Search results for: optimal taxation

Authors: Ratul Das, Udit Narayan Das

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Surface imperviousness in urban area brings significant changes in storm water drainage systems and some recent studies reveals that the impervious surfaces that passes the storm water runoff directly to drainage systems through storm water collection systems, called directly connected impervious area (DCIA) is an effective parameter rather than total impervious areas (TIA) for computation of surface runoff. In the present study, extension of DCIA and TIA were computed for a small sub-urban area of Agartala, the capital of state Tripura. Total impervious surfaces covering the study area were identified on the existing storm water drainage map from landuse map of the study area in association with field assessments. Also, DCIA assessed through field survey were compared to DCIA computed by empirical relationships provided by other investigators. For the assessment of DCIA in the study area two methods were adopted. First, partitioning the study area into four drainage sub-zones based on average basin slope and laying of existing storm water drainage systems. In the second method, the entire study area was divided into small grids. Each grid or parcel comprised of 20m× 20m area. Total impervious surfaces were delineated from landuse map in association with on-site assessments for efficient determination of DCIA within each sub-area and grid. There was a wide variation in percent connectivity of TIA across each sub-drainage zone and grid. In the present study, total impervious area comprises 36.23% of the study area, in which 21.85% of the total study area is connected to storm water collection systems. Total pervious area (TPA) and others comprise 53.20% and 10.56% of the total area, respectively. TIA recorded by field assessment (36.23%) was considerably higher than that calculated from the available land use map (22%). From the analysis of recoded data, it is observed that the average percentage of connectivity (% DCIA with respect to TIA) is 60.31 %. The analysis also reveals that the observed DCIA lies below the line of optimal impervious surface connectivity for a sub-urban area provided by other investigators and which indicate the probable reason of water logging conditions in many parts of the study area during monsoon period.

Keywords: Drainage, imperviousness, runoff, storm water.

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Authors: N. N. Mosola, S. J. Molete, L. S. Masoebe, M. Letsae

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Hand gesture recognition is a technique used to locate, detect, and recognize a hand gesture. Detection and recognition are concepts of Artificial Intelligence (AI). AI concepts are applicable in Human Computer Interaction (HCI), Expert systems (ES), etc. Hand gesture recognition can be used in sign language interpretation. Sign language is a visual communication tool. This tool is used mostly by deaf societies and those with speech disorder. Communication barriers exist when societies with speech disorder interact with others. This research aims to build a hand recognition system for Lesotho’s Sesotho and English language interpretation. The system will help to bridge the communication problems encountered by the mentioned societies. The system has various processing modules. The modules consist of a hand detection engine, image processing engine, feature extraction, and sign recognition. Detection is a process of identifying an object. The proposed system uses Canny pruning Haar and Haarcascade detection algorithms. Canny pruning implements the Canny edge detection. This is an optimal image processing algorithm. It is used to detect edges of an object. The system employs a skin detection algorithm. The skin detection performs background subtraction, computes the convex hull, and the centroid to assist in the detection process. Recognition is a process of gesture classification. Template matching classifies each hand gesture in real-time. The system was tested using various experiments. The results obtained show that time, distance, and light are factors that affect the rate of detection and ultimately recognition. Detection rate is directly proportional to the distance of the hand from the camera. Different lighting conditions were considered. The more the light intensity, the faster the detection rate. Based on the results obtained from this research, the applied methodologies are efficient and provide a plausible solution towards a light-weight, inexpensive system which can be used for sign language interpretation.

Keywords: canny pruning, hand recognition, machine learning, skin tracking

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Authors: Constance Singo, Choja Oduaran

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Child mental disorders are strongly associated with different forms of challenges, including behavioural problems. The burden of care for children with a mental disorder is high and put primary caregivers, parents in particular, at risk of poor mental wellbeing. Understanding the experience of parents of children with mental disorders is crucial to developing a relevant intervention to assist them to attain optimal mental wellbeing. The aim of this study was to explore the experiences of parents of children with conduct disorder by focussing on the psychological and social stress experience of the parents in raising and caring for their children with conduct disorder. A qualitative research approach, using in-depth interview was utilized in this study. Purposive and snowballing sampling techniques were used to select 9 parents of children with conduct disorder in Thulamela Municipality, Limpopo Province of South Africa. Participants comprising of 2 males and 7 females aged between 30 years and 49 years were interviewed individually at scheduled appointment in-home setting. Interviews were conducted in both English and Setswana language. Data collected in Setswana language were translated to English by 'expert in language translation'. Ethical approval was obtained from appropriate authority before data collection. Thematic analysis was conducted to analyse the collected data. The findings identified anger, fear, depressive symptoms, denial, and suicidal ideation as predominant psychological experiences of the parents. Furthermore, deteriorated interpersonal relationships with family and community members, financial stress, and stigma emerged as social problems being the experience of the parents. It was concluded that parents of children with conduct disorder are highly traumatized by the challenges of caring for their children. We recommend professional engagement in terms of counselling service to support the parents. There is also a need for massive enlightenment programmes for members of the community in order to support the parents of children with child mental disorders.

Keywords: conduct disorder, parents, psychosocial experiences, South Africa

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Authors: Victor Manuel Alcántara Alza

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The way in which the application of the deep cryogenic treatment DCT(-196°C) affects, applied with subsequent aging, was investigated, regarding the mechanical properties of hardness, toughness and microstructure, applied to martensitic stainless steels, with the aim of establishing a different methodology compared to the traditional DCT cryogenic treatment with subsequent tempering. For this experimental study, a muffle furnace was used, first subjecting the specimens to deep cryogenization in a liquid Nitrogen bath/4h, after being previously austenitized at the following temperatures: 1020-1030-1040-1050 (°C) / 1 hour; and then tempered in oil. A first group of cryogenic samples were subjected to subsequent aging at 150°C, with immersion times: 2.5 -5- 10 - 20 - 50 – 100 (h). The next group was subjected to subsequent tempering at temperatures: 480-500-510-520-530-540 (°C)/ 2h. The hardness tests were carried out under standards, using a Universal Durometer, and the readings were made on the HRC scale. The Impact Resistance tests were carried out in a Charpy machine following the ASTM E 23 – 93ª standard. Measurements were taken in joules. Microscopy was performed at the optical level using a 1000X microscope. It was found: For the entire aging interval, the samples austenitized at 1050°C present greater hardness than austenitized at 1040°C, with the maximum peak aged being at 30h. In all cases, the aged samples exceed the hardness of the tempered samples, even in their minimum values. In post-tempered samples, the tempering temperature hardly have effect on the impact strength of material. In the Cryogenic Treatment: DCT + subsequent aging, the maximum hardness value (58.7 HRC) is linked to an impact toughness value (54J) obtained with aging time of 39h, which is considered an optimal condition. The higher hardness of steel after the DCT treatment is attributed to the transformation of retained austenite into martensite. The microstructure is composed mainly of lath martensite; and the original grain size of the austenite can be appreciated. The choice of the combination: Hardness-toughness, is subject to the required service conditions of steel.

Keywords: deep cryogenic treatment; aged precipitation; martensitic steels;, mechanical properties; martensitic steels, hardness, carbides precipitaion

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Authors: Sobhy A. El-Sohaimy, Mohamed G. Shehata, Ashwani Mathur, Amira G. Darwish, Nourhan M. Abd El-Aziz, Pammi Gauba, Pooja Upadhyay

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Sea buckthorn is a temperate bush plant native to Asian and European countries, explored across the world in traditional medicine to treat various diseases due to the presence of an exceptionally high content of phenolics, flavonoids and antioxidants. In addition to the evaluation of nutrients and active compounds, the focus of the present work was to assess the optimal levels for L. plantarum RM1 growth by applying response surface methodology (RSM), and to determine the impact of juice fermentation on antioxidant, anti-hypertension and anticancer activity, as well as on organoleptic properties. Sea buckthorn berries were shown to contain good fiber content (6.55%, 25 DV%), high quality of protein (3.12%, 6.24 DV%) containing: histidine, valine, threonine, leucine and lysine (with AAS 24.32, 23.66, 23.09, 23.05 and 21.71%, respectively), and 4.45% sugar that pro- vides only 79 calories. Potassium was shown to be the abundant mineral content (793.43%, 22.66 DV), followed by copper and phosphorus (21.81 and 11.07 DV%, respectively). Sea buckthorn juice exhibited a rich phenolic, flavonoid and carotenoid content (283.58, 118.42 and 6.5 mg/g, respec- tively), in addition to a high content of vitamin C (322.33 mg/g). The HPLC profile indicated that benzoic acid is the dominant phenolic compound in sea buckthorn berries (3825.90 mg/kg). Antiox- idant potentials (DPPH and ABTS) of sea buckthorn showed higher inhibition than ascorbic acid. Antimicrobial potentials were most pronounced against Escherichia coli BA12296 (17.46 mm). The probiotic growth was 8.5 log cfu/mL, with juice concentration, inoculum size and temperature as the main contributors to probiotic growth with a 95% confidence level. Fermentation of sea buck- thorn juice with L. plantarum RM1 enhanced the functional phenolic and flavonoid content, as well as antioxidant and antimicrobial activities. The fermentation with L. plantarum RM1 enhanced the anti-hypertension and anticancer properties of the sea buckthorn juice and gained consumers’ sensorial overall acceptance.

Keywords: sea buckthorn juice, L. plantarum RM1, fermentation, antioxidant, antimicrobial, angiotensin converting enzyme inhibition

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Authors: Mark Lin, Periklis Papadopoulos

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This paper explores the aerodynamics of the formula racecar when a ‘halo’ driver-protection device is added to the chassis. The halo protection device was introduced at the start of the 2018 racing season as a safety measure against foreign object impacts that a driver may encounter when driving an open-wheel racecar. In the one-year since its introduction, the device has received wide acclaim for protecting the driver on two separate occasions. The benefit of such a safety device certainly cannot be disputed. However, by adding the halo device to a car, it changes the airflow around the vehicle, and most notably, to the engine air-intake and the rear wing. These negative effects in the air supply to the engine, and equally to the downforce created by the rear wing are studied in this paper using numerical technique, and the resulting CFD outputs are presented and discussed. Comparing racecar design prior to and after the introduction of the halo device, it is shown that the design of the air intake and the rear wing has not followed suit since the addition of the halo device. The reduction of engine intake mass flow due to the halo device is computed and presented for various speeds the car may be going. Because of the location of the halo device in relation to the air intake, airflow is directed away from the engine, making the engine perform less than optimal. The reduction is quantified in this paper to show the correspondence to reduce the engine output when compared to a similar car without the halo device. This paper shows that through aerodynamic arguments, the engine in a halo car will not receive unobstructed, clean airflow that a non-halo car does. Another negative effect is on the downforce created by the rear wing. Because the amount of downforce created by the rear wing is influenced by every component that comes before it, when a halo device is added upstream to the rear wing, airflow is obstructed, and less is available for making downforce. This reduction in downforce is especially dramatic as the speed is increased. This paper presents a graph of downforce over a range of speeds for a car with and without the halo device. Acknowledging that although driver safety is paramount, the negative effect of this safety device on the performance of the car should still be well understood so that any possible redesign to mitigate these negative effects can be taken into account in next year’s rules regulation.

Keywords: automotive aerodynamics, halo device, downforce. engine intake

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Authors: M. Reyes, R. Sastre, P. Gabana, F. V. Tinaut

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In this work, an optical characterization of the ethanol-air laminar combustion is presented in order to investigate the origin of the instabilities developed during the combustion, the onset of the cellular structure and the laminar burning velocity. Experimental tests of ethanol-air have been developed in an optical cylindrical constant volume combustion bomb equipped with a Schlieren technique to record the flame development and the flame front surface wrinkling. With this procedure, it is possible to obtain the flame radius and characterize the time when the instabilities are visible through the cell's apparition and the cellular structure development. Ethanol is an aliphatic alcohol with interesting characteristics to be used as a fuel in Internal Combustion Engines and can be biologically synthesized from biomass. Laminar burning velocity is an important parameter used in simulations to obtain the turbulent flame speed, whereas the flame front structure and the instabilities developed during the combustion are important to understand the transition to turbulent combustion and characterize the increment in the flame propagation speed in premixed flames. The cellular structure is spontaneously generated by volume forces, diffusional-thermal and hydrodynamic instabilities. Many authors have studied the combustion of ethanol air and mixtures of ethanol with other fuels. However, there is a lack of works that investigate the instabilities and the development of a cellular structure in ethanol flames, a few works as characterized the ethanol-air combustion instabilities in spherical flames. In the present work, a parametrical study is made by varying the fuel/air equivalence ratio (0.8-1.4), initial pressure (0.15-0.3 MPa) and initial temperature (343-373K), using a design of experiments type I-optimal. In reach mixtures, it is possible to distinguish the cellular structure formed by the hydrodynamic effect and by from the thermo-diffusive. Results show that ethanol-air flames tend to stabilize as the equivalence ratio decreases in lean mixtures and develop a cellular structure with the increment of initial pressure and temperature.

Keywords: ethanol, instabilities, premixed combustion, schlieren technique, cellularity

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Authors: Lynn Louis, Bor Shin Chee, Marion McAfee, Michael Nugent

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This article aims to develop a sustained release formulation of microspheres containing the mTOR inhibitor Everolimus (EVR) using Polyvinyl alcohol (PVA) to enhance the bioavailability of the drug and to overcome poor solubility characteristics of Everolimus. This paper builds on recent work in the manufacture of microspheres using the sessile droplet technique by freezing the polymer-drug solution by suspending the droplets into pre-cooled ethanol vials immersed in liquid nitrogen. The spheres were subjected to 6 freezing cycles and 3 freezing cycles with thawing to obtain proper geometry, prevent aggregation, and achieve physical cross-linking. The prepared microspheres were characterised for surface morphology by SEM, where a 3-D porous structure was observed. The in vitro release studies showed a 62.17% release over 12.5 days, indicating a sustained release due to good encapsulation. This result is comparatively much more than the 49.06% release achieved within 4 hours from the solvent cast Everolimus film as a control with no freeze-thaw cycles performed. The solvent cast films were made in this work for comparison. A prolonged release of Everolimus using a polymer-based drug delivery system is essential to reach optimal therapeutic concentrations in treating SEGA tumours without systemic exposure. These results suggest that the combination of PVA and Everolimus via a rheological synergism enhanced the bioavailability of the hydrophobic drug Everolimus. Physical-chemical characterisation using DSC and FTIR analysis showed compatibility of the drug with the polymer, and the stability of the drug was maintained owing to the high molecular weight of the PVA. The obtained results indicate that the developed PVA/EVR microsphere is highly suitable as a potential drug delivery system with improved bioavailability in treating Subependymal Giant cell astrocytoma (SEGA).

Keywords: drug delivery system, everolimus, freeze-thaw cycles, polyvinyl alcohol

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Authors: Martina Dickson, Hanadi Kadbey, Melissa Mcminn

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Research has shown that anxiety and trepidation towards learning about science is prevalent among elementary school teachers in Western countries. It has also been shown repeatedly that pre-service and in-service teachers who show signs of anxiety towards science are; a) less likely to teach it at all, where they have some autonomy over this, b) less likely to teach it effectively c) ultimately that their students have lower attainment scores in science. It is therefore critically important to gauge pre-service teachers’ science anxiety levels early on whilst there are still possibilities to overturn some of the reasons behind these fears and avert these serious issues occurring later on. This study takes place in the capital of the United Arab Emirates (U.A.E.) in the context of training local elementary school teachers. In the U.A.E., where Emirati teachers are already in the vast minority and attrition rates are high, it is important to offer as much support to pre-service teachers as possible. If pre-service teachers are graduating with high levels of science anxiety unabated, according to the research there is a very real concern that as generalist primary school teachers, their science teaching will be far from optimal. The aims of this research study were to ascertain the science anxiety levels of pre-service elementary teachers and to identify particular areas of their science anxiety, if appropriate. We surveyed 200 Emirati pre-service teachers and found that levels of science anxiety were directly related to their perceptions of performance in science exams, laboratory experiments and inquiry approaches to science learning. Whilst some studies have shown that science anxiety can decrease as students gain confidence in science knowledge by studying courses, we did not see this effect in our study. This is based upon a theoretical framework which holds that in some cases, science anxiety is related to lack of exposure to, or insecurity with science content itself which in some cases is alleviated by the students’ covering of material and greater confidence in the subject. Exploring this variable allowed us to explore whether students educated in schools influenced by the educational reform in Abu Dhabi have differing science anxiety levels from those who were educated prior to the reforms. We discuss the possible implications of these findings to the future teaching of science in Abu Dhabi public schools.

Keywords: pre-service teachers, science anxiety, United Arab Emirates, educational reform

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Authors: Seada Hussen, Frie Ayalew

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Integrating different energy resources, like solar PV and hydro, is used to ensure reliable power to rural communities like Hara village in Ethiopia. Hybrid power system offers power supply for rural villages by providing an alternative supply for the intermittent nature of renewable energy resources. The intermittent nature of renewable energy resources is a challenge to electrifying rural communities in a sustainable manner with solar resources. Major rural villages in Ethiopia are suffering from a lack of electrification, that cause our people to suffer deforestation, travel for long distance to fetch water, and lack good services like clinic and school sufficiently. The main objective of this project is to provide a balanced, stable, reliable supply for Hara village, Ethiopia using solar power with a pumped hydro energy storage system. The design of this project starts by collecting data from villages and taking solar irradiance data from NASA. In addition to this, geographical arrangement and location are also taken into consideration. After collecting this, all data analysis and cost estimation or optimal sizing of the system and comparison of solar with pumped hydro and solar with battery storage system is done using Homer Software. And since solar power only works in the daytime and pumped hydro works at night time and also at night and morning, both load will share to cover the load demand; this need controller designed to control multiple switch and scheduling in this project fuzzy logic controller is used to control this scenario. The result of the simulation shows that solar with pumped hydro energy storage system achieves good results than with a battery storage system since the comparison is done considering storage reliability, cost, storage capacity, life span, and efficiency.

Keywords: pumped hydro storage, solar energy, solar PV, battery energy storage, fuzzy logic controller

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Authors: Da Tao, Tieyan Wang, Mingfu Qin

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While social robots have been increasingly developed and rapidly applied in our daily life, how robots should interact with humans is still an urgent problem to be explored. Appropriate use of interactive behavior is likely to create a good user experience in human-robot interaction situations, which in turn can improve people’s acceptance of robots. This paper aimed to systematically and quantitatively examine the effects of several important situational factors (i.e., interaction distance, interaction posture, and feedback style) on user experience during human-robot interaction. A three-factor mixed designed experiment was adopted in this study, where subjects were asked to interact with a social robot in different interaction situations by combinations of varied interaction distance, interaction posture, and feedback style. A set of data on users’ behavioral performance, subjective perceptions, and eye movement measures were tracked and collected, and analyzed by repeated measures analysis of variance. The results showed that the three situational factors showed no effects on behavioral performance in tasks during human-robot interaction. Interaction distance and feedback style yielded significant main effects and interaction effects on the proportion of fixation times. The proportion of fixation times on the robot is higher for negative feedback compared with positive feedback style. While the proportion of fixation times on the robot generally decreased with the increase of the interaction distance, it decreased more under the positive feedback style than under the negative feedback style. In addition, there were significant interaction effects on pupil diameter between interaction distance and posture. As interaction distance increased, mean pupil diameter became smaller in side interaction, while it became larger in frontal interaction. Moreover, the three situation factors had significant interaction effects on user acceptance of the interaction mode. The findings are helpful in the underlying mechanism of user experience in human-robot interaction situations and provide important implications for the design of robot behavioral expression and for optimal strategies to improve user experience during human-robot interaction.

Keywords: social robots, human-robot interaction, interaction posture, interaction distance, feedback style, user experience

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Authors: Deniz Guven, Wil Ward, Jinming Duan, Li Bai

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Over the past two decades or so, Optical Coherence Tomography (OCT) has been used to diagnose retina and optic nerve diseases. The retinal nerve fibre layer, for example, is a powerful diagnostic marker for detecting and staging glaucoma. With the advances in optical imaging hardware, the adoption of OCT is now commonplace in clinics. More and more OCT images are being generated, and for these OCT images to have clinical applicability, accurate automated OCT image segmentation software is needed. Oct image segmentation is still an active research area, as OCT images are inherently noisy, with the multiplicative speckling noise. Simple edge detection algorithms are unsuitable for detecting retinal layer boundaries in OCT images. Intensity fluctuation, motion artefact, and the presence of blood vessels also decrease further OCT image quality. In this paper, we introduce a new method for segmenting three-dimensional (3D) OCT images. This involves the use of a Kalman filter, which is commonly used in computer vision for object tracking. The Kalman filter is applied to the 3D OCT image volume to track the retinal layer boundaries through the slices within the volume and thus segmenting the 3D image. Specifically, after some pre-processing of the OCT images, points on the retinal layer boundaries in the first image are identified, and curve fitting is applied to them such that the layer boundaries can be represented by the coefficients of the curve equations. These coefficients then form the state space for the Kalman Filter. The filter then produces an optimal estimate of the current state of the system by updating its previous state using the measurements available in the form of a feedback control loop. The results show that the algorithm can be used to segment the retinal layers in OCT images. One of the limitations of the current algorithm is that the curve representation of the retinal layer boundary does not work well when the layer boundary is split into two, e.g., at the optic nerve, the layer boundary split into two. This maybe resolved by using a different approach to representing the boundaries, such as b-splines or level sets. The use of a Kalman filter shows promise to developing accurate and effective 3D OCT segmentation methods.

Keywords: optical coherence tomography, image segmentation, Kalman filter, object tracking

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Authors: Huseyn Nuraddin Qurbanov

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The reliable food supply of the population of the republic is one of the main directions of the state's economic policy. Grain growing, which is the basis of agriculture, is important in this area. In the cultivation of cereals on the slopes, the application of equal amounts of mineral fertilizers the under the soil before sowing is a very important technological process. The low level of technical equipment in this area prevents producers from providing the country with the necessary quality cereals. Experience in the operation of modern technical means has shown that, at present, there is a need to provide an equal amount of fertilizer on the slopes to under the soil, fully meeting the agro-technical requirements. No fundamental changes have been made to the industrial machines that fertilize the under the soil, and unequal application of fertilizers under the soil on the slopes has been applied. This technological process leads to the destruction of new seedlings and reduced productivity due to intolerance to frost during the winter for the plant planted in the fall. In special climatic conditions, there is an optimal fertilization rate for each agricultural product. The application of fertilizers to the soil is one of the conditions that increase their efficiency in the field. As can be seen, the development of a new technical proposal for fertilizing and plowing the slopes in equal amounts on the slopes, improving the technological and design parameters, and taking into account the physical and mechanical properties of fertilizers is very important. Taking into account the above-mentioned issues, a combined plough was developed in our laboratory. Combined plough carries out pre-sowing technological operation in the cultivation of cereals, providing a smooth equal amount of mineral fertilizers under the soil on the slopes. Mathematical models of a smooth spreader that evenly distributes fertilizers in the field have been developed. Thus, diagrams and graphs obtained without distribution on the 8 partitions of the smooth spreader are constructed under the inclined angles of the slopes. Percentage and productivity of equal distribution in the field were noted by practical and theoretical analysis.

Keywords: combined plough, mineral fertilizer, equal sowing, fertilizer norm, grain-crops, sowing fertilizer

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Authors: Katja Siefken, Astrid Junge

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Background: Research indicates that physical activity (PA) protects us from developing mental disorders. The knowledge regarding optimal domain, intensity, type, context, and amount of PA promotion for the prevention of mental disorders is sparse and incoherent. The objective of this study is to determine the relationship between PA domains and mental well-being, and whether associations vary by domain, amount, context, intensity, and type of PA. Methods: 310 individuals (age: 25 yrs., SD 7; 73% female) completed a questionnaire on personal patterns of their PA behaviour (IPQA) and their mental health (Centre of Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder (GAD-7) scale, the subjective physical well-being (FEW-16)). Linear and multiple regression were used for analysis. Findings: Individuals who met the PA recommendation (N=269) reported higher scores on subjective physical well-being than those who did not meet the PA recommendations (N=41). Whilst vigorous intensity PA predicts subjective well-being (β = .122, p = .028), it also correlates with depression. The more vigorously physically active a person is, the higher the depression score (β = .127, p = .026). The strongest impact of PA on mental well-being can be seen in the transport domain. A positive linear correlation on subjective physical well-being (β =.175, p = .002), and a negative linear correlation for anxiety (β =-.142, p = .011) and depression (β = -.164, p = .004) was found. Multiple regression analysis indicates similar results: Time spent in active transport on the bicycle significantly lowers anxiety and depression scores and enhances subjective physical well-being. The more time a participant spends using the bicycle for transport, the lower the depression (β = -.143, p = .013) and anxiety scores (β = -.111,p = .050). Conclusions: Meeting the PA recommendations enhances subjective physical well-being. Active transport has a substantial impact on mental well-being. Findings have implications for policymakers, employers, public health experts and civil society. A stronger focus on the promotion and protection of health through active transport is recommended. Inter-sectoral exchange, outside the health sector, is required. Health systems must engage other sectors in adopting policies that maximize possible health gains.

Keywords: active transport, mental well-being, health promotion, psychological disorders

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Authors: Amanina Iymia Jeffree, Reena Thriumani, Mohammad Iqbal Omar, Ammar Zakaria, Yumi Zuhanis Has-Yun Hashim, Ali Yeon Md Shakaff

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Metabolite profiling is a strategy to be approached in the pattern recognition method focused on three types of cancer cell line that driving the most to death specifically lung, breast, and colon cancer. The purpose of this study was to discriminate the VOCs pattern among cancerous and control group based on metabolite profiling. The sampling was executed utilizing the cell culture technique. All culture flasks were incubated till 72 hours and data collection started after 24 hours. Every running sample took 24 minutes to be completed accordingly. The comparative metabolite patterns were identified by the implementation of headspace-solid phase micro-extraction (HS-SPME) sampling coupled with gas chromatography-mass spectrometry (GCMS). The optimizations of the main experimental variables such as oven temperature and time were evaluated by response surface methodology (RSM) to get the optimal condition. Volatiles were acknowledged through the National Institute of Standards and Technology (NIST) mass spectral database and retention time libraries. To improve the reliability of significance, it is of crucial importance to eliminate background noise which data from 3rd minutes to 17th minutes were selected for statistical analysis. Targeted metabolites, of which were annotated as known compounds with the peak area greater than 0.5 percent were highlighted and subsequently treated statistically. Volatiles produced contain hundreds to thousands of compounds; therefore, it will be optimized by chemometric analysis, such as principal component analysis (PCA) as a preliminary analysis before subjected to a pattern classifier for identification of VOC samples. The volatile organic compound profiling has shown to be significantly distinguished among cancerous and control group based on metabolite profiling.

Keywords: in vitro cancer cell line, metabolite profiling, pattern recognition, volatile organic compounds

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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Authors: Gobena D. Bayisa, A. Mekonen, Megersa O. Dinka, Tilahun H. Nebi, M. Boja

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Crop production in arid and semi-arid regions of Ethiopia is largely limited by water availability. Changing climate conditions and declining water resources increase the need for appropriate approaches to improve water use and find ways to increase production through reduced and more reliable water supply. In the years 2021/22 and 2022/23, a field experiment was conducted to evaluate the effect of limited irrigation water use on bread wheat (Triticum aestivum L.) production, water use efficiency, and financial benefits. Five irrigation treatments, i.e., full irrigation (100% ETc/ control), 85% ETc, 70% ETc, 55% ETc, and 40% ETc, were evaluated using a randomized complete block design (RCBD) with four replicates in the semi-arid climate condition of Awash basin of Ethiopia. Statistical analysis showed a significant effect of irrigation levels on wheat grain yield, water use efficiency, crop water response factor, economic profit, wheat grain quality, aboveground biomass, and yield index. The highest grain yield (5085 kg ha⁻¹) was obtained with 100% ETc irrigation (417.2 mm), and the lowest grain yield with 40% ETc (223.7 mm). Of the treatments, 70% ETc produced the higher wheat grain yield (4555 kg ha⁻¹), the highest water use efficiency (1.42 kg m⁻³), and the highest yield index (0.43). Using the saved water, wheat could be produced 23.4% more with a 70% ETc deficit than full irrigation on 1.38 ha of land, and it could get the highest profit (US$2563.9) and higher MRR (137%). The yield response factor and crop-water production function showed potential reductions associated with increased irrigation deficits. However, a 70% ETc deficit is optimal for increasing wheat grain yield, water use efficiency, and economic benefits of irrigated wheat production. The result indicates that deficit irrigation of wheat under the typical arid and semi-arid climatic conditions of the Awash Basin can be a viable irrigation management approach for enhancing water use efficiency while minimizing the decrease in crop yield could be considered effective.

Keywords: crop-water response factor, deficit irrigation, water use efficiency, wheat production

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Authors: Ketevan Goletiani, Parmen Khvedelidze

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discusses the importance of the topic, which is reflected in the advanced and developed countries in the formation of a new innovative stage of the distinctive mark of the modern world development. This phase includes the construction of the economy, which generates stockpiling and use is based. Intensifying the production and use of the results of new scientific and technical innovation has led to a sharp reduction in the cycle and accelerate the pace of product and technology updates. The world's leading countries in the development of innovative management systems for the formation of long-term and stable development of the socio-economic order conditions. The last years of the 20th century, the social and economic relations, modification, accelerating economic reforms, and profound changes in the system of the time. At the same time, the country should own place in the world geopolitical and economic space. Accelerated economic development tasks, the World Trade Organization, the European Union deep and comprehensive trade agreement, the new system of economic management, technical and technological renewal of production potential, and scientific fields in the share of the total volume of GDP growth requires new approaches. XX - XXI centuries Georgia's socio-economic changes is one of the urgent tasks in the form of a rise to the need for change, involving the use of natural resource-based economy to the latest scientific and technical achievements of an innovative and dynamic economy based on an accelerated pace. But Georgia still remains unresolved in many methodological, theoretical, and practical nature of the problem relating to the management of the economy in various fields for the development of innovative systems for optimal implementation. Therefore, the development of an innovative system for the formation of a complex and multi-problem, which is reflected in the following: countries should have higher growth rates than the geopolitical space of the neighboring countries that its competitors are. Formation of such a system is possible only in a deep theoretical research and innovative processes in the multi-level (micro, meso- and macro-levels) management on the basis of creation.

Keywords: georgia, innovative, socio-economic, innovative manage

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Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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Authors: Georgios Koronis, Arlindo Silva

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This study seeks to understand the mechanical behavior of a natural fiber reinforced composite (epoxy/flax) in more depth, utilizing both experimental and numerical methods. It is attempted to identify relationships between the design parameters and the product performance, understand the effect of noise factors and reduce process variations. Optimization of the mechanical performance of manufactured goods has recently been implemented by numerous studies for green composites. However, these studies are limited and have explored in principal mass production processes. It is expected here to discover knowledge about composite’s manufacturing that can be used to design artifacts that are of low batch and tailored to niche markets. The goal is to reach greater consistency in the performance and further understand which factors play significant roles in obtaining the best mechanical performance. A prediction of response function (in various operating conditions) of the process is modeled by the DoE. Normally, a full factorial designed experiment is required and consists of all possible combinations of levels for all factors. An analytical assessment is possible though with just a fraction of the full factorial experiment. The outline of the research approach will comprise of evaluating the influence that these variables have and how they affect the composite mechanical behavior. The coupons will be fabricated by the vacuum infusion process defined by three process parameters: flow rate, injection point position and fiber treatment. Each process parameter is studied at 2-levels along with their interactions. Moreover, the tensile and flexural properties will be obtained through mechanical testing to discover the key process parameters. In this setting, an experimental phase will be followed in which a number of fabricated coupons will be tested to allow for a validation of the design of the experiment’s setup. Finally, the results are validated by performing the optimum set of in a final set of experiments as indicated by the DoE. It is expected that after a good agreement between the predicted and the verification experimental values, the optimal processing parameter of the biocomposite lamina will be effectively determined.

Keywords: design of experiments, flax fabrics, mechanical performance, natural fiber reinforced composites

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Authors: Ali Mamizadeh, Ires Iskender, Saeid Aghaei

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Energy is one of the important issues with high priority property in the world. Energy demand is rapidly increasing depending on the growing population and industry. The useable energy sources in the world will be insufficient to meet the need for energy. Therefore, the efficient and economical usage of energy sources is getting more importance. In a survey conducted among electric consuming machines, the electrical machines are consuming about 40% of the total electrical energy consumed by electrical devices and 96% of this consumption belongs to induction motors. Induction motors are the workhorses of industry and have very large application areas in industry and urban systems like water pumping and distribution systems, steel and paper industries and etc. Monitoring and the control of the motors have an important effect on the operating performance of the motor, driver selection and replacement strategy management of electrical machines. The sensorless monitoring system for monitoring and calculating efficiency of induction motors are studied in this study. The equivalent circuit of IEEE is used in the design of this study. The terminal current and voltage of induction motor are used in this motor to measure the efficiency of induction motor. The motor nameplate information and the measured current and voltage are used in this system to calculate accurately the losses of induction motor to calculate its input and output power. The efficiency of the induction motor is monitored online in the proposed method without disconnecting the motor from the driver and without adding any additional connection at the motor terminal box. The proposed monitoring system measure accurately the efficiency by including all losses without using torque meter and speed sensor. The monitoring system uses embedded architecture and does not need to connect to a computer to measure and log measured data. The conclusion regarding the efficiency, the accuracy and technical and economical benefits of the proposed method are presented. The experimental verification has been obtained on a 3 phase 1.1 kW, 2-pole induction motor. The proposed method can be used for optimal control of induction motors, efficiency monitoring and motor replacement strategy.

Keywords: induction motor, efficiency, power losses, monitoring, embedded design

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Authors: Yang Zhou, Kaijian Li, Guiwen Liu

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Offsite construction is an innovative alternative to conventional site-based construction, with wide-ranging benefits. It requires building components, elements or modules were prefabricated and pre-assembly before installed into their final locations. To improve efficiency and achieve synergies, in recent years, construction companies were clustered into construction industrial parks (CIPs) in China. A CIP is a community of construction manufacturing and service businesses located together on a common property. Companies involved in industrial clusters can obtain environment and economic benefits by sharing resources and information in a given region. Therefore, the concept of industrial symbiosis (IS) can be applied to the traditional CIP to achieve sustainable industrial development or redevelopment through the implementation of eco-industrial parks (EIP). However, before designing a symbiosis network between companies in a CIP, candidate support tenants need to be selected to complement the existing construction companies. In this study, an access indicator system and a linear programming model are established to select candidate tenants in a CIP while satisfying the degree of connectivity among the enterprises in the CIP, minimizing the environmental impact, and maximizing the annualized profit of the CIP. The access indicator system comprises three primary indicators and fifteen secondary indicators, is proposed from the perspective of park-based level. The fifteen indicators are classified as three primary indicators including industrial symbiosis, environment performance and economic benefit, according to the three dimensions of sustainability (environment, economic and social dimensions) and the three R's of the environment (reduce, reuse and recycle). The linear programming model is a method to assess the satisfactoriness of all the indicators and to make an optimal multi-objective selection among candidate tenants. This method provides a practical tool for planners of a CIP in evaluating which among the candidate tenants would best complement existing anchor construction tenants. The reasonability and validity of the indicator system and the method is worth further study in the future.

Keywords: construction industrial park, China, industrial symbiosis, offsite construction, selection of support tenants

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Authors: Yulistiani, Muhammad Amin, Fasich

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A surface charge of the nanoparticle is a very important consideration in pulmonal drug delivery system. The zeta potential (ZP) is related to the surface charge which can predict stability of nanoparticles as nebules of liposomal amikacin. Anionic lipid such as 1,2-dipalmitoyl-sn-glycero-3-phosphatidylglycerol (DPPG) is expected to contribute to the physical stability of liposomal amikacin and the optimal ZP value. Suitable ZP can improve drug release profiles at specific sites in alveoli as well as their stability in dosage form. This study aimed to analyze the effect of DPPG on ZP values and physical stability of liposomal amikacin. Liposomes were prepared by using the reserved phase evaporation method. Liposomes consisting of DPPG, 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine (DPPC), cholesterol and amikacin were formulated in five different compositions 0/150/5/100, 10//150/5/100, 20/150/5/100, 30/150/5/100 and 40/150/5/100 (w/v) respectively. A chloroform/methanol mixture in the ratio of 1 : 1 (v/v) was used as solvent to dissolve lipids. These systems were adjusted in the phosphate buffer at pH 7.4. Nebules of liposomal amikacin were produced by using the vibrating nebulizer and then characterized by the X-ray diffraction, differential scanning calorimetry, particle size and zeta potential analyzer, and scanning electron microscope. Amikacin concentration from liposome leakage was determined by the immunoassay method. The study revealed that presence of DPPG could increase the ZP value. The addition of 10 mg DPPG in the composition resulted in increasing of ZP value to 3.70 mV (negatively charged). The optimum ZP value was reached at -28.780 ± 0.70 mV and particle size of nebules 461.70 ± 21.79 nm. Nebulizing process altered parameters such as particle size, conformation of lipid components and the amount of surface charges of nanoparticles which could influence the ZP value. These parameters might have profound effects on the application of nebules in the alveoli; however, negatively charge nanoparticles were unexpected to have a high ZP value in this system due to increased macrophage uptake and pulmonal clearance. Therefore, the ratio of liposome 20/150/5/100 (w/v) resulted in the most stable colloidal system and might be applicable to pulmonal drug delivery system.

Keywords: anionic lipid, dipalmitoylphosphatidylglycerol, liposomal amikacin, stability, zeta potential

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Authors: Yu A. Pluttsova , O. V. Vakhnina , K. B. Zhogova

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Nowadays, many devices operate under conditions of enhanced humidity, temperature drops, fog, and vibration. To ensure long-term and uninterruptable equipment operation under adverse conditions, one applies moisture-proof films on products and electronics components, which helps to prevent corrosion, short circuit, allowing a significant increase in device lifecycle. The reliability of such moisture-proof films is mainly determined by their coating uniformity without gaps and cracks. Unprotected product edges, as well as pores in films, can cause device failure during operation. The work objective was to develop an effective, affordable, and profit-proved method for determining the presence of through defects of protective polymer films on the surface of parts made of iron and its alloys. As a diagnostic reagent, one proposed water solution of potassium ferricyanide (III) in hydrochloric acid, this changes the color from yellow to blue according to the reactions; Feº → Fe²⁺ and 4Fe²⁺ + 3[Fe³⁺(CN)₆]³⁻ → Fe ³⁺4[Fe²⁺(CN)₆]₃. There was developed the principle scheme of technological process for determining the presence of polymer films through defects on the surface of parts made of iron and its alloys. There were studied solutions with different diagnostic reagent compositions in water: from 0,1 to 25 mass fractions, %, of potassium ferricyanide (III), and from 5 to 25 mass fractions, %, of hydrochloride acid. The optimal component ratio was chosen. The developed method consists in submerging a part covered with a film into a vessel with a diagnostic reagent. In the polymer film through defect zone, the part material (ferrum) interacts with potassium ferricyanide (III), the color changes to blue. Pilot samples were tested by the developed method for the presence of through defects in the moisture-proof coating. It was revealed that all the studied parts had through defects of the polymer film coating. Thus, the claimed method efficiently reveals polymer film coating through defects on parts made of iron or its alloys, being affordable and profit-proved.

Keywords: diagnostic reagent, metal parts, polimer films, through defects

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Authors: L. Ebralidze, A. Tsertsvadze, D. Berashvili, A. Bakuridze

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Current cancer therapy strategies are based on surgery, radiotherapy and chemotherapy. The problems associated with chemotherapy are one of the biggest challenges for clinical medicine. These include: low specificity, broad spectrum of side effects, toxicity and development of cellular resistance. Therefore, anti-cance drugs need to be develop urgently. Particularly, in order to increase efficiency of anti-cancer drugs and reduce their side effects, scientists work on formulation of nano-drugs. The objective of this study was to develop composition and technology of vincristine nanoparticles using high-molecular carbohydrates of plant origin. Plant polysacharides, particularly, soy bean seed polysaccharides, flaxseed polysaccharides, citrus pectin, gum arabic, sodium alginate were used as objects. Based on biopharmaceutical research, vincristine containing nanoparticle formulations were prepared. High-energy emulsification and solvent evaporation methods were used for preparation of nanosystems. Polysorbat 80, polysorbat 60, sodium dodecyl sulfate, glycerol, polyvinyl alcohol were used in formulation as emulsifying agent and stabilizer of the system. The ratio of API and polysacharides, also the type of the stabilizing and emulsifying agents are very effective on the particle size of the final product. The influence of preparation technology, type and concentration of stabilizing agents on the properties of nanoparticles were evaluated. For the next stage of research, nanosystems were characterized. Physiochemical characterization of nanoparticles: their size, shape, distribution was performed using Atomic force microscope and Scanning electron microscope. The present study explored the possibility of production of NPs using plant polysaccharides. Optimal ratio of active pharmaceutical ingredient and plant polysacharids, the best stabilizer and emulsifying agent was determined. The average range of nanoparticles size and shape was visualized by SEM.

Keywords: nanoparticles, target delivery, natural high molecule carbohydrates, surfactants

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Authors: Salman Obaidoon, Mohamed Hassan, Omer Bakather

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As environmental regulations increase, the need for a clean and inexpensive energy is becoming necessary these days using an available raw material with high efficiency and low emissions of toxic gases. This paper presents a study on modifying a gas turbine power plant fired by diesel, which is located in Saudi Arabia in order to increase the efficiency and capacity of the station as well as decrease the rate of emissions. The studied power plant consists of 30 units with different capacities and total net power is 1470 MW. The study was conducted on unit number 25 (GT-25) which produces 72.3 MW with 29.5% efficiency. In the beginning, the unit was modeled and simulated by using WinSim Design II software. In this step, actual unit data were used in order to test the validity of the model. The net power and efficiency obtained from software were 76.4 MW and 32.2% respectively. A difference of about 6% was found in the simulated power plant compared to the actual station which means that the model is valid. After the validation of the model, the simple gas turbine power plant was converted to a combined cycle power plant (CCPP). In this case, the exhausted gas released from the gas turbine was introduced to a heat recovery steam generator (HRSG), which consists of three heat exchangers: an economizer, an evaporator and a superheater. In this proposed model, many scenarios were conducted in order to get the optimal operating conditions. The net power of CCPP was increased to 116.4 MW while the overall efficiency of the unit was reached to 49.02%, consuming the same amount of fuel for the gas turbine power plant. For the purpose of comparing the rate of emissions of carbon dioxide on each model. It was found that the rate of CO₂ emissions was decreased from 15.94 kg/s to 9.22 kg/s by using the combined cycle power model as a result of reducing of the amount of diesel from 5.08 kg/s to 2.94 kg/s needed to produce 76.5 MW. The results indicate that the rate of emissions of carbon dioxide was decreased by 42.133% in CCPP compared to the simple gas turbine power plant.

Keywords: combined cycle power plant, efficiency, heat recovery steam generator, simulation, validation, WinSim design II software

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Authors: Sarah Gounden, Mukesh Dheda, Boikhutso Tlou, Elizabeth Ojewole, Frasia Oosthuizen

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Background: Antiretroviral therapy (ART) has been effective in the reduction of mortality and resulted in an improvement in the prognosis of HIV-infected patients. However, treatment with antiretrovirals (ARVs) has led to the development of many adverse drug reactions (ADRs). It is, therefore, necessary to determine the safety profile of these medicines in a South African population in order to ensure safe and optimal medicine use. Objectives: The aim of this study was to quantify ADRs experienced with the different ARVs currently used in South Africa, to determine the safety profile of ARV medicine in South Africa based on reported ADRs, and to determine the ARVs with the lowest risk profile based on specific patient populations. Methodology: This was a quantitative study. Individual case safety reports for the period January 2010 – December 2013 were obtained from the National Pharmacovigilance Center; these reports contained information on ADRs, ARV medicine, and patient demographics. Data was analysed to find associations that may exist between ADRs experienced, ARV medicines used and patient demographics. Results: A total of 1916 patient reports were received of which 1534 met the inclusion criteria for the study. The ARV with the lowest risk of ADRs were found to be lamivudine (0.51%, n=12), followed by lopinavir/ritonavir combination (0.8%, n=19) and abacavir (0.64%, n=15). A higher incidence of ADRs was observed in females compared to males. The age group 31–50 years and the weight group 61–80 kg had the highest incidence of ADRs reported. Conclusion: This study found that the safest ARVs to be used in a South African population are lamivudine, abacavir, and the lopinavir/ritonavir combination. Gender differences play a significant role in the occurrence of ADRs and both anatomical and physiological differences account for this. An increased BMI (body mass index) in both men and women showed an increase in the incidence of ADRs associated with ARV therapy.

Keywords: adverse drug reaction, antiretrovirals, HIV/AIDS, pharmacovigilance, South Africa

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

Procedia PDF Downloads 109

Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.

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Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.

Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism

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Authors: Julius M. Ndambuki, Gislar E. Kifanyi, Samuel N. Odai, Charles Gyamfi

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Conjunctive management of surface and groundwater resources is a challenging task due to the spatial and temporal variability nature of hydrology as well as hydrogeology of the water storage systems. Surface water-groundwater hydrogeology is highly uncertain; thus it is imperative that this uncertainty is explicitly accounted for, when managing water resources. Various methodologies have been developed and applied by researchers in an attempt to account for the uncertainty. For example, simulation-optimization models are often used for conjunctive water resources management. However, direct application of such an approach in which all realizations are considered at each iteration of the optimization process leads to a very expensive optimization in terms of computational time, particularly when the number of realizations is large. The aim of this paper, therefore, is to introduce and apply an efficient approach referred to as Retrospective Optimization Approximation (ROA) that can be used for optimizing conjunctive use of surface water and groundwater over a multiple hydrogeological model simulations. This work is based on stochastic simulation-optimization framework using a recently emerged technique of sample average approximation (SAA) which is a sampling based method implemented within the Retrospective Optimization Approximation (ROA) approach. The ROA approach solves and evaluates a sequence of generated optimization sub-problems in an increasing number of realizations (sample size). Response matrix technique was used for linking simulation model with optimization procedure. The k-means clustering sampling technique was used to map the realizations. The methodology is demonstrated through the application to a hypothetical example. In the example, the optimization sub-problems generated were solved and analysed using “Active-Set” core optimizer implemented under MATLAB 2014a environment. Through k-means clustering sampling technique, the ROA – Active Set procedure was able to arrive at a (nearly) converged maximum expected total optimal conjunctive water use withdrawal rate within a relatively few number of iterations (6 to 7 iterations). Results indicate that the ROA approach is a promising technique for optimizing conjunctive water use of surface water and groundwater withdrawal rates under hydrogeological uncertainty.

Keywords: conjunctive water management, retrospective optimization approximation approach, sample average approximation, uncertainty

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