Search results for: OHS improvement

Authors: Masashi Kanazawa, Takaaki Nakano, Masaaki Takemoto, Tomonori Imamura, Mamiko Sugimura, Toshitaka Ito

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Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks.

Keywords: CT scan, intoxication, pulmonary edema, water-soluble paint

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Authors: Tarek M. Ahmed, Ahmed S. El Mesalamy, Amro M. Youssef, Tawfik T. El Midany

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Abrasive waterjet (AWJ) machining is considered as one of the most powerful cutting processes. It can be used for cutting heat sensitive, hard and reflective materials. Aluminum 2024 is a high-strength alloy which is widely used in aerospace and aviation industries. This paper aims to improve aluminum alloy and to investigate the effect of AWJ control parameters on surface geometry quality. Design of experiments (DoE) is used for establishing an experimental matrix. Statistical modeling is used to present a relation between the cutting parameters (pressure, speed, and distance between the nozzle and cut surface) and responses (taper angle and surface roughness). The results revealed a tangible improvement in productivity by using AWJ processing. The taper kerf angle can be improved by decreasing standoff distance and speed and increasing water pressure. While decreasing (cutting speed, pressure and distance between the nozzle and cut surface) improve the surface roughness in the operating window of cutting parameters.

Keywords: abrasive waterjet machining, machining of aluminum alloy, non-traditional cutting, statistical modeling

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Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: Jagdeep Nayak, Biswajit Paul, Anup Gupta

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Characterization of coal refuses to fly ash, and steel slag from steel industries have been performed to develop a mixture of both these materials to enhance strength properties of their utilization in other sectors like mine fill, construction work, etc. A large amount of Linz-Donawitz (LD) slag and fly ash waste are generated from steel and thermal power industries respectively. Management of these wastes is problematic, and their reutilization may provide a sustainable waste management option. LD slag and fly ash mixed in different proportions were tested to analyse the micro structural improvement and hardening rate of the matrix. Mixing of activators such as sodium hydroxide and potassium silicate with silica-alumina of LD slag-fly ash mixture, geopolymeric structure were found to be developed. The effect of geo-polymerization behaviour and subsequent structural rearrangement has been studied using compressibility; shear strength and permeability tests followed by micro-graphical analysis. Densification in the mixture was observed along with an improvement of geotechnical properties due to the addition of LD slag. Due to suitable strength characteristics of these two waste materials as mixture, it can be used in the various construction field or may be used as a filling material in mine voids.

Keywords: LD slag, fly-ash, geopolymer, strength property, compressibility

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Authors: Muhamad Azani Yahya, Umi Nadiah Nor Ali, Mohammed Alias Yusof, Norazman Mohamad Nor, Vikneswaran Munikanan

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In construction, concrete is one of the materials that can commonly be used as for structural elements. Concrete consists of cement, sand, aggregate and water. Concrete can be added with admixture in the wet condition to suit the design purpose such as to prolong the setting time to improve workability. For strength improvement, concrete is being added with other hybrid materials to increase strength; this is because the tensile strength of concrete is very low in comparison to the compressive strength. This paper shows the usage of a waterproofing agent in concrete to enhance the tensile strength. High tensile concrete is expensive because the concrete mix needs fiber and also high cement content to be incorporated in the mix. High tensile concrete being used for structures that are being imposed by high impact dynamic load such as blast loading that hit the structure. High tensile concrete can be defined as a concrete mix design that achieved 30%-40% tensile strength compared to its compression strength. This research evaluates the usage of a waterproofing agent in a concrete mix as an element of reinforcement to enhance the tensile strength. According to the compression and tensile test, it shows that the concrete mix with a waterproofing agent enhanced the mechanical properties of the concrete. It is also show that the composite concrete with waterproofing is a high tensile concrete; this is because of the tensile is between 30% and 40% of the compression strength. This mix is economical because it can produce high tensile concrete with low cost.

Keywords: high tensile concrete, waterproofing agent, concrete, rheology

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Authors: Meltem Nur Erdöl, Feyzanur Bayrak, Elif Emanetçi, Faik Nüzhet Oktar, Cevriye Kalkandelen, Oğuzhan Gündüz

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Nowadays, the bioceramic graft applications are very important due to the fact that especially European population is getting much older. Consequently, healing approaches for some health problems become more important in the near future. For instance, osteoporosis is one of the reasons for serious hip fractures. Beside these, the traffic accidents playing role increasing of various hip fractures and other bone fractures. Naturally all these are leading the importance developing new bioceramic graft materials. Hydroxyapatite (HA) is one of the leading bioceramics on the market. Beside the high biocompatibility HA bioceramics unfortunately are weak materials for loaded areas. For improvement mechanical properties of HA material, some oxides and metallic powders can be added. In this study, some rare earth oxides like hafnium (IV) oxide (HfO₂) and samarium (III) oxide (Sm₂O₃) are added to HA for improvement of their material characteristics. Thus, compression, microhardness and theoretical density tests are performed. X-ray diffraction patterns are also investigated corresponding x-ray diffraction equipment. At the end, studies of scanning electron microscope (SEM) and energy-dispersive x-ray spectroscopy (EDX) are completed. All values were compared with past BHA and various composites.

Keywords: biocomposite, hafnium oxide, hydroxyapatite, nanotechnology, samarium oxide

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Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

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Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

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Authors: Zhanara B. Suleimenova, Zhazira K. Saduyeva

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Filamentous fungi are major producers of enzymes that have important applications in the food and beverage industries. The overall objective of this research is a strain improvement technology for efficient industrial enzymes production. The new way of filamentous fungi cultivation method has been developed. Such technology prolong producers’ cultivation period up to 60 days and create the opportunity to obtain enzymes repeatedly in every 2-3 days of fungal cultivation. This method is based on immobilizing enzymes producers with solid support in submerged conditions of growth. Immobilizing has a range of advantages: Decreasing the price of the final product, absence of foreign substances, controlled process of enzyme-genesis, ability of various enzymes simultaneous production, etc. Design of proposed technology gives the opportunity to increase the activity of immobilized cells culture filtrate comparing to free cells, growing in periodic culture conditions. Thus, proposed research focuses on new, more versatile, microorganisms capable of squeezing more end-products as well as proposed cultivation technology led to increased enzymatic productivity by several times.

Keywords: filamentous fungi, immobilization, industrial enzymes production, strain improvement

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Authors: Gheyder Concha Bendezu, Rodrigo Lescano Loli, Aldo Bravo Lizano

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In big urbanized cities of Latin America, motor vehicles have priority over non-motor vehicles and pedestrians. There is an important problem that affects people's health and quality of life; lack of inclusion towards pedestrians makes it difficult for them to move smoothly and safely since the city has been planned for the transit of motor vehicles. Faced with the new trend for sustainable and economical transport, the city is forced to develop infrastructure in order to incorporate pedestrians and users with non-motorized vehicles in the transport system. The present research aims to study the influence of non-motorized vehicles on an avenue, the optimization of a cycle using traffic lights based on simulation in Synchro software, to improve the flow of non-motor vehicles. The evaluation is of the microscopic type; for this reason, field data was collected, such as vehicular, pedestrian, and non-motor vehicle user demand. With the values of speed and travel time, it is represented in the current scenario that contains the existing problem. These data allow to create a microsimulation model in Vissim software, later to be calibrated and validated so that it has a behavior similar to reality. The results of this model are compared with the efficiency parameters of the proposed model; these parameters are the queue length, the travel speed, and mainly the travel times of the users at this intersection. The results reflect a reduction of 27% in travel time, that is, an improvement between the proposed model and the current one for this great avenue. The tail length of motor vehicles is also reduced by 12.5%, a considerable improvement. All this represents an improvement in the level of service and in the quality of life of users.

Keywords: bikeway, microsimulation, pedestrians, queue length, traffic light cycle, travel time

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Authors: Kouzi Katia

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This paper proposes a Direct Torque Control (DTC) algorithm of dual Stator Induction Motor (DSIM) drive using two approach intelligent techniques: Artificial Neural Network (ANN) approach replaces the switching table selector block of conventional DTC and Mamdani Fuzzy Logic controller (FLC) is used for stator resistance estimation. The fuzzy estimation method is based on an online stator resistance correction through the variations of stator current estimation error and its variation. The fuzzy logic controller gives the future stator resistance increment at the output. The main advantage of suggested algorithm control is to reduce the hardware complexity of conventional selectors, to avoid the drive instability that may occur in certain situation and ensure the tracking of the actual of the stator resistance. The effectiveness of the technique and the improvement of the whole system performance are proved by results.

Keywords: artificial neural network, direct torque control, dual stator induction motor, fuzzy logic estimator, switching table

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Authors: Md Asif Imrul, Maria Rafique, M. Habibur Rahman

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The study deals with an investigation into the impact of the relocation of tannery industry on water quality parameters of Buriganga. For this purpose, previous records have been collected from authentic data resources and for the attainment of present values, several samples were collected from three major locations of the Buriganga River during summer and winter seasons in 2018 to determine the distribution and variation of water quality parameters. Samples were collected six ft below the river water surface. Analysis indicates slightly acidic to slightly alkaline (6.8-7.49) in nature. Bio-Chemical Oxygen Demand, Total Dissolved Solids, Total Solids (TS) & Total Suspended Solids (TSS) have been found greater in summer. On the other hand, Dissolved Oxygen is found greater in rainy seasons. Relocation shows improvement in water quality parameters. Though the improvement related to relocation of tannery industry is not adequate to turn the water body to be an inhabitable place for aquatic lives.

Keywords: Buriganga river, river pollution, tannery industry, water quality parameters

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Authors: Attiq Ur Rahman Dogar, Sohaib Ishaq

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Pakistan had experienced rapid motorization in the last decade. Due to the soft leasing schemes of banks and increase in average household income, even the middle class can now afford cars. The public transit system is inadequate and sparse. Due to these reasons, traffic demand on urban arterials has increased manifold. Poor urban transit planning and aging transportation systems have resulted in traffic congestion. The focus of this study is to improve traffic flow on a section of N-5 passing through the Rawalpindi downtown. Present efforts aim to carry out the analysis of traffic conditions on this section and to investigate the impact of traffic signal co-ordination on travel time. In addition to signal co-ordination, we also examined the effect of different infrastructure improvements on the travel time. After the economic analysis of alternatives and discussions, the improvement plan for Rawalpindi downtown urban arterial section is proposed for implementation.

Keywords: signal coordination, infrastructure intervention, infrastructure improvement, cycle length, fuel consumption cost, travel time cost, economic analysis, travel time, Rawalpindi, Pakistan, traffic signals

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Authors: Ayman Haddad, Wafaa Sbeiti, Amr Qasem

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The main aim of this paper is to provide an overview of the most influential economic changes and accounting legislation affecting financial reporting and disclosure practices in Jordan. It also provides an overview of disclosure studies conducted in Jordan covering the year(s) between 1986 and 2014. The economic changes in Jordan required conducting economic reform and revising/issuing new regulations and financial market reforms that led to an improvement in disclosure practices. The issuance of Temporary Securities Law and its Directives of Disclosure in 1997, which came into effect in 1998, is considered as the turning point in the improvement of disclosure practice in Jordan. Based on a review of prior disclosure studies, we conclude that disclosure practices have improved overtime. We also observe that that firm size as a factor has always affected the level of disclosure in Jordan and followed by external auditing while liquidity was found to have the least effect. The paper also addresses the disclosure items required in Corporate Governance Codes that exist for listed shareholding companies, banks, and insurance companies. Finally, the paper discusses the quality of accounting education in Jordan since prior studies noted its impact on accounting practice.

Keywords: accounting legislation, corporate governance, disclosure practice, Jordan

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Authors: Rabbya Ashrafi, Mohammad Tarikul Islam , Al-Amin Bhuiyan, Aminur Rahman

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Injury is the leading killer of children in Bangladesh. Anchal (community crèche) is an effective intervention to prevent injuries among children under 5. Through the SoLiD project, 1,600 Anchals are in place in three sub-districts in Bangladesh. The objectives of the Anchal are to provide supervision and early childhood development stimulations (ECD) to the children. A locally trained caregiver supervises 20-25 children, 9 to 59 months old, from 9 a.m. to 1 p.m., six days a week. Although it was found effective, during its implementation phase several challenges were noticed. To identify challenges and means to overcome those to improve the Anchal activities. In-depth interviews were conducted with Anchal caregivers, their supervisors, and trainers. Focus group discussions were conducted with the mothers of the Anchal children. The study was conducted in the Manohardi sub-district in November 2015. Decay of knowledge and skills after 2-3 months of training, lack of formal certification and inappropriate selection of women as Anchal caregivers, and enrollment of small children (less than 12 months) were the important challenges. The reluctance of parents to send children to the Anchal at the proper time, failure to engage children in various ECD activities, ineffective conduction of parents and community leaders meeting by the Anchal caregivers, insufficient accommodation, and poor supply of logistics for children were also the important challenges. The suggestion for improvement was to recruit caregivers as per standard criteria, provide them refreshers training at three months intervals, train them on effective conduction of parents and community leaders meetings, provide a formal certificate, and ensure regular supply of logistics. The identified challenges are needed to be addressed by utilizing the suggestions obtained from the IDIs and FGDs to make the Anchal intervention more effective in preventing childhood injuries.

Keywords: comunity crech, earlychildhood development, measures for improvement, childhood injury

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Authors: Alia Aldarmaki, Ahmad Elshennawy

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There is a global shift in healthcare systems’ emphasizing engaging different stakeholders in selecting quality improvement initiatives and incorporating their preferences to improve the healthcare efficiency and outcomes. Although experts bring scientific knowledge based on the scientific model and their personal experience, other stakeholders can bring new insights and information into the decision-making process. This study attempts to explore the impact of incorporating different stakeholders’ preference in identifying the most significant criteria that should be considered in healthcare for electing the improvement projects. A Framework based on a modified Fuzzy Delphi Method (FDM) was built. In addition to, the subject matter experts, doctors/physicians, nurses, administrators, and managers groups contribute to the selection process. The research identifies potential criteria for evaluating projects in healthcare, then utilizes FDM to capture expertise knowledge. The first round in FDM is intended to validate the identified list of criteria from experts; which includes collecting additional criteria from experts that the literature might have overlooked. When an acceptable level of consensus has been reached, a second round is conducted to obtain experts’ and other related stakeholders’ opinions on the appropriate weight of each criterion’s importance using linguistic variables. FDM analyses eliminate or retain the criteria to produce a final list of the critical criteria to select improvement projects in healthcare. Finally, reliability and validity were investigated using Cronbach’s alpha and factor analysis, respectively. Two case studies were carried out in a public hospital in the United Arab Emirates to test the framework. Both cases demonstrate that even though there were common criteria between the experts and the stakeholders, still stakeholders’ perceptions bring additional critical criteria into the evaluation process, which can impact the outcomes. Experts selected criteria related to strategical and managerial aspects, while the other participants preferred criteria related to social aspects such as health and safety and patients’ satisfaction. The health and safety criterion had the highest important weight in both cases. The analysis showed that Cronbach’s alpha value is 0.977 and all criteria have factor loading greater than 0.3. In conclusion, the inclusion of stakeholders’ perspectives is intended to enhance stakeholders’ engagement, improve transparency throughout the decision process, and take robust decisions.

Keywords: Fuzzy Delphi Method, fuzzy number, healthcare, stakeholders

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Authors: Mardani Ali Serah, Yuriadi Kusuma, Chandrasa Soekardi

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The improvement of flow strategy was implemented in the intake system of the engine to produce better Compressed Natural Gas engine performance. Three components were studied, designed, simulated, developed,tested and validated in this research. The components are: the mixer, swirl device and fuel cooler device. The three components were installed to produce pressurised turbulent flow with higher fuel volume in the intake system, which is ideal condition for Compressed Natural Gas (CNG) fuelled engine. A combination of experimental work with simulation technique were carried out. The work included design and fabrication of the engine test rig; the CNG fuel cooling system; fitting of instrumentation and measurement system for the performance testing of both gasoline and CNG modes. The simulation work was utilised to design appropriate mixer and swirl device. The flow test rig, known as the steady state flow rig (SSFR) was constructed to validate the simulation results. Then the investigation of the effect of these components on the CNG engine performance was carried out. A venturi-inlet holes mixer with three variables: number of inlet hole (8, 12, and 16); the inlet angles (300, 400, 500, and 600) and the outlet angles (200, 300, 400, and 500) were studied. The swirl-device with number of revolution and the plane angle variables were also studied. The CNG fuel cooling system with the ability to control water flow rate and the coolant temperature was installed. In this study it was found that the mixer and swirl-device improved the swirl ratio and pressure condition inside the intake manifold. The installation of the mixer, swirl device and CNG fuel cooling system had successfully increased 5.5%, 5%, and 3% of CNG engine performance respectively compared to that of existing operating condition. The overall results proved that there is a high potential of this mixer and swirl device method in increasing the CNG engine performance. The overall improvement on engine performance of power and torque was about 11% and 13% compared to the original mixer.

Keywords: intake system, Compressed Natural Gas, volumetric efficiency, engine performance

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Authors: Alhassan Dahiru

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Value management is widely accepted technique of eliminating unnecessary cost at different stages of project development that maximizes the functional value of a project by managing its evolution and development from concept to completion. Many construction industry practitioners are not aware of Value Management practice, and its use is less widespread in Nigeria. The aim of this research is to identify the level of awareness on value management practice amongst construction practitioners with a view to contribute to the improvement of the implementation of value management practice in the Nigerian construction industry. In this study, construction practitioners have been chosen as respondents from the 6 geopolitical zones of the federation including FCT Abuja. Through the survey, a total number of 360 semi-structured questionnaires were administered and 284 were returned and remained good for the analysis. The results indicate that most of the respondents were aware of the value management concept and issues surrounding construction industry in Nigeria, while about 32% of the respondents were not aware of its potential benefits. Therefore, organisations should review their techniques and processes from time to time for improvement on effective service delivery. Additionally, a change management strategy should also be part of every organization to ease the introduction of new techniques such as value management. There is also the need for more value management training workshops and seminars in order to enlighten the participants of the construction industry on the principles, concept, and techniques involved in the value management process.

Keywords: sustainability, value management, construction practitioners, Nigeria

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Authors: Mitra Assadi, Md. Faan

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Background: Autism Spectrum Disorder (ASD) in a common neurodevelopmental disorder with limited pharmacological interventions. Transcranial Magnetic Stimulation (rTMS) has produced promising results in ASD, although there is no consensus regarding optimal targets or stimulation paradigms. A prevailing theory in ASD attributes the core deficits to dysfunction of the mirror neurons located in the inferior parietal lobule (IPL) and inferior frontal gyrus (IFG). Methods: Thus far, 11 subjects with ASD, 10 boys and 1 girl with the mean age of 13.36 years have completed the study by receiving 10 session of high frequency rTMS to the IPL. The subjects were randomized to receive stimulation on the left or right IPL and sham stimulation to the opposite side. The outcome measures included the Social Responsiveness Scale – Second Edition (SRS-2) and Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency task. Results: None of the 11 subjects experienced any adverse effects. The rTMS did not produce any improvement in verbal fluency, nor there was any statistically significant difference between the right versus left sided stimulation. Analysis of social awareness on SRS-2 (SRS-AWR) indicated a close to significant effect of the treatment with a small to medium effect size. After removing a single subject with Level 3 ASD, we demonstrated a close to significant improvement on SRS-AWR with a large effect size. The analysis of the data 3-month post TMS demonstrated return of the SRS-AWR values to baseline. Conclusion: This preliminary analysis of the 11 subjects who have completed our study thus far shows a favorable response to high frequency rTMS stimulation of the mirror neurons/IPL on social awareness. While the decay of the response noted during the 3-month follow-up may be considered a limitation of rTMS, the presence of the improvement, especially the effect size despite the small sample size, is indicative of the efficacy of this technique.

Keywords: rTMS, autism, scoial cognition, mirror neurons

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Authors: Ahuja Ashish, Nain Prabhdeep Singh

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Introduction: Polycystic ovarian syndrome(PCOS) is the most common endocrine disorder among women of reproductive age.Pcos encompasses a broad spectrum of signs&symptoms of ovary dysfunction,obesity,blood pressure,insulin resistance & infertility. Bariatric Surgery can be an effective means of weight loss in Pcos & curing infertility. Materials and Methods: 15 female patients were enrolled in the study from 2012-2014.66%(n=10) were in age group of 20-25 years,33%(n=5) were in age group of 25-33 years who underwent. Bariatric surgery in form of Laproscopic sleeve Gastrectomy(LSG)& Roux-en-Y gastric bypass. LSG 73%(n=11), RYGB26% (n=4). Results: There was a significant improvement in obesity (60% excess weight loss)over 1 year after bariatric surgery, in 12 patients there was gross improvement in restoration of menstrual cycle who had irregular menstrual cycle. In 80% patients the serum insulin level showed normal value. Over two years 8 patients become pregnant. Conclusions: 1)Obese women with Pcos maybe able to conceive after Bariatric Surgery. 2) Women with Pcos should only consider bariatric surgery if they were already considering it for other reasons to treat obesity, blood pressure & other co-morbid conditions.

Keywords: obesity, bariatric surgery, polycystic ovarian syndrome, infertility

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Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: K. M. Saif Ur Rahman, Razib Mamun, Himica Arjuman, Fida Al Shams

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Introduction: Autism spectrum disorder (ASD) has become an emerging neurodevelopmental disorder with increasing prevalence. It has become an important public health issue globally. Many approaches including speech and language therapy (SLT), occupational therapy, behavioral therapy etc. are being applied for the betterment of the ASD patients. This study aims to describe the characteristics of ASD patients and perception of caregiver regarding SLT in Bangladesh. Methods: This cross-sectional study was conducted in a therapy and rehabilitation center at Dhaka city. Caregivers of 48 ASD patients responded regarding their perception of SLT and characteristics of patients. Results: Among 48 ASD patients, 56.3% were between 3 to 5 years age group with a male predominance (87.5%). More than half of the participants (56.3%) initiated SLT at the age of 1-3 years and the majority (43.8%) were taking SLT for less than 1 year. Majority of the patients (64.6%) were taken to a physician for healthcare as a first contact of which 29.2% were referred to SLT by physicians. More than half (56.3%) of the caregivers were moderately satisfied with SLT and most of them (62.5%) mentioned moderate improvement through SLT. Improvement rate was 10-15% in specific symptoms such as eye contact, complex mannerism, pointing, imitation etc. Conclusion: This study reveals the self-reported perception of caregivers on SLT. Despite reported improvements, more exploration of different approaches and intervention for management of ASD is recommended.

Keywords: ASD, characteristics, SLT, Bangladesh

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Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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Authors: Howaidi M. Al-Otaibi, Abdulrahman S. Al-Suhaibani, Hamad A. Alsoliman

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Fibers are extensively used in civil engineering applications for many years. In this study, empty fruit bunch of date palm trees were used to produce cellulose fiber that were used as additives in the asphalt binder. Two sizes (coarse and fine) of cellulose fibers were pre-blended in PG64-22 binder with various contents of 1.5%, 3%, 4.5%, 6%, and 7.5% by weight of asphalt binder. The physical and rheological properties of fiber modified asphalt binders were tested by using conventional tests such as penetration, softening point and viscosity; and SHRP test such as dynamic shear rheometer. The results indicated that the fiber modified asphalt binders were higher in softening point, viscosity, and complex shear modulus, and lower in penetration compared to pure asphalt. The fiber modified binders showed an improvement in rheological properties since it was possible to raise the control binder (pure asphalt) PG from 64 to 70 by adding 6% (by weight) of either fine or coarse fibers. Such improvement in stiffness of fiber modified binder is expected to improve pavement resistance to rutting.

Keywords: cellulose date palm fiber, fiber modified asphalt, physical properties, rheological properties

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Authors: Karin M. Granstrom

Abstract:

Paper mills produce wastewater with a high content of organic substances. Treatment usually consists of sedimentation, biological treatment of activated sludge basins, and chemical precipitation. The resulting sludges are currently a waste problem, deposited in landfills or used as low-grade fuels for incineration. There is a growing awareness of the need for energy efficiency and environmentally sound management of sludge. A resource-efficient method would be to digest the wastewater sludges anaerobically to produce biogas, refine the biogas to biomethane for use in the transportation sector, and utilize the resulting digestate for soil improvement. The biomethane yield of pulp and paper wastewater sludge is comparable to that of straw or manure. As a bonus, the digestate has an improved dewaterability compared to the feedstock biosludge. Limitations of this process are predominantly a weak economic viability - necessitating both sufficiently large-scale paper production for the necessary large amounts of produced wastewater sludge, and the resolving of remaining questions on the certifiability of the digestate and thus its sales price. A way to improve the practical and economical feasibility of using paper mill wastewater for biomethane production and soil improvement is to co-digest it with other feedstocks. In this study, pulp and paper sludge were co-digested with (1) silage and manure, (2) municipal sewage sludge, (3) food waste, or (4) microalgae. Biomethane yield analysis was performed in 500 ml batch reactors, using an Automatic Methane Potential Test System at thermophilic temperature, with a 20 days test duration. The results show that (1) the harvesting season of grass silage and manure collection was an important factor for methane production, with spring feedstocks producing much more than autumn feedstock, and pulp mill sludge benefitting the most from co-digestion; (2) pulp and paper mill sludge is a suitable co-substrate to add when a high nitrogen content cause impaired biogas production due to ammonia inhibition; (3) the combination of food waste and paper sludge gave higher methane yield than either of the substrates digested separately; (4) pure microalgae gave the highest methane yield. In conclusion, although pulp and paper mills are an almost untapped resource for biomethane production, their wastewater is a suitable feedstock for such a process. Furthermore, through co-digestion, the pulp and paper mill wastewater and mill sludges can aid biogas production from more nutrient-rich waste streams from other industries. Such co-digestion also enhances the soil improvement properties of the residue digestate.

Keywords: anaerobic, biogas, biomethane, paper, sludge, soil

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Authors: Zainal Abu Zarim, Hafizah Omar Zaki

Abstract:

The objective of this study is to analyse the success factors of entrepreneurs in the Malaysian SMEs in the urge to discover their entrepreneurial leadership characteristics. Data has been collected from top 50 SME award winning companies. The study has used the qualitative approach to data collection, where interviews are dispersed on these selected companies. From these 50 SMEs, only 25 accepted the interview request where one entrepreneur from each SME answered the questions. To successfully run this study, we administered some questions based on Hornaday 42 characteristics of an entrepreneurs, as well some structured questions to determine a successful of a company. The result shows that, entrepreneurs are confident, determine, diligent, flexible, responsive to challenges, responsible, foresight, courageous, aggressive, and committed. Consistent to this, several elements that makes the company successful includes (1) strong financial control, (2) continuous improvement, (3) product quality and product safety as top priority, (4) hard work and team work, and (5) eagerness in taking challenges. These results has deemed that entrepreneurs in many aspects are also leaders that are risk averse and determine, and are eager to work on continuous improvement in a financially strong company.

Keywords: characteristics of entrepreneurs, success of a company, key success factors, Malaysian SMEs

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Authors: Khin Khin Thant Sin

Abstract:

This study is a case study which investigates successful and ongoing bottom-up innovations for school improvement initiatives in Hungary. Two innovative schools are selected in this study due to their outstanding achievement during the past ten years in Hungary. In one school, data from the personal experiences of a school principal who initiated the bottom-up innovation are included. For the second school, three interviews were carried out with two schoolteachers and one secondary school student. In addition, desk research, including the principal’s published articles, the schoolteachers’ master thesis, the school websites, and other published articles, are analysed to explore the schools’ innovative processes. This study investigates how bottom-up innovation led to major achievements in student learning, teacher professional development, networking and collaboration with other schools, and the establishment of successful partnerships with universities. The highlight of this study is how innovative schools can be the major sources promoting educational innovations as well as improving teacher education, especially in initial teacher education and continuous professional development.

Keywords: school innovation, teacher education, hungary, educational innovation, school improvement

Procedia PDF Downloads 80

Authors: Gia Lam Le, Dennis T. Bergado, Thi Ngoc Truc Nguyen

Abstract:

This study focuses on behaviors of improved soft clay using prefabricated vertical drain (PVD) combined with vacuum and electro-osmotic preloading. Large-scale consolidations of reconstituted soft Bangkok clay were conducted for PVD improvement with vacuum (vacuum-PVD), and vacuum combined with heat (vacuum-thermo-PVD). The research revealed that vacuum-thermo-PVD gives high efficiency of the consolidation rate compared to the vacuum-PVD. In addition, the magnitude of settlement of the specimen improved by the vacuum-thermo-PVD is higher than the vacuum-PVD because the assistance of heat causes the collapse of the clay structure. Particularly, to reach 90% degree of consolidation, the thermal-vacuum-PVD reduced about 58% consolidation time compared to the vacuum-PVD. The increase in consolidation rate is resulted from the increase in horizontal coefficient of consolidation, Ch, the reduction of the smear effect expressed by the ratio of the horizontal hydraulic conductivity in the undisturbed zone, kh, and the horizontal hydraulic conductivity in the smeared zone, ks. Furthermore, the shear strength, Su, increased about 100% when compared using the vacuum-thermal-PVD to the vacuum PVD. In addition, numerical simulations gave reasonable results compared to the laboratory data.

Keywords: PVD improvement, vacuum preloading, prefabricated vertical drain, thermal PVD

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Authors: Madhu Patial, Dharam Pal, Jagdish Kumar, H. K. Chaudhary

Abstract:

Doubled haploid breeding serves as a useful technique in wheat improvement by providing instant and complete homozygosity. Of the various techniques employed for haploid production chromosome elimination has a large scale practical application in wheat improvement. Barclay (1975) initiated the technique in wheat by crossing wheat variety Chinese spring with Hordeum bulbosum, but due to presence of the dominant crossability inhibitor genes Kr7 and Kr2 in many wheat varieties, the technique was however genotypic specific. The discovery of wheat X maize system of haploid production being genotype non-specific is quite successful but still maize needs to be grown in greenhouse to coincide flowering with wheat crop. Recently, wheat X Imperate cylindrica has been identified as a new chromosome mediated DH approach for efficient haploid induction. An experiment to use this technique in wheat was set up by crossing six F1s and two three way F1s with Imperata cylindrica. The data was recorded for the three component traits of haploid induction viz., seed formation, embryo formation and regeneration frequency. Variation among wheat F1s was observed and higher frequency for all the traits were recorded in cross HD 2997/2*FL-8/DONSK-POLL and KLE/BER/2*FL-8/DONSK-POLL.

Keywords: wheat, haploid, imperata cylindrica, chromosome elimination technique

Procedia PDF Downloads 394

Authors: Ekaterina Sánchez Romero, Emily Gabriela Aguirre Herrera, Sandra Luz Espinoza Esquerra, Jorge García Campos

Abstract:

Female, 7 months old, daughter of a mother with anemia during pregnancy, with no history of atopy in the family, since birth she presents with recurrent dermatological and gastrointestinal infections, chronically treated for recurrent diaper dermatitis. At 6 months of age, she begins with generalized pallor, hyperpigmentation in hands and feet, smooth tongue, psychomotor retardation with lack of head support, sedation, and hypoactivity. She was referred to our hospital for a fever of 38°C, severe diaper rash, and pancytopenia with HB 9.3, platelets 38000, neutrophils 0.39 MCV: 86.80 high for her age. The approach was initiated to rule out myeloproliferative syndrome, with negative immunohistochemical results of bone marrow aspirate; during her stay, she presented neurological regression, lack of sucking, and focal seizures. CT scan showed cortical atrophy. The patient was diagnosed with primary immunodeficiency due to history; gamma globulin was administered without improvement with normal results of immunoglobulins and metabolic screening. When dermatological and neurological diagnoses were ruled out as the primary cause, a nutritional factor was evaluated, and a therapeutic trial was started with the administration of vitamin B12 and zinc, presenting clinical neurological improvement and resolution of pancytopenia in 2 months. It was decided to continue outpatient management. Discussion: We present a patient with neurological, dermatological involvement, and pancytopenia, so the most common differential diagnoses in this population were ruled out. Vitamin B12 deficiency is an uncommon entity. Due to maternal and clinical history, a therapeutic trial was started resulting in an improvement. Conclusion: VitaminB12 deficiency should be considered one of the differential diagnoses in the approach to pancytopenia with megaloblastic anemia associated with dermatologic and neurologic manifestations. Early treatment can reduce irreversible damage in these patients.

Keywords: vitamin B12 deficiency, pediatrics, pancytopenia, diaper dermatitis

Procedia PDF Downloads 62

Authors: Fatemeh Khalili Varnamkhasti

Abstract:

Numerous nations have recognized the critical ought to address natural issues, such as discuss contamination, squander transfer, worldwide warming, and common asset consumption, through the application of green innovation. The rise of cleverly advances has driven mechanical basic changes that will offer assistance accomplish carbon decrease. Manufactured insights (AI) innovation is an imperative portion of digitalization, giving unused mechanical apparatuses and bearings for the moo carbon advancement of endeavors. Quickening the brilliantly change of fabricating industry is an critical vital choice to realize the green advancement change. The reason why fabricating insights can advance the advancement of green advancement execution is that fabricating insights is conducive to the generation of "innovation advancement impact" and "fetched decrease impact" so as to advance green innovation advancement, at that point viably increment the alluring yields and essentially diminish the undesirable yields. AI improvement will boost GTI as it were when the escalated of natural direction and organization environment is over a certain edge esteem. In any case, the AI improvement spoken to by mechanical robot applications still has no self-evident impact on GTI, indeed, when the R&D venture surpasses a certain edge.

Keywords: greenhouse gas emissions, green infrastructure, artificial intelligence, environmental protection

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