Search results for: cardiovascular risk factors in CKD

Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Konstantine Eristavi

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The paper will contribute to the discussion on the pitfalls, limits, and possibilities of legal and rights discourse in opposing large infrastructural projects in the context of neoliberal globalisation. To this end, the paper will analyse the struggle against the Namakhvani HPP project in Georgia. The latter has been hailed by the government as one of the largest energy projects in the history of the country, with an enormous potential impact on energy security, energy independence, economic growth, and development. This takes place against the backdrop of decades of market-led -or neoliberal- model of development in Georgia, characterised by structural adjustments, deregulation, privatisation, and Laissez-Fair approach to foreign investment. In this context, the Georgian state vies with other low and middle-income countries for foreign capital by offering to potential investors, on the one hand, exemptions from social and environmental regulations and, on the other hand, huge legal concessions and safeguards, thereby participating in what is often called a “race to the bottom.” The Namakhvani project is a good example of this. At every stage, the project has been marred with violations of laws and regulations concerning transparency, participation, social and environmental regulations, and so on. Moreover, the leaked contract between the state and the developer reveals the contractual safeguards which effectively insulate the investment throughout the duration of the contract from the changes in the national law that might adversely affect investors’ rights and returns. These clauses, aimed at preserving investors' economic position, place the contract above national law in many respects and even conflict with fundamental constitutional rights. In response to the perceived deficiencies of the project, one of the largest and most diverse social movements in the history of post-soviet Georgia has been assembled, consisting of the local population, conservative and leftist groups, human rights and environmental NGOs, etc. Crucially, the resistance movement is actively using legal tools. In order to analyse both the limitations and possibilities of legal discourse, the paper will distinguish between internal and immanent critiques. Law as internal critique, in the context of the struggles around the Namakhvani project, while potentially fruitful in hindering the project, risks neglecting and reproducing those factors -e.g., the particular model of development- that made such contractual concessions and safeguards and concomitant rights violations possible in the first place. On the other hand, the use of rights and law as part of immanent critique articulates a certain incapacity on the part of the addressee government to uphold existing laws and rights due to structural factors, hence, pointing to a need for a fundamental change. This 'ruptural' form of legal discourse that the movement employs makes it possible to go beyond the discussion around the breaches of law and enables a critical deliberation on the development model within which these violations and extraordinary contractual safeguards become necessary. It will be argued that it is this form of immanent critique that expresses the emancipatory potential of legal discourse.

Keywords: law, resistance, development, rights

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Authors: Kari Saarelainen, Marko Jantti

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IT service trending of root causes of service incidents and problems is an important part of proactive problem management and service improvement. Human error related root causes are an important root cause category also in IT service management, although it’s proportion among root causes is smaller than in the other industries. The research problem in this study is: How root causes of incidents related to human errors should be categorized in an ITSM organization to effectively support service improvement. Categorization based on IT service management processes and based on Human Factors Analysis and Classification System (HFACS) taxonomy was studied in a case study. HFACS is widely used in human error root cause categorization across many industries. Combining these two categorization models in a two dimensional matrix was found effective, yet impractical for daily work.

Keywords: IT service management, ITIL, incident, problem, HFACS, swiss cheese model

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Authors: Nadezhda Kvatashidze

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The International Accounting Standards Board updated the conceptual framework for financial reporting. The main reason behind it is to resolve the tasks of the accounting, which are caused by the market development and business-transactions of a new economic content. Also, the investors call for higher transparency of information and responsibility for the results in order to make a more accurate risk assessment and forecast. All these make it necessary to further develop the conceptual framework for financial reporting so that the users get useful information. The market development and certain shortcomings of the conceptual framework revealed in practice require its reconsideration and finding new solutions. Some issues and concepts, such as disclosure and supply of information, its qualitative characteristics, assessment, and measurement uncertainty had to be supplemented and perfected. The criteria of recognition of certain elements (assets and liabilities) of reporting had to be updated, too and all this is set out in the updated edition of the conceptual framework for financial reporting, a comprehensive collection of concepts underlying preparation of the financial statement. The main objective of conceptual framework revision is to improve financial reporting and development of clear concepts package. This will support International Accounting Standards Board (IASB) to set common “Approach & Reflection” for similar transactions on the basis of mutually accepted concepts. As a result, companies will be able to develop coherent accounting policies for those transactions or events that are occurred from particular deals to which no standard is used or when standard allows choice of accounting policy.

Keywords: conceptual framework, measurement basis, measurement uncertainty, neutrality, prudence, stewardship

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Authors: Austin P. Hopkins, R. Daren Harmel, Jim A Ippolito, P. J. A. Kleinman, D. Sahoo

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Field-scale runoff and water quality data are critical to understanding the fate and transport of nutrients applied to agricultural lands and minimizing their off-site transport because it is at that scale that agricultural management decisions are typically made based on hydrologic, soil, and land use factors. However, regional influences such as precipitation, temperature, and prevailing cropping systems and land use patterns also impact nutrient runoff. In the present study, the recently-updated MANAGE (Measured Annual Nutrient loads from Agricultural Environments) database was used to conduct an ecoregion-level analysis of nitrogen and phosphorus runoff from agricultural lands in the North America. Specifically, annual N and P runoff loads for cropland and grasslands in North American Level II EPA ecoregions were presented, and the impact of factors such as land use, tillage, and fertilizer timing and placement on N and P runoff were analyzed. Specifically we compiled annual N and P runoff load data (i.e., dissolved, particulate, and total N and P, kg/ha/yr) for each Level 2 EPA ecoregion and for various agricultural management practices (i.e., land use, tillage, fertilizer timing, fertilizer placement) within each ecoregion to showcase the analyses possible with the data in MANAGE. Potential differences in N and P runoff loads were evaluated between and within ecoregions with statistical and graphical approaches. Non-parametric analyses, mainly Mann-Whitney tests were conducted on median values weighted by the site years of data utilizing R because the data were not normally distributed, and we used Dunn tests and box and whisker plots to visually and statistically evaluate significant differences. Out of the 50 total North American Ecoregions, 11 were found that had significant data and site years to be utilized in the analysis. When examining ecoregions alone, it was observed that ER 9.2 temperate prairies had a significantly higher total N at 11.7 kg/ha/yr than ER 9.4 South Central Semi Arid Prairies with a total N of 2.4. When examining total P it was observed that ER 8.5 Mississippi Alluvial and Southeast USA Coastal Plains had a higher load at 3.0 kg/ha/yr than ER 8.2 Southeastern USA Plains with a load of 0.25 kg/ha/yr. Tillage and Land Use had severe impacts on nutrient loads. In ER 9.2 Temperate Prairies, conventional tillage had a total N load of 36.0 kg/ha/yr while conservation tillage had a total N load of 4.8 kg/ha/yr. In all relevant ecoregions, when corn was the predominant land use, total N levels significantly increased compared to grassland or other grains. In ER 8.4 Ozark-Ouachita, Corn had a total N of 22.1 kg/ha/yr while grazed grassland had a total N of 2.9 kg/ha/yr. There are further intricacies of the interactions that agricultural management practices have on one another combined with ecological conditions and their impacts on the continental aquatic nutrient loads that still need to be explored. This research provides a stepping stone to further understanding of land and resource stewardship and best management practices.

Keywords: water quality, ecoregions, nitrogen, phosphorus, agriculture, best management practices, land use

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Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

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Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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Authors: P. Panwalkar, K. Veravalli, M. Tofighi, A. Mofidi

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Introduction: Anterior femoral perforation or distal anterior nail position is a known complication of femoral nailing specifically in pertrochantric fractures fixed with cephalomedullary nail. This has been attributed to wrong entry point for the femoral nail, nail with large radius of curvature or malreduced fracture. Left alone anterior perforation of femur or abutment of nail on anterior femur will result in pain and risk stress riser at distal femur and periprosthetic fracture. There have been multiple techniques described to avert or correct this problem ranging from using different nail, entry point change, poller screw to deflect the nail position, use of shorter nail or use of curved guidewire or change of nail to ensure a nail with large radius of curvature Methods: We present this technique which we have used in order to centralise the femoral nail either when the nail has been put anteriorly or when the guide wire has been inserted too anteriorly prior to the insertion of the nail. This technique requires the use of femoral reduction spool from the nailing set. This technique was used by eight trainees of different level of experience under supervision. Results: This technique was easily reproducible without any learning curve without a need for opening of fracture site or change in the entry point with three different femoral nailing sets in twenty-five cases. The process took less than 10 minutes even when revising a malpositioned femoral nail. Conclusion: Our technique of using femoral reduction spool is easily reproducible and repeatable technique for avoidance of non-centralised femoral nail insertion and distal anterior perforation of femoral nail.

Keywords: femoral fracture, nailing, malposition, surgery

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Authors: Juhan Kim, Jinsoo Kim

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South Korea cannot import natural gas in any form other than LNG because of the division of South and North Korea. Further, the high proportion of natural gas in the national energy mix makes this resource crucial for energy security in Korea. Expansion of Panama Canal will allow for reducing the cost of shipping between the Far East and U.S East. Panama Canal expansion can have significant impacts on South Korea. Due to this situation, we review the natural gas optimal portfolio by considering the uniqueness of the Korean Natural gas market and expansion of Panama Canal. In order to assess Korea’s natural gas optimal portfolio, we developed natural gas portfolio model. The model comprises two steps. First, to obtain the optimal long-term spot contract ratio, the study examines the price level and the correlation between spot and long-term contracts by using the Markowitz, portfolio model. The optimal long-term spot contract ratio follows the efficient frontier of the cost/risk level related to this price level and degree of correlation. Second, by applying the obtained long-term contract purchase ratio as the constraint in the linear programming portfolio model, we determined the natural gas optimal import portfolio that minimizes total intangible and tangible costs. Using this model, we derived the optimal natural gas portfolio considering the expansion of Panama Canal. Based on these results, we assess the portfolio for natural gas import to Korea from the perspective of energy security and present some relevant policy proposals.

Keywords: natural gas, Panama Canal, portfolio analysis, South Korea

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Authors: Emmanuel Uba, Oluwasegun Omidiora, Eugenia Abiodun-Eniayekan

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The role of phonology on reading comprehension is long established in the literature. However, the vast majority of studies on the relationship between phonology and reading or comprehension among adults involve investigating the role of intonation, stress, and segmental knowledge on understanding texts. Not much attention is paid to junctural observation and its effect on the interpretation of texts. This study, therefore, presents a preliminary case-study investigation of the effect of juncture on comprehension of texts among adult Nigerian learners of English. Eighty adult learners of English in Nigeria were presented with fifteen seemingly ambiguous sentences to interpret. The sentences were structured in a way that pausing at different points would produce different interpretations. The results reveal that wrong application of pause is capable of affecting comprehension even when other phonological factors such as stress and intonation are observed properly.

Keywords: comprehension, juncture, phonology, reading

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Authors: Hossein Barri Ghazani

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Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

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Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Diabetes is a chronic health problem and a major risk factor of stroke. A number of therapeutic modalities exist for diabetes management. It’s still unknown whether the different oral hypoglycemic agents would ameliorate the detrimental effect of diabetes on stroke severity. The objective of this work is to assess the effect of pretreatment with oral hypoglycemic agents, insulin and their combination on stroke severity at presentation. Patients and Methods: Patients admitted to the King Abdullah University Hospital (KAUH)-Jordan with ischemic stroke between January 2015 and December 2016 were evaluated and their comorbid diseases, treatment on admission and their neurologic severity was assessed using the National Institute of Health Stroke Scale (NIHSS) were documented. Stroke severity was compared for non-diabetic patients and diabetic patients treated with different antidiabetic agents. Results: Data from 324 patients with acute stroke was documented. The median age of participants was 69 years. Diabetes was documented in about 50% of the patients. Multinomial regression analysis identified diabetes treatment status as an independent predictor of neurological severity of stroke (p=0.032). Patients treated with oral hypoglycemic agents had a significantly lower NIHSS as compared to nondiabetic patients and insulin treated patients (p < 0.02). The positive effect of oral hypoglycemic agents was blunted by insulin co-treatment. Insulin did not alter the severity of stroke as compared to non-diabetics. Conclusion: Oral hypoglycemic agents may reduce the severity of neurologic deficit of ischemic stroke and may have neuroprotective effect.

Keywords: diabetes, stroke, neuroprotection, oral hypoglycemic agents

Procedia PDF Downloads 147

Authors: Niyongabo Elyse

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Prefabricated building construction is a pioneering approach that combines design, production, and assembly to attain energy efficiency, environmental sustainability, and economic feasibility. Despite continuous development in the industry in China, the low technical maturity of standardized design, factory production, and construction assembly introduces uncertainties affecting prefabricated component production and on-site assembly processes. This research focuses on enhancing project management performance under uncertainty to help enterprises navigate these challenges and optimize project resources. The study introduces a perspective on how uncertain factors influence the implementation of prefabricated building construction projects. It proposes a theoretical model considering project process management ability, adaptability to uncertain environments, and collaboration ability of project participants. The impact of uncertain factors is demonstrated through case studies and quantitative analysis, revealing constraints on implementation time, cost, quality, and safety. To address uncertainties in prefabricated component production scheduling, a fuzzy model is presented, expressing processing times in interval values. The model utilizes a cooperative co-evolution evolution algorithm (CCEA) to optimize scheduling, demonstrated through a real case study showcasing reduced project duration and minimized effects of processing time disturbances. Additionally, the research addresses on-site assembly construction scheduling, considering the relationship between task processing times and assigned resources. A multi-objective model with fuzzy activity durations is proposed, employing a hybrid cooperative co-evolution evolution algorithm (HCCEA) to optimize project scheduling. Results from real case studies indicate improved project performance in terms of duration, cost, and resilience to processing time delays and resource changes. The study also introduces a multistage dynamic process control model, utilizing IoT technology for real-time monitoring during component production and construction assembly. This approach dynamically adjusts schedules when constraints arise, leading to enhanced project management performance, as demonstrated in a real prefabricated housing project. Key contributions include a fuzzy prefabricated components production scheduling model, a multi-objective multi-mode resource-constrained construction project scheduling model with fuzzy activity durations, a multi-stage dynamic process control model, and a cooperative co-evolution evolution algorithm. The integrated mathematical model addresses the complexity of prefabricated building construction project management, providing a theoretical foundation for practical decision-making in the field.

Keywords: prefabricated construction, project management performance, uncertainty, fuzzy scheduling

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Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

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Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

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Authors: Razzaghifard P., Arya F., Chen S. Chien-I, Abdi B., Razzaghifard V., Arya A. H., Nazary A., Hosseinpour H., Ghabelnezam K.

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E-learning, also known as online learning, has indicated increased growth in recent years. One of the critical factors in the successful application of e-learning in higher education is students’ perceptions towards it. The main purpose of this paper is to investigate the perceptions of engineering students about e-learning in the UK. For the purpose of the present study, 145 second-year engineering students were randomly selected from the total population of 1280 participants. The participants were asked to complete a questionnaire containing 16 items. The data collected from the questionnaire were analyzed through the Statistical Package for Social Science (SPSS) software. The findings of the study revealed that the majority of participants have negative perceptions of e-learning. Most of the students had trouble interacting effectively during online classes. Furthermore, the majority of participants had negative experiences with the learning platform they used during e-learning. Suggestions were made on what could be done to improve the students’ perceptions of e-learning.

Keywords: e-learning, higher, education, engineering education, online learning

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Authors: Odeh Linus

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The pace of globalization is increasing continuously in terms of markets for goods and services, investment opportunities across borders amongst others. Enterprises face competition from all fronts. Human resource management is not left out in this transformation crusade as it has obligation to move along with the changing demands of the globalization process. One of the objectives of this paper is to show that effective managers should constantly be aware of the changes taking place in domestic (home country) environment, as well as around the globe (international and foreign environments) on HR issues and developments. By so doing, they can scan their environment on an ongoing basis, and when they detect opportunities and/or threats, they can transform their organization to seize the opportunities and/or combat or neutralize the threats as the case may be. In this presentation, problems, issues and trends in HRM practice in Nigeria in the current period were reviewed. The factors affecting HRM and its practice in a global context and what should be the direction of the profession and its practice in Nigeria constitute the main focus of this paper.

Keywords: human resource, globalization, management, developing countries

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Authors: Mohamad Ghozali Hassan, Abdul Aziz Othman, Mohd Azril Ismail

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Adapting quickly to environmental dynamism is essential for an organization to develop outsourcing strategic and management in order to sustain competitive advantage. This research used the Partial Least Squares Structural Equation Modeling (PLS-SEM) tool to investigate the factors of environmental dynamism impact on the strategic outsourcing success among electrical and electronic manufacturing industries in outsourcing management. Statistical results confirm that the inclusion of customer demand, technological change, and competition level as a new combination concept of environmental dynamism, has positive effects on outsourcing success. Additionally, this research demonstrates the acceptability of PLS-SEM as a statistical analysis to furnish a better understanding of environmental dynamism in outsourcing management in Malaysia. A practical finding contributes to academics and practitioners in the field of outsourcing management.

Keywords: environmental dynamism, customer demand, technological change, competition level, outsourcing success

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Authors: Abida Mariam, Anwaar Ahmed, Asif Ahmad, Muhammad Sheeraz Ahmad, Muhammad Akram Khan, Muhammad Mazahir

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The plant olive (Olea europaea L.) is known for its commercial significance due to nutritional and health benefits. Pakistan is ranked 4th among countries who import olive oil whereas, 70% of edible oil is imported to fulfil the needs of the country. There exists great potential for Olea europaea cultivation in Pakistan. The popularity and cultivation of olive fruit has increased in recent past due to its high socio-economic and health significance. There exist almost negligible data on the chemical composition of extra virgin olive oil extracted from cultivars grown in Pothwar, an area with arid climate conducive for growth of olive trees. Keeping in view these factors a study has been conducted to characterize the olive oil extracted from olive cultivars collected from Pothwar regions of Pakistan for their nutritional potential and value addition. Ten olive cultivars (Gemlik, Coratina, Sevillano, Manzanilla, Leccino, Koroneiki, Frantoio, Arbiquina, Earlik and Ottobratica) were collected from Barani Agriculture Research Institute, Chakwal. Extra Virgin Olive Oil (EVOO) was extracted by cold pressing and centrifuging of olive fruits. The highest amount of oil was yielded in Coratina (23.9%) followed by Frantoio (23.7%), Koroneiki (22.8%), Sevillano (22%), Ottobratica (22%), Leccino (20.5%), Arbiquina (19.2%), Manzanilla (17.2%), Earlik (14.4%) and Gemllik (13.1%). The extracted virgin olive oil was studied for various physico- chemical properties and fatty acid profile. The Physical and chemical properties i.e., characteristic odor and taste, light yellow color with no foreign matter, insoluble impurities (≤0.08), fee fatty acid (0.1 to 0.8), acidity (0.5 to 1.6 mg/g acid), peroxide value (1.5 to 5.2 meqO2/kg), Iodine value (82 to 90), saponification value (186 to 192 mg/g) and unsaponifiable matter (4 to 8g/kg), ultraviolet spectrophotometric analysis (k232 and k270), showed values in the acceptable range, established by PSQCA and IOOC set for extra virgin olive oil. Olive oil was analyzed by Near Infra-Red spectrophotometry (NIR) for fatty acids sin olive oils which were found as: palmitic, palmitoleic, stearic, oleic, linoleic and alpha-linolenic. Major fatty acid was Oleic acid in the highest percentage ranging from (55 to 66.1%), followed by linoleic (10.4 to 20.4%), palmitic (13.8 to 19.5%), stearic (3.9 to 4.4%), palmitoleic (0.3 to 1.7%) and alpha-linolenic (0.9 to 1.7%). The results were significant with differences in parameters analyzed for all ten cultivars which confirm that genetic factors are important contributors in the physico-chemical characteristics of oil. The olive oil showed superior physical and chemical properties and recommended as one of the healthiest forms of edible oil. This study will help consumers to be more aware of and make better choices of healthy oils available locally thus contributing towards their better health.

Keywords: characterization, extra virgin olive oil, oil yield, fatty acids

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Authors: Preethi Grace Theva Neethi Dhas

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A healthy human gut microbiome has commensal and symbiotic functions in digestion and is a decisive factor for human health. The soil microbiome is a crucial component in the ecosystem of soils and their health and resilience. Changes in soil microbiome are linked to human health. Ever since the industrial era, the human and the soil microbiome have been going through drastic changes. The soil microbiome has changed due to industrialization and extensive agricultural practices, whereas humans have less contact with soil and increased intake of highly processed foods, leading to changes in the human gut microbiome. Regenerating the soil becomes crucial in maintaining a healthy ecosystem. The nutrients, once obtained from the soil, need to be given back to the soil. Soil degradation needs to be addressed in effective ways, like adding organic nutrients back to the soil. Manure from animals and humans needs to be returned to the soil, which can complete the nutrient cycle in the soil. On the other hand, fecal sludge management (FSM) is a growing concern in many parts of the developing world. Hence, it becomes crucial to treat and reuse fecal sludge in a safe manner, i.e., low in risk to human health. Co-composting fecal sludge with organic wastes is a practice that allows the safe management of fecal sludge and the safe application of nutrients to the soil. This paper will discuss the possible impact of co-composting fecal sludge with coconut choir waste on the soil, water, and ecosystem at large. Impact parameters like nitrogen, phosphorus, and fecal coliforms will be analyzed. The overall impact of fecal sludge application on the soil will be researched and presented in this study.

Keywords: fecal sludge management, nutrient cycle, soil health, composting

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Authors: Kholoud H. Al-Zedjali, Abir S. Al-Harrasi, Ali H. Al-Badi

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Recently there has been a dramatic proliferation in the number of social networking sites (SNSs) users; however, little is published about what motivates college students to use SNSs in education. The main goal of this research is to explore the college students’ motives for using SNSs in education. A conceptual framework has therefore been developed to identify the main factors that influence/motivate students to use social networking sites for learning purposes. To achieve the research objectives a quantitative method was used to collect data. A questionnaire has been distributed amongst college students. The results reveal that social influence, perceived enjoyment, institute regulation, perceived usefulness, ranking up-lift, attractiveness, communication tools, free of charge, sharing material and course nature all play an important role in the motivation of college students to use SNSs for learning purposes.

Keywords: Social Networking Sites (SNSs), education, college students, motivations

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Authors: Jiahui Yang, John Quigley, Lesley Walls

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In this paper, the authors develop a stochastic model regarding the investment in supplier delivery performance development from a buyer’s perspective. The authors propose a multivariate model through a Multinomial-Dirichlet distribution within an Empirical Bayesian inference framework, representing both the epistemic and aleatory uncertainties in deliveries. A closed form solution is obtained and the lower and upper bound for both optimal investment level and expected profit under uncertainty are derived. The theoretical properties provide decision makers with useful insights regarding supplier delivery performance improvement problems where multiple delivery statuses are involved. The authors also extend the model from a single supplier investment into a supplier portfolio, using a Lagrangian method to obtain a theoretical expression for an optimal investment level and overall expected profit. The model enables a buyer to know how the marginal expected profit/investment level of each supplier changes with respect to the budget and which supplier should be invested in when additional budget is available. An application of this model is illustrated in a simulation study. Overall, the main contribution of this study is to provide an optimal investment decision making framework for supplier development, taking into account multiple delivery statuses as well as multiple projects.

Keywords: decision making, empirical bayesian, portfolio optimization, supplier development, supply chain management

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Authors: Megha Ramnik Kotecha

Abstract:

To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. Detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected with dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P<0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film unstability. On comparision of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight threatening complications.

Keywords: dry eye, pterygium, Schirmer's test, tear break up time (TBUT)

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Authors: Majid Farsadrooh, Mehran Feizi-Dehnayebi

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Serum albumin is the most abundant protein that is present in the circulatory system of a wide variety of organisms. Although it is a significant macromolecule, it can contribute to osmotic blood pressure and also, plays a superior role in drug disposition and efficiency. Molecular docking simulation can improve in silico drug design and discovery procedures to propound a lead compound and develop it from the discovery step to the clinic. In this study, the molecular docking simulation was applied to select a lead molecule through an investigation of the interaction of the two anticancer drugs (Alitretinoin and Abemaciclib) with Human Serum Albumin (HSA). Then, a series of new compounds (a-e) were suggested using lead molecule modification. Density functional theory (DFT) including MEP map and HOMO-LUMO analysis were used for the newly proposed compounds to predict the reactivity zones on the molecules, stability, and chemical reactivity. DFT calculation illustrated that these new compounds were stable. The estimated binding free energy (ΔG) values for a-e compounds were obtained as -5.78, -5.81, -5.95, -5,98, and -6.11 kcal/mol, respectively. Finally, the pharmaceutical properties and toxicity of these new compounds were estimated through OSIRIS DataWarrior software. The results indicated no risk of tumorigenic, irritant, or reproductive effects and mutagenicity for compounds d and e. As a result, compounds d and e, could be selected for further study as potential therapeutic candidates. Moreover, employing molecular docking simulation with the prediction of pharmaceutical properties helps to discover new potential drug compounds.

Keywords: drug design, anticancer, computational studies, DFT analysis

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Authors: Stefan Bradu, Daniel Siegel, Jameson Loyal, Andrea Leaf, Alana Kurtti, Usha Alapati, Jared Jagdeo

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Compared with all other variants of nodular melanoma, patients with polypoid nodular melanoma have the lowest 5-year survival rate. The pathophysiology and management of polypoid melanoma are scarcely reported in the literature. Although surgical excision is the cornerstone of melanoma management, treatment of polypoid melanoma is complicated by several negative prognostic factors, including early metastasis. This report demonstrates the successful treatment of a rapidly developing red nodular polypoid melanoma with metastasis using surgery and adjuvant nivolumab in a SARS-CoV-2-positive patient who delayed seeking care due to the COVID-19 pandemic. In addition to detailing the successful treatment approach, the immunosuppressive effects of SARS-2-CoV and its possible contribution to the rapid progression of polypoid melanoma are discussed. This case highlights the complex challenges of melanoma diagnosis and management during the COVID-19 pandemic.

Keywords: covid-19, dermatology, immunotherapy, melanoma, nivolumab

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Authors: Jimmy Eadie

Abstract:

Convolutional Cross Synthesis (CCS) has emerged as a powerful technique for blending input signals to create hybrid sounds. It has significantly expanded the horizons of digital signal processing, enabling artists to explore audio effects. However, the conventional applications of CCS primarily revolve around reverberation and room simulation rather than being utilized as a creative synthesis method. In this paper, we present the design of a digital instrument called CrossSampler that harnesses a parametric approach to convolution cross-synthesis, which involves using adjustable parameters to control the blending of audio signals through convolution. These parameters allow for customization of the resulting sound, offering greater creative control and flexibility. It enables users to shape the output by manipulating factors such as duration, intensity, and spectral characteristics. This approach facilitates experimentation and exploration in sound design and opens new sonic possibilities.

Keywords: convolution, synthesis, sampling, virtual instrument

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Authors: Nawaf Al-Kharashi, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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Superior gluteal artery is one of the largest branches of posterior division of the internal iliac artery. It passes between the lumbosacral and first sacral root to escape from the pelvic cavity through the grater sciatic foramen just above the piriformis. The current study includes 41 cadaver investigates the origin and branch of the superior gluteal artery and clarify the clinical significance. In present study, the superior gluteal artery arises from the posterior division of the internal iliac artery directly in 82.5% whereas it arises indirectly as from the sciatic artery in 15.9%. However, it is congenital absence in 1.6% which is compensated by sciatic artery. The sciatic nerve gains vascular supply from superior gluteal artery in two ways either during its course or giving lateral sacral artery in 27% and lumbar branches in 1.6%. It also supplies the adductors group and iliacus via giving obturator artery in 14.3% and in 1.6% respectively. The superior gluteal artery usually passes between lumbosacral trunk and first sacral root in 82.5% whereas it does not passes the sciatic roots as it arises behind them in 15.9%. With a variability of the superior gluteal artery origin, there is a variability of sciatic nerve roots supply. Further, the superior gluteal artery arising from sciatic artery behind the sciatic roots carries a high risk of intra-pelvic bleeding in case of posterior pelvic fracture. Prolonged ligation of the superior gluteal artery which gives lateral sacral artery may result in sciatic neuropathy. Therefore, surgeons have to be aware of the superior gluteal artery variation in origin, course and branches to reduce the iatrogenic faults.

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery. sciatic neuropathy, sciatic nerve

Procedia PDF Downloads 338

Authors: Lingfeng Wang, Zhipeng Chen, Shuang Qiu, Shijian Ge

Abstract:

The effects of wastewater, with four different nutrient loadings, from synthetic centrate on biomass production of Chlorella vulgaris, nutrient removal, microalgal settling, and lipid production were investigated in photobioreactors under both batches and, subsequently, semi-continuous operations. At higher centrate concentration factors (17.2% and 36.2%), hydraulic retention time and pH adjustments could be employed to sustain acceptable microalgal growth rates and wastewater treatment. Similar nutrient removals efficiencies (>95%) and biomass production (0.42-0.51 g/L) were observed for the four centrate concentrations. Both the lipid productivity and lipid content decreased with increasing nutrient loading in the wastewater. The results also demonstrated that the mass ratio of carbohydrate to protein could provide a good indication of microalgal settling performance, rather than sole component composition or total extracellular polymeric substances.

Keywords: lipid production, microalgae, nutrient removal, wastewater

Procedia PDF Downloads 216

Authors: M. Amelsakhi, A. Sohrabi-Bidar, A. Shareghi

Abstract:

One of the most important issues about the structural damages caused by earthquake is the evaluating of the spectral response of the site on which the construction is built. This fact has demonstrated during many earlier earthquakes and many researchers’ reports have concerned with it. According to these reports, features of the site materials and geometry of the ground surface are considered the main factors. This study concentrates on the specific form of topographies like hills. Assessing of spectral responses of different points on the hills and beside demonstrates considerable differences between 1D and 2D methods of geotechnical analyses. A general trend of amplifications on the top of the hills and de-amplifications near the toe of the hills has been appeared within the acceleration, velocity and displacement response spectrums of horizontal motion. Evaluating of spectral responses of different sizes of the hills revealed that as much as the hill-size enlarges differences between spectral responses of 1D and 2D analyses transfers to longer range of periods and becomes wider.

Keywords: topography effect, amplification ratio, response spectrum, earth resources engineering

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Authors: Sandesh Achar

Abstract:

Cloud computing security is a broad term that covers a variety of security concerns for organizations that use cloud services. Multi-cloud service providers must consider several factors when addressing security for their customers, including identity and access management, data at rest and in transit, egress and ingress traffic control, vulnerability and threat management, and auditing. This paper explores each of these aspects of cloud security in detail and provides recommendations for best practices for multi-cloud service providers. It also discusses the challenges inherent in securing a multi-cloud environment and offers solutions for overcoming these challenges. By the end of this paper, readers should have a good understanding of the various security concerns associated with multi-cloud environments in the context of today’s modern cyber threats and how to address them.

Keywords: multi-cloud service, system organization control, data loss prevention, identity and access management

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Authors: Sumia Fatima, Tayyaba Idrees

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Cardiac Arrest and Heart Failures are an important causes of mortality in developed and developing countries and even a second spent without Cardiopulmonary Resuscitation (CPR) increases the risk of mortality. Youngs doctors are expected to partake in CPR from the first day and if they are not taught basic life support (BLS) skills during their studies. They have next to no opportunity to learn them in clinical settings. To determine the exact level of knowledge of Basic Life Support among medical students. To compare the degree of knowledge among 1st and 2nd year medical students of RMU (Rawalpindi Medical University), using self-structured questionnaires. A cross sectional, qualitative primary study was conducted in March 2020 in order to analyse theoretical and practical knowledge of Basic Life Support among Medical Students of 1st and 2nd year MBBS. Self-Structured Questionnaires were distributed among 300 students, 150 from 1st year and 150 from 2nd year. Data was analysed using SPSS v 22. Chi Square test was employed. The results showed that only 13 (4%) students had received formal BLS training.129 (42%) students had encountered accidents in real life but had not known how to react. Majority responded that Basic Life Support should be made part of medical college curriculum (189 students), 194 participants (64%) had moderate knowledge of both theoretical and practical aspects of BLS. 75-80% students of both 1st and 2nd year had only moderate knowledge, which must be improved for them to be better healthcare providers in future. It was also found that male students had more practical knowledge than females, but both had almost the same proficiency in theoretical knowledge. The study concluded that the level of knowledge of BLS among the students was not up to the mark, and there is a dire need to include BLS training in the medical colleges’ curriculum.

Keywords: basic cardiac life support, cardiac arrest, awareness, medical students

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

Abstract:

Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

Procedia PDF Downloads 115