Antibiotic Prescribing in the Acute Care in Iraq

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.

A Taxonomy of Routing Protocols in Wireless Sensor Networks

The Internet of Everything (IoE) presents today a very attractive and motivating field of research. It is basically based on Wireless Sensor Networks (WSNs) in which the routing task is the major analysis topic. In fact, it directly affects the effectiveness and the lifetime of the network. This paper, developed from recent works and based on extensive researches, proposes a taxonomy of routing protocols in WSNs. Our main contribution is that we propose a classification model based on nine classes namely application type, delivery mode, initiator of communication, network architecture, path establishment (route discovery), network topology (structure), protocol operation, next hop selection and latency-awareness and energy-efficient routing protocols. In order to provide a total classification pattern to serve as reference for network designers, each class is subdivided into possible subclasses, presented, and discussed using different parameters such as purposes and characteristics.

Comparative Advantage of Mobile Agent Application in Procuring Software Products on the Internet

This paper brings to fore the inherent advantages in application of mobile agents to procure software products rather than downloading software content on the Internet. It proposes a system whereby the products come on compact disk with mobile agent as deliverable. The client/user purchases a software product, but must connect to the remote server of the software developer before installation. The user provides an activation code that activates mobile agent which is part of the software product on compact disk. The validity of the activation code is checked on connection at the developer’s end to ascertain authenticity and prevent piracy. The system is implemented by downloading two different software products as compare with installing same products on compact disk with mobile agent’s application. Downloading software contents from developer’s database as in the traditional method requires a continuously open connection between the client and the developer’s end, a fixed network is not economically or technically feasible. Mobile agent after being dispatched into the network becomes independent of the creating process and can operate asynchronously and autonomously. It can reconnect later after completing its task and return for result delivery. Response Time and Network Load are very minimal with application of Mobile agent.

Multi-Stage Multi-Period Production Planning in Wire and Cable Industry

This paper presents a methodology for serial production planning problem in wire and cable manufacturing process that addresses the problem of input-output imbalance in different consecutive stations, hoping to minimize the halt of machines in each stage. To this end, a linear Goal Programming (GP) model is developed, in which four main categories of constraints as per the number of runs per machine, machines’ sequences, acceptable inventories of machines at the end of each period, and the necessity of fulfillment of the customers’ orders are considered. The model is formulated based upon on the real data obtained from IKO TAK Company, an important supplier of wire and cable for oil and gas and automotive industries in Iran. By solving the model in GAMS software the optimal number of runs, end-of-period inventories, and the possible minimum idle time for each machine are calculated. The application of the numerical results in the target company has shown the efficiency of the proposed model and the solution in decreasing the lead time of the end product delivery to the customers by 20%. Accordingly, the developed model could be easily applied in wire and cable companies for the aim of optimal production planning to reduce the halt of machines in manufacturing stages.

A Survey of Online User Perspectives and Age Profile in an Undergraduate Fundamental Business Technology Course

Over the past few decades, more and more students choose to enroll in online classes instead of attending in-class lectures. While past studies consider students’ attitudes towards online education and how their grades differed from in-class lectures, the profile of the online student remains a blur. To shed light on this, an online survey was administered to about 1,500 students enrolled in an undergraduate Fundamental Business Technology course at a Canadian University. The survey was comprised of questions on students’ demographics, their reasons for choosing online courses, their expectations towards the course, the communication channels they use for the course with fellow students and with the instructor. This paper focused on the research question: Do the perspectives of online students concerning the online experience, in general, and in the course in particular, differ according to age profile? After several statistical analyses, it was found that age does have an impact on the reasons why students select online classes instead of in-class. For example, it was found that the perception that an online course might be easier than in-class delivery was a more important reason for younger students than for older ones. Similarly, the influence of friends is much more important for younger students, than for older students. Similar results were found when analyzing students’ expectation about the online course and their use of communication tools. Overall, the age profile of online users had an impact on reasons, expectations and means of communication in an undergraduate Fundamental Business Technology course. It is left to be seen if this holds true across other courses, graduate and undergraduate.

Silicon-To-Silicon Anodic Bonding via Intermediate Borosilicate Layer for Passive Flow Control Valves

Flow control valves comprise a silicon flexible membrane that deflects against a substrate, usually made of glass, containing pillars, an outlet hole, and anti-stiction features. However, there is a strong interest in using silicon instead of glass as substrate material, as it would simplify the process flow by allowing the use of well controlled anisotropic etching. Moreover, specific devices demanding a bending of the substrate would also benefit from the inherent outstanding mechanical strength of monocrystalline silicon. Unfortunately, direct Si-Si bonding is not easily achieved with highly structured wafers since residual stress may prevent the good adhesion between wafers. Using a thermoplastic polymer, such as parylene, as intermediate layer is not well adapted to this design as the wafer-to-wafer alignment is critical. An alternative anodic bonding method using an intermediate borosilicate layer has been successfully tested. This layer has been deposited onto the silicon substrate. The bonding recipe has been adapted to account for the presence of the SOI buried oxide and intermediate glass layer in order not to exceed the breakdown voltage. Flow control valves dedicated to infusion of viscous fluids at very high pressure have been made and characterized. The results are compared to previous data obtained using the standard anodic bonding method.

Fluorescence Quenching as an Efficient Tool for Sensing Application: Study on the Fluorescence Quenching of Naphthalimide Dye by Graphene Oxide

Recently, graphene has gained much attention because of its unique optical, mechanical, electrical, and thermal properties. Graphene has been used as a key material in the technological applications in various areas such as sensors, drug delivery, super capacitors, transparent conductor, and solar cell. It has a superior quenching efficiency for various fluorophores. Based on these unique properties, the optical sensors with graphene materials as the energy acceptors have demonstrated great success in recent years. During quenching, the emission of a fluorophore is perturbed by a quencher which can be a substrate or biomolecule, and due to this phenomenon, fluorophore-quencher has been used for selective detection of target molecules. Among fluorescence dyes, 1,8-naphthalimide is well known for its typical intramolecular charge transfer (ICT) and photo-induced charge transfer (PET) fluorophore, strong absorption and emission in the visible region, high photo stability, and large Stokes shift. Derivatives of 1,8-naphthalimides have found applications in some areas, especially fluorescence sensors. Herein, the fluorescence quenching of graphene oxide has been carried out on a naphthalimide dye as a fluorescent probe model. The quenching ability of graphene oxide on naphthalimide dye was studied by UV-VIS and fluorescence spectroscopy. This study showed that graphene is an efficient quencher for fluorescent dyes. Therefore, it can be used as a suitable candidate sensing platform. To the best of our knowledge, studies on the quenching and absorption of naphthalimide dyes by graphene oxide are rare.

A Hybrid Algorithm for Collaborative Transportation Planning among Carriers

In this paper, there is concentration on collaborative transportation planning (CTP) among multiple carriers with pickup and delivery requests and time windows. This problem is a vehicle routing problem with constraints from standard vehicle routing problems and new constraints from a real-world application. In the problem, each carrier has a finite number of vehicles, and each request is a pickup and delivery request with time window. Moreover, each carrier has reserved requests, which must be served by itself, whereas its exchangeable requests can be outsourced to and served by other carriers. This collaboration among carriers can help them to reduce total transportation costs. A mixed integer programming model is proposed to the problem. To solve the model, a hybrid algorithm that combines Genetic Algorithm and Simulated Annealing (GASA) is proposed. This algorithm takes advantages of GASA at the same time. After tuning the parameters of the algorithm with the Taguchi method, the experiments are conducted and experimental results are provided for the hybrid algorithm. The results are compared with those obtained by a commercial solver. The comparison indicates that the GASA significantly outperforms the commercial solver.

System Security Impact on the Dynamic Characteristics of Measurement Sensors in Smart Grids

Smart grid is a term used to describe the next generation power grid. New challenges such as integration of renewable and decentralized energy sources, the requirement for continuous grid estimation and optimization, as well as the use of two-way flows of energy have been brought to the power gird. In order to achieve efficient, reliable, sustainable, as well as secure delivery of electric power more and more information and communication technologies are used for the monitoring and the control of power grids. Consequently, the need for cybersecurity is dramatically increased and has converged into several standards which will be presented here. These standards for the smart grid must be designed to satisfy both performance and reliability requirements. An in depth investigation of the effect of retrospectively embedded security in existing grids on it’s dynamic behavior is required. Therefore, a retrofitting plan for existing meters is offered, and it’s performance in a test low voltage microgrid is investigated. As a result of this, integration of security measures into measurement architectures of smart grids at the design phase is strongly recommended.

Performance Study of ZigBee-Based Wireless Sensor Networks

The IEEE 802.15.4 standard is designed for low-rate wireless personal area networks (LR-WPAN) with focus on enabling wireless sensor networks. It aims to give a low data rate, low power consumption, and low cost wireless networking on the device-level communication. The objective of this study is to investigate the performance of IEEE 802.15.4 based networks using simulation tool. In this project the network simulator 2 NS2 was used to several performance measures of wireless sensor networks. Three scenarios were considered, multi hop network with a single coordinator, star topology, and an ad hoc on demand distance vector AODV. Results such as packet delivery ratio, hop delay, and number of collisions are obtained from these scenarios.

Reference Model for the Implementation of an E-Commerce Solution in Peruvian SMEs in the Retail Sector

E-commerce is a business model that allows companies to optimize the processes of buying, selling, transferring goods and exchanging services through computer networks or the Internet. In Peru, the electronic commerce is used infrequently. This situation is due, in part to the fact that there is no model that allows companies to implement an e-commerce solution, which means that most SMEs do not have adequate knowledge to adapt to electronic commerce. In this work, a reference model is proposed for the implementation of an e-commerce solution in Peruvian SMEs in the retail sector. It consists of five phases: Business Analysis, Business Modeling, Implementation, Post Implementation and Results. The present model was validated in a SME of the Peruvian retail sector through the implementation of an electronic commerce platform, through which the company increased its sales through the delivery channel by 10% in the first month of deployment. This result showed that the model is easy to implement, is economical and agile. In addition, it allowed the company to increase its business offer, adapt to e-commerce and improve customer loyalty.

Comparative Study of Ad Hoc Routing Protocols in Vehicular Ad-Hoc Networks for Smart City

In this paper, we perform the investigation of some routing protocols in Vehicular Ad-Hoc Network (VANET) context. Indeed, we study the efficiency of protocols like Dynamic Source Routing (DSR), Ad hoc On-demand Distance Vector Routing (AODV), Destination Sequenced Distance Vector (DSDV), Optimized Link State Routing convention (OLSR) and Vehicular Multi-hop algorithm for Stable Clustering (VMASC) in terms of packet delivery ratio (PDR) and throughput. The performance evaluation and comparison between the studied protocols shows that the VMASC is the best protocols regarding fast data transmission and link stability in VANETs. The validation of all results is done by the NS3 simulator.

Assessment of Drug Delivery Systems from Molecular Dynamic Perspective

In this study, we developed and simulated nano-drug delivery systems efficacy in compare to free drug prescription. Computational models can be utilized to accelerate experimental steps and control the experiments high cost. Molecular dynamics simulation (MDS), in particular NAMD was utilized to better understand the anti-cancer drug interaction with cell membrane model. Paclitaxel (PTX) and dipalmitoylphosphatidylcholine (DPPC) were selected for the drug molecule and as a natural phospholipid nanocarrier, respectively. This work focused on two important interaction parameters between molecules in terms of center of mass (COM) and van der Waals interaction energy. Furthermore, we compared the simulation results of the PTX interaction with the cell membrane and the interaction of DPPC as a nanocarrier loaded by the drug with the cell membrane. The molecular dynamic analysis resulted in low energy between the nanocarrier and the cell membrane as well as significant decrease of COM amount in the nanocarrier and the cell membrane system during the interaction. Thus, the drug vehicle showed notably better interaction with the cell membrane in compared to free drug interaction with the cell membrane.

Soil Moisture Control System: A Product Development Approach

In this work, we propose the concept and geometrical design of a soil moisture control system (SMCS) module by following the product development approach to develop an inexpensive, easy to use and quick to install product targeted towards agriculture practitioners. The module delivers water to the agricultural land efficiently by sensing the soil moisture and activating the delivery valve. We start with identifying the general needs of the potential customer. Then, based on customer needs we establish product specifications and identify important measuring quantities to evaluate our product. Keeping in mind the specifications, we develop various conceptual solutions of the product and select the best solution through concept screening and selection matrices. Then, we develop the product architecture by integrating the systems into the final product. In the end, the geometric design is done using human factors engineering concepts like heuristic analysis, task analysis, and human error reduction analysis. The result of human factors analysis reveals the remedies which should be applied while designing the geometry and software components of the product. We find that to design the best grip in terms of comfort and applied force, for a power-type grip, a grip-diameter of 35 mm is the most ideal.

Development of Active Learning Calculus Course for Biomedical Program

The paper reviews design and implementation of a Calculus Course required for the Biomedical Competency Based Program developed as a joint project between The University of Texas Rio Grande Valley, and the University of Texas’ Institute for Transformational Learning, from the theoretical perspective as presented in scholarly work on active learning, formative assessment, and on-line teaching. Following a four stage curriculum development process (objective, content, delivery, and assessment), and theoretical recommendations that guarantee effectiveness and efficiency of assessment in active learning, we discuss the practical recommendations on how to incorporate a strong formative assessment component to address disciplines’ needs, and students’ major needs. In design and implementation of this project, we used Constructivism and Stage-by-Stage Development of Mental Actions Theory recommendations.

Maternal and Child Health Care: A Study among the Rongmeis of Manipur, India

Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Risk Assessment for Aerial Package Delivery

Recent developments in unmanned aerial vehicles (UAVs) have begun to attract intense interest. UAVs started to use for many different applications from military to civilian use. Some online retailer and logistics companies are testing the UAV delivery. UAVs have great potentials to reduce cost and time of deliveries and responding to emergencies in a short time. Despite these great positive sides, just a few works have been done for routing of UAVs for package deliveries. As known, transportation of goods from one place to another may have many hazards on delivery route due to falling hazards that can be exemplified as ground objects or air obstacles. This situation refers to wide-range insurance concept. For this reason, deliveries that are made with drones get into the scope of shipping insurance. On the other hand, air traffic was taken into account in the absence of unmanned aerial vehicle. But now, it has been a reality for aerial fields. In this study, the main goal is to conduct risk analysis of package delivery services using drone, based on delivery routes.

The Impact of Leadership Style and Sense of Competence on the Performance of Post-Primary School Teachers in Oyo State, Nigeria

The not so pleasing state of the nation's quality of education has been a major area of research. Many researchers have looked into various aspects of the educational system and organizational structure in relation to the quality of service delivery of the staff members. However, there is paucity of research in areas relating to the sense of competence and commitment in relation to leadership styles. Against this backdrop, this study investigated the impact of leadership style and sense of competence on the performance of post-primary school teachers in Oyo state Nigeria. Data were generated across public secondary schools in the city using survey design method. Ibadan as a metropolis has eleven local government areas contained in it. A systematic random sampling technique of the eleven local government areas in Ibadan was done and five local government areas were selected. The selected local government areas are Akinyele, Ibadan North, Ibadan North-East, Ibadan South and Ibadan South-West. Data were obtained from a range of two – three public secondary schools selected in each of the local government areas mentioned above. Also, these secondary schools are a representation of the variations in the constructs under consideration across the Ibadan metropolis. Categorically, all secondary school teachers in Ibadan were clustered into selected schools in those found across the five local government areas. In all, a total of 272 questionnaires were administered to public secondary school teachers, while 241 were returned. Findings revealed that transformational leadership style makes room for job commitment when compared with transactional and laissez-faire leadership styles. Teachers with a high sense of competence are more likely to demonstrate more commitment to their job than others with low sense of competence. We recommend that, it is important an assessment is made of the leadership styles employed by principals and school administrators. This guides administrators and principals in to having a clear, comprehensive knowledge of the style they currently adopt in the management of the staff and the school as a whole; and know where to begin the adjustment process from. Also to make an impact on student achievement, being attentive to teachers’ levels of commitment may be an important aspect of leadership for school principals.

A Comparative Study on Fuzzy and Neuro-Fuzzy Enabled Cluster Based Routing Protocols for Wireless Sensor Networks

Dynamic Routing in Wireless Sensor Networks (WSNs) has played a significant task in research for the recent years. Energy consumption and data delivery in time are the major parameters with the usage of sensor nodes that are significant criteria for these networks. The location of sensor nodes must not be prearranged. Clustering in WSN is a key methodology which is used to enlarge the life-time of a sensor network. It consists of numerous real-time applications. The features of WSNs are minimized the consumption of energy. Soft computing techniques can be included to accomplish improved performance. This paper surveys the modern trends in routing enclose fuzzy logic and Neuro-fuzzy logic based on the clustering techniques and implements a comparative study of the numerous related methodologies.

Building the Professional Readiness of Graduates from Day One: An Empirical Approach to Curriculum Continuous Improvement

Industry employers require new graduates to bring with them a range of knowledge, skills and abilities which mean these new employees can immediately make valuable work contributions. These will be a combination of discipline and professional knowledge, skills and abilities which give graduates the technical capabilities to solve practical problems whilst interacting with a range of stakeholders. Underpinning the development of these disciplines and professional knowledge, skills and abilities, are “enabling” knowledge, skills and abilities which assist students to engage in learning. These are academic and learning skills which are essential to common starting points for both the learning process of students entering the course as well as forming the foundation for the fully developed graduate knowledge, skills and abilities. This paper reports on a project created to introduce and strengthen these enabling skills into the first semester of a Bachelor of Information Technology degree in an Australian polytechnic. The project uses an action research approach in the context of ongoing continuous improvement for the course to enhance the overall learning experience, learning sequencing, graduate outcomes, and most importantly, in the first semester, student engagement and retention. The focus of this is implementing the new curriculum in first semester subjects of the course with the aim of developing the “enabling” learning skills, such as literacy, research and numeracy based knowledge, skills and abilities (KSAs). The approach used for the introduction and embedding of these KSAs, (as both enablers of learning and to underpin graduate attribute development), is presented. Building on previous publications which reported different aspects of this longitudinal study, this paper recaps on the rationale for the curriculum redevelopment and then presents the quantitative findings of entering students’ reading literacy and numeracy knowledge and skills degree as well as their perceived research ability. The paper presents the methodology and findings for this stage of the research. Overall, the cohort exhibits mixed KSA levels in these areas, with a relatively low aggregated score. In addition, the paper describes the considerations for adjusting the design and delivery of the new subjects with a targeted learning experience, in response to the feedback gained through continuous monitoring. Such a strategy is aimed at accommodating the changing learning needs of the students and serves to support them towards achieving the enabling learning goals starting from day one of their higher education studies.