Search results for: cross breed

Authors: Ahmad Esmaillzadeh, Javad Anjom-Shoae, Omid Sadeghi,

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Background: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nuts consumption in relation to psychological disorders. Objective: The current study aimed to examine the association of legume and nuts consumption with depression, anxiety and psychological distress in Iranian adults. Methods: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nuts consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected through the use of General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress. Results: Mean age of participants was 36.5±7.9 years. Compared with the lowest quintile, men in the highest quintile of legume and nuts consumption had lower odds of anxiety; such that after adjusting for potential confounding variables, men in the top quintile of legume and nuts consumption were 66% less likely to be anxious than those in the bottom quintile (OR: 0.34; 95% CI: 0.14-0.82). Such relationship was not observed among women. We failed to find any significant association between legume plus nuts consumption and depression or psychological distress after adjustment for potential confounders. Conclusion: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No significant association was seen between consumption of legume and nuts and odds of depression or psychological disorder. Further prospective studies are required to confirm these findings.

Keywords: anxiety, depression, legumes, nuts, psychological distress

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Authors: Junzhang Wu, Yifeng Zou, Alessandro Manzardo, Antonio Scipioni

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Dynamic expiration dates (DEDs) play an essential role in reducing food waste in the context of the sustainable cold chain and food system. However, it is unknown for the trades-off in retail benefits when setting an expiration date on fresh food products. This study aims to develop a multi-dimensional decision-making model that integrates DEDs with food waste based on wireless sensor network technology. The model considers the initial quality of fresh food and the change rate of food quality with the storage temperature as cross-independent variables to identify the potential impacts of food waste in retail by applying s DEDs system. The results show that retail benefits from the DEDs system depend on each scenario despite its advanced technology. In the DEDs, the storage temperature of the retail shelf leads to the food waste rate, followed by the change rate of food quality and the initial quality of food products. We found that the DEDs system could reduce food waste when food products are stored at lower temperature areas. Besides, the potential of food savings in an extended replenishment cycle is significantly more advantageous than the fixed expiration dates (FEDs). On the other hand, the information-sharing approach of the DEDs system is relatively limited in improving sustainable assessment performance of food waste in retail and even misleads consumers’ choices. The research provides a comprehensive understanding to support the techno-economic choice of the DEDs associated with food waste in retail.

Keywords: dynamic expiry dates (DEDs), food waste, retail benefits, fixed expiration dates (FEDs)

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Authors: Zhibin Lei, Minghui Yang

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Ningwu-Jingle basin is a structural syncline which has undergone a complex tectono-thermal history since Cretaceous. It stretches along the strike of the northern Lvliang Mountains which are the most important mountains in the middle and west of North China Craton. The Mesozoic units make up of the core of Ningwu-Jingle Basin, with pre-Mesozoic units making up of its flanks. The available low-temperature thermochronology implies that Ningwu-Jingle Basin has experienced two stages of uplifting: 94±7Ma to 111±8Ma (Albian to Cenomanian) and 62±4 to 75±5Ma (Danian to Maastrichtian). In order to constrain its tectono-thermal history in the Cenozoic, both apatite (U-Th-Sm)/He and fission track dating analysis are applied on 3 Middle Jurassic and 3 Upper Triassic sandstone samples. The central fission track ages range from 74.4±8.8Ma to 66.0±8.0Ma (Campanian to Maastrichtian) which matches well with previous data. The central He ages range from 20.1±1.2Ma to 49.1±3.0Ma (Ypresian to Burdigalian). Inverse thermal modeling is established based on both apatite fission track data and (U-Th-Sm)/He data. The thermal history obtained reveals that all 6 sandstone samples cross the high-temperature limit of fission track partial annealing zone by the uppermost Cretaceous and that of He partial retention zone by the uppermost Eocene to the early Oligocene. The result indicates that the middle and west of North China Craton is not stable in the Cenozoic.

Keywords: apatite fission track thermochronology, apatite (u–th)/he thermochronology, Ningwu-Jingle basin, North China craton, tectono-thermal history

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Authors: Rong Sun, Laihong Shen

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La-based perovskite oxygen carriers, especially the doped-La(M)FeO₃, showed excellent performances during chemical looping processes. However, the mechanisms of the undoped and doped La(M)FeO₃ are not clear at present, making the mechanisms clear may help the development of chemical looping technologies. In this paper, the method based on the density function theory (DFT) was used to analysis the influence of Ca, Sr, and Ba doping of La on the electronic structure, while the CO oxidation mechanisms on the surface of LaFeO₃ and Ca-doped LaFeO₃ oxygen carriers were also analyzed. The results showed that the band gap was decreased by the doping of low valence. While the doping of low valence element Ca, Sr, and Ba at La site simultaneously resulted to the moving of the valence band toward high energy and made the valence band cross the Fermi energy level. This was resulted from the holes generated by divalent ion substitution. The holes can change the total magnetization from antiferromagnet to weakly ferromagnetism. The calculation results about the formation of oxygen vacancy showed that substitutions of Ca, Sr, and Ba caused a large drop in oxygen vacancy formation energy, indicating that the bulk oxygen transport was improved. Based on the optimized bulk of the undoped and Ca-doped LaFeO₃(010) surface, the CO adsorption was analyzed. The results indicated that the adsorption energy increased by divalent ion substitution, meaning that the adsorption stability decreased. The results can provide a certain theoretical basis for the development of perovskite oxides in chemical looping technologies.

Keywords: chemical looping technologies, lanthanum ferrate (LaFeO₃), divalent ion substitution, CO oxidation

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Authors: Lisa Winstead, Penny Congcong Wang

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This two-year multiple case study of eight Spanish-English speaking teachers explores bilingual-bicultural Latino teachers’ lived experiences as English Language Learners and, more recently, as adult teachers who work with English Language Learners in mainstream schools. Research questions explored include: How do bilingual-bicultural teachers perceive their native language use and sense of self within society from childhood to adulthood? Correspondingly, what are bilingual teachers’ perceptions of how their own language learning experience might affect teaching students of similar linguistic and cultural backgrounds? This study took place in an urban area in the Pacific Southwest of the United States. Participants were K-8 teachers and enrolled in a Spanish-English bilingual authorization program. Data were collected from journals, focus group interviews, field notes, and class artifacts. Within case and cross-case analysis revealed that the participants were shamed about their language use as children which contributed to their primary language loss. They similarly reported how experiences of mainstream educator and administrator language shaming invalidated their ability to provide support for Latino heritage ELLs, despite their bilingual-bicultural expertise. However, participants reported that counter-narratives from the bilingual authorization program, parents, community and church organizations, and cultural responsive teachers were effective in promoting their language retention, pride, and feelings of well-being.

Keywords: teacher education, bilingual education, English language learners, emergent bilinguals, social justice, language shame, language loss, translanguaging

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Authors: Pronob Kumar Mozumder, M. Abdur Rob Mollah

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This research was conducted in two coastal locations of Bangladesh from February, 2013 to January, 2014.The objective of this research was to assess the potential vulnerabilities of climate change on local ecosystem and people and to identify and recommend local level adaptation strategies to climate change. Focus group discussions, participatory rural appraisal, interviewing local elderly people were conducted. Perceptions about climate change indicate that local people are experiencing impacts of climate change. According to local people, temperature, cyclone, rain, water-logging, siltation, salinity, erosion, and flash flood are increasing. Vulnerability assessment revealed that local people are variously affected by abnormal climate related disasters. This is jeopardizing their livelihoods, risking their lives, health, and their assets. This prevailing climatic situation in the area is also impacting their environmental conditions, biodiversity and natural resources, and their economic activities. The existing adaptation includes using traditional boat and mobile phone while fishing and making house on high land and lower height. Proposed adaptation for fishing boat are using more than 60 feet length with good timber, putting at least 3 longitudinal bar along upper side, using enough vertical side bars. The homestead measures include use of cross bracing of wall frame, roof tying with extra-post by ropes and plantation of timber tree against wind.

Keywords: community level vulnerabilities, climate change, Cox’s Bazar-Teknaf Coastal Area, Bangladesh

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Authors: Saman Naqvi

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Introduction: Telemedicine is the practise of providing remote healthcare to patients via the utilisation of communication technologies. Its application has become increasingly important since the Coronavirus Disease 2019 (COVID-19) pandemic. It is essential to determine the knowledge and attitudes of healthcare professionals concerning its use in order to maximise its application. Purpose: We aim to examine and evaluate the current understanding and perceptions of medical staff toward the use of telemedicine. Methods: In this cross-sectional study, we surveyed 1091 healthcare professionals worldwide. Following an extensive review of the literature, data were gathered using a questionnaire. To depict the participant profile, frequency, percentages, and cumulative percentages were determined. Results: The majority of respondents had either heard of (90.9%), seen (65.3%), or were familiar with (74.6%) how telemedicine is implemented in practice. 72.2% of people were familiar with the tools that could be applied to this technology. Those with a medical degree and experience of under five years were found to be more familiar with telemedicine. Additionally, opinions on providing healthcare remotely were largely favorable, with 80% of respondents stating that it reduced staff burden and 80.6% thinking that it eliminated unnecessary transportation costs. Furthermore, 83% expressed that it saves clinicians' time. However, 20% of participants believed telemedicine adds to staff workload and 40% of healthcare professionals felt it compromises patient privacy and information confidentiality. Conclusion: Despite being a new and developing practice in many countries, telemedicine appears to have a bright future. This is crucial during a pandemic as it provides effective healthcare while maintaining social isolation measures. Moreover, the majority of the participants in this study demonstrated a good understanding and a favorable attitude toward telemedicine.

Keywords: healthcare system, global survey, knowledge, attitude, covid 19, telemedicine

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Authors: Rian Diana, Naufal Muharam Nurdin, Faisal Anwar, Hadi Riyadi, Ali Khomsan

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The use of traditional medicine (herbs and medicinal plants) are common among Indonesian people especially the elderly. Few study explore the use of medicinal plants in middle aged people. This study aims to collect information on the use of medicinal plants in middle aged people in rural areas. This cross sectional study included 224 subjects aged 45-59 years old and conducted in Cianjur District, West Java in 2014. Semi-structured questionnaires were used to collect information about preference in treatment of illness, the use of medicinal plants, and their purposes. Information also recorded plant names, parts used, mode of preparation, and dosage. Buying drugs in stall (83.9%) is the first preference in treatment of illness, followed by modern treatment 19.2% (doctors) and traditional treatment 17.0% (herbs/medicinal plants). 87 subjects (38.8%) were using herbs and medicinal plants for curative (66.7%), preventive (31.2%), and rehabilitative (2.1%) purposes. In this study, 48 species are used by the subjects. Physalis minima L. 'cecenet', Orthosiphon aristatus Mic. 'kumis kucing', and Annona muricata 'sirsak' are commonly used for the treatment of hypertension and stiffness. Leaves (64.6%) are the most common part used. Medicinal plants were washed and boiled in a hot water. Subject drinks the herbs with a different dosage. One in three middle aged people used herbal and medicinal plants for curative and preventive treatment particularly hypertension and stiffness. Increasing knowledge about herbal or medicinal plants dosage and their interaction with medical drugs are important to do.Doses vary between 1-3 glasses/day for treatment and 1-2 glasses/months for prevention of diseases.

Keywords: herbs, hypertension, medicinal plants, middle age, rural

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Authors: Reuben Kinyuru Njuguna, Martin Mabuya Njuguna

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Digital platforms, such as The Internet, and the advent of digital marketing strategies, have led to many changes in the marketing of goods and services. These have resulted in improved service quality, enhanced customer relations, productivity gains, marketing transaction cost reductions, improved customer service and flexibility in fulfilling customers’ changing needs and lifestyles. Consequently, the purpose of this study was to determine the effect of digital marketing practices on the financial performance of mobile network operators in the telecommunications industry in Kenya. The objectives of the study were to establish how digital customer relationship management strategies on performance of mobile network operators in Kenya. The study used an explanatory cross-sectional survey research design, while the target population was made up of from the 4 major mobile network operators in Kenya, namely Safaricom Limited, Airtel Networks Kenya Limited, Finserve Africa Limited and Telkom Kenya Limited. Sampling strategy was stratified sampling with a sample size of 97 respondents. Digital customer relationship strategies were seen to influence firm performance, through enhancing convenience, building trust, encouraging growth in market share through creating sustainable relationships, building commitment with customers, enhancing customer retention and customer satisfaction. Digital customer relationship management were seen to maximize gross profits by increasing customer satisfaction, loyalty and retention. The study recommended upscaling the use of digital customer relationship management strategies to further enhance firm performance, given their great potential in this regard.

Keywords: customer relationship management, customer service delivery, performance, customer satisfaction

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Authors: Vedansh Gupta, Allyson Lutz, Ameen Razavi, Fatemeh Shirazi

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The agriculture industry is especially vulnerable to forecasted water shortages. In the fresh and fresh-cut produce sector, conventional flume-based washing with recirculation exhibits high water demand. This leads to a large water footprint and possible cross-contamination of pathogens. These can be alleviated through advanced water reuse processes, such as membrane technologies including reverse osmosis (RO). Water reuse technologies effectively remove dissolved constituents but can easily foul without pre-treatment. Biological treatment is effective for the removal of organic compounds responsible for fouling, but not at the low temperatures encountered at most produce processing facilities. This study showed that the Microvi MicroNiche Engineering (MNE) technology effectively removes organic compounds (> 80%) at low temperatures (6-8 °C) from wash water. The MNE technology uses synthetic microorganism-material composites with negligible solids production, making it advantageously situated as an effective bio-pretreatment for RO. A preliminary technoeconomic analysis showed 60-80% savings in operation and maintenance costs (OPEX) when using the Microvi MNE technology for organics removal. This study and the accompanying economic analysis indicated that the proposed technology process will substantially reduce the cost barrier for adopting water reuse practices, thereby contributing to increased food safety and furthering sustainable water reuse processes across the agricultural industry.

Keywords: biological pre-treatment, innovative technology, vegetable processing, water reuse, agriculture, reverse osmosis, MNE biocatalysts

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Authors: Bernard L. Middleton, Susan P. Cosgrove

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There is an immediate need for alternative anti-herpetic treatment options effective for both primary infections and reoccurring reactivations of herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). Alternatives currently approved for the purposes of clinical administration includes antivirals and a reduced set of nucleoside analogues. The present article tests a treatment based on a systemic understanding of how the herpes virus affects cell inhibition and breakdown and targets different phases of the viral cycle, including the entry stage, reproductive cross mutation, and cell-to-cell infection. The treatment consisted of five immunotherapeutic core compounds (5CC), which were hypothesized to be capable of neutralizing human monoclonal antibodies. The tested 5CC were noted as being functional in the application of eliminating the DNA synthesis of herpes viral interferon (IFN) - induced cellular antiviral response. They were here found to neutralize antiviral reproduction by blocking cell-to-cell infection. The activity of the 5CC was tested on RC-37 in vitro using an assay plaque reduction and in vivo against HSV-1 and HSV-2. The 50% inhibitory concentration (IC50) of 5CC was 0.0009% for HSV-1 plaque formation and 0.0008% for HSV-2 plaque formation. Further tests were performed to evaluate the susceptibility of HSV-1 and HSV-2 to anti-herpetic drugs in Vero cells after virus entry. There were high-level markers of the 5CC virucidal activity in the viral suspension of HSV-1 and HSV-2. These concentrations of the 5CC are nontoxic and reduced plaque formation by 98.2% for HSV-1 and 93.0% for HSV-2. Virus HSV-1 and HSV-2 titers were reduced significantly by 5CC to the point of being negative, ranging 0.01–0.09 in 72%. The results concluded the 5CC as being an effective treatment option for the herpes simplex virus.

Keywords: synergy pharmaceuticals, herpes treatment, herpes cure, synergy pharmaceuticals treatment

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Authors: Jichi Wu

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The dwindling of resources requires a more sustainable design. New technology could bring new materials and processing techniques to the fashion industry and push it to a more sustainable future. Thus this paper explores cutting-edge researches on the life-cycle of closed-loop products and aims to find innovative ways to recycle and upcycle. For such a goal, the author investigated how low utilization plants and leftover fiber could be turned into ecological textiles in fashion. Through examining the physical and chemical properties (cellulose content/ fiber form) of ecological textiles to explore their wearability, this paper analyzed the prospect of bio-fabrics (weavable plants) in body-oriented fashion design and their potential in sustainable fashion and textile design. By extracting cellulose from 9 different types or sections of plants, the author intends to find an appropriate method (such as ion solution extraction) to mostly increase the weavability of plants, so raw materials could be more effectively changed into fabrics. All first-hand experiment data were carefully collected and then analyzed under the guidance of related theories. The result of the analysis was recorded in detail and presented in an understandable way. Various research methods are adopted through this project, including field trip and experiments to make comparisons and recycle materials. Cross-discipline cooperation is also conducted for related knowledge and theories. From this, experiment data will be collected, analyzed, and interpreted into a description and visualization results. Based on the above conclusions, it is possible to apply weavable plant fibres to develop new textile and fashion.

Keywords: wearable bio-textile, sustainability, economy, ecology, technology, weavability, fashion design

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Authors: Mohammad Saleem, Neeta Kumar, Anita Sharma, Sazina Muzammil

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It is observed that some of the dental students in our setting take less interest in medical subjects. Various teaching methods are focus of research interest currently and being tried to generate interest among students. An approach of interactive integrated tutorial was used to assess its feasibility in teaching medical subjects to dental undergraduates. The aim was to generate interest and promote active self-learning among students. The objectives were to (1) introduce the integrated interactive learning method through two departments, (2) get feedback from the students and faculty on feasibility and effectiveness of this method. Second-year students in Bachelor of Dental Surgery course were divided into two groups. Each group was asked to study physiology and pathology of a common and important condition (anemia and hypertension) in a week’s time. During the tutorial, students asked questions on physiology and pathology of that condition from each other in the presence of teachers of both physiology and pathology departments. The teachers acted only as facilitators. After the session, the feedback from students and faculty on this alternative learning method was obtained. Results: Majority of the students felt that this method of learning is enjoyable, helped to develop reasoning skills and ability to correlate and integrate the knowledge from two related fields. Majority of the students felt that this kind of learning led to better understanding of the topic and motivated them towards deep learning. Teachers observed that the study promoted interdepartmental cross-discipline collaboration and better students’ linkages. Conclusion: Interactive integrated tutorial is effective in motivating dental students for better and deep learning of medical subjects.

Keywords: active learning, education, integrated, interactive, self-learning, tutorials

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Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Saja M. Nabat Al-Ajrash, Charles Browning, Rose Eckerle, Li Cao

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A process that utilizes a combination of additive manufacturing (AM), a preceramic polymer, and a chopped carbon fiber precursorto fabricate Silicon Carbon/ Carbon fibers (SiC/C) composites have been developed. The study has shown a promising, cost-effective, and efficient route to fabricate complex SiC/C composites using additive manufacturing. A key part of this effort was the mapping of the material’s microstructure through the thickness of the composite. Microstructural features in the pyrolyzed composites through the successive AM layers, such as defects, crystal size and their distribution, interatomic spacing, chemical bonds, were investigated using high-resolution scanning and transmission electron microscopy. As a result, the microstructure developed in SiC/C composites after printing, cure, and pyrolysis has been successfully mapped through the thickness of the derived composites. Dense and nearly defect-free parts after polymer to ceramic conversion were observed. The ceramic matrix composite displayed three coexisting phases, including silicon carbide, silicon oxycarbide, and turbostratic carbon. Lattice fringes imaging and X-Ray Diffraction analysis showed well-defined SiC and turbostratic carbon features. The cross-sectional mapping of the printed-then-pyrolyzed structures has confirmed consistent structural and chemical features within the internal layers of the AM parts. Noteworthy, however, is that a crust-like area with high crystallinity has been observed in the first and last external layers. Not only do these crust-like regions have structural characteristics distinct from the internal layers, but they also have elemental distributions different than the internal layers.

Keywords: SiC, preceramic polymer, additive manufacturing, ceramic

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Authors: Fabiana Souza Orlandi, Juliana Gomes Duarte, Gabriela Dutra Gesualdo

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Chronic renal disease (CKD), accompanied by hemodialysis, causes chronic renal failure in a number of situations that compromises not only physical, personal and environmental aspects, but also psychological, social and family aspects. Objective: To verify the level of cognitive impairment of chronic renal patients on hemodialysis. Methodology: This is a descriptive, cross-sectional study. The present study was performed in a Dialysis Center of a city in the interior of the State of São Paulo. The inclusion criteria were: being 18 years or older; have a medical diagnosis of CKD; being in hemodialysis treatment in this unit; and agree to participate in the research, with the signature of the Informed Consent (TCLE). A total of 115 participants were evaluated through the Participant Characterization Instrument and the Addenbrooke Cognitive Exam - Revised Version (ACE-R), being scored from 0 to 100, stipulating the cut-off note for the complete battery <78 and subdivided into five domains: attention and guidance; memory; fluency; language; (66.9%) and caucasian (54.7%), 53.7 (±14.8) years old. Most of the participants were retired (74.7%), with incomplete elementary schooling (36.5%) and the average time of treatment was 46 months. Most of the participants (61.3%) presented impairment in the area of attention and orientation, 80.4% in the spatial visual domain. Regarding the total ACE-R score, 75.7% of the participants presented scores below the established cut grade. Conclusion: There was a high percentage (75.7%) below the cut-off score established for ACE-R, suggesting that there may be some cognitive impairment among these participants, since the instrument only performs a screening on cognitive health. The results of the study are extremely important so that possible interventions can be traced in order to minimize impairment, thus improving the quality of life of chronic renal patients.

Keywords: cognition, chronic renal insufficiency, adult health, dialysis

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Authors: Clementina Ebere Okoro, Olumuyiwa Adeyemi Owolabi, Doris Bola James, Aloysius Nwabugo Maduforo, Andrew Lingililani Mbewe, Christopher Osaruwanmwen Isokpunwu

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Poor dietary practices and malnutrition, including severe acute malnutrition among under-five children in Nigeria has remained a great public health concern. This study assessed infant and young child feeding practices and nutritional status of under-five children to determine the prevalence of malnutrition of under-five children in Kuje area council, Abuja. The study was a cross-sectional study. Multi-stage sampling techniques was used in selecting the population that was studied. Probability proportion by size was applied in choosing 30 clusters for the survey using ENA for SMART software 2011 version. Questionnaires were used to obtain information from the population, while appropriate equipment was used for measurements of anthropometric parameters. The data was also subjected to statistical analysis. Results were presented in tables and figures. The result showed that 96.7% of the children were breastfed, 30.6% had early initiation to breastfeeding within first hour of birth and 22.4% were breastfed exclusively up to 6 months, 69.8% fed infants’ colostrum, while 30.2% discarded colostrum. About half of the respondents (49.1%) introduced complementary feeding before six months and 23.2% introduced it after six months while 27.7% had age appropriate timely introduction of complementary feeding. The anthropometric result showed that the prevalence of global acute malnutrition (GAM) was 12.8%, severe wasting prevalence was 5.4%, moderate wasting was 7.4%, underweight was 24.4%, stunting was 40.3% and overweight was 7.0%. The result showed that there is a high prevalence of malnutrition among under-five children in Kuje

Keywords: malnutrition, under five children, breastfeeding, complementary feeding

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Authors: S. I. Nwadioha, M. S. Odimayo, J. A. Omotayo, A. Olu Taiwo, O. E. Olabiyi

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The current study was conducted to determine the epidemiology and antibiotic sensitivity pattern of bacteria isolated from blood of septicemic patients for improved antibiotic therapy. A three-year descriptive study has been carried out at Microbiology Laboratory, Ekiti State University Teaching Hospital, Ado Ekiti, from April 2012 to April 2015. Information compiled from patients’ records includes age, sex, isolated organisms and antibiotic susceptibility patterns. Three hundred and thirteen blood cultures were collected from neonatology and pediatrics wards, Out Patients’ Department (OPD) and from other adult patients. Forty-one cultures yielded mono microbial growth (no polymicrobial growth), giving an incidence of 13.1% positive blood culture (N=41/313). There were 58.4% Gram-negative bacilli and 41.6% Gram-positive cocci in the microbial growth. Bacteria isolated were Staphylococcus aureus 34%(14/41), Klebsiella species22% (9/41), Enterococci 17%(7/41), Proteus species12%(5/41), Escherichia coli 7%(3/41) and Streptococcal pneumoniae 7%(3/41). There was a (35%) higher occurrence of septicemia in neonates than in any other age groups in the hospital. Bacterial sensitivity to 13 antibiotic agents was determined by antibiotics disc diffusion using modified Kirby Bauer’s method. Gram-positive organisms showed a higher antibiotic sensitivity ranging from 14- 100% than the Gram-negative bacteria (11-80%). Staphylococcus aureus and Klebsiella species are the most prevalent organisms. The third generation Cephalosporins (Ceftriaxone) and Floroquinolone(Levofloxacin, Ofloxacin) have proved reliable for management of these blood infections.

Keywords: blood cultures, septicemia, antibiogram, Nigeria

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Authors: P. K. Sarkar, Amit Kumar Jain

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The demand for Urban transportation is characterised by a large scale temporal and spatial variations which causes heavy congestion inside metro trains in peak hours near Centre Business District (CBD) of the city. The conventional approach to address peak hour congestion, metro trains has been to increase the supply by way of introduction of more trains, increasing the length of the trains, optimising the time table to increase the capacity of the system. However, there is a limitation of supply side measures determined by the design capacity of the systems beyond which any addition in the capacity requires huge capital investments. The demand side interventions are essentially required to actually spread the demand across the time and space. In this study, an attempt has been made to identify the potential Transport Demand Management tools applicable to Urban Rail Transportation systems with a special focus on differential pricing. A conceptual price elasticity model has been developed to analyse the effect of various combinations of peak and nonpeak hoursfares on demands. The elasticity values for peak hour, nonpeak hour and cross elasticity have been assumed from the relevant literature available in the field. The conceptual price elasticity model so developed is based on assumptions which need to be validated with actual values of elasticities for different segments of passengers. Once validated, the model can be used to determine the peak and nonpeak hour fares with an objective to increase overall ridership, revenue, demand levelling and optimal utilisation of assets.

Keywords: urban transport, differential fares, congestion, transport demand management, elasticity

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Authors: Yasin I. Tayem, Jamil Ahmed, Mahmood Bahzad, Abdullah Alnama, Fahad Al Asfoor, Mahmood A. Jalil, Mohammed Radhi, Ahmed Alenezi, Khalid A. J. Al-Khaja

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Drug-drug interactions (DDIs) represent a significant cause of patient’s morbidity and mortality. The rate of DDIs is rapidly increasing worldwide with the increasing proportion of ageing population and frequent requirement of polypharmacy-prescription of multiple drugs to treat comorbidities. Prescribing physicians are responsible for checking their prescriptions for the presence and severity of DDIs. However, since a large number of new drugs are approved and marketed every year, new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely only upon their previous knowledge of medicine to avoid potential DDIs. The aim of this study was to explore the perceptions of physicians working at primary healthcare centers in Bahrain towards DDIs and how they manage them during their practice. Methodology: In this cross-sectional study, physicians working at all governmental primary healthcare centers in Bahrain were invited to voluntarily, privately and anonymously respond to a self-administered questionnaire. The questionnaire aims to assess their self-reported knowledge of DDIs and how they check for them in their practice. The participants were requested to provide socio demographic data and information related to their attitudes towards DDIs including strategies they employ for detecting and managing them, and their awareness of drugs which commonly cause DDIs. At the end of the questionnaire, an open-ended item was added to allow participants to further add any comment. Findings and Conclusions: The study is going on currently, and the results and conclusions will be presented at the conference.

Keywords: awareness, drug interactions, health centres, physicians

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Authors: Takalani Tshitangano

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Background: In Limpopo province the rate of new tuberculosis (TB) cases increase daily. The Infection Control (IC) plan is one of the essential actions for TB IC. This study aimed to establish the availability of these plans at health care facilities. Objectives: The objectives were to explore and describe the awareness and knowledge of health care workers (HCWs) of the availability and content of TB IC plan; and to identity the role of infection control committees from the perspective of HCWs. Method: A qualitative approach using a cross-sectional descriptive design was adopted. The target population was all HCWs from the seven hospitals of Vhembe district. A purposive sampling approach was used to select 57 participants. The approval to conduct this study was obtained from the relevant authorities and participants. Data were collected through seven focus group discussions comprising five to 10 members. An unstructured discussion guide was used to collect data, and an open-coding method was used to analyse the data. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results: Findings revealed that HCWs were not aware of the availability and the information contained in the TB IC plans. No person was designated as TB IC officer at hospital level. There was lack of a TB IC Committee and teams as well as ineffective utilisation of those that did exist. Conclusions: It was concluded that if the TB IC plans are not available at health care facilities, then the TB IC practices implemented by HCWs vary, resulting in TB nosocomial infection transmission. It was recommended that the World Health Organisation’s TB IC plans be adopted and implemented in Vhembe district.

Keywords: health care workers' awareness, health care workers' knowledge, availability of TB infection control plans, rural hospitals

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Authors: Jamil Ahmed, Li P. Wong, Yan P. Chua

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The United Nation's sustainable development goals include the target to ensure access to water and sanitation for all; however, very few studies have assessed school-based drinking water in Pakistan. The purpose of this study was to characterize water quality in primary schools of Pakistan and to characterize how recent WASH interventions were associated with school water quality. We conducted a representative cross-sectional study of primary schools in the Sindh province of Pakistan. We used structured observations and structured interviews to ascertain the school’s WASH conditions. Our primary exposures of interest were the implementation of previous WASH interventions in the school and the water source type. Outcomes of interest included water quality (measured by various chemical and microbiological indicators) and water availability at the school’s primary drinking water source. We used log-binomial regression to characterize how WASH exposures were associated with water quality outcomes. We collected data from 256 schools. Groundwater was the primary drinking water source at most schools (87%). Water testing showed that 14% of the school’s water had arsenic above the WHO recommendations, and over 50% of the water samples exceeded recommendations for both lead and cadmium. A majority of the water sources (52%) had fecal coliform contamination. None of the schools had nitrate contamination (0%), and few had fluoride contamination (5%). Regression results indicated that having a recent WASH intervention at the school was not associated with either arsenic contamination (prevalence ratio=0.97; 95% CI: 0.46-2.1) or with fecal coliform contamination (PR=0.88; 95% CI: 0.67-1.17). Our assessment unveiled several water quality gaps that exist, including high heavy metal and fecal contamination. Our findings will help various stakeholders to take suitable action to improve water quality in Pakistani schools.

Keywords: WASH interventions, water quality, primary school children, heavy metals

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Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

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Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

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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: U. Tumaini, J. Msuya

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Food insecurity is a worrying challenge worldwide with sub-Saharan Africa including Tanzania being the most affected. Although factors that influence household food access security status and ways of coping with such factors have been examined, little has been reported on how these coping strategies vary along the urban-rural continuum especially in medium-sized towns. The purpose of this study was to identify food insecurity coping strategies employed by households and assess whether they are similar along the urban-rural continuum. The study was cross-sectional in design whereby a random sample of 279 households was interviewed using structured questionnaire. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 20 software. It was revealed that the proportion of households relying on less preferred and quality foods, eating fewer meals per day, undertaking work for food or money, performing farm and off-farm activities, and selling fall back assets was higher in rural settings compared to urban and peri-urban areas. Similarly, more households in urban and peri-urban areas cope with food access insecurity by having strict food budgets compared to those in rural households (p ≤ 0.001). The study concludes that food insecurity coping strategies vary significantly from one spatial entity to another. It is thereby recommended that poor, particularly rural households should be supported to diversify their income-generating activities not only for food security purposes during times of food shortage but also as businesses aimed at increasing their household incomes.

Keywords: food coping strategies, household food insecurity, medium-sized towns, urban-rural continuum

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Authors: T. Aboumahboub, R. Brecha, H. B. Shrestha, U. F. Hutfilter, A. Geiges, W. Hare, M. Schaeffer, L. Welder, M. Gidden

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The proposed stringent mitigation targets require an immediate start for a drastic transformation of the whole energy system. The current Australian energy system is mainly centralized and fossil fuel-based in most states with coal and gas-fired plants dominating the total produced electricity over the recent past. On the other hand, the country is characterized by a huge, untapped renewable potential, where wind and solar energy could play a key role in the decarbonization of the Australia’s future energy system. However, integrating high shares of such variable renewable energy sources (VRES) challenges the power system considerably due to their temporal fluctuations and geographical dispersion. This raises the concerns about flexibility gap in the system to ensure the security of supply with increasing shares of such intermittent sources. One main flexibility dimension to facilitate system integration of high shares of VRES is to increase the cross-sectoral integration through coupling of electricity to other energy sectors alongside the decarbonization of the power sector and reinforcement of the transmission grid. This paper applies a multi-sectoral energy system optimization model for Australia. We investigate the cost-optimal configuration of a renewable-based Australian energy system and its transformation pathway in line with the ambitious range of proposed climate change mitigation targets. We particularly analyse the implications of linking the electricity and transport sectors in a prospective, highly renewable Australian energy system.

Keywords: decarbonization, energy system modelling, renewable energy, sector coupling

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Authors: Behnaz Farahani, Razieh Sotoudeh, Ali Vahdani, Hamed Abdi

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Individual differences in eating behavior can cause underweight or overweight and obesity. Thus influencing factors on children’s eating behavior such as mothers’ feeding practices are needed to be more investigated. The goals of this survey are to evaluate the association of (i) parental pressure and children’s food avoidant tendency, (ii) parental restriction and children’s food approach tendency, (iii) modeling of healthy eating in front of children and their children’s eating behavior. 760 mothers of children aged 7-10 from schools in Isfahan were asked to complete questionnaires including Child Feeding Questionnaire, Children’s Eating Behavior Questionnaire, Modeling Questionnaire, and self-administered demographic questionnaire in which mothers reported their children’s height and weight as well. Of those mothers, 745 completed the questionnaires for the children’s index (mean age: 8.513±1.112) during the 2011-2012 school year. The results of this quantitative, descriptive, cross-sectional analysis indicated that “parental restriction” was positively associated with child food responsiveness (P,0.000) and food enjoyment (P,0.000) and surprisingly, it was positively associated with Food Fussiness(0.000) .Parental pressure to eat was positively associated with child satiety responsiveness (P,0.000), slowness (P,0.000), and fussiness (P,0.00) and negatively associated with Food responsiveness(p,0.000)and Enjoyment of food (p,0.002), modeling of healthy eating were positively associated with Enjoyment of food / q (p,0.000) and negatively with food fussiness (P,0.000). The results of this survey will improve interventions and maternal guidance on their feeding practices and their association with children’s eating behavior and weight.

Keywords: feeding practices, eating behavior, pressure to eat, restriction, modeling, satiety responsiveness, slowness in eating, food fussiness, food responsiveness, enjoyment of food

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Authors: Abdullah Arafat, Ali Al-Farhan, Amir Omair

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Objectives: To review and assess the effectiveness of the implemented modified five-levels triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residential city, Riyadh, Saudi Arabia. Method: The applied study design was an observational cross sectional design. A data collection sheet was designed and distributed to triage nurses; the data collection was done during triage process and was directly observed by the co-investigator. Triage system was reviewed by measuring three time intervals as quality indicators: time before triage (TBT), time before being seen by physician (TBP) and total length of stay (TLS) taking in consideration timing of presentation and level of triage. Results: During the study period, a total of 187 patients were included in our study. 118 visits were at weekdays and 68 visits at weekends. Overall, 173 patients (92.5%) were seen by the physician in timely manner according to triage guidelines while 14 patients (7.5%) were not seen at appropriate time.Overall, The mean time before seen the triage nurse (TBT) was 5.36 minutes, the mean time to be seen by physician (TBP) was 22.6 minutes and the mean length of stay (TLS) was 59 minutes. The data didn’t showed significant increase in TBT, TBP, and number of patients not seen at the proper time, referral rate and admission rate during weekend. Conclusion: The CTAS is adaptable to countries beyond Canada and worked properly. The applied CTAS triage system in Al-Yarmook UCC is considered to be effective and well applied. Overall, urgent cases have been seen by physician in timely manner according to triage system and there was no delay in the management of urgent cases.

Keywords: CTAS, emergency, Saudi Arabia, triage, urgent care

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Authors: Ruziana Masiran, Hamidin Awang, Cheah Y. T. Jun, Nor Fauziah Hashim, Archana Premkumar, Mohd. Feizel Aisiddiq, Mohd. Fakharuddin

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Risk behaviours among secondary school students are common and show an increasing trend over the years. Existing attachment styles between the students and their parents influence the psychosocial development of this group of population hence contributing to the adoption of risk behaviours. The aim of this study was to determine the associations between three risk behaviours; smoking, bullying and being bullied among secondary school students and their styles of attachment to parents in a district in Malaysia. Using multistage simple random sampling, a cross-sectional study was designed with the level of significance, α set at 0.05. The validated self-administered Inventory of Parent and Peer Attachment (IPPA) and Youth Risk Behaviours Surveillance Questionnaire focusing on smoking and bullying were utilized. Secondary school students aged 13 to 17 years old from ten schools in the district of Hulu Langat, Malaysia were sampled. Prevalence of smoking was 15.8%, bullying 8.5% and being bully victims 19.0%. It was found that male gender was a significant risk factor for smoking (p < 0.001), while being Chinese (OR=0.156, 95%CI=0.029-0.837, p=0.030) and having married parents (OR=0.490, 95%CI=0.302-0.796, p=0.490) are protective against smoking. Students with insecure attachment to mothers (OR=1.650, 95%CI=1.018-2.675, p=0.042) and fathers (OR=2.039, 95%CI=1.285-3.234, p=0.002) are at 1.6 and 2 times risk respectively to smoke compared to those with secure attachment. The odds of male students bullying is almost twice than that for female students (OR=2.017, 95%CI=1.416-2.873, p < 0.001), and the odds of being bullied is 1.5 times higher for male students (OR=1.519, 95%CI=1.183-1.950, p=0.001). Those who are insecurely attached to fathers are at 1.8 times higher risk to be bullies (OR=1.867, 95%CI=1.272-2.740, p < 0.001) and 1.5 times higher risk to be bullied (OR=1.546, 95%CI=1.026-2.329, p=0.037). In conclusion, insecure attachment shows a strong association with smoking, bullying and being bullied among secondary school students in Malaysia.

Keywords: attachment styles, bullied, bullying, insecure attachment, risk behaviours, smoking and attachment

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Authors: Sudhir K. Gupta

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Introduction: When a forensic doctor determines that a suspicious death is a suicide, homicide, or accident, the decision virtually becomes incontestable by the investigating police officer, and it becomes an issue whether the medical opinion was created with necessary checks and balances on the other probabilities of the case. It is suggested that the opinion of Forensic Medical experts is conventional, mutable, and shifting from one expert to another. The determination of suicide, accident, or homicide is mandatorily required, which is the Gold Standard for conducting death investigations. Forensic investigations serve many audiences, but the court is by far the most critical. The likely questions on direct and cross-examination determine how forensic doctors gather and handle evidence and what conclusions they reach. Methodology: The author interacted with the investigative authority, and a crime scene visit was also done along with the perusal of the Postmortem report, subsequent opinion, and crime scene photographs and statements of the witness and accused. Further analysis of all relevant scientific documents and opinions of other forensic doctors, forensic scientists, and ballistic experts involved in these cases was done to arrive at an opinion with scientific justification. Findings: The opinions arrived at by the author and how they helped the judiciary in delivering justice in these cases have been discussed in this article. This can help the readers to understand the process involved in formulating a credible forensic medical expert opinion for investigators and the judiciary. Conclusion: A criminal case might be won or lost over doubt cast on the chain of custody. Medically trained forensic doctors, therefore, learn to practice their profession in legally appropriate ways, and opinions must be based on medical justifications with credible references.

Keywords: forensic doctor, professional credibility, investigation, expert opinion

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