Search results for: disaster risk management

Authors: Raed Alsufyani, Hissam Tawfik, Victor Chang, Muthu Ramachandran

Abstract:

This study investigates the factors that influence the decision by players in the healthcare sector to embrace Cloud Business Intelligence Technology with a focus on healthcare organizations in Saudi Arabia. To bring this matter into perspective, this study primarily considers the Technology-Organization-Environment (TOE) framework and the Human Organization-Technology (HOT) fit model. A survey was hypothetically designed based on literature review and was carried out online. Quantitative data obtained was processed from descriptive and one-way frequency statistics to inferential and regression analysis. Data were analysed to establish factors that influence the decision to adopt Cloud Business intelligence technology in the healthcare sector. The implication of the identified factors was measured, and all assumptions were tested. 66.70% of participants in healthcare organization backed the intention to adopt cloud business intelligence system. 99.4% of these participants considered security concerns and privacy risk have been the most significant factors in the adoption of cloud Business Intelligence (CBI) system. Through regression analysis hypothesis testing point that usefulness, service quality, relative advantage, IT infrastructure preparedness, organization structure; vendor support, perceived technical competence, government support, and top management support positively and significantly influence the adoption of (CBI) system. The paper presents quantitative phase that is a part of an on-going project. The project will be based on the consequences learned from this study.

Keywords: cloud computing, business intelligence, HOT-fit model, TOE, healthcare and innovation adoption

Procedia PDF Downloads 155

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

Abstract:

Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

Procedia PDF Downloads 53

Authors: Bandojo Paula Maria Noella, Bernardo Bea Samantha B., Del Rosario Hanassa Mae S., Gomez Marian Louise D., Gomez Rome Voltaire M., Reyes Alessa Anne Therese A.

Abstract:

The purpose of this study is to determine if there is a significant difference between the training program of Pan Pacific Hotel to other Five Star Hotels in terms of the technical, professional and personal competencies before and after their training. The theoretical framework of this study is the practicum manual of the University of Santo Tomas College of Tourism and Hospitality Management, Hotel and Restaurant Management Program Practicum Manual. This study was conducted using survey questionnaires that were distributed to 50 respondents. The results showed that there is a significant difference with the level of competencies of the practicum trainee before and after the training regardless if the training is structured or unstructured. Results also showed that the structured training program of Pan Pacific Hotel significantly improved the Technical Competencies in the different departments of the hotel industry. On the other hand, the findings also showed that there is no difference between the structured and unstructured training program in terms of Professional Competencies and Personal Competencies. The proponents concluded the study by providing recommendations to the partner hotels of the University of Santo Tomas College of Tourism and Hospitality Management that there should be a structured training program for the practicum trainees.

Keywords: structured and structured training program, practicum trainees, competencies, tourism

Procedia PDF Downloads 346

Authors: Chun-Qing Li, Guoyang Fu, Wei Yang

Abstract:

A significant portion of current water networks is made of cast iron pipes. Due to aging and deterioration with corrosion being the most predominant mechanism, the failure rate of cast iron pipes is very high. Although considerable research has been carried out in the past few decades, most are on the effect of corrosion on the structural capacity of pipes using strength theory as the failure criterion. This paper presents a reliability-based methodology for the assessment of corrosion affected cast iron pipe cracking failures. A nonlinear limit state function taking into account all three fracture modes is proposed for brittle metal pipes with mixed mode fracture. A stochastic model of the load effect is developed, and time-dependent reliability method is employed to quantify the probability of failure and predict the remaining service life. A case study is carried out using the proposed methodology, followed by sensitivity analysis to investigate the effects of the random variables on the probability of failure. It has been found that the larger the inclination angle or the Mode I fracture toughness is, the smaller the probability of pipe failure is. It has also been found that the multiplying and exponential coefficients k and n in the power law corrosion model and the internal pressure have the most influence on the probability of failure for cast iron pipes. The methodology presented in this paper can assist pipe engineers and asset managers in developing a risk-informed and cost-effective strategy for better management of corrosion-affected pipelines.

Keywords: corrosion, inclined surface cracks, pressurized cast iron pipes, stress intensity

Procedia PDF Downloads 304

Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

Abstract:

Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

Procedia PDF Downloads 47

Authors: Almutazballlah Bassam Qablan, Jihan M. Muhaidat, bana Abu Rajab

Abstract:

Background: Acne vulgaris is considered one of the most common skin conditions encountered by dermatologists. It is a chronic inflammation affecting the pilosebaceous unit. Although acne vulgaris is not fatal, it leads to permanent scarring and disfigurement, and even without scarring, it has a huge effect on patients, causing negative health outcomes. Acne vulgaris patients experience psychological, and emotional ramifications as those with chronic health problems; they feel depressed, angry, anxious, and confused. Although acne is a popular disease, many thoughts and myths are still discussed about its origins and triggering factors. These myths can make you feel guilt as if you were somehow responsible for your acne. In this case control study, we want to define the relationship between two modifiable risk factors ;BMI and smoking, with acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Ramtha, Jordan in 2019/2020. A total number of 325 participants between 14 and 33 years of age were interviewed by the authors; including 163 acne vulgaris cases and 162 controls without acne vulgaris. Anthropometric measures and smoking for Acne patients and control participants were the independent variables used to assess acne. Univariate and multivariate analysis were used to compare the characteristics of people who reported acne with those with no acne. The collected data analyzed by using the Statistical Package for Social Sciences (SPSS). Results: Cigarette smoking was highly associated with controls; odds ratio 0.4 (95% CI: 0.2–0.9) , P-value = 0.018. BMI and waterpipe smoking were statistically insignificant with acne in the multivariate analysis. Conclusion: We found that cigarette smoking was protective against Acne. There was a statistically insignificant relation between BMI, waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, adolescents, BMI, smoking, case-control, risk factors

Procedia PDF Downloads 79

Authors: Israel Becerril Rosales, Manuel González De La Rosa, Gerardo Villa Sánchez

Abstract:

In this work, the effects that produce not having a good inventory management is analyzed, in addition of the way that how it affects the storage costs. The research began conducting the historical analysis about stored products, its storage capacity, and distribution. The results were not optimal, since in all its raw materials (RM) have overstocking, the warehouse capacity is only used by 61%, does not have a specific place for each of its RM, causing that the delivery times increases and makes difficult a cyclical inventory. These shortcomings allowed to view and select as design alternatives the inventory ABC, so that depending on the consumption of each RM would be redistributed by using economic amount requested. Also, the Delphi method to ensure the practical applicability of the proposed tool was used, taking in account comments and suggestions of the involved experts, as well as the compliance of NOM-059-SSA1-2015 good manufacturing practices of drug. With the actions implemented, the utilization rate drops of 61% to 32% capacity, it shows that the warehouse was not designed properly due to there is not an industrial engineering area.

Keywords: lead time, improve delivery, storage costs, inventory management

Procedia PDF Downloads 215

Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

Abstract:

Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

Procedia PDF Downloads 74

Authors: Muhammad Faisal, Zai-Jin You, Muhammad Naeem

Abstract:

Concerns about the environment, public health, and the economy are raised by the fact that the world produces around 6 trillion cigarettes annually. Arguably the most pervasive forms of environmental litter, this dangerous trash must be eliminated. The researchers wanted to get an idea of how much pollution is seeping out of cigarette butts in metropolitan areas by studying their distribution and concentration. In order to accomplish this goal, the cigarette butt pollution indicator was applied in 29 different areas. The locations were monitored monthly for a full calendar year. The conditions for conducting the investigation of the venues were the same on both weekends and during the weekdays. By averaging the metal leakage ratio in various climates and the average weight of cigarette butts, we were able to estimate the total amount of heavy metal leakage. The findings revealed that the annual average value of the index for the areas that were investigated ranged from 1.38 to 10.4. According to these numbers, just 27.5% of the areas had a low pollution rating, while 43.5% had a major pollution status or worse. Weekends witnessed the largest fall (31% on average) in all locations' indices, while spring and summer saw the largest increase (26% on average) compared to autumn and winter. It was calculated that the average amount of heavy metals such as Cr, Cu, Cd, Zn, and Pb that seep into the environment from discarded cigarette butts in commercial, residential, and park areas, respectively, is 0.25 µg/m2, 0.078 µg/m2, and 0.18 µg/m2. Butt from cigarettes is one of the most prevalent forms of litter in the area that was examined. This litter is the origin of a wide variety of contaminants, including heavy metals. This toxic garbage poses a significant risk to the city.

Keywords: heavy metal, hazardous waste, waste management, litter

Procedia PDF Downloads 63

Authors: Abdelrahman Abdelrahman, Lawrence Nip, Seun Ikotun, Iman Satar, Anur Miah

Abstract:

Introduction: Incision and drainage of an abscess is a common procedure performed by the general surgeon. Pus swabs are often obtained routinely for MC&S.Our study aimed to investigate whether swabs taken at our local institution had any impact on the overall management plan for uncomplicated abscesses. Methods: We retrospectively assessed all patients presenting to University Hospital Lewisham with an abscess between October 2020 – April 2021. Exclusion criteria were recurrent abscesses, patients admitted with sepsis, known inflammatory bowel disease, immunocompromised, and those managed non-operatively. Results: We identified 131 patients who met the inclusion criteria. Two thirds were performed in theatre under general anaesthetic and the other one third under local. 63% of patients had a pus swab collected. Of these, 96% were not followed up by the requesting doctor, and there was no further patient contact. In the other 4%, the organisms cultured were flagged as atypical such as MRSA. In these cases, microbiology advice was that if the patient was clinically well and adequate drainage was achieved, then no furtherantibiotics were required. All patients were discharged before any microbiology results had come back with no subsequent change in the management plan. Average cost of pus swab = £10.10 – potentially cost saving of £1656.4 annually. Conclusion: Our study reveals that the majority of pus swabs taken from uncomplicated abscessesare not followed up by requesting doctor with no impact on the overall management plan. We, therefore, do not recommend the routine use of pus swabs for uncomplicated abscesses.

Keywords: pus swabs, uncomplated abscess, Pus MCS, follow up of uncomplicated abscess

Procedia PDF Downloads 167

Authors: Redha Elhuni, M. Munir Ahmad

Abstract:

The main purpose of this research is to construct a generic model for successful implementation of Total Quality Management (TQM) in oil sector, and to find out the effects of this model on the organizational sustainability development (OSD) performance of Libyan oil and gas companies using the structured equation modeling (SEM) approach. The research approach covers both quantitative and qualitative methods. A questionnaire was developed in order to identify the quality factors that are seen by Libyan oil and gas companies to be critical to the success of TQM implementation. Hypotheses were developed to evaluate the impact of TQM implementation on O SD. Data analysis reveals that there is a significant positive effect of the TQM implementation on OSD. 24 quality factors are found to be critical and absolutely essential for successful TQM implementation. The results generated a structure of the TQMSD implementation framework based on the four major road map constructs (Top management commitment, employee involvement and participation, customer-driven processes, and continuous improvement culture).

Keywords: total quality management, critical success factors, oil and gas, organizational sustainability development (SD), Libya

Procedia PDF Downloads 264

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

Abstract:

Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

Procedia PDF Downloads 475

Authors: A. Das, L. Hitihamillage, S. Moridpour

Abstract:

Natural disasters are inevitable to the biodiversity. Disasters such as flood, tsunami and tornadoes could be brutal, harsh and devastating. In Australia, flooding is a major issue experienced by different parts of the country. In such crisis, delays in evacuation could decide the life and death of the people living in those regions. Congestion management could become a mammoth task if there are no steps taken before such situations. In the past to manage congestion in such circumstances, many strategies were utilised such as converting the road shoulders to extra lanes or changing the road geometry by adding more lanes. However, expansion of road to resolving congestion problems is not considered a viable option nowadays. The authorities avoid this option due to many reasons, such as lack of financial support and land space. They tend to focus their attention on optimising the current resources they possess and use traffic signals to overcome congestion problems. Traffic Signal Management strategy was considered a viable option, to alleviate congestion problems in the City of Geelong, Victoria. Arterial road with signalised intersections considered in this paper and the traffic data required for modelling collected from VicRoads. Traffic signalling software SIDRA used to model the roads, and the information gathered from VicRoads. In this paper, various signal parameters utilised to assess and improve the corridor performance to achieve the best possible Level of Services (LOS) for the arterial road.

Keywords: congestion, constraints, management, LOS

Procedia PDF Downloads 377

Authors: Shima Nikanjam, Badiossadat Hassanpour, Adi Irfan Che Ani

Abstract:

The design process in architecture education is based upon the Learning-by-Doing method, which leads students to understand how to design by practicing rather than studying. First-year design studios, as starting educational stage, provide integrated knowledge and skills of design for newly jointed architecture students. Within the basic design studio environment, students are guided to transfer their abstract thoughts into visual concrete decisions under the supervision of design educators for the first time. Therefore, introductory design studios have predominant impacts on students’ operational thinking and designing. Architectural design thinking is quite different from students’ educational backgrounds and learning habits. This educational challenge at basic design studios creates a severe need to study the reality of design education at foundation year and define appropriate educational methods with convenient project types with the intention of enhancing architecture education quality. Material for this study has been gathered through long-term direct observation at a first year second semester design studio at the faculty of architecture at EMU (known as FARC 102), fall and spring academic semester 2014-15. Distribution of a questionnaire among case study students and interviews with third and fourth design studio students who passed through the same methods of education in the past 2 years and conducting interviews with instructors are other methodologies used in this research. The results of this study reveal a risk of a mismatch between the implemented teaching method, project type and scale in this particular level and students’ learning styles. Although the existence of such risk due to varieties in students’ profiles could be expected to some extent, recommendations can support educators to reach maximum compatibility.

Keywords: architecture education, basic design studio, educational method, forms creation skill

Procedia PDF Downloads 356

Authors: Jonas A. R. H. Lima, Maria Antonia Carravilla

Abstract:

As productivity concepts are widely related to industrial savings, it is becoming particularly important in a more and more competitive world, to really understand how productivity can be well used in industrial management techniques. Nowadays, consumers are no more willing to pay for mistakes and inefficiencies. Therefore, one way for companies to stay competitive is to control and increase their productivity. This study aims to define clearly the productivity concept, understand how a company can affect productivity, and, if possible, identify the relation between each identified productivity factor. This will help managers, by clarifying the main issues behind productivity concepts and proposing a methodology to measure, control and increase productivity. The main questions to be answered are: what is the importance of productivity for the Portuguese Wood Furniture Industry? Is it possible to control productivity internally, or is it a phenomenon external to companies, hard or even impossible to control? How to understand, control and adjust productivity performance? How to make productivity to become one main asset for maximizing the use of the available resources? This essay will follow a constructive approach mostly based in the research hypothesis mentioned above. For that, a literature review is being done to find the main conceptual frameworks and empirical studies that already exist, and by doing so, highlight eventual knowledge or conflicting research to be addressed in this work. We expect to build theoretical explanations and test theoretical predictions from participants understandings and own experiences, by elaborating field surveys and interviews, to select adjusted productivity indicators and analyze the productivity evolution according the adjustments on other variables. Its intended the conduction of an exploratory work that can simultaneous clarify productivity concepts, objectives, and define frameworks. This investigation intends to migrate from merely academic concepts to a daily basis operational reality of the companies from the Portuguese Wood Furniture Industry highlighting productivity increased importance within modern engineering and industrial management. The ambition is to clarify, systemize and develop a management tool that may not only control but positively influence the way resources are used.

Keywords: industrial management, motivation, productivity, performance indicators, reward management, wood furniture industry

Procedia PDF Downloads 220

Authors: Xiujuan Qiao

Abstract:

Cities worldwide are increasingly adopting sustainable stormwater solutions such as using green infrastructure to mitigate challenges related to stormwater, e.g., pluvial flooding, and stormwater pollution. Barriers caused by governance factors have been identified as the main reason for the slow pace of sustainable stormwater management implementation. In this study, we examined governance factors influencing local implementation in four case cities: Lund and Malmö, Sweden, and Xi’xian New Area and Zhenjiang, China. Based on systems thinking of interrelations between previously identified influencing governance factors in sustainable stormwater management (SSM), we developed a causal loop diagram (SSM-CLD) and used it to analyze 23 semi-structured interviews with local government officers in the four case cities. Based on the results, we created one SSM-CLD for each country and analyzed the main differences between these four SSM-CLDs. The results revealed that differences in governance structures can lead to differences in the influencing governance factors. In top-down political systems, e.g., China, the role of national policy in setting local leaders’ priorities is significant for SSM implementation. In political systems with more power devolved to local governments, e.g., Sweden, public awareness and local government politicians’ priorities are important for SSM implementation. Acquiring funding for long-term maintenance was identified as a challenge in all four cities studied. These results are relevant for policymakers, local government departments, consultancy companies, and researchers seeking a better understanding of how governance factors influence sustainable stormwater management.

Keywords: sustainable stormwater management, causal loop diagram, governance structures, local government priorities, public awareness, maintenance

Procedia PDF Downloads 238

Authors: Itee Chowdhury, Shikha Modi

Abstract:

Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

Procedia PDF Downloads 109

Authors: Abeer K. Jameel, Harry Evdorides

Abstract:

Iraq is a middle income country where the road safety issue is considered one of the leading causes of deaths. To control the road risk issue, the Iraqi Ministry of Planning, General Statistical Organization started to organise a collection system of traffic accidents data with details related to their causes and severity. These data are published as an annual report. In this paper, a review of the available crash data in Iraq will be presented. The available data represent the rate of accidents in aggregated level and classified according to their types, road users’ details, and crash severity, type of vehicles, causes and number of causalities. The review is according to the types of models used in road safety studies and research, and according to the required road safety data in the road constructions tasks. The available data are also compared with the road safety dataset published in the United Kingdom as an example of developed country. It is concluded that the data in Iraq are suitable for descriptive and exploratory models, aggregated level comparison analysis, and evaluation and monitoring the progress of the overall traffic safety performance. However, important traffic safety studies require disaggregated level of data and details related to the factors of the likelihood of traffic crashes. Some studies require spatial geographic details such as the location of the accidents which is essential in ranking the roads according to their level of safety, and name the most dangerous roads in Iraq which requires tactic plan to control this issue. Global Road safety agencies interested in solve this problem in low and middle-income countries have designed road safety assessment methodologies which are basing on the road attributes data only. Therefore, in this research it is recommended to use one of these methodologies.

Keywords: road safety, Iraq, crash data, road risk assessment, The International Road Assessment Program (iRAP)

Procedia PDF Downloads 241

Authors: Sabiha S. Marine, Nicole Flint, John Rolfe

Abstract:

The Queensland state government introduced commercial gill net fishing closures in Cairns, Mackay, and Rockhampton in November 2015 to increase the recreational fishing opportunities, nature-based tourism, and economic benefits in these three regional areas. This management change is likely to improve the potential for more desirable stock structures through natural recruitment. Barramundi (Lates calcarifer) is one of the popular target fish for recreational and commercial fishers in Northern Australia. This investigation examines the effects of reduced commercial fishing from both biological and economic perspectives, particularly on the local Barramundi population of the Fitzroy River in Rockhampton, the largest river catchment flowing to the eastern coast of Australia. Data on different parameters of biological and economic aspects have been collated from secondary sources for analysis through a system simulation approach to identify the effectiveness of the commercial netting closures on recreational fishing effort, especially for the Barramundi population. The results have the potential to explain certain consequences of the netting closures in Queensland, which could serve to inform future fisheries management decisions. The study output as a whole will help in the better management of fisheries resources by evaluating recreational fishing opportunities in Queensland, where the potential for increases in recreation is high.

Keywords: Barramundi, bioeconomic model, fishery management, recreational fishing

Procedia PDF Downloads 155

Authors: Jin Xu

Abstract:

5G network developers need to satisfy the necessary requirements of additional capacity from massive users and spectrally efficient wireless technologies. Therefore, the significant amount of underutilized spectrum in network is motivating operators to combine long-term evolution (LTE) with intelligent spectrum management technology. This new LTE intelligent spectrum management in unlicensed band (LTE-U) has the physical layer topology to access spectrum, specifically the 5-GHz band. We proposed a new intelligent cloud RAN for 5G.

Keywords: cloud radio access network, wireless network, cloud computing, multi-agent

Procedia PDF Downloads 411

Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen

Abstract:

Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.

Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants

Procedia PDF Downloads 324

Authors: Ciprian Briciu-Burghina, Brendan Heery, Dermot Brabazon, Fiona Regan

Abstract:

Good quality bathing water is a highly desirable natural resource which can provide major economic, social, and environmental benefits. Both in Ireland and Europe, such water bodies are managed under the European Directive for the management of bathing water quality (BWD). The BWD aims mainly: (i) to improve health protection for bathers by introducing stricter standards for faecal pollution assessment (E. coli, enterococci), (ii) to establish a more pro-active approach to the assessment of possible pollution risks and the management of bathing waters, and (iii) to increase public involvement and dissemination of information to the general public. Standard methods for E. coli and enterococci quantification rely on cultivation of the target organism which requires long incubation periods (from 18h to a few days). This is not ideal when immediate action is required for risk mitigation. Municipalities that oversee the bathing water quality and deploy appropriate signage have to wait for laboratory results. During this time, bathers can be exposed to pollution events and health risks. Although forecasting tools exist, they are site specific and as consequence extensive historical data is required to be effective. Another approach for early detection of faecal pollution is the use of marker enzymes. β-glucuronidase (GUS) is a widely accepted biomarker for E. coli detection in microbiological water quality control. GUS assay is particularly attractive as they are rapid, less than 4 h, easy to perform and they do not require specialised training. A method for on-site detection of GUS from environmental samples in less than 75 min was previously demonstrated. In this study, the capability of ColiSense as an early warning system for faecal pollution in freshwater is assessed. The system successfully detected GUS activity in all of the 45 freshwater samples tested. GUS activity was found to correlate linearly with E. coli (r2=0.53, N=45, p < 0.001) and enterococci (r2=0.66, N=45, p < 0.001) Although GUS is a marker for E. coli, a better correlation was obtained for enterococci. For this study water samples were collected from 5 rivers in the Dublin area over 1 month. This suggests a high diversity of pollution sources (agricultural, industrial, etc) as well as point and diffuse pollution sources were captured in the sample size. Such variety in the source of E. coli can account for different GUS activities/culturable cell and different ratios of viable but not culturable to viable culturable bacteria. A previously developed protocol for the recovery and detection of E. coli was coupled with a miniaturised fluorometer (ColiSense) and the system was assessed for the rapid detection FIB in freshwater samples. Further work will be carried out to evaluate the system’s performance on seawater samples.

Keywords: faecal pollution, β-glucuronidase (GUS), bathing water, E. coli

Procedia PDF Downloads 269

Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

Abstract:

Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

Procedia PDF Downloads 258

Authors: Fernanda M. Assef, Maria Teresinha A. Steiner

Abstract:

The aim of this paper is to compare and discuss better classifier algorithm options for credit risk assessment by applying different Machine Learning techniques. Using records from a Brazilian financial institution, this study uses a database of 5,432 companies that are clients of the bank, where 2,600 clients are classified as non-defaulters, 1,551 are classified as defaulters and 1,281 are temporarily defaulters, meaning that the clients are overdue on their payments for up 180 days. For each case, a total of 15 attributes was considered for a one-against-all assessment using four different techniques: Artificial Neural Networks Multilayer Perceptron (ANN-MLP), Artificial Neural Networks Radial Basis Functions (ANN-RBF), Logistic Regression (LR) and finally Support Vector Machines (SVM). For each method, different parameters were analyzed in order to obtain different results when the best of each technique was compared. Initially the data were coded in thermometer code (numerical attributes) or dummy coding (for nominal attributes). The methods were then evaluated for each parameter and the best result of each technique was compared in terms of accuracy, false positives, false negatives, true positives and true negatives. This comparison showed that the best method, in terms of accuracy, was ANN-RBF (79.20% for non-defaulter classification, 97.74% for defaulters and 75.37% for the temporarily defaulter classification). However, the best accuracy does not always represent the best technique. For instance, on the classification of temporarily defaulters, this technique, in terms of false positives, was surpassed by SVM, which had the lowest rate (0.07%) of false positive classifications. All these intrinsic details are discussed considering the results found, and an overview of what was presented is shown in the conclusion of this study.

Keywords: artificial neural networks (ANNs), classifier algorithms, credit risk assessment, logistic regression, machine Learning, support vector machines

Procedia PDF Downloads 90

Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

Abstract:

Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

Procedia PDF Downloads 148

Authors: Soheila Sadeghi

Abstract:

Accurate cost prediction is essential for effective project management and decision-making in the construction industry. This study aims to develop a cost prediction model for construction projects using Machine Learning techniques and Particle Swarm Optimization (PSO). The research utilizes a comprehensive dataset containing project cost estimates, actual costs, resource details, and project performance metrics from a road reconstruction project. The methodology involves data preprocessing, feature selection, and the development of an Artificial Neural Network (ANN) model optimized using PSO. The study investigates the impact of various input features, including cost estimates, resource allocation, and project progress, on the accuracy of cost predictions. The performance of the optimized ANN model is evaluated using metrics such as Mean Squared Error (MSE), Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), and R-squared. The results demonstrate the effectiveness of the proposed approach in predicting project costs, outperforming traditional benchmark models. The feature selection process identifies the most influential variables contributing to cost variations, providing valuable insights for project managers. However, this study has several limitations. Firstly, the model's performance may be influenced by the quality and quantity of the dataset used. A larger and more diverse dataset covering different types of construction projects would enhance the model's generalizability. Secondly, the study focuses on a specific optimization technique (PSO) and a single Machine Learning algorithm (ANN). Exploring other optimization methods and comparing the performance of various ML algorithms could provide a more comprehensive understanding of the cost prediction problem. Future research should focus on several key areas. Firstly, expanding the dataset to include a wider range of construction projects, such as residential buildings, commercial complexes, and infrastructure projects, would improve the model's applicability. Secondly, investigating the integration of additional data sources, such as economic indicators, weather data, and supplier information, could enhance the predictive power of the model. Thirdly, exploring the potential of ensemble learning techniques, which combine multiple ML algorithms, may further improve cost prediction accuracy. Additionally, developing user-friendly interfaces and tools to facilitate the adoption of the proposed cost prediction model in real-world construction projects would be a valuable contribution to the industry. The findings of this study have significant implications for construction project management, enabling proactive cost estimation, resource allocation, budget planning, and risk assessment, ultimately leading to improved project performance and cost control. This research contributes to the advancement of cost prediction techniques in the construction industry and highlights the potential of Machine Learning and PSO in addressing this critical challenge. However, further research is needed to address the limitations and explore the identified future research directions to fully realize the potential of ML-based cost prediction models in the construction domain.

Keywords: cost prediction, construction projects, machine learning, artificial neural networks, particle swarm optimization, project management, feature selection, road reconstruction

Procedia PDF Downloads 28

Authors: Prem Bahadur Giri

Abstract:

The nationalization of forests during the early 1960s had become counterproductive for the conservation of forests in Nepal. Realizing this fact, the Government of Nepal initiated a paradigm shift from a government-controlled forestry system to people’s direct participation in managing forestry, conceptualizing a community forest approach in the early 1980s. The community forestry approach is expected to promote sustainable forest management, restoring degraded forests to enhance the forest condition on the one hand, and on the other, improvement of livelihoods, particularly of low-income people and forest-dependent communities, as well as promoting community ownership of a forest. As a result, the establishment of community forests started and had taken faster momentum in Nepal. Of the total land in Nepal, forest occupies 6.5 million hectares which are around 45 percent of the forest area. Of the total forest area, 1.8 million hectares have been handed over to community management. A total of 19,361 ‘community forest users groups’ are already created to manage the community forest. To streamline the governance of community forests, the enactment of ‘The Forest Act 1993’ provides a clear legal basis for managing community forests in Nepal. This article is based on an in-depth study taking the case of Tarpakha Community Forest (TCF) located in Siranchok Rural Municipality of Gorkha District in Nepal. It mainly discusses the extent to which the TCF is able to achieve the twin objectives of this community forest for catalyzing socio-economic improvement of the targeted community and conservation of the forest. The primary information was generated through in-depth interviews along with group discussions with members, the management committee, and other relevant stakeholders. The findings reveal that there is a significant improvement in the regeneration of the forest and also changes in the socio-economic status of the local community. However, coordination with local municipalities and forest governing entities is still weak.

Keywords: community forest, socio-economic benefit, sustainable forest management, Nepal

Procedia PDF Downloads 75

Authors: S. M. Azad, H. Ghodsi Pour, F. Roshannafasa

Abstract:

In recent years ‘technology management and policymaking’ is one of the most important problems in management science. In this field, different generations of innovation and technology management are presented which the earliest one is Innovation System (IS) approach. In a general classification, innovation systems are divided in to 4 approaches: Technical, sectoral, regional, and national. There are many researches in relation to each of these approaches in different academic fields. Every approach has some benefits. If two or more approaches hybrid, their benefits would be combined. In addition, according to the sectoral structure of the governance model in Iran, in many sectors such as information technology, the combination of three other approaches with sectoral approach is essential. Hence, in this paper, combining two IS approaches (technical and sectoral) and using system dynamics, a generic model is presented for a sample of software industry. As a complimentary point, this article is introducing a new hybrid approach called Techno-Sectoral Innovation System. This TSIS model is accomplished by Changing concepts of the ‘functions’ which came from Technological IS literature and using them into sectoral system as measurable indicators.

Keywords: innovation system, technology, techno-sectoral system, functional indicators, system dynamics

Procedia PDF Downloads 421

Authors: Aishi Kundu, Elhan Raza

Abstract:

"Necessity is the mother of invention" - Rapid increase in the global human population has directed the agricultural domain toward machine learning. The basic need of human beings is considered to be food which can be satisfied through farming. Farming is one of the major revenue generators for the Indian economy. Agriculture is not only considered a source of employment but also fulfils humans’ basic needs. So, agriculture is considered to be the source of employment and a pillar of the economy in developing countries like India. This paper provides a brief review of the progress made in implementing Machine Learning in the agricultural sector. Accurate predictions are necessary at the right time to boost production and to aid the timely and systematic distribution of agricultural commodities to make their availability in the market faster and more effective. This paper includes a thorough analysis of various machine learning algorithms applied in different aspects of agriculture (crop management, soil management, water management, yield tracking, livestock management, etc.).Due to climate changes, crop production is affected. Machine learning can analyse the changing patterns and come up with a suitable approach to minimize loss and maximize yield. Machine Learning algorithms/ models (regression, support vector machines, bayesian models, artificial neural networks, decision trees, etc.) are used in smart agriculture to analyze and predict specific outcomes which can be vital in increasing the productivity of the Agricultural Food Industry. It is to demonstrate vividly agricultural works under machine learning to sensor data. Machine Learning is the ongoing technology benefitting farmers to improve gains in agriculture and minimize losses. This paper discusses how the irrigation and farming management systems evolve in real-time efficiently. Artificial Intelligence (AI) enabled programs to emerge with rich apprehension for the support of farmers with an immense examination of data.

Keywords: machine Learning, artificial intelligence, crop management, precision farming, smart farming, pre-harvesting, harvesting, post-harvesting

Procedia PDF Downloads 89

Authors: Fasil Wagnew, Kerri Viney, Kefyalew Addis Alene, Matthew Kelly, Darren Gray

Abstract:

Background: Undernutrition is a risk factor for tuberculosis (TB), including poor treatment outcomes. However, evidence regarding the effect of undernutrition on TB treatment outcomes is not well understood. We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multi-drug resistance (MDR)-TB. Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases without restrictions on geography or year of publication. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Two reviewers independently assessed the study eligibility, extracted the necessary information, and assessed the risk of bias. Depending on the nature of the data, odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger’s tests. Results: Of 2358 records screened, 59 studies comprising a total of 31,254 people with MDR-TB were included. Undernutrition was significantly associated with a lower sputum culture conversion rate (HR 0·7, 95% CI 0·6–0·9, I2=67·1%) and a higher rate of mortality (OR 2·9, 95%CI 2·1–3·8, I2=23·7%) and unfavourable treatment outcomes (OR 1·8, 95%CI 1·5–2·0, I2=72·7%). There was no statistically significant publication bias in the included studies. Three studies were low, forty-two studies were moderate, and fourteen studies were high quality. Interpretations: Undernutrition was significantly associated with unfavourable treatment outcomes, including mortality and lower sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardised second-line TB drugs.

Keywords: undernutrition, MDR-TB, sputum culture conversion, treatment outcomes, meta-analysis

Procedia PDF Downloads 135