Search results for: effective income tax rate
13559 Environmental Fatigue Analysis for Control Rod Drive Mechanisms Seal House
Authors: Xuejiao Shao, Jianguo Chen, Xiaolong Fu
Abstract:
In this paper, the elastoplastic strain correction factor computed by software of ANSYS was modified, and the fatigue usage factor in air was also corrected considering in water under reactor operating condition. The fatigue of key parts on control rod drive mechanisms was analyzed considering the influence of environmental fatigue caused by the coolant in the react pressure vessel. The elastoplastic strain correction factor was modified by analyzing thermal and mechanical loads separately referring the rules of RCC-M 2002. The new elastoplastic strain correction factor Ke(mix) is computed to replace the original Ke computed by the software of ANSYS when evaluating the fatigue produced by thermal and mechanical loads together. Based on the Ke(mix) and the usage cycle and fatigue design curves, the new range of primary plus secondary stresses was evaluated to obtain the final fatigue usage factor. The results show that the precision of fatigue usage factor can be elevated by using modified Ke when the amplify of the primary and secondary stress is large to some extent. One approach has been proposed for incorporating the environmental effects considering the effects of reactor coolant environments on fatigue life in terms of an environmental correction factor Fen, which is the ratio of fatigue life in air at room. To incorporate environmental effects into the RCCM Code fatigue evaluations, the fatigue usage factor based on the current Code design curves is multiplied by the correction factor. The contribution of environmental effects to results is discussed. Fatigue life decreases logarithmically with decreasing strain rate below 10%/s, which is insensitive to strain rate when temperatures below 100°C.Keywords: environmental fatigue, usage factor, elastoplastic strain correction factor, environmental correction
Procedia PDF Downloads 32413558 Stochastic Fleet Sizing and Routing in Drone Delivery
Authors: Amin Karimi, Lele Zhang, Mark Fackrell
Abstract:
Rural-to-urban population migrations are a global phenomenon, with projections indicating that by 2050, 68% of the world's population will inhabit densely populated urban centers. Concurrently, the popularity of e-commerce shopping has surged, evidenced by a 51% increase in total e-commerce sales from 2017 to 2021. Consequently, distribution and logistics systems, integral to effective supply chain management, confront escalating hurdles in efficiently delivering and distributing products within bustling urban environments. Additionally, events like environmental challenges and the COVID-19 pandemic have indicated that decision-makers are facing numerous sources of uncertainty. Therefore, to design an efficient and reliable logistics system, uncertainty must be considered. In this study, it examine fleet sizing and routing while considering uncertainty in demand rate. Fleet sizing is typically a strategic-level decision, while routing is an operational-level one. In this study, a carrier must make two types of decisions: strategic-level decisions regarding the number and types of drones to be purchased, and operational-level decisions regarding planning routes based on available fleet and realized demand. If the available fleets are insufficient to serve some customers, the carrier must outsource that delivery at a relatively high cost, calculated per order. With this hierarchy of decisions, it can model the problem using two-stage stochastic programming. The first-stage decisions involve planning the number and type of drones to be purchased, while the second-stage decisions involve planning routes. To solve this model, it employ logic-based benders decomposition, which decomposes the problem into a master problem and a set of sub-problems. The master problem becomes a mixed integer programming model to find the best fleet sizing decisions, and the sub-problems become capacitated vehicle routing problems considering battery status. Additionally, it assume a heterogeneous fleet based on load and battery capacity, and it consider that battery health deteriorates over time as it plan for multiple periods.Keywords: drone-delivery, stochastic demand, VRP, fleet sizing
Procedia PDF Downloads 5813557 Approaches to Ethical Hacking: A Conceptual Framework for Research
Authors: Lauren Provost
Abstract:
The digital world remains increasingly vulnerable, making the development of effective cybersecurity approaches even more critical in supporting the success of the digital economy and national security. Although approaches to cybersecurity have shifted and improved in the last decade with new models, especially with cloud computing and mobility, a record number of high severity vulnerabilities were recorded in the National Institute of Standards and Technology (NIST), and its National Vulnerability Database (NVD) in 2020. This is due, in part, to the increasing complexity of cyber ecosystems. Security must be approached with a more comprehensive, multi-tool strategy that addresses the complexity of cyber ecosystems, including the human factor. Ethical hacking has emerged as such an approach: a more effective, multi-strategy, comprehensive approach to cyber security's most pressing needs, especially understanding the human factor. Research on ethical hacking, however, is limited in scope. The two main objectives of this work are to (1) provide highlights of case studies in ethical hacking, (2) provide a conceptual framework for research in ethical hacking that embraces and addresses both technical and nontechnical security measures. Recommendations include an improved conceptual framework for research centered on ethical hacking that addresses many factors and attributes of significant attacks that threaten computer security; a more robust, integrative multi-layered framework embracing the complexity of cybersecurity ecosystems.Keywords: ethical hacking, literature review, penetration testing, social engineering
Procedia PDF Downloads 21813556 Efficacy and Safety of COVID-19 Vaccination in Patients with Multiple Sclerosis: Looking Forward to Post-COVID-19
Authors: Achiron Anat, Mathilda Mandel, Mayust Sue, Achiron Reuven, Gurevich Michael
Abstract:
Introduction: As coronavirus disease 2019 (COVID-19) vaccination is currently spreading around the world, it is of importance to assess the ability of multiple sclerosis (MS) patients to mount an appropriate immune response to the vaccine in the context of disease-modifying treatments (DMT’s). Objectives: Evaluate immunity generated following COVID-19 vaccination in MS patients, and assess factors contributing to protective humoral and cellular immune responses in MS patients vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus infection. Methods: Review our recent data related to (1) the safety of PfizerBNT162b2 COVID-19 mRNA vaccine in adult MS patients; (2) the humoral post-vaccination SARS-CoV2 IgG response in MS vaccinees using anti-spike protein-based serology; and (3) the cellular immune response of memory B-cells specific for SARS-CoV-2 receptor-binding domain (RBD) and memory T-cells secreting IFN-g and/or IL-2 in response to SARS-CoV2 peptides using ELISpot/Fluorospot assays in MS patients either untreated or under treatment with fingolimod, cladribine, or ocrelizumab; (4) covariate parameters related to mounting protective immune responses. Results: COVID-19 vaccine proved safe in MS patients, and the adverse event profile was mainly characterised by pain at the injection site, fatigue, and headache. Not any increased risk of relapse activity was noted and the rate of patients with acute relapse was comparable to the relapse rate in non-vaccinated patients during the corresponding follow-up period. A mild increase in the rate of adverse events was noted in younger MS patients, among patients with lower disability, and in patients treated with DMTs. Following COVID-19 vaccination protective humoral immune response was significantly decreased in fingolimod- and ocrelizumab- treated MS patients. SARS-CoV2 specific B-cell and T-cell cellular responses were respectively decreased. Untreated MS patients and patients treated with cladribine demonstrated protective humoral and cellular immune responses, similar to healthy vaccinated subjects. Conclusions: COVID-19 BNT162b2 vaccine proved as safe for MS patients. No increased risk of relapse activity was noted post-vaccination. Although COVID-19 vaccination is new, accumulated data demonstrate differences in immune responses under various DMT’s. This knowledge can help to construct appropriate COVID-19 vaccine guidelines to ensure proper immune responses for MS patients.Keywords: covid-19, vaccination, multiple sclerosis, IgG
Procedia PDF Downloads 13913555 Experimental investigation on the lithium-Ion Battery Thermal Management System Based on Micro Heat Pipe Array in High Temperature Environment
Authors: Ruyang Ren, Yaohua Zhao, Yanhua Diao
Abstract:
The intermittent and unstable characteristics of renewable energy such as solar energy can be effectively solved through battery energy storage system. Lithium-ion battery is widely used in battery energy storage system because of its advantages of high energy density, small internal resistance, low self-discharge rate, no memory effect and long service life. However, the performance and service life of lithium-ion battery is seriously affected by its operating temperature. Thus, the safety operation of the lithium-ion battery module is inseparable from an effective thermal management system (TMS). In this study, a new type of TMS based on micro heat pipe array (MHPA) for lithium-ion battery is established, and the TMS is applied to a battery energy storage box that needs to operate at a high temperature environment of 40 °C all year round. MHPA is a flat shape metal body with high thermal conductivity and excellent temperature uniformity. The battery energy storage box is composed of four battery modules, with a nominal voltage of 51.2 V, a nominal capacity of 400 Ah. Through the excellent heat transfer characteristics of the MHPA, the heat generated by the charge and discharge process can be quickly transferred out of the battery module. In addition, if only the MHPA cannot meet the heat dissipation requirements of the battery module, the TMS can automatically control the opening of the external fan outside the battery module according to the temperature of the battery, so as to further enhance the heat dissipation of the battery module. The thermal management performance of lithium-ion battery TMS based on MHPA is studied experimentally under different ambient temperatures and the condition to turn on the fan or not. Results show that when the ambient temperature is 40 °C and the fan is not turned on in the whole charge and discharge process, the maximum temperature of the battery in the energy storage box is 53.1 °C and the maximum temperature difference in the battery module is 2.4 °C. After the fan is turned on in the whole charge and discharge process, the maximum temperature is reduced to 50.1 °C, and the maximum temperature difference is reduced to 1.7 °C. Obviously, the lithium-ion battery TMS based on MHPA not only could control the maximum temperature of the battery below 55 °C, but also ensure the excellent temperature uniformity of the battery module. In conclusion, the lithium-ion battery TMS based on MHPA can ensure the safe and stable operation of the battery energy storage box in high temperature environment.Keywords: heat dissipation, lithium-ion battery thermal management, micro heat pipe array, temperature uniformity
Procedia PDF Downloads 18113554 Taphonomy and Paleoecology of Cenomanian Oysters (Mollusca: Bivalvia) from Egypt
Authors: Ahmed El-Sabbagh, Heba Mansour, Magdy El-Hedeny
Abstract:
This study provided a taphonomic alteration and paleoecology of Cenomanian oysters from the Musabaa Salama area, south western Sinai, Egypt. Three oyster zones can be recognized in the studied area, a lower one of Amphidonte (Ceratostreon) flabellatum (lower-middle Cenomanian), a middle zone of Ilymatogyra (Afrogyra) africana (upper Cenomanian) and an upper one of Exogyra (Costagyra) olisiponensis (upper Cenomanian). Taphonomic features including disarticulation, fragmentation, encrustation and bioerosion were subjected to multivariate statistical analyses. The analyses showed that the distributions of the identified ichnospecies were greatly similar within the identified oyster zones in the Musabaa Salama section. With rare exceptions, Entobia cretacea, Gastrochaenolites torpedo and Maeandropolydora decipiens are considered as common to abundant ichnospecies within the three recorded oyster zones. In contrast, and with some exceptions, E. ovula, E. retiformis and Rogerella pattei are considered as frequent to common ichnospecies within the identified oyster zones. Other ichnospecies, including Caulostrepsis cretacea, G. orbicularis, Trypanites solitarius, E. geometrica and C. taeniola, are mostly recorded in rare to frequent occurrences. Careful investigation of these host shells and the preserved encrusters and/or bioerosion sculptures provided data concerning: 1) the substrate characteristics, 2) time of encrustation and bioerosion, 3) rate of sedimentation, 4) the planktonic productivity level, and 5) the general bathymetry and the rate of transgression across the substrate.Keywords: oysters, Cenomanian, taphonomy, palaeoecology, Sinai, Egypt
Procedia PDF Downloads 30913553 Development of an Information System Based on the Establishment and Evaluation of Performance Rating by Application Part/Type of Remodeling Element Technologies
Authors: Sungwon Jung
Abstract:
The percentage of 20 years or older apartment houses in South Korea is approximately 20% (1.55 million houses), and the explosive increase of aged houses is expected around the first planned new towns. Accordingly, we should prepare for social issues such as difficulty of housing lease and degradation of housing performance. The improvement of performance of aged houses is essential for achieving the national energy and carbon reduction goals, and we should develop techniques to respond to the changing construction environment. Furthermore, we should develop a performance evaluation system that is appropriate for the demands of residents such as the improvement of remodeling floor plan by performance improvement in line with the residence type of the housing vulnerable groups such as low-income group and elderly people living alone. For this purpose, remodeling techniques and business models optimized for the target complexes must be spread through the development of various business models. In addition, it is necessary to improve the remodeling business by improving the laws and systems related to the improvement of the residential performance and to prepare techniques to respond to the increasing business demands. In other words, performance improvement and evaluation and knowledge systems need to be researched as new issues related to remodeling that has not been addressed in the existing research.Keywords: remodelling, performance evaluation, web-based system, big data
Procedia PDF Downloads 22413552 Homogenization of a Non-Linear Problem with a Thermal Barrier
Authors: Hassan Samadi, Mustapha El Jarroudi
Abstract:
In this work, we consider the homogenization of a non-linear problem in periodic medium with two periodic connected media exchanging a heat flux throughout their common interface. The interfacial exchange coefficient λ is assumed to tend to zero or to infinity following a rate λ=λ(ε) when the size ε of the basic cell tends to zero. Three homogenized problems are determined according to some critical value depending of λ and ε. Our method is based on Γ-Convergence techniques.Keywords: variational methods, epiconvergence, homogenization, convergence technique
Procedia PDF Downloads 52513551 Ultrasound-Assisted Extraction of Carotenoids from Tangerine Peel Using Ostrich Oil as a Green Solvent and Optimization of the Process by Response Surface Methodology
Authors: Fariba Tadayon, Nika Gharahgolooyan, Ateke Tadayon, Mostafa Jafarian
Abstract:
Carotenoid pigments are a various group of lipophilic compounds that generate the yellow to red colors of many plants, foods and flowers. A well-known type of carotenoids which is pro-vitamin A is β-carotene. Due to the color of citrus fruit’s peel, the peel can be a good source of different carotenoids. Ostrich oil is one of the most valuable foundations in many branches of industry, medicine, cosmetics and nutrition. The animal-based ostrich oil could be considered as an alternative and green solvent. Following this study, wastes of citrus peel will recycle by a simple method and extracted carotenoids can increase properties of ostrich oil. In this work, a simple and efficient method for extraction of carotenoids from tangerine peel was designed. Ultrasound-assisted extraction (UAE) showed significant effect on the extraction rate by increasing the mass transfer rate. Ostrich oil can be used as a green solvent in many studies to eliminate petroleum-based solvents. Since tangerine peel is a complex source of different carotenoids separation and determination was performed by high-performance liquid chromatography (HPLC). In addition, the ability of ostrich oil and sunflower oil in carotenoid extraction from tangerine peel and carrot was compared. The highest yield of β-carotene extracted from tangerine peel using sunflower oil and ostrich oil were 75.741 and 88.110 (mg/L), respectively. Optimization of the process was achieved by response surface methodology (RSM) and the optimal extraction conditions were tangerine peel powder particle size of 0.180 mm, ultrasonic intensity of 19 W/cm2 and sonication time of 30 minutes.Keywords: β-carotene, carotenoids, citrus peel, ostrich oil, response surface methodology, ultrasound-assisted extraction
Procedia PDF Downloads 31613550 Increasing National Health Insurance Scheme Enrolment in Ghana: Pro-Rata Insurance Premium Payment with Mobile Phone as the Answer
Authors: Joseph Marfo Boaheng, Daniel Ansong, Eugenia Amporfo
Abstract:
Health Insurance is proposed to provide financial protection against catastrophic health care cost arising from disease. Ghana has had a National Health Insurance Scheme (NHIS) since 2003 with the current enrolment/retention rate of 36%. The main goal of the scheme is to provide equity in the health sector as well as ensuring affordable health care for the poor. However, the current payment system is not flexible to attract significant proportion of the poor informal sector onto the scheme. Looking at the extensive use of mobiles in the Ghana where about 29,220,602.00 registered mobile phone lines are actively in used as of June 2014, paying health insurance premium through mobile phone could be feasible to attract larger proportion of the informal sector onto the scheme. Methodology: The quantitative cross-sectional survey was used to solicit the required information from 877 respondents living in Kumasi, the second capital city of Ghana. The magnitude of the effect of Pro-rata system (flexible payment terms) on NHIS enrollment rate was estimated with binary logistic regression model. Results: The odds for an individual to enroll onto NHIS with mobile phone increases about 2 times more when payment of insurance premium is on pro-rata basis ie. flexible payment terms (p=0.008, CI=1.212-3.565). Conclusion: The study advocates the National Health Insurance Authority consider this alternative payment system that has the potential of attracting a greater proportion of the informal sector to be enrolled or retained onto the scheme.Keywords: enrollment, health insurance, mobile phone, pro-rata
Procedia PDF Downloads 39413549 Zoledronic Acid with Neoadjuvant Chemotherapy in Advanced Breast Cancer Prospective Study 2011–2014
Authors: S. Sakhri
Abstract:
Background: The use of Zoledronic acid (ZA) is an established place in the treatment of malignant tumors with a predilection for the skeleton of interest (in particular metastasis). Although the main target of Zoledronic acid was osteoclasts, there are preclinical data suggest that Zoledronic acid may have an antitumor effect on cells other than osteoclasts, including tumor cells. Antitumor activity, including the inhibition of tumor cell growth and the induction of apoptosis of tumor cells, inhibition of tumor cell adhesion and invasion, and anti-angiogenic effects have been demonstrated. Methods. From (2012 to 2014), 438 patients were included respondents the inclusion criteria, respectively. This is a prospective study over a 4 year period. Of all patients (N=438), 432 received neoadjuvant chemotherapy with Zoledronic acid. The primary end point was the pathologic complete response in advancer breast cancer stage. The secondary end point is to evaluate Clinical response according to RECIST criteria; estimate the bone density before and at the end of chemotherapy in women with locally advanced breast cancer, Toxicity Evaluation and Overall survival using Kaplan-Meier and log test. Result: The Objective response rate was 97% after (C4) with 3% stabilizations and 99, 3% of which 0.7% C8 after stabilization. The clinical complete response was 28% after C4 respectively, and 46.8% after C8, the pathologic complete response rate was 40.13% according to the classification Sataloff. We observed that the pathologic complete response rate was the most raised in the group including Her2 (luminal Her2 and Her2) the lowest in the triple negative group as classified by Sataloff. We found that the pCR is significantly higher in the age group (35-50 years) with 53.17%. Those who have more than 50 years in 2nd place with 27.7% and the lower in young woman 35 years pCR was 19%, not statistically significant, -The pCR was also in favor of the menopausal group in 51, 4%, and 48, 55% for non-menopausal women. The average duration of overall survival was also significantly in the subgroup (Luminal -Her2, Her2) compared with triple negative. It is 47.18 months in the luminal group vs. 38.95 in the triple negative group. -Was observed in our study a difference in quality of life between (C1) was the admission of the patient, and after (C8), we found an increase in general signs and a deterioration in the psychological state C1, in contrast to the C8 these general signs and mental status improves, up to 12, and 24 months. Conclusion The results of this study suggest that the addition of ZA to néoadjuvant CT has potential anti-cancer benefit in patients (Luminal -Her2, Her2) compared with triple negative with or without menopause status.Keywords: HER2+, RH+, breast cancer, tyrosine kinase
Procedia PDF Downloads 20913548 The Increase of Adolescent Obesity Rates after the COVID-19 Pandemic and Possible Obesity Prevention Programs for Implementation
Authors: Tatiana Pratt, Benyamin Hanasabzadeh, Panayiota Courelli
Abstract:
The COVID-19 pandemic is one of the largest global public health issues of this current century. COVID-19 puts people diagnosed with obesity at higher risk of not only contracting the virus but also being hospitalized and dying, making this a vital time to implement obesity prevention programs. However, COVID-19 is predicted to rapidly increase the obesity rate in the United States due to the mandatory sedentary lifestyle the pandemic demands; this is especially harmful to adolescent-aged children because it creates lifelong unhealthy habits and behaviors. Adolescent obesity prevention programs have been rigorously implemented throughout the last century to help diminish the ever-increasing adolescent obesity rate. Since the pandemic kept adolescents inside and away from in-person school, many programs have now become ineffective due to their in-person participation. Examples of in-person participation programs include school lunch programs, OSNAP and New Moves. Therefore, online programs or remote intervention measures are now more essential. This leads to programs such as Time2bHealthy, HEALTH[e]TEEN, and SWITCH should be looked at with more vitality. Adolescents have intertwined their lives with technology and screen usage. Therefore, online and remote prevention programs will continue to play a large role in the post-pandemic era. This literature review will be reviewing past and current adolescent obesity prevention programs and their effectiveness with the new remote, sedentary lifestyle adolescents. Furthermore, it will suggest new ways to more productively decrease adolescent obesity rates by analyzing the harmful factors that COVID-19 introduced into their lifestyles.Keywords: adolescent, obesity, overweight, COVID-19, preventative care, public health, public policy, obesity prevention programs, online programs
Procedia PDF Downloads 23813547 On the Right an Effective Administrative Justice in the Republic of Macedonia: Challenges and Problems
Authors: Arlinda Memetaj
Abstract:
A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of effective public administration, has been since 1990s among the most 'important and urgent' final strategic objectives of the Republic of Macedonia. To this aim the country has so far adopted a huge series of legislative and strategic documents related to any aspects of the administrative justice system. The latter is designed to strengthen the legal position of citizens, businesses, civic organizations, and other societal subjects. 'Changes and reforms' in this field have been thus the most frequent terms being used in the country for the last more than 20 years. Several years ago the County established Administrative Courts, while permanently amending the Law on the General Administrative procedure (LGAP). The new LGAP was adopted in 2015 and it introduced considerable innovations concerned. The most recent inputs in this regard includes the National Public Administration Reform Strategy 2017 – 2022, one of the key expected result of which includes both providing effective protection of the citizens` rights. In doing the aforesaid however there is still a series of interrelated shortcomings in this regard, such as (just to mention few) the complex appeal procedure, delays in enforcing court rulings, etc. Against the above background, the paper firstly describes the Macedonian institutional and legislative framework in the above field, and then illustrates the shortcomings therein. It finally claims that the current status quo situation may be overcome only if there is a proper implementation of the administrative courts decisions and far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main method used in this paper is the descriptive, analytical and comparative one due to the very character of the paper itself.Keywords: administrative justice, administrative procedure, administrative courts/disputes, European Human Rights Court, human rights, monitoring, reform, benefit.
Procedia PDF Downloads 15513546 Performance the SOFA and APACHEII Scoring System to Predicate the Mortality of the ICU Cases
Authors: Yu-Chuan Huang
Abstract:
Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.Keywords: SOFA, APACHEII, mortality, ICU
Procedia PDF Downloads 14713545 Resistance Training Contribution to the Aerobic Component of the International Physical Activity Guidelines in Adults
Authors: Neha Bharti, Martin Sénéchal, Danielle R. Bouchard
Abstract:
Mostly attributed to lack of time, only 15% of adults currently reach the International Physical Activity Guidelines, which state that every adult should achieve minimum of 150 minutes of aerobic exercise per week at moderate to vigorous intensity in minimum bouts of 10 minutes each, in addition to two days of resistance training. Recent studies have suggested that any bout of aerobic exercise reaching moderate intensity has potential to improve health. If one could reach moderate intensity while doing resistance training, this could reduce the total weekly time involvement to reach the International Physical Activity Guidelines. Objectives: 1) To determine whether overweight and older adults can reach a minimum of moderate intensity while doing resistance training compared with young non-overweight adults, 2) To identify if the proportion of time spent at moderate to vigorous intensity is different in overweight adults and older adults when compared with young non-overweight adults when lifting 70% or 80% of maximal load, 3) To determine variables associated with proportion of time spent at moderate to vigorous intensity while doing resistance training. Methods: Sixty participants already doing resistance training were recruited (20 young non-overweight adults, 20 overweight adults, and 20 older adults). Participants visited fitness facility three times, separated by at least 48 hours, and performed eight resistance exercises each time. First visit was to collect baseline measurements and to measure maximal load for each of the eight exercises. Second and third visits were performed wearing a heart rate monitor to record heart rate and to measure exercise intensity. The two exercise sessions were performed at 70% and 80% of maximal capacity. Moderate intensity was defined as 40% of heart rate reserve. Results: The proportion of time spent at moderate to vigorous intensity ranged from 51% to 93% among the three groups. No difference was observed between the young group and the overweight adults group in the proportion of time spent at moderate to vigorous intensity, 82.6% (69.2-94.6) vs 92.5% (73.3-99.1). However, older adults spent lower proportion of time at moderate to vigorous intensity for both sessions 51.5% (22.0-86.6); P < .01. When doing resistance training at 70% and 80% of maximal capacity, the proportion of time spent at moderate to vigorous intensity was 82.3% (56.1-94.7) and 82.0% (59.2-98.0) with no significant difference (P=.83). Conclusion: This study suggests that overweight adults and older adults can reach moderate intensity for at least 51% of the time spent doing resistance training. However, time spent at moderate to vigorous intensity was lower for older adults compared to young non-overweight adults. For adults aged 60 or less, three resistance training sessions of 60 minutes weekly could be enough to reach both aerobic and resistance training components of the International Physical Activity Guidelines. Further research is needed to test if resistance training at moderate to vigorous intensity can have the same health benefits compared with adults completing the International Physical Activity Guidelines as currently suggested.Keywords: aerobic exercise, international physical activity guidelines, moderate to vigorous intensity, resistance training
Procedia PDF Downloads 53713544 Is Swaziland on Track with the 2015 Millennium Development Goals?
Authors: A. Sathiya Susuman
Abstract:
Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors
Procedia PDF Downloads 49913543 Role of Yeast-Based Bioadditive on Controlling Lignin Inhibition in Anaerobic Digestion Process
Authors: Ogemdi Chinwendu Anika, Anna Strzelecka, Yadira Bajón-Fernández, Raffaella Villa
Abstract:
Anaerobic digestion (AD) has been used since time in memorial to take care of organic wastes in the environment, especially for sewage and wastewater treatments. Recently, the rising demand/need to increase renewable energy from organic matter has caused the AD substrates spectrum to expand and include a wider variety of organic materials such as agricultural residues and farm manure which is annually generated at around 140 billion metric tons globally. The problem, however, is that agricultural wastes are composed of materials that are heterogeneous and too difficult to degrade -particularly lignin, that make up about 0–40% of the total lignocellulose content. This study aimed to evaluate the impact of varying concentrations of lignin on biogas yields and their subsequent response to a commercial yeast-based bioadditive in batch anaerobic digesters. The experiments were carried out in batches for a retention time of 56 days with different lignin concentrations (200 mg, 300 mg, 400 mg, 500 mg, and 600 mg) treated to different conditions to first determine the concentration of the bioadditive that was most optimal for overall process improvement and yields increase. The batch experiments were set up using 130 mL bottles with a working volume of 60mL, maintained at 38°C in an incubator shaker (150rpm). Digestate obtained from a local plant operating at mesophilic conditions was used as the starting inoculum, and commercial kraft lignin was used as feedstock. Biogas measurements were carried out using the displacement method and were corrected to standard temperature and pressure using standard gas equations. Furthermore, the modified Gompertz equation model was used to non-linearly regress the resulting data to estimate gas production potential, production rates, and the duration of lag phases as indicatives of degrees of lignin inhibition. The results showed that lignin had a strong inhibitory effect on the AD process, and the higher the lignin concentration, the more the inhibition. Also, the modelling showed that the rates of gas production were influenced by the concentrations of the lignin substrate added to the system – the higher the lignin concentrations in mg (0, 200, 300, 400, 500, and 600) the lower the respective rate of gas production in ml/gVS.day (3.3, 2.2, 2.3, 1.6, 1.3, and 1.1), although the 300 mg increased by 0.1 ml/gVS.day over that of the 200 mg. The impact of the yeast-based bioaddition on the rate of production was most significant in the 400 mg and 500 mg as the rate was improved by 0.1 ml/gVS.day and 0.2 ml/gVS.day respectively. This indicates that agricultural residues with higher lignin content may be more responsive to inhibition alleviation by yeast-based bioadditive; therefore, further study on its application to the AD of agricultural residues of high lignin content will be the next step in this research.Keywords: anaerobic digestion, renewable energy, lignin valorisation, biogas
Procedia PDF Downloads 9113542 Time to Second Line Treatment Initiation Among Drug-Resistant Tuberculosis Patients in Nepal
Authors: Shraddha Acharya, Sharad Kumar Sharma, Ratna Bhattarai, Bhagwan Maharjan, Deepak Dahal, Serpahine Kaminsa
Abstract:
Background: Drug-resistant (DR) tuberculosis (TB) continues to be a threat in Nepal, with an estimated 2800 new cases every year. The treatment of DR-TB with second line TB drugs is complex and takes longer time with comparatively lower treatment success rate than drug-susceptible TB. Delay in treatment initiation for DR-TB patients might further result in unfavorable treatment outcomes and increased transmission. This study thus aims to determine median time taken to initiate second-line treatment among Rifampicin Resistant (RR) diagnosed TB patients and to assess the proportion of treatment delays among various type of DR-TB cases. Method: A retrospective cohort study was done using national routine electronic data (DRTB and TB Laboratory Patient Tracking System-DHIS2) on drug resistant tuberculosis patients between January 2020 and December 2022. The time taken for treatment initiation was computed as– days from first diagnosis as RR TB through Xpert MTB/Rif test to enrollment on second-line treatment. The treatment delay (>7 days after diagnosis) was calculated. Results: Among total RR TB cases (N=954) diagnosed via Xpert nationwide, 61.4% were enrolled under shorter-treatment regimen (STR), 33.0% under longer treatment regimen (LTR), 5.1% for Pre-extensively drug resistant TB (Pre-XDR) and 0.4% for Extensively drug resistant TB (XDR) treatment. Among these cases, it was found that the median time from diagnosis to treatment initiation was 6 days (IQR:2-15.8). The median time was 5 days (IQR:2.0-13.3) among STR, 6 days (IQR:3.0-15.0) among LTR, 30 days (IQR:5.5-66.8) among Pre-XDR and 4 days (IQR:2.5-9.0) among XDR TB cases. The overall treatment delay (>7 days after diagnosis) was observed in 42.4% of the patients, among which, cases enrolled under Pre-XDR contributed substantially to treatment delay (72.0%), followed by LTR (43.6%), STR (39.1%) and XDR (33.3%). Conclusion: Timely diagnosis and prompt treatment initiation remain fundamental focus of the National TB program. The findings of the study, however suggest gaps in timeliness of treatment initiation for the drug-resistant TB patients, which could bring adverse treatment outcomes. Moreover, there is an alarming delay in second line treatment initiation for the Pre-XDR TB patients. Therefore, this study generates evidence to identify existing gaps in treatment initiation and highlights need for formulating specific policies and intervention in creating effective linkage between the RR TB diagnosis and enrollment on second line TB treatment with intensified efforts from health providers for follow-ups and expansion of more decentralized, adequate, and accessible diagnostic and treatment services for DR-TB, especially Pre-XDR TB cases, due to the observed long treatment delays.Keywords: drug-resistant, tuberculosis, treatment initiation, Nepal, treatment delay
Procedia PDF Downloads 8513541 Economic Community of West African States Court of Justice and the Development of Human Rights Jurisprudence in Africa: A Difficult Take-off with a Bright and Visionary Landing
Authors: Timothy Fwa Yerima
Abstract:
This paper evaluates the development of human rights jurisprudence in Africa by the ECOWAS Court of Justice. It traces that though ECOWAS was not established with the aim of promoting and protecting human rights as the African Court of Human and Peoples’ Rights, no doubt, the 1991 ECOWAS Court Protocol and the 1993 ECOWAS Revised Treaty give the ECOWAS Court its human rights mandate. The paper, however, points out that despite the availability of these two Laws, the ECOWAS Court had difficulty in its human rights mandate, in view of the twin problems of lack of access to the Court by private parties and personal jurisdiction of the Court to entertain cases filed by private parties. The paper considers the 2005 Supplementary Protocol, not only as an effective legal framework in West African Sub-Region that tackles these problems in human rights cases but also a strong foundation upon which the Court has been developing human rights jurisprudence in Africa through the interpretation and application of this Law and other sources of Law of the Court. After a thorough analysis of some principles laid down by the ECOWAS Court so far, the paper observes that human rights jurisprudence in Africa is growing rapidly; depicting that though the ECOWAS Court initially had difficulty in its human rights mandate, today it has a bright and visionary landing. The paper concludes that West African Sub-Region will witness a more effective performance of the ECOWAS Court if some of its challenges are tackled.Keywords: access, African human rights, ECOWAS court of justice, jurisprudence, personal jurisdiction
Procedia PDF Downloads 34913540 Epidemiology of Gestational Choriocarcinoma: A Systematic Review
Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan
Abstract:
Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor
Procedia PDF Downloads 33013539 Sustainable Wood Harvesting from Juniperus procera Trees Managed under a Participatory Forest Management Scheme in Ethiopia
Authors: Mindaye Teshome, Evaldo Muñoz Braz, Carlos M. M. Eleto Torres, Patricia Mattos
Abstract:
Sustainable forest management planning requires up-to-date information on the structure, standing volume, biomass, and growth rate of trees from a given forest. This kind of information is lacking in many forests in Ethiopia. The objective of this study was to quantify the population structure, diameter growth rate, and standing volume of wood from Juniperus procera trees in the Chilimo forest. A total of 163 sample plots were set up in the forest to collect the relevant vegetation data. Growth ring measurements were conducted on stem disc samples collected from 12 J. procera trees. Diameter and height measurements were recorded from a total of 1399 individual trees with dbh ≥ 2 cm. The growth rate, maximum current and mean annual increments, minimum logging diameter, and cutting cycle were estimated, and alternative cutting cycles were established. Using these data, the harvestable volume of wood was projected by alternating four minimum logging diameters and five cutting cycles following the stand table projection method. The results show that J. procera trees have an average density of 183 stems ha⁻¹, a total basal area of 12.1 m² ha⁻¹, and a standing volume of 98.9 m³ ha⁻¹. The mean annual diameter growth ranges between 0.50 and 0.65 cm year⁻¹ with an overall mean of 0.59 cm year⁻¹. The population of J. procera tree followed a reverse J-shape diameter distribution pattern. The maximum current annual increment in volume (CAI) occurred at around 49 years when trees reached 30 cm in diameter. Trees showed the maximum mean annual increment in volume (MAI) around 91 years, with a diameter size of 50 cm. The simulation analysis revealed that 40 cm MLD and a 15-year cutting cycle are the best minimum logging diameter and cutting cycle. This combination showed the largest harvestable volume of wood potential, volume increments, and a 35% recovery of the initially harvested volume. It is concluded that the forest is well stocked and has a large amount of harvestable volume of wood from J. procera trees. This will enable the country to partly meet the national wood demand through domestic wood production. The use of the current population structure and diameter growth data from tree ring analysis enables the exact prediction of the harvestable volume of wood. The developed model supplied an idea about the productivity of the J. procera tree population and enables policymakers to develop specific management criteria for wood harvesting.Keywords: logging, growth model, cutting cycle, minimum logging diameter
Procedia PDF Downloads 8813538 Educational Mobility as a Factor of Tourism Development in the Regional University
Authors: К. Lisinchuk
Abstract:
An effective approach to the management of international educational mobility in regional universities with the purpose of increasing tourist activity in the region is considered.Keywords: export and import of tourist and educational services, international academic mobility, regional tourist activities
Procedia PDF Downloads 39813537 Formation of an Artificial Cultural and Language Environment When Teaching a Foreign Language in the Material of Original Films
Authors: Konysbek Aksaule
Abstract:
The purpose of this work is to explore new and effective ways of teaching English to students who are studying a foreign language since the timeliness of the problem disclosed in this article is due to the high level of English proficiency that potential specialists must have due to high competition in the context of global globalization. The article presents an analysis of the feasibility and effectiveness of using an authentic feature film in teaching English to students. The methodological basis of the study includes an assessment of the level of students' proficiency in a foreign language, the stage of evaluating the film, and the method of selecting the film for certain categories of students. The study also contains a list of practical tasks that can be applied in the process of viewing and perception of an original feature film in a foreign language, and which are aimed at developing language skills such as speaking and listening. The results of this study proved that teaching English to students through watching an original film is one of the most effective methods because it improves speech perception, speech reproduction ability, and also expands the vocabulary of students and makes their speech fluent. In addition, learning English through watching foreign films has a huge impact on the cultural views and knowledge of students about the country of the language being studied and the world in general. Thus, this study demonstrates the high potential of using authentic feature film in English lessons for pedagogical science and methods of teaching English in general.Keywords: university, education, students, foreign language, feature film
Procedia PDF Downloads 14813536 The Development of Shariah-Based Cooperative and Its Governance System: Cases in Thailand, Malaysia, and Indonesia
Authors: Zurina Shafii, Mohamed Obaidullah, Rochania Ayu Yunanda, Nor Farha Zubair
Abstract:
Cooperative members (also known as user-owners) are responsible in running the cooperative businesses in order to improve their socio economic well-being. Cooperatives have always been recognized as a vehicle to elevate the standard of living of the poor and low-income earners by improving their ability to mobilize resources among the people within the urban and rural sectors of the population. To improve its performance and role, the cooperative should ensure the existence of its specific governance. Using narrative analysis and quasi-statistics, this paper describes the state of operation, growth and nature of products and services offered in Sakofah Savings Co-op (the largest Islamic cooperative in Krabi), Koperasi Muslimin Malaysia Berhad (KMMB) in Malaysia and KOSPIN Jasa Keuangan in Indonesia. Furthermore, it identifies and evaluates the current governance system in each cooperatives and proposes governance framework which may enhance the performance of the cooperatives. The paper, in turn discusses the challenges to cooperative growth and investment from the aspects of governance and monitoring, transparency and human capital. The paper will be useful for regulators and governance organs of cooperatives, namely Board of Members, Management and Shariah Committee in order for these parties to strengthen the governance within cooperatives to further grow this economic sector.Keywords: Islamic cooperatives, governance, Shariah governance, case study
Procedia PDF Downloads 36113535 Project Financing and Poverty Trends in the Islamic Development Bank Member Countries
Authors: Sennanda Musa, Ahmed Mutunzi Kitunzi, Gerald Kasigwa, Ismail Kintu
Abstract:
This paper is an analysis of the empirical relationship between project financing by Islamic Development Bank (IsDB) and the poverty trends in the context of countries benefiting from IsDB. Specifically, the study seeks to find out whether there is a statistically significant relationship between the project financing dollar amounts by IsDB (PF) and the GNI Per Capita, PPP of 57 countries for the years 2002 to 2021. The research is a longitudinal, desk-top triangulation of correlation, regression, hypothesis-testing employing the linear dynamic panel data GMM model as an estimator of the empirical relationships between the key variables of the study. The study results show that there is a significant positive relationship between the PF dollar amounts from the IsDB and the GNI Per Capita, PPP in these 57 countries. Therefore, countries that receive higher PF dollar amounts from the IsDB, generally have more GNI Per Capita, PPP (less poverty) than their counterparts. It is, therefore, recommendable for countries to formulate policies that facilitate Islamically financed projects to mitigate poverty. This paper develops policy discussions regarding allocation of political attention to the policy topics on poverty mitigation, and their relation to financing projects Islamically, thus generate information on policy choices regarding the Islamic financing alternative.Keywords: gross-national-income, IsDB-project-financing, public policy, poverty
Procedia PDF Downloads 8913534 Investigating the Effective Factors on Product Performance and Prioritizing Them: Case Study of Pars-Khazar Company
Authors: Ebrahim Sabermaash Eshghi, Donna Sandsmark
Abstract:
Nowadays, successful companies try to create a reliable and unique competitive position in the market. It is important to consider that only choosing and codifying a competitive strategy appropriate with the market conditions does not have any influence on the final performance of the company by itself, but it is the connection and interaction between upstream level strategies and functional level strategies which leads to development of company performance in its operating environment. Given the importance of the subject, this study tries to investigate effective factors on product performance and prioritize them. This study was done with quantitative-qualitative approach (interview and questionnaire). In sum, 103 informed managers and experts of Pars-Khazar Company were investigated in a census. Validity of measure tools was approved through experts’ judgments. Reliability of the tools was also gained through Cronbach's Alpha Coefficient as 0.930 and in sum, validity and reliability of the tools was approved generally. Analysis of collected data was done through Spearman Correlation Test and Friedman Test using SPSS software. The results showed that management of distribution and demand process (0.675), management of Product Pre-test (0.636) and Manufacturing and inventory management(0.628) had the highest correlation with product performance. Prioritization of factors of structure of launching new products based on the average showed that management of volume of launched products and Manufacturing and inventory management had the most importance.Keywords: product performance, home appliances, market, case study
Procedia PDF Downloads 22413533 Test Suite Optimization Using an Effective Meta-Heuristic BAT Algorithm
Authors: Anuradha Chug, Sunali Gandhi
Abstract:
Regression Testing is a very expensive and time-consuming process carried out to ensure the validity of modified software. Due to the availability of insufficient resources to re-execute all the test cases in time constrained environment, efforts are going on to generate test data automatically without human efforts. Many search based techniques have been proposed to generate efficient, effective as well as optimized test data, so that the overall cost of the software testing can be minimized. The generated test data should be able to uncover all potential lapses that exist in the software or product. Inspired from the natural behavior of bat for searching her food sources, current study employed a meta-heuristic, search-based bat algorithm for optimizing the test data on the basis certain parameters without compromising their effectiveness. Mathematical functions are also applied that can effectively filter out the redundant test data. As many as 50 Java programs are used to check the effectiveness of proposed test data generation and it has been found that 86% saving in testing efforts can be achieved using bat algorithm while covering 100% of the software code for testing. Bat algorithm was found to be more efficient in terms of simplicity and flexibility when the results were compared with another nature inspired algorithms such as Firefly Algorithm (FA), Hill Climbing Algorithm (HC) and Ant Colony Optimization (ACO). The output of this study would be useful to testers as they can achieve 100% path coverage for testing with minimum number of test cases.Keywords: regression testing, test case selection, test case prioritization, genetic algorithm, bat algorithm
Procedia PDF Downloads 38113532 Computational Fluid Dynamics Simulation of Reservoir for Dwell Time Prediction
Authors: Nitin Dewangan, Nitin Kattula, Megha Anawat
Abstract:
Hydraulic reservoir is the key component in the mobile construction vehicles; most of the off-road earth moving construction machinery requires bigger side hydraulic reservoirs. Their reservoir construction is very much non-uniform and designers used such design to utilize the space available under the vehicle. There is no way to find out the space utilization of the reservoir by oil and validity of design except virtual simulation. Computational fluid dynamics (CFD) helps to predict the reservoir space utilization by vortex mapping, path line plots and dwell time prediction to make sure the design is valid and efficient for the vehicle. The dwell time acceptance criteria for effective reservoir design is 15 seconds. The paper will describe the hydraulic reservoir simulation which is carried out using CFD tool acuSolve using automated mesh strategy. The free surface flow and moving reference mesh is used to define the oil flow level inside the reservoir. The first baseline design is not able to meet the acceptance criteria, i.e., dwell time below 15 seconds because the oil entry and exit ports were very close. CFD is used to redefine the port locations for the reservoir so that oil dwell time increases in the reservoir. CFD also proposed baffle design the effective space utilization. The final design proposed through CFD analysis is used for physical validation on the machine.Keywords: reservoir, turbulence model, transient model, level set, free-surface flow, moving frame of reference
Procedia PDF Downloads 15213531 Risk Factors for Postoperative Recurrence in Indian Patients with Crohn’s Disease
Authors: Choppala Pratheek, Vineet Ahuja
Abstract:
Background: Crohn's disease (CD) recurrence following surgery is a common challenge, and current detection methods rely on risk factors identified in Western populations. This study aimed to investigate the risk factors and rates of postoperative CD recurrence in a tuberculosis-endemic region like India. Retrospective data was collected from a structured database from a specialty IBD clinic by reviewing case files from January 2005 to December 2021. Inclusion criteria involved CD patients diagnosed based on the ECCO-ESGAR consensus guidelines, who had undergone at least one intestinal resection and had a minimum follow-up period of one year at the IBD clinic. Results: A total of 90 patients were followed up for a median period of 45 months (IQR, 20.75 - 72.00). Out of the 90 patients, 61 received ATT prior to surgery, with a mean delay in diagnosis of 2.5 years, although statistically non-significant (P=0.078). Clinical recurrence occurred in 50% of patients, with the cumulative rate increasing from 13.3% at one year to 40% at three years. Among 63 patients who underwent endoscopy, 65.7% showed evidence of endoscopic recurrence, with the cumulative rate increasing from 31.7% at one year to 55.5% at four years. Smoking was identified as a significant risk factor for early endoscopic recurrence (P=0.001) by Cox regression analysis, but no other risk factors were identified. Initiating post-operative medications prior to clinical recurrence delayed its onset (P=0.004). Subgroup analysis indicated that endoscopic monitoring aided in the early identification of recurrence (P=0.001). The findings contribute to enhancing post-operative CD management strategies in such regions where the disease burden is escalating.Keywords: crohns, post operative, tuberculosis-endemic, risk factors
Procedia PDF Downloads 6613530 Public Participation Best Practices in Environmental Decision-making in Newfoundland and Labrador: Analyzing the Forestry Management Planning Process
Authors: Kimberley K. Whyte-Jones
Abstract:
Public participation may improve the quality of environmental management decisions. However, the quality of such a decision is strongly dependent on the quality of the process that leads to it. In order to ensure an effective and efficient process, key features of best practice in participation should be carefully observed; this would also combat disillusionment of citizens, decision-makers and practitioners. The overarching aim of this study is to determine what constitutes an effective public participation process relevant to the Newfoundland and Labrador, Canada context, and to discover whether the public participation process that led to the 2014-2024 Provincial Sustainable Forest Management Strategy (PSFMS) met best practices criteria. The research design uses an exploratory case study strategy to consider a specific participatory process in environmental decision-making in Newfoundland and Labrador. Data collection methods include formal semi-structured interviews and the review of secondary data sources. The results of this study will determine the validity of a specific public participation best practice framework. The findings will be useful for informing citizen participation processes in general and will deduce best practices in public participation in environmental management in the province. The study is, therefore, meaningful for guiding future policies and practices in the management of forest resources in the province of Newfoundland and Labrador, and will help in filling a noticeable gap in research compiling best practices for environmentally related public participation processes.Keywords: best practices, environmental decision-making, forest management, public participation
Procedia PDF Downloads 322