Search results for: physical vapor deposition coating method

Authors: Hayriye Anıl, Görkem Kar

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In addition to being rich in renewable energy resources, Turkey is one of the countries that promise potential in geothermal energy production with its high installed power, cheapness, and sustainability. Increasing imbalance penalties become an economic burden for organizations since geothermal generation plants cannot maintain the balance of supply and demand due to the inadequacy of the production forecasts given in the day-ahead market. A better production forecast reduces the imbalance penalties of market participants and provides a better imbalance in the day ahead market. In this study, using machine learning, deep learning, and, time series methods, the total generation of the power plants belonging to Zorlu Natural Electricity Generation, which has a high installed capacity in terms of geothermal, was estimated for the first one and two weeks of March, then the imbalance penalties were calculated with these estimates and compared with the real values. These modeling operations were carried out on two datasets, the basic dataset and the dataset created by extracting new features from this dataset with the feature engineering method. According to the results, Support Vector Regression from traditional machine learning models outperformed other models and exhibited the best performance. In addition, the estimation results in the feature engineering dataset showed lower error rates than the basic dataset. It has been concluded that the estimated imbalance penalty calculated for the selected organization is lower than the actual imbalance penalty, optimum and profitable accounts.

Keywords: machine learning, deep learning, time series models, feature engineering, geothermal energy production forecasting

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Authors: Magarò Floriana, Zinno Raffaele

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Since 2009, with the coming into force of the January 14, 2008 Ministerial Decree "New technical standards for construction", and the explanatory ministerial circular N°.617 of February 2, 2009, the question of seismic hazard and the design of seismic-resistant structures in Italy has acquired increasing importance. One of the most discussed aspects in recent Italian and international scientific literature concerns the dynamic interaction between land and structure, and the effects which dynamic coupling may have on individual buildings. In effect, from systems dynamics, it is well known that resonance can have catastrophic effects on a stimulated system, leading to a response that is not compatible with the previsions in the design phase. The method used in this study to estimate the frequency of oscillation of the structure is as follows: the analysis of HVSR (Horizontal to Vertical Spectral Ratio) relations. This allows for evaluation of very simple oscillation frequencies for land and structures. The tool used for data acquisition is an experimental digital tromograph. This is an engineered development of the experimental Languamply RE 4500 tromograph, equipped with an engineered amplification circuit and improved electronically using extremely small electronic components (size of each individual amplifier 16 x 26 mm). This tromograph is a modular system, completely "free" and "open", designed to interface Windows, Linux, OSX and Android with the outside world. It an amplifier designed to carry out microtremor measurements, yet which will also be useful for seismological and seismic measurements in general. The development of single amplifiers of small dimension allows for a very clean signal since being able to position it a few centimetres from the geophone eliminates cable “antenna” phenomena, which is a necessary characteristic in seeking to have signals which are clean at the very low voltages to be measured.

Keywords: microtremor, HVSR, tromograph, structural engineering

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Authors: M. Çevik, S. Sabancı, D. Tezcan, C. Çelebi, F. İçier

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Ultrasound technology is the one of the non-thermal food processing method in recent years which has been used widely in the food industry. Ultrasound application in the food industry is divided into two groups: low and high intensity ultrasound application. While low intensity ultrasound is used to obtain information about physicochemical properties of foods, high intensity ultrasound is used to extract bioactive components and to inactivate microorganisms and enzymes. In this study, the ultrasound pre-treatment at a constant power (1500 W) and fixed frequency (20 kHz) was applied to the red beetroot slices having the dimension of 25×25×50 mm at the constant temperature (25°C) for different application times (0, 5, 10, 15 and 20 min). The red beet root slices pretreated with ultrasonication was squeezed immediately. The changes on rheological properties of red beet root juice depending on ultrasonication duration applied to slices were investigated. Rheological measurements were conducted by using Brookfield viscometer (LVDV-II Pro, USA). Shear stress-shear rate data was obtained from experimental measurements for 0-200 rpm range by using spindle 18. Rheological properties of juice were determined by fitting this data to some rheological models (Newtonian, Bingham, Power Law, Herschel Bulkley). It was investigated that the best model was Power Law model for both untreated red beet root juice (R2=0.991, χ2=0.0007, RMSE=0.0247) and red beetroot juice produced from ultrasonicated slices (R2=0.993, χ2=0.0006, RMSE=0.0216 for 20 min pre-treatment). k (consistency coefficient) and n (flow behavior index) values of red beetroot juices were not affected from the duration of ultrasonication applied to the slices. Ultrasound treatment does not result in any changes on the rheological properties of red beetroot juice. This can be explained by lack of ability to homogenize of the intensity of applied ultrasound.

Keywords: ultrasonication, rheology, red beet root slice, juice

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Authors: Chi-Ching Lee, Po-Jung Huang, Kuo-Yang Huang, Petrus Tang

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Background: Recent advances in high-throughput research technologies such as new-generation sequencing and multi-dimensional liquid chromatography makes it possible to dissect the complete transcriptome and proteome in a single run for the first time. However, it is almost impossible for many laboratories to handle and analysis these “BIG” data without the support from a bioinformatics team. We aimed to provide a web-based analysis platform for users with only limited knowledge on bio-computing to study the functional genomics and proteomics. Method: We use NCI-60 as an example dataset to demonstrate the power of the web-based analysis platform and data delivering system: C-eXpress takes a simple text file that contain the standard NCBI gene or protein ID and expression levels (rpkm or fold) as input file to generate a distribution map of gene/protein expression levels in a heatmap diagram organized by color gradients. The diagram is hyper-linked to a dynamic html table that allows the users to filter the datasets based on various gene features. A dynamic summary chart is generated automatically after each filtering process. Results: We implemented an integrated database that contain pre-defined annotations such as gene/protein properties (ID, name, length, MW, pI); pathways based on KEGG and GO biological process; subcellular localization based on GO cellular component; functional classification based on GO molecular function, kinase, peptidase and transporter. Multiple ways of sorting of column and rows is also provided for comparative analysis and visualization of multiple samples.

Keywords: cancer, visualization, database, functional annotation

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Authors: Wellemans Isabelle, Remmelink Myriam, Foucart Annick, Rusu Stefan, Compère Christophe

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Primary pulmonary meningioma (PPM) is a very rare tumor, and its occurrence has been reported only sporadically. Multiple PPMs are even more exceptional, and herein, we report, to the best of our knowledge, the fourth case, focusing on the clinicopathological features of the tumor. Moreover, the possible relationship between the use of progesterone–only contraceptives and the development of these neoplasms will be discussed. Case Report: We report a case of a 51-year-old female presenting three solid pulmonary nodules, with the following localizations: right upper lobe, middle lobe, and left lower lobe, described as incidental findings on computed tomography (CT) during a pre-bariatric surgery check-up. The patient revealed no drinking or smoking history. The physical exam was unremarkable except for the obesity. The lesions ranged in size between 6 and 24 mm and presented as solid nodules with lobulated contours. The largest lesion situated in the middle lobe had mild fluorodeoxyglucose (FDG) uptake on F-18 FDG positron emission tomography (PET)/CT, highly suggestive of primary lung neoplasm. For pathological assessment, video-assisted thoracoscopic middle lobectomy and wedge resection of the right upper nodule was performed. Histological examination revealed relatively well-circumscribed solid proliferation of bland meningothelial cells growing in whorls and lobular nests, presenting intranuclear pseudo-inclusions and psammoma bodies. No signs of anaplasia were observed. The meningothelial cells expressed diffusely Vimentin, focally Progesterone receptors and were negative for epithelial (cytokeratin (CK) AE1/AE3, CK7, CK20, Epithelial Membrane Antigen (EMA)), neuroendocrine markers (Synaptophysin, Chromogranin, CD56) and Estrogenic receptors. The proliferation labelling index Ki-67 was low (<5%). Metastatic meningioma was ruled out by brain and spine magnetic resonance imaging (MRI) scans. The third lesion localized in the left lower lobe was followed-up and resected three years later because of its slow but significant growth (14 mm to 16 mm), alongside two new infra centimetric lesions. Those three lesions showed a morphological and immunohistochemical profile similar to previously resected lesions. The patient was disease-free one year post-last surgery. Discussion: Although PPMs are mostly benign and slow-growing tumors with an excellent prognosis, they do not present specific radiological characteristics, and it is difficult to differentiate it from other lung tumors, histopathologic examination being essential. Aggressive behavior is associated with atypical or anaplastic features (WHO grades II–III) The etiology is still uncertain and different mechanisms have been proposed. A causal connection between sexual hormones and meningothelial proliferation has long been suspected and few studies examining progesterone only contraception and meningioma risk have all suggested an association. In line with this, our patient was treated with Levonorgestrel, a progesterone agonist, intra-uterine device (IUD). Conclusions: PPM, defined by the typical histological and immunohistochemical features of meningioma in the lungs and the absence of central nervous system lesions, is an extremely rare neoplasm, mainly solitary and associating, and indolent growth. Because of the unspecific radiologic findings, it should always be considered in the differential diagnosis of lung neoplasms. Regarding multiple PPM, only three cases are reported in the literature, and this is the first described in a woman treated by a progesterone-only IUD to the best of our knowledge.

Keywords: pulmonary meningioma, multiple meningioma, meningioma, pulmonary nodules

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Authors: Rachel Danielson, Brendan Bohannan, S.M. Tsai, Kyle Meyer, Jorge L.M. Rodrigues

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The Amazon Rainforest is a global diversity hotspot and crucial carbon sink, but approximately 20% of its total extent has been deforested- primarily for the establishment of cattle pasture. Understanding the impact of this large-scale disturbance on soil microbial community composition and activity is crucial in understanding potentially consequential shifts in nutrient or greenhouse gas cycling, as well as adding to the body of knowledge concerning how these complex communities respond to human disturbance. In this study, surface soils (0-10cm) were collected from three forests and three 45-year-old pastures in Rondonia, Brazil (the Amazon state with the greatest rate of forest destruction) in order to determine the impact of forest conversion on microbial communities involved in nitrogen fixation. Soil chemical and physical parameters were paired with measurements of microbial activity and genetic profiles to determine how community composition and process rates relate to environmental conditions. Measuring both the natural abundance of 15N in total soil N, as well as incorporation of enriched 15N2 under incubation has revealed that conversion of primary forest to cattle pasture results in a significant increase in the rate of nitrogen fixation by free-living diazotrophs. Quantification of nifH gene copy numbers (an essential subunit encoding the nitrogenase enzyme) correspondingly reveals a significant increase of genes in pasture compared to forest soils. Additionally, genetic sequencing of both nifH genes and transcripts shows a significant increase in the diversity of the present and metabolically active diazotrophs within the soil community. Levels of both organic and inorganic nitrogen tend to be lower in pastures compared to forests, with ammonium rather than nitrate as the dominant inorganic form. However, no significant or consistent differences in total, extractable, permanganate-oxidizable, or loss-on-ignition carbon are present between the two land-use types. Forest conversion is associated with a 0.5- 1.0 unit pH increase, but concentrations of many biologically relevant nutrients such as phosphorus do not increase consistently. Increases in free-living diazotrophic community abundance and activity appear to be related to shifts in carbon to nitrogen pool ratios. Furthermore, there may be an important impact of transient, low molecular weight plant-root-derived organic carbon on free-living diazotroph communities not captured in this study. Preliminary analysis of nitrogenase gene variant composition using NovoSeq metagenomic sequencing indicates that conversion of forest to pasture may significantly enrich vanadium-based nitrogenases. This indication is complemented by a significant decrease in available soil molybdenum. Very little is known about the ecology of diazotrophs utilizing vanadium-based nitrogenases, so further analysis may reveal important environmental conditions favoring their abundance and diversity in soil systems. Taken together, the results of this study indicate a significant change in nitrogen cycling and diazotroph community composition with the conversion of the Amazon Rainforest. This may have important implications for the sustainability of cattle pastures once established since nitrogen is a crucial nutrient for forage grass productivity.

Keywords: free-living diazotrophs, land use change, metagenomic sequencing, nitrogen fixation

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Authors: Vaishakh Medikeri

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Energy in this Universe is the most basic characteristic of every particle. Since the birth of life on this planet, there has been a quest undertaken by the living beings to analyze, understand and harness the precious natural facts of the nature. In this quest, one of the greatest undertaken is the process of harnessing the naturally available energy. Scientists around the globe have discovered many ways to harness the freely available energy. But even today we speak of “Power Crisis”. Nikola Tesla once said “Nature has stored up in this universe infinite energy”. Energy is everywhere around us in unlimited quantities; all of it waiting to be harnessed by us. Here in this paper a method has been proposed to harness earth's electric field and transmit the stored electric energy using strong magnetic fields and electric fields. In this paper a new technique has been proposed to harness earth's electric field which is everywhere around the world in infinite quantities. Near the surface of the earth there is an electric field of about 120V/m. This electric field is used to charge a capacitor with high capacitance. Later the energy stored is allowed to pass through a device which converts the DC stored into AC. The AC so produced is then passed through a step down transformer to magnify the incoming current. Later the current passes through the RLC circuit. Later the current can be transmitted wirelessly using the principle of resonant inductive coupling. The proposed apparatus can be placed in most of the required places and any circuit tuned to the frequency of the transmitted current can receive the energy. The new source of renewable energy is of great importance if implemented since the apparatus is not costly and can be situated in most of the required places. And also the receiver which receives the transmitted energy is just an RLC circuit tuned to the resonant frequency of the transmitted energy. By using the proposed apparatus the energy losses can be reduced to a very large extent.

Keywords: capacitor, inductive resonant coupling, RLC circuit, transmission of electricity

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Authors: Edit Xhajanka, Gresa Baboci, Irene Malagnino, Mimoza Canga, Vito Antonio Malagnino

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Purpose: This study aimed at identifying dental caries increment or reduction, based on factors such as smoking, the scaling of teeth, BMI before and during pregnancy, carbohydrates consumption in relation to childbirth. Material and method: In this observational study, the sample included a total of 98 pregnant women and their age class was 18-45 years old, with a median age of 31.5 years. The setting of the participants resides in Vlora –Albania. Moreover, 64.4% were from the city and 35.6% were from the nearby villages. The study was conducted in the time period January 2018 –June 2021. Body mass index (BMI) was calculated using the standard formula (kg/m²). Maternal pre, during and post-pregnancy BMI was collected by using a validated questionnaire. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: Based on the data analysis, 44.4% of the sample declared that they did smoke before pregnancy and 55.6% not smoked during their pregnancy. As a result, no association was found between smoking and length of pregnancy P=0.95. There is also a strong relation (P=0.000) between the number of teeth with caries before pregnancy and the number of teeth with caries during pregnancy. There is a significant relationship between the scaling of teeth and childbirth, P=0.05. BMI before and during pregnancy in relation to carbohydrates consumption have a significant correlation P=0.004 and P=0.002. The values of BMI before and during pregnancy in relation to childbirth have a strong correlation: P=0.043 and P=0.040, respectively. As a result, obesity was associated with preterm birth. The percentage of children born during 34-36 weeks of pregnancy was 69%, and children born during 32-34 weeks of pregnancy were 31%. CONCLUSION: There was a positive association between dental caries experience, BMI and carbohydrates consumption. Obesity in pregnancy is increasing worldwide; that is why this study suggests the importance of an appropriate weight before and during pregnancy.

Keywords: BMI, dental caries, pregnancy, scaling, smoking

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Authors: Pramod Jagtap, Kisan Jadhav, Neha Dand

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Risperidone (RISP) is an antipsychotic agent and has low water solubility and nontargeted delivery results in numerous side effects. Hence, an attempt was made to develop SLNs hydrogel for intranasal delivery of RISP to achieve maximum bioavailability and reduction of side effects. RISP loaded SLNs composed of 1.65% (w/v) lipid mass were produced by high shear homogenization (HSH) coupled ultrasound (US) method using glyceryl monostearate (GMS) or Imwitor 900K (solid lipid). The particles were loaded with 0.2% (w/v) of the RISP & surface-tailored with a 2.02% (w/v) non-ionic surfactant Tween® 80. Optimization was done using 32 factorial design using Design Expert® software. The prepared SLNs dispersion incorporated into Polycarbophil AA1 hydrogel (0.5% w/v). The final gel formulation was evaluated for entrapment efficiency, particle size, rheological properties, X ray diffraction, in vitro diffusion, ex vivo permeation using sheep nasal mucosa and histopathological studies for nasocilliary toxicity. The entrapment efficiency of optimized SLNs was found to be 76 ± 2 %, polydispersity index <0.3., particle size 278 ± 5 nm. This optimized batch was incorporated into hydrogel. The pH was found to be 6.4 ± 0.14. The rheological behaviour of hydrogel formulation revealed no thixotropic behaviour. In histopathology study, there was no nasocilliary toxicity observed in nasal mucosa after ex vivo permeation. X-ray diffraction data shows drug was in amorphous form. Ex vivo permeation study shows controlled release profile of drug.

Keywords: ex vivo, particle size, risperidone, solid lipid nanoparticles

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Authors: Viktorya Sargsyan, Arax Hovhannesyan, Karine Abelyan

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Introduction: During the last decade, scientific studies have proven the importance of Early Childhood Development (ECD) interventions. These interventions are shown to create strong foundations for children’s intellectual, emotional and physical well-being, as well as the impact they have on learning and economic outcomes for children as they mature into adulthood. Many children in rural Armenia fail to reach their full development potential due to lack of early brain stimulation (playing, singing, reading, etc.) from their parents, and lack of community tools and services to follow-up children’s neurocognitive development. This is exacerbated by high rates of stunting and anemia among children under 3(CU3). This research study tested the effectiveness of an integrated ECD and Maternal, Newborn and Childhood Health (MNCH) model, called “Go Baby, Go!” (GBG), against the traditional (MNCH) strategy which focuses solely on preventive health and nutrition interventions. The hypothesis of this quasi-experimental study was: Children exposed to GBG will have better neurocognitive and nutrition outcomes compared to those receiving only the MNCH intervention. The secondary objective was to assess the effect of GBG on parental child care and nutrition practices. Methodology: The 14 month long study, targeted all 1,300 children aged 0 to 23 months, living in 43 study communities the in Gavar and Vardenis regions (Gegharkunik province, Armenia). Twenty-three intervention communities, 680 children, received GBG, and 20 control communities, 630 children, received MCHN interventions only. Baseline and evaluation data on child development, nutrition status and parental child care and nutrition practices were collected (caregiver interview, direct child assessment). In the intervention sites, in addition to MNCH (maternity schools, supportive supervision for Health Care Providers (HCP), the trained GBG facilitators conducted six interactive group sessions for mothers (key messages, information, group discussions, role playing, video-watching, toys/books preparation, according to GBG curriculum), and two sessions (condensed GBG) for adult family members (husbands, grandmothers). The trained HCPs received quality supervision for ECD counseling and screening. Findings: The GBG model proved to be effective in improving ECD outcomes. Children in the intervention sites had 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites (aOR 1.83; 95 percent CI: 1.08-3.09; p=0.025). Caregivers also demonstrated better child care and nutrition practices (minimum dietary diversity in intervention site is 55 percent higher compared to control (aOR=1.55, 95 percent CI 1.10-2.19, p =0.013); support for learning and disciplining practices (aOR=2.22, 95 percent CI 1.19-4.16, p=0.012)). However, there was no evidence of stunting reduction in either study arm. he effect of the integrated model was more prominent in Vardenis, a community which is characterised by high food insecurity and limited knowledge of positive parenting skills. Conclusion: The GBG model is effective and could be applied in target areas with the greatest economic disadvantages and parenting challenges to improve ECD, care practices and developmental outcomes. Longitudinal studies are needed to view the long-term effects of GBG on learning and school readiness.

Keywords: early childhood development, integrated interventions, parental practices, quasi-experimental study

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Authors: Alessandro Preziosi, Antonio Prioletti, Luca Castangia

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Deformable part models achieve high precision in pedestrian recognition, but all publicly available implementations are too slow for real-time applications. We implemented a deformable part model algorithm fast enough for real-time use by exploiting information about the camera position and orientation. This implementation is both faster and more precise than alternative DPM implementations. These results are obtained by computing convolutions in the frequency domain and using lookup tables to speed up feature computation. This approach is almost an order of magnitude faster than the reference DPM implementation, with no loss in precision. Knowing the position of the camera with respect to horizon it is also possible prune many hypotheses based on their size and location. The range of acceptable sizes and positions is set by looking at the statistical distribution of bounding boxes in labelled images. With this approach it is not needed to compute the entire feature pyramid: for example higher resolution features are only needed near the horizon. This results in an increase in mean average precision of 5% and an increase in speed by a factor of two. Furthermore, to reduce misdetections involving small pedestrians near the horizon, input images are supersampled near the horizon. Supersampling the image at 1.5 times the original scale, results in an increase in precision of about 4%. The implementation was tested against the public KITTI dataset, obtaining an 8% improvement in mean average precision over the best performing DPM-based method. By allowing for a small loss in precision computational time can be easily brought down to our target of 100ms per image, reaching a solution that is faster and still more precise than all publicly available DPM implementations.

Keywords: autonomous vehicles, deformable part model, dpm, pedestrian detection, real time

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Authors: Thi Huong Vu, Vijay Jayasena, Zhongxiang Fang, Gary Dykes

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Carob kibble has recently received attention due to the presence of high level of polyphenol antioxidants. The capacity of microorganisms to improve antioxidant activities and total phenolics in carob kibble was investigated in the study. Two types of microorganisms including lactic acid bacteria Lactobacillus plantarum (L. plantarum) and yeast Saccharomyces cerevisiae (S. cerevisiae) were used in single and in their combination as starters. The total phenolic content was determined by the Folin–Ciocalteu method. Antioxidant activities were assessed scavenging capacity using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS). The study found that S. cerevisiae alone considerably improved 55% total phenolics content at 15 h, while L. plantarum caused in a loss of 20% through the process. Antioxidant capacity of the yeast-fermented samples significantly increased by 43 % and 10 % in ABTS and DPPH assays, respectively. However, reduction of 13 % and 32 % inhibition were recorded in the carob treated with L. plantarum. In the combination of S. cerevisiae and L. plantarum (1:1), both total phenolic content and antioxidant activity of carob kibble were a similar trend as these of S. cerevisiae single, but a lower improvement. The antioxidant power of the extracts was linearly correlated to their total phenolic contents (R=0.75). The results suggested that S. cerevisiae alone was the better for enhancement of both total phenolic content and antioxidant activity in carob kibble using submerged fermentation. The efficiency of fermentation reached the highest at 15h. Thus submerged fermentation with S. cerevisiae offers a tool with simple and cost effective to further increase the bioactive potential of carob kibble, which is in use for food, cosmetic and pharmaceutical industries.

Keywords: antioxidant activity, carob kibble, lactobacillus plantarum, saccharomyces cerevisiae, total phenolics

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Authors: Nesrine Boussaoui

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Background: International students often encounter challenges while studying in the UK, including communication and language barriers, lack of social networks, and socio-cultural differences that adversely impact on their mental health. For Algerian international students (AISs), these challenges may be heightened as English is not their first language and the culture of their homeland is substantially different from British culture, yet research has to incorporate their experiences and perspectives. Aim: The current study aimed to explore AISs’ 1) understandings of mental health; 2) issues of disclosure for mental health difficulties; and 3) mental health help-seeking and coping strategies. Method: In-depth, audio recorded semi-structured interviews (n = 20) with AISs in UK universities were conducted. An inductive, reflective thematic approach analysis was used. Finding: The following themes and associated sub-themes were developed: (1) Algerian cultural influences on mental health understanding(socio-cultural comparisons); (2) the paradox of the family (pressure vs. support); (3) stigma and fear of disclosure; (4) Barriers to formal help-seeking (informal disclosure as first step to seeking help); (5) Communication barriers (resort to mother tongue to disclose); (6) Self-reliance and religious coping. Conclusion: Recognising and understanding the challenges faced by AISs in terms of disclosure and mental health help-seeking is essential to reduce barriers to formal help-seeking. Informal disclosure among peers is often the first step to seeking help. Enhancing practitioners’ cultural competences and awareness of diverse understandings of mental health and the role of religious coping among AISs’ may have transferable benefits to a wider international student population.

Keywords: mental health, stegma, coping, disclosure

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Authors: Isomar Lima da Silva, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Biological isolation capsules are equipment commonly used in the control and prevention of infectious diseases in the hospital environment. This type of equipment, combined with pre-established medical protocols, contributes significantly to the containment of highly transmissible pathogens such as COVID-19. Due to its hermetic isolation, it allows more excellent patient safety, protecting companions and the health team. In this context, this work presents the development, testing, and validation of a medical capsule to treat patients affected by COVID-19. To this end, requirements such as low cost and easy handling were considered to meet the demand of people infected with the virus in remote locations in the Amazon region and/or where there are no ICU beds and mechanical ventilators for orotracheal intubation. Conceived and developed in a partnership between SAMEL Planos de Saúde and Instituto Conecthus, the device entitled "Vanessa Capsule" was designed to be used together with the NIV protocol (non-invasive ventilation), has an automatic exhaust system and filters performing the CO2 exchange, in addition to having BiPaps ventilatory support equipment (mechanical fans) in the Cabin Kit. The results show that the degree of effectiveness in protecting against infection by aerosols, with the protection cabin, is satisfactory, implying the consideration of the Vanessa capsule as an auxiliary method to be evaluated by the health team. It should also be noted that the medical observation of the evaluated patients found that the treatment against the COVID-19 virus started earlier with non-invasive mechanical ventilation reduces the patient's suffering and contributes positively to their recovery, in association with isolation through the Vanessa capsule.

Keywords: COVID-19, mechanical ventilators, medical capsule, non-invasive ventilation

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Authors: Abdelkrim Belhaoua, Jean-Pierre Radoux, Mariana Kuras, Vincent Récamier, Martial Piotto, Karim Elbayed, François Proust, Izzie Namer

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This paper proposes an augmented reality system dedicated to neurosurgery in order to assist the surgeon during an operation. This work is part of the ExtempoRMN project (Funded by Bpifrance) which aims at analyzing during a surgical operation the metabolic content of tumoral brain biopsy specimens by HRMAS NMR. Patients affected with a brain tumor (gliomas) frequently need to undergo an operation in order to remove the tumoral mass. During the operation, the neurosurgeon removes biopsy specimens using image-guided surgery. The biopsy specimens removed are then sent for HRMAS NMR analysis in order to obtain a better diagnosis and prognosis. Image-guided refers to the use of MRI images and a computer to precisely locate and target a lesion (abnormal tissue) within the brain. This is performed using preoperative MRI images and the BrainLab neuro-navigation system. With the patient MRI images loaded on the Brainlab Cranial neuro-navigation system in the operating theater, surgeons can better identify their approach before making an incision. The Brainlab neuro-navigation tool tracks in real time the position of the instruments and displays their position on the patient MRI data. The results of the biopsy analysis by 1H HRMAS NMR are then sent back to the operating theater and superimposed on the 3D localization system directly on the MRI images. The method we have developed to communicate between the HRMAS NMR analysis software and Brainlab makes use of a combination of C++, VTK and the Insight Toolkit using OpenIGTLink protocol.

Keywords: neuro-navigation, augmented reality, biopsy, BrainLab, HR-MAS NMR

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Authors: R. Hosny, Mahmoud F. Mubarak, Heba M. Salem, Asmaa A. Abdelrahman

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Oilfield scaling is a major problem in the oil and gas industry. Scale issues cost the industry millions of dollars in damage and lost production every year. One of the main causes of global production decline is scale. In this study, solid scale inhibitors based on silver tungstate loaded KIT-6 were synthesized and evaluated in both static and scale inhibition modeling. The silver tungstate loaded KIT-6 catalysts were synthesized via a simple impregnated method using 3D mesoporous KIT-6 as support. The synthesized materials were characterized using wide and low XRD, N2 adsorption–desorption analysis, TGA analysis, and FTIR, SEM, and XPS analysis. The scale inhibition efficiency of the synthesized materials was evaluated using a static scale inhibition test. The results of this study demonstrate the potential application of silver tungstate-loaded KIT-6 solid scale inhibitors for the oil and gas industry. The results of this study will contribute to the development of new and innovative solid scale inhibitors based on silver tungstate-loaded KIT-6. The inhibition efficiency of the scale inhibitor increases, and calcite scale inhibitor decreases with increasing pH (2 to8), it proposes that the scale inhibitor was more effective under alkaline conditions. An inhibition efficiency of 99% on calcium carbonate can be achieved at the optimal dosage of 7.5 ppm at 55oC, indicating that the scale inhibitor exhibits a relatively good inhibition performance on calcium carbonate. The use of these materials can potentially lead to more efficient and cost-effective solutions for scaling inhibition in various industrial processes.

Keywords: produced water treatment, solid scale inhibitors, calcite, silver tungestate, 3 D mesoporous KIT-6, oilfield scales, adsorption

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Authors: Kamal KC, Zhendong Yin, Dasen Li, Zhilu Wu

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Intra-plant disease classification based on leaf images is a challenging computer vision task due to similarities in texture, color, and shape of leaves with a slight variation of leaf spot; and external environmental changes such as lighting and background noises. Deep convolutional neural network (DCNN) has proven to be an effective tool for binary classification. In this paper, two methods for binary classification of diseased plant leaves using DCNN are presented; model created from scratch and transfer learning. Our main contribution is a thorough evaluation of 4 networks created from scratch and transfer learning of 5 pre-trained models. Training and testing of these models were performed on a plant leaf images dataset belonging to 16 distinct classes, containing a total of 22,265 images from 8 different plants, consisting of a pair of healthy and diseased leaves. We introduce a deep CNN model, Optimized MobileNet. This model with depthwise separable CNN as a building block attained an average test accuracy of 99.77%. We also present a fine-tuning method by introducing the concept of a convolutional block, which is a collection of different deep neural layers. Fine-tuned models proved to be efficient in terms of accuracy and computational cost. Fine-tuned MobileNet achieved an average test accuracy of 99.89% on 8 pairs of [healthy, diseased] leaf ImageSet.

Keywords: deep convolution neural network, depthwise separable convolution, fine-grained classification, MobileNet, plant disease, transfer learning

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Authors: Cheng Yang Kwa, Yoke Rung Wong

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Laminated composite materials are widely employed in automotive, aerospace, and other industries. These materials provide distinct benefits due to their high specific strength, high specific modulus, and ability to be customized for a specific function. However, delamination of laminated composite materials is one of the main defects which can occur during manufacturing, regular operations, or maintenance. Delamination can bring about considerable internal damage, unobservable by visual check, that causes significant loss in strength and stability, leading to composite structure catastrophic failure. Structural health monitoring (SHM) is known to be the automated method for monitoring and evaluating the condition of a monitored object. There are several ways to conduct SHM in aerospace. One of the effective methods is to monitor the natural frequency shift of structure due to the presence of defect. This study investigated the mechanical resonance frequency shift of a multi-layer composite cantilever beam due to interlaminar delamination. ANSYS Workbench® was used to create a 4-plies laminated composite cantilever finite element model with [90/0]s fiber setting. Epoxy Carbon UD (230GPA) Prepreg was chosen, and the thickness was 2.5mm for each ply. The natural frequencies of the finite element model with various degree of delamination were simulated based on modal analysis and then validated by using literature. It was shown that the model without delamination had natural frequency of 40.412 Hz, which was 1.55% different from the calculated result (41.050 Hz). Thereafter, the various degree of delamination was mimicked by changing the frictional conditions at the middle ply-to-ply interface. The results suggested that delamination in the laminated composite cantilever induced a change in its stiffness which alters its mechanical resonance frequency.

Keywords: structural health monitoring, NDT, cantilever, laminate

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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Authors: Iman Shabanzadeh

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The purpose of this research is to understand the lived experience of private sector entrepreneurs in facing the sources of freedom and unfreedom and benefiting from opportunities and basic capabilities in the process of realizing entrepreneurial ability in order to get closer to the macro situation of the narrative of human development in Iranian society. Therefore, the main question of the present research is to figure out what sources of freedom and social opportunities and unfreedom entrepreneurs in Iran's society benefit from the process of transforming their potential entrepreneurial abilities into entrepreneurial and business enterprises. In terms of methodology, the current research method will be thematic analysis in the form of semi-structured interviews with entrepreneurs active in small and medium-sized enterprises in Tehran, whose process of establishing and expanding their entrepreneurial activity has been in the last two decades. By examining the possibilities and refusals of advancing these people in the three stages of 'Idea creation and desire for entrepreneurship’, ‘Starting and creating a business’, and finally, ‘Continuing and expanding the business’, the findings of the research show the impact of five main resources for people to realize their potential talents, from the stage of creating an idea to expanding their business. These sources include' family institution,’ ‘education institution,’ ‘social norms and beliefs,’ ‘government and market,’ and ‘personality components of the entrepreneur.’ Finally, the findings are reported in three levels of basic themes (fifteen items), organizing themes (five items), and comprehensive themes (one item) and in the form of a theme network.

Keywords: entrepreneurship, human development, capability, sources of freedom

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Authors: Abara Onu, Augustine Mina Ephraim, Emmanuel Teidi

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Terrorism has been a major challenge and is so dare to the Nigerian government in recent times. The actions and activities of the Islamic sect known as Boko Haram had led to enormous loss of lives and properties in the country, mostly the Northern part of Nigeria. Some of these activities entails bombings, suicide attacks, intimidations, sporadic gunfire of the unarmed, blameless and innocent Nigerians, burning of police stations and churches, kidnappings, raping of school girls and women. Nigeria has also been included amongst one of the terrorist countries of the world. This has serious implications for the development of Nigerian economy. Although, Nigeria had made several worried hard work to deal with these challenges masqueraded by terrorism and insecurity in the country but the rate of insurgency and insecurity is still worrisome. The study looks at exploring the determinants of Boko Haram terrorism in Nigerian security systems and economy. Data used for the study work was from questionnaire administered, using Analysis of Variance (ANOVA) method to analyse the data. The result shows that Ideology and funding are significant basic factors that propelled the Boko Haram group in Nigeria. The Boko Haram disaster poses a significant threat to Nigeria’s economy and the military is the best option and solution in tackling the Boko Haram menace in Nigeria. The work x-rayed the following recommendations; government should declare war on terrorism and as well seek support and cooperation from international communities who in time or the other might have faced with this kind ugly experience and challenge and were able to tackle it. Nigerian Military needs to be more empowered with high dangerous weapons to combat the insurgency as well as beef up security across the Country to curb the threats.

Keywords: terrorism, economy, Boko Haram, Nigeria

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Authors: Annamária Käferné Rácz, Bence Jáger, Balázs Kövesdi, László Dunai

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Due to the numerous advantages of steel corrugated web girders, its application field is growing for bridges as well as for buildings. The global stability behavior of such girders is significantly larger than those of conventional I-girders with flat web, thus the application of the structural steel material can be significantly reduced. Design codes and specifications do not provide clear and complete rules or recommendations for the determination of the lateral torsional buckling (LTB) resistance of corrugated web girders. Therefore, the authors made a thorough investigation regarding the LTB resistance of the corrugated web girders. Finite element (FE) simulations have been performed to develop new design formulas for the determination of the LTB resistance of trapezoidally corrugated web girders. FE model is developed considering geometrical and material nonlinear analysis using equivalent geometric imperfections (GMNI analysis). The equivalent geometric imperfections involve the initial geometric imperfections and residual stresses coming from rolling, welding and flame cutting. Imperfection sensitivity analysis was performed to determine the necessary magnitudes regarding only the first eigenmodes shape imperfections. By the help of the validated FE model, an extended parametric study is carried out to investigate the LTB resistance for different trapezoidal corrugation profiles. First, the critical moment of a specific girder was calculated by FE model. The critical moments from the FE calculations are compared to the previous analytical calculation proposals. Then, nonlinear analysis was carried out to determine the ultimate resistance. Due to the numerical investigations, new proposals are developed for the determination of the LTB resistance of trapezoidally corrugated web girders through a modification factor on the design method related to the conventional flat web girders.

Keywords: corrugated web, lateral torsional buckling, critical moment, FE modeling

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Authors: P. N. Okeke, J. N. Chikwendu

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The study evaluated the effects of varying fermentation periods on the nutrients and anti-nutrients composition of African yam bean (Sphenostylis stenocarpa) and acha (Digitaria exilis) flour blends and sensory properties of their products. The African yam bean seeds and acha grains were fermented for 24 hrs, 48 and 72 hrs, dried (sun drying) and milled into fine flour. The fermented flours were used in a ratio of 70:30 (Protein basis) to formulate composite flour for meat pie and biscuits production. Both the fermented and unfermented flours and products were analyzed for chemical composition using the standard method. The data were statistically analyzed using SPSS version 15 to determine the mean and standard deviation. The 24, 48, and 72 hrs fermentation periods increased protein (22.81, 26.15 and 24.00% respectively). The carbohydrate, ash and moisture contents of the flours were also increased as a result of fermentation (68.01-76.83, 2.26-4.88, and 8.36-13.00% respectively). The 48 hrs fermented flour blends had the highest increase in ash relative to the control (4.88%). Fermentation increased zinc, iron, magnesium and phosphorus content of the flours. Treatment drastically reduced the anti-nutrient (oxalate, saponin, tannin, phytate, and hemagglutinin) levels of the flours. Both meat pie and biscuits had increased protein relative to the control (27.36-34.28% and 23.66-25.09%). However, the protein content of the meat pie increased more than that of the biscuits. Zinc, Iron, Magnesium and phosphorus levels increased in both meat pie and biscuits. Organoleptic attributes of the products (meat pie and biscuits) were slightly lower than the control except those of the 72 hrs fermented flours.

Keywords: fermentation, African yam bean, acha, biscuits, meat-pie

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Authors: Ya-Yi Yen

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The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.

Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting

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Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia

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Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.

Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders

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Authors: Tshimangadzo Oscar Magadze

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For successful re-integration, the individual offender must adapt and transform, which requires that the offender should adopt and internalise socially approved norms, attitudes, values, and beliefs. However, the offender’s labelling and community stigmatisation decide the destination of the offender. Community involvement in ex-offenders’ re-integration is an important issue in efforts to reduce recidivism and to control overcrowding in our correctional facilities. Crime is a social problem that requires society to come together to fight against it. This study was conducted in the Limpopo Province in Vhembe District Municipality within four local municipalities, namely Musina, Makhado, Mutale, and Thulamela. A total number of 30 participants were interviewed, and all were members of the Community Corrections Forums. This was necessitated by the fact that Musina is a very small area, which compelled the Department of Correctional Services to combine the two (Musina and Makhado) into one social re-integration entity. This is a qualitative research study where participants were selected through the use of purposive sampling. Participants were selected based on the value they would add to this study in order to achieve the objectives. The data collection method of this study was the focus group, which comprised of three groups of 10 participants each. Thulamela and Mutale local municipalities formed a group with (10) participants each, whereas Musina (2) and Makhado (8) formed another. Results indicate that the current situation is not conducive for re-integration to be successful. Participants raised many factors that need serious redress, namely offenders’ discrimination, lack of forgiveness by members of the community, which is fuelled by lack of community awareness due to the failure of the Department of Correctional Services in educating communities on ex-offenders’ re-integration.

Keywords: ex-offender, labeling, re-integration, stigmatization

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Authors: Gokcen Akyurek, Hulya Kayihan, Deniz Yuce, Selen Yilmaz

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The stigma towards mental illness is still very rooted in our society, despite the number of studies, campaigns, and anti-stigma programs developed in recent years. Stigma represents a serious obstacle to recovery and social integration for people who experience a mental illness, affecting directly their well-being and quality of life. It implies that these persons have to deal with many other barriers apart from the disease symptoms (1-5). Convergent, recent literature suggests that less positive attitudes by mental health professionals interfere with the self-determination and recovery process (4-10).The aim of this study was to translate the Attribution Questionnaire-27 (AQ-27) to the Turkish language (AQ-27-T), and to examine the reliability and validity of this new Turkish version. Cultural adaptation was implemented according to the internationally suggested method. To determine the understandability and appropriateness of this measure for the Turkish culture, a pretest was administered and the final form was generated. Then, 424 randomly chosen people took part in the study. Participant’s mean age was 36.9±12.7 years and %52 of them female. Cronbach's alpha and intra-class coefficients were used to estimate instrument reliability. The AQ-27-T was assessed again 14 days later for test retest reliability. The AQ-27-T demonstrated acceptable internal consistency, with a Cronbach's alpha of 0.88 for the total scale and ranging between 0.86 and 0.89 for the items. The test-retest reliability was good, with Pearson correlation coefficients of 0.79 for the total scale and ranging between 0.35 and 0.77 for the items (p<0.05). Correlation between subscales was moderate-good, with Pearson correlation coefficients of 0.18-0.88 (p<0.05). Fit indices of the model supported the factor structure and paths. The AQ-27-T is a reliable measure to assess stigmatizing attitudes in Turkish.

Keywords: attribution questionnaire, validity, reliability, stigma

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Authors: F. Clara Fang, Hernan Castaneda

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The Connecticut Department of Transportation (ConnDOT) has constructed four roundabouts in the State of Connecticut within the past ten years. VISSIM traffic simulation software was utilized to analyze these roundabouts during their design phase. The queue length and level of service observed in the field appear to be better than predicted by the VISSIM model. The objectives of this project are to: identify VISSIM input variables most critical to accurate modeling; recommend VISSIM calibration factors; and, provide other recommendations for roundabout traffic operations modeling. Traffic data were collected at these roundabouts using Miovision Technologies. Cameras were set up to capture vehicle circulating activity and entry behavior for two weekdays. A large sample size of filed data was analyzed to achieve accurate and statistically significant results. The data extracted from the videos include: vehicle circulating speed; critical gap estimated by Maximum Likelihood Method; peak hour volume; follow-up headway; travel time; and, vehicle queue length. A VISSIM simulation of existing roundabouts was built to compare both queue length and travel time predicted from simulation with measured in the field. The research investigated a variety of simulation parameters as calibration factors for describing driver behaviors at roundabouts. Among them, critical gap is the most effective calibration variable in roundabout simulation. It has a significant impact to queue length, particularly when the volume is higher. The results will improve the design of future roundabouts in Connecticut and provide decision makers with insights on the relationship between various choices and future performance.

Keywords: driver critical gap, roundabout analysis, simulation, VISSIM modeling

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Authors: J. Magerman, P. Martin

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Nursing students' clinical abilities is highly dependent on the quality of the clinical experience obtained while placed in the clinical environment. The clinical environment has amongst other, key role players which include the clinical supervisor. The primary role of the clinical supervisor is to guide nursing students to become the best practice nursing professionals. However, globally literature alludes to the failure of educating institutions to deliver competent nursing professionals to meet the needs of patients and deliver quality patient care. At the participating university, this may be due to various factors such as large student numbers and social and environmental challenges experienced by clinical supervisors. The aim of this study was to explore and describe the lived experiences of clinical supervisors who supervise nursing students at a higher education institution. The study employed a qualitative research approach utilizing a descriptive phenomenological design. Purposive sampling was used to select participants, who supervised first and second year nursing studnets at the higher education institution under study. TH esample comprised of eight clinical supervisors who supervise first and secon year nursing studnets at teh institution under study. Data was collected by means of in-depht interviews. Data was analysed using Collaizzi's seven steps method of qualitative analysis. Five major themes identified , focussed on the experiences regarding time a sa constraint to job productivity, the impact of teh organisational culture on the fluidity of support, interpersonal relationships a sa dynamic communication process, impact on the self, and limited resources. Trustworthiness of the data was ensured by means of applying Guba's model of truth value, applicability, consistency and neutrality. Reflexivity was also used by the researcher to further enhance trustworthiness.

Keywords: clinical supervision, clinical supervisors, nursing students, clinical placements

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Authors: Euan Donley

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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

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