Search results for: safe prescribing.

Authors: Amudha Kadirvelu, Sunil Gurtu, Sivalal Sadasivan

Abstract:

Pharmacology curriculum plays an integral role in medical education. Learning pharmacology to choose and prescribe drugs is a major challenge encountered by students. We developed pharmacology applied learning activities for first year medical students that included realistic clinical situations with escalating complications which required the students to analyze the situation and think critically to choose a safe drug. Tutor feedback was provided at the end of session. Evaluation was done to assess the students- level of interest and usefulness of the sessions in rational selection of drugs. Majority (98 %) of the students agreed that the session was an extremely useful learning exercise and agreed that similar sessions would help in rational selection of drugs. Applied learning sessions in the early years of medical program may promote deep learning and bridge the gap between pharmacology theory and clinical practice. Besides, it may also enhance safe prescribing skills.

Keywords: Medical education, pharmacology curriculum, applied learning, safe prescribing.

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Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently crosschecked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014 – September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: Antibiotic resistance, antibiotic stewardship, dental infection and hygiene standards.

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Authors: P. Nazemzadeh, A. Dideban, M. Zareiee

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In this paper the effect of faults in the elements and parts of discrete event systems is investigated. In the occurrence of faults, some states of the system must be changed and some of them must be forbidden. For this goal, different states of these elements are examined and a model for fail-safe behavior of each state is introduced. Replacing new models of the target elements in the preliminary model by a systematic method, leads to a fail-safe discrete event system.

Keywords: Discrete event systems, Fail-safe, Petri nets, Supervisory control.

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Authors: Fotis N. Koumboulis, Maria P. Tzamtzi

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A supervisory scheme is proposed that implements Stepwise Safe Switching Logic. The functionality of the supervisory scheme is organized in the following eight functional units: Step- Wise Safe Switching unit, Common controllers design unit, Experimentation unit, Simulation unit, Identification unit, Trajectory cruise unit, Operating points unit and Expert system unit. The supervisory scheme orchestrates both the off-line preparative actions, as well as the on-line actions that implement the Stepwise Safe Switching Logic. The proposed scheme is a generic tool, that may be easily applied for a variety of industrial control processes and may be implemented as an automation software system, with the use of a high level programming environment, like Matlab.

Keywords: Supervisory systems, safe switching, nonlinear systems.

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Authors: M. Zareiee, A. Dideban

Abstract:

This paper addresses the problem of forbidden states in non safe Petri Nets. In the system, for preventing it from entering the forbidden states, some linear constraints can be assigned to them. Then these constraints can be enforced on the system using control places. But when the number of constraints in the system is large, a large number of control places must be added to the model of system. This concept complicates the model of system. There are some methods for reducing the number of constraints in safe Petri Nets. But there is no a systematic method for non safe Petri Nets. In this paper we propose a method for reducing the number of constraints in non safe Petri Nets which is based on solving an integer linear programming problem.

Keywords: discrete event system, Supervisory control, Petri Net, Constraint

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Authors: Ola A. Nassr, Ali M. Abd Alridha, Rua A. Naser, Rasha S. Abbas

Abstract:

Background: Excessive and inappropriate use of antimicrobial agents among hospitalized patients remains an important patient safety and public health issue worldwide. Not only does this behavior incur unnecessary cost but it is also associated with increased morbidity and mortality. The objective of this study is to obtain an insight into the prescribing patterns of antibiotics in surgical and medical wards, to help identify a scope for improvement in service delivery. Method: A simple point prevalence survey included a convenience sample of 200 patients admitted to medical and surgical wards in a government teaching hospital in Baghdad between October 2017 and April 2018. Data were collected by a trained pharmacy intern using a standardized form. Patient’s demographics and details of the prescribed antibiotics, including dose, frequency of dosing and route of administration, were reported. Patients were included if they had been admitted at least 24 hours before the survey. Patients under 18 years of age, having a diagnosis of cancer or shock, or being admitted to the intensive care unit, were excluded. Data were checked and entered by the authors into Excel and were subjected to frequency analysis, which was carried out on anonymized data to protect patient confidentiality. Results: Overall, 88.5% of patients (n=177) received 293 antibiotics during their hospital admission, with a small variation between wards (80%-97%). The average number of antibiotics prescribed per patient was 1.65, ranging from 1.3 for medical patients to 1.95 for surgical patients. Parenteral third-generation cephalosporins were the most commonly prescribed at a rate of 54.3% (n=159) followed by nitroimidazole 29.4% (n=86), quinolones 7.5% (n=22) and macrolides 4.4% (n=13), while carbapenems and aminoglycosides were the least prescribed together accounting for only 4.4% (n=13). The intravenous route was the most common route of administration, used for 96.6% of patients (n=171). Indications were reported in only 63.8% of cases. Culture to identify pathogenic organisms was employed in only 0.5% of cases. Conclusion: Broad-spectrum antibiotics are prescribed at an alarming rate. This practice may provoke antibiotic resistance and adversely affect the patient outcome. Implementation of an antibiotic stewardship program is warranted to enhance the efficacy, safety and cost-effectiveness of antimicrobial agents.

Keywords: Acute care, antibiotic misuse, Iraq, prescribing.

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Authors: Moosa Haji Abbasi, Emad Benhelal, Arshad Ahmad

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Storage tank farms are essential industrial facilities to accumulate oil, petrochemicals and gaseous products. Since tank farms contain huge mass of fuel and hazardous materials, they are always targets of serious accidents such as fire, explosion, spill and toxic release which may cause severe impacts on human health, environmental and properties.

Although having a safe layout is not able to prevent initiating accidents, however it effectively controls and reduces the adverse impact of such accidents.

The aim of this paper is to determine the optimal layout for a storage tank contains different type of hydrocarbon fuels. A quantitative risk assessment is carried out on a selected tank farm in Jaipur, India, with particular attention given to both the consequence modeling and the overall risk assessment using PHAST Software. Various designs of tank layouts are examined taking into consideration several issues of plant operations and maintenance. In all stages of the work, standard guidelines specified by the industry are considered and recommendations are substantiated with simulation results and risk quantification.

Keywords: Tank farm, safe distance, safe layout, risk assessment, PHAST.

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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: M. Zareiee, A. Dideban, P. Nazemzadeh

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This paper deals with the problem of constructing constraints in non safe Petri Nets and then reducing the number of the constructed constraints. In a system, assigning some linear constraints to forbidden states is possible. Enforcing these constraints on the system prevents it from entering these states. But there is no a systematic method for assigning constraints to forbidden states in non safe Petri Nets. In this paper a useful method is proposed for constructing constraints in non safe Petri Nets. But when the number of these constraints is large enforcing them on the system may complicate the Petri Net model. So, another method is proposed for reducing the number of constructed constraints.

Keywords: discrete event system, Supervisory control, Petri Net, Constraint

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Authors: Yi-Ting Liu, Pei-Ying Wen

Abstract:

In order to improve the overall safety of chemotherapy, safety-protecting netwas established for the whole process from prescribing by physicians, transcribing by nurses, dispensing by pharmacists to administering by nurses. The information system was used to check and monitorwhole process of administration and related sheets were computerized to simplify the paperwork.

Keywords: Chemotherapy, Bar Code Medication Administration (BCMA), Medication Safety.

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Authors: Ching - Yi Lee, I-Hsiung Tseng, Feng-Chuan Pan

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Environment today is featured with aging population, increasing prevalence of chronic disease and complex of medical treatment. Safe use of pharmaceutics relied very much on the efforts made by both the health- related organizations and as well as the government agencies. As far as the specialization concern in providing health services to the patients, the government actively issued and implemented the divisions of medical treatment and pharmaceutical to improve the quality of care and to reduce medication errors and ensure public health. Pharmaceutical sub-sector policy has been implemented for 13 years. This study attempts to explore the factors that affect the patients- behavior intention of refilling a prescription from a NHIB pharmacy. Samples were those patients refilling their prescriptions with the case NHIB pharmacies. A self-administered questionnaire was used to collect respondents- information while the patients or family members visit the pharmacy for the refilling. 1,200 questionnaires were dispatched in 37 pharmacies that randomly selected from Pingtung City, Dongkang, Chaozhou, Hengchun areas. 732 responses were gained with 604 valid samples for further analyses. Results of data analyses indicated that respondents- attitude, subjective norm, perceived behavior control and behavior intentions toward refilling behavior varied from some demographic variables to another. This research also suggested adding actual behavior, either by a self-report or observed, into the research.

Keywords: Separation of dispensing and prescribing, prescriptions refill slip, NHIB contracted pharmacy, drug safety, theory of planned behavior.

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Authors: Bozena Dohnalkova, Jakub Hodul, Rostislav Drochytka, Jana Kosikova

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This paper deals with a proposal of a new methodology for durability assessment of solidification product for its safe further use. The new methodology is based on a review of the current state of assessment of treated waste in Czech Republic and abroad. The aim of the paper is to propose an optimal evaluation methodology for verifying properties of solidification product to ensure its safe further use in building industry.

Keywords: Solidification/stabilization, durability, waste.

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Authors: Tanvir Ahmed, Thanh N. Long, Phan T. Huong, Donald E. Stewart

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This paper presents views on condom use and the contexts of safe and unsafe sexual practices with different sexual partners and their relationships among Injecting Drug Users (IDUs) in Hai Phong, Vietnam. Fifteen IDUs participated and two local interviewers conducted qualitative semi-structured face-to-face interviews in September-October, 2012 in Vietnamese language. Data were analyzed thematically. Non-protective condom attitudes include negotiate or convince Female Sex Workers (FSW); not realizing risk, importance or necessity; partner doesn’t like, and having extra money/drug from clients. On the other hand, self-awareness, family-consciousness, suspicion of STI presence, fear of getting HIV, and client negotiation sometimes resulted in a safe-sex practice. A thematic diagram was developed to present the relationship (strong/weak) between condom attitude and sexual practice (safe/unsafe) by partner types. The experiences and views reflected in the qualitative information emphasize the heightened need for safe-sex education especially among young IDUs (male/female) highlighting sexual transmission risk.

Keywords: AIDS, HIV, injecting drug user, risk behaviors, Vietnam.

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Authors: R. Govender, D. Naidoo, E. M. Buys

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The importance of ensuring safe meat handling and processing practices has been demonstrated in global reports on food safety scares and related illness and deaths. This necessitated stricter meat safety control strategies. Today, many countries have regulated towards preventative and systematic control over safe meat processing at abattoirs utilizing the Hazard Analysis Critical Control Point (HACCP) principles. HACCP systems have been reported as effective in managing food safety risks, if correctly implemented. South Africa has regulated the Hygiene Management System (HMS) based on HACCP principles applicable to abattoirs. Regulators utilise the Hygiene Assessment System (HAS) to audit compliance at abattoirs. These systems were benchmarked from the United Kingdom (UK). Little research has been done them since inception as of 2004. This paper presents a review of the two systems, its implementation and comparison with HACCP. Recommendations are made for future research to demonstrate the utility of the HMS and HAS in assuring safe meat to consumers.

Keywords: Abattoir, co-regulation, food safety, HACCP, meat hygiene.

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Authors: Rade Ciric, Sasa Mandic

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Students of Higher Education Technical School of Professional Studies in Novi Sad follow the subject ‘Maintenance of Electric Power Equipment’ at the Electrotechnical Department. This paper presents educational plan and program of the subject Maintenance of Electric Power Equipment. The course deals with the problems of preventive and investing maintenance of transformer stations (TS), performing and maintenance of grounding of TS and pillars, as well as tracing and detection the location of the cables failure. There is a special elaborated subject concerning the safe work conditions for the electrician during network maintenance, as well as the basics of making and keeping technical documentation of the equipment.

Keywords: Educational plan and program, electric power equipment, maintenance, technical documentation, safe work.

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Authors: Mehdi Modabberifar, Sanaz Jabary, Mojtaba Ghodsi

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Stiffness sensing is an important issue in medical diagnostic, robotics surgery, safe handling, and safe grasping of objects in production lines. Detecting and obtaining the characteristics in dwelling lumps embedded in a soft tissue and safe removing and handling of detected lumps is needed in surgery. Also in industry, grasping and handling an object without damaging in a place where it is not possible to access a human operator is very important. In this paper, a method for object handling is presented. It is based on the use of an intelligent gripper to detect the object stiffness and then setting a programmable force for grasping the object to move it. The main components of this system includes sensors (sensors for measuring force and displacement), electrical (electrical and electronic circuits, tactile data processing and force control system), mechanical (gripper mechanism and driving system for the gripper) and the display unit. The system uses a rotary potentiometer for measuring gripper displacement. A microcontroller using the feedback received by the load cell, mounted on the finger of the gripper, calculates the amount of stiffness, and then commands the gripper motor to apply a certain force on the object. Results of Experiments on some samples with different stiffness show that the gripper works successfully. The gripper can be used in haptic interfaces or robotic systems used for object handling.

Keywords: Gripper, haptic, stiffness, robotic.

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Authors: Almutasim Billa A. Alanazi, Hal S. Tharp

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Safe performance and efficient energy consumption are essential factors for designing a control system. This paper presents a reinforcement learning (RL) model that can be applied to control applications to improve safety and reduce energy consumption. As hardware constraints and environmental disturbances are imprecise and unpredictable, conventional control methods may not always be effective in optimizing control designs. However, RL has demonstrated its value in several artificial intelligence (AI) applications, especially in the field of control systems. The proposed model intelligently monitors a system's success by observing the rewards from the environment, with positive rewards counting as a success when the controlled reference is within the desired operating zone. Thus, the model can determine whether the system is safe to continue operating based on the designer/user specifications, which can be adjusted as needed. Additionally, the controller keeps track of energy consumption to improve energy efficiency by enabling the idle mode when the controlled reference is within the desired operating zone, thus reducing the system energy consumption during the controlling operation. Water temperature control for a hydroponic system is taken as a case study for the RL model, adjusting the variance of disturbances to show the model’s robustness and efficiency. On average, the model showed safety improvement by up to 15% and energy efficiency improvements by 35%-40% compared to a traditional RL model.

Keywords: Control system, hydroponics, machine learning, reinforcement learning.

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Authors: Mohd Shahriman B. Mohd Yunus, Mohd Hanif B. Jamaludin, Norain Bt. Bahror

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The performance of an embedded grounding system is very important for the safe operation of electrical appliances and human beings. In principle, a safe grounding system has two objectives, which are to dissipate fault current without exceeding any operating and equipment limits and to ensure there is no risk of electric shock to humans in the vicinity of earthed facilities. The case studies in this paper present the calculating grounding resistance for multiple configurations of vertical and horizontally by using a simple and accurate formula. From the analytic calculated results, observed good/empirical relationship between the grounding resistance and length of the embedded grounding configurations. Moreover, the configurations of vertical and horizontal observed effectiveness of grounding resistance and good agreement on the reduction of grounding resistance values especially for vertical configuration.

Keywords: Grounding system, grounding resistance, soil resistivity, electrode geometry, configurations.

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Authors: Aaron Aboshio

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Numerical study of the static response of homogeneous clay stratum considering a wide range of cohesion and subject to foundation loads is presented. The linear elastic–perfectly plastic constitutive relation with the von Mises yield criterion were utilised to develop a numerically cost effective finite element model for the soil while imposing a rigid body constrain to the foundation footing. From the analyses carried out, estimate of the bearing capacity factor, Nc as well as the ultimate load-carrying capacities of these soils, effect of cohesion on foundation settlements, stress fields and failure propagation were obtained. These are consistent with other findings in the literature and hence can be a useful guide in design of safe foundations in clay soils for buildings and other structure.

Keywords: Bearing capacity factors, finite element method, safe bearing pressure, structure-soil interaction.

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Authors: Hsuan-Chia Yang, Yan-Jhih Haung, Yu-Chuan Li

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Researchers of drug-drug interaction alert systems have often suggested that there were high overridden rate for alerts and also too false alerts. However, research about decreasing false alerts is scant. Therefore, the aim of this article attempts to proactive identification of false alert for drug-drug interaction and provide solution to decrease false alerts. This research involved retrospective analysis prescribing database and calculated false alert rate by using MYSQL and JAVA. Results of this study showed 17% of false alerts and the false alert rate in the hospitals (37%) was more than in the clinics. To conclude, this study described the importance that drug-drug interaction alert system should not only detect drug name but also detect frequency or route, as well as in providing solution to decrease false alerts.

Keywords: drug-drug interaction, proactive identification, false alert

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Authors: Mohammad Saraj Sharifzai, Keisuke Kitagawa, Mohammad Kamil Halimee, Javid Habib, Daishi Sakaguchi

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The purpose of this research is to upgrade a pleasing, sustainable and safe shelter in the Afghan urban community. It also aims to maintain traditional housing, which is fitted to its environment, while attempting to upgrade it with new, traditional standards. The three main objectives of this study are to upgrade the traditional courtyard house to become safe and sustainable today and tomorrow; to fit the contemporary house environmentally and culturally, and to suppress or reduce the broad gap between traditional and contemporary housing. The paper tries to exhibit and analyze the sustainably best practices available in both traditional and contemporary courtyard housing in Afghanistan. For instance, the use of thick walls and Tawa-Khana (floor heating system) shows the best sustainable practice in that context.

Keywords: Afghan Traditional Courtyard Housing (ATCH), Afghan Contemporary Courtyard Housing (ACCH), suitability planning, affordable and thermal comfort.

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Authors: Noura Al-Ajmi, Mohammed A. Almulla

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With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.

Keywords: Headache diagnosis system, treatment recommender system, rule-based expert system.

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Authors: M. A. Sanda, B. Johansson, J. Johansson

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The purpose of this paper is to conceptualize a futureoriented human work environment and organizational activity in deep mines that entails a vision of good and safe workplace. Futureoriented technological challenges and mental images required for modern work organization design were appraised. It is argued that an intelligent-deep-mine covering the entire value chain, including environmental issues and with work organization that supports good working and social conditions towards increased human productivity could be designed. With such intelligent system and work organization in place, the mining industry could be seen as a place where cooperation, skills development and gender equality are key components. By this perspective, both the youth and women might view mining activity as an attractive job and the work environment as a safe, and this could go a long way in breaking the unequal gender balance that exists in most mines today.

Keywords: Mining activity; deep mining; human operators; intelligent deep mine; work environment; organizational activity.

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Authors: Roza Dastres, Mohsen Soori

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Networks are vulnerable devices due to their basic feature of facilitating remote access and data communication. The information in the networks needs to be kept secured and safe in order to provide an effective communication and sharing device in the web of data. Due to challenges and threats of the data in networks, the network security is one of the most important considerations in information technology infrastructures. As a result, the security measures are considered in the network in order to decrease the probability of accessing the secured data by the hackers. The purpose of network security is to protect the network and its components from unauthorized access and abuse in order to provide a safe and secured communication device for the users. In the present research work a review in recent development of network threats and security measures is presented and future research works are also suggested. Different attacks to the networks and security measured against them are discussed in order to increase security in the web of data. So, new ideas in the network security systems can be presented by analyzing the published papers in order to move forward the research field.

Keywords: Network threats, network security, security measures, firewalls.

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Authors: Jiradett K., Ornin S.

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With the advance in wireless networking, IEEE 802.16 WiMAX technology has been widely deployed for several applications such as “last mile" broadband service, cellular backhaul, and high-speed enterprise connectivity. As a result, military employed WiMAX as a high-speed wireless connection for data-link because of its point to multi-point and non-line-of-sight (NLOS) capability for many years. However, the risk of using WiMAX is a critical factor in some sensitive area of military applications especially in ammunition manufacturing such as solid propellant rocket production. The US DoD policy states that the following certification requirements are met for WiMAX: electromagnetic effects on the environment (E3) and Hazards of Electromagnetic Radiation to Ordnance (HERO). This paper discuses the Recommended Power Densities and Safe Separation Distance (SSD) for HERO on WiMAX systems deployed on solid propellant rocket production. The result of this research found that WiMAX is safe to operate at close proximity distances to the rocket production based on AF Guidance Memorandum immediately changing AFMAN 91-201.

Keywords: WiMAX, ammunition, explosive, munition, solidpropellant, safety, rocket, missile

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Authors: Pattama Ratana-Arporn, Pongtep Wilaipun

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White scar oyster (Crassostrea belcheri) is often eaten raw and being the leading vehicle for foodborne disease, especially Salmonella Weltevreden which exposed the prominent and most resistant to radiation. Gamma irradiation at a low dose of 1 kGy was enough to eliminate S. Weltevreden contaminated in oyster meat at a level up to 5 log CFU/g while it still retain the raw characteristics and equivalent sensory quality as the non-irradiated one. Process development of ready-to-eat chilled oyster meat was conducted by shucking the meat, individually packed in plastic bags, subjected to 1 kGy gamma radiation at chilled condition and then stored in 4oC refrigerated temperature. Microbiological determination showed the absence of S. Weltevreden (5 log CFU/g initial inoculated) along the whole storage time of 30 days. Sensory evaluation indicated the decreasing in sensory scores along storage time which determining the product shelf life to be 18 days compared to 15 days of nonirradiated one. The most advantage of developed process was to provide the safe raw oyster to consumers and in addition sensory quality retained and 3-day extension shelf life also exist.

Keywords: decontamination, food safety, irradiation, oyster, Salmonella Weltevreden

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Authors: R. Sharma, M. Gopal

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Markov games can be effectively used to design controllers for nonlinear systems. The paper presents two novel controller design algorithms by incorporating ideas from gametheory literature that address safety and consistency issues of the 'learned' control strategy. A more widely used approach for controller design is the H∞ optimal control, which suffers from high computational demand and at times, may be infeasible. We generate an optimal control policy for the agent (controller) via a simple Linear Program enabling the controller to learn about the unknown environment. The controller is facing an unknown environment and in our formulation this environment corresponds to the behavior rules of the noise modeled as the opponent. Proposed approaches aim to achieve 'safe-consistent' and 'safe-universally consistent' controller behavior by hybridizing 'min-max', 'fictitious play' and 'cautious fictitious play' approaches drawn from game theory. We empirically evaluate the approaches on a simulated Inverted Pendulum swing-up task and compare its performance against standard Q learning.

Keywords: Fictitious Play, Cautious Fictitious Play, InvertedPendulum, Controller, Markov Games, Mobile Robot.

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Authors: Brian M. Mehling, Louis Quartararo, Marine Manvelyan, Paul Wang, Dong-Cheng Wu

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Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of antiaging. They have been given one intravenous infusion of UCMSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

Keywords: Chronic inflammatory diseases, intravenous infusion, mesenchymal stem cells (MSCs), umbilical cord blood.

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Authors: May A. Massoud

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The availability of water in adequate quantity and quality is imperative for sustainable development. Worldwide, significant imbalance exists with regards to sustainable development particularly from a water and sanitation perspective. Water is a critical component of public health, and failure to supply safe water will place a heavy burden on the entire population. Although the 21st century has witnessed wealth and advanced development, it has not been realized everywhere. Billions of people are still striving to access the most basic human needs which are food, shelter, safe drinking water and adequate sanitation. The global picture conceals various inequalities particularly with regards to sanitation coverage in rural and urban areas. Currently, water scarcity and in particular water governance is the main challenge which will cause a threat to sustainable development goals. Within the context of water, sanitation and health, sustainable development is a confusing concept primarily when examined from the viewpoint of policy options for developing countries. This perspective paper aims to summarize and critically evaluate evidence of published studies in relation to water, sanitation and health and to identify relevant solutions to reduce public health impacts. Evidently, improving water and sanitation services will result in significant and lasting gains in health and economic development.

Keywords: developing countries, health, sanitation, sustainability, water

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Authors: Kimutai Joan Jepkorir, Moturi Wilkister Nyaora

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The practice of open defecation can be devastating for human health as well as the environment, and this practice persistence could be due to ingrained habits that individuals continue to engage in despite having a better alternative. Safe disposal of human excreta is essential for public health protection. This study sought to find if open defecation relates to fecal-oral infections in Burat and Ngaremara Wards in Isiolo County. This was achieved through conducting a cross-sectional study. Simple random sampling technique was used to select 385 households that were used in the study. Data collection was done by use of questionnaires and observation checklists. The result show that 66% of the respondents disposed-off fecal matter in a safe manner, whereas 34% disposed-off fecal matter in unsafe manner through open defecation. The prevalence proportions per 1000 of diarrhea and intestinal worms among children under-5 years of age were 142 and 21, respectively. The prevalence proportions per 1000 of diarrhea and typhoid among children over-5 years of age were 20 and 20, respectively.

Keywords: Fecal-oral infections, open defecation, prevalence proportion, sanitation.

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