Search results for: Ayman M. Atta

Authors: Rania Albsoul, Muhammad Ahmed Alshyyab, Baraa Ayed Al Odat, Nermeen Borhan Al Dwekat, Batool Emad Al-masri, Fatima Abdulsattar Alkubaisi, Salsabil Awni Flefil, Majd Hussein Al-Khawaldeh, Ragad Ayman Sa’ed, Maha Waleed Abu Ajamieh, Gerard Fitzgerald

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Purpose: The purpose of this paper is to explore the perceptions of operating room staff towards the use of the World Health Organization Surgical Safety Checklist in a tertiary hospital in Jordan. Design/methodology/approach: This was a qualitative descriptive study. Semi-structured interviews were conducted with a purposeful sample of 21 healthcare staff employed in the operating room (nurses, residents, surgeons, and anaesthesiologists). The interviews were conducted in the period from October to December 2021. Thematic analysis was used to analyse the data. Findings: Three main themes emerged from data analysis, namely compliance with the surgical safety checklist, the impact of the surgical safety checklist, and barriers and facilitators to the use of the surgical safety checklist. The use of the checklist was seen as enabling staff to communicate effectively and thus accomplish patient safety and positive outcomes. The perceived barriers to compliance included excessive workload, congestion, and lack of training and awareness. Enhanced training and education were thought to improve the utilization of the surgical safety checklist and help enhance awareness about its importance. Originality/value: While steps to utilize the surgical safety checklist by the operation room personnel may seem simple, the quality of its administration is not necessarily robust. There are several challenges to consistent, complete, and effective administration of the surgical safety checklist by the surgical team members. Healthcare managers must employ interventions to eliminate barriers to and offer facilitators of adherence to the application of the surgical safety checklist, therefore promoting quality healthcare and patient safety.

Keywords: patient safety, surgical safety checklist, compliance, utility, operating room, quality healthcare, communication, teamwork

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Authors: Ayat Ayman Abdelaziz Ibrahim Amayem, Hassan Abdel-Salam, Zeyad El-Sayad

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Nowadays, ICTs have spread extensively in everyday life in an unprecedented way. A great attention is paid to the ICTs while ignoring the social aspect. With the immersive invasion of internet as well as smart phones’ applications and digital social networking, people become more socially connected through virtual spaces instead of meeting in physical public spaces. Thus, this paper aims to find the ways of implementing ICTs in public spaces to regain their status as attractive places for people, incite meetings in real life and create sustainable lively city centers. One selected example of urban space in the city center of Alexandria is selected for the study. Alexandria represents a large metropolitan city subjected to rapid transformation. Improving the quality of its public spaces will have great effects on the whole well-being of the city. The major roles that ICTs can play in the public space are: culture and art, education, planning and design, games and entertainment, and information and communication. Based on this classification various examples and proposals of ICTs interventions in public spaces are presented and analyzed to encourage good old fashioned social interaction by creating the New Social Public Place of this Digital Era. The paper will adopt methods such as questionnaire for evaluating the people’s willingness to accept the idea of using ICTs in public spaces, their needs and their proposals for an attractive place; the technique of observation to understand the people behavior and their movement through the space and finally will present an experimental design proposal for the selected urban space. Accordingly, this study will help to find design principles that can be adopted in the design of future public spaces to meet the needs of the digital era’s users with the new concepts of social life respecting the rules of place-making.

Keywords: Alexandria sustainable city center, digital place-making, ICTs, social interaction, social networking, urban places

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Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

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Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

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Authors: Aya M. H. Eissa, Ayman H. A. Mahmoud

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When it comes to energy efficient thermal regulation system, natural systems do not only offer an inspirational source of innovative strategies but also sustainable and even regenerative ones. Using biomimetic design an energy efficient thermal regulation system can be developed. Although, conventional design process methods achieved fairly efficient systems, they still had limitations which can be overcome by using parametric design software. Accordingly, the main objective of this study is to apply and assess the efficiency of heat regulation strategies inspired from termite mounds in residential buildings’ thermal regulation system. Parametric design software is used to pave the way for further and more complex biomimetic design studies and implementations. A hot arid region is selected due to the deficiency of research in this climatic region. First, the analysis phase in which the stimuli, affecting, and the parameters, to be optimized, are set mimicking the natural system. Then, based on climatic data and using parametric design software Grasshopper, building form and openings height and areas are altered till settling on an optimized solution. Finally, an assessment of the efficiency of the optimized system, in comparison with a conventional system, is determined by firstly, indoors airflow and indoors temperature, by Ansys Fluent (CFD) simulation. Secondly by and total solar radiation falling on the building envelope, which was calculated using Ladybug, Grasshopper plugin. The results show an increase in the average indoor airflow speed from 0.5m/s to 1.5 m/s. Also, a slight decrease in temperature was noticed. And finally, the total radiation was decreased by 4%. In conclusion, despite the fact that applying a single bio-inspired heat regulation strategy might not be enough to achieve an optimum system, the concluded system is more energy efficient than the conventional ones as it aids achieving indoors comfort through passive techniques. Thus demonstrating the potential of parametric design software in biomimetic design.

Keywords: biomimicry, heat regulation systems, hot arid regions, parametric design, thermal comfort

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Authors: Ayman K. El Essawy, Amal M. Hosny, Hala M. Abu Shady

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The rapid detection of TB and drug resistance, both optimizes treatment and improves outcomes. In the current study, respiratory specimens were collected from 155 patients. Conventional susceptibility testing and MIC determination were performed for rifampicin (RIF) and isoniazid (INH). Genotype MTBDRplus assay, which is a molecular genetic assay based on the DNA-STRIP technology and specific gene sequencing with primers for rpoB, KatG, and mab-inhA genes were used to detect mutations associated with resistance to rifampicin and isoniazid. In comparison to other categories, most of rifampicin resistant (61.5%) and isoniazid resistant isolates (47.1%) were from patients relapsed in treatment. The genotypic profile (using Genotype MTBDRplus assay) of multi-drug resistant (MDR) isolates showed missing of katG wild type 1 (WT1) band and appearance of mutation band katG MUT2. For isoniazid mono-resistant isolates, 80% showed katG MUT1, 20% showed katG MUT1, and inhA MUT1, 20% showed only inhA MUT1. Accordingly, 100% of isoniazid resistant strains were detected by this assay. Out of 17 resistant strains, 16 had mutation bands for katG distinguished high resistance to isoniazid. The assay could clearly detect rifampicin resistance among 66.7% of MDR isolates that showed mutation band rpoB MUT3 while 33.3% of them were considered as unknown. One mono-resistant rifampicin isolate did not show rifampicin mutation bands by Genotype MTBDRplus assay, but it showed an unexpected mutation in Codon 531 of rpoB by DNA sequence analysis. Rifampicin resistance in this strain could be associated with a mutation in codon 531 of rpoB (based on molecular sequencing), and Genotype MTBDRplus assay could not detect the associated mutation. If the results of Genotype MTBDRplus assay and sequencing were combined, this strain shows hetero-resistance pattern. Gene sequencing of eight selected isolates, previously tested by Genotype MTBDRplus assay, could detect resistance mutations mainly in codon 315 (katG gene), position -15 in inhA promotes gene for isoniazid resistance and codon 531 (rpoB gene) for rifampicin resistance. Genotyping techniques allow distinguishing between recurrent cases of reinfection or reactivation and supports epidemiological studies.

Keywords: M. tuberculosis, rpoB, KatG, inhA, genotype MTBDRplus

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Authors: Maha Azzam, Mahmoud Gabr, Mahmoud Zakaria, Ayman Refaie, Amani Ismail, Sherry Khater, Sylvia Ashamallah, Mohamed Ghoniem

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Evidence was provided that human bone marrow-derived mesenhymal stem cells (HBM-MSCs) could be differentiated to form insulin-producing cells (IPCs). Transplantation of these cells was able to cure chemically-induced diabetes in nude mice. The efficacy of these cells to control diabetes in large animals was carried out to evaluate the sufficient number of cells needed/Kg body weight and to determine the functional longevity in vivo. Materials/Methods: Ten male mongrel dogs weighing 15-20 Kg were used in this study. Diabetes was chemically-induced in 7 dogs by a mixture of alloxan and streptozotocin. Three non-diabetic served as normal controls. Differentiated HBM-MSCs (5 million/Kg) were encapsulated in theracyte capsules and transplanted beneath the rectus sheath. Each dog received 2 capsules. One dog died 4 days postoperative from inhalation pneumonia. The remaining 6 dogs were followed up for 6-18 months. Results: Four dogs became normoglycemic within 6-8 weeks with normal glucose tolerance curves providing evidence that the transplanted cells were glucose-sensitive and insulin-responsive. In the remaining 2 dogs, fasting blood glucose was reduced but did not reach euglycemic levels. The sera of all transplanted dogs contained human insulin and c-peptide but negligible levels of canine insulin. When the HBM-MSCs loaded capsules were removed, rapid return of diabetic state was noted. The harvested capsules were examined by immunofluorescence. IPCs were seen and co-expression of with c-peptide was confirmed. Furthermore, all the pancreatic endocrine genes were expressed by the transplanted cells. Conclusions: This study provided evidence that theracyte capsules could protect the xenogenic HBM-MSCs from the host immune response. This is an important issue when clinical stem cell therapy is considered for definitive treatment for T1DM.

Keywords: diabetes, mesenchymal stem cells, dogs, Insulin-producing cells

Procedia PDF Downloads 173

Authors: David C. Boettiger, Tracy Kuo Lin, Maram Almansour, Mariam M. Hamza, Reem Alsukait, Christopher H. Herbst, Nada Altheyab, Ayman Afghani, Faisal Kattan

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Background The number of people aged greater than 65 years per 100 people aged 20–64 years is expected to almost double in The Kingdom of Saudi Arabia (KSA) between 2020 and 2030. We therefore aimed to quantify the growing non-communicable disease (NCD) burden in KSA between 2020 and 2030, and the impact this will have on the national health budget. Methods Ten priority NCDs were selected: ischemic heart disease, stroke, type 2 diabetes, chronic obstructive pulmonary disease, chronic kidney disease, dementia, depression, osteoarthritis, colorectal cancer, and breast cancer. Age- and sex-specific prevalence was projected for each priority NCD between 2020 and 2030. Treatment coverage rates were applied to the projected prevalence estimates to calculate the number of patients incurring treatment costs for each condition. For each priority NCD, the average cost-of-illness was estimated based on published literature. The impact of changes to our base-case model in terms of assumed disease prevalence, treatment coverage, and costs of care, coming into effect from 2023 onwards, were explored. Results The prevalence estimates for colorectal cancer and stroke were estimated to almost double between 2020 and 2030 (97% and 88% increase, respectively). The only priority NCD prevalence projected to increase by less than 60% between 2020 and 2030 was for depression (22% increase). It is estimated that the total cost of managing priority NCDs in KSA will increase from USD 19.8 billion in 2020 to USD 32.4 billion in 2030 (an increase of USD 12.6 billion or 63%). The largest USD value increases were projected for osteoarthritis (USD 4.3 billion), diabetes (USD 2.4 billion), and dementia (USD 1.9 billion). In scenario analyses, our 2030 projection for the total cost of managing priority NCDs varied between USD 29.2 billion - USD 35.7 billion. Conclusions Managing the growing NCD burden in KSA’s aging population will require substantial healthcare spending increases over the coming years.

Keywords: aging, non communicable disease, costs, Saudi Arabia

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Authors: Eleftheria Atta, Yianna Vovides, Marios Katsioloudes

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In the fusion of neoliberalism and globalization, Higher Education (HE) is becoming increasingly complex. The changing patterns of the economy worldwide caused the development of high value-added economy HE has been viewed as a social investment, significant for the development of knowledge-based societies and economies. In order to contribute to economic competitiveness universities are required to produce local and employable workers in order to fit into the neoliberal economic environment. The emergence of neoliberal performativity, which measures outcomes, is a key aspect in a neoliberal era. It facilitates the redesign of institutions making organizations and individuals to think about themselves in relation to their performance. Performativity and performance management systems lead academics to become more effective, professionally advance, improve and become better than others and therefore act competitively. Besides the aforementioned complexities, universities also encounter the challenge of maintaining a set of values to guide an institution’s actions and which have always been highly respected in developing a HE institution. The formulation of a clear set of values also determines the institutional culture which will be maintained. It is evident that values create a significant framework for the workplace and may determine positive institutional results. Universities are required to engage in activities for capacity building which will improve their students’ competence as well as offer opportunities to administrative and academic staff to professionally develop in light of neoliberal performativity. Additionally, the University is now considered as an innovation ecosystem playing a significant role in providing education, research and innovation to help create solutions to meet social, environmental and economic challenges. Thus, Universities become central in orchestrating multi-actor innovation networks. This presentation will discuss the establishment of an institutional unit entitled ‘Human Development Unit’ (HDU) in a European start-up university. The activities of the HDU are envisioned as drivers for innovation that would enable the university as a whole to maintain its position in a fast-changing world and be ready to face adaptive challenges. In addition, the HDU provides its students, staff, and faculty with opportunities to advance their academic and professional development through engagement in programs that align with institutional values. It also serves as a connector with the broader community. The presentation will highlight the functions of three centers which the unit will coordinate namely, the Student Development Center (SDC), the Faculty & Staff Development Center (FSDC) and the Continuing Education Center (CEC). The presentation aligns with the aim of the conference as it welcomes presentations to discuss innovations and challenges encountered in HE. Particularly, this presentation seeks to discuss the establishment of an innovative unit at a start-up university which will contribute to creating an institutional culture shaped by the value of academic excellence for students as well as for staff, shaping and defining the functions and activities of the unit. The establishment of the proposed unit is crucial in a start-up university both to differentiate from other competitors but also to sustain its presence given the pressures in a neoliberal HE context.

Keywords: academic excellence, globalization, human development unit, neoliberalism

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Authors: Ayman M. El-Zahaby, Ahmed S. El-Gendy

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Aeration for wastewater is essential for the proper operation of aerobic treatment units where the wastewater normally has zero dissolved oxygen. This is due to the need of oxygen by the aerobic microorganisms to grow and survive. Typical aeration units for wastewater treatment require electric energy for their operation such as mechanical aerators or diffused aerators. The passive units are units that operate without the need of electric energy such as cascade aerators, spray aerators and tray aerators. In contrary to the cascade aerators and spray aerators, tray aerators require much smaller area foot print for their installation as the treatment stages are arranged vertically. To the extent of the authors knowledge, the design of tray aerators for the aeration purpose has not been presented in the literature. The current research concerns with an analytical study for the design of tray aerators for the purpose of increasing the dissolved oxygen in wastewater treatment systems, including an investigation on different design parameters and their impact on the aeration efficiency. The studied aerator shall act as an intermediate stage between an anaerobic primary treatment unit and an aerobic treatment unit for small scale treatment systems. Different free falling flow regimes were investigated, and the thresholds for transition between regimes were obtained from the literature. The study focused on the jetting flow regime between trays. Starting from the two film theory, an equation that relates the dissolved oxygen concentration effluent from the system was derived as a function of the flow rate, number of trays, tray area, spacing between trays, number and diameter of holes and the water temperature. A MATLab ® model was developed for the derived equation. The expected aeration efficiency under different tray configurations and operating conditions were illustrated through running the model with varying the design parameters. The impact of each parameter was illustrated. The overall system efficiency was found to increase by decreasing the hole diameter. On the other side, increasing the number of trays, tray area, flow rate per hole or tray spacing had positive effect on the system efficiency.

Keywords: aeration, analytical, passive, wastewater

Procedia PDF Downloads 176

Authors: Ayman Mutahar Alrassas, Shaoran Ren, Renyuan Ren, Hung Vo Thanh, Mohammed Hail Hakimi, Zhenliang Guan

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The significant effect of CO₂ on global climate and the environment has gained more concern worldwide. Enhance oil recovery (EOR) associated with sequestration of CO₂ particularly into the depleted oil reservoir is considered the viable approach under financial limitations since it improves the oil recovery from the existing oil reservoir and boosts the relation between global-scale of CO₂ capture and geological sequestration. Consequently, practical measurements are required to attain large-scale CO₂ emission reduction. This paper presents an integrated modeling workflow to construct an accurate 3D reservoir geological model to estimate the storage capacity of CO₂ under geological uncertainty in an unconventional oil reservoir of the Paleogene Shahejie Formation (Es1) in the block Nv32, Shenvsi oilfield, China. In this regard, geophysical data, including well logs of twenty-two well locations and seismic data, were combined with geological and engineering data and used to construct a 3D reservoir geological modeling. The geological modeling focused on four tight reservoir units of the Shahejie Formation (Es1-x1, Es1-x2, Es1-x3, and Es1-x4). The validated 3D reservoir models were subsequently used to calculate the theoretical CO₂ storage capacity in the block Nv32, Shenvsi oilfield. Well logs were utilized to predict petrophysical properties such as porosity and permeability, and lithofacies and indicate that the Es1 reservoir units are mainly sandstone, shale, and limestone with a proportion of 38.09%, 32.42%, and 29.49, respectively. Well log-based petrophysical results also show that the Es1 reservoir units generally exhibit 2–36% porosity, 0.017 mD to 974.8 mD permeability, and moderate to good net to gross ratios. These estimated values of porosity, permeability, lithofacies, and net to gross were up-scaled and distributed laterally using Sequential Gaussian Simulation (SGS) and Simulation Sequential Indicator (SIS) methods to generate 3D reservoir geological models. The reservoir geological models show there are lateral heterogeneities of the reservoir properties and lithofacies, and the best reservoir rocks exist in the Es1-x4, Es1-x3, and Es1-x2 units, respectively. In addition, the reservoir volumetric of the Es1 units in block Nv32 was also estimated based on the petrophysical property models and fund to be between 0.554368

Keywords: CO₂ storage capacity, 3D geological model, geological uncertainty, unconventional oil reservoir, block Nv32

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Authors: Ayman El Sabagh, AbdElhamid Omar, Dekoum Assaha, Khair Mohammad Youldash, Akihiro Ueda, Celaleddin Barutçular, Hirofumi Saneoka

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Drought and salinity stress are a worldwide problem, constraining global crop production seriously. Hence, soybean is susceptible to yield loss from water deficit and salinity stress. Therefore, different approaches have been suggested to solve these issues. Osmoprotectants play an important role in protection the plants from various environmental stresses. Moreover, organic fertilization has several beneficial effects on agricultural fields. Presently, efforts to maximize nitrogen fixation in soybean are critical because of widespread increase in soil degradation in Egypt. Therefore, a greenhouse research was conducted at plant nutritional physiology laboratory, Hiroshima University, Japan for assessing the impact of exogenous osmoregulators and compost application in alleviating the adverse effects of salinity and water stress on soybean. Treatments was included (i) water stress treatments (different soil moisture levels consisting of (100%, 75%, and 50% of field water holding capacity), (ii) salinity concentrations (0 and 15 mM) were applied in fully developed trifoliolate leaf node (V1), (iii) compost treatments (0 and 24 t ha-1) and (iv) the exogenous, proline and glycine betaine concentrations (0 mM and 25 mM) for each, was applied at two growth stages (V1 and R1). The seeds of soybean cultivar Giza 111, was sown into basin from wood (length10 meter, width 50cm, height 50cm and depth 350cm) containing a soil mixture of granite regosol soil and perlite (2:1 v/v). The nitrogen-fixing activity was estimated by using gas chromatography and all measurements were made in three replicates. The results showed that water deficit and salinity stress reduced biological nitrogen fixation and specific nodule activity than normal irrigation conditions. Exogenous osmoprotectants were improved biological nitrogen fixation and specific nodule activity as well as, applying of compost led to improving many of biological nitrogen fixation and specific nodule activity with superiority than stress conditions. The combined application compost fertilizer and exogenous osmoprotectants were more effective in alleviating the adverse effect of stress to improve biological nitrogen fixation and specific nodule activity of Soybean.

Keywords: a biotic stress, biological nitrogen fixation, compost, osmoprotectants, specific nodule activity, soybean

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Authors: Ayman El Sabagh, SobhySorour, AbdElhamid Omar, Adel Ragab, Mohammad Sohidul Islam, Celaleddin Barutçular, Akihiro Ueda, Hirofumi Saneoka

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Salinity is one of the major factors limiting crop production in an arid environment. What adds to the concern is that all the legume crops are sensitive to increasing soil salinity. So it is implacable to either search for salinity enhancement of legume plants. The exogenous of osmoprotectants has been found effective in reducing the adverse effects of salinity stress on plant growth. Despite its global importance soybean production suffer the problems of salinity stress causing damages at plant development. Therefore, in the current study we try to clarify the mechanism that might be involved in the ameliorating effects of osmo-protectants such as proline and glycine betaine and compost application on soybean plants grown under salinity stress. Experiments were carried out in the greenhouse of the experimental station, plant nutritional physiology, Hiroshima University, Japan in 2011- 2012. The experiment was arranged in a factorial design with 4 replications at NaCl concentrations (0 and 15 mM). The exogenous, proline and glycine betaine concentrations (0 mM and 25 mM) for each. Compost treatments (0 and 24 t ha-1). Results indicated that salinity stress induced reduction in all growth and physiological parameters (dry weights plant-1, chlorophyll content, N and K+ content) likewise, seed and quality traits of soybean plant compared with those of the unstressed plants. In contrast, salinity stress led to increases in the electrolyte leakage ratio, Na and proline contents. Thus tolerance against salt stress was observed, the improvement of salt tolerance resulted from proline, glycine betaine and compost were accompanied with improved membrane stability, K+, and proline accumulation on contrary, decreased Na+ content. These results clearly demonstrate that could be used to reduce the harmful effect of salinity on both physiological aspects and growth parameters of soybean. They are capable of restoring yield potential and quality of seed and may be useful in agronomic situations where saline conditions are diagnosed as a problem. Consequently, exogenous osmo-protectants combine with compost will effectively solve seasonal salinity stress problem and are a good strategy to increase salinity resistance in the drylands.

Keywords: compost, glycine betaine, proline, salinity tolerance, soybean

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Authors: Hamza Saeed, Khurram Iqbal Ahmad Khan

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Effective information management is crucial for any construction project and its success. Primary areas of information generation are either the construction site or the design office. There are different types of information required at different stages of construction involving various stakeholders creating complexity. There is a need for effective management of information flows to reduce uncertainty creating complexity. Nature provides a unique perspective in terms of dealing with complexity, in particular, information complexity. System dynamics methodology provides tools and techniques to address complexity. It involves modeling and simulation techniques that help address complexity. Nature has been dealing with complex systems since its creation 4.5 billion years ago. It has perfected its system by evolution, resilience towards sudden changes, and extinction of unadaptable and outdated species that are no longer fit for the environment. Nature has been accommodating the changing factors and handling complexity forever. Humans have started to look at their natural counterparts for inspiration and solutions for their problems. This brings forth the possibility of using a biomimetics approach to improve the management practices used in the construction sector. Ants inhabit different habitats. Cataglyphis and Pogonomyrmex live in deserts, Leafcutter ants reside in rainforests, and Pharaoh ants are native to urban developments of tropical areas. Detailed studies have been done on fifty species out of fourteen thousand discovered. They provide the opportunity to study the interactions in diverse environments to generate collective behavior. Animals evolve to better adapt to their environment. The collective behavior of ants emerges from feedback through interactions among individuals, based on a combination of three basic factors: The patchiness of resources in time and space, operating cost, environmental stability, and the threat of rupture. If resources appear in patches through time and space, the response is accelerating and non-linear, and if resources are scattered, the response follows a linear pattern. If the acquisition of energy through food is faster than energy spent to get it, the default is to continue with an activity unless it is halted for some reason. If the energy spent is rather higher than getting it, the default changes to stay put unless activated. Finally, if the environment is stable and the threat of rupture is low, the activation and amplification rate is slow but steady. Otherwise, it is fast and sporadic. To further study the effects and to eliminate the environmental bias, the behavior of four different ant species were studied, namely Red Harvester ants (Pogonomyrmex Barbatus), Argentine ants (Linepithema Humile), Turtle ants (Cephalotes Goniodontus), Leafcutter ants (Genus: Atta). This study aims to improve the information system in the construction sector by providing a guideline inspired by nature with a systems-thinking approach, using system dynamics as a tool. Identified factors and their interdependencies were analyzed in the form of a causal loop diagram (CLD), and construction industry professionals were interviewed based on the developed CLD, which was validated with significance response. These factors and interdependencies in the natural system corresponds with the man-made systems, providing a guideline for effective use and flow of information.

Keywords: biomimetics, complex systems, construction management, information management, system dynamics

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Authors: Kamal Ahmed, Othman Ayman, Refat Mostafa

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The post-construction phase represents a critical milestone in the project lifecycle. This is because design errors and omissions, as well as construction defects, are examined during this phase. The traditional procurement approaches that are commonly adopted in construction projects separate design from construction, which ultimately inhibits contractors, suppliers and other parties from providing the design team with constructive comments and feedback to improve the project design. As a result, a lack of considering maintainability aspects during the design process results in increasing maintenance and operation costs as well as reducing building performance. This research aims to investigate the role of Early Supplier Involvement (ESI) in the design process as an approach to enhancing building maintainability. In order to achieve this aim, a research methodology consisting of a literature review, case studies and a survey questionnaire was designed to accomplish four objectives. Firstly, a literature review was used to examine the concepts of building maintenance, maintainability, the design process and ESI. Secondly, three case studies were presented and analyzed to investigate the role of ESI in enhancing building maintainability during the design process. Thirdly, a survey questionnaire was conducted with a representative sample of Architectural Design Firms (ADFs) in Egypt to investigate their perception and application of ESI towards enhancing building maintainability during the design process. Finally, the research developed a framework to facilitate ESI in the design process in ADFs in Egypt. Data analysis showed that the ‘Difficulty of trusting external parties and sharing information with transparency’ was ranked the highest challenge of ESI in ADFs in Egypt, followed by ‘Legal competitive advantage restrictions’. Moreover, ‘Better estimation for operation and maintenance costs’ was ranked the highest contribution of ESI towards enhancing building maintainability, followed by ‘Reduce the number of operation and maintenance problems or reworks’. Finally, ‘Innovation, technical expertise, and competence’ was ranked the highest supplier’s selection criteria, while ‘paying consultation fees for offering advice and recommendations to the design team’ was ranked the highest form of supplier’s remuneration. The proposed framework represents a synthesis that is creative in thought and adds value to the knowledge in a manner that has not previously occurred.

Keywords: maintenance, building maintainability, building life cycle cost (ICC), material supplier

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Authors: Jahangir Alam, Ayman El Sabagh, Kamrul Hasan, Shafiqul Islam Sikdar, Celaleddin Barutçular, Sohidul Islam

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The experiment (Germination test and seedling growth) was carried out at the laboratory of Agronomy Department, Hajee Mohammad Danesh Science and Technology University (HSTU), Dinajpur, Bangladesh during January 2014. Germination and seedling growth of 22 existing wheat genotypes in Bangladesh viz. Kheri, Kalyansona, Sonora, Sonalika, Pavon, Kanchan, Akbar, Barkat, Aghrani, Prativa, Sourab, Gourab, Shatabdi, Sufi, Bijoy, Prodip, BARI Gom 25, BARI Gom 26, BARI Gom 27, BARI Gom 28, Durum and Triticale were tested with three salinity levels (0, 100 and 200 mM NaCl) for 10 days in sand culture in small plastic pot. Speed of germination as expressed by germination percentage (GP), rate of germination (GR), germination coefficient (GC) and germination vigor index (GVI) of all wheat genotypes was delayed and germination percentage was reduced due to salinization compared to control. The lower reduction of GP, GR, GC and VI due to salinity was observed in BARI Gom 25, BARI Gom 27, Shatabdi, Sonora, and Akbbar and higher reduction was recorded in BARI Gom 26, Duram, Triticale, Sufi and Kheri. Shoot and root lengths, fresh and dry weights were found to be affected due to salinization and shoot was more affected than root. Under saline conditions, longer shoot and root length were recorded in BARI Gom 25, BARI Gom 27, Akbar, and Shatabdi, i.e. less reduction of shoot and root lengths was observed while, BARI Gom 26, Duram, Prodip and Triticale produced shorted shoot and root lengths. In this study, genotypes BARI Gom 25, BARI Gom 27, Shatabdi, Sonora and Aghrani showed better performance in terms shoot and root growth (fresh and dry weights) and proved to be tolerant genotypes to salinity. On the other hand, Duram, BARI Gom 26, Triticale, Kheri and Prodip affected seriously in terms of fresh and dry weights by the saline environment. BARI Gom 25, BARI Gom 27, Shatabdi, Sonora and Aghrani showed more salt tolerance index (STI) based on shoot dry weight while, BARI Gom 26, Triticale, Durum, Sufi, Prodip and Kalyanson demonstrate lower STI value under saline conditions. Based on the most salt tolerance and susceptible trait, genotypes under 100 and 200 mM NaCl stresses can be arranged as salt tolerance genotypes: BARI Gom 25> BARI Gom 27> Shatabdi> Sonora, and salt susceptible genotypes: BARI Gom 26> Durum> Triticale> Prodip> Sufi> Kheri. Considering the experiment, it can be concluded that the BARI Gom 25 may be treated as the most salt tolerant and BARI Gom 26 as the most salt sensitive genotypes in Bangladesh.

Keywords: genotypes, germination, salinity, wheat

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Authors: Taha Anjamrooz, Sareh Rajabi, Ayman Alzaatreh

Abstract:

Smart cities are playing important roles in real life. Integration and automation between different features of modern cities and information technologies improve smart city efficiency, energy management, human and equipment resource management, life quality and better utilization of resources for the customers. One of difficulties in this path, is use, interface and link between software, hardware, and other IT technologies to develop and optimize processes in various business fields such as construction, supply chain management and transportation in parallel to cost-effective and resource reduction impacts. Also, Smart cities are certainly intended to demonstrate a vital role in offering a sustainable and efficient model for smart houses while mitigating environmental and ecological matters. Energy management is one of the most important matters within smart houses in the smart cities and communities, because of the sensitivity of energy systems, reduction in energy wastage and maximization in utilizing the required energy. Specially, the consumption of energy in the smart houses is important and considerable in the economic balance and energy management in smart city as it causes significant increment in energy-saving and energy-wastage reduction. This research paper develops features and concept of smart city in term of overall efficiency through various effective variables. The selected variables and observations are analyzed through data analysis processes to demonstrate the efficiency of smart city and compare the effectiveness of each variable. There are ten chosen variables in this study to improve overall efficiency of smart city through increasing effectiveness of smart houses using an automated solar photovoltaic system, RFID System, smart meter and other major elements by interfacing between software and hardware devices as well as IT technologies. Secondly to enhance aspect of energy management by energy-saving within smart house through efficient variables. The main objective of smart city and smart houses is to reproduce energy and increase its efficiency through selected variables with a comfortable and harmless atmosphere for the customers within a smart city in combination of control over the energy consumption in smart house using developed IT technologies. Initially the comparison between traditional housing and smart city samples is conducted to indicate more efficient system. Moreover, the main variables involved in measuring overall efficiency of system are analyzed through various processes to identify and prioritize the variables in accordance to their influence over the model. The result analysis of this model can be used as comparison and benchmarking with traditional life style to demonstrate the privileges of smart cities. Furthermore, due to expensive and expected shortage of natural resources in near future, insufficient and developed research study in the region, and available potential due to climate and governmental vision, the result and analysis of this study can be used as key indicator to select most effective variables or devices during construction phase and design

Keywords: smart city, traditional housing, RFID, photovoltaic system, energy efficiency, energy saving

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Authors: Rawan Ashraf, Ahmed E. Gomaa, Gehan Safwat, Ayman Diab

Abstract:

Background: Three-dimensional (3D) bio-printing has become a versatile and powerful method for generating a variety of biological constructs, including bone or extracellular matrix scaffolds endo- or epithelial, muscle tissue, as well as organoids. Aim of the study: Fabricate a low cost DIY 3D bio-printer to produce 3D bio-printed products such as anti-microbial packaging or multi-organs on chips. We demonstrate the alignment between two types of 3D printer technology (3D Bio-printer and DLP) on Multi-organ-on-a-chip (multi-OoC) devices fabrication. Methods: First, Design and Fabrication of the Syringe Unit for Modification of an Off-the-Shelf 3D Printer, then Preparation of Hydrogel based on natural polymers Sodium Alginate and Gelatin, followed by acquisition of the cell suspension, then modeling the desired 3D structure. Preparation for 3D printing, then Cell-free and cell-laden hydrogels went through the printing process at room temperature under sterile conditions and finally post printing curing process and studying the printed structure regards physical and chemical characteristics. The hard scaffold of the Organ on chip devices was designed and fabricated using the DLP-3D printer, following similar approaches as the Microfluidics system fabrication. Results: The fabricated Bio-Ink was based onHydrogel polymer mix of sodium alginate and gelatin 15% to 0.5%, respectively. Later the 3D printing process was conducted using a higher percentage of alginate-based hydrogels because of it viscosity and the controllable crosslinking, unlike the thermal crosslinking of Gelatin. The hydrogels were colored to simulate the representation of two types of cells. The adaption of the hard scaffold, whether for the Microfluidics system or the hard-tissues, has been acquired by the DLP 3D printers with fabricated natural bioactive essential oils that contain antimicrobial activity, followed by printing in Situ three complex layers of soft-hydrogel as a cell-free Bio-Ink to simulate the real-life tissue engineering process. The final product was a proof of concept for a rapid 3D cell culturing approaches that uses an engineered hard scaffold along with soft-tissues, thus, several applications were offered as products of the current prototype, including the Organ-On-Chip as a successful integration between DLP and 3D bioprinter. Conclusion: Multiple designs for the organ-on-a-chip (multi-OoC) devices have been acquired in our study with main focus on the low cost fabrication of such technology and the potential to revolutionize human health research and development. We describe circumstances in which multi-organ models are useful after briefly examining the requirement for full multi-organ models with a systemic component. Following that, we took a look at the current multi-OoC platforms, such as integrated body-on-a-chip devices and modular techniques that use linked organ-specific modules.

Keywords: 3d bio-printer, hydrogel, multi-organ on chip, bio-inks

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Authors: Ayman Hijazi, Witold Kwapinski, J. J. Leahy

Abstract:

Finding a sustainable alternative energy to fossil fuel is an urgent need as various environmental challenges in the world arise. Therefore, formic acid (FA) decomposition has been an attractive field that lies at the center of biomass platform, comprising a potential pool of hydrogen energy that stands as a new energy vector. Liquid FA features considerable volumetric energy density of 6.4 MJ/L and a specific energy density of 5.3 MJ/Kg that qualifies it in the prime seat as an energy source for transportation infrastructure. Additionally, the increasing research interest in FA decomposition is driven by the need of in-situ H2 production, which plays a key role in the hydrogenation reactions of biomass into higher value components. It is reported elsewhere in literature that catalytic decomposition of FA is usually performed in poorly designed setup using simple glassware under magnetic stirring, thus demanding further energy investment to retain the used catalyst. it work suggests an approach that integrates designing a novel catalyst featuring magnetic property with a robust setup that minimizes experimental & measurement discrepancies. One of the most prominent active species for dehydrogenation/hydrogenation of biomass compounds is palladium. Accordingly, we investigate the potential of engrafting palladium metal onto functionalized magnetic nanoparticles as a heterogeneous catalyst to favor the production of CO-free H2 gas from FA. Using ordinary magnet to collect the spent catalyst renders core-shell magnetic nanoparticles as the backbone of the process. Catalytic experiments were performed in a jacketed batch reactor equipped with an overhead stirrer under inert medium. Through a novel approach, FA is charged into the reactor via high-pressure positive displacement pump at steady state conditions. The produced gas (H2+CO2) was measured by connecting the gas outlet to a measuring system based on the amount of the displaced water. The novelty of this work lies in designing a very responsive catalyst, pumping consistent amount of FA into a sealed reactor running at steady state mild temperatures, and continuous gas measurement, along with collecting the used catalyst without the need for centrifugation. Catalyst characterization using TEM, XRD, SEM, and CHN elemental analyzer provided us with details of catalyst preparation and facilitated new venues to alter the nanostructure of the catalyst framework. Consequently, the introduction of amine groups has led to appreciable improvements in terms of dispersion of the doped metals and eventually attaining nearly complete conversion (100%) of FA after 7 hours. The relative importance of the process parameters such as temperature (35-85°C), stirring speed (150-450rpm), catalyst loading (50-200mgr.), and Pd doping ratio (0.75-1.80wt.%) on gas yield was assessed by a Taguchi design-of-experiment based model. Experimental results showed that operating at lower temperature range (35-50°C) yielded more gas while the catalyst loading and Pd doping wt.% were found to be the most significant factors with a P-values 0.026 & 0.031, respectively.

Keywords: formic acid decomposition, green catalysis, hydrogen, mesoporous silica, process optimization, nanoparticles

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Authors: Ayman Hijazi, Witold Kwapinski, J. J. Leahy

Abstract:

Finding a sustainable alternative energy to fossil fuel is an urgent need as various environmental challenges in the world arise. Therefore, formic acid (FA) decomposition has been an attractive field that lies at the center of the biomass platform, comprising a potential pool of hydrogen energy that stands as a distinct energy vector. Liquid FA features considerable volumetric energy density of 6.4 MJ/L and a specific energy density of 5.3 MJ/Kg that qualifies it in the prime seat as an energy source for transportation infrastructure. Additionally, the increasing research interest in FA decomposition is driven by the need for in-situ H₂ production, which plays a key role in the hydrogenation reactions of biomass into higher-value components. It is reported elsewhere in the literature that catalytic decomposition of FA is usually performed in poorly designed setups using simple glassware under magnetic stirring, thus demanding further energy investment to retain the used catalyst. Our work suggests an approach that integrates designing a distinct catalyst featuring magnetic properties with a robust setup that minimizes experimental & measurement discrepancies. One of the most prominent active species for the dehydrogenation/hydrogenation of biomass compounds is palladium. Accordingly, we investigate the potential of engrafting palladium metal onto functionalized magnetic nanoparticles as a heterogeneous catalyst to favor the production of CO-free H₂ gas from FA. Using an ordinary magnet to collect the spent catalyst renders core-shell magnetic nanoparticles as the backbone of the process. Catalytic experiments were performed in a jacketed batch reactor equipped with an overhead stirrer under an inert medium. Through a distinct approach, FA is charged into the reactor via a high-pressure positive displacement pump at steady-state conditions. The produced gas (H₂+CO₂) was measured by connecting the gas outlet to a measuring system based on the amount of the displaced water. The uniqueness of this work lies in designing a very responsive catalyst, pumping a consistent amount of FA into a sealed reactor running at steady-state mild temperatures, and continuous gas measurement, along with collecting the used catalyst without the need for centrifugation. Catalyst characterization using TEM, XRD, SEM, and CHN elemental analyzer provided us with details of catalyst preparation and facilitated new venues to alter the nanostructure of the catalyst framework. Consequently, the introduction of amine groups has led to appreciable improvements in terms of dispersion of the doped metals and eventually attaining nearly complete conversion (100%) of FA after 7 hours. The relative importance of the process parameters such as temperature (35-85°C), stirring speed (150-450rpm), catalyst loading (50-200mgr.), and Pd doping ratio (0.75-1.80wt.%) on gas yield was assessed by a Taguchi design-of-experiment based model. Experimental results showed that operating at a lower temperature range (35-50°C) yielded more gas, while the catalyst loading and Pd doping wt.% were found to be the most significant factors with P-values 0.026 & 0.031, respectively.

Keywords: formic acid decomposition, green catalysis, hydrogen, mesoporous silica, process optimization, nanoparticles

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Authors: Rana Mohamed, Ahmed E. Gomaa, Gehan Safwat, Ayman Diab

Abstract:

Background: Bio-fabrication is a multidisciplinary research field that combines several principles, fabrication techniques, and protocols from different fields. The open-source-software movement is a movement that supports the use of open-source licenses for some or all software as part of the broader notion of open collaboration. Additive manufacturing is the concept of 3D printing, where it is a manufacturing method through adding layer-by-layer using computer-aided designs (CAD). There are several types of AM system used, and they can be categorized by the type of process used. One of these AM technologies is Digital light processing (DLP) which is a 3D printing technology used to rapidly cure a photopolymer resin to create hard scaffolds. DLP uses a projected light source to cure (Harden or crosslinking) the entire layer at once. Current applications of DLP are focused on dental and medical applications. Other developments have been made in this field, leading to the revolutionary field 3D bioprinting. The open-source movement was started to spread the concept of open-source software to provide software or hardware that is cheaper, reliable, and has better quality. Objective: Modification of desktop 3D printer into 3D bio-printer and the integration of DLP technology and bio-fabrication to produce an antibacterial dental model. Method: Modification of a desktop 3D printer into a 3D bioprinter. Gelatin hydrogel and sodium alginate hydrogel were prepared with different concentrations. Rhizome of Zingiber officinale, Flower buds of Syzygium aromaticum, and Bulbs of Allium sativum were extracted, and extractions were selected on different levels (Powder, aqueous extracts, total oils, and Essential oils) prepared for antibacterial bioactivity. Agar well diffusion method along with the E. coli have been used to perform the sensitivity test for the antibacterial activity of the extracts acquired by Zingiber officinale, Syzygium aromaticum, and Allium sativum. Lastly, DLP printing was performed to produce several dental models with the natural extracted combined with hydrogel to represent and simulate the Hard and Soft tissues. Result: The desktop 3D printer was modified into 3D bioprinter using open-source software Marline and modified custom-made 3D printed parts. Sodium alginate hydrogel and gelatin hydrogel were prepared at 5% (w/v), 10% (w/v), and 15%(w/v). Resin integration with the natural extracts of Rhizome of Zingiber officinale, Flower buds of Syzygium aromaticum, and Bulbs of Allium sativum was done following the percentage 1- 3% for each extract. Finally, the Antimicrobial dental model was printed; exhibits the antimicrobial activity, followed by merging with sodium alginate hydrogel. Conclusion: The open-source movement was successful in modifying and producing a low-cost Desktop 3D Bioprinter showing the potential of further enhancement in such scope. Additionally, the potential of integrating the DLP technology with bioprinting is a promising step toward the usage of the antimicrobial activity using natural products.

Keywords: 3D printing, 3D bio-printing, DLP, hydrogel, antibacterial activity, zingiber officinale, syzygium aromaticum, allium sativum, panax ginseng, dental applications

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Authors: Joshua Kaufman, Felix Tan, Morgan Monroe, Ayman Abouraddy

Abstract:

Textiles and clothing have been a staple of human existence for millennia, yet the basic structure and functionality of textile fibers and yarns has remained unchanged. While color and appearance are essential characteristics of a textile, an advancement in the fabrication of yarns that allows for user-controlled dynamic changes to the color or appearance of a garment has been lacking. Touch-activated and photosensitive pigments have been used in textiles, but these technologies are passive and cannot be controlled by the user. The technology described here allows the owner to control both when and in what pattern the fabric color-change takes place. In addition, the manufacturing process is compatible with mass-producing the user-controlled, color-changing yarns. The yarn fabrication utilizes a fiber spinning system that can produce either monofilament or multifilament yarns. For products requiring a more robust fabric (backpacks, purses, upholstery, etc.), larger-diameter monofilament yarns with a coarser weave are suitable. Such yarns are produced using a thread-coater attachment to encapsulate a 38-40 AWG metal wire inside a polymer sheath impregnated with thermochromic pigment. Conversely, products such as shirts and pants requiring yarns that are more flexible and soft against the skin comprise multifilament yarns of much smaller-diameter individual fibers. Embedding a metal wire in a multifilament fiber spinning process has not been realized to date. This research has required collaboration with Hills, Inc., to design a liquid metal-injection system to be combined with fiber spinning. The new system injects molten tin into each of 19 filaments being spun simultaneously into a single yarn. The resulting yarn contains 19 filaments, each with a tin core surrounded by a polymer sheath impregnated with thermochromic pigment. The color change we demonstrate is distinct from garments containing LEDs that emit light in various colors. The pigment itself changes its optical absorption spectrum to appear a different color. The thermochromic color-change is induced by a temperature change in the inner metal wire within each filament when current is applied from a small battery pack. The temperature necessary to induce the color change is near body temperature and not noticeable by touch. The prototypes already developed either use a simple push button to activate the battery pack or are wirelessly activated via a smart-phone app over Wi-Fi. The app allows the user to choose from different activation patterns of stripes that appear in the fabric continuously. The power requirements are mitigated by a large hysteresis in the activation temperature of the pigment and the temperature at which there is full color return. This was made possible by a collaboration with Chameleon International to develop a new, customized pigment. This technology enables a never-before seen capability: user-controlled, dynamic color and pattern change in large-area woven and sewn textiles and fabrics with wide-ranging applications from clothing and accessories to furniture and fixed-installation housing and business décor. The ability to activate through Wi-Fi opens up possibilities for the textiles to be part of the ‘Internet of Things.’ Furthermore, this technology is scalable to mass-production levels for wide-scale market adoption.

Keywords: activation, appearance, color, manufacturing

Procedia PDF Downloads 258

Authors: Hosein I. Hosein, Ragab Azzam, Ahmed M. S. Menshawy, Sherin Rouby, Khaled Hendy, Ayman Mahrous, Hany Hussien

Abstract:

Brucellosis is a highly contagious bacterial zoonotic disease of a worldwide spread and has different names; Infectious or enzootic abortion and Bang's disease in animals; and Mediterranean or Malta fever, Undulant Fever and Rock fever in humans. It is caused by the different species of genus Brucella which is a Gram-negative, aerobic, non-spore forming, facultative intracellular bacterium. Brucella affects a wide range of mammals including bovines, small ruminants, pigs, equines, rodents, marine mammals as well as human resulting in serious economic losses in animal populations. In human, Brucella causes a severe illness representing a great public health problem. The disease was reported in Egypt for the first time in 1939; since then the disease remained endemic at high levels among cattle, buffalo, sheep and goat and is still representing a public health hazard. The annual economic losses due to brucellosis were estimated to be about 60 million Egyptian pounds yearly, but actual estimates are still missing despite almost 30 years of implementation of the Egyptian control programme. Despite being the gold standard, bacterial isolation has been reported to show poor sensitivity for samples with low-level of Brucella and is impractical for regular screening of large populations. Thus, serological tests still remain the corner stone for routine diagnosis of brucellosis, especially in developing countries. In the present study, a total of 1533 cows (256 from Beni-Suef Governorate, 445 from Al-Fayoum Governorate and 832 from Damietta Governorate), were employed for estimation of relative sensitivity, relative specificity, positive predictive value and negative predictive value of buffered acidified plate antigen test (BPAT), rose bengal test (RBT) and complement fixation test (CFT). The overall seroprevalence of brucellosis revealed (19.63%). Relative sensitivity, relative specificity, positive predictive value and negative predictive value of BPAT,RBT and CFT were estimated as, (96.27 %, 96.76 %, 87.65 % and 99.10 %), (93.42 %, 96.27 %, 90.16 % and 98.35%) and (89.30 %, 98.60 %, 94.35 %and 97.24 %) respectively. BPAT showed the highest sensitivity among the three employed serological tests. RBT was less specific than BPAT. CFT showed the least sensitivity 89.30 % among the three employed serological tests but showed the highest specificity. Different tissues specimens of 22 seropositive cows (spleen, retropharyngeal udder, and supra-mammary lymph nodes) were subjected for bacteriological studies for isolation and identification of Brucella organisms. Brucella melitensis biovar 3 could be recovered from 12 (54.55%) cows. Bacteriological examinations failed to classify 10 cases (45.45%) and were culture negative. Bruce-ladder PCR was carried out for molecular identification of the 12 Brucella isolates at the species level. Three fragments of 587 bp, 1071 bp and 1682 bp sizes were amplified indicating Brucella melitensis. The results indicated the importance of using several procedures to overcome the problem of escaping of some infected animals from diagnosis.Bruce-ladder PCR is an important tool for diagnosis and epidemiologic studies, providing relevant information for identification of Brucella spp.

Keywords: brucellosis, relative sensitivity, relative specificity, Bruce-ladder, Egypt

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