Search results for: non-elective admission.

Authors: Bharat Raj Singh, Onkar Singh

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This paper deals with new concept of using compressed atmospheric air as a zero pollution power source for running motorbikes. The motorbike is equipped with an air turbine in place of an internal combustion engine, and transforms the energy of the compressed air into shaft work. The mathematical modeling and performance evaluation of a small capacity compressed air driven vaned type novel air turbine is presented in this paper. The effect of isobaric admission and adiabatic expansion of high pressure air for different rotor to casing diameter ratios with respect to different vane angles (number of vanes) have been considered and analyzed. It is found that the shaft work output is optimum for some typical values of rotor / casing diameter ratios at a particular value of vane angle (no. of vanes). In this study, the maximum power is obtained as 4.5kW - 5.3kW (5.5-6.25 HP) when casing diameter is taken 100 mm, and rotor to casing diameter ratios are kept from 0.65 to 0.55. This value of output is sufficient to run motorbike.

Keywords: zero pollution, compressed air, air turbine, vane angle, rotor / casing diameter ratio

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Authors: Rashid Slaheldinn Elhaj Mohammed

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The design of high performance combustion chambers for turbojet engines is considered as one of the most challenges that face gas turbine designers, since the design approach depends on empirical correlations of data derived from the previous design experiences. The objective of this paper is to design a combustion chamber that suits the requirements of a micro-turbojet engine with 400 N output thrust and operates with kerosene as fuel. In this paper, only preliminary calculations related to the annular type of combustion chamber are explained in details. These calculations will cover the evaluation of reference quantities, calculation of required dimensions, calculation of air distribution and pressure drop, estimation of number and diameters for air admission holes, as well as aerodynamic considerations. The design process is then accompanied by analytical procedure using commercial CFD ANALYSIS tool; ANSYS 16 CFX software. After conducting CFD analysis, the design process will be then iterated in order to gain satisfactory results. It should be noted that the design of the fuel preparation and installation systems is beyond the scope of this work, and it will be discussed separately in another work.  

Keywords: Annular combustion chamber, micro-turbojet engine, CFD ANALYSIS, pressure drop.

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Authors: Ambra Giovannelli, Erika Maria Archilei

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The amount of the electrical power required by refrigeration systems is relevant worldwide. It is evaluated in the order of 15% of the total electricity production taking refrigeration and air-conditioning into consideration. For this reason, in the last years several energy saving techniques have been proposed to reduce the power demand of such plants. The paper deals with the development of an innovative internal recovery system for cryogenic cooling plants. Such a system consists in a Compressor-Expander Group (CEG) designed on the basis of the automotive turbocharging technology. In particular, the paper is focused on the design of the expander, the critical component of the CEG system. Due to the low volumetric flow entering the expander and the high expansion ratio, a commercial turbocharger expander wheel was strongly modified. It was equipped with a transonic nozzle, designed to have a radially inflow full admission. To verify the performance of such a machine and suggest improvements, two different set of nozzles have been designed and modelled by means of the commercial Ansys-CFX software. steady-state 3D CFD simulations of the second-generation prototype are presented and compared with the initial ones.

Keywords: Energy saving, organic fluids, radial turbine, refrigeration plant, vapor compression systems.

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Authors: Chau-Kuang Chen, John Hughes, Jr., A. Dexter Samuels

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The prediction models for the United States Medical Licensure Examination (USMLE) Steps 1 and 2 performances were constructed by the Monte Carlo simulation modeling approach via linear regression. The purpose of this study was to build robust simulation models to accurately identify the most important predictors and yield the valid range estimations of the Steps 1 and 2 scores. The application of simulation modeling approach was deemed an effective way in predicting student performances on licensure examinations. Also, sensitivity analysis (a/k/a what-if analysis) in the simulation models was used to predict the magnitudes of Steps 1 and 2 affected by changes in the National Board of Medical Examiners (NBME) Basic Science Subject Board scores. In addition, the study results indicated that the Medical College Admission Test (MCAT) Verbal Reasoning score and Step 1 score were significant predictors of the Step 2 performance. Hence, institutions could screen qualified student applicants for interviews and document the effectiveness of basic science education program based on the simulation results.

Keywords: Prediction Model, Sensitivity Analysis, Simulation Method, USMLE.

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Authors: Maha Hammami, Olfa Benouda Sioud

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This study investigates the reliability of management earnings forecasts with reference to these two ingredients: verifiability and neutrality. Specifically, we examine the biasedness (or accuracy) of management earnings forecasts and company specific characteristics that can be associated with accuracy. Based on sample of 102 IPO prospectuses published for admission on NYSE Euronext Paris from 2002 to 2010, we found that these forecasts are on average optimistic and two of the five test variables, earnings variability and financial leverage are significant in explaining ex post bias. Acknowledging the possibility that the bias is the result of the managers’ forecasting behavior, we then examine whether managers decide to under-predict, over-predict or forecast accurately for self-serving purposes. Explicitly, we examine the role of financial distress, operating performance, ownership by insiders and the economy state in influencing managers’ forecasting preferences. We find that managers of distressed firms seem to over-predict future earnings. We also find that when managers are given more stock options, they tend to under-predict future earnings. Finally, we conclude that the management earnings forecasts are affected by an intentional bias due to managers’ forecasting preferences.

Keywords: Intentional bias, Management earnings forecasts, neutrality, verifiability.

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Authors: Muhibul Haque Bhuyan

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Most educational institutions were compelled to switch over to the online mode of teaching, learning, and assessment due to the lockdown when the corona pandemic started around the globe in the early part of the year 2020. However, they faced a unique set of challenges in delivering knowledge and skills to their students as well as formulating a proper assessment policy. This paper investigates whether there is an impact on the student Semester Grade Point Average (SGPA) due to the online mode of teaching and learning assessment at the Department of Electrical and Electronic Engineering (EEE) of Southeast University (SEU). Details of student assessments are discussed. Then students’ grades were analyzed to find out the impact on SGPA based on the z-test by finding the standard deviation (). It also pointed out the challenges associated with the online classes and assessment strategies to be adopted during the online assessment. The student admission, course advising, and registration statistics were also presented in several tables and analyzed based on the change in percentage to observe the impact on it due to the pandemic. In summary, it was observed that the students’ SGPAs are not affected but student course advising and registration were affected slightly by the pandemic. Finally, the paper provides some recommendations to improve the online teaching, learning, assessment, and evaluation system.

Keywords: electrical and electronic engineering students, impact on course grading and SGPA, online assessment, online teaching, student registration, semester result

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Authors: Abdallah AL Sabbagh, Robin Braun, Mehran Abolhasan

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Due to the coexistence of different Radio Access Technologies (RATs), Next Generation Wireless Networks (NGWN) are predicted to be heterogeneous in nature. The coexistence of different RATs requires a need for Common Radio Resource Management (CRRM) to support the provision of Quality of Service (QoS) and the efficient utilization of radio resources. RAT selection algorithms are part of the CRRM algorithms. Simply, their role is to verify if an incoming call will be suitable to fit into a heterogeneous wireless network, and to decide which of the available RATs is most suitable to fit the need of the incoming call and admit it. Guaranteeing the requirements of QoS for all accepted calls and at the same time being able to provide the most efficient utilization of the available radio resources is the goal of RAT selection algorithm. The normal call admission control algorithms are designed for homogeneous wireless networks and they do not provide a solution to fit a heterogeneous wireless network which represents the NGWN. Therefore, there is a need to develop RAT selection algorithm for heterogeneous wireless network. In this paper, we propose an approach for RAT selection which includes receiving different criteria, assessing and making decisions, then selecting the most suitable RAT for incoming calls. A comprehensive survey of different RAT selection algorithms for a heterogeneous wireless network is studied.

Keywords: Heterogeneous Wireless Network, RAT selection algorithms, Next Generation Wireless Network (NGWN), Beyond 3G Network, Common Radio Resource Management (CRRM).

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Authors: Kobra Nalbandi, Bahram Baghban Kohnehrouz, Khalil Alami Saeed

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The low level of foreign genes expression in transgenic plants is a key factor that limits plant genetic engineering. Because of the critical regulatory activity of the promoters on gene transcription, they are studied extensively to improve the efficiency of the plant transgenic system. The strong constitutive promoters, such as CaMV 35S promoter and Ubiqutin 1 maize are usually used in plant biotechnology research. However the expression level of the foreign genes in all tissues is often undesirable. But using a strong seed-specific promoter to limit gene expression in the seed solves such problems. The purpose of this study is to isolate one of the seed specific promoters of Hordeum vulgare. So one of the common varieties of Hordeum vulgare in Iran was selected and their genomes extracted then the D-Hordein promoter amplified using the specific designed primers. Then the amplified fragment of the insert cloned in an appropriate vector and then transformed to E. coli. At last for the final admission of accuracy the cloned fragments sent for sequencing. Sequencing analysis showed that the cloned fragment DHPcontained motifs; like TATA box, CAAT-box, CCGTCC-box, AMYBOX1 and E-box etc., which constituted the seed-specific promoter activity. The results were compared with sequences existing in data banks. D-Hordein promoters of Alger has 99% similarity at 100 % coverage. The results also showed that D-Hordein promoter of barley and HMW promoter of wheat are too similar.

Keywords: Barley, Seed specific promoter, Hordein.

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Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: Alcohol screening, AUDIT-C, CAGE, Hazardous drinking.

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Authors: L.A du Plessis

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South Africa is facing a crisis with not being able to produce enough graduates in the scarce skills areas to sustain economic growth. The crisis is fuelled by a school system that does not produce enough potential students with Mathematics, Accounting and Science. Since the introduction of the new school curriculum in 2008, there is no longer an option to take pure maths on a standard grade level. Instead, only two mathematical subjects are offered: pure maths (which is on par with higher grade maths) and mathematical literacy. It is compulsory to take one or the other. As a result, lees student finishes Grade 12 with pure mathematics every year. This national problem needs urgent attention if South Africa is to make any headway in critical skills development as mathematics is a gateway to scarce skills professions. Higher education institutions initiated several initiatives in an attempt to address the above, including preparatory courses, bridging programmes and extended curricula with foundation provisions. In view of the above, and government policy directives to broaden access in the scarce skills areas to increase student throughput, foundation provision was introduced for Commerce and Information Technology programmes at the Vaal Triangle Campus (VTC) of North-West University (NWU) in 2010. Students enrolling for extended programmes do not comply with the minimum prerequisites for the normal programmes. The question then arises as to whether these programmes have the intended impact? This paper reports the results of a two year longitudinal study, tracking the first year academic achievement of the two cohorts of enrolments since 2010. The results provide valuable insight into the structuring of an extended programme and its potential impact.

Keywords: Access, extended programmes, foundation provision, mathematics.

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Authors: Samy A. Selim, Nashwa I. Hagag

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Abstract–The objectives of the current study are to determine the prevalence, etiological agents, drug susceptibility pattern and plasmid profile of Acinetobacter baumannii isolates from Hospital-Acquired Infections (HAI) at Community Hospital, Al Jouf Province, Saudi Arabia. A total of 1890 patients had developed infection during hospital admission and were included in the study. Among those who developed nosocomial infections, 15(9.4), 10(2.7) and 118 (12.7) had respiratory tract infection (RTI), blood stream infections (BSI) and urinary tract (UTI) respectively. A total of 268 bacterial isolates were isolated from nosocomial infection. S. aureus was reported in 23.5% for of the total isolates followed by Klebsiella pneumoniae (17.5%), E. coli (17.2%), P. aeruginosa (11.9%), coagulase negative staphylococcus (9%), A. baumannii (7.1%), Enterobacter spp. (3.4%), Citrobacter freundii (3%), Proteus mirabilis (2.6%), and Proteus vulgaris and Enterococcous faecalis (0.7%). Isolated organisms are multi-drug resistant, predominantly Gram-positive pathogens with a high incidence of methicillin-resistant S. aureus, extended spectrum beta lactamase and vancomycin resistant enterococci organisms. The RFLP (Fragment Length Polymorphisms) patterns of plasmid preparations from isolated A. baumannii isolates had altered RFLP patterns, possibly due to the presence of plasmid(s). Five A. baumannii isolates harbored plasmids all of which were not less than 2.71kbp in molecular weight. Hence, it showed that the gene coding for the isolates were located on the plasmid DNA while the remaining isolates which have no plasmid might showed gene coding for antibiotic resistance being located on chromosomal DNA. Nosocomial infections represent a current problem in Community Hospital, Al Jouf Province, Saudi Arabia. Problems associated with SSI include infection with multidrug resistant pathogens which are difficult to treat and are associated with increased mortality.

Keywords: Hospital-Acquired Infections, Acinetobacter baumannii, antibiotic resistance, plasmid profile, RFLP patterns, Al Jouf Province, Saudi Arabia

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Authors: Neelam Vats, Madhvi Pathak Pillai, Rajender Lal, Indu Dabas

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The pressure of scoring higher marks to be able to get admission in a higher ranked institution has become a social stigma for school students. It leads to various social and academic pressures on them, causing psychological anxiety. This undue stress on students sometimes may even steer to aggressive behavior or suicidal tendencies. Human mind is always surrounded by the some desires, emotions and passions, which usually disturbs our mental peace. In such a scenario, we look for a solution that helps in removing all the obstacles of mind and make us mentally peaceful and strong enough to be able to deal with all kind of pressure. Preksha meditation is one such technique which aims at bringing the positive changes for overall transformation of personality. Hence, the present study was undertaken to assess the impact of Preksha Meditation on the academic anxiety on female teenagers. The study was conducted on 120 high school students from the capital city of India. All students were in the age group of 13-15 years. They also belonged to similar social as well as economic status. The sample was equally divided into two groups i.e. experimental group (N = 60) and control group (N = 60). Subjects of the experimental group were given the intervention of Preksha Meditation practice by the trained instructor for one hour per day, six days a week, for three months for the first experimental stage and another three months for the second experimental stage. The subjects of the control group were not assigned any specific type of activity rather they continued doing their normal official activities as usual. The Academic Anxiety Scale was used to collect data during multi-level stages i.e. pre-experimental stage, post-experimental stage phase-I, and post-experimental stage phase-II. The data were statistically analyzed by computing the two-tailed-‘t’ test for inter group comparison and Sandler’s ‘A’ test with alpha = or p < 0.05 for intra-group comparisons. The study concluded that the practice for longer duration of Preksha Meditation practice brings about very significant and beneficial changes in the pattern of academic anxiety.

Keywords: Academic anxiety, academic pressure, Preksha, meditation.

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

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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: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: Antinuclear antibody, Subclinical hypothyroidism, Thyroxin, TPO antibody.

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