Search results for: financial risk tolerance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8716

Search results for: financial risk tolerance

5386 Bone Mineral Density in Type 2 Diabetes Mellitus Postmenopausal Egyptian Female Patients: Correlation with Fetuin-A Level and Metabolic Parameters

Authors: Ahmed A. M. Shoaib, Heba A. Esaily, Mahmoud M. Emara, Eman A. E. Badr, Amany S. Khalifa, Mayada M. M., Abdel-Raizk

Abstract:

Background: DM is associated with metabolic bone diseases, osteoporosis, low-impact fractures and falls in geriatrics. Fetuin-A, which is a serum protein produced by the liver and promotes bone mineralization, is an independent risk factor for type 2 diabetes. Aim: Evaluation of fetuin-A level and bone mineral density in postmenopausal Egyptian female patients with type 2 diabetes mellitus and their correlation with each other & with other metabolic parameters. Patients and methods: Seventy postmenopausal female patients with type II diabetes and thirty postmenopausal female as control were included in this study. Measurement of Fetuin-A together with metabolic parameters and DXA in wrist, hip and spine, ALP, CBC, FBS, PP2H and HBA1c was done in all participants. Results: - Fetuin-A level was found to be highly significant (p< 0.001) between diabetic and nondiabetic groups and negatively correlated with BMD in spine. No difference in BMD was found between patients and control groups while significant negative correlation was found between FBS and hip BMD (<0.05) and between 2hpp and HBA1c with spine BMD in the diabetic group (<0.05). Osteoporosis represented 12.9% in spine area and 7.2% in hip and wrist areas in diabetic patients, while osteopenia were found in 58.5%, 57.1%, and 37.1% in diabetic patients in spine, wrist, and hip respectively. Conclusion: - type II diabetes cannot be considered as a risk factor for osteoporosis; while glycemic parameters (FBS, 2hpp & HBA1c) and serum Fetuin-A levels were correlated with BMD in diabetics. Good glycemic control can be protective against osteoporosis in diabetic elderly.

Keywords: fetuin-A, BMD, postmenopausal, DM type II

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5385 Evaluating the Use of Manned and Unmanned Aerial Vehicles in Strategic Offensive Tasks

Authors: Yildiray Korkmaz, Mehmet Aksoy

Abstract:

In today's operations, countries want to reach their aims in the shortest way due to economical, political and humanitarian aspects. The most effective way of achieving this goal is to be able to penetrate strategic targets. Strategic targets are generally located deep inside of the countries and are defended by modern and efficient surface to air missiles (SAM) platforms which are operated as integrated with Intelligence, Surveillance and Reconnaissance (ISR) systems. On the other hand, these high valued targets are buried deep underground and hardened with strong materials against attacks. Therefore, to penetrate these targets requires very detailed intelligence. This intelligence process should include a wide range that is from weaponry to threat assessment. Accordingly, the framework of the attack package will be determined. This mission package has to execute missions in a high threat environment. The way to minimize the risk which depends on loss of life is to use packages which are formed by UAVs. However, some limitations arising from the characteristics of UAVs restricts the performance of the mission package consisted of UAVs. So, the mission package should be formed with UAVs under the leadership of a fifth generation manned aircraft. Thus, we can minimize the limitations, easily penetrate in the deep inside of the enemy territory with minimum risk, make a decision according to ever-changing conditions and finally destroy the strategic targets. In this article, the strengthens and weakness aspects of UAVs are examined by SWOT analysis. And also, it revealed features of a mission package and presented as an example what kind of a mission package we should form in order to get marginal benefit and penetrate into strategic targets with the development of autonomous mission execution capability in the near future.

Keywords: UAV, autonomy, mission package, strategic attack, mission planning

Procedia PDF Downloads 537
5384 Awareness on Department of Education’s Disaster Risk Reduction Management Program at Oriental Mindoro National High School: Basis for Support School DRRM Program

Authors: Nimrod Bantigue

Abstract:

The Department of Education is continuously providing safe teaching-learning facilities and hazard-free environments to the learners. To achieve this goal, teachers’ awareness of DepEd’s DRRM programs and activities is extremely important; thus, this descriptive correlational quantitative study was conceptualized. This research answered four questions on the profile and level of awareness of the 153 teacher respondents of Oriental Mindoro National High School for the academic year 2018-2019. Stratified proportional sampling was employed, and both descriptive and inferential statistics were utilized to treat data. The findings revealed that the majority of the teachers at OMNHS are female and are in the age bracket of 20-40. Most are married and pursue graduate studies. They have moderate awareness of the Department of Education’s DRRM programs and activities in terms of assessment of risks activities, planning activities, implementation activities during disaster and evaluation and monitoring activities with 3.32, 3.12, 3.40 and 3.31 as computed means, respectively. Further, the result showed a significant relationship between the profile of the respondents such as age, civil status and educational attainment and the level of awareness. On the contrary, sex does not have a significant relationship with the level of awareness. The Support School DRRM program with Utilization Guide on School DRRM Manual was proposed to increase, improve and strengthen the weakest areas of awareness rated in each DRRM activity, such as assessment of risks, planning, and implementation during disasters and monitoring and evaluation.

Keywords: awareness, management, monitoring, risk reduction

Procedia PDF Downloads 202
5383 Flood Devastation Assessment Through Mapping in Nigeria-2022 using Geospatial Techniques

Authors: Hafiz Muhammad Tayyab Bhatti, Munazza Usmani

Abstract:

One of nature's most destructive occurrences, floods do immense damage to communities and economic losses. Nigeria country, specifically southern Nigeria, is known for being prone to flooding. Even though periodic flooding occurs in Nigeria frequently, the floods of 2022 were the worst since those in 2012. Flood vulnerability analysis and mapping are still lacking in this region due to the very limited historical hydrological measurements and surveys on the effects of floods, which makes it difficult to develop and put into practice efficient flood protection measures. Remote sensing and Geographic Information Systems (GIS) are useful approaches to detecting, determining, and estimating the flood extent and its impacts. In this study, NOAA VIIR has been used to extract the flood extent using the flood water fraction data and afterward fused with GIS data for some zonal statistical analysis. The estimated possible flooding areas are validated using satellite imagery from the Moderate Resolution Imaging Spectroradiometer (MODIS). The goal is to map and studied flood extent, flood hazards, and their effects on the population, schools, and health facilities for each state of Nigeria. The resulting flood hazard maps show areas with high-risk levels clearly and serve as an important reference for planning and implementing future flood mitigation and control strategies. Overall, the study demonstrated the viability of using the chosen GIS and remote sensing approaches to detect possible risk regions to secure local populations and enhance disaster response capabilities during natural disasters.

Keywords: flood hazards, remote sensing, damage assessment, GIS, geospatial analysis

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5382 Evaluation of Surgical Site Infection in Bile Spillage Cases Compared to Non Bile Spillage Cases Following Laparoscopic Cholecystectomy

Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

Abstract:

Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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5381 Needs for Primary Prevention in Families with Mentally Ill Parents

Authors: Patricia Wahl, Dirk Bruland, Albert Lenz

Abstract:

Children of mentally ill parents are a large high risk group for mental disorders which is hardly reached by preventive programs. The children inherit a heightened risk to develop a mental disorder themselves during their lifetime, but they and their parents are often rejecting to seek help. To elicit the factors determining this prevention dilemma, an explorative qualitative interview study is conducted in 25 families with mentally ill parents and yet unaffected children. Inclusion criteria are the children’s age (7 to 14 years old) and that these children live together with the affected parent. With regard to the concept of Mental Health Literacy the following research questions are leading the Qualitative Content Analysis: What are the needs of families with mentally ill parents? How can their help-seeking behaviour be described? What are their subjective illness theories? And which influences do gender, ethnicity and socio-economic status have on needs, help-seeking and illness theories? Mental Health Literacy relates to the knowledge and attitudes towards mental disorders influencing the recognition, management or prevention of these disorders. The concept seems to be an interesting starting point for our analysis with the aim to understand antecedences and processes in the families more deeply. Results of an extensive literature review serve as deductive framework for our analysis, first findings from the interviews will be available up to the time of the conference and can be presented. They hopefully will give inside in the families’ living environment and help to adapt/develop interventions and in the long term reduce health inequalities. The project at hand is part of the Health Literacy in Childhood and Adolescence (HLCA) Research Consortium financed by the German Federal Ministry of Education and Research (BMBF).

Keywords: children of mentally ill parents, help-seeking behaviour, mental health literacy, prevention dilemma

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5380 Prevalence of Human Papillomavirus in Squamous Intraepithelial Lesions and Cervical Cancer in Women of the North of Chihuahua, Mexico

Authors: Estefania Ponce-Amaya, Ana Lidia Arellano-Ortiz, Cecilia Diaz-Hernandez, Jose Alberto Lopez-Diaz, Antonio De La Mora-Covarrubias, Claudia Lucia Vargas-Requena, Mauricio Salcedo-Vargas, Florinda Jimenez-Vega

Abstract:

Cervical Cancer (CC) is the second leading cause of death among women worldwide and it had been associated with a persistent infection of human papillomavirus (HPV). The goal of the current study was to identify the prevalence of HPV infection in women with abnormal Pap smear who were attended at Dysplasia Clinic of Ciudad Juarez, Mexico. Methods: Cervical samples from 146 patients, who attended the Colposcopy Clinic at Sanitary Jurisdiction II of Cd Juarez, were collected for histopathology and molecular study. DNA was isolated for the HPV detection by Polymerase Chain Reaction (PCR) using MY09/011 and GP5/6 primers. The associated risk factors were assessed by a questionnaire. The statistical analysis was performed by ANOVA, using EpiINFO V7 software. Results: HPV infection was present in 142 patients (97.3 %). The prevalence of HPV infection was distributed in a 96% of all evaluated groups, low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HISIL) and CC. We found a statistical significance (α = <0.05) between gestation and number of births as risk factors. The median values showed an ascending tend according with the lesion progression. However, CC showed a statistically significant difference with respect to the pre-carcinogenic stages. Conclusions: In these Mexican patients exists a high prevalence of HPV infection, and for that reason, we are studying the most prevalent HPV genotypes in this population.

Keywords: cervical cancer, HPV, prevalence hpv, squamous intraepithelial lesion

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5379 The Effects of Root Zone Supply of Aluminium on Vegetative Growth of 15 Groundnut Cultivars Grown in Solution Culture

Authors: Mosima M. Mabitsela

Abstract:

Groundnut is preferably grown on light textured soils. Most of these light textured soils tend to be highly weathered and characterized by high soil acidity and low nutrient status. One major soil factor associated with infertility of acidic soils that can negatively depress groundnut yield is aluminium (Al) toxicity. In plants Al toxicity damages root cells, leading to inhibition of root growth as a result of the suppression of cell division, cell elongation and cell expansion in the apical meristem cells of the root. The end result is that roots become stunted and brittle, root hair development is poor, and the root apices become swollen. This study was conducted to determine the effects of aluminium (Al) toxicity on a range of groundnut varieties. Fifteen cultivars were tested in incremental aluminum (Al) supply in an ebb and flow solution culture laid out in a randomized complete block design. There were six aluminium (Al) treatments viz. 0 µM, 1 µM, 5.7 µM, 14.14 µM, 53.18 µM, and 200 µM. At 1 µM there was no inhibitory effect on the growth of groundnut. The inhibition of groundnut growth was noticeable from 5.7 µM to 200 µM, where the severe effect of aluminium (Al) stress was observed at 200 µM. The cultivars varied in their response to aluminium (Al) supply in solution culture. Groundnuts are one of the most important food crops in the world, and its supply is on a decline due to the light-textured soils that they thrive under as these soils are acidic and can easily solubilize aluminium (Al) to its toxic form. Consequently, there is a need to develop groundnut cultivars with high tolerance to soil acidity.

Keywords: aluminium toxicity, cultivars, reduction, root growth

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5378 Female Entrepreneurship in the Creative Industry: The Antecedents of Their Ventures' Performance

Authors: Naoum Mylonas, Eugenia Petridou

Abstract:

Objectives: The objectives of this research are firstly, to develop an integrated model of predicting factors to new ventures performance, taking into account certain issues and specificities related to creative industry and female entrepreneurship based on the prior research; secondly, to determine the appropriate measures of venture performance in a creative industry context, drawing upon previous surveys; thirdly, to illustrate the importance of entrepreneurial orientation, networking ties, environment dynamism and access to financial capital on new ventures performance. Prior Work: An extant review of the creative industry literature highlights the special nature of entrepreneurship in this field. Entrepreneurs in creative industry share certain specific characteristics and intensions, such as to produce something aesthetic, to enrich their talents and their creativity, and to combine their entrepreneurial with their artistic orientation. Thus, assessing venture performance and success in creative industry entails an examination of how creative people or artists conceptualize success. Moreover, female entrepreneurs manifest more positive attitudes towards sectors primarily based on creativity, rather than innovation in which males outbalance. As creative industry entrepreneurship based mainly on the creative personality of the creator / artist, a high interest is accrued to examine female entrepreneurship in the creative industry. Hypotheses development: H1a: Female entrepreneurs who are more entrepreneurially-oriented show a higher financial performance. H1b: Female entrepreneurs who are more artistically-oriented show a higher creative performance. H2: Female entrepreneurs who have personality that is more creative perform better. H3: Female entrepreneurs who participate in or belong to networks perform better. H4: Female entrepreneurs who have been consulted by a mentor perform better. Η5a: Female entrepreneurs who are motivated more by pull-factors perform better. H5b: Female entrepreneurs who are motivated more by push-factors perform worse. Approach: A mixed method triangulation design has been adopted for the collection and analysis of data. The data are collected through a structured questionnaire for the quantitative part and through semi-structured interviews for the qualitative part as well. The sample is 293 Greek female entrepreneurs in the creative industry. Main findings: All research hypotheses are accepted. The majority of creative industry entrepreneurs evaluate themselves in creative performance terms rather than financial ones. The individuals who are closely related to traditional arts sectors have no EO but also evaluate themselves highly in terms of venture performance. Creative personality of creators is appeared as the most important predictor of venture performance. Pull factors in accordance with our hypothesis lead to higher levels of performance compared to push factors. Networking and mentoring are viewed as very important, particularly now during the turbulent economic environment in Greece. Implications-Value: Our research provides an integrated model with several moderating variables to predict ventures performance in the creative industry, taking also into account the complicated nature of arts and the way artists and creators define success. At the end, the findings may be used for the appropriate design of educational programs in creative industry entrepreneurship. This research has been co-financed by the European Union (European Social Fund – ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF) - Research Funding Program: Heracleitus II. Investing in knowledge society through the European Social Fund.

Keywords: venture performance, female entrepreneurship, creative industry, networks

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5377 Characterization and Selection of Phosphorus Deficiency Tolerant Genotypes in Nigeria Based on Morpho-Physiologic Traits

Authors: Umego Chukwudi T., Ntui Valentine O., Uyoh Edak A.

Abstract:

Phosphorus (P) deficiency has been identified as a major hindrance to rice production the world over. Eleven (11) rice genotypes predominantly used by local farmers in Nigeria were studied for their responses to P deficient conditions. The characterization was based on morpho-physiologic parameters. The genotypes were screened using a hydroponic system in a modified Hoagland’s solution. Morphological and physiologic parameters, including Plant height (PH), number of tillers per plant, shoot dry weight (SDW), shoot phosphate concentration (SPC), and chlorophyll content, were recorded after exposure to three levels of phosphate concentration (0µM, 400 µM, and 800 µM). The data obtained were subjected to analysis of variance (ANOVA), and the means were separated using least significance difference tests. The results obtained showed that P starvation caused a significant (p≤0.05) reduction in PH, SDW, and tillering and also triggered a significant (p≤0.05) increase in root length among the genotypes. The Pearsons correlation coefficient was used to estimate the relationships among studied parameters, and a significant negative correlation was observed between plant height and root length. FARO63 was identified as a highly tolerant genotype to P deficiency with a low (0.24) SPC and higher (4.81) phosphate utilization efficiency (PUE). This study has identified FARO63 as a true tolerant genotype to Phosphate deficiency, which will be useful in breeding for phosphate deficiency tolerance in rice and thus combating food insecurity.

Keywords: phosphate deficiency, rice genotypes, hydroponic system, food security

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5376 Dosimetric Comparison among Different Head and Neck Radiotherapy Techniques Using PRESAGE™ Dosimeter

Authors: Jalil ur Rehman, Ramesh C. Tailor, Muhammad Isa Khan, Jahnzeeb Ashraf, Muhammad Afzal, Geofferry S. Ibbott

Abstract:

Purpose: The purpose of this analysis was to investigate dose distribution of different techniques (3D-CRT, IMRT and VMAT) of head and neck cancer using 3-dimensional dosimeter called PRESAGETM Dosimeter. Materials and Methods: Computer tomography (CT) scans of radiological physics center (RPC) head and neck anthropomorphic phantom with both RPC standard insert and PRESAGETM insert were acquired separated with Philipp’s CT scanner and both CT scans were exported via DICOM to the Pinnacle version 9.4 treatment planning system (TPS). Each plan was delivered twice to the RPC phantom first containing the RPC standard insert having TLD and film dosimeters and then again containing the Presage insert having 3-D dosimeter (PRESAGETM) by using a Varian True Beam linear accelerator. After irradiation, the standard insert including point dose measurements (TLD) and planar Gafchromic® EBT film measurement were read using RPC standard procedure. The 3D dose distribution from PRESAGETM was read out with the Duke Midsized optical scanner dedicated to RPC (DMOS-RPC). Dose volume histogram (DVH), mean and maximal doses for organs at risk were calculated and compared among each head and neck technique. The prescription dose was same for all head and neck radiotherapy techniques which was 6.60 Gy/friction. Beam profile comparison and gamma analysis were used to quantify agreements among film measurement, PRESAGETM measurement and calculated dose distribution. Quality assurances of all plans were performed by using ArcCHECK method. Results: VMAT delivered the lowest mean and maximum doses to organ at risk (spinal cord, parotid) than IMRT and 3DCRT. Such dose distribution was verified by absolute dose distribution using thermoluminescent dosimeter (TLD) system. The central axial, sagittal and coronal planes were evaluated using 2D gamma map criteria(± 5%/3 mm) and results were 99.82% (axial), 99.78% (sagital), 98.38% (coronal) for VMAT plan and found the agreement between PRESAGE and pinnacle was better than IMRT and 3D-CRT plan excludes a 7 mm rim at the edge of the dosimeter. Profile showed good agreement for all plans between film, PRESAGE and pinnacle and 3D gamma was performed for PTV and OARs, VMAT and 3DCRT endow with better agreement than IMRT. Conclusion: VMAT delivered lowered mean and maximal doses to organs at risk and better PTV coverage during head and neck radiotherapy. TLD, EBT film and PRESAGETM dosimeters suggest that VMAT was better for the treatment of head and neck cancer than IMRT and 3D-CRT.

Keywords: RPC, 3DCRT, IMRT, VMAT, EBT2 film, TLD, PRESAGETM

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5375 Fatigue Crack Behaviour in a Residual Stress Field at Fillet Welds in Ship Structures

Authors: Anurag Niranjan, Michael Fitzpatrick, Yin Jin Janin, Jazeel Chukkan, Niall Smyth

Abstract:

Fillet welds are used in joining longitudinal stiffeners in ship structures. Welding residual stresses in fillet welds are generally distributed in a non-uniform manner, as shown in previous research the residual stress redistribution occurs under the cyclic loading that is experienced by such joints during service, and the combination of the initial residual stress, local constraints, and loading can alter the stress field in ways that are extremely difficult to predict. As the residual stress influences the crack propagation originating from the toe of the fillet welds, full understanding of the residual stress field and how it evolves is very important for structural integrity calculations. Knowledge of the residual stress redistribution in the presence of a flaw is therefore required for better fatigue life prediction. Moreover, defect assessment procedures such as BS7910 offer very limited guidance for flaw acceptance and the associated residual stress redistribution in the assessment of fillet welds. Therefore the objective of this work is to study a surface-breaking flaw at the weld toe region in a fillet weld under cyclic load, in conjunction with residual stress measurement at pre-defined crack depths. This work will provide details of residual stress redistribution under cyclic load in the presence of a crack. The outcome of this project will inform integrity assessment with respect to the treatment of residual stress in fillet welds. Knowledge of the residual stress evolution for this weld geometry will be greatly beneficial for flaw tolerance assessments (BS 7910, API 591).

Keywords: fillet weld, fatigue, residual stress, structure integrity

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5374 Capacity for Care: A Management Model for Increasing Animal Live Release Rates, Reducing Animal Intake and Euthanasia Rates in an Australian Open Admission Animal Shelter

Authors: Ann Enright

Abstract:

More than ever, animal shelters need to identify ways to reduce the number of animals entering shelter facilities and the incidence of euthanasia. Managing animal overpopulation using euthanasia can have detrimental health and emotional consequences for the shelter staff involved. There are also community expectations with moral and financial implications to consider. To achieve the goals of reducing animal intake and the incidence of euthanasia, shelter best practice involves combining programs, procedures and partnerships to increase live release rates (LRR), reduce the incidence of disease, length of stay (LOS) and shelter intake whilst overall remaining financially viable. Analysing daily processes, tracking outcomes and implementing simple strategies enabled shelter staff to more effectively focus their efforts and achieve amazing results. The objective of this retrospective study was to assess the effect of implementing the capacity for care (C4C) management model. Data focusing on the average daily number of animals on site for a two year period (2016 – 2017) was exported from a shelter management system, Customer Logic (CL) Vet to Excel for manipulation and comparison. Following the implementation of C4C practices the average daily number of animals on site was reduced by >50%, (2016 average 103 compared to 2017 average 49), average LOS reduced by 50% from 8 weeks to 4 weeks and incidence of disease reduced from ≥ 70% to less than 2% of the cats on site at the completion of the study. The total number of stray cats entering the shelter due to council contracts reduced by 50% (486 to 248). Improved cat outcomes were attributed to strategies that increased adoptions and reduced euthanasia of poorly socialized cats, including foster programs. To continue to achieve improvements in LRR and LOS, strategies to decrease intake further would be beneficial, for example, targeted sterilisation programs. In conclusion, the study highlighted the benefits of using C4C as a management tool, delivering a significant reduction in animal intake and euthanasia with positive emotional, financial and community outcomes.

Keywords: animal welfare, capacity for care, cat, euthanasia, length of stay, managed intake, shelter

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5373 Comparative Outcomes of Percutaneous Coronary Intervention in Smokers versus Non Nonsmokers Patients: Observational Studies

Authors: Pratima Tatke, Archana Avhad, Bhanu Duggal, Meeta Rajivlochan, Sujata Saunik, Pradip Vyas, Nidhi Pandey, Aditee Dalvi, Jyothi Subramanian

Abstract:

Background: Smoking is well established risk factor for the development and progression of coronary artery disease. It is strongly related to morbidity and mortality from cardiovascular causes. The aim of this study is to observe effect of smoking status on percutaneous coronary intervention(PCI) after 1 year. Methods: 2527 patients who underwent PCI at different hospital of Maharashtra(India) from 2012 to 2015 under the health insurance scheme which is launched by Health department, Government of Maharashtra for below poverty line(BPL) families which covers cardiology. Informed consent of patients was taken .They were followed by telephonic survey after 6months to 1year of PCI . Outcomes of interest included myocardial infarction, restenosis, cardiac rehospitalization, death, and a composite of events after PCI. Made group of two non smokers-1861 and smokers (including patients who quit at time of PCI )-659. Results: Statistical Analysis using Pearson’s chi square test revealed that there was trend seen of increasing incidence of death, Myocardial infarction and Restenosis in smokers than non smokers .Smokers had a greater death risk compared to nonsmoker; 5.7% and 5.1% respectively p=0.518. Also Repeat procedures (2.1% vs. 1.5% p=0.222), breathlessness (17.8% vs. 18.20% p=0.1) and Myocardial Infarction (7.3% vs. 10%) high in smoker than non smokers. Conclusion: Major adverse cardiovascular events (MACE) were observed even after successful PCI in smokers. Patients undergoing percutaneous coronary intervention should be encouraged to stop smoking.

Keywords: coronary artery diseases, major adverse cardiovascular events, percutaneous coronary intervention, smoking

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5372 Overcoming the Impacts of Covid-19 Outbreak Using Value Integrated Project Delivery Model

Authors: G. Ramya

Abstract:

Value engineering is a systematic approach, widely used to optimize the design or process or product in the designing stage. It used to achieve the client's obligation by increasing the functionality and attain the targeted cost in the cost planning. Value engineering effectiveness and benefits decrease along with the progress of the project since the change in the scope of the work and design will account for more cost all along the lifecycle of the project. Integrating the value engineering with other project management activities will promote cost minimization, client satisfaction, and ensure early completion of the project in time. Previous research studies suggested that value engineering can integrate with other project delivery activities, but research studies unable to frame a model that collaborates the project management activities with the job plan of value engineering approach. I analyzed various project management activities and their synergy between each other. The project management activities and processes like a)risk analysis b)lifecycle cost analysis c)lean construction d)facility management e)Building information modelling f)Contract administration, collaborated, and project delivery model planned along with the RIBA plan of work. The key outcome of the research is a value-driven project delivery model, which will succeed in dealing with the economic impact, constraints and conflicts arise due to the COVID-19 outbreak in the Indian construction sector. Benefits associated with the structured framework is construction project delivery that ensures early contractor involvement, mutual risk sharing, and reviving the project with a cost overrun and delay back on track ,are discussed. Keywords: Value-driven project delivery model, Integration, RIBA plan of work Themes: Design Economics

Keywords: value-driven project delivery model, Integration, RIBA

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5371 A Study of 3 Different Reintroduction Regimens in Anti-Tubercular Therapy-Induced Hepatitis in Extra-Pulmonary Tuberculosis

Authors: Alpana Meena

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Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

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5370 Evidence of Social Media Addiction and Problematic Internet Use Among High School and University Students in Cyprus

Authors: Costas Christodoulides

Abstract:

Excessive use of social networking sites (SNS) and the Internet by high school pupils and university students, can cause consequences similar to those observed in substance or gambling related addictions, negatively influence individual well-being notwithstanding self-assessments that people make about their life and experiences. The present study examined, for the first time in Cyprus, the levels of problematic use of the Social Media and the Internet among Cypriot pupils and students aiming at contributing to the discussion about the need for a more conclusive policy framework in the island. The Bergen Social Media Addiction Scale (BSMAS) and the Generalized Problematic Internet Use Scale 2 (GPIUS-2) were adapted to a Cypriot version and along with a sociodemographic questionnaire were introduced to a sample of 1059 young persons in order to respectively assess the addiction risk for Social Media Use and the risk of Problematic Internet Use. The sample consisted of 59% females, aged 15 to 35 (M=18.9 years, SD=3.20), 465 of them were high school students and 594 university students. Of 1059 respondents from 4 high-schools and 5 Universities (HEI) in Cyprus, 8.3% of the sample had BSMAS scores suggestive of addiction. Approximately a quarter of the sample (24%), demonstrated GPIUS-2 scores suggestive of high risk for problematic internet use. It is notable that differences seem to exist across gender with the score of the female population (11.1%) reaching levels of addiction to social media more than twice the level of addiction of the male population (4.3%). Also, the female population of high school students seems to be at the most vulnerable position for problematic internet use (28%). The 26% of the sample often or very often used some SNSs to forget of personal problems. The results of this study show that half of those surveyed used the Internet to feel better when they were upset or to escape the isolation they felt. Among the sample population, the study reports that 60% of the pupils and female university students are in agreement with the relevant statements. Conclusively, this study suggests that SNSs addiction levels among pupils and students in Cyprus ought to be an important public health concern. The same if not more alarming is the identified by the study prevalence of problematic Internet use among the same population. These results confirm international trends reported by scholarly research while also suggest that particular categories such as high school pupils and young females may be more exposed to problem SNSs and Internet use. Preventive strategies need first to acknowledge the problem in order to then formulate an effective strategy for prevention and intervention. For relevant authorities it is of primary importance to “exploit” the fact that high schools and universities can be seen as small communities and units potentially available for forging alliances for healthy Social Media and Internet use.

Keywords: problematic internet use, social media addiction, social networking sites, well-being

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5369 Effects of Handgrip Isometric Training in Blood Pressure of Patients with Peripheral Artery Disease

Authors: Raphael M. Ritti-Dias, Marilia A. Correia, Wagner J. R. Domingues, Aline C. Palmeira, Paulo Longano, Nelson Wolosker, Lauro C. Vianna, Gabriel G. Cucato

Abstract:

Patients with peripheral arterial disease (PAD) have a high prevalence of hypertension, which contributes to a high risk of acute cardiovascular events and cardiovascular mortality. Strategies to reduce cardiovascular risk of these patients are needed. Meta-analysis studies have shown that isometric handgrip training promotes reductions in clinical blood pressure in normotensive, pre-hypertensive and hypertensive individuals. However, the effect of this exercise training on other cardiovascular function indicators in PAD patients remains unknown. Thus, the aim of this study was to analyze the effects of isometric handgrip training on blood pressure in patients with PAD. In this clinical trial, 28 patients were randomly allocated into two groups: isometric handgrip training (HG) and control (CG). The HG conducted the unilateral handgrip training three days per week (four sets of two minutes, with 30% of maximum voluntary contraction with an interval of four minutes between sets). CG was encouraged to increase their physical activity levels. At baseline and after eight weeks blood pressure and heart rate were obtained. ANOVA two-way for repeated measures with the group (GH and GC) and time (pre- and post-intervention) as factors was performed. After 8 weeks of training there were no significant changes in systolic blood pressure (HG pre 141 ± 24.0 mmHg vs. HG post 142 ± 22.0 mmHg; CG pre 140 ± 22.1 mmHg vs. CG post 146 ± 16.2 mmHg; P=0.18), diastolic blood pressure (HG pre 74 ± 10.4 mmHg vs. HG post 74 ± 11.9 mmHg; CG pre 72 ± 6.9 mmHg vs. CG post 74 ± 8.0 mmHg; P=0.22) and heart rate (HG pre 61 ± 10.5 bpm vs. HG post 62 ± 8.0 bpm; CG pre 64 ± 11.8 bpm vs. CG post 65 ± 13.6 bpm; P=0.81). In conclusion, our preliminary data indicate that isometric handgrip training did not modify blood pressure and heart rate in patients with PAD.

Keywords: blood pressure, exercise, isometric, peripheral artery disease

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5368 Knowledge State of Medical Students in Morocco Regarding Metabolic Dysfunction Associated with Non-alcoholic Fatty Liver Disease (MASLD)

Authors: Elidrissi Laila, El Rhaoussi Fatima-Zahra, Haddad Fouad, Tahiri Mohamed, Hliwa Wafaa, Bellabah Ahmed, Badre Wafaa

Abstract:

Introduction: Metabolic Dysfunction Associated with Non-Alcoholic Fatty Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is the leading cause of chronic liver disease. The cardiometabolic risk factors associated with MASLD represent common health issues and significant public health challenges. Medical students, being active participants in the healthcare system and a young demographic, are particularly relevant for understanding this entity to prevent its occurrence on a personal and collective level. The objective of our study is to assess the level of knowledge among medical students regarding MASLD, its risk factors, and its long-term consequences. Materials and Methods: We conducted a descriptive cross-sectional study using an anonymous questionnaire distributed through social media over a period of 2 weeks. Medical students from various faculties in Morocco answered 22 questions about MASLD, its etiological factors, diagnosis, complications, and principles of treatment. All responses were analyzed using the Jamovi software. Results: A total of 124 students voluntarily provided complete responses. 59% of our participants were in their 3rd year, with a median age of 21 years. Among the respondents, 27% were overweight, obese, or diabetic. 83% correctly answered more than half of the questions, and 77% believed they knew about MASLD. However, 84% of students were unaware that MASLD is the leading cause of chronic liver disease, and 12% even considered it a rare condition. Regarding etiological factors, overweight and obesity were mentioned in 93% of responses, and type 2 diabetes in 84%. 62% of participants believed that type 1 diabetes could not be implicated in MASLD. For 83 students, MASLD was considered a diagnosis of exclusion, while 41 students believed that a biopsy was mandatory for diagnosis. 12% believed that MASLD did not lead to long-term complications, and 44% were unaware that MASLD could progress to hepatocellular carcinoma. Regarding treatment, 85% included weight loss, and 19% did not consider diabetes management as a therapeutic approach for MASLD. At the end of the questionnaire, 89% of the students expressed a desire to learn more about MASLD and were invited to access an informative sheet through a hyperlink. Conclusion: MASLD represents a significant public health concern due to the prevalence of its risk factors, notably the obesity pandemic, which is widespread among the young population. There is a need for awareness about the seriousness of this emerging and long-underestimated condition among young future physicians.

Keywords: MASLD, medical students, obesity, diabetes

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5367 Clinical Prediction Score for Ruptured Appendicitis In ED

Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

Abstract:

Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

Procedia PDF Downloads 155
5366 When Religion is Meaningful and When Religion is Detrimental

Authors: Tennyson Samraj

Abstract:

The intent of this paper is threefold: (1) to propose the Epicurean tenet that beliefs associated with God are to be detached from the transcendent God, as the basis to end religious conflicts; (2) to project John Hick’s advice that no one has monopoly over religious claims, as the basis for religious tolerance and (3) to present the common sense approach to respect religion without disrespecting science. Religious claims create societal tension on two matters: conflict between believers and conflict with the sciences. Anyone interested in the two fundamental questions related to consciousness and cosmology as to how and why the universe exists will have to deal with science and religion. However, while science addresses the question of how the universe came into existence and how it works, religion addresses the question of why the universe exists. If religion is a quest to understand why the universe exists, then we must address the question as to when religion is considered meaningful and when is it considered detrimental. Is there a relationship between why we choose to live and why the universe exists? Science and Religion are partners in defining our life in the context of the universe. Science without Religion limits itself to knowing ‘how’ the universe came into existence without questioning ‘why’; Religion without Science limits itself of knowing ‘why’ the universe exists without knowing ‘how.’ Is it possible to detach beliefs about God from God? When religious claims are understood in the context of the questions that necessitates the answers, religious claims can be understood as being separate from the transcendent God. This paper purports that this Epicurean tenet provides the impetus to address the questions that necessitate religious claims. This helps us to explain the relevance of why we believe in what we believe; define the relationship between the self, soul and the sacred; and establish the connection between this life and the after-life in the context of life-beyond-this-planet.

Keywords: religion, epicurus, John Hick, relevance of religion

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5365 Examining the Effects of National Disaster on the Performance of Hospitality Industry in Korea

Authors: Kim Sang Hyuck, Y. Park Sung

Abstract:

The outbreak of national disasters stimulates the decrease of the both internal and domestic tourism demands, causing bad effects on the hospitality industry. The effective and efficient risk management regarding national disasters are being increasingly required from the hospitality industry practitioners and the tourism policymakers. To establish the effective and efficient risk management strategy on national disasters, the most essential prerequisite condition is the correct estimation of national disasters’ effects in terms of the size and duration of the damages occurred from national disaster on hospitality industry. More specifically, the national disasters are twofold: natural disaster and social disaster. In addition, the hospitality industry has consisted of several types of business, such as hotel, restaurant, travel agency, etc. As reasons of the above, it is important to consider how each type of national disasters differently influences on the performance of each type of hospitality industry. Therefore, the purpose of this study is examining the effects of national disaster on hospitality industry in Korea based on the types of national disasters as well as the types of hospitality business. The monthly data was collected from Jan. 2000 to Dec. 2016. The indexes of industrial production for each hospitality industry in Korea were used with the proxy variable for the performance of each hospitality industry. Two national disaster variables (natural disaster and social disaster) were treated as dummy variables. In addition, the exchange rate, industrial production index, and consumer price index were used as control variables in the research model. The impulse response analysis was used to examine the size and duration of the damages occurred from each type of national disaster on each type of hospitality industries. The results of this study show that the natural disaster and the social disaster differently influenced on each type of hospitality industry. More specifically, the performance of airline industry is negatively influenced by the natural disaster at the time of 3 months later from the incidence. However, the negative impacts of social disaster on airline industry occurred not significantly over the time periods. For the hotel industry, both natural disaster and social disaster negatively influence the performance of hotel industry at the time of 5 months and 6 months later, respectively. Also, the negative impact of natural disaster on the performance of restaurant industry occurred at the time of 5 months later, as well as for both 3 months and 6 months later for the social disaster. Finally, both natural disaster and social disaster negatively influence the performance of travel agency at the time of 3 months and 4 months later, respectively. In conclusion, the types of national disasters differently influence the performance of each type of hospitality industry in Korea. These results would provide an important information to establish the effective and efficient risk management strategy for the national disasters.

Keywords: impulse response analysis, Korea, national disaster, performance of hospitality industry

Procedia PDF Downloads 173
5364 Biodegrading Potentials of Plant Growth - Promoting Bacteria on Insecticides Used in Agricultural Soil

Authors: Chioma Nwakanma, Onyeka Okoh Irene, Emmanuel Eze

Abstract:

Pesticide residues left in agricultural soils after cropping are always accumulative, difficult to degrade and harmful to animals, plants, soil and human health in general. The biodegrading potential of pesticides- resistant PGPB on soil pollution was investigated using in situ remediation technique following recommended standards. In addition, screening for insecticide utilization, maximum insecticide concentration tolerance, insecticide biodegradation and insecticide residues analyses via gas chromatographic/electron column detector were determined. The location of bacterial degradation genes was also determined. Three plant growth-promoting rhizophere (PGPR) were isolated and identified according to 16S rRNA as Paraburkholderia tropica, Burkolderia glumae and Achromobacter insolitus. From the results, all the three isolates showed phosphate solubilizing traits and were able to grow on nitrogen free medium. The isolates were able to utilize the insecticide as sole carbon source and increase in biomass. They were statistically significantly tolerant to all the insecticide concentrations screened. The gas chromatographic profiles of the insecticide residues showed a reduction in the peak areas of the insecticides, indicating degradation. The bacterial consortium had the lowest peak areas, showing the highest degradation efficiency. The genes responsible for degradation were found to be in the plasmids of the isolates. Therefore, the use of PGPR is recommended for bioremediation of agricultural soil insecticide polluted areas and can also enhance soil fertility.

Keywords: biodegradation, rhizosphere, insecticides utilization, agricultural soil

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5363 A Case-Study Analysis on the Necessity of Testing for Cyber Risk Mitigation on Maritime Transport

Authors: Polychronis Kapalidis

Abstract:

In recent years, researchers have started to turn their attention to cyber security and maritime security independently, neglecting, in most cases, to examine the areas where these two critical issues are intertwined. The impact of cybersecurity issues on the maritime economy is emerging dramatically. Maritime transport and all related activities are conducted by technology-intensive platforms, which today rely heavily on information systems. The paper’s argument is that when no defense is completely effective against cyber attacks, it is vital to test responses to the inevitable incursions. Hence, preparedness in the form of testing existing cybersecurity structure via different tools for potential attacks is vital for minimizing risks. Traditional criminal activities may further be facilitated and evolved through the misuse of cyberspace. Kidnap, piracy, fraud, theft of cargo and imposition of ransomware are the major of these activities that mainly target the industry’s most valuable asset; the ship. The paper, adopting a case-study analysis, based on stakeholder consultation and secondary data analysis, namely policy and strategic-related documentation, presents the importance of holistic testing in the sector. Arguing that poor understanding of the issue leads to the adoption of ineffective policies the paper will present the level of awareness within the industry and assess the risks and vulnerabilities of ships to these cybercriminal activities. It will conclude by suggesting that testing procedures must be focused on three main pillars within the maritime transport sector: the human factor, the infrastructure, and the procedures.

Keywords: cybercrime, cybersecurity, organized crime, risk mitigation

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5362 Challenging Clinical Scenario of Blood Stream Candida Infections – An Indian Experience

Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

Abstract:

Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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5361 Retrospective Demographic Analysis of Patients Lost to Follow-Up from Antiretroviral Therapy in Mulanje Mission Hospital, Malawi

Authors: Silas Webb, Joseph Hartland

Abstract:

Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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5360 Impact of Climatic Hazards on the Jamuna River Fisheries and Coping and Adaptation Strategies

Authors: Farah Islam, Md. Monirul Islam, Mosammat Salma Akter, Goutam Kumar Kundu

Abstract:

The continuous variability of climate and the risk associated with it have a significant impact on the fisheries leading to a global concern for about half a billion fishery-based livelihoods. Though in the context of Bangladesh mounting evidence on the impacts of climate change on fishery-based livelihoods or their socioeconomic conditions are present, the country’s inland fisheries sector remains in a negligible corner as compared to the coastal areas which are spotted on the highlight due to its higher vulnerability to climatic hazards. The available research on inland fisheries, particularly river fisheries, has focussed mainly on fish production, pollution, fishing gear, fish biodiversity and livelihoods of the fishers. This study assesses the impacts of climate variability and changes on the Jamuna (a transboundary river called Brahmaputra in India) River fishing communities and their coping and adaptation strategies. This study has used primary data collected from Kalitola Ghat and Debdanga fishing communities of the Jamuna River during May, August and December 2015 using semi-structured interviews, oral history interviews, key informant interviews, focus group discussions and impact matrix as well as secondary data. This study has found that both communities are exposed to storms, floods and land erosions which impact on fishery-based livelihood assets, strategies, and outcomes. The impact matrix shows that human and physical capitals are more affected by climate hazards which in turn affect financial capital. Both communities have been responding to these exposures through multiple coping and adaptation strategies. The coping strategies include making dam with soil, putting jute sac on the yard, taking shelter on boat or embankment, making raised platform or ‘Kheua’ and involving with temporary jobs. While, adaptation strategies include permanent migration, change of livelihood activities and strategies, changing fishing practices and making robust houses. The study shows that migration is the most common adaptation strategy for the fishers which resulted in mostly positive outcomes for the migrants. However, this migration has impacted negatively on the livelihoods of existing fishers in the communities. In sum, the Jamuna river fishing communities have been impacted by several climatic hazards and they have traditionally coped with or adapted to the impacts which are not sufficient to maintain sustainable livelihoods and fisheries. In coming decades, this situation may become worse as predicted by latest scientific research and an enhanced level of response would be needed.

Keywords: climatic hazards, impacts and adaptation, fisherfolk, the Jamuna River

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5359 Patterns of Self-Reported Overweight, Obesity, and Other Chronic Diseases Among University Students in the United Arab Emirates: A Cross-Sectional Study

Authors: Maryam M. Bashir, Luai A. Ahmed, Meera R. Alshamsi, Sara Almahrooqi, Taif Alyammahi, Shooq A. Alshehhi, Waad I. Alhammadi, Fatima H. Alhammadi, Hind A. Alhosani, Rami H. Al-Rifai, Fatma Al-Maskari

Abstract:

Obesity in the Middle East and North Africa (MENA) region has exponentially increased over the past five decades due to rapid urbanization and unhealthy lifestyle changes. It has been well established that overweight and obesity increase the risk of non-communicable diseases (NCDs) and are the leading cause of mortality and economic burden locally, and globally. In the United Arab Emirates (UAE), there is a growing epidemic of obesity and other chronic diseases like type 2 diabetes mellitus and cardiovascular diseases. Prevalence of overweight and obesity in UAE range up to 70% depending on the group being studied. Hence, there is a need to explore their patterns in the country for more targeted and responsive interventions. Our study aimed to explore the patterns of overweight and obesity and some self-reported chronic diseases among university students in Abu Dhabi, the capital city of UAE. A validated online self-administered questionnaire was used to collect data from UAE University (UAEU) students, 18years and above, from August to September 2021. Students’ characteristics were summarized using appropriate descriptive statistics. Overweight, obesity and self-reported chronic diseases were described and compared between male and female students using chi-square and t tests. Other associated factors were also explored in relation to overweight and obesity. All analyses were conducted using STATA statistical software version 16.1 (StataCorp LLC, College Station, TX, USA). 902 students participated in the study. 79.8% were females and mean age was 21.90 ± 5.19 years. Majority of the respondents were undergraduate students (80.71%). The prevalence of self-reported chronic diseases was 22.95%. Obesity (BMI≥30kg/m2), Diabetes Mellitus, and Asthma/Allergies were the commonest diseases (12.48%, 4.21% & 3.22%, respectively). Approximately 5% of the students reported more than one chronic disease. Out of the 833 participating students who had complete weight and height data, prevalence of overweight and obesity was 34.81% (22.33% and 12.48%, respectively). More than half of the male students (54.36%) were overweight or obese. This is significantly higher than in female students (30.56%, p=0.001). Overweight/obesity when compared to normal weight is associated with increasing mean age [23.40 vs 21.01, respectively (p=0.001)]. In addition to gender and age, being married [57.63% vs 31.05% (p=0.001)], being a postgraduate student [51.59% vs 30.92% (p=0.001)] and having two or more chronic diseases [65.85% vs 33.21% (p=0.001)] were also significantly associated with overweight/obesity. Our study showed that almost a quarter of the participating university students reported at least one chronic disease. Obesity was the commonest and more than 1 in 3 students were either overweight or obese. This shows the need for intensive health promotion and screening programs on obesity and other chronic diseases to meet the health needs of these students. This study is also a basis for further research, especially qualitative, to explore the relevant risk factors and risk groups for more targeted interventions.

Keywords: chronic disease, obesity, overweight, students, United Arab Emirates

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5358 Entrepreneurship Education as an Enhancement of Skills for Graduate Employability: The Case of the University of Buea

Authors: Akumeyam Elvis Akum, Njanjo Thecla Anyongo Mukete, Fonkeng George Epah

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Globally, the goal of higher education is to enhance graduate employability skills. Paradoxically, Cameroon’s graduate employability rate is far below the graduation rate. This worrisome situation caused the researcher to hypothesize that the teaching and learning experiences account for this increasing disparity. The study sought to investigate the effect on graduate employability of the teaching of organizational, problem-solving, innovation, and risk management skills on graduate employability. The study adopted a descriptive survey design with a quantitative approach. Data was collected by quantitative techniques from a random sample of 385 graduates using closed-ended structured questionnaire. Generally, findings revealed that entrepreneurship education does not sufficiently enhance graduate employability in the University of Buea. Specifically, the teaching of organizational skills does not significantly enhance their employability, as an average of 55% of graduates indicated that the course did not sufficiently help them develop skills for planning, management of limited resources, collaboration, and the setting of priorities. Also, 60% of the respondents indicated that the teaching of problem-solving skills does not significantly enhance graduate employability at the University of Buea. Contrarily, 57% of the respondents agreed that through their experiences in entrepreneurship education, their innovation skills were improved. The study recommended that a practical approach to teaching should be adopted, with attention to societal needs. A framework to ensure the teaching of entrepreneurship to students at the undergraduate level is recommended, such that those who do not continue with university studies after their Bachelor’s degree would have acquired the needed skills for employability.

Keywords: employability, entrepreneurship education, graduate, innovative skills, organizational skills, problem-solving skills, risk management skills

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5357 Effect of Zinc-Lysine on Growth, Photosynthesis, Oxidative Stress and Antioxidant System and Chromium Uptake in Rice under Cr Stress

Authors: Shafaqat Ali, Afzal Hussain, Muhammad Rizwan, Longhua Wu

Abstract:

Chromium (Cr) is one of the widespread and toxic trace elements present in the agricultural land. Chromium can enter into the food chain mainly through agricultural crops grown on Cr-contaminated soils such as rice (Oryza sativa L.). The current study was done to evaluate the effects of increasing concentrations foliar applied zinc (Zn) chelated with lysine (Zn-lys) (0, 10, 20, and 30 mg L⁻¹) on rice biomass, photosynthesis, oxidative stress, key antioxidant enzyme activities and Cr uptake under increasing levels of Cr in the soil (0, 100, 500 mg kg⁻¹). Cr-induced toxicity reduced the height of plants, biomass, chlorophyll contents, gas exchange parameters, and antioxidant enzyme activities while increased the Cr concentrations and oxidative stress (malondialdehyde, electrolyte leakage, and H₂O₂) in shoots and roots than control plants. Foliar application of Zn-lys increased the plant growth, photosynthesis, Zn concentrations, and enzyme activities in rice seedlings. In addition, Zn-lys reduced the Cr concentrations and oxidative stress compared to the respective Cr treatments alone. The present results indicate that foliar Zn-lys stimulates the antioxidant defense system in rice, increase the rice growth while reduced the Cr concentrations in plants by promoting the Zn uptake and photosynthesis. Taken together, foliar spray of Zn-lys chelate can efficiently be employed for improving plant growth and Zn contents while reducing Cr concentration in rice grown in Cr-contaminated and Zn-deficient soils.

Keywords: antioxidants, chromium, zinc-lysine, oxidative stress, photosynthesis, tolerance

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