Search results for: delayed diagnosis and poor outcome

Authors: Faith Eweluegim Enahoro-Ofagbe

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Worldwide, every nation is experiencing the effects of global warming. In developing countries, due to the heavy reliance on agriculture for socioeconomic growth and security, among other things, these countries are more affected by climate change, particularly with the availability of water. Floods, droughts, rising temperatures, saltwater intrusion, groundwater depletion, and other severe environmental alterations are all brought on by climatic change. Life depends on water, a vital resource; these ecological changes affect all water use, including agriculture and household water use. Therefore adequate and adaptive water usage strategies for sustainability are essential in developing countries. Therefore, this paper investigates Nigeria's challenges due to climate change and adaptive techniques that have evolved in response to such issues to ensure water management and sustainability for irrigation and provide quality water to residents. Questionnaires were distributed to respondents in the study area, central Nigeria, for quantitative evaluation of sustainable water resource management techniques. Physicochemical analysis was done, collecting soil and water samples from several locations under investigation. Findings show that farmers use different methods, ranging from intelligent technologies to traditional strategies for water resource management. Also, farmers need to learn better water resource management techniques for sustainability. Since more residents obtain their water from privately held sources, the government should enforce legislation to ensure that private borehole construction businesses treat water sources of poor quality before the general public uses them.

Keywords: developing countries, irrigation, strategies, sustainability, water resource management, water usage

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Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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Authors: Goutom K. Pall

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At the very heart of the power system, power transmission (PT) acts as an essential link between power generation and distribution. Timely completion of PT infrastructures is therefore crucial to support the development of power system as a whole. Yet despite the importance, studies on PT infrastructure development projects are embryonic and, hence, PT projects undergoing widespread delays worldwide. These delay factors are idiosyncratic and identifying the critical delay factors is essential if the PT industry professionals are to complete their projects efficiently and within the expected timeframes. This study identifies and categorizes 46 causes of PT project delay under ten major groups using six sector expert’s recommendations studied by a preliminary questionnaire survey. Based on the experts’ strong recommendations, two new groups are introduced in the final questionnaire survey: sector specific factors (SSF) and general factors (GF). SSF pertain to delay factors applicable only to the PT projects, while GF represents less biased samples with shared responsibilities of all project parties involved in a project. The study then uses 112 data samples from the contractors to rank the delay factors using relative importance index (RII). The results reveal that SSF, GF and external factors are the most critical groups, while the highest ranked delay factors include the right of way (RoW) problems of transmission lines (TL), delay in payments, frequent changes in TL routes, poor communication and coordination among the project parties and accessibility to TL tower locations. Finally, recommendations are made to minimize the identified delay. The findings are expected to be of substantial benefit to professionals in minimizing time overrun in PT projects implementation, as well as power generation, power distribution, and non-power linear construction projects worldwide.

Keywords: delay, project delay, power transmission projects, time-overruns

Procedia PDF Downloads 178

Authors: Hazrat Salman Sidique, Muhammad Tahir Khan, Haq Aman Ullah, Muhammad Mobashar, Muhammad Ishtiaq Sohail Mehmood

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The poor quality conventional feed for the livestock production in Pakistan are wheat straw, tops of sugar cane and tree leaves. To enhance the nutritive value of feed, this study focused on investigating the effects of fibrolytic enzyme (Fibrozyme®, Alltech Inc. Company, USA) at different levels i.e. 0, 5, 10, and 15g/kg of total mix ration on feed intake, digestibility, milk yield and composition, and economics of the ration in Holstein Friesians cows. Twelve Holstein Friesians cows of almost the same age, and lactation stage were randomly allocated into 4 equal groups i.e. A, B, C, and D. Four experimental rations supplemented with Fibrozyme® 0g, 5g, 10g, and 15g/Kg of total mix ration were assigned to these sets correspondingly. The dry matter intake was linearly and significantly (P<0.05) improved. A significant effect of Fibrozyme® was observed for organic matter digestibility, ether extract digestibility, crude fiber digestibility, nitrogen free extract digestibility, and acid detergent fiber digestibility while the results were statistically non-significant for crude protein digestibility, neutral detergent fiber digestibility, and ash digestibility. Milk yield and composition except fat were significantly (P<0.05) increased in all Fibrozyme® treated groups. This study concludes that supplementation of Fibrozyme® at the rate of 15g/Kg total mix ration improved the dry matter intake, nutrients digestibility, and milk production and constituents like protein, lactose, and solid not fat. Therefore, treatment of total mix ration with Fibrozyme® was desirably reasonable and profitable.

Keywords: digestibility, fibrozyme, TMR, digestibility, lactating cow

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Authors: Maulik L. Sisodia, Tirth K. Raval, Aarsh S. Mistry

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This paper summarizes the ongoing researches about the defects in both flexible and rigid pavement and the maintenance in both flexible and rigid pavements. Various defects in pavements have been identified since the existence of both flexible and rigid pavement. Flexible Pavement failure is defined in terms of decreasing serviceability caused by the development of cracks, ruts, potholes etc. Flexible Pavement structure can be destroyed in a single season due to water penetration. Defects in flexible pavements is a problem of multiple dimensions, phenomenal growth of vehicular traffic (in terms of no. of axle loading of commercial vehicles), the rapid expansion in the road network, non-availability of suitable technology, material, equipment, skilled labor and poor funds allocation have all added complexities to the problem of flexible pavements. In rigid pavements due to different type of destress the failure like joint spalling, faulting, shrinkage cracking, punch out, corner break etc. Application of correction in the existing surface will enhance the life of maintenance works as well as that of strengthening layer. Maintenance of a road network involves a variety of operations, i.e., identification of deficiencies and planning, programming and scheduling for actual implementation in the field and monitoring. The essential objective should be to keep the road surface and appurtenances in good condition and to extend the life of the road assets to its design life. The paper describes lessons learnt from pavement failures and problems experienced during the last few years on a number of projects in India. Broadly, the activities include identification of defects and the possible cause there off, determination of appropriate remedial measures; implement these in the field and monitoring of the results.

Keywords: Flexible Pavements, Rigid Pavements, Defects, Maintenance

Procedia PDF Downloads 172

Authors: Adfer Rashid Shah

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This study brings an introduction to the concept of waqf and explores the institution of waqf in the valley of Kashmir. Waqfs (pl. Auqaf) are Islamic endowments which can be movable or immovable property by Muslims for the welfare of the poor and the upkeep of the mosques, shrines, imambaras, madrassas, orphanages, etc,. The study was undertaken to venture into the sociology of these endowments and see the dynamics and role of waqf institution in the welfare of masses especially the deserving populace of the state of Jamu and Kashmir. The Jammu and Kashmir Muslim Waqf Board (JKMWB) is a significant religio-social organization for it possesses the largest assets after the State government and has an immense potential and ownership in terms of huge properties besides having rich and perpetual cash and kind donations, gold, silver and other commodities from the believers. It is certainly the perpetual wealth of faith. Therefore this study besides exploring the waqf institution, sociologically probed into the social, religious and philanthropic interventions of the Wakf Board besides studying the waqf of education (both religious and general). Also, a passing reference on personalized Auqaf, local waqf committees particularly shia Auqaf was also made. As far methodology employed, the study was purely a qualitative study using various sociological perspectives like functionalism, grounded theory besides a range other concepts to see the total role of waqf that it has been playing for the people’s welfare in the valley of Kashmir since its establishment in 1940’s. The overall discussion revealed the social dynamics of waqf institution in Kashmir valley is increasing its social interventions and making difference in the lives of many deserving Muslims within its capacities.

Keywords: waqf, wakf board, religious waqf, philanthropy and education waqf, religious waqf, Kashmir

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Authors: Ademola Azeez

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Background: This study is a two year review of requests pattern for Prostate Specific Antigen (PSA), in a Nigerian tertiary health care institution. Prostate specific antigen was first described about 44 years ago but is still in use today for, diagnosis, monitoring, screening and prognosis of prostatic carcinoma though not-very specific as was widely believed. Prostate cancer is an increasingly important public health problem among adult men worldwide. Nigeria, which was formerly regarded as a low-incidence area by several authors is now witnessing a steep rise in the occurrence of this disease. This has been suggested to be due to increasing availability of screening tests and diagnostic facilities and not necessarily because of increased incidence of the diseases. Many notable Nigerians have died due to this dreaded disease. Methods: All plasma samples for PSA from January 2021-December 2022 were analyzed weekly by abbot autoanalyser, chemiluminescence assay method. Bio-data from request form were collated and analyzed. A total of 385 requests were received for the period under review. Result: There was an increase of request from inception to the last year of review. Smoked food, consumption of local herb and alcohol in order of importance, respectively, appears to be prominent factor in patient requested for PSA. The mean age was 67.years; the youngest was 29, while the oldest was 93years. Age 70 has the highest frequency of 8.5% .Mean PSA was 12.9ng/ml. There was a positive correlation between age and PSA (R=0.255, P < 0.05).Significant increase in PSA with age were reported. Men who retired from active jobs constitute the highest request for PSA test. Conclusion: There was an increasing trend in the proportion of requests with values outside the reference interval especially in patients diagnosed of benign prostatic hyperplasia, prostate cancer, while some routine test for PSA were elevated for the first time .This is in line with earlier report of increasing incidence of prostate cancer in Nigeria despite the increasing knowledge of healthy lifestyle.

Keywords: pattern, PSA, tertiary institution, Nigeria

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Authors: Maria Luisa Boninelli

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This study wants to explore the effects of a mediated intervention program in a primary school. The participants where 120 students aged 8-9, half of them Italian and half immigrants of first or second generation. The activities consisted on the cognitive enhancement of the participants through Feuerstein’s Instrumental Enrichment, (IE) and on an activity centred on body awareness and mediated learning experience. Given that there are limited studied on learners in remedial schools, the current study intented to hypothesized that participants exposed to mediation would yiel a significant improvement in cognitive functioning. Hypothesis One proposed that, following the intervention, improved Q1vata scores of the participants would occur in each of the groups. Hypothesis two postulated that participants within the Mediated Learning Experience would perform significantly better than those group of control. For the intervention a group of 60 participants constituted a group of Mediation sample and were exposed to Mediated Learning Experience through Enrichment Programm. Similiary the other 60 were control group. Both the groups have students with special needs and were exposed to the same learning goals. A pre-experimental research design, in particular a one-group pretest-posttest approach was adopted. All the participants in this study underwent pretest and post test phases whereby they completed measures according to the standard instructions. During the pretest phase, all the participants were simultaneously exposed to Q1vata test for logical and linguistic evaluation skill. During the mediation intervention, significant improvement was demonstrated with the group of mediation. This supports Feuerstein's Theory that initial poor performance was a result of a lack of mediated learning experience rather than inherent difference or deficiencies. Furthermore the use of an appropriate mediated learning enabled the participants to function adequately.

Keywords: cognitive structural modifiability, learning to learn, mediated learning experience, Reuven Feuerstein, special needs

Procedia PDF Downloads 378

Authors: Shidvash Vakilipour, Masoud Mohammadi, Rouzbeh Riazi, Scott Ormiston, Kimia Amiri, Sahar Barati

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An essential component of a finite volume method (FVM) is the advection scheme that estimates values on the cell faces based on the calculated values on the nodes or cell centers. The most widely used advection schemes are upwind schemes. These schemes have been developed in FVM on different kinds of structured and unstructured grids. In this research, the physical influence scheme (PIS) is developed for a cell-centered FVM that uses an implicit coupled solver. Results are compared with the exponential differencing scheme (EDS) and the skew upwind differencing scheme (SUDS). Accuracy of these schemes is evaluated for a lid-driven cavity flow at Re = 1000, 3200, and 5000 and a backward-facing step flow at Re = 800. Simulations show considerable differences between the results of EDS scheme with benchmarks, especially for the lid-driven cavity flow at high Reynolds numbers. These differences occur due to false diffusion. Comparing SUDS and PIS schemes shows relatively close results for the backward-facing step flow and different results in lid-driven cavity flow. The poor results of SUDS in the lid-driven cavity flow can be related to its lack of sensitivity to the pressure difference between cell face and upwind points, which is critical for the prediction of such vortex dominant flows.

Keywords: cell-centered finite volume method, coupled solver, exponential differencing scheme (EDS), physical influence scheme (PIS), pressure weighted interpolation method (PWIM), skew upwind differencing scheme (SUDS)

Procedia PDF Downloads 284

Authors: Paras Agarwal

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Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.

Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer

Procedia PDF Downloads 136

Authors: Clementina Ebere Okoro, Olumuyiwa Adeyemi Owolabi, Doris Bola James, Aloysius Nwabugo Maduforo, Andrew Lingililani Mbewe, Christopher Osaruwanmwen Isokpunwu

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Poor dietary practices and malnutrition, including severe acute malnutrition among under-five children in Nigeria has remained a great public health concern. This study assessed infant and young child feeding practices and nutritional status of under-five children to determine the prevalence of malnutrition of under-five children in Kuje area council, Abuja. The study was a cross-sectional study. Multi-stage sampling techniques was used in selecting the population that was studied. Probability proportion by size was applied in choosing 30 clusters for the survey using ENA for SMART software 2011 version. Questionnaires were used to obtain information from the population, while appropriate equipment was used for measurements of anthropometric parameters. The data was also subjected to statistical analysis. Results were presented in tables and figures. The result showed that 96.7% of the children were breastfed, 30.6% had early initiation to breastfeeding within first hour of birth and 22.4% were breastfed exclusively up to 6 months, 69.8% fed infants’ colostrum, while 30.2% discarded colostrum. About half of the respondents (49.1%) introduced complementary feeding before six months and 23.2% introduced it after six months while 27.7% had age appropriate timely introduction of complementary feeding. The anthropometric result showed that the prevalence of global acute malnutrition (GAM) was 12.8%, severe wasting prevalence was 5.4%, moderate wasting was 7.4%, underweight was 24.4%, stunting was 40.3% and overweight was 7.0%. The result showed that there is a high prevalence of malnutrition among under-five children in Kuje

Keywords: malnutrition, under five children, breastfeeding, complementary feeding

Procedia PDF Downloads 267

Authors: Sanela Slavkovic, Congor Nad, Spela Golubovic

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Background: The diagnosis of multiple sclerosis (MS) is a major life challenge and has repercussions on all aspects of the daily functioning of those attained by it – personal activities, social participation, and quality of life. Regular follow-up of only the neurological status is not informative enough so that it could provide data on the sort of support and rehabilitation that is required. Objective: The aim of this study was to establish the current level of functioning of persons attained by MS and the factors that influence it. Methods: The study was conducted in Serbia, on a sample of 108 persons with relapse-remitting form of MS, aged 20 to 53 (mean 39.86 years; SD 8.20 years). All participants were fully ambulatory. Methods applied in the study include Expanded Disability Status Scale-EDSS and World Health Organization Disability Assessment Schedule, WHODAS 2.0 (36-item version, self-administered). Results: Participants were found to experience the most problems in the domains of Participation, Mobility, Life activities and Cognition. The least difficulties were found in the domain of Self-care. Symptom duration was the only control variable with a significant partial contribution to the prediction of the WHODAS scale score (β=0.30, p < 0.05). The total EDSS score correlated with the total WHODAS 2.0 score (r=0.34, p=0.00). Statistically significant differences in the domain of EDSS 0-5.5 were found within categories (0-1.5; 2-3.5; 4-5.5). The more pronounced a participant’s EDSS score was, although not indicative of large changes in the neurological status, the more apparent the changes in the functional domain, i.e. in all areas covered by WHODAS 2.0. Pyramidal (β=0.34, p < 0.05) and Bowel and bladder (β=0.24, p < 0.05) functional systems were found to have a significant partial contribution to the prediction of the WHODAS score. Conclusion: Measuring functioning and disability is important in the follow-up of persons suffering from MS in order to plan rehabilitation and define areas in which additional support is needed.

Keywords: disability, functionality, multiple sclerosis, rehabilitation

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Authors: Kelly E. Tow, Peter Caputi, Claudia Rogge, Thomas Lee, Simon R. Knowles

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Inflammatory Bowel Disease (IBD) is a serious chronic health condition, characterised by inflammation of the gastrointestinal tract. Individuals with active IBD experience severe abdominal symptoms, which can adversely impact their physical and mental health, as well as their quality of life (QoL). Given that stress may exacerbate IBD symptoms and is frequently highlighted as a contributing factor for the development of psychological difficulties and poorer QoL, it is vital to investigate stress-management strategies aimed at improving the lives of those with IBD. The present study extends on the limited research in IBD cohorts by exploring the role of dispositional mindfulness and its impact on psychological well-being and QoL. The study examined how disease activity and dispositional mindfulness were related to psychological distress and QoL in a cohort of IBD patients. The potential role of dispositional mindfulness as a moderator between stress and anxiety, depression and QoL in these individuals was also examined. Participants included 47 patients with a clinical diagnosis of IBD. Each patient completed a series of psychological questionnaires and was assessed by a gastroenterologist to determine their disease activity levels. Correlation analyses indicated that disease activity was not significantly related to psychological distress or QoL in the sample of IBD patients. However, dispositional mindfulness was inversely related to psychological distress and positively related to QoL. Furthermore, moderation analyses demonstrated a significant interaction between stress and dispositional mindfulness on anxiety. These findings demonstrate that increased levels of dispositional mindfulness may be beneficial for individuals with IBD. Specifically, the results indicate positive links between dispositional mindfulness, general psychological well-being and QoL, and suggest that dispositional mindfulness may attenuate the negative impacts of stress on levels of anxiety in IBD patients. While further research is required to validate and expand on these findings, the current study highlights the importance of addressing psychological factors in IBD and indicates support for the use of mindfulness-based interventions for patients with the disease.

Keywords: anxiety, depression, dispositional mindfulness, inflammatory bowel disease, quality of life, stress

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Authors: Ingy Ibrahim El-Darwish, Neveen Youssef Azmy

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The endowment of a healthy environment can be implemented by endorsing sustainable fundamentals. Design of sustainable buildings through recycling of waste, can reduce health problems, provide good environments and contribute to the aesthetically pleasing entourage. Such environments can help in providing energy-saving alternatives to consolidate the principles of sustainability. The poor community awareness and the absence of laws and legislation in Egypt for waste management specifically in residential areas have led to an inability to provide an integrated system for waste management in urban and rural areas. Many problems and environmental challenges face the Egyptian urban environments. From these problems, is the lack of a cohesive vision for waste collection and recycling for energy-saving. The second problem is the lack public awareness of the short term and long term vision of waste management. Bad practices have adversely affected the efficiency of environmental management systems due to lack of urban legislations that codify collection and recycling of residential communities in Egyptian urban environments. Hence, this research tries to address residents on waste management matters to facilitate legislative process on waste collection and classification within residential units and outside them in a preparation phase for recycling in the Egyptian urban environments. In order to achieve this goal, one of the Egyptian communities has been addressed, analyzed and studied. Waste collection, classification, separation and access to recycling places in the urban city are proposed in preparation for a legislation ruling and regulating the process. Hence, sustainable principles are to be achieved.

Keywords: recycling, residential buildings, sustainability, waste

Procedia PDF Downloads 327

Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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Authors: Eveline Muika Kabongo, Peter Delobelle, Ferdinand Mukumbang, Edward Nicol

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Introduction: Studies have been conducted to establish the effect of the MomConnect program in South Africa, but these studies did not focus on the stakeholders' and implementers' perspectives and the underlying program theory of the MomConnect initiative program. We strived to obtain stakeholders’ perspectives and assumptions on the MomConnect program and develop an initial program theory (IPT) of how the MomConnect initiative was expected to work. Methods: A realist-informed explanatory design used. The interviewer was performed with 10 key informants selected purposively among MomConnect key informants at the a national level of NDoH South Africa. The interview was done via zoom and lasted for 30 to 60 minutes. Introduction and abduction inferencing approaches were applied. The deductive and inductive approaches were performed during the analysis. ICAMO hereustic framework was used to analysed the data in order to get key informants expectations on how the MomConnect will work or not. Results: We developed three folk’s theories illustrating how the key informants’ expected the MomConnect to work. These theories showed that the MomConnect intended to provide users with health information and education that will empower and motivate them with knowledge which will allow the improvement of health services delivery among HCPs and improvement of the uptake of MCH services among pregnant women and mothers and decrease the rate of maternal and child mortality in the country. The lack of an updated mechanism to link women to the outcome was an issue. Another problem enlightened was the introduction of the WhatsApp program instead of SMS messaging, which was free of charge to women. Conclusion: The Folk’s theory developed from this study provided an insight into how the MomConnect was expected to work and what did not work. The folk’s theory will be merged with information from candidate theories on synthesis review and document review to develop our initial program theory of the MomConnect initiative.

Keywords: mHealth, MomConnect program, realist evaluation, maternal and child health, maternal and child health services, introduction, theory-driven

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Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal

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Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.

Keywords: resistant, hypertension, spironolactone, blood pressure

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Authors: Ranjit Kumar Sahu, Ramakar Jha

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Urban Water Management is the practice of managing freshwater, waste water, and storm water as components of a basin-wide management plan. It builds on existing water supply and sanitation considerations within an urban settlement by incorporating urban water management within the scope of the entire river basin. The pervasive problems generated by urban development have prompted, in the present work, to study the spatial extent of urbanization in Golden Triangle of Odisha connecting the cities Bhubaneswar (20.2700° N, 85.8400° E), Puri (19.8106° N, 85.8314° E) and Konark (19.9000° N, 86.1200° E)., and patterns of periodic changes in urban development (systematic/random) in order to develop future plans for (i) urbanization promotion areas, and (ii) urbanization control areas. Remote Sensing, using USGS (U.S. Geological Survey) Landsat8 maps, supervised classification of the Urban Sprawl has been done for during 1980 - 2014, specifically after 2000. This Work presents the following: (i) Time series analysis of Hydrological data (ground water and rainfall), (ii) Application of SWMM (Storm Water Management Model) and other soft computing techniques for Urban Water Management, and (iii) Uncertainty analysis of model parameters (Urban Sprawl and correlation analysis). The outcome of the study shows drastic growth results in urbanization and depletion of ground water levels in the area that has been discussed briefly. Other relative outcomes like declining trend of rainfall and rise of sand mining in local vicinity has been also discussed. Research on this kind of work will (i) improve water supply and consumption efficiency (ii) Upgrade drinking water quality and waste water treatment (iii) Increase economic efficiency of services to sustain operations and investments for water, waste water, and storm water management, and (iv) engage communities to reflect their needs and knowledge for water management.

Keywords: Storm Water Management Model (SWMM), uncertainty analysis, urban sprawl, land use change

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Authors: Ladda Silanoi

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One of the main purposes in establishment of ASEAN Community is educational development. All countries in ASEAN shall then prepare for plans and strategies for country development. Therefore, Thailand set up the policy concerning educational management for all educational institutions to understand about ASEAN Community. However, some educational institutions lack of precision in determining the curriculums of ASEAN Community, especially schools in rural areas, for example, schools along the common border with Laos, and Cambodia. One of the effective methods to promote the precision in ASEAN Community is to design additional learning courses. The important process of additional learning courses design is to provide learning outcomes of ASEAN Community for course syllabus determination. Therefore, the researcher is interested in developing teachers in the schools of common border with Laos, and Cambodia to provide learning outcomes and learning process. This research has the objective of developing the learning outcomes and learning process management of basic education along Thailand, Laos, and Cambodia Common Border for the ASEAN Community Preparation. Research methodology consists of 2 steps. Step 1: Delphi Technique was used to provide guidelines in development of learning outcomes and learning process. Step 2: Action Research procedures was employed to study the result of additional learning courses design. Result of the study: By using Delphi technique, consensus is expected to be achieved, from 50 experts in the study within 3 times of the survey. The last survey found that experts’ opinions were compatible on every item (inter-quartile range = 0) leading to the arrangement of training courses in step of Action Research. The result from the workshop found that teachers in schools of Srisaket and Bueng Kan provinces could be able to provide learning outcomes of all courses.

Keywords: learning outcome and learning process, basic education, ASEAN Community preparation, Thailand Laos and Cambodia common border

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Authors: Tesfahiwot Abay Weldearegay

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Ethiopian Federal ministry of health, in collaboration with different partners, provides financial support from sustainable development grants and global fund budget sources to Regional health science colleges through the regional health bureau to improve the quality of training and avail professionals based on the regional health bureau demand from the year of 2012 to 2019EC. It was mainly focused on health extension workers (HEW) Level III&IV, Health Information technicians (HIT), Emergency Medical technicians (EMT), laboratory technicians, Pharmacy technicians, Anesthesia Level V, Radiography, midwifery, Environmental health and biomedical equipment technician. Laboratory technician, Radiography and Pharmacy technician, was retooling program. The study aims at assessing the Utilization and outcome of budgets transferred through regional health bureau to regional health science colleges. The study used both quantitative and qualitative approaches to develop sufficient data to explain the utilization of the budget, and outcomes obtained from the transferred budget and to identify the gaps. The data for the study were obtained through structured questionnaires and interviews was conducted to increase the reliability of the data. Nationally, students enrolled in different disciplines at RHSC through budget support for RHB to improve the quality of training were 87 840 students and the total Budget transferred, according to MOU was 895,752,038 Ethiopian birr. Among the students enrolled nationally in different disciplines at RHSC through budget support only 72% of students have graduated from different disciplines. In Hareri and Addis Ababa, all enrolled students were graduated (100%). At the same time, Oromia 69%, Amara 77%, SNNP 58% students graduated, respectively. The demand of the regional health bureau and the enrollment capacity of health science colleges increased from year to year. The financial support added great value to the HSCs to cop with problems related to student fees, skill lab materials and renovation.

Keywords: emergency medical technician, radiography, Biomedical, health extension

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Authors: Ting Kai Chia, Ruifeng Yan, Feifei Bai, Tapan Saha

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This research presents a real-world power system oscillation incident in 2022 originated by a hybrid solar photovoltaic (PV) and wind renewable energy farm with a rated capacity of approximately 300MW in Australia. The voltage and reactive power outputs recorded at the point of common coupling (PCC) oscillated at a sub-synchronous frequency region, which sustained for approximately five hours in the network. The reactive power oscillation gradually increased over time and reached a recorded maximum of approximately 250MVar peak-to-peak (from inductive to capacitive). The network service provider was not able to quickly identify the location of the oscillation source because the issue was widespread across the network. After the incident, the original equipment manufacturer (OEM) concluded that the oscillation problem was caused by the incorrect setting recovery of the hybrid power plant controller (HPPC) in the voltage and reactive power control loop after a loss of communication event. The voltage controller normally outputs a reactive (Q) reference value to the Q controller which controls the Q dispatch setpoint of PV and wind plants in the hybrid farm. Meanwhile, a feed-forward (FF) configuration is used to bypass the Q controller in case there is a loss of communication. Further study found that the FF control mode was still engaged when communication was re-established, which ultimately resulted in the oscillation event. However, there was no detailed explanation of why the FF control mode can cause instability in the hybrid farm. Also, there was no duplication of the event in the simulation to analyze the root cause of the oscillation. Therefore, this research aims to model and replicate the oscillation event in a simulation environment and investigate the underlying behavior of the HPPC and the consequent oscillation mechanism during the incident. The outcome of this research will provide significant benefits to the safe operation of large-scale renewable energy generators and power networks.

Keywords: PV, oscillation, modelling, wind

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Authors: Bing-Fang Lee, Srinivasan Periasamy, Ming-Yie Liu

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Shift work sleep disorder is a common problem in industrialized world. It is a type of circadian rhythmic sleep disorders characterized by insomnia and sleep deprivation. Lack of sleep in workers may lead to poor health conditions such as hepatic dysfunction. Melatonin is a hormone secreted by the pineal gland to alleviate insomnia. Moreover, it is a powerful antioxidant and may prevent acute liver injury. Therefore, workers take in melatonin to deal with sleep-related health is an important issue. The aim of this study was to investigate the effect of melatonin on an acute hepatic injury model sinusoidal obstruction syndrome (SOS) in mice. Male C57BL/6 mice were injected with a single dose (500 mg/kg) of monocrotaline (MCT) to induce SOS. Melatonin (1, 3, 10 and 30 mg/kg) was injected 1 h before MCT treatment. After 24 h of MCT treatment, mice were sacrificed. The blood and liver were collected. Organ damage was evaluated by serum biochemistry, hematology analyzer, and histological examination. Low doses of melatonin (1 and 3 mg/kg) had no protective effect on SOS. However, high doses (10 and 30 mg/kg) exacerbated SOS. In addition, it not only increased serum glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and extended liver damage indicated by histological examination but also decreased platelet levels, lymphocyte ratio, and glutathione level; it had no effect on malondialdehyde and nitric oxide level in SOS mice. To conclude, melatonin may exacerbate MCT-induced SOS in mice. Furthermore, melatonin might have a synergistic action with SOS. Usage of melatonin for insomnia by people working in long shift must be cautioned; it might cause acute hepatic injury.

Keywords: acute liver injury, melatonin, shift work, sleep deprivation

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Authors: S. O. Okoro

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Some words become the catch phrase of a particular decade. Globalization, Openness, and Privatization are certainly among the most frequently encapsulation of 1990’s; the market is ‘in’, ‘the state is out’. In the 1970’s, there were many political economists who spoke of autarky as one possible response to global economic forces. Be self-contained, go it alone, put up barriers to trans-nationalities, put in place import-substitution industrialization policy and grow domestic industries. In 1990’s, the emasculation of the state is by no means complete, but there is an acceptance that the state’s power is circumscribed by forces beyond its control and potential leverage. Autarky is no longer as a policy option. Nigeria, since its emergence as an independent nation, has evolved two macroeconomic management regimes of the interventionist and market friendly styles. This paper investigates Nigeria’s growth performance over the periods incorporating these two regimes and finds that there is no structural break in Total Factor Productivity, (TFP) growth and besides, the TFP growth over the entire period of study 1970-2012 is very negligible and hence growth can only be achieved by the unsustainable factor accumulation. Another important finding of this work is that the openness-human capital interaction term has a significant impact on the TFP growth, but the sign of the estimated coefficient does not meet it a theoretical expectation. This is because the negative coefficient on the human capital outweighs the positive openness effect. The poor quality of human capital is considered to have given rise to this. Given these results a massive investment in the education sector is required. The investment should be targeted at reforms that go beyond mere structural reforms to a reform agenda that will improve the quality of human capital in Nigeria.

Keywords: globalization, emasculation, openness and privatization, total factor productivity

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Authors: U. Tumaini, J. Msuya

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Food insecurity is a worrying challenge worldwide with sub-Saharan Africa including Tanzania being the most affected. Although factors that influence household food access security status and ways of coping with such factors have been examined, little has been reported on how these coping strategies vary along the urban-rural continuum especially in medium-sized towns. The purpose of this study was to identify food insecurity coping strategies employed by households and assess whether they are similar along the urban-rural continuum. The study was cross-sectional in design whereby a random sample of 279 households was interviewed using structured questionnaire. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 20 software. It was revealed that the proportion of households relying on less preferred and quality foods, eating fewer meals per day, undertaking work for food or money, performing farm and off-farm activities, and selling fall back assets was higher in rural settings compared to urban and peri-urban areas. Similarly, more households in urban and peri-urban areas cope with food access insecurity by having strict food budgets compared to those in rural households (p ≤ 0.001). The study concludes that food insecurity coping strategies vary significantly from one spatial entity to another. It is thereby recommended that poor, particularly rural households should be supported to diversify their income-generating activities not only for food security purposes during times of food shortage but also as businesses aimed at increasing their household incomes.

Keywords: food coping strategies, household food insecurity, medium-sized towns, urban-rural continuum

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Authors: Timea Harmath-Tánczos

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Drug-resistant epilepsy (DRE) is defined as the persistence of seizures despite at least two syndrome-adapted antiseizure drugs (ASD) used at efficacious daily doses. About a third of patients with epilepsy suffer from drug resistance. Cognitive assessment has a crucial role in the diagnosis and clinical management of epilepsy. Previous studies have addressed the clinical targets and indications for measuring neuropsychological functions; best to our knowledge, no studies have examined it in a Hungarian therapy-resistant population. To fill this gap, we investigated the Hungarian diagnostic protocol between 18 and 65 years of age. This study aimed to describe and analyze neuropsychological functions in patients with drug-resistant epilepsy and identify factors associated with neuropsychology deficits. We perform a prospective case-control study comparing neuropsychological performances in 50 adult patients and 50 healthy individuals between March 2023 and July 2023. Neuropsychological functions were examined in both patients and controls using a full set of specific tests (general performance level, motor functions, attention, executive facts., verbal and visual memory, language, and visual-spatial functions). Potential risk factors for neuropsychological deficit were assessed in the patient group using a multivariate analysis. The two groups did not differ in age, sex, dominant hand and level of education. Compared with the control group, patients with drug-resistant epilepsy showed worse performance on motor functions and visuospatial memory, sustained attention, inhibition and verbal memory. Neuropsychological deficits could therefore be systematically detected in patients with drug-resistant epilepsy in order to provide neuropsychological therapy and improve quality of life. The analysis of the classical and complex indices of the special neuropsychological tasks presented in the presentation can help in the investigation of normal and disrupted memory and executive functions in the DRE.

Keywords: drug-resistant epilepsy, Hungarian diagnostic protocol, memory, executive functions, cognitive neuropsychology

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Authors: Uday S. Goel, G. Senthil Kumar, Biswajit Ghosh, V. V. Mahashabde, Dhirendra Kumar, H. Manjunath, Ritesh Kumar, Mahesh Bhagwat, Subodh Pandey

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Tata Steel Bhushan Steel Ltd.(TSBSL)’s Hot Mill at Angul , Orissa , India, was facing shape issues in Hot Rolled (HR) coils. This was resulting in a defect called as ‘Ridge’, which was appearing in subsequent cold rolling operations at various cold mills (CRM) and external customers. A collaborative project was undertaken to resolve this issue. One of the reasons identified was the strange drop in thermal crown after rolling of 20-25 coils in the finishing mill (FM ) schedule. On the shop floor, it was observed that work roll temperatures in the FM after rolling were very high and non uniform across the work roll barrel. Jammed work roll cooling nozzles, insufficient roll bite lubrication and inadequate roll cooling water quality were found to be the main reasons. Regular checking was initiated to check roll cooling nozzles health, and quick replacement done if found jammed was implemented. Improvements on roll lubrication, especially flow rates, was done. Usage of anti-peeling headers and inter stand descaling was enhanced. A subsequent project was also taken up for improving the quality of roll cooling water. Encouraging results were obtained from the project with a reduction in rejection due to ridge at CRM’s by almost 95% of the pre project start levels. Poor profile occurrence of HR coils at HSM was also reduced from a high of 32% in May’19 to <1% since Apr’20.

Keywords: hot rolling flat, shape, ridge, work roll, roll cooling nozzle, lubrication

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Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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Authors: Polychronis Kapalidis

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

Keywords: cybercrime, cybersecurity, organized crime, risk mitigation

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Authors: Misbah Nizamani, Saira Malik

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Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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Authors: Mamta Bulla, Vinay Kumar

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The transition to renewable energy sources is essential due to the finite limitations of conventional fossil fuels, which contribute significantly to environmental pollution and greenhouse gas emissions. Traditional energy storage solutions, such as batteries and capacitors, are also hindered by limitations, particularly in capacity, cycle life, and energy density. Conventional supercapacitors, while able to deliver high power, often suffer from low energy density, limiting their efficiency in storing and providing renewable energy consistently. Renewable energy sources, such as solar and wind, produce power intermittently, so efficient energy storage solutions are required to manage this variability. Advanced materials, particularly those with high capacity and long cycle life, are critical to developing supercapacitors capable of effectively storing renewable energy. Among various electrode materials, vanadium pentoxide (V₂O₅) offers high theoretical capacitance, but its poor conductivity and cycling stability limit practical applications. This study explores the hydrothermal synthesis of a V₂O₅-carbon nanotube (CNT) composite to overcome these drawbacks, combining the high capacitance of V₂O₅ with the exceptional conductivity and mechanical stability of CNTs. The resulting V₂O₅-CNT composite demonstrates enhanced electrochemical performance, showing high specific capacitance of 890 F g⁻¹ at 0.1 A g⁻¹ current density, excellent rate capability, and improved cycling stability, making it a promising candidate for next-generation supercapacitors, with significant improvements in energy storage efficiency and durability.

Keywords: cyclability, energy density, nanocomposite, renewable energy, supercapacitor

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