Search results for: intensive care unit.

Authors: P. Bogas

Abstract:

As a scientific contribution to this discussion, a pedagogical intervention of a quasi-experimental nature was developed, with a mixed methodology, evaluating the intervention within a single curricular unit of Marketing, using cases based on real challenges of brands, business simulation and customer projects. Primary and secondary experiences were incorporated in the intervention: the primary experiences are the experiential activities themselves; the secondary experiences resulted from the primary experience, such as reflection and discussion in work teams. A diversified learning relationship was encouraged through the various connections between the different members of the learning community. The present study concludes that in the same context, the students' response can be described as: students who reinforce the initial deep approach, students who maintain the initial deep approach level and others who change from an emphasis on the deep approach to one closer to superficial. This typology did not always confirm studies reported in the literature, namely, whether the initial level of deep processing would influence the superficial and the opposite. The result of this investigation points to the inclusion of pedagogical and didactic activities that integrate different motivations and initial strategies, leading to a possible adoption of deep approaches to learning, since it revealed statistically significant differences in the difference in the scores of the deep/superficial approach and the experiential level. In the case of real challenges, the categories of “attribution of meaning and meaning of studied” and the possibility of “contact with an aspirational context” for their future professional stand out. In this category, the dimensions of autonomy that will be required of them were also revealed when comparing the classroom context of real cases and the future professional context and the impact they may have on the world. Regarding to the simulated practice, two categories of response stand out: on the one hand, the motivation associated with the possibility of measuring the results of the decisions taken, an awareness of oneself and, on the other hand, the additional effort that this practice required for some of the students.

Keywords: Experiential learning, higher education, marketing, mixed methods, reflective thinking.

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Authors: B. O. Diyaolu, E. A. Okebanjo

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Children in today’s world need attention and care even with their physique as obesity is also at the increased. Several factors can be responsible for obesity in children and adequate attention is paramount in other not to accommodate it into adolescent period. This study investigated perceived determinants of obesity among primary school pupils in Eti Osa Local Government area of Lagos State. Descriptive survey research design was used and population was all obese pupils in Eti Osa Local Government Area of Lagos State. 92 pupils were selected from randomly picked 12 primary schools while purposive sampling technique was used to pick primary 4-6 pupils. With the aid of body mass index (BMI) and age percentile chart the obese pupils were selected. The instrument for the study was a self-developed and structured questionnaire on perceived determinant of obesity. The questionnaire was divided into three sections. The Cronbach’s Alpha reliability coefficient of 0.74 was obtained. The hypotheses were tested at 0.05 significant levels. The completed questionnaire was collated coded and analyzed using descriptive statistics of frequency counts and percentage and inferential statistics of chi-square (X²). Findings of this study revealed that physical activities and parental influences were determinant of obesity. Physical activity is essential in reducing the rate of obesity in Eti Osa Local Government Area both at home and within the school environment. Primary schools need to create more playing ground for pupils to exercise themselves. Parents need to cater for their children diet ensuring not just the quantity but the quality as well.

Keywords: Feeding pattern, obese pupils, parental influence, physical activities.

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Authors: S. Demiray, M. E. Pintado, P. M. L. Castro

Abstract:

There is a growing interest in the food industry and in preventive health care for the development and evaluation of natural antioxidants from medicinal plant materials. In the present work, extracts of three medicinal plants (Tilia argentea, Crataegi folium leaves and Polygonum bistorta roots) used in Turkish phytotheraphy were screened for their phenolic profiles and antioxidant properties. Crude extracts were obtained from different parts of plants, by solidliquid extraction with pure water, 70% acetone and 70% methanol aqueous solvents. The antioxidant activity of the extracts was determined by ABTS.+ radical cation scavenging activity. The Folin Ciocalteu procedure was used to assess the total phenolic concentrations of the extracts as gallic acid equivalents. A modified liquid chromatography-electro spray ionization-mass spectrometry (LC-ESI-MS) was used to obtain chromatographic profiles of the phenolic compounds in the medicinal plants. The predominant phenolic compounds detected in different extracts of the plants were catechin, protocatechuic and chlorogenic acids. The highest phenolic contents were obtained by using 70% acetone as aqueous solvent, whereas the lowest phenolic contents were obtained by water extraction due to Folin Ciocalteu results. The results indicate that acetone extracts of Tilia argentea had the highest antioxidant capacity as free ABTS radical scavengers. The lowest phenolic contents and antioxidant capacities were obtained from Polygonum bistorta root extracts.

Keywords: Medicinal plants, antioxidant activity, totalphenolics, LC-ESI-MS.

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Authors: Jienny Lee, In-Soo Cho, Sang-Ho Cha

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Adult mesenchymal stem cells (MSCs) have been investigated using preclinical approaches for tissue regeneration. Porcine MSCs (pMSCs) are capable of growing and attaching to plastic with a fibroblast-like morphology and then differentiating into bone, adipose, and cartilage tissues in vitro. This study was conducted to investigate the proliferating abilities, differentiation potentials, and multipotency of miniature pig adipose tissue-derived MSCs (mpAD-MSCs) with or without long-term cryopreservation, considering that cryostorage has the potential for use in clinical applications. After confirming the characteristics of the mpAD-MSCs, we examined the effect of long-term cryopreservation (> 2 years) on expression of cell surface markers (CD34, CD90 and CD105), proliferating abilities (cumulative population doubling level, doubling time, colony-forming unit, and MTT assay) and differentiation potentials into mesodermal cell lineages. As a result, the expression of cell surface markers is similar between thawed and fresh mpAD-MSCs. However, long-term cryopreservation significantly lowered the differentiation potentials (adipogenic, chondrogenic, and osteogenic) of mpAD-MSCs. When compared with fresh mpAD-MSCs, thawed mpAD-MSCs exhibited lower expression of mesodermal cell lineage-related genes such as peroxisome proliferator-activated receptor-g2, lipoprotein lipase, collagen Type II alpha 1, osteonectin, and osteocalcin. Interestingly, long-term cryostoraged mpAD-MSCs exhibited significantly higher cell viability than the fresh mpAD-MSCs. Long-term cryopreservation induced a 30% increase in the cell viability of mpAD-MSCs when compared with the fresh mpAD-MSCs at 5 days after thawing. However, long-term cryopreservation significantly lowered expression of stemness markers such as Oct3/4, Sox2, and Nanog. Furthermore, long-term cryopreservation negatively affected expression of senescence-associated genes such as telomerase reverse transcriptase and heat shock protein 90 of mpAD-MSCs when compared with the fresh mpAD-MSCs. The results from this study might be important for the successful application of MSCs in clinical trials after long-term cryopreservation.

Keywords: Mesenchymal stem cells, Cryopreservation, Stemness, Senescence.

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Authors: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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Authors: Nareelux Suwannobol, JintanaTapin, Khuanchanok Narachan

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The objective of this study was to determine the accuracy to estimation fetal weight by Johnson-s method and compares it with actual birth weight. The sample group was 126 infants delivered in Dan KhunThot hospital from January March 2012. Fetal weight was estimated by measuring fundal height according to Johnson-s method. The information was collected by studying historical delivery records and then analyzed by using the statistics of frequency, percentage, mean, and standard deviation. Finally, the difference was analyzed by a paired t-test.The results showed had an average birth weight was 3093.57 ± 391.03 g (mean ± SD) and 3,455 ± 454.55 g average estimated fetal weight by Johnson-s method higher than average actual birth weight was 384.09 grams. When classifying the infants according to birth weight found that low birth weight (<2500 g) and the appropriate birth weight (2500-3999g) actual birth weight less than estimate fetal weight . But the high birth weight (> 4000 g) actual birth weight was more than estimated fetal weight. The difference was found between actual birth weight and estimation fetal weight of the minimum weight in high birth weight ( > 4000 g) , the appropriate birth weight (2500-3999g) and low birth weight (<2500 g) respectively. The rate of estimates fetal weight within 10% of actual birth weight was 35.7%. Actual birth weight were compared with the found that the difference is statistically significant (p <.000). Employing Johnson-s method to estimate fetal weight can estimate initial fetal weight before passing to special examinations, which may require excessive high cost. A variety of methods should be employed to estimate fetal weight more precisely, which will help plan care for mother-s and infant-s safety.

Keywords: Johnson's method, Fetal weight estimate, Delivery Room, Student nurse.

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Authors: George Charkoftakis, Panagiotis Liosatos, Nicolas-Alexander Tatlas, Dimitrios Goustouridis, Stelios M. Potirakis

Abstract:

E-maintenance is a relatively recent concept, generally referring to maintenance management by monitoring assets over the Internet. One of the key links in the chain of an e-maintenance system is data acquisition and transmission. Specifically for the case of a fleet of heavy-duty vehicles, where the main challenge is the diversity of the vehicles and vehicle-embedded self-diagnostic/reporting technologies, the design of the data acquisition and transmission unit is a demanding task. This is clear if one takes into account that a heavy-vehicles fleet assortment may range from vehicles with only a limited number of analog sensors monitored by dashboard light indicators and gauges to vehicles with plethora of sensors monitored by a vehicle computer producing digital reporting. The present work proposes an adaptable internet of things (IoT) sensor node that is capable of addressing this challenge. The proposed sensor node architecture is based on the increasingly popular single-board computer – expansion boards approach. In the proposed solution, the expansion boards undertake the tasks of position identification, cellular connectivity, connectivity to the vehicle computer, and connectivity to analog and digital sensors by means of a specially targeted design of expansion board. Specifically, the latter offers a number of adaptability features to cope with the diverse sensor types employed in different vehicles. In standard mode, the IoT sensor node communicates to the data center through cellular network, transmitting all digital/digitized sensor data, IoT device identity and position. Moreover, the proposed IoT sensor node offers connectivity, through WiFi and an appropriate application, to smart phones or tablets allowing the registration of additional vehicle- and driver-specific information and these data are also forwarded to the data center. All control and communication tasks of the IoT sensor node are performed by dedicated firmware.

Keywords: IoT sensor nodes, e-maintenance, single-board computers, sensor expansion boards, on-board diagnostics

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Authors: Rania Mustafa

Abstract:

This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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Authors: Basant H. El-Refay, Nabeel T. Faiad

Abstract:

Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.

Keywords: Children, Hypocaloric diet, Lower body positive pressure supported treadmill, obesity.

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Authors: Mai Miyabe, Taku Fukushima, Takashi Yoshino, Aguri Shigeno

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The need for multilingual communication in Japan has increased due to an increase in the number of foreigners in the country. When people communicate in their nonnative language, the differences in language prevent mutual understanding among the communicating individuals. In the medical field, communication between the hospital staff and patients is a serious problem. Currently, medical translators accompany patients to medical care facilities, and the demand for medical translators is increasing. However, medical translators cannot necessarily provide support, especially in cases in which round-the-clock support is required or in case of emergencies. The medical field has high expectations from information technology. Hence, a system that supports accurate multilingual communication is required. Despite recent advances in machine translation technology, it is very difficult to obtain highly accurate translations. We have developed a support system called M3 for multilingual medical reception. M3 provides support functions that aid foreign patients in the following respects: conversation, questionnaires, reception procedures, and hospital navigation; it also has a Q&A function. Users can operate M3 using a touch screen and receive text-based support. In addition, M3 uses accurate translation tools called parallel texts to facilitate reliable communication through conversations between the hospital staff and the patients. However, if there is no parallel text that expresses what users want to communicate, the users cannot communicate. In this study, we have developed a circulating support environment for multilingual medical communication using parallel texts. The proposed environment can circulate necessary parallel texts through the following procedure: (1) a user provides feedback about the necessary parallel texts, following which (2) these parallel texts are created and evaluated.

Keywords: multilingual medical communication, parallel texts.

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Authors: Appanah Rao Appadu, Muhammad Zaid Dauhoo

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In this paper, we have combined some spatial derivatives with the optimised time derivative proposed by Tam and Webb in order to approximate the linear advection equation which is given by = 0. Ôêé Ôêé + Ôêé Ôêé x f t u These spatial derivatives are as follows: a standard 7-point 6 th -order central difference scheme (ST7), a standard 9-point 8 th -order central difference scheme (ST9) and optimised schemes designed by Tam and Webb, Lockard et al., Zingg et al., Zhuang and Chen, Bogey and Bailly. Thus, these seven different spatial derivatives have been coupled with the optimised time derivative to obtain seven different finite-difference schemes to approximate the linear advection equation. We have analysed the variation of the modified wavenumber and group velocity, both with respect to the exact wavenumber for each spatial derivative. The problems considered are the 1-D propagation of a Boxcar function, propagation of an initial disturbance consisting of a sine and Gaussian function and the propagation of a Gaussian profile. It is known that the choice of the cfl number affects the quality of results in terms of dissipation and dispersion characteristics. Based on the numerical experiments solved and numerical methods used to approximate the linear advection equation, it is observed in this work, that the quality of results is dependent on the choice of the cfl number, even for optimised numerical methods. The errors from the numerical results have been quantified into dispersion and dissipation using a technique devised by Takacs. Also, the quantity, Exponential Error for Low Dispersion and Low Dissipation, eeldld has been computed from the numerical results. Moreover, based on this work, it has been found that when the quantity, eeldld can be used as a measure of the total error. In particular, the total error is a minimum when the eeldld is a minimum.

Keywords: Optimised time derivative, dissipation, dispersion, cfl number, Nomenclature: k : time step, h : spatial step, β :advection velocity, r: cfl/Courant number, hkrβ= , w =θ, h : exact wave number, n :time level, RPE : Relative phase error per unit time step, AFM :modulus of amplification factor

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Authors: Vinko Lešić, Mario Vašak, Anita Martinčević, Marko Gulin, Antonio Starčić, Hrvoje Novak

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With 40% of total world energy consumption, building systems are developing into technically complex large energy consumers suitable for application of sophisticated power management approaches to largely increase the energy efficiency and even make them active energy market participants. Centralized control system of building heating and cooling managed by economically-optimal model predictive control shows promising results with estimated 30% of energy efficiency increase. The research is focused on implementation of such a method on a case study performed on two floors of our faculty building with corresponding sensors wireless data acquisition, remote heating/cooling units and central climate controller. Building walls are mathematically modeled with corresponding material types, surface shapes and sizes. Models are then exploited to predict thermal characteristics and changes in different building zones. Exterior influences such as environmental conditions and weather forecast, people behavior and comfort demands are all taken into account for deriving price-optimal climate control. Finally, a DC microgrid with photovoltaics, wind turbine, supercapacitor, batteries and fuel cell stacks is added to make the building a unit capable of active participation in a price-varying energy market. Computational burden of applying model predictive control on such a complex system is relaxed through a hierarchical decomposition of the microgrid and climate control, where the former is designed as higher hierarchical level with pre-calculated price-optimal power flows control, and latter is designed as lower level control responsible to ensure thermal comfort and exploit the optimal supply conditions enabled by microgrid energy flows management. Such an approach is expected to enable the inclusion of more complex building subsystems into consideration in order to further increase the energy efficiency.

Keywords: Energy-efficient buildings, Hierarchical model predictive control, Microgrid power flow optimization, Price-optimal building climate control.

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Authors: Frank C. Pan, Che-Long Su, Ching-Hsuen Chen

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Background, measuring an individual-s Health Literacy is gaining attention, yet no appropriate instrument is available in Taiwan. Measurement tools that were developed and used in western countries may not be appropriate for use in Taiwan due to a different language system. Purpose of this research was to develop a Health Literacy measurement instrument specific for Taiwan adults. Methods, several experts of clinic physicians; healthcare administrators and scholars identified 125 common used health related Chinese phrases from major medical knowledge sources that easy accessible to the public. A five-point Likert scale is used to measure the understanding level of the target population. Such measurement is then used to compare with the correctness of their answers to a health knowledge test for validation. Samples, samples under study were purposefully taken from four groups of people in the northern Pingtung, OPD patients, university students, community residents, and casual visitors to the central park. A set of health knowledge index with 10 questions is used to screen those false responses. A sample size of 686 valid cases out of 776 was then included to construct this scale. An independent t-test was used to examine each individual phrase. The phrases with the highest significance are then identified and retained to compose this scale. Result, a Taiwan Health Literacy Scale (THLS) was finalized with 66 health-related phrases under nine divisions. Cronbach-s alpha of each division is at a satisfactory level of 89% and above. Conclusions, factors significantly differentiate the levels of health literacy are education, female gender, age, family members of stroke victims, experience with patient care, and healthcare professionals in the initial application in this study..

Keywords: Health literacy, health knowledge, REALM, THLS.

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Authors: Nina Kaufmans

Abstract:

Traditional treatments for post-traumatic stress disorder (PTSD) that rely primarily on oral narratives are partially insufficient to prevent PTSD symptoms from recurrence. As a result of the global COVID-19 pandemic, war conflicts, and economic crises, a rising proportion of users of mental health services express somatically based distress in addition to their existing mental health symptoms. Furthermore, the rapid increase in demand for mental health services has resulted in substantial burnout among mental health professionals, which may further impact the quality of services provided and the sustainability of professional life-work balance. This article examines the implications of current developments and challenges in mental health services demand and subsequent responses, as well as the effects of those responses on mental health professionals. The article examines the neurobiological mechanisms underlying traumatic experiences, then discusses the premises for "bottom-up," or somatically oriented, psychotherapy approaches, and concludes with suggestions for clinical skills and interventions to be used by practitioners who work with clients diagnosed with PTSD. In addition, we examine how somatically based psychotherapy interventions performed in sessions might reduce clinician burnout and improve their well-being. We examine how incorporating somatically based therapies into counseling will boost the efficacy of mental health recovery and maintain remission while providing mental health practitioners with chances for self-care.

Keywords: Somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment.

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Authors: Makkia, Ahmad, Al-Falahi, Abdullah Abdelaziz Muharram

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Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. The current study aimed to assess sng the prevalence of ‎occupational health hazards among Health care workers and associated ‎risk factors in public hospitals in Sana'a City, Yemen. Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. More the half (60.6%) of HCWs were aged between 20-30 years, 50.8% were males, 56.3% were married, and 45.5% had a diploma qualification, while 65.2% of HCWs had less than 6 years of experience. The results show a high prevalence of occupational hazards (99%); ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p > 0.05). The study revealed that occupational hazards were highly prevalent among the participants. The most common biological hazard was exposure to sharp-related injuries, while the predominant physical hazard was slip, trip, and fall incidents. Ergonomic hazards manifested as back or neck pain during work. Chemical hazards were represented by allergic reactions to medical gloves powder. Psychosocial hazards included experiencing verbal and physical harassment. In conclusion, the study emphasized the importance of raising awareness among HCWs and conducting training courses to prevent occupational hazards.

Keywords: Health workers, occupational hazard, prevalence, risk factors.

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Authors: Virupakshaiah DBM, Chandrakanth Kelmani, Rachanagouda Patil, Prasad Hegade

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Severe acute respiratory syndrome (SARS) is a respiratory disease in humans which is caused by the SARS coronavirus. The treatment of coronavirus-associated SARS has been evolving and so far there is no consensus on an optimal regimen. The mainstream therapeutic interventions for SARS involve broad-spectrum antibiotics and supportive care, as well as antiviral agents and immunomodulatory therapy. The Protein- Ligand interaction plays a significant role in structural based drug designing. In the present work we have taken the receptor Angiotensin converting enzyme 2 and identified the drugs that are commonly used against SARS. They are Lopinavir, Ritonavir, Ribavirin, and Oseltamivir. The receptor Angiotensin converting enzyme 2 (ACE-2) was docked with above said drugs and the energy value obtained are as follows, Lopinavir (-292.3), Ritonavir (-325.6), Oseltamivir (- 229.1), Ribavirin (-208.8). Depending on the least energy value we have chosen the best two drugs out of the four conventional drugs. We tried to improve the binding efficiency and steric compatibility of the two drugs namely Ritonavir and Lopinavir. Several modifications were made to the probable functional groups (phenylic, ketonic groups in case of Ritonavir and carboxylic groups in case of Lopinavir respectively) which were interacting with the receptor molecule. Analogs were prepared by Marvin Sketch software and were docked using HEX docking software. Lopinavir analog 8 and Ritonavir analog 11 were detected with significant energy values and are probable lead molecule. It infers that some of the modified drugs are better than the original drugs. Further work can be carried out to improve the steric compatibility of the drug based upon the work done above for a more energy efficient binding of the drugs to the receptor.

Keywords: Protein data bank, Rasmol, Marvin sketch, Hexdocking.

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Authors: Esam Jassim

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Industries using conventional fossil fuels have an  interest in better understanding the mechanism of particulate  formation during combustion since such is responsible for emission  of undesired inorganic elements that directly impact the atmospheric  pollution level. Fine and ultrafine particulates have tendency to  escape the flue gas cleaning devices to the atmosphere. They also  preferentially collect on surfaces in power systems resulting in  ascending in corrosion inclination, descending in the heat transfer  thermal unit, and severe impact on human health. This adverseness  manifests particularly in the regions of world where coal is the  dominated source of energy for consumption.  This study highlights the behavior of calcium transformation as  mineral grains verses organically associated inorganic components  during pulverized coal combustion. The influence of existing type of  calcium on the coarse, fine and ultrafine mode formation mechanisms  is also presented. The impact of two sub-bituminous coals on particle  size and calcium composition evolution during combustion is to be  assessed. Three mixed blends named Blends 1, 2, and 3 are selected  according to the ration of coal A to coal B by weight. Calcium  percentage in original coal increases as going from Blend 1 to 3.  A mathematical model and a new approach of describing  constituent distribution are proposed. Analysis of experiments of  calcium distribution in ash is also modeled using Poisson distribution.  A novel parameter, called elemental index λ, is introduced as a  measuring factor of element distribution.  Results show that calcium in ash that originally in coal as mineral  grains has index of 17, whereas organically associated calcium  transformed to fly ash shown to be best described when elemental  index λ is 7.  As an alkaline-earth element, calcium is considered the  fundamental element responsible for boiler deficiency since it is the  major player in the mechanism of ash slagging process. The  mechanism of particle size distribution and mineral species of ash  particles are presented using CCSEM and size-segregated ash  characteristics. Conclusions are drawn from the analysis of  pulverized coal ash generated from a utility-scale boiler.

 

Keywords: Calcium transformation, Coal Combustion, Inorganic Element, Poisson distribution.

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Authors: Diptoshi Roy, G. Sreevidya Varma, S. Asokan, Chandasree Das

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Germanium Telluride based quaternary thin film switching devices with composition Ge₁₅In₅Te₅₆Ag_24, have been deposited in sandwich geometry on glass substrate with aluminum as top and bottom electrodes. The bulk glassy form of the said composition is prepared by melt quenching technique. In this technique, appropriate quantity of elements with high purity are taken in a quartz ampoule and sealed under a vacuum of 10^-5 mbar. Then, it is allowed to rotate in a horizontal rotary furnace for 36 hours to ensure homogeneity of the melt. After that, the ampoule is quenched into a mixture of ice - water and NaOH to get the bulk ingot of the sample. The sample is then coated on a glass substrate using flash evaporation technique at a vacuum level of 10^-6 mbar. The XRD report reveals the amorphous nature of the thin film sample and Energy - Dispersive X-ray Analysis (EDAX) confirms that the film retains the same chemical composition as that of the base sample. Electrical switching behavior of the device is studied with the help of Keithley (2410^c) source-measure unit interfaced with Lab VIEW 7 (National Instruments). Switching studies, mainly SET (changing the state of the material from amorphous to crystalline) operation is conducted on the thin film form of the sample. This device is found to manifest memory switching as the device remains 'ON' even after the removal of the electric field. Also it is found that amorphous Ge₁₅In₅Te₅₆Ag₂₄ thin film unveils clean memory type of electrical switching behavior which can be justified by the absence of fluctuation in the I-V characteristics. The I-V characteristic also reveals that the switching is faster in this sample as no data points could be seen in the negative resistance region during the transition to on state and this leads to the conclusion of fast phase change during SET process. Scanning Electron Microscopy (SEM) studies are performed on the chosen sample to study the structural changes at the time of switching. SEM studies on the switched Ge₁₅In₅Te₅₆Ag₂₄ sample has shown some morphological changes at the place of switching wherein it can be explained that a conducting crystalline channel is formed in the device when the device switches from high resistance to low resistance state. From these studies it can be concluded that the material may find its application in fast switching Non-Volatile Phase Change Memory (PCM) Devices.

Keywords: Chalcogenides, vapor deposition, electrical switching, PCM.

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Authors: Dinabandhu Mahata, Amit Kumar, Ambarish Kumar Rai

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India is known as a country of diversity regarding the social, cultural and wide geographical variations. In the north and north-west part of the country, the strong patriarchal norms and the male dominance based social structure are the important constructs. Patriarchal social setup adversely affects the women’s social and economic wellbeing and hence in that social structure women are considered as second level citizen. Work participation rate of women has directly linked to the development of society or household. Haryana is one of the developed states of India, still being ahead in economic prosperity, much lagged behind in gender-based equality and male dominance in all dimensions of life. The position of women in the Haryana is no better than the other states of India. Haryana state has the great difference among the male-female sex ratio which is a serious concern for social science research as a demographic problem for the state. Now women are requiring for their holistic empowerment and that will take care of them for an enabling process that must lead to their economic as well as social transformation. Hence, the objective of the paper is to address the role of sex ratio, women literacy and her work participation in the process of their empowerment with special attention to the gender perspective. The study used the data from Census of India from 1991 to 2011. This paper will examine the regional disparity of sex ratio, literacy rate and female work participation and the improvement of empowerment of women in the state of Haryana. This paper will suggest the idea for focusing much intensively on the issues of women empowerment through enhancement of her education, workforce participation and social participation with people participation and holistic approach.

Keywords: Sex ratio, literacy rate, workforce participation rate, women empowerment, Haryana.

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Authors: Alan Walsh, Peter Walker

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Differences in commercial, professional and personal cultural traditions between western consultants and project sponsors in the Gulf Cooperation Council (GCC) region are potentially significant in the workplace, and this can impact on project outcomes. These cultural differences can, for example, result in conflict amongst senior managers, which can negatively impact the megaproject. New entrants to the GCC often experience ‘culture shock’ as they attempt to integrate into their unfamiliar environments. Megaprojects are unique ventures with individual project characteristics, which need to be considered when managing their associated risks. Megaproject research to date has mostly ignored the significance of the absence of cultural congruence in the GCC, which is surprising considering that there are large volumes of megaprojects in various stages of construction in the GCC. An initial step to dealing with cultural issues is to acknowledge culture as a significant risk factor (SRF). This paper seeks to understand the criticality for western consultants to address these risks. It considers the cultural barriers that exist between GCC sponsors and western consultants and examines the cultural distance between the key actors. Initial findings suggest the presence to a certain extent of ethnocentricity. Other cultural clashes arise out of a lack of appreciation of the customs, practices and traditions of ‘the Other’, such as the need for avoiding public humiliation and the hierarchal significance rankings. The concept and significance of cultural shock as part of the integration process for new arrivals are considered. Culture shock describes the state of anxiety and frustration resulting from the immersion in a culture distinctly different from one's own. There are potentially substantial project risks associated with underestimating the process of cultural integration. This paper examines two distinct but intertwined issues: the societal and professional culture differences associated with expatriate assignments. A case study examines the cultural congruences between GCC sponsors and American, British and German consultants, over a ten-year cycle. This provides indicators as to which nationalities encountered the most profound cultural issues and the nature of these. GCC megaprojects are typically intensive fast track demanding ventures, where consultant turnover is high. The study finds that building trust-filled relationships is key to successful project team integration and therefore, to successful megaproject execution. Findings indicate that both professional and social inclusion processes have steep learning curves. Traditional risk management practice is to approach any uncertainty in a structured way to mitigate the potential impact on project outcomes. This research highlights cultural risk as a significant factor in the management of GCC megaprojects. These risks arising from high staff turnover typically include loss of project knowledge, delays to the project, cost and disruption in replacing staff. This paper calls for cultural risk to be recognised as an SRF, as the first step to developing risk management strategies, and to reduce staff turnover for western consultants in GCC megaprojects.

Keywords: Western consultants in megaprojects, national culture impacts on GCC Megaprojects, significant risk factors in megaprojects, professional culture in megaprojects.

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Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: Bilingual, English, medicine, doctor.

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Authors: Mayuresh Thombre, Prajyot Borkar, Mangirish Bhobe

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New advancement of technology and never satisfying demands of the civilization are putting huge pressure on the natural fuel resources and these resources are at a constant threat to its sustainability. To get the best out of the automobile, the optimum balance between performance and fuel economy is important. In the present state of art, either of the above two aspects are taken into mind while designing and development process which puts the other in the loss as increase in fuel economy leads to decrement in performance and vice-versa. In-depth observation of the vehicle dynamics apparently shows that large amount of energy is lost during braking and likewise large amount of fuel is consumed to reclaim the initial state, this leads to lower fuel efficiency to gain the same performance. Current use of Kinetic Energy Recovery System is only limited to sports vehicles only because of the higher cost of this system. They are also temporary in nature as power can be squeezed only during a small time duration and use of superior parts leads to high cost, which results on concentration on performance only and neglecting the fuel economy. In this paper Kinetic Energy Recovery System for storing the power and then using the same while accelerating has been discussed. The major storing element in this system is a Flat Spiral Spring that will store energy by compression and torsion.

The use of spring ensure the permanent storage of energy until used by the driver unlike present mechanical regeneration system in which the energy stored decreases with time and is eventually lost. A combination of internal gears and spur gears will be used in order to make the energy release uniform which will lead to safe usage. The system can be used to improve the fuel efficiency by assisting in overcoming the vehicle’s inertia after braking or to provide instant acceleration whenever required by the driver. The performance characteristics of the system including response time, mechanical efficiency and overall increase in efficiency are demonstrated. This technology makes the KERS (Kinetic Energy Recovery System) more flexible and economical allowing specific application while at the same time increasing the time frame and ease of usage.

Keywords: Electric control unit, Energy, Mechanical KERS, Planetary Gear system, Power, Smart braking, Spiral Spring.

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: Virological non-suppression, HIV-positive, ART, Woliso Town, Ethiopia.

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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Authors: Akhtar N, Khan BA, Khan MS, Mahmood T, Khan HMS, Iqbal M, Bashir S

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This study was designed to formulate, pharmaceutically evaluate a topical skin-care cream (w/o emulsion) of Aloe Vera versus its vehicle (Base) as control and determine their effects on Stratum Corneum (SC) water content and Transepidermal water loss (TEWL). Base containing no extract and a Formulation containing 3% concentrated extract of Aloe Vera was developed by entrapping in the inner aqueous phase of w/o emulsion (cream). Lemon oil was incorporated to improve the odor. Both the Base and Formulation were stored at 8°C ±0.1°C (in refrigerator), 25°C±0.1°C, 40°C±0.1°C and 40°C± 0.1°C with 75% RH (in incubator) for a period of 4 weeks to predict their stability. The evaluation parameters consisted of color, smell, type of emulsion, phase separation, electrical conductivity, centrifugation, liquefaction and pH. Both the Base and Formulation were applied to the cheeks of 21 healthy human volunteers for a period of 8 weeks Stratum corneum (SC) water content and Transepidermal water loss (TEWL) were monitored every week to measure any effect produced by these topical creams. The expected organoleptic stability of creams was achieved from 4 weeks in-vitro study period. Odor was disappeared with the passage of time due to volatilization of lemon oil. Both the Base and Formulation produced significant (p≤0.05) changes in TEWL with respect to time. SC water content was significantly (p≤0.05) increased by the Formulation while the Base has insignificant (p 0.05) effects on SC water content. The newly formulated cream of Aloe Vera, applied is suitable for improvement and quantitative monitoring of skin hydration level (SC water content/ moisturizing effects) and reducing TEWL in people with dry skin.

Keywords: Aloe Vera; Skin; Stratum corneum (SC) water content and Transepidermal water loss (TEWL).

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Authors: A. M. John-Otumu, M. M. Rahman, O. C. Nwokonkwo, M. C. Onuoha

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Online social media networks have long served as a primary arena for group conversations, gossip, text-based information sharing and distribution. The use of natural language processing techniques for text classification and unbiased decision making has not been far-fetched. Proper classification of these textual information in a given context has also been very difficult. As a result, a systematic review was conducted from previous literature on sentiment classification and AI-based techniques. The study was done in order to gain a better understanding of the process of designing and developing a robust and more accurate sentiment classifier that could correctly classify social media textual information of a given context between hate speech and inverted compliments with a high level of accuracy using the knowledge gain from the evaluation of different artificial intelligence techniques reviewed. The study evaluated over 250 articles from digital sources like ACM digital library, Google Scholar, and IEEE Xplore; and whittled down the number of research to 52 articles. Findings revealed that deep learning approaches such as Convolutional Neural Network (CNN), Recurrent Neural Network (RNN), Bidirectional Encoder Representations from Transformer (BERT), and Long Short-Term Memory (LSTM) outperformed various machine learning techniques in terms of performance accuracy. A large dataset is also required to develop a robust sentiment classifier. Results also revealed that data can be obtained from places like Twitter, movie reviews, Kaggle, Stanford Sentiment Treebank (SST), and SemEval Task4 based on the required domain. The hybrid deep learning techniques like CNN+LSTM, CNN+ Gated Recurrent Unit (GRU), CNN+BERT outperformed single deep learning techniques and machine learning techniques. Python programming language outperformed Java programming language in terms of development simplicity and AI-based library functionalities. Finally, the study recommended the findings obtained for building robust sentiment classifier in the future.

Keywords: Artificial Intelligence, Natural Language Processing, Sentiment Analysis, Social Network, Text.

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Authors: Frodouard Minani

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Since last decade, wireless sensor networks (WSNs) have been used in many areas like health care, agriculture, defense, military, disaster hit areas and so on. Wireless Sensor Networks consist of a Base Station (BS) and more number of wireless sensors in order to monitor temperature, pressure, motion in different environment conditions. The key parameter that plays a major role in designing a protocol for Wireless Sensor Networks is energy efficiency which is a scarcest resource of sensor nodes and it determines the lifetime of sensor nodes. Maximizing sensor node’s lifetime is an important issue in the design of applications and protocols for Wireless Sensor Networks. Clustering sensor nodes mechanism is an effective topology control approach for helping to achieve the goal of this research. In this paper, the researcher presents an energy efficiency protocol to prolong the network lifetime based on Energy efficient clustering algorithm. The Low Energy Adaptive Clustering Hierarchy (LEACH) is a routing protocol for clusters which is used to lower the energy consumption and also to improve the lifetime of the Wireless Sensor Networks. Maximizing energy dissipation and network lifetime are important matters in the design of applications and protocols for wireless sensor networks. Proposed system is to maximize the lifetime of the Wireless Sensor Networks by choosing the farthest cluster head (CH) instead of the closest CH and forming the cluster by considering the following parameter metrics such as Node’s density, residual-energy and distance between clusters (inter-cluster distance). In this paper, comparisons between the proposed protocol and comparative protocols in different scenarios have been done and the simulation results showed that the proposed protocol performs well over other comparative protocols in various scenarios.

Keywords: Base station, clustering algorithm, energy efficient, wireless sensor networks.

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Authors: Pradip Kumar Das

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As the entire world continues its rapid move towards industrialization, it has seriously threatened mankind’s ability to maintain an ecological balance. Geographical and natural forces have a significant influence on the location of industries. Industrialization is the foundation stone of the development of any country, while the unplanned industrialization and discharge of waste by industries is the cause of environmental pollution. There is growing degree of awareness and concern globally among nations about environmental degradation or pollution. Environmental resources endowed by the gift of nature and not manmade are invaluable natural resources of a country like India. Any developmental activity is directly related to natural and environmental resources. Economic development without environmental considerations brings about environmental crises and damages the quality of life of present, as well as future generation. As corporate sectors in the global market, especially in India, are becoming anxious about environmental degradation, naturally more and more emphasis will be ascribed to how environment-friendly the outcomes are. Maintaining accounts of such environmental and natural resources in the country has become more urgent. Moreover, international awareness and acceptance of the importance of environmental issues has motivated the development of a branch of accounting called “Environmental Accounting”. Environmental accounting attempts to detect and focus the resources consumed and the costs rendered by an industrial unit to the environment. For the sustainable development of mankind, a healthy environment is indispensable. Gradually, therefore, in many countries including India, environment matters are being given top most priority. Accounting and disclosure of environmental matters have been increasingly manifesting as an important dimension of corporate accounting and reporting practices. But, as conventional accounting deals with mainly non-living things, the formulation of valuation, and measurement and accounting techniques for incorporating environment-related matters in the corporate financial statement sometimes creates problems for the accountant. In the light of this situation, the conceptual analysis of the study is concerned with the rationale of environmental accounting on the economy and society as a whole, and focuses the failures of the traditional accounting system. A modest attempt has been made to throw light on the environmental awareness in developing nations like India and discuss the problems associated with the implementation of environmental accounting. The conceptual study also reflects that despite different anomalies, environmental accounting is becoming an increasing important aspect of the accounting agenda within the corporate sector in India. Lastly, a conclusion, along with recommendations, has been given to overcome the situation.

Keywords: Environmental accounting, environmental degradation, environmental management, environmental resources.

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Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: Resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan.

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Authors: K. Jyothi, T. S. Mohamed Saleem, L. Vineela, C. Gopinath, K. B. Yadavender Reddy

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Objective: Acute coronary syndrome is a clinical condition encompassing ST segments elevation myocardial infraction, Non ST segment is elevation myocardial infraction and un stable angina is characterized by ruptured coronary plaque, stress and myocardial injury. Angina pectoris is a pressure like pain in the chest that is induced by exertion or stress and relived with in the minute after cessation of effort or using sublingual nitroglycerin. The present research was undertaken to study the drug utilization pattern of antiplatelet drugs for the ischemic heart disease in a tertiary care hospital. Method: The present study is retrospective drug utilization study and study period is 6months. The data is collected from the discharge case sheet of general medicine department from medical department Rajiv Gandhi institute of medical sciences, Kadapa. The tentative sample size fixed was 250 patients. Out of 250 cases 19 cases was excluded because of unrelated data. Results: A total of 250 prescriptions were collected for the study according to the inclusion criteria 233 prescriptions were diagnosed with ischemic heart disease 17 prescriptions were excluded due to unrelated information. out of 233 prescriptions 128 are male (54.9%) and 105 patients are were female (45%). According to the gender distribution, the prevalence of ischemic heart disease in males are 90 (70.31%) and females are 39 (37.1%). In the same way the prevalence of ischemic heart disease along with cerebrovascular disease in males are 39 (29.6%) and females are 66 (62.6%). Conclusion: We found that 94.8% of drug utilization of antiplatelet drugs was achieved in the Rajiv Gandhi institute of medical sciences, Kadapa from 2011-2012.

Keywords: Angina pectoris, aspirin, clopidogrel, myocardial infarction.

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