ParMooN - a modernized program package based on mapped finite elements

{\sc ParMooN} is a program package for the numerical solution of elliptic and parabolic partial differential equations. It inherits the distinct features of its predecessor {\sc MooNMD} \cite{JM04}: strict decoupling of geometry and finite element spaces, implementation of mapped finite elements as their definition can be found in textbooks, and a geometric multigrid preconditioner with the option to use different finite element spaces on different levels of the multigrid hierarchy. After having presented some thoughts about in-house research codes, this paper focuses on aspects of the parallelization for a distributed memory environment, which is the main novelty of {\sc ParMooN}. Numerical studies, performed on compute servers, assess the efficiency of the parallelized geometric multigrid preconditioner in comparison with some parallel solvers that are available in the library {\sc PETSc}. The results of these studies give a first indication whether the cumbersome implementation of the parallelized geometric multigrid method was worthwhile or not.Comment: partly supported by European Union (EU), Horizon 2020, Marie Sk{\l}odowska-Curie Innovative Training Networks (ITN-EID), MIMESIS, grant number 67571

Evaluation of Nutrition Surveys in Flood-affected Areas of Pakistan: Seeing the Unseen!

In 2010 Pakistan experienced the worst floods recorded in its history; millions of people were affected and thousands lost their lives. Nutrition assessment surveys led by UNICEF were conducted in flood?affected areas of Punjab and Sindh provinces to assess the nutrition status of children between 6–59 months while Aga Khan University (AKU) undertook a parallel assessment including micronutrient status in their project areas within Balochistan, Sindh and Punjab. Standardised Monitoring and Assessment of Relief and Transition (SMART) methodology was used. 881 children from Sindh, 1,143 from Punjab and 817 from AKU project areas were measured for anthropometry and their households were interviewed. The findings indicated that while immediate life?saving interventions were essential, there was also an urgent need to address chronic malnutrition. Through high?level dissemination of the survey results, treatment and prevention of malnutrition has become a priority for the provincial and federal government in Pakistan and for donors

ParMooN - a modernized program package based on mapped finite elements

PARMOON is a program package for the numerical solution of elliptic and parabolic partial differential equations. It inherits the distinct features of its predecessor MOONMD [28]: strict decoupling of geometry and finite element spaces, implementation of mapped finite elements as their definition can be found in textbooks, and a geometric multigrid preconditioner with the option to use different finite element spaces on different levels of the multigrid hierarchy. After having presented some thoughts about in-house research codes, this paper focuses on aspects of the parallelization, which is the main novelty of PARMOON. Numerical studies, performed on compute servers, assess the efficiency of the parallelized geometric multigrid preconditioner in comparison with parallel solvers that are available in external libraries. The results of these studies give a first indication whether the cumbersome implementation of the parallelized geometric multigrid method was worthwhile or not

Maternal Depression and Its Associated Factors among the Mothers at Narayanganj in Bangladesh

Maternal depression is becoming a serious public health concern in the world day by day. The purpose of the current study was to assess the maternal depression and its associated factors among the mothers of Narayanganj city in Bangladesh. A cross-sectional study was conducted in six different areas at Narayanganj in Dhaka among 377 mothers having children of five to ten years between the periods of May, 2019 to September, 2019. The respondents were selected by simple random sampling method. All data analysis was done by using IBM SPSS version 20.0. The mean age of the pregnant women was 26±4 years. It was found that about 77% of mothers had high depressive symptoms whereas 10.7%, 6.63% and 6.36% of mothers had moderate, mild and no depressive symptoms, respectively.  It was observed that family income, family size, age of children and age at marriage were significantly (p<0.05) associated with maternal depression status. Further investigations might be carried out to assess the effect size of the associated factors mentioned above. Keywords: Maternal depression, mothers, children, associated factors. DOI: 10.7176/JHMN/102-06 Publication date:September 30th 2022

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Tribological and aerosol mechanics aspects of oil mist lubrication

Vita.The tribological performance of the oil mist lubrication has been evaluated. A ten bearing censored group endurance was conducted to evaluated the influence of oil mist lubrication on the life of rolling element bearings as compared to conventional oil sump lubrication. It has been found that the oil mist lubrication provides better fatigue and wear protection to the bearings compared to the conventional sump lubrication, under identical operating conditions. The performance of the test bearings were also monitored for the oil mist and oil sump lubrication for prolonged periods of time operating under identical conditions. The test bearings with oil mist lubrication operated cooler (about 10° C) and with less friction (about 25%) compared to the conventional oil sump lubrication. It has also been found that oil mist (under the test conditions) formed and maintained a carbonaceous solid lubricating layer on the operating surfaces of bearings. The basic operating principles (aerosol aspects) of the oil mist lubrication system have been investigated for the first time. The study included the penetration of oil mist in the supply line, reclassification of oil mist and deposition of oil mist in bearings. The results indicate that there is room for improvements in the basic operation of the oil mist lubrication system. The results should form a basis for improving the system to provide the best possible protection to bearing surfaces with the least amount of oil and stray mist

Tribological and aerosol mechanics aspects of oil mist lubrication

Vita.The tribological performance of the oil mist lubrication has been evaluated. A ten bearing censored group endurance was conducted to evaluated the influence of oil mist lubrication on the life of rolling element bearings as compared to conventional oil sump lubrication. It has been found that the oil mist lubrication provides better fatigue and wear protection to the bearings compared to the conventional sump lubrication, under identical operating conditions. The performance of the test bearings were also monitored for the oil mist and oil sump lubrication for prolonged periods of time operating under identical conditions. The test bearings with oil mist lubrication operated cooler (about 10° C) and with less friction (about 25%) compared to the conventional oil sump lubrication. It has also been found that oil mist (under the test conditions) formed and maintained a carbonaceous solid lubricating layer on the operating surfaces of bearings. The basic operating principles (aerosol aspects) of the oil mist lubrication system have been investigated for the first time. The study included the penetration of oil mist in the supply line, reclassification of oil mist and deposition of oil mist in bearings. The results indicate that there is room for improvements in the basic operation of the oil mist lubrication system. The results should form a basis for improving the system to provide the best possible protection to bearing surfaces with the least amount of oil and stray mist

Design, fabrication and testing of a bearing test rig and preliminary studies on oil mist lubrication

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Effect of tramadol on extubation response and quality of emergence following Supratentorial surgery: a randomised controlled trial

Objectives: To observe the effect of a single dose of tramadol 1mg/kg on haemodynamic changes related to extubation, and to assess the quality of emergence as judged by incidence of cough, laryngospasm and bronchospasm. Method: The double-blind randomised controlled trial was conducted at the Department of Anaesthesiology, Aga Khan University Hospital, Karachi, from 2016 to 2017, and comprised patients of either gender aged 18-65 years scheduled for elective supratentorial craniotomy under general anaesthesia. The patients were randomised to two Tramadol and Saline groups. The drug was given 45 minutes before extubation at the time of dura closure. The patients were extubated after resumption of adequate spontaneous breathing. Invasive blood pressure and heart rate were recorded one minute before reversal, at 1 minute interval for five minutes and then every 10 minute for 30 minutes after extubation. Cough, laryngospasm and bronchospasm were noted. Pain, post-operative nausea, vomiting, convulsions and conscious levels were also noted till 6 hours post-operatively. Data was analysed using SPSS 19. Results: Of the 80 patients enrolled, 79(98.75%) completed the study. Of them, 38(48%) were in the Tramadol group; 27(71.1%) males and 11(28.9%) females with a mean age of 43.42+/-13.2 years. The remaining 41(52%) patients were in the Saline group; 28(68.3%) males and 13(31.7%) females with a mean age of 45.9+/-15.9 years. Intergroup comparison showed no significant difference in the extubation response (p>0.05), but the changes in blood pressure and heart rate were shorter in magnitude and duration in the Tramadol group compared to the baseline. Significant rise in blood pressure and heart rate was observed in the Saline group at 5 minutes after extubation (p=0.046). There was no difference in the quality of emergence as judged by cough or secondary complications (p>0.05). Conclusion: Tramadol 1mg/kg was considered superior in attenuating the duration and magnitude of haemodynamic response in the shape of hypertension and tachycardia during extubation, but did not affect other parameters in patients undergoing craniotomy. Clinical Trial Number: Clinical Trials.gov PRS: NCT02964416 https://clinicaltrials.gov/ct2/show/NCT02964416 Key Words: Craniotomy, Endotracheal extubation, Haemodynamics, Opioid, Cough