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.

Using “Eckel” Model to Measure Income Smoothing Practices: The Case of French Companies

Income smoothing represents an attempt on the part of the company's management to reduce variations in earnings through the manipulation of the accounting principles. In this study, we aimed to measure income smoothing practices in a sample of 30 French joint stock companies during the period (2007-2009), we used Dummy variables method and “ECKEL” model to measure income smoothing practices and Binomial test accourding to SPSS program, to confirm or refute our hypothesis. This study concluded that there are no significant statistical indicators of income smoothing practices in the sample studied of French companies during the period (2007-2009), so the income series in the same sample studied of is characterized by stability and non-volatility without any intervention of management through accounting manipulation. However, this type of accounting manipulation should be taken into account and efforts should be made by control bodies to apply Eckel model and generalize its use at the global level.

Designing a Pre-Assessment Tool to Support the Achievement of Green Building Certifications

The impact of common buildings on climate and environment has prompted people to get involved in the green building standards aimed at implementing rating tools or certifications. Thus, green building rating systems were introduced to the construction industry, and the demand for certified green buildings has increased gradually and succeeded considerably in enhancing people’s environmental awareness. However, the existing certification process has been unsatisfactory in attracting stakeholders and/or professionals who are actively engaged in adopting a rating system. It is because they have faced recurring barriers regarding limited information in understanding the rating process, time-consuming procedures and higher costs, which have a direct influence on pursuing green building rating systems. To promote the achievement of green building certifications within the building industry more successfully, this paper aims at designing a Pre-Assessment Tool (PAT) framework that can help stakeholders and/or professionals engaged in the construction industry to clarify their basic knowledge, timeframe and extra costs needed to activate a green building certification. First, taking the first steps towards the rating tool seems to be complicated because of upfront commitment to understanding the overall rating procedure is required. This conceptual PAT framework can increase basic knowledge of the rating tool and the certification process, mainly in terms of all resources or information of each credit requirements. Second, the assessment process of rating tools is generally known as a “lengthy and time-consuming system”, contributing to unenthusiastic reactions concerning green building projects. The proposed framework can predict the timeframe needed to identify how long it will take for a green project to process each credit requirement and the documentation required from the beginning of the certification process to final approval. Finally, most people often have the initial perception that pursuing green building certification costs more than constructing a non-green building, which makes it more difficult to execute rating tools. To overcome this issue, this PAT will help users to estimate the extra expenses such as certification fees and third-party contributions based on the track of the amount of time it takes to implement the rating tool throughout all the related stages. Also, it can prevent unexpected or hidden costs occurring in the process of assessment. Therefore, this proposed PAT framework can be recommended as an effective method to support the decision-making of inexperienced users and play an important role in promoting green building certification.

Using TRACE and SNAP Codes to Establish the Model of Maanshan PWR for SBO Accident

In this research, TRACE code with the interface code-SNAP was used to simulate and analyze the SBO (station blackout) accident which occurred in Maanshan PWR (pressurized water reactor) nuclear power plant (NPP). There are four main steps in this research. First, the SBO accident data of Maanshan NPP were collected. Second, the TRACE/SNAP model of Maanshan NPP was established by using these data. Third, this TRACE/SNAP model was used to perform the simulation and analysis of SBO accident. Finally, the simulation and analysis of SBO with mitigation equipments was performed. The analysis results of TRACE are consistent with the data of Maanshan NPP. The mitigation equipments of Maanshan can maintain the safety of Maanshan in the SBO according to the TRACE predictions.

Using RASCAL Code to Analyze the Postulated UF6 Fire Accident

In this research, the RASCAL code was used to simulate and analyze the postulated UF6 fire accident which may occur in the Institute of Nuclear Energy Research (INER). There are four main steps in this research. In the first step, the UF6 data of INER were collected. In the second step, the RASCAL analysis methodology and model was established by using these data. Third, this RASCAL model was used to perform the simulation and analysis of the postulated UF6 fire accident. Three cases were simulated and analyzed in this step. Finally, the analysis results of RASCAL were compared with the hazardous levels of the chemicals. According to the compared results of three cases, Case 3 has the maximum danger in human health.

Composite Kernels for Public Emotion Recognition from Twitter

The Internet has grown into a powerful medium for information dispersion and social interaction that leads to a rapid growth of social media which allows users to easily post their emotions and perspectives regarding certain topics online. Our research aims at using natural language processing and text mining techniques to explore the public emotions expressed on Twitter by analyzing the sentiment behind tweets. In this paper, we propose a composite kernel method that integrates tree kernel with the linear kernel to simultaneously exploit both the tree representation and the distributed emotion keyword representation to analyze the syntactic and content information in tweets. The experiment results demonstrate that our method can effectively detect public emotion of tweets while outperforming the other compared methods.

Dead Bodies that Matter: A Consensual Qualitative Research on the Lived Experience of Embalmers

Embalmers are widely recognized as someone who mends the cadavers, but behind that is a great deal of work. These professionals are competent in physiology, chemicals, and cosmetics. Another is that such professionals face cadavers day-to-day. Given this background, the researchers intended to find out the lived experience of embalmers. The purpose of the present study is to discover the essence of the work of these professionals, to determine factors that influence their work, the depths of their life and on how the occupation affects upon physical, emotional-mental, spiritual, moral and social aspects. The researchers used the Consensual Qualitative Research, and eight embalmers, seven male and one female, from Manila and Bulacan were interviewed using open-ended questions and were used to triangulate the results. A primary research team conducted the consensus of domains, and an external auditor reviewed the results. A personal data sheet was also used, this helped the researchers group the respondents according to demographic profile. The results of the consensual qualitative research investigation revealed the four core components of the lived experience of embalmers which are motivation, struggles, acceptance, and contentment. The results revealed core components that play an important role in their everyday lives as an embalmer, daily hardships, and source of their pleasures. The present study will help future researchers, embalmers, and society.

Multimodal Database of Emotional Speech, Video and Gestures

People express emotions through different modalities. Integration of verbal and non-verbal communication channels creates a system in which the message is easier to understand. Expanding the focus to several expression forms can facilitate research on emotion recognition as well as human-machine interaction. In this article, the authors present a Polish emotional database composed of three modalities: facial expressions, body movement and gestures, and speech. The corpora contains recordings registered in studio conditions, acted out by 16 professional actors (8 male and 8 female). The data is labeled with six basic emotions categories, according to Ekman’s emotion categories. To check the quality of performance, all recordings are evaluated by experts and volunteers. The database is available to academic community and might be useful in the study on audio-visual emotion recognition.

Interaction of between Cd and Zn in Barley (Hordeum vulgare L.) Plant for Phytoextraction Method

The aim of this research is to remediation of the cadmium (Cd) pollution in agricultural soils by using barley (Hordeum vulgare L.) plant. For this purpose, a pot experiment was done in greenhouse conditions. Cadmium (100 mg/kg) as CdSO4.8H2O forms was applied to each pot and incubated during 30 days. Then Ethylenediamine tetraacetic acid (EDTA) chelate was applied to each pot at five doses (0, 3, 6, 8 and 10 mmol/kg) 20 days before harvesting time of the barley plants. The plants were harvested after two months planting. According to the pot experiment results, Cd and Zn amounts of barley plant increased with increasing EDTA application and Zn and Cd contents of barley 20,13 and 1,35 mg/kg for 0 mmol /kg EDTA; 58,61 and 113,24 mg/kg for 10 mmol/kg EDTA doses, respectively. On the other hand, Cd and Zn concentrations of experiment soil increased with EDTA application to the soil samples. Zinc and Cd concentrations of soil 0,31 and 0,021 mg/kg for 0 mmol /kg EDTA; 2,39 and 67,40 mg/kg for 10 mmol/kg EDTA doses, respectively. These increases were found to be statistically significant at the level of 1 %. According to the results of the pot experiment, some heavy metal especially Cd pollution of barley (Hordeum vulgare L.) plant province can be remediated by the phytoextraction method.

Financial Burden of Family for the Children with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p

Methodology for Developing an Intelligent Tutoring System Based on Marzano’s Taxonomy

The Mexican educational system faces diverse challenges related with the quality and coverage of education. The development of Intelligent Tutoring Systems (ITS) may help to solve some of them by helping teachers to customize their classes according to the performance of the students in online courses. In this work, we propose the adaptation of a functional ITS based on Bloom’s taxonomy called Sistema de Apoyo Generalizado para la Enseñanza Individualizada (SAGE), to measure student’s metacognition and their emotional response based on Marzano’s taxonomy. The students and the system will share the control over the advance in the course, so they can improve their metacognitive skills. The system will not allow students to get access to subjects not mastered yet. The interaction between the system and the student will be implemented through Natural Language Processing techniques, thus avoiding the use of sensors to evaluate student’s response. The teacher will evaluate student’s knowledge utilization, which is equivalent to the last cognitive level in Marzano’s taxonomy.

Developing an Instrument to Measure Teachers’ Self-Efficacy of Teaching Innovation Skills

There is a growing consensus that adoption of teachers’ self-efficacy measurement tools help to assess teachers’ abilities in specific areas in order to improve their skills. As a result, different instruments to assess teachers’ ability were developed by academics and practitioners. However, many of these instruments focused either on general teaching skills, or on the other hand, were very specific to one subject. As such, these instruments do not offer a tool to measure the ability of teachers in teaching 21st century skills such as innovation skills. Teaching innovation skills helps to prepare students for lives and careers in the 21st century. The purpose of this study is to develop an instrument measuring teachers’ self-efficacy of teaching innovation skills related to the classroom context and evaluating the teachers’ beliefs regarding their ability in teaching innovation skills. To reach this goal, the 16-item instrument measures four dimensions of innovation skills: creativity, critical thinking, communication, and collaboration. 211 secondary-school teachers filled out the survey to quantitatively analyze the quality of the instrument. The instrument’s reliability and item analysis were measured by using jMetrik. The results concluded that the mean of self-efficacy ranged from 3 to 3.6 without extreme high or low self-efficacy scores. The discrimination analysis revealed that one item recorded a negative correlation with the total, and three items recorded low correlation with the total. The reliabilities of items ranged from 0.64 to 0.69 and the instrument needed a couple of revisions before practical use. The study concluded the need to discard one item and revise five items to increase the quality of the instrument for future work.

Safety Climate Assessment and Its Impact on the Productivity of Construction Enterprises

Research background: Problems related to the occupational health and decreasing level of safety occur commonly in the construction industry. Important factor in the occupational safety in construction industry is scaffold use. All scaffolds used in construction, renovation, and demolition shall be erected, dismantled and maintained in accordance with safety procedure. Increasing demand for new construction projects unfortunately still is linked to high level of occupational accidents. Therefore, it is crucial to implement concrete actions while dealing with scaffolds and risk assessment in construction industry, the way on doing assessment and liability of assessment is critical for both construction workers and regulatory framework. Unfortunately, professionals, who tend to rely heavily on their own experience and knowledge when taking decisions regarding risk assessment, may show lack of reliability in checking the results of decisions taken. Purpose of the article: The aim was to indicate crucial parameters that could be modeling with Risk Assessment Model (RAM) use for improving both building enterprise productivity and/or developing potential and safety climate. The developed RAM could be a benefit for predicting high-risk construction activities and thus preventing accidents occurred based on a set of historical accident data. Methodology/Methods: A RAM has been developed for assessing risk levels as various construction process stages with various work trades impacting different spheres of enterprise activity. This project includes research carried out by teams of researchers on over 60 construction sites in Poland and Portugal, under which over 450 individual research cycles were carried out. The conducted research trials included variable conditions of employee exposure to harmful physical and chemical factors, variable levels of stress of employees and differences in behaviors and habits of staff. Genetic modeling tool has been used for developing the RAM. Findings and value added: Common types of trades, accidents, and accident causes have been explored, in addition to suitable risk assessment methods and criteria. We have found that the initial worker stress level is more direct predictor for developing the unsafe chain leading to the accident rather than the workload, or concentration of harmful factors at the workplace or even training frequency and management involvement.

Preparation and Characterization of Maltodextrin Microcapsules Containing Walnut Green Husk Extract

In recent years, the field of natural antimicrobial and antioxidant compounds is one of the main research topics in the food industry. Application of agricultural residues is mainly cheap, and available resources are receiving increased attention. Walnut green husk is one of the agricultural residues that is considered as natural compounds with biological properties because of phenolic compounds. In this study, maltodextrin 10% was used for microencapsulation of walnut green husk extract. At first, the extract was examined to consider extraction yield, total phenolic compounds, and antioxidant activation. The results showed the extraction yield of 81.43%, total phenolic compounds of 3997 [mg GAE/100 g], antioxidant activity [DPPH] of 84.85% for walnut green husk extract. Antioxidant activity is about 75%-81% and by DPPH. At the next stage, microencapsulation was done by spry-drying method. The microencapsulation efficiency was 72%-79%. The results of SEM tests confirmed this microencapsulation process. In addition, microencapsulated and free extract was more effective on gram-positive bacteria’s rather than the gram-negative ones. According to the study, walnut green husk can be used as a cheap antioxidant and antimicrobial compounds due to sufficient value of phenolic compounds.

Consolidating Service Engineering Ontologies Building Service Ontology from SOA Modeling Language (SoaML)

As a term for characterizing a process of devising a service system, the term ‘service engineering’ is still regarded as an ‘open’ research challenge due to unspecified details and conflicting perspectives. This paper presents consolidated service engineering ontologies in collecting, specifying and defining relationship between components pertinent within the context of service engineering. The ontologies are built by way of literature surveys from the collected conceptual works by collating various concepts into an integrated ontology. Two ontologies are produced: general service ontology and software service ontology. The software-service ontology is drawn from the informatics domain, while the generalized ontology of a service system is built from both a business management and the information system perspective. The produced ontologies are verified by exercising conceptual operationalizations of the ontologies in adopting several service orientation features and service system patterns. The proposed ontologies are demonstrated to be sufficient to serve as a basis for a service engineering framework.

Analysis of Cooperative Learning Behavior Based on the Data of Students' Movement

The purpose of this paper is to analyze the cooperative learning behavior pattern based on the data of students' movement. The study firstly reviewed the cooperative learning theory and its research status, and briefly introduced the k-means clustering algorithm. Then, it used clustering algorithm and mathematical statistics theory to analyze the activity rhythm of individual student and groups in different functional areas, according to the movement data provided by 10 first-year graduate students. It also focused on the analysis of students' behavior in the learning area and explored the law of cooperative learning behavior. The research result showed that the cooperative learning behavior analysis method based on movement data proposed in this paper is feasible. From the results of data analysis, the characteristics of behavior of students and their cooperative learning behavior patterns could be found.

A Geographical Spatial Analysis on the Benefits of Using Wind Energy in Kuwait

Wind energy is associated with many geographical factors including wind speed, climate change, surface topography, environmental impacts, and several economic factors, most notably the advancement of wind technology and energy prices. It is the fastest-growing and least economically expensive method for generating electricity. Wind energy generation is directly related to the characteristics of spatial wind. Therefore, the feasibility study for the wind energy conversion system is based on the value of the energy obtained relative to the initial investment and the cost of operation and maintenance. In Kuwait, wind energy is an appropriate choice as a source of energy generation. It can be used in groundwater extraction in agricultural areas such as Al-Abdali in the north and Al-Wafra in the south, or in fresh and brackish groundwater fields or remote and isolated locations such as border areas and projects away from conventional power electricity services, to take advantage of alternative energy, reduce pollutants, and reduce energy production costs. The study covers the State of Kuwait with an exception of metropolitan area. Climatic data were attained through the readings of eight distributed monitoring stations affiliated with Kuwait Institute for Scientific Research (KISR). The data were used to assess the daily, monthly, quarterly, and annual available wind energy accessible for utilization. The researchers applied the Suitability Model to analyze the study by using the ArcGIS program. It is a model of spatial analysis that compares more than one location based on grading weights to choose the most suitable one. The study criteria are: the average annual wind speed, land use, topography of land, distance from the main road networks, urban areas. According to the previous criteria, the four proposed locations to establish wind farm projects are selected based on the weights of the degree of suitability (excellent, good, average, and poor). The percentage of areas that represents the most suitable locations with an excellent rank (4) is 8% of Kuwait’s area. It is relatively distributed as follows: Al-Shqaya, Al-Dabdeba, Al-Salmi (5.22%), Al-Abdali (1.22%), Umm al-Hayman (0.70%), North Wafra and Al-Shaqeeq (0.86%). The study recommends to decision-makers to consider the proposed location (No.1), (Al-Shqaya, Al-Dabdaba, and Al-Salmi) as the most suitable location for future development of wind farms in Kuwait, this location is economically feasible.

Innovating and Disrupting Higher Education: The Evolution of Massive Open Online Courses

A great deal has been written on Massive Open Online Courses (MOOCs) since 2012 (considered by some as the year of the MOOCs). The emergence of MOOCs caused a great deal of interest amongst academics and technology experts as well as ordinary people. Some of the authors who wrote on MOOCs perceived it as the next big thing that will disrupt education. Other authors saw it as another fad that will go away once it ran its course (as most fads often do). But MOOCs did not turn out to be a fad and it is still around. Most importantly, they evolved into something that is beginning to look like a viable business model. This paper explores this phenomenon within the theoretical frameworks of disruptive innovations and jobs to be done as developed by Clayton Christensen and his colleagues and its implications for the future of higher education (HE).

Experimental Study on Recycled Aggregate Pervious Concrete

Concrete is the most widely used building material in the world. At the same time, the world produces a large amount of construction waste each year. Waste concrete is processed and treated, and the recycled aggregate is used to make pervious concrete, which enables the construction waste to be recycled. Pervious concrete has many advantages such as permeability to water, protection of water resources, and so on. This paper tests the recycled aggregate obtained by crushing high-strength waste concrete (TOU) and low-strength waste concrete (PU), and analyzes the effect of porosity, amount of cement, mineral admixture and recycled aggregate on the strength of permeable concrete. The porosity is inversely proportional to the strength, and the amount of cement used is proportional to the strength. The mineral admixture can effectively improve the workability of the mixture. The quality of recycled aggregates had a significant effect on strength. Compared with concrete using "PU" aggregates, the strength of 7d and 28d concrete using "TOU" aggregates increased by 69.0% and 73.3%, respectively. Therefore, the quality of recycled aggregates should be strictly controlled during production, and the mix ratio should be designed according to different use environments and usage requirements. This test prepared a recycled aggregate permeable concrete with a compressive strength of 35.8 MPa, which can be used for light load roads and provides a reference for engineering applications.