Search results for: hospital discharge

Authors: Kyung Min Park, Cheol Hee Moon

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In this study we are to develop a sealing process using a mixture of a LMPA and an epoxy for the atmospheric OLED sealing process as a substitute for the thin-film process. Electrode lines were formed on the substrates, which were covered with insulating layers and sacrificial layers. A mixture of a LMPA and an epoxy was screen printed between the two electrodes. In order to generate a heat for the melting of the mixture, Joule heating method was used. Were used instantaneous discharge process for generating Joule heating. Experimental conditions such as voltage, time and constituent of the electrode were varied to optimize the heating conditions. As a result, the mixture structure of this study showed a great potential for a low-cost, low-temperature, atmospheric OLED sealing process as a substitute for the thin-film process.

Keywords: organic light emitting diode, encapsulation, low melting point alloy, joule heat

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Authors: Sun-Ki Hong, Yong-Ho Cho, Ki-Seok Kim, Tae-Sam Kang

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Piezoelectric actuator is treated as RC load when it is modeled electrically. For some piezoelectric actuator applications, arbitrary voltage is required to actuate. Especially for unidirectional arbitrary voltage driving like as sine wave, some special inverter with circuit that can charge and discharge the capacitive energy can be used. In this case, the difference between power supply level and the object voltage level for RC load is varied. Because the control gain is constant, the controlled output is not uniform according to the voltage difference. In this paper, for charge and discharge circuit for unidirectional arbitrary voltage driving for piezoelectric actuator, the controller gain is controlled according to the voltage difference. With the proposed simple idea, the load voltage can have controlled smoothly although the voltage difference is varied. The appropriateness is proved from the simulation of the proposed circuit.

Keywords: analog voltage inverter, capacitive load, gain control, dc-dc converter, piezoelectric, voltage waveform

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Authors: Mahmoud Abdel Hameed Shahin

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Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.

Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress

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Authors: Aneta Nitsch-Osuch, Damian Okrucinski, Magdalena Dawgialło, Izabela Gołębiak, Ernest Kuchar

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The Hospital Antibiotic Policy (HAP) should be implemented to rationalize the antibiotic use and to decrease the risk of spreading of spreading of resistant bacteria. The aim of our study was to describe the antibiotic consumption patterns at the single oncosurgery ward before and after implementation of the HAP. We conducted a retrospective analysis of the antibiotic use at the Oncosurgery Ward in Warsaw (Poland) in years 2011-2016. Calculations were based on daily defined doses (DDDs), DDDs/100 hospitalizations and DDDs/100 person-days, drug utilization rates (DU 90% and DU 100%) were also analysed. After implementation of the HAP, the total antibiotic consumption increased (365.35 DDD in 2011 vs. 1359,22 DDD in 2016). The significant change was observed in antibiotic consumption patterns: the use of amoxicillin clavulanate and carbapenems or glycopeptides decreased significantly (p < 0,05), while the use of ciprofloxacin and aminoglycosides increased (p < 0,05). The DU100% rate varied from 6 in 2011 to 12 in 2016; while DU 90% rate varied from 2 in 2011 to 3-5 in 2013-2016. Although the implementation of the HAP did not result in the decreased total antibiotic consumption, it provided favorable changes in the antibiotic consumption patterns.

Keywords: antibiotics, hospital, policy, stewardship

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Authors: Miguel Chen Austin, Denis Bruneau, Alain Sempey, Laurent Mora, Alain Sommier

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An experimental study in a Plus Energy House (PEH) prototype was conducted in August 2016. It aimed to highlight the energy charge and discharge of a concrete-slab floor submitted to the day-night-cycles heat exchanges in the southwestern part of France and to identify the heat transfer phenomena that take place in both processes: charge and discharge. The main features of this PEH, significant to this study, are the following: (i) a non-active slab covering the major part of the entire floor surface of the house, which include a concrete layer 68 mm thick as upper layer; (ii) solar window shades located on the north and south facades along with a large eave facing south, (iii) large double-glazed windows covering the majority of the south facade, (iv) a natural ventilation system (NVS) composed by ten automatized openings with different dimensions: four are located on the south facade, four on the north facade and two on the shed roof (north-oriented). To highlight the energy charge and discharge processes of the non-active slab, heat flux and temperature measurement techniques were implemented, along with airspeed measurements. Ten “measurement-poles” (MP) were distributed all over the concrete-floor surface. Each MP represented a zone of measurement, where air and surface temperatures, and convection and radiation heat fluxes, were intended to be measured. The airspeed was measured only at two points over the slab surface, near the south facade. To identify the heat transfer phenomena that take part in the charge and discharge process, some relevant dimensionless parameters were used, along with statistical analysis; heat transfer phenomena were identified based on this analysis. Experimental data, after processing, had shown that two periods could be identified at a glance: charge (heat gain, positive values) and discharge (heat losses, negative values). During the charge period, on the floor surface, radiation heat exchanges were significantly higher compared with convection. On the other hand, convection heat exchanges were significantly higher than radiation, in the discharge period. Spatially, both, convection and radiation heat exchanges are higher near the natural ventilation openings and smaller far from them, as expected. Experimental correlations have been determined using a linear regression model, showing the relation between the Nusselt number with relevant parameters: Peclet, Rayleigh, and Richardson numbers. This has led to the determination of the convective heat transfer coefficient and its comparison with the convective heat coefficient resulting from measurements. Results have shown that forced and natural convection coexists during the discharge period; more accurate correlations with the Peclet number than with the Rayleigh number, have been found. This may suggest that forced convection is stronger than natural convection. Yet, airspeed levels encountered suggest that it is natural convection that should take place rather than forced convection. Despite this, Richardson number values encountered indicate otherwise. During the charge period, air-velocity levels might indicate that none air motion occurs, which might lead to heat transfer by diffusion instead of convection.

Keywords: heat flux measurement, natural ventilation, non-active concrete slab, plus energy house

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Authors: Mandeep Kumar, Hari Singh

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The effective optimization of machining process parameters affects dramatically the cost and production time of machined components as well as the quality of the final products. This paper presents the optimization aspects of a Wire Electrical Discharge Machining operation using Inconel X-750 as work material. The objective considered in this study is minimization of the dimensional deviation. Six input process parameters of WEDM namely spark gap voltage, pulse-on time, pulse-off time, wire feed rate, peak current and wire tension, were chosen as variables to study the process performance. Taguchi's design of experiments methodology has been used for planning and designing the experiments. The analysis of variance was carried out for raw data as well as for signal to noise ratio. Four input parameters and one two-factor interaction have been found to be statistically significant for their effects on the response of interest. The confirmation experiments were also performed for validating the predicted results.

Keywords: ANOVA, DOE, inconel, machining, optimization

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Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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Authors: Seyed Abolhasan Naeini, Ali Namaei

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This study presents the effect of prefabricated vertical drain system properties on embankment behavior by calculating the settlement, lateral displacement and induced excess pore pressure by numerical method. In order to investigate this behavior, three different prefabricated vertical drains have been simulated under an embankment. The finite element software PLAXIS has been carried out for analyzing the displacements and excess pore pressures. The results showed that the consolidation time and induced excess pore pressure are highly depended to the discharge capacity of the prefabricated vertical drain. The increase in the discharge capacity leads to decrease the consolidation process and the induced excess pore pressure. Moreover, it was seen that the vertical drains spacing does not have any significant effect on the consolidation time. However, the increase in the drains spacing would decrease the system stiffness.

Keywords: vertical drain, prefabricated, consolidation, embankment

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Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

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The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

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Authors: L. K. Nivedha, V. Maruthapandian, R. Kothandaraman

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Rechargeable zinc-air batteries (ZAB) are gaining significant research attention owing to their high energy density and copious zinc resources worldwide. However, the unsolved obstacles such as dendrites, passivation, depth of discharge and the lack of an efficient cathode catalyst restrict their practical application1. By and large, non-noble transition metal-based catalysts are well-reputed materials for catalysing oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) with greater stability in alkaline medium2. Herein, we report the synthesis and application of Mn₃O4-NiFeLDH/Carbon composite as a cathode catalyst for rechargeable ZAB. The synergetic effects of the mixed transition metals (Mn/Ni/Fe) have aided in catalysing ORR and OER in alkaline electrolyte with a shallow potential gap of 0.7 V. The composite, by its distinctive physicochemical characteristics, shows an excellent OER activity with a current density of 1.5 mA cm⁻² at a potential of 1.6 V and a superior ORR activity with an onset potential of 0.8 V when compared with their counterparts. Nevertheless, the catalyst prefers a two-electron pathway for the electrochemical reduction of oxygen which results in a limiting current density of 2.5 mA cm⁻². The bifunctional activity of the Mn₃O₄-NiFeLDH/Carbon composite was utilized in developing rechargeable ZAB. The fully fabricated ZAB delivers an open circuit voltage of 1.4 V, a peak power density of 70 mW cm⁻², and a specific capacity of 800 mAh g⁻¹ at a current density of 20 mA cm⁻² with an average discharge voltage of 1 V and the cell is operable upto 50 mA cm-2. Rechargeable ZAB demonstrated over 110 h at 10 mA cm⁻². Further, the cause for the diminished charge-discharge performance experienced beyond the 100th cycle was investigated, and carbon corrosion was testified using Infrared spectroscopy.

Keywords: rechargeable zinc-air battery, oxygen evolution reaction, bifunctional catalyst, alkaline medium

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Authors: Kyoung-Il Do, Jun-Geol Park, Hee-Guk Chae, Jeong-Yun Seo, Yong-Seo Koo

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A SCR stacking structure is proposed to have improved Latch-up immunity. In comparison with conventional SCR (Silicon Controlled Rectifier), the proposed Electrostatic Discharge (ESD) protection circuit has a lower trigger characteristic by using the LVTSCR (Low Voltage Trigger) structure. Also the proposed ESD protection circuit has improved Holding Voltage Characteristic by using N-stack technique. These characteristics enable to have latch-up immunity in operating conditions. The simulations are accomplished by using the Synopsys TCAD. It has a trigger voltage of 8.9V and a holding voltage of 1.8V in a single structure. And when applying the stack technique, 2-stack has the holding voltage of 3.8V and 3-stack has the holding voltage of 5.1 V.

Keywords: electrostatic discharge (ESD), low voltage trigger silicon controlled rectifier (LVTSCR), MVTSCR, power clamp, silicon controlled rectifier (SCR), latch-up

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Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization

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Authors: Abdulrahman Abdulrahman, Abir Abdulrahman

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Free over-fall is an instrument for measuring discharge in open channels by measuring end depth. A comprehensive researchers investigated theoretically and experimentally brink phenomenon with various approaches for different cross-sectional shapes. Anderson's method, based on Boussinq's approximation and energy approach was used to derive a pressure distribution factor at end depth. Applying the one-dimensional momentum equation and the principles of limit slope analysis, a relevant analytical solution may be derived for brink depth ratio (EDR) in prismatic rectangular channel. Also relationships between end depth ratio and slope ratio for a given non-dimensional normal or critical depth with upstream supercritical flow regime are presented. Simple indirect procedure is used to estimate the end depth discharge ratio (EDD) for subcritical and supercritical flow using measured end depth. The comparison of this analysis with all previous theoretical and experimental studies showed an excellent agreement.

Keywords: analytical solution, brink depth, end depth, flow measurement, free over fall, hydraulics, rectangular channel

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Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

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Authors: Farhina Haque, Chanyeop Park

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The high efficiency, high field, and high power density provided by wide bandgap (WBG) semiconductors and advanced power electronic converter (PEC) topologies enabled the dynamic control of power in medium to high voltage systems. Although WBG semiconductors outperform the conventional Silicon based devices in terms of voltage rating, switching speed, and efficiency, the increased voltage handling properties, high dv/dt, and compact device packaging increase local electric fields, which are the main causes of partial discharge (PD) in the advanced medium and high voltage applications. PD, which occurs actively in voids, triple points, and airgaps, is an inevitable dielectric challenge that causes insulation and device aging. The aging process accelerates over time and eventually leads to the complete failure of the applications. Hence, it is critical to mitigating PD. Sharp edges, airgaps, triple points, and bubbles are common defects that exist in any medium to high voltage device. The defects are created during the manufacturing processes of the devices and are prone to high-electric-field-induced PD due to the low permittivity and low breakdown strength of the gaseous medium filling the defects. A contemporary approach of mitigating PD by neutralizing electric fields in high power density applications is introduced in this study. To neutralize the locally enhanced electric fields that occur around the triple points, airgaps, sharp edges, and bubbles, electrets are developed and incorporated into high voltage applications. Electrets are electric fields emitting dielectric materials that are embedded with electrical charges on the surface and in bulk. In this study, electrets are fabricated by electrically charging polyvinylidene difluoride (PVDF) films based on the widely used triode corona discharge method. To investigate the PD mitigation performance of the fabricated electret films, a series of PD experiments are conducted on both the charged and uncharged PVDF films under square voltage stimuli that represent PWM waveform. In addition to the use of single layer electrets, multiple layers of electrets are also experimented with to mitigate PD caused by higher system voltages. The electret-based approach shows great promise in mitigating PD by neutralizing the local electric field. The results of the PD measurements suggest that the development of an ultimate solution to the decades-long dielectric challenge would be possible with further developments in the fabrication process of electrets.

Keywords: electrets, high power density, partial discharge, triode corona discharge

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Authors: Dorina Rusu, Emil Ghiocel Ioanid, Marta Ursescu, Ana Maria Vlad, Mihaela Popescu

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During the last decades the cold plasma discharges made the subject of numerous studies concerning the applications in the cultural heritage field, especially concentrated on ecological and non-invasive aspect of these conservation procedures. The conservation treatment using cold plasma is based, on the one hand, on the well-known property of plasma discharges to inactivate the contaminant biological species and, on the other hand, on the surface cleaning effect. Moreover the plasma discharge produces the functionalization of the treated surface, allowing subsequent deposition of protective layers. The paper presents the behavior of printing inks on historical documents treated in cold RF plasma. Two types of printing inks were studied, namely red and black ink, used on a religious book published in 19 century. SEM-EDX analysis results in the identification of the two inks as carbon black ink (C presence in the EDX spectrum) and cinnabar based red ink (Hg and S lines in the spectrum), result confirmed by XRF analysis. The experiments have been performed on paper samples written with laboratory- made inks, of similar composition with the inks identified on historical documents. The samples were subjected to RF plasma discharge, operating in nitrogen gaseous medium, at 1.2 MHz frequency and low-pressure (0.5 mbar), performed in a self-designed equipment for the application of conservation treatments on naturally aged paper supports. The impact of plasma discharge on the inks has been evaluated by SEM, XRD and color analysis. The color analysis revealed a slight discoloration of cinnabar ink on the historical document. SEM and XRD analyses have been carried out in an attempt to elucidate the process responsable for color modification.

Keywords: RF plasma, printing inks, historical documents, surface cleaning effect

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Authors: Mohammad Derakhshani, Saeed Reza Allahkaram, Michael Isakani-Zakaria, Masoud Samadian, Hojat Sharifi Rasaey

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Dynamic stray currents tend to change their magnitude and polarity with time at their source which will create anodic and cathodic spots on a nearby interfered structure. To date, one of the biggest known dynamic stray current sources are DC traction systems. Laboratory simulation is a suitable method to apply theoretical principles in order to identify effective parameters in dynamic stray current influenced corrosion. Simulation techniques can be utilized for various mitigation methods applied in a small scales for selection of the most efficient method with regards to field applications. In this research, laboratory simulation of potential fluctuations caused by dynamic stray current on a cathodically protected structure was investigated. A lab model capable of generating DC static and dynamic stray currents and simulating its effects on cathodically protected samples were developed based on stray current induced (contact-less) polarization technique. Stray current pick-up and discharge spots on an influenced structure were simulated by inducing fluctuations in the sample’s stationary potential. Two mitigation methods for dynamic stray current interference on buried structures namely application of sacrificial anodes as preferred discharge point for the stray current and potentially controlled cathodic protection was investigated. Results showed that the application of sacrificial anodes can be effective in reducing interference only in discharge spot. But cathodic protection through potential controlling is more suitable for mitigating dynamic stray current effects.

Keywords: simulation, dynamic stray current, fluctuating potentials, sacrificial anode

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Authors: Mohammad Salem Abdullah Alhwaiti

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This study was conducted to assess the physical, chemical, and radionuclide concentrations of pharmaceutical industrial wastewater effluents. Fourteen wastewater samples were collected from pharmaceutical industries. The results showed a marked reduction in the levels of TH, Mg, and Ca concentration in wastewater limit for properties and criteria for discharge of wastewater to streams or wadies or water bodies in the effluent, whereas TSS and TDS showed higher concentration allowable for discharge of wastewater to streams or wadies or water bodies. The gross α activity in all the wastewater samples ranged between (0.086-0.234 Bq/L) lowered the 0.1 Bq/L limit set by World Health Organization (WHO), whereas gross β activity in few samples ranged between (2.565-4.800 Bq/L), indicating the higher limit set by WHO. Gamma spectroscopy revealed that K-40, Cr-51, Co-60, I-131, Cs-137, and U-238 activity are ≤0.114 Bq/L, ≤0.062 Bq/L, ≤0.00815Bq/L, ≤0.00792Bq/L, ≤0.00956 Bq/L, and ≤0.151 Bq/L, respectively, indicating lowest concentrations of these radionuclides in the pharmaceutical industrial wastewater effluents.

Keywords: pharmaceutical wastewater, gross α/β activity, radionuclides, Jordan

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Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora

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Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.

Keywords: equipment donation, teaching hospital, decision-making, North India

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Authors: Rahul R. Gurpude, Pallvita Yadav, Amrut Mulay

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In recent years, there has been a growing focus on advanced manufacturing processes, and one such emerging process is wire electric discharge machining (WEDM). WEDM is a precision machining process specifically designed for cutting electrically conductive materials with exceptional accuracy. It achieves material removal from the workpiece metal through spark erosion facilitated by electricity. Initially developed as a method for precision machining of hard materials, WEDM has witnessed significant advancements in recent times, with numerous studies and techniques based on electrical discharge phenomena being proposed. These research efforts and methods in the field of ED encompass a wide range of applications, including mirror-like finish machining, surface modification of mold dies, machining of insulating materials, and manufacturing of micro products. WEDM has particularly found extensive usage in the high-precision machining of complex workpieces that possess varying hardness and intricate shapes. During the cutting process, a wire with a diameter ranging from 0.18mm is employed. The evaluation of EDM performance typically revolves around two critical factors: material removal rate (MRR) and surface roughness (SR). To comprehensively assess the impact of machining parameters on the quality characteristics of EDM, an Analysis of Variance (ANOVA) was conducted. This statistical analysis aimed to determine the significance of various machining parameters and their relative contributions in controlling the response of the EDM process. By undertaking this analysis, optimal levels of machining parameters were identified to achieve desirable material removal rates and surface roughness.

Keywords: WEDM, MRR, optimization, surface roughness

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Authors: Solomon Gebremariam, Mulugeta Naizigi, Aregawi Haileselassie

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Background: Knowledge of the pattern of bacterial isolates and their antimicrobial susceptibility is crucial for guiding empirical treatment and infection prevention and control measures. Objective: The aim of this study was to analyze the pattern of bacterial isolates and their susceptibility patterns from various specimens. Methods: Retrospectively, a total of 1067 microbiological culture results that were isolated, characterized, and identified by standard microbiological methods and whose antibiotic susceptibility was determined using CLSI guidelines between 2017 and 2019 were retrieved and analyzed. Data were entered and analyzed using the Stata release 10.1 statistical package. Result: The positivity rate of culture was 26.04% (419/1609). The most common bacteria isolated were S. aureus 23.8% (94), E. coli 15.1% (60), Klebsiella pneumonia 14.1% (56), Pseudomonas aeruginosa 8.5% (34), and CONS 7.3% (29). S. aureus and CONS showed a high (58.1% - 96.2%) rate of resistance to most antibiotics tested. They were less resistant to Vancomycin which is 18.6% (13/70) and 11.8% (2/17), respectively. Similarly, the resistance of E. coli, Klebsella pneumonia, and Pseudomonas aeruginosa was high (69.4% - 100%) to most antibiotics. They were less resistant to Ciprofloxacilin, which is 41.1% (23/56), 19.2% (10/52), and 16.1% (5/31), respectively. Conclusion: This study has shown that there is a high rate of antibiotic resistance among bacterial isolates in this hospital. A combination of Vancomycin and Ciprofloxacin should be considered in the choice of antibiotics for empirical treatment of suspected infections due to S. aureus, CONS, E. coli, Klebsiella pneumonia, Pseudomonas such as in infections within hospital setup.

Keywords: antimicrobial, resistance, bacteria, hospital

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Authors: Adel Bougamouza, Boualam Remini, Abd El Hadi Ammari, Feteh Sakhraoui

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The assessment of sediments being carried by a river is importance for planning and designing of various water resources projects. In this study, Artificial Neural Network Techniques are used to estimate the daily suspended sediment concentration for the corresponding daily discharge flow in the upstream of Foum El Gherza dam, Biskra, Algeria. The FFNN, GRNN, and RBNN models are established for estimating current suspended sediment values. Some statistics involving RMSE and R2 were used to evaluate the performance of applied models. The comparison of three AI models showed that the RBNN model performed better than the FFNN and GRNN models with R2 = 0.967 and RMSE= 5.313 mg/l. Therefore, the ANN model had capability to improve nonlinear relationships between discharge flow and suspended sediment with reasonable precision.

Keywords: artificial neural network, Oued Abiod watershed, feedforward network, generalized regression network, radial basis network, sediment concentration

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Authors: R. A. Abdel Rahman, A. E. Abdel Wahab, E. A. Goghneimy, H. F. Mohamed, E. M. Salama

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Infectious diseases are a major cause of death worldwide. The treatment of infections continues to be problematic in modern time because of the severe side effects of some drugs and the growing resistance to antimicrobial agents. Hence, the search for newer, safer and more potent antimicrobials is a pressing need. Herbal medicines have received much attention as a source of new antibacterial drugs since they are considered time-tested and comparatively safe both for human use and the environment. In the present study, the antimicrobial activity of marjoram (Origanum majorana L.) essential oil on some gram positive and gram negative reference bacteria, as well as some hospital resistant microbes, was tested. Marjoram oil was extracted and the oil chemical constituents were identified using GC/MS analysis. Staphylococcus aureas ATCC 6923, Pseudomonus auregonosa ATCC 9027, Bacillus subtilis ATCC 6633, E. coli ATCC 8736 and two hospital resistant microbes isolates 16 and 21 were used. The two isolates were identified by biochemical tests and 16s rRNA as proteus spp. and Enterococcus facielus. The effect of different concentrations of essential oils on bacterial growth was tested using agar disk diffusion assay method to determine the minimum inhibitory concentrations and using micro dilution method to determine the minimum bactericidal concentrations. Marjoram oil was found to be effective against both reference and hospital resistance strains. Hospital strains were more resistant to marjoram oil than reference strains. P. auregonosa growth was completely inhibited at a low concentration of oil (4µl/ml). The other reference strains showed sensitivity to marjoram oil at concentrations ranged from 5 to 7µl/ml. The two hospital strains showed sensitivity at media containing 10 and 15µl/ml oil. The major components of oil were terpineol, cis-beta (23.5%), 1,6 – octadien –3-ol,3,7-dimethyl, 2 aminobenzoate (10.9%), alpha terpieol (8.6%) and linalool (6.3%). Scanning electron microscope (SEM) and transmission electron microscope (TEM) analysis were used to determine the difference between treated and untreated hospital strains. SEM results showed that treated cells were smaller in size than control cells. TEM data showed that cell lysis has occurred to treated cells. Treated cells have ruptured cell wall and appeared empty of cytoplasm compared to control cells which shown to be intact with normal volume of cytoplasm. The results indicated that marjoram oil has a positive antimicrobial effect on hospital resistance microbes. Natural crude extracts can be perfect resources for new antimicrobial drugs.

Keywords: antimicrobial activity, essential oil, hospital resistance microbes, marjoram

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Authors: C. Yaddaden, M. Berouaken, L. Talbi, K. Ayouz, M. Ayat, A. Cheriet, F. Boudeffar, A. Manseri, N. Gabouze

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Lithium-ion batteries (LIBs) are widely used in various electronic devices due to their high energy density. However, the performance of the anode material in LIBs is crucial for enhancing the battery's overall efficiency. This research focuses on developing a new anode material by modifying silicon nanostructures, specifically porous silicon nanowires (PSiNWs) and porous silicon nanoparticles (NPSiP), with silver nanoparticles (Ag) to improve the performance of LIBs. The aim of this research is to investigate the potential application of PSiNWs/Ag and NPSiP/Ag as anodes in LIBs and evaluate their performance in terms of specific capacity and Coulombic efficiency. The research methodology involves the preparation of PSiNWs and NPSiP using metal-assisted chemical etching and electrochemical etching techniques, respectively. The Ag nanoparticles are introduced onto the nanostructures through electrodissolution of the porous film and ultrasonic treatment. Galvanostatic charge/discharge measurements are conducted between 1 and 0.01 V to evaluate the specific capacity and Coulombic efficiency of both PSiNWs/Ag and NPSiP/Ag electrodes. The specific capacity of the PSiNWs/Ag electrode is approximately 1800 mA h g-1, with a Coulombic efficiency of 98.8% at the first charge/discharge cycle. On the other hand, the NPSiP/Ag electrode exhibits a specific capacity of 2600 mAh g-1. Both electrodes show a slight increase in capacity retention after 80 cycles, attributed to the high porosity and surface area of the nanostructures and the stabilization of the solid electrolyte interphase (SEI). This research highlights the potential of using modified silicon nanostructures as anodes for LIBs, which can pave the way for the development of more efficient lithium-ion batteries.

Keywords: porous silicon nanowires, silicon nanoparticles, lithium-ion batteries, galvanostatic charge/discharge

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Authors: Bara M. Yousef

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Kingdome of Saudi Arabia (KSA). High numbers of traffic accidents with sever, moderate and mild level of impairments admits to Sultan bin Abdulaziz humanitarian city. Over a period of 4 months the city received 111 male and 79 female subjects with CP, who received 4-6 weeks of rehabilitation and using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings shed the light on the fact that nearly 85% of people at admission got better after rehabilitation program services at individual sever moderate and mild and has arrange of (59 out of 128 WeeFIM score) and by the time of discharge they leave the city with better FIM score close to (72 out of 128 WeeFIM score) for the entire study sample. WeeFIM score is providing fair evidence to rehabilitation specialists to assess their outcomes. However there is a need to implement other instruments and compare it to WeeFIM in order to reach better outcomes at discharge level.

Keywords: Cerepral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability

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Authors: Asibor Godwin, Adeniyi Funsho

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This study was carried out to investigate the impact of biological treated effluent on the physico-chemical properties of receiving waterbodies and also to establish its suitability for other purposes. It focused on the changes of some physic-chemical variables as one move away from the point of discharge downstream of the waterbodies. Water samples were collected from 14 sampling stations made up of the untreated effluent, treated effluent and receiving streams (before and after treated effluent discharge) over a period of 6 months spanning the dry and rainy seasons. Analyses were carried out on the following: temperature, turbidity, pH, conductivity, major anions and cation, dissolved oxygen, percentage oxygen Saturation, biological oxygen demand (BOD), solids (total solids, suspended solids and dissolved solids), nitrates, phosphates, organic matter and flow discharge using standard analytical methods. The relationships between investigated sites with regards to their physico-chemical properties were analyzed using student-t statistics. Also changes in the treated effluent receiving streams after treated effluent outfall was discussed fully. The physico-chemical water quality of the receiving water bodies meets most of the general water requirements for both domestic and industrial uses. The untreated effluent quality was shown to be of biological origin based on the biological oxygen demand, chloride, dissolved oxygen, total solids, pH and organic matter. The treated effluent showed significant improvement over the raw untreated effluent based on most parameters assessed. There was a significant difference (p<0.05) between the physico-chemical quality of untreated effluent and the treated effluent for the most of the investigated physico-chemical quality. The difference between the discharged treated effluent and the unimpacted section of the receiving waterbodies was also significant (p<0.05) for the most of the physico-chemical parameters.

Keywords: eflluent, Opa River, physico-chemical, waterbody

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Authors: S. Ithai, A. Oloo

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The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

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