Search results for: hospital management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10984

Search results for: hospital management

5614 Teenage Pregnancy: The Unmet Needs of Female Adolescents in Uganda

Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan

Abstract:

Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.

Keywords: adolescents, attitudes, teenage pregnancy, Uganda

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5613 Analysis of the Treatment Hemorrhagic Stroke in Multidisciplinary City Hospital №1 Nur-Sultan

Authors: M. G. Talasbayen, N. N. Dyussenbayev, Y. D. Kali, R. A. Zholbarysov, Y. N. Duissenbayev, I. Z. Mammadinova, S. M. Nuradilov

Abstract:

Background. Hemorrhagic stroke is an acute cerebrovascular accident resulting from rupture of a cerebral vessel or increased permeability of the wall and imbibition of blood into the brain parenchyma. Arterial hypertension is a common cause of hemorrhagic stroke. Male gender and age over 55 years is a risk factor for intracerebral hemorrhage. Treatment of intracerebral hemorrhage is aimed at the primary pathophysiological link: the relief of coagulopathy and the control of arterial hypertension. Early surgical treatment can limit cerebral compression; prevent toxic effects of blood to the brain parenchyma. Despite progress in the development of neuroimaging data, the use of minimally invasive techniques, and navigation system, mortality from intracerebral hemorrhage remains high. Materials and methods. The study included 78 patients (62.82% male and 37.18% female) with a verified diagnosis of hemorrhagic stroke in the period from 2019 to 2021. The age of patients ranged from 25 to 80 years, the average age was 54.66±11.9 years. Demographic, brain CT data (localization, volume of hematomas), methods of treatment, and disease outcome were analyzed. Results. The retrospective analyze demonstrate that 78.2% of all patients underwent surgical treatment: decompressive craniectomy in 37.7%, craniotomy with hematoma evacuation in 29.5%, and hematoma draining in 24.59% cases. The study of the proportion of deaths, depending on the volume of intracerebral hemorrhage, shows that the number of deaths was higher in the group with a hematoma volume of more than 60 ml. Evaluation of the relationship between the time before surgery and mortality demonstrates that the most favorable outcome is observed during surgical treatment in the interval from 3 to 24 hours. Mortality depending on age did not reveal a significant difference between age groups. An analysis of the impact of the surgery type on mortality reveals that decompressive craniectomy with or without hematoma evacuation led to an unfavorable outcome in 73.9% of cases, while craniotomy with hematoma evacuation and drainage led to mortality only in 28.82% cases. Conclusion. Even though the multimodal approaches, the development of surgical techniques and equipment, and the selection of optimal conservative therapy, the question of determining the tactics of managing and treating hemorrhagic strokes is still controversial. Nevertheless, our experience shows that surgical intervention within 24 hours from the moment of admission and craniotomy with hematoma evacuation improves the prognosis of treatment outcomes.

Keywords: hemorragic stroke, Intracerebral hemorrhage, surgical treatment, stroke mortality

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5612 Time-Interval between Rectal Cancer Surgery and Reintervention for Anastomotic Leakage and the Effects of a Defunctioning Stoma: A Dutch Population-Based Study

Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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5611 Integrating Efficient Anammox with Enhanced Biological Phosphorus Removal Process Through Flocs Management for Sustainable Ultra-deep Nutrients Removal from Municipal Wastewater

Authors: Qiongpeng Dan, Xiyao Li, Qiong Zhang, Yongzhen Peng

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The nutrients removal from wastewater is of great significance for global wastewater recycling and sustainable reuse. Traditional nitrogen and phosphorus removal processes are very dependent on the input of aeration and carbon sources, which makes it difficult to meet the low-carbon goal of energy saving and emission reduction. This study reported a proof-of-concept demonstration of integrating anammox and enhanced biological phosphorus removal (EBPR) by flocs management in a single-stage hybrid bioreactor (biofilms and flocs) for simultaneous nitrogen and phosphorus removal (SNPR). Excellent removal efficiencies of nitrogen (97.7±1.3%) and phosphorus (97.4±0.7%) were obtained in low C/N ratio (3.0±0.5) municipal wastewater treatment. Interestingly, with the loss of flocs, anammox bacteria (Ca. Brocadia) was highly enriched in biofilms, with relative and absolute abundances reaching up to 12.5% and 8.3×1010 copies/g dry sludge, respectively. The anammox contribution to nitrogen removal also rose from 32.6±9.8% to 53.4±4.2%. Endogenous denitrification by flocs was proven to be the main contributor to both nitrite and nitrate reduction, and flocs loss significantly promoted nitrite flow towards anammox, facilitating AnAOB enrichment. Moreover, controlling the floc's solid retention time at around 8 days could maintain a low poly-phosphorus level of 0.02±0.001 mg P/mg VSS in the flocs, effectively addressing the additional phosphorus removal burden imposed by the enrichment of phosphorus-accumulating organisms in biofilms. This study provides an update on developing a simple and feasible strategy for integrating anammox and EBPR for SNPR in mainstream municipal wastewater.

Keywords: anammox process, enhanced biological phosphorus removal, municipal wastewater, sustainable nutrients removal

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5610 Data Quality as a Pillar of Data-Driven Organizations: Exploring the Benefits of Data Mesh

Authors: Marc Bachelet, Abhijit Kumar Chatterjee, José Manuel Avila

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Data quality is a key component of any data-driven organization. Without data quality, organizations cannot effectively make data-driven decisions, which often leads to poor business performance. Therefore, it is important for an organization to ensure that the data they use is of high quality. This is where the concept of data mesh comes in. Data mesh is an organizational and architectural decentralized approach to data management that can help organizations improve the quality of data. The concept of data mesh was first introduced in 2020. Its purpose is to decentralize data ownership, making it easier for domain experts to manage the data. This can help organizations improve data quality by reducing the reliance on centralized data teams and allowing domain experts to take charge of their data. This paper intends to discuss how a set of elements, including data mesh, are tools capable of increasing data quality. One of the key benefits of data mesh is improved metadata management. In a traditional data architecture, metadata management is typically centralized, which can lead to data silos and poor data quality. With data mesh, metadata is managed in a decentralized manner, ensuring accurate and up-to-date metadata, thereby improving data quality. Another benefit of data mesh is the clarification of roles and responsibilities. In a traditional data architecture, data teams are responsible for managing all aspects of data, which can lead to confusion and ambiguity in responsibilities. With data mesh, domain experts are responsible for managing their own data, which can help provide clarity in roles and responsibilities and improve data quality. Additionally, data mesh can also contribute to a new form of organization that is more agile and adaptable. By decentralizing data ownership, organizations can respond more quickly to changes in their business environment, which in turn can help improve overall performance by allowing better insights into business as an effect of better reports and visualization tools. Monitoring and analytics are also important aspects of data quality. With data mesh, monitoring, and analytics are decentralized, allowing domain experts to monitor and analyze their own data. This will help in identifying and addressing data quality problems in quick time, leading to improved data quality. Data culture is another major aspect of data quality. With data mesh, domain experts are encouraged to take ownership of their data, which can help create a data-driven culture within the organization. This can lead to improved data quality and better business outcomes. Finally, the paper explores the contribution of AI in the coming years. AI can help enhance data quality by automating many data-related tasks, like data cleaning and data validation. By integrating AI into data mesh, organizations can further enhance the quality of their data. The concepts mentioned above are illustrated by AEKIDEN experience feedback. AEKIDEN is an international data-driven consultancy that has successfully implemented a data mesh approach. By sharing their experience, AEKIDEN can help other organizations understand the benefits and challenges of implementing data mesh and improving data quality.

Keywords: data culture, data-driven organization, data mesh, data quality for business success

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5609 Socio-Economic Problems in Treatment of Non-Union Both Bones Fracture of the Leg: A Retrospective Study

Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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5608 Societal Stakes for Small Cruise Ships: A Recurrent Issue of Our Time

Authors: Maud Tixier

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Societal issues are at stake for cruises anywhere, whatever the size of the ships and their destinations are. However, the Mediterranean sea is the main region where many operate and the challenges are both social and environmental. The presentation focuses on small ships, accounting for market niches, aimed at more specific cruise passengers and calling at less visited areas. How they cope with the benefit of all stakeholders is a persistent issue of our time.

Keywords: environment, management, social, societal, safety

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5607 The History of Chartered Certified Accountants: The Case of Tunisia

Authors: Mariam Dammak, Yosra Makni Fourati, Rania Mnejja

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This paper aims to highlight the conditions and the context of the birth and the implementation of the Chartered Certified Accountants in Tunisian universities. For this purpose, we present an historical overview of the establishment of institutions that started the courses of Chartered accounting, including the Institute of Higher Commercial Studies (IHEC) of Carthage, the Higher Institute of Management (ISG) of Tunis, the Faculty of Economics and Management (FSEG) of Sfax and later the Higher Institute of Accounting and Administration of Enterprises (ISCAE) of Tunis. Then, it would be relevant to examine the changes, carried out by the Tunisian government, of the regulations in force relating to this academic path, from its birth during the 1970s until nowadays. We conducted a documentary study (archival documents, official documents, etc.) accompanied by semi-structured interviews with key actors (accountants, academics, officials of the Ministry of Higher Education) who marked the history of the studies of Tunisian charted accounting. Addressing this research question in Tunisia may contribute to the literature in three ways. First, previous researches dealing with the history of charted accounting-education are scared. Second, this paper allows us to understand the circumstances and context of the birth and teaching of accounting in Tunisia. Eventually, it helps to position the accounting curriculum in relation to international requirements. In fact, the training of accountants is closely related to the practice of the profession, regulated by the Order of Chartered Accountants in Tunisia (OECT). This Order is a member of the International Federation of Accountants (IFAC), since its creation in the 80s, has obligations to align with international requirements, particularly those relating to higher education, set up in 2005 and updated in 2015 (International Standard Education: IES).

Keywords: accounting history, chartered certified accountants, higher accounting education, Tunisian context

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5606 Analysis of the Effect of Increased Self-Awareness on the Amount of Food Thrown Away

Authors: Agnieszka Dubiel, Artur Grabowski, Tomasz Przerywacz, Mateusz Roganowicz, Patrycja Zioty

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Food waste is one of the most significant challenges humanity is facing nowadays. Every year, reports from global organizations show the scale of the phenomenon, although society's awareness is still insufficient. One-third of the food produced in the world is wasted at various points in the food supply chain. Wastes are present from the delivery through the food preparation and distribution to the end of the sale and consumption. The first step in understanding and resisting the phenomenon is a thorough analysis of the everyday behaviors of humanity. This concept is understood as finding the correlation between the type of food and the reason for throwing it out and wasting it. Those actions were identified as a critical step in the start of work to develop technology to prevent food waste. In this paper, the problem mentioned above was analyzed by focusing on the inhabitants of Central Europe, especially Poland, aged 20-30. This paper provides an insight into collecting data through dedicated software and an organized database. The proposed database contains information on the amount, type, and reasons for wasting food in households. A literature review supported the work to answer research questions, compare the situation in Poland with the problem analyzed in other countries, and find research gaps. The proposed article examines the cause of food waste and its quantity in detail. This review complements previous reviews by emphasizing social and economic innovation in Poland's food waste management. The paper recommends a course of action for future research on food waste management and prevention related to the handling and disposal of food, emphasizing households, i.e., the last link in the supply chain.

Keywords: food waste, food waste reduction, consumer food waste, human-food interaction

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5605 The Implementation of Human Resource Information System in the Public Sector: An Exploratory Study of Perceived Benefits and Challenges

Authors: Aneeqa Suhail, Shabana Naveed

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The public sector (in both developed and developing countries) has gone through various waves of radical reforms in recent decades. In Pakistan, under the influence of New Public Management(NPM) Reforms; best practices of private sector are introduced in the public sector to modernize public organizations. Human Resource Information System (HRIS) has been popular in the private sector and proven to be a successful system, therefore it is being adopted in the public sector too. However, implementation of private business practices in public organizations us very challenging due to differences in context. This implementation gets further critical in Pakistan due to a centralizing tendency and lack of autonomy in public organizations. Adoption of HRIS by public organizations in Pakistan raises several questions: What challenges are faced by public organizations in implementation of HRIS? Are benefits of HRIS such as efficiency, process integration and cost reduction achieved? How is the previous system improved with this change and what are the impacts? Yet, it is an under-researched topic, especially in public enterprises. This study contributes to the existing body of knowledge by empirically exploring benefits and challenges of implementation of HRIS in public organizations. The research adopts a case study approach and uses qualitative data based on in-depth interviews conducted at various levels in the hierarchy including top management, departmental heads and employees. The unit of analysis is LESCO, the Lahore Electric Supply Company, a state-owned entity that generates, transmits and distributes electricity to 4 big cities in Punjab, Pakistan. The findings of the study show that LESCO has not achieved the benefits of HRIS as established in literature. The implementation process remained quite slow and costly. Various functions of HR are still in isolation and integration is a big challenge for the organization. Although the data is automated, the previous system of manually record maintenance and paperwork is still in work, resulting in the presence of parallel practices. The findings also identified resistance to change from top management and labor workforce, lack of commitment and technical knowledge, and costly vendors as major barriers that affect the effective implementation of HRIS. The paper suggests some potential actions to overcome these barriers and to enhance effective implementation of HR-technology. The findings are explained in light of an institutional logics perspective. HRIS’ new logic of automated and integrated HR system is in sharp contrast with the prevailing logic of process-oriented manual data maintenance, leading to resistance to change and deadlock.

Keywords: human resource information system, technological changes, state-owned enterprise, implementation challenges

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5604 Human Resource Information System: Role in HRM Practices and Organizational Performance

Authors: Ejaz Ali M. Phil

Abstract:

Enterprise Resource Planning (ERP) systems are playing a vital role in effective management of business functions in large and complex organizations. Human Resource Information System (HRIS) is a core module of ERP, providing concrete solutions to implement Human Resource Management (HRM) Practices in an innovative and efficient manner. Over the last decade, there has been considerable increase in the studies on HRIS. Nevertheless, previous studies relatively lacked to examine the moderating role of HRIS in performing HRM practices that may affect the firms’ performance. The current study was carried out to examine the impact of HRM practices (training, performance appraisal) on perceived organizational performance, with moderating role of HRIS, where the system is in place. The study based on Resource Based View (RBV) and Ability Motivation Opportunity (AMO) Theories, advocating that strengthening of human capital enables an organization to achieve and sustain competitive advantage which leads to improved organizational performance. Data were collected through structured questionnaire based upon adopted instruments after establishing reliability and validity. The structural equation modeling (SEM) were used to assess the model fitness, hypotheses testing and to establish validity of the instruments through Confirmatory Factor Analysis (CFA). A total 220 employees of 25 firms in corporate sector were sampled through non-probability sampling technique. Path analysis revealing that HRM practices and HRIS have significant positive impact on organizational performance. The results further showed that the HRIS moderated the relationships between training, performance appraisal and organizational performance. The interpretation of the findings and limitations, theoretical and managerial implications are discussed.

Keywords: enterprise resource planning, human resource, information system, human capital

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5603 Bridge Members Segmentation Algorithm of Terrestrial Laser Scanner Point Clouds Using Fuzzy Clustering Method

Authors: Donghwan Lee, Gichun Cha, Jooyoung Park, Junkyeong Kim, Seunghee Park

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3D shape models of the existing structure are required for many purposes such as safety and operation management. The traditional 3D modeling methods are based on manual or semi-automatic reconstruction from close-range images. It occasions great expense and time consuming. The Terrestrial Laser Scanner (TLS) is a common survey technique to measure quickly and accurately a 3D shape model. This TLS is used to a construction site and cultural heritage management. However there are many limits to process a TLS point cloud, because the raw point cloud is massive volume data. So the capability of carrying out useful analyses is also limited with unstructured 3-D point. Thus, segmentation becomes an essential step whenever grouping of points with common attributes is required. In this paper, members segmentation algorithm was presented to separate a raw point cloud which includes only 3D coordinates. This paper presents a clustering approach based on a fuzzy method for this objective. The Fuzzy C-Means (FCM) is reviewed and used in combination with a similarity-driven cluster merging method. It is applied to the point cloud acquired with Lecia Scan Station C10/C5 at the test bed. The test-bed was a bridge which connects between 1st and 2nd engineering building in Sungkyunkwan University in Korea. It is about 32m long and 2m wide. This bridge was used as pedestrian between two buildings. The 3D point cloud of the test-bed was constructed by a measurement of the TLS. This data was divided by segmentation algorithm for each member. Experimental analyses of the results from the proposed unsupervised segmentation process are shown to be promising. It can be processed to manage configuration each member, because of the segmentation process of point cloud.

Keywords: fuzzy c-means (FCM), point cloud, segmentation, terrestrial laser scanner (TLS)

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5602 A Lower Dose of Topiramate with Enough Antiseizure Effect: A Realistic Therapeutic Range of Topiramate

Authors: Seolah Lee, Yoohyk Jang, Soyoung Lee, Kon Chu, Sang Kun Lee

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Objective: The International League Against Epilepsy (ILAE) currently suggests a topiramate serum level range of 5-20 mg/L. However, numerous institutions have observed substantial drug response at lower levels. This study aims to investigate the correlation between topiramate serum levels, drug responsiveness, and adverse events to establish a more accurate and tailored therapeutic range. Methods: We retrospectively analyzed topiramate serum samples collected between January 2017 and January 2022 at Seoul National University Hospital. Clinical data, including serum levels, antiseizure regimens, seizure frequency, and adverse events, were collected. Patient responses were categorized as "insufficient" (reduction in seizure frequency <50%) or "sufficient" (reduction ≥ 50%). Within the "sufficient" group, further subdivisions included seizure-free and tolerable seizure subgroups. A population pharmacokinetic model estimated serum levels from spot measurements. ROC curve analysis determined the optimal serum level cut-off. Results: A total of 389 epilepsy patients, with 555 samples, were reviewed, having a mean dose of 178.4±117.9 mg/day and a serum level of 3.9±2.8 mg/L. Out of the samples, only 5.6% (n=31) exhibited insufficient response, with a mean serum level of 3.6±2.5 mg/L. In contrast, 94.4% (n=524) of samples demonstrated sufficient response, with a mean serum level of 4.0±2.8 mg/L. This difference was not statistically significant (p = 0.45). Among the 78 reported adverse events, logistic regression analysis identified a significant association between ataxia and serum concentration (p = 0.04), with an optimal cut-off value of 6.5 mg/L. In the subgroup of patients receiving monotherapy, those in the tolerable seizure group exhibited a significantly higher serum level compared to the seizure-free group (4.8±2.0 mg/L vs 3.4±2.3 mg/L, p < 0.01). Notably, patients in the tolerable seizure group displayed a higher likelihood of progressing into drug-resistant epilepsy during follow-up visits compared to the seizure-free group. Significance: This study proposed an optimal therapeutic concentration for topiramate based on the patient's responsiveness to the drug and the incidence of adverse effects. We employed a population pharmacokinetic model and analyzed topiramate serum levels to recommend a serum level below 6.5 mg/L to mitigate the risk of ataxia-related side effects. Our findings also indicated that topiramate dose elevation is unnecessary for suboptimal responders, as the drug's effectiveness plateaus at minimal doses.

Keywords: topiramate, therapeutic range, low dos, antiseizure effect

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5601 Basal Cell Carcinoma Excision Intraoperative Frozen Section for Tumor Clearance and Reconstructive Surgery: A Prospective Open Label Interventional Study

Authors: Moizza Tahir, Uzma Bashir, Aisha Akhtar, Zainab Ansari, Sameen Ansari, Muhammad Ali Tahir

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Cancer burden has globally increased. Among cutaneous cancers basal cell carcinoma constitute vast majority of skin cancer. There is need for appropriate diagnostic, therapeutic and prognostic significance evaluation for skin cancers Present study report intraoperative frozen section (FS) histopathological clearance for excision of BCC in a tertiary care center and find the frequency of involvement of surgical margin with reference to anatomical site, with size and surgical technique. It was prospective open label interventional study conducted at Dermatology department of tertiary care hospital Rawalpindi Pakistan in lais on with histopathology department from January 2023 to April 2024. Total of thirty-six (n = 36) patients between age 45-80 years with basal cell carcinoma of 10-20mm on face were included following inclusion exclusion criteria by purposive sampling technique. Informed consent was taken. Surgical excision was performed and intraoperative frozen section histopathology clearance of tumor margin was taken from histopathologist on telephone. Surgical reconstruction was done. Final Histopathology report was reexamined on day 10th for margin and depth clearance. Descriptive statistics were calculated for age, gender, sun exposure, reconstructive technique, anatomical site, and tumor free margin report on frozen section analysis. Chi square test was employed for statistical significance of involvement of surgical margin with reference to anatomical site, size and decision on reconstructive surgical technique, p value of <0.05 was considered significant. Total of 36 patients of BCC were enrolled, males 12 (33.3%) and females were 24 (66.6%). Age ranged from 45 year to 80 year mean of 58.36 ±SD7.8. Size of BCC ranged from 10mm to 35mm mean of 25mm ±SD 0.63. Morphology was nodular 18 (50%), superficial spreading 11(30.6%), morphoeic 1 (2.8%) and ulcerative in 6(16.7%) cases. Intraoperative frozen section for histopathological margin clearance with 2-3 mm safety margin and surgical technique has p-value0.51, for anatomical site p value 0.24 and size p-0.84. Intraoperative frozen section (FS) histopathological clearance for BCC face with 2-3mm safety margin with reference to reconstructive technique, anatomical site and size of BCC were insignificant.

Keywords: basal cell carcinoma, tumor free amrgin, basal cell carcinoma and frozen section, safety margin

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5600 Competency Model as a Key Tool for Managing People in Organizations: Presentation of a Model

Authors: Andrea ČopíKová

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Competency Based Management is a new approach to management, which solves organization’s challenges with complexity and with the aim to find and solve organization’s problems and learn how to avoid these in future. They teach the organizations to create, apart from the state of stability – that is temporary, vital organization, which is permanently able to utilize and profit from internal and external opportunities. The aim of this paper is to propose a process of competency model design, based on which a competency model for a financial department manager in a production company will be created. Competency models are very useful tool in many personnel processes in any organization. They are used for acquiring and selection of employees, designing training and development activities, employees’ evaluation, and they can be used as a guide for a career planning and as a tool for succession planning especially for managerial positions. When creating a competency model the method AHP (Analytic Hierarchy Process) and quantitative pair-wise comparison (Saaty’s method) will be used; these methods belong among the most used methods for the determination of weights, and it is used in the AHP procedure. The introduction part of the paper consists of the research results pertaining to the use of competency model in practice and then the issue of competency and competency models is explained. The application part describes in detail proposed methodology for the creation of competency models, based on which the competency model for the position of financial department manager in a foreign manufacturing company, will be created. In the conclusion of the paper, the final competency model will be shown for above mentioned position. The competency model divides selected competencies into three groups that are managerial, interpersonal and functional. The model describes in detail individual levels of competencies, their target value (required level) and the level of importance.

Keywords: analytic hierarchy process, competency, competency model, quantitative pairwise comparison

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5599 A Comparison of Clinical and Pathological TNM Staging in a COVID-19 Era

Authors: Sophie Mills, Leila L. Touil, Richard Sisson

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Introduction: The TNM classification is the global standard for the staging of head and neck cancers. Accurate clinical-radiological staging of tumours (cTNM) is essential to predict prognosis, facilitate surgical planning and determine the need for other therapeutic modalities. This study aims to determine the accuracy of pre-operative cTNM staging using pathological TNM (pTNM) and consider possible causes of TNM stage migration, noting any variation throughout the COVID-19 pandemic. Materials and Methods: A retrospective cohort study examined records of patients with surgical management of head and neck cancer at a tertiary head and neck centre from November 2019 to November 2020. Data was extracted from Somerset Cancer Registry and histopathology reports. cTNM and pTNM were compared before and during the first wave of COVID-19, as well as with other potential prognostic factors such as tumour site and tumour stage. Results: 119 cases were identified, of which 52.1% (n=62) were male, and 47.9% (n=57) were female with a mean age of 67 years. Clinical and pathological staging differed in 54.6% (n=65) of cases. Of the patients with stage migration, 40.4% (n=23) were up-staged and 59.6% (n=34) were down-staged compared with pTNM. There was no significant difference in the accuracy of cTNM staging compared with age, sex, or tumour site. There was a statistically highly significant (p < 0.001) correlation between cTNM accuracy and tumour stage, with the accuracy of cTNM staging decreasing with the advancement of pTNM staging. No statistically significant variation was noted between patients staged prior to and during COVID-19. Conclusions: Discrepancies in staging can impact management and outcomes for patients. This study found that the higher the pTNM, the more likely stage migration will occur. These findings are concordant with the oncology literature, which highlights the need to improve the accuracy of cTNM staging for more advanced tumours.

Keywords: COVID-19, head and neck cancer, stage migration, TNM staging

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5598 A Seven Year Single-Centre Study of Dental Implant Survival in Head and Neck Oncology Patients

Authors: Sidra Suleman, Maliha Suleman, Stephen Brindley

Abstract:

Oral rehabilitation of head and neck cancer patients plays a crucial role in the quality of life for such individuals post-treatment. Placement of dental implants or implant-retained prostheses can help restore oral function and aesthetics, which is often compromised following surgery. Conventional prosthodontic techniques can be insufficient in rehabilitating such patients due to their altered anatomy and reduced oral competence. Hence, there is a strong clinical need for the placement of dental implants. With an increasing incidence of head and neck cancer patients, the demand for such treatment is rising. Aim: The aim of the study was to determine the survival rate of dental implants in head and neck cancer patients placed at the Restorative and Maxillofacial Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: All patients who received dental implants between January 1, 2013 to December 31, 2020 were identified. Patients were excluded based on three criteria: 1) non-head and neck cancer patients, 2) no outpatient follow-up post-implant placement 3) provision of non-dental implants. Scanned paper notes and electronic records were extracted and analyzed. Implant survival was defined as fixtures that had remained in-situ / not required removal. Sample: Overall, 61 individuals were recruited from the 143 patients identified. The mean age was 64.9 years, with a range of 35 – 89 years. The sample included 37 (60.7%) males and 24 (39.3%) females. In total, 211 implants were placed, of which 40 (19.0%) were in the maxilla, 152 (72.0%) in the mandible and 19 (9.0%) in autogenous bone graft sites. Histologically 57 (93.4%) patients had squamous cell carcinoma, with 43 (70.5%) patients having either stage IVA or IVB disease. As part of treatment, 42 (68.9%) patients received radiotherapy, which was carried out post-operatively for 29 (69.0%) cases. Whereas 21 (34.4%) patients underwent chemotherapy, 13 (61.9%) of which were post-operative. The Median follow-up period was 21.9 months with a range from 0.9 – 91.4 months. During the study, 23 (37.7%) patients died and their data was censored beyond the date of death. Results: In total, four patients who had received radiotherapy had one implant failure each. Two mandibular implants failed secondary to osteoradionecrosis, and two maxillary implants did not survive as a result of failure to osseointegrate. The overall implant survival rates were 99.1% at three years and 98.1% at both 5 and 7 years. Conclusions: Although this data shows that implant failure rates are low, it highlights the difficulty in predicting which patients will be affected. Future studies involving larger cohorts are warranted to further analyze factors affecting outcomes.

Keywords: oncology, dental implants, survival, restorative

Procedia PDF Downloads 221
5597 Power Energy Management For A Grid-Connected PV System Using Rule-Base Fuzzy Logic

Authors: Nousheen Hashmi, Shoab Ahmad Khan

Abstract:

Active collaboration among the green energy sources and the load demand leads to serious issues related to power quality and stability. The growing number of green energy resources and Distributed-Generators need newer strategies to be incorporated for their operations to keep the power energy stability among green energy resources and micro-grid/Utility Grid. This paper presents a novel technique for energy power management in Grid-Connected Photovoltaic with energy storage system under set of constraints including weather conditions, Load Shedding Hours, Peak pricing Hours by using rule-based fuzzy smart grid controller to schedule power coming from multiple Power sources (photovoltaic, grid, battery) under the above set of constraints. The technique fuzzifies all the inputs and establishes fuzzify rule set from fuzzy outputs before defuzzification. Simulations are run for 24 hours period and rule base power scheduler is developed. The proposed fuzzy controller control strategy is able to sense the continuous fluctuations in Photovoltaic power generation, Load Demands, Grid (load Shedding patterns) and Battery State of Charge in order to make correct and quick decisions.The suggested Fuzzy Rule-based scheduler can operate well with vague inputs thus doesn’t not require any exact numerical model and can handle nonlinearity. This technique provides a framework for the extension to handle multiple special cases for optimized working of the system.

Keywords: photovoltaic, power, fuzzy logic, distributed generators, state of charge, load shedding, membership functions

Procedia PDF Downloads 468
5596 Causes of Road Crashes Among Students Attending Schools in Huye District and Kigali City

Authors: Ami Nkumbuye

Abstract:

Background: Every year 1.3 million people die due to Road crashes, according to the Global status report. Road crashes remain the greatest killer aged between 15-29 years. Young people are paying an unacceptable price for their own safer mobility. 23,498 students attending class daily from home crossing the roads of 3 districts Kigali and Southern province is showing a similar trend with 40320 cross road daily. As most of them don't have any idea about the safety, they should have when they are crossing roads and traffic rules and signs as well. Despite the high number of mortality related to road crashes in Rwanda, we don't have any approved calendar to teach young people road safety as the most affected age group. Objective: The objective of this study was to identify the causes of road crashes and the outcome of victims after being involved in road crashes over a period of two years, from January 2020 to December 2021, in Huye district and Kigali City. Methods: A retrospective descriptive study with open questions and then data analysis, students were identified from 15 schools in Kigali City and Southern Province and through the Local Action Project supported by Global Youth Coalition for Road Safety and Youth for Road Safety (YOURS), students asked about the cause of road crashes through open and closed question and data analyzed. Result: There were 354 students from 15 schools: 198 males and 156 females. Their age ranged from 10 to 25 years. The commonest cause of road crashes among students attending schools daily was: high speed, lack of education on safe behavior on the road, drinking and driving, and poor road infrastructures, with 47%, 32%, 13% and 8 %, respectively. The hospital admission after road crashes for the victims was 32.3%. In most scenes where road crashes occur, students report that they didn't see any person who could provide post-crash care until the ambulance came, in some cases, resulted in bad outcomes for the victims after road crashes. Conclusion: This study revealed that high speed and lack of education n road safety are the major cause of road crashes among young people in Rwanda. If local Non-Governmental Organization and Decision makers work on these issues like never before, we can see a decrease in road crash among young people and adult as well. We would like to give a recommendation to two institutions: the first is the Rwanda National Police Traffic department to set 30km/m as the maximum speed limit in City and near schools. The second is for the Ministry of Education to put Road Safety and Post Crash Care curricula in both Primary and Secondary schools.

Keywords: road safety, post-crash care, young people, students

Procedia PDF Downloads 76
5595 Management of Distillery Spentwash to Enhance Productivity of Dryland Crops and Reduce Environmental Pollution: A Case Study in Southern Dry Zone of Karnataka, India

Authors: A. Sathish, N. N. Lingaraju, K. N. Geetha, C. A. Srinivasamurthy, S. Bhaskar

Abstract:

Under dryland conditions, it is observed that the soil organic matter is low due to low organic carbon content due to poor management with less use of inputs. On the other hand, disposal of sugar industry waste, i.e., spentwash is a major concern with limited space for land based treatment and disposal which causes environmental pollution. Spentwash is also a resource that can be applied for productive uses since it contains nutrients that have the potential for use in agriculture. The disposal of spent wash may lead to environmental pollution. Hence as an alternative mechanism, it was applied once to dry lands, and the experiments were conducted from 2012-13 to 2016-17 in kharif season in Maddur Taluk, Mandya District, Karnataka State, India. The study conducted was in 93 different farmers field (maize-11, finger millet-80 & horsegram-14). Spentwash was applied at the rate of 100 m³ ha⁻¹ before sowing of the crops. The results showed that yield of dryland crops like finger millet, horse gram and maize was recorded 14.75 q ha⁻¹, 6 q ha⁻¹ and 31.00 q ha⁻¹, respectively and the yield increase to an extent of 10-25 per cent with one time application of spentwash to dry lands compared to farmers practice, i.e., chemical fertilizer application. The higher yield may be attributed to slow and steady release of nutrients by spentwash throughout the crop growth period. In addition, the growth promoting and other beneficial substances present in spentwash might have also helped in better plant growth and yield. The soil sample analysis after harvest of the crops indicate acidic to neutral pH, EC of 0.11 dSm⁻¹ and Na of 0.20 C mol (P⁺) kg⁻¹ in the normal range which are not harmful. Hence, it can be applied to drylands at least once in 3 years which enhances yield as well as reduces environmental pollution.

Keywords: dryland crops, pollution, sugar industry waste, spentwash

Procedia PDF Downloads 228
5594 An Analysis of Different Essential Components of Flight Plan Operations at Low Altitude

Authors: Apisit Nawapanpong, Natthapat Boonjerm

Abstract:

This project aims to analyze and identify the flight plan of low-altitude aviation in Thailand and other countries. The development of UAV technology has led the innovation and revolution in the aviation industry; this includes the development of new modes of passenger or freight transportation, and it has also affected other industries widely. At present, this technology is being developed rapidly and has been tested all over the world to make the most efficient for technology or innovation, and it is likely to grow more extensively. However, no flight plan for low-altitude operation has been published by the government organization; when compared with high-altitude aviation with manned aircraft, various unique factors are different, whether mission, operation, altitude range or airspace restrictions. In the study of the essential components of low-altitude operation measures to be practical and tangible, there were major problems, so the main consideration of this project is to analyze the components of low-altitude operations which are conducted up to the altitudes of 400 ft or 120 meters above ground level referring to the terrain, for example, air traffic management, classification of aircraft, basic necessity and safety, and control area. This research will focus on confirming the theory through qualitative and quantitative research combined with theoretical modeling and regulatory framework and by gaining insights from various positions in aviation industries, including aviation experts, government officials, air traffic controllers, pilots, and airline operators to identify the critical essential components of low-altitude flight operation. This project analyzes by using computer programs for science and statistics research to prove that the result is equivalent to the theory and be beneficial for regulating the flight plan for low-altitude operation by different essential components from this project and can be further developed for future studies and research in aviation industries.

Keywords: low-altitude aviation, UAV technology, flight plan, air traffic management, safety measures

Procedia PDF Downloads 37
5593 Sensor and Actuator Fault Detection in Connected Vehicles under a Packet Dropping Network

Authors: Z. Abdollahi Biron, P. Pisu

Abstract:

Connected vehicles are one of the promising technologies for future Intelligent Transportation Systems (ITS). A connected vehicle system is essentially a set of vehicles communicating through a network to exchange their information with each other and the infrastructure. Although this interconnection of the vehicles can be potentially beneficial in creating an efficient, sustainable, and green transportation system, a set of safety and reliability challenges come out with this technology. The first challenge arises from the information loss due to unreliable communication network which affects the control/management system of the individual vehicles and the overall system. Such scenario may lead to degraded or even unsafe operation which could be potentially catastrophic. Secondly, faulty sensors and actuators can affect the individual vehicle’s safe operation and in turn will create a potentially unsafe node in the vehicular network. Further, sending that faulty sensor information to other vehicles and failure in actuators may significantly affect the safe operation of the overall vehicular network. Therefore, it is of utmost importance to take these issues into consideration while designing the control/management algorithms of the individual vehicles as a part of connected vehicle system. In this paper, we consider a connected vehicle system under Co-operative Adaptive Cruise Control (CACC) and propose a fault diagnosis scheme that deals with these aforementioned challenges. Specifically, the conventional CACC algorithm is modified by adding a Kalman filter-based estimation algorithm to suppress the effect of lost information under unreliable network. Further, a sliding mode observer-based algorithm is used to improve the sensor reliability under faults. The effectiveness of the overall diagnostic scheme is verified via simulation studies.

Keywords: fault diagnostics, communication network, connected vehicles, packet drop out, platoon

Procedia PDF Downloads 223
5592 Forest Degradation and Implications for Rural Livelihood in Kaimur Reserve Forest of Bihar, India

Authors: Shashi Bhushan, Sucharita Sen

Abstract:

In India, forest and people are inextricably linked since millions of people live adjacent to or within protected areas and harvest forest products. Indian forest has their own legacy to sustain by its own climatic nature with several social, economic and cultural activities. People surrounding forest areas are not only dependent on this resource for their livelihoods but also for the other source, like religious ceremonies, social customs and herbal medicines, which are determined by the forest like agricultural land, groundwater level, and soil fertility. The assumption that fuelwood and fodder extraction, which is the part of local livelihood leads to deforestation, has so far been the dominant mainstream views in deforestation discourses. Given the occupational division across social groups in Kaimur reserve forest, the differential nature of dependence of forest resources is important to understand. This paper attempts to assess the nature of dependence and impact of forest degradation on rural households across various social groups. Also, an additional element that is added to the enquiry is the way degradation of forests leading to scarcity of forest-based resources impacts the patterns of dependence across various social groups. Change in forest area calculated through land use land cover analysis using remote sensing technique and examination of different economic activities carried out by the households that are forest-based was collected by primary survey in Kaimur reserve forest of state of Bihar in India. The general finding indicates that the Scheduled Tribe and Scheduled Caste communities, the most socially and economically deprived sections of the rural society are involved in a significant way in collection of fuelwood, fodder, and fruits, both for self-consumption and sale in the market while other groups of society uses fuelwood, fruit, and fodder for self-use only. Depending on the local forest resources for fuelwood consumption was the primary need for all social groups due to easy accessibility and lack of alternative energy source. In last four decades, degradation of forest made a direct impact on rural community mediated through the socio-economic structure, resulting in a shift from forest-based occupations to cultivation and manual labour in agricultural and non-agricultural activities. Thus there is a need to review the policies with respect to the ‘community forest management’ since this study clearly throws up the fact that engagement with and dependence on forest resources is socially differentiated. Thus tying the degree of dependence and forest management becomes extremely important from the view of ‘sustainable’ forest resource management. The statization of forest resources also has to keep in view the intrinsic way in which the forest-dependent population interacts with the forest.

Keywords: forest degradation, livelihood, social groups, tribal community

Procedia PDF Downloads 152
5591 Lethal and Sub-Lethal Effects of Pyriproxyfen on Demography of Convergent Lady Beetle, Hippodamia convergens (Goeze) (Coccinellidae: Coleoptera)

Authors: Ayesha Iftikhar, Faisal Hafeez, Muhammad Jawad Saleem, Afifa Naeem, Muhammad Sohaib

Abstract:

To further develop integrated pest management (IPM) tactics against insect pests, demographic toxicology is considered important and efficient to evaluate the long-term effects of pesticides on biological control agents. In this study, lethal and sub-lethal effects of Pyriproxyfen (insect growth regulator) two concentrations of LC10 and LC30 were tested on second instar larvae of convergent lady beetle, Hippodamia convergens (Goeze) in order to evaluate the effect of insecticide on demographic parameters of the predator under laboratory conditions. The life table parameters were analysed statistically by using age-stage, two sex life table procedure. The results of this study show that developmental time for immature was prolonged in treated population (LC30 and LC10) rather than in control. Similarly, male and female longevity was also longer in the control group as compared to the treated population. Adult pre-oviposition period and fecundity were also greater in control as compared to the treated population. In addition, population parameters such as net reproductive rate (R0), intrinsic rate of increase (r) and finite rate of increase (λ) were also greater in control group rather than treated population. However, mean generation time (T) was greater in the treated group. The results revealed that pyriproxyfen, even at low concentrations, has potential to greatly affect the population growth of predatory lady beetle, therefore care should be taken when insect growth regulators are used within an IPM framework.

Keywords: ladybird beetle, IGR, integrated pest management, population inhibition

Procedia PDF Downloads 110
5590 School as a Space of Power: A Foucauldian Critique

Authors: Yildirim Ortaoglan

Abstract:

The attempt to make thought school-like by fitting it into various frameworks with the institutionalization of it is almost simultaneous with philosophy itself. What once sprouted in the “academia” of old has institutionalized under the enlightenment's light, becoming the fundamental space reflecting the spirit of its age. However, the shift from the thinking temple where truth's knowledge was sought to functional spaces where power/power relations are constructed indicates a significant rupture in the meaning of school. Therefore, a genealogical inquiry into the meaning of the school can provide us with a path toward understanding how it should be approached in contemporary times. From this perspective, it is essential to highlight how power/power relations operate in the school in terms of disciplinary practices, temporal management, and spatial organization to construct a distinct subjectivation. Recognizing that the changing and evolving nature of education is related to the structure of space can be understood by revealing how disciplinary power and bio-power, two fundamental aspects of genealogical research, operate. In disciplinary power, the relationship of the subject with discipline, temporal management, and space is about improvement and normalization, while in biopower, it manifests in maximizing utility, increasing free time, and constructing spaces that seem more vital. These indicators not only facilitate the formation of students as a subjectivation but also enable the condition of the possibility of power/power relations. Because power is not applied to subjects but used by them for passage, and behind this lies the idea that the individual is already one of the components of power. As one of the components of power, in terms of subjectivation type, the student is one of the primary targets of power relations. Therefore, conducting a genealogical inquiry of the student as a type of subjectivation and the school as its living area from the philosophical foundations of education may offer a new opportunity for thinking about the contemporary crisis of thought. Within the framework of this possibility, our investigation will consider which aspects of the school and the student, brought together for educational purposes, can be thought of within and beyond power/power relations.

Keywords: power, education, space, school, student, discipline

Procedia PDF Downloads 47
5589 Deforestation, Vulnerability and Adaptation Strategies of Rural Farmers: The Case of Central Rift Valley Region of Ethiopia

Authors: Dembel Bonta Gebeyehu

Abstract:

In the study area, the impacts of deforestation for environmental degradation and livelihood of farmers manifest in different faces. They are more vulnerable as they depend on rain-fed agriculture and immediate natural forests. On the other hand, after planting seedling, waste disposal and management system of the plastic cover is poorly practiced and administered in the country in general and in the study area in particular. If this situation continues, the plastic waste would also accentuate land degradation. Besides, there is the absence of empirical studies conducted comprehensively on the research under study the case. The results of the study could suffice to inform any intervention schemes or to contribute to the existing knowledge on these issues. The study employed a qualitative approach based on intensive fieldwork data collected via various tools namely open-ended interviews, focus group discussion, key-informant interview and non-participant observation. The collected data was duly transcribed and latter categorized into different labels based on pre-determined themes to make further analysis. The major causes of deforestation were the expansion of agricultural land, poor administration, population growth, and the absence of conservation methods. The farmers are vulnerable to soil erosion and soil infertility culminating in low agricultural production; loss of grazing land and decline of livestock production; climate change; and deterioration of social capital. Their adaptation and coping strategies include natural conservation measures, diversification of income sources, safety-net program, and migration. Due to participatory natural resource conservation measures, soil erosion has been decreased and protected, indigenous woodlands started to regenerate. These brought farmers’ attitudinal change. The existing forestation program has many flaws. Especially, after planting seedlings, there is no mechanism for the plastic waste disposal and management. It was also found out organizational challenges among the mandated offices In the studied area, deforestation is aggravated by a number of factors, which made the farmers vulnerable. The current forestation programs are not well-planned, implemented, and coordinated. Sustainable and efficient seedling plastic cover collection and reuse methods should be devised. This is possible through creating awareness, organizing micro and small enterprises to reuse, and generate income from the collected plastic etc.

Keywords: land-cover and land-dynamics, vulnerability, adaptation strategy, mitigation strategies, sustainable plastic waste management

Procedia PDF Downloads 370
5588 Impact of Tillage and Crop Establishment on Fertility and Sustainability of the Rice-Wheat Cropping System in Inceptisols of Varanasi, Up, India

Authors: Pramod Kumar Sharma, Pratibha Kumari, Udai Pratap Singh, Sustainability

Abstract:

In the Indo-Gangetic Plains of South-East Asia, the rice-wheat cropping system (RWCS) is dominant with conventional tillage (CT) without residue management, which shows depletion of soil fertility and non-sustainable crop productivity. Hence, this investigation was planned to identify suitable natural resource management practices involving different tillage and crop establishment (TCE) methods along with crop residue and their effects, on the sustainability of dominant cropping systems through enhancing soil fertility and productivity. This study was conducted for two consecutive years 2018-19 and 2019-20 on a long-term field experiment that was started in the year 2015-16 taking six different combinations of TCE methods viz. CT, partial conservation agriculture (PCA) i.e. anchored residue of rice and full conservation agriculture (FCA)] i.e. anchored residue of rice and wheat under RWCS in terms of crop productivity, sustainability of soil health, and crop nutrition by the crops. Results showed that zero tillage direct-seeded rice (ZTDSR) - zero tillage wheat (ZTW) [FCA + green gram residue retention (RR)] recorded the highest yield attributes and yield during both the crops. Compared to conventional tillage rice (CTR)-conventional tillage wheat (CTW) [residue removal (R 0 )], the soil quality parameters were improved significantly with ZTDSR-ZTW (FCA+RR). Overall, ZTDSR-ZTW (FCA+RR) had higher nutrient uptake by the crops than CT-based treatment CTR-CTW (R 0 ) and CTR-CTW (RI).These results showed that there is significant profitability of yield and resource utilization by the adoption of FCA it may be a better alternative to the dominant tillage system i.e. CT in RWSC.

Keywords: tillage and crop establishment, soil fertility, rice-wheat cropping system, sustainability

Procedia PDF Downloads 89
5587 Pulmonary Complications of Dengue Infection

Authors: Shilpa Avarebeel

Abstract:

Background: India is one of the seven identified countries in South-East Asia region, regularly reporting dengue infection and may soon transform into a major niche for dengue epidemics. Objective: To study the clinical profile of dengue in our setting with special reference to respiratory complication. Study design: Descriptive and exploratory study, for one year in 2014. All patients confirmed as dengue infection were followed and their clinical profile, along with outcome was determined. Study proforma was designed based on the objective of the study and it was pretested and used after modification. Data was analyzed using statistical software SPSS-Version 16. Data were expressed as mean ±S .D for parametric variables and actual frequencies or percentage for non-parametric data. Comparison between groups was done using students’ t-test for independent groups, Chie square test, one-way ANOVA test, Karl Pearson’s correlation test. Statistical significance is taken at P < 0.05. Results: Study included 134 dengue positive cases. 81% had dengue fever, 18% had dengue hemorrhagic fever, and one had dengue shock syndrome. Most of the cases reported were during the month of June. Maximum number of cases was in the age group of 26-35 years. Average duration of hospital stay was less than seven days. Fever and myalgia was present in all the 134 patients, 16 had bleeding manifestation. 38 had respiratory symptoms, 24 had breathlessness, and 14 had breathlessness and dry cough. On clinical examination of patients with respiratory symptoms, all twenty-eight had hypoxia features, twenty-four had signs of pleural effusion, and four had ARDS features. Chest x-ray confirmed the same. Among the patients with respiratory symptoms, the mean platelet count was 26,537 c/cmm. There was no statistical significant difference in the platelet count in those with ARDS and other dengue complications. Average four units of platelets were transfused to all those who had ARDS in view of bleeding tendency. Mechanical ventilator support was provided for ARDS patients. Those with pleural effusion and pulmonary oedema were given NIV (non-invasive ventilation) support along with supportive care. However, steroids were given to patients with ARDS and 10 patients with signs of respiratory distress. 100%. Mortality was seen in patients with ARDS. Conclusion: Dengue has to be checked for those presenting with fever and breathlessness. Supportive treatments remain the cornerstone of treatment. Platelet transfusion has to be given only by clinical judgment. Steroids have no role except in early ARDS, which is controversial. Early NIV support helps in speedy recovery of dengue patients with respiratory distress.

Keywords: adult respiratory distress syndrome, dengue fever, non-invasive ventilation, pulmonary complication

Procedia PDF Downloads 420
5586 Efficacy and Safety of Sublingual Sufentanil for the Management of Acute Pain

Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

Abstract:

Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

Procedia PDF Downloads 345
5585 Identifying and Evaluating the Effectiveness of Communication Channels between Employees and Management Based on the EFQM Excellence Model

Authors: Mehrdad Hosseinishakib, Mozhgan Chakani, Gholamreza Babaei

Abstract:

This study aims to investigate the relationship between the bilateral communication channels, communication technologies with effective communications and communication technologies, employee participation in motivated decision-making of employees using the EFQM excellence model in Education Organization of Area 4 in Karaj. This research is an applied research in terms of the purpose and is a descriptive survey research in terms of nature and method and assesses the current situation using field studies. The statistical population consists of all employees and managers of Education Organization of Area 4 in Karaj including 5442 persons and random sampling was used and sample size is 359 using Cochran formula. Measurement tool is a researcher-made questionnaire with 20 questions including two categories of expertise and general questions. The first category includes general questions about respondents' personal characteristics such as gender and level of education, work experience and courses of study. The second category includes expertise questions of the questionnaire that have been designed to test research hypotheses that its reliability was approved by Cronbach's alpha coefficient 0.916 and its validity was approved according to the vies of teachers and some senior managers of Education Organization of Area 4 in Karaj. The results of the analysis of the findings show that there is a significant relationship between mutual communication channels, communication technologies with effective communication between employees and management. There is also a significant relationship between communication technologies and employee motivation and employee participation in their motivated decision-making in Education Organization of Area 4 in Karaj.

Keywords: communication channels, effective communication, EFQM model, ANOVA

Procedia PDF Downloads 228