parameters, and analysis and discussion were also conducted for experimental results. The results show that the main leading parameters to edge-indentation of glass ceramic are cutting depth and feed rate. In order to reduce edge-indentation, it needs to use lower cutting depth and feed rate. Water-soluble cutting fluid provides a better cooling effect in the primary cutting area; it may effectively reduce the edge-indentation and improve the surface morphology of the glass ceramic. The use of ultrasonic assisted technique can effectively enhance the surface finish cleanness and reduce cutting tool wear and edge-indentation.

Keywords: glass-ceramic, ultrasonic assisted machining, cutting performance, edge-indentation

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Authors: Harmeet Pal Singh Dhooria, Deepinder Chinna, UPS Sidhu, Alok Jain

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Serious infections caused by gram-negative bacteria are a significant cause of mortality and morbidity in the hospital setting. In acute care facilities like in intensive care units (ICUs), the intensity of antimicrobial use together with a population highly susceptible to infection, creates an environment, which facilitates both emergence and transmission of Extended Spectrum -lactamase (ESBL) producing Enterobacteriaceae species. The study was conducted in the Medical Intensive Care Unit (MICU) and the Pulmonary Critical Care Unit (PCCU) of the Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Out of a total of 1108 samples of urine, blood and respiratory tract secretions received for culture and sensitivity analysis from Medical Intensive Care Unit and Pulmonary Critical Care Unit, a total of 170 isolates of Enterobacteriaceae species were obtained which were then included in our study. Out of these 170 isolates, confirmed ESBL production was seen in 116 (68.24%) cases. E.coli was the most common species isolated (56.47%) followed by Klebsiella (32.94%), Enterobacter (5.88%), Citrobacter (3.53%), Enterobacter (0.59%) and Morganella (0.59%) among the total isolates. The rate of ESBL production was more in Klebsiella (78.57%) as compared to E.coli (60.42%). ESBL producers were found to be significantly more common in patients with prior history of hospitalization, antibiotic use, and prolonged ICU stay. Also significantly increased the prevalence of ESBL related infections was observed in patients with a history of catheterization or central line insertion but not in patients with the history of intubation. Patients who had an underlying malignancy had significantly higher prevalence of ESBL related infections as compared to other co-morbid illnesses. A slightly significant difference in the rate of mortality/LAMA was observed in the ESBL producer versus the non-ESBL producer group. The rate of mortality/LAMA was significantly higher in the ESBL related UTI but not in the ESBL related respiratory tract and bloodstream infections. ESBL producing isolates had significantly higher rates of resistance to Cefepime and Piperacillin/Tazobactum, and to non β-lactum antibiotics like Amikacin and Ciprofloxacin. The level of resistance to Imipenem was lower as compared to other antibiotics. However, it was noted that ESBL producing isolates had higher levels of resistance to Imipenem as compared to non-ESBL producing isolates. Conclusion- The prevalence of ESBL producing organisms was found to be very high (68.24%) among Enterobacteriaceae isolates in our ICU setting as among other ICU care settings around the world.

Keywords: enterobacteriaceae, extended spectrum B-lactamase (ESBL), ICU, antibiotic resistance

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