Search results for: risk management failure

Authors: Firouz Amani, Adalat Hoseinian, Sajjad Hakimian

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Background: The mortality due to Myocardial Infarction (MI) is often occur during the first hours after onset of symptom. So, for taking the necessary treatment and decreasing the mortality rate, timely visited of the hospital could be effective in this regard. The aim of this study was to investigate the impact of effective factors in mortality of MI patients by using Linear Logistic Regression. Materials and Methods: In this case-control study, all patients with Acute MI who referred to the Ardabil city hospital were studied. All of died patients were considered as the case group (n=27) and we select 27 matched patients without Acute MI as a control group. Data collected for all patients in two groups by a same checklist and then analyzed by SPSS version 24 software using statistical methods. We used the linear logistic regression model to determine the effective factors on mortality of MI patients. Results: The mean age of patients in case group was significantly higher than control group (75.1±11.7 vs. 63.1±11.6, p=0.001).The history of non-cardinal diseases in case group with 44.4% significantly higher than control group with 7.4% (p=0.002).The number of performed PCIs in case group with 40.7% significantly lower than control group with 74.1% (P=0.013). The time distance between hospital admission and performed PCI in case group with 110.9 min was significantly upper than control group with 56 min (P=0.001). The mean of delay time from Onset of symptom to hospital admission (patient delay) and the mean of delay time from hospital admissions to receive treatment (system delay) was similar between two groups. By using logistic regression model we revealed that history of non-cardinal diseases (OR=283) and the number of performed PCIs (OR=24.5) had significant impact on mortality of MI patients in compare to other factors. Conclusion: Results of this study showed that of all studied factors, the number of performed PCIs, history of non-cardinal illness and the interval between onset of symptoms and performed PCI have significant relation with morality of MI patients and other factors were not meaningful. So, doing more studies with a large sample and investigated other involved factors such as smoking, weather and etc. is recommended in future.

Keywords: acute MI, mortality, heart failure, arrhythmia

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Authors: Halima Akhtar, Abhijeet Chandra

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The paper attempts to analyze the factors that influence the Consumer Behavior to purchase apparel through the internet. The intentions to buy apparels online were based on in terms of user style, orientation, size and reputation of the merchant, social influence, perceived information utility, perceived ease of use, perceived pleasure and attractiveness and perceived trust and risk. The basic framework used was Technology acceptance model to explain apparels acceptance. A survey was conducted to gather the data from 200 people. The measures and hypotheses were analyzed using Correlation testing and would be further validated by the Structural Equation Modelling. The implications of the findings for theory and practice could be used by marketers of online apparel websites. Based on the values obtained, we can conclude that the factors such as social influence, Perceived information utility, attractiveness and trust influence the decision for a user to buy apparels online. The major factors which are found to influence an online apparel buying decision are ease of use, attractiveness that a website can offer and the trust factor which a user shares with the website.

Keywords: E-tailers, consumer behaviour, technology acceptance model, structural modelling

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Authors: Ronald L. Kaunda

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The education system in Zambia still bears scars of colonialism in the area of policy, curriculum and implementation. This historical context resulted in the failure by the Government of the Republic of Zambia to achieve literacy goals expected among school going children. Specifically, research shows that the use of English for initial literacy and Western based teaching methods to engage learners in literacy activities at lower levels of education including preschool has exacerbated this situation. In 2014, the Government of the Republic of Zambia implemented a new curriculum that, among others things, required preschool teachers to use local and cultural materials and familiar languages for early literacy teaching from preschool to grade 4. This paper presents findings from a study that sought to establish ways in which preschool teachers use Zambian Indigenous knowledge systems and Indigenous teaching strategies to support literacy development among preschool children. The study used Indigenous research methodology for data collection and iterative feature of Constructivist Grounded Theory (CGT) in the data collection process and analysis. This study established that, as agents of education, preschool teachers represented community adult educators because of some roles which they played beyond their academic mandate. The study further found that classrooms as venues of learning were equipped with learning corners reflecting Indigenous literacy materials and Indigenous ways of learning. Additionally, the study found that learners were more responsive to literacy lessons because of the use of familiar languages and local contextualized environments that supported their own cultural ways of learning. The study recommended that if the education system in Zambia is to be fully inclusive of Indigenous knowledge systems and cultural ways of learning, the education policy and curriculum should include conscious steps on how this should be implemented at the classroom level. The study further recommended that more diverse local literacy materials and teaching aids should be produced for use in the classroom.

Keywords: agents of learning, early literacy, indigenous knowledge systems, venues of education

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Authors: Farzad Shidfar, Najmeh Rostami, Ziaodin Mazhari, Fatemeh Hosseini Baharanchi

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Background and Aim: The rate of failure to maintain a reduced weight has been increased. By definition, people who regain about one-third to two-thirds of their lost weight after one year from the end of the dietary treatment and return all the lost weight after 5 years it is called weight regain. This study was performed to find the causes of weight regain and its relationship with biochemical and psychological factors. Materials and Methods: This cross-sectional study was performed by reviewing the files of people who followed the dietary treatment in 1397-1398.seventy-three persons was in the weight regain group, and seventy-three people were in the weight maintenance group. Psychological factors such as depression, anxiety, quality of life, physical activity, and dietary frequency were assessed through a questionnaire, and biochemical factors such as serum insulin and fasting blood sugar were measured. The mean basal energy in the weight regain group was significantly higher than the weight maintenance group (p = 0.004). There was no significant difference between the two groups in terms of food intake and inflammatory index of food. There was no significant difference between the two groups in terms of food intake and inflammatory index of food. Mean serum insulin concentration (p = 0.023), mean fasting blood sugar (p = 0.04) and insulin resistance (p = 0.013) in the weight regain group were higher than the weight maintenance group. The weight maintenance group showed higher insulin sensitivity than the weight regain group (p = 0.005). There was no significant difference between the two groups in terms of psychological indicators. Conclusion: The only body mass index after one year from the end of the treatment period, insulin sensitivity, serum insulin concentration, fasting blood sugar, insulin resistance, selenium intake, and basal energy expenditure Specific and significant with weight regain. However, the significance of insulin resistance, basal energy expenditure, and body mass index after one year from the end of the treatment period was higher than other variables in the weight regain group.

Keywords: body weight maintenance, weight regain, insulin resistance, insulin sensitivity

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Authors: Angie M. Wolf, DeVone Boggan

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This paper highlights an innovative and nontraditional violence prevention program that is making a noticeable impact in what was once one of the country’s most violent communities. With unique and tailored strategies, the Operation Peacemaker Fellowship, established in Richmond, California, combines components of evidence-based practices with a community-oriented focus on relationships and mentoring to fill a gap in services and increase community safety. In an effort to highlight these unique strategies and provide a blueprint for other communities with violent crime problems, the authors of this paper hope to clearly delineate how one community is moving forward with vanguard approaches to invest in the lives of young men who once were labeled the communities’ most violent, even the most deadly, youth. The impact of this program is evidenced through the fellows’ own voices as they illuminate the experience of being in the Fellowship. In interviews, fellows’ describe how participating in this program has transformed their lives, and the lives of those they love. The authors of this article spent more than two years researching this Fellowship program in order to conduct an evaluation of it and, ultimately, to demonstrate how this program is a testament to the power of relationship and love combined with evidence-based practices, consequently enriching the lives of youth and the community that embraces them.

Keywords: gun violence prevention, high risk youth, law, policing justice

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Authors: Ahmed Barakat, Nourhan Ahmed Saad, Mahmoud Hammad

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Tracking and monitoring agricultural products, cold chain activities, and transportation in real-time can effectively ensure both the quality and safety of agricultural products, as well as reduce overall logistics costs. Effective supply chain practices are one of the main requirements for enhancing agricultural business in Egypt. Cold chain is among the best practices for the storage and transportation of perishable goods and has potential within the agricultural sector in Egypt. This practice has the scope of reducing the wastage of food and increasing the profitability with a reduction in costs. Even though it has several implementation challenges for the farmers, traders, and people involved in the entire supply chain, it has highlighted better benefits for all and for the export of goods for the economic progression for Egypt. The aim of this paper is to explore cold supply chain practices for the agriculture sector in Egypt, to enhance the export performance of fresh goods. In this context, this study attempts to explore those aspects of the performance of cold supply chain practices that can enhance the functioning of the agriculture sector in Egypt from the perspective of export companies (traders) and farmers. Based on the empirical results obtained by data collection from the farmers and traders, the study argues that there is a significant association between cold supply chain practices and enhancement of the agriculture value chain. The paper thus highlights the contribution of the study with final conclusions and limitations with scope for future research.

Keywords: agriculture sector, cold chain management, export companies, non-traded goods, supply chain management

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Authors: William Thomas Worster

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This paper will highlight the failure of international adjudication to prevent a state from evading an order of provisional measures by simply issuing a diplomatic assurance to the court. This practice changes the positions of the litigants as equals before a court, prevents the court from inquiring into the reliability of the political pledge as it would with assurances from a state to an individual, and diminishes the court’s ability to control its own proceedings in the face of concerns over sovereignty. Both the European Court of Human Rights (ECtHR) and International Court of Justice (ICJ) will entertain these kinds of unilateral pledges, but they consider them differently when the declaration is made between states or between a state and an individual, and when made directly to the court. In short, diplomatic assurances issued between states or to individuals are usually considered not to be legally binding and are essentially questions of fact, but unilateral assurances issued directly to an international court are questions of law, and usually legally binding. At the same time, orders for provisional measures are now understood also to be legally binding, yet international courts will sometimes permit a state to substitute an assurance in place of an order for provisional measures. This emerging practice has brought the nature of a state as a sovereign capable of creating legal obligations into the forum of adjudication where the parties should have equality of arms and permitted states to create legal obligations that escape inquiry into the reliability of the outcome. While most recent practice has occurred at the ICJ in state-to-state litigation, there is some practice potentially extending the practice to human rights courts. Especially where the litigants are factually unequal – a state and an individual – this practice is problematic since states could more easily overcome factual failings in their pledges and evade the control of the court. Consider, for example, the potential for evading non-refoulement obligations by extending the current diplomatic assurances practice from the state-to-state context to the state-to-court context. The dual nature of assurances, as both legal and factual instruments, should be considered as addressed to distinct questions, each with its own considerations, and that we need to be more demanding about their precise legal and factual effects.

Keywords: unilateral, diplomacy, assurances, undertakings, provisional measures, interim measures

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Authors: Haian Dukhan

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The death of Hafez al-Assad and the ascension of his son, Bashar, to rule brought an end to the state-society dynamics that his father worked on for decades. Hafez al-Assad built an authoritarian state that rests on patronage networks that connected his regime to the society. During Bashar’s reign, these patronage relationships have been affected by the policies of privatization and liberalization. Privatization and liberalisation of the economy have created new economic and social players that transformed the populist nature of the authoritarian regime into a regime that is connected mainly with bourgeoisie and the upper class neglecting the rural tribal constituency that was a vital part of Hafez al-Assad’s authoritarian state. Drawing on different data gathered through interviews as well as written literature, this paper will explore the policies that Bashar al-Assad carried out towards the Arab tribes in the period extended from 2000 until 2010. The paper starts by outlining how Bashar al-Assad narrowed the coalition of his rule to depend mainly on his family, the city merchants excluding the lower and middle strata in the periphery. It will then trace the disintegration of the social contract between the regime and the Arab tribe as a result of the latter’s failure to deliver adequate development services in their regions. Losing the support of the tribes undermined the stability of the regime resulting in different clashes between the tribes themselves, the tribes and the Kurds, the tribes and the druze (a sect of Islam situated in Southern Syria), which will be investigated in detail in this paper. In similar policies adopted by his father who used the tribes as leverage against the Islamists and the Kurds, Bashar al-Assad’s regime encouragement of Syrian tribal youth to join the Iraqi insurgency against the Americans will be explored in detail. The regime’s tolerance of Iran missionary activities in the tribal regions and its accommodation of Islamists group’s activities in those regions have erased the regime’s secular foundation. This paper will argue that Bashar al-Assad’s policies towards the Arab tribes have chipped away the regime’s ideological pillars and threatened the longer-term cohesion of its social base which paved the way for the uprising to start in the tribal regions.

Keywords: Syria, tribes, uprising, regime

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Authors: Chibuzo Okoye Daniels, Gillian Glegg, Lynda Rodwell

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Marine debris from fishing nets to medical equipment to food packaging that play major roles in boosting the economy and protecting human health is now more than an environmental problem that can be solved by legislation, law enforcement and technical solutions. It has also been identified as a cultural problem that can only be addressed by identifying instruments that can be used to change human attitudes and behaviors. This may be through management approaches, education and involvement of all sectors/interests, including the public. To contribute to the sustainable development of coastal Nigeria, two case study areas (Ikoyi and Victoria Islands of Lagos State) were used to evaluate the socio-economic impacts of marine debris problem in coastal Nigeria. The following methods were used: (1) semi-structured interviews with key stakeholders and businesses on beaches, waterfronts and waterways within the study areas and (2) observational study of beaches, waterfronts and waterways within the study areas. The results of the study have shown that marine debris is a cultural and multi-sectoral problem that poses great threat not only to the environmental sustainability of the study areas but also to the wellbeing of its citizens and the economy of coastal Nigeria. Current solid waste and marine debris management practices are inefficient due to inadequate knowledge of how to tackle the problem. To ensure environmental sustainability in coastal Nigeria and avoid waste of scarce financial resources, adequate, appropriate and cost effective solutions to the marine debris problem need to be identified and effectively transferred for implementation in the study areas.

Keywords: sustainability, coastal Nigeria, study areas, aquaculture

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Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

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Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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Authors: Marcella De Filippo, Delio Colangelo, Luca Farnia

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In recent decades, the hyper-competition of tourism scenario has implicated the maturity of many businesses, attributing a central role to innovative processes and their dissemination in the economy of company management. At the same time, it has defined the need for monitoring the application of innovations, in order to govern and improve the performance of companies and destinations. The study aims to analyze and define the innovation in the tourism sector. The research actions have concerned, on the one hand, some in-depth interviews with experts, identifying innovation in terms of process and product, digitalization, sustainability policies and, on the other hand, to evaluate the interaction between these factors, in terms of substitutability and complementarity in management scenarios, in order to identify which one is essential to be competitive in the global scenario. Fuzzy measures and Choquet integral were used to elicit Experts’ preferences. This method allows not only to evaluate the relative importance of each pillar, but also and more interestingly, the level of interaction, ranging from complementarity to substitutability, between pairs of factors. The results of the survey are the following: in terms of Shapley values, Experts assert that Innovation is the most important factor (32.32), followed by digitalization (31.86), Network (20.57) and Sustainability (15.25). In terms of Interaction indices, given the low degree of consensus among experts, the interaction between couples of criteria on average could be ignored; however, it is worth to note that the factors innovations and digitalization are those in which experts express the highest degree of interaction. However for some of them, these factors have a moderate level of complementarity (with a pick of 57.14), and others consider them moderately substitutes (with a pick of -39.58). Another example, although outlier is the interaction between network and digitalization, in which an expert consider them markedly substitutes (-77.08).

Keywords: innovation, business model, tourism, fuzzy

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Authors: Spada Alessia, Fiore Mariantonietta, Lamonaca Emilia, Contò Francesco

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Bioeconomy can give the chance to face new global challenges and can move ahead the transition from a waste economy to an economy based on renewable resources and sustainable consumption. Air pollution is a grave issue in green challenges, mainly caused by anthropogenic factors. The agriculture sector is a great contributor to global greenhouse gases (GHGs) emissions due to lacking efficient management of the resources involved and research policies. In particular, livestock sector contributes to emissions of GHGs, deforestation, and nutrient imbalances. More effective agricultural research systems and technologies are crucial in order to improve farm productivity but also to reduce the GHGs emissions. Using data from FAOSTAT statistics and concern the EU countries; the aim of this research is to evaluate the impact of ASTI R&D (Agricultural Science and Technology Indicators) on GHGs emissions for countries EU in 2015 by generalized propensity score procedures, estimating a dose-response function, also considering a set of covariates. Expected results show the existence of the influence of ASTI R&D on GHGs across EU countries. Implications are crucial: reducing GHGs emissions by means of R&D based policies and correlatively reaching eco-friendly management of required resources by means of green available practices could have a crucial role for fair intra-generational implications.

Keywords: agricultural research systems, dose-response function, generalized propensity score, GHG emissions

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Authors: Zakaria Baka, Halima Alem

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Cancer is a major worldwide health problem that has caused around ten million deaths in 2020. In addition, efforts to develop new anti-cancer drugs still face a high failure rate. This is partly due to the lack of preclinical models that recapitulate in-vivo drug responses. Indeed conventional cell culture approach (known as 2D cell culture) is far from reproducing the complex, dynamic and three-dimensional environment of tumors. To set up more in-vivo-like cancer models, 3D bioprinting seems to be a promising technology due to its ability to achieve 3D scaffolds containing different cell types with controlled distribution and precise architecture. Moreover, the introduction of microfluidic technology makes it possible to simulate in-vivo dynamic conditions through the so-called “cancer-on-chip” platforms. Whereas several cancer types have been modeled through the cancer-on-chip approach, such as lung cancer and breast cancer, only a few works describing ovarian cancer models have been described. The aim of this work is to combine 3D bioprinting and microfluidic technics with setting up a 3D dynamic model of ovarian cancer. In the first phase, alginate-gelatin hydrogel containing SKOV3 cells was used to achieve tumor-like structures through an extrusion-based bioprinter. The desired form of the tumor-like mass was first designed on 3D CAD software. The hydrogel composition was then optimized for ensuring good and reproducible printability. Cell viability in the bioprinted structures was assessed using Live/Dead assay and WST1 assay. In the second phase, these bioprinted structures will be included in a microfluidic device that allows simultaneous testing of different drug concentrations. This microfluidic dispositive was first designed through computational fluid dynamics (CFD) simulations for fixing its precise dimensions. It was then be manufactured through a molding method based on a 3D printed template. To confirm the results of CFD simulations, doxorubicin (DOX) solutions were perfused through the dispositive and DOX concentration in each culture chamber was determined. Once completely characterized, this model will be used to assess the efficacy of anti-cancer nanoparticles developed in the Jean Lamour institute.

Keywords: 3D bioprinting, ovarian cancer, cancer-on-chip models, microfluidic techniques

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Authors: Jingyuan Hu, Zhandong Liu

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CRISPR genome editing technology has transformed molecular biology by accurately targeting and altering an organism’s DNA. Despite the state-of-art precision of CRISPR genome editing, the imprecise mutation outcome and off-target effects present considerable risk, potentially leading to unintended genetic changes. Targeted deep sequencing, combined with bioinformatics sequence alignment, can detect such unwanted mutations. Nevertheless, the classical method, Needleman-Wunsch (NW) algorithm may produce false alignment outcomes, resulting in inaccurate mutation identification. The key to precisely identifying CRISPR-induced mutations lies in determining optimal parameters for the sequence alignment algorithm. Hidden Markov models (HMM) are ideally suited for this task, offering flexibility across CRISPR systems by leveraging forward-backward algorithms for parameter estimation. In this study, we introduce CRISPR-HMM, a statistical software to precisely call CRISPR-induced mutations. We demonstrate that the software significantly improves precision in identifying CRISPR-induced mutations compared to NW-based alignment, thereby enhancing the overall understanding of the CRISPR gene-editing process.

Keywords: CRISPR, HMM, sequence alignment, gene editing

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Authors: Muluneh Ademe, Zeleke Mekonnen

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Objective: to determine the level of bacterial contamination of reused insulin syringes among diabetic patients. Method: A facility based cross-sectional study was conducted among diabetic patients. Data on socio-demographic variables, history of injection syringe reuse, and frequency of reuse of syringes were collected using predesigned questionnaire. Finally, the samples from the syringes were cultured according to standard microbiological techniques. Result: Eighteen diabetic patients at Jimma University Hospital participated. A total of 83.3% of participants reused a single injection syringe for >30 consecutive injections, while 16.7% reused for >30 injections. Our results showed 22.2% of syringes were contaminated with methicillin-resistant Staphylococcus aures. Conclusion: We conclude reuse of syringe is associated with microbial contamination. The findings that 4/18 syringes being contaminated with bacteria is an alarming situation. A mechanism should be designed for patients to get injection syringes with affordable price. If reusing is not avoidable, reducing number of injections per a single syringe and avoiding needle touching with hand or other non-sterile material may be an alternative to reduce the risk of contamination.

Keywords: diabetes mellitus, Ethiopia, subcutaneous insulin injection, syringe reuse

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Authors: Belkacem Selma, Boumediene Selma, Tourkia Guerzou, Abbes Labdelli

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Natural disasters have occurred and will continue to cause human and material damage. Therefore, the idea of "preventing" natural disasters will never be possible. However, their prediction is possible with the advancement of technology. Even if natural disasters are effectively inevitable, their consequences may be partly controlled. The rapid growth and progress of artificial intelligence (AI) had a major impact on the prediction of natural disasters and risk assessment which are necessary for effective disaster reduction. The Earthquakes prediction to prevent the loss of human lives and even property damage is an important factor; that is why it is crucial to develop techniques for predicting this natural disaster. This present study aims to analyze the ability of artificial neural networks (ANNs) to predict earthquakes that occur in a given area. The used data describe the problem of high energy (higher than 10^4J) seismic bumps forecasting in a coal mine using two long walls as an example. For this purpose, seismic bumps data obtained from mines has been analyzed. The results obtained show that the ANN with high accuracy was able to predict earthquake parameters; the classification accuracy through neural networks is more than 94%, and that the models developed are efficient and robust and depend only weakly on the initial database.

Keywords: earthquake prediction, ANN, seismic bumps

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Authors: Kamesh Gupta, Nitin Jain, Anurag Rohatgi

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Objective: To study Vitamin B12 levels and presence of peripheral neuropathy among diabetes mellitus patients on metformin therapy. Method: The observational study was conducted from November 2014 to March 2015. Patients were selected from the Lady Hardinge Medical College, Delhi, India. Exhaustive history regarding dietary habits and metformin usage was taken. Lab tests including HbA1c levels and Vit B12 assays were done, on the basis of which patients were classified into subgroups. Peripheral neuropathy was detected by both clinical scoring and electrophysiological studies. Appropriate Statistical analysis for observational studies was done to evaluate the data. Results: The average duration of metformin usage was higher in patients with definite B12 deficiency (9.4y) than patients with normal B12 levels (5.6 y). Patients in the definite B12 deficiency group had much higher incidence of neuropathy (89%) than patients with no deficiency (27%). The incidence of neuropathy was higher in cases with longer metformin usage (100% with 18-22y of use and 83% with 14-17y of use) than shorter periods (29% with 2-5y of use and 75% with 6-9y of use). Conclusion: Thus patients on long-term metformin therapy are at a high risk for Vitamin B12 deficiency. Definite and possible Vitamin B12 deficiency on metformin had an earlier onset of neuropathy than the subgroup with normal Vitamin B12 levels.

Keywords: diabetic neuroptahy, cobalamine deficiency, metformin, nerve conduction studies

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Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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Authors: Keshav Raj Acharya, Thakur Silwal, Neelam C. Poudyal

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Buffer zones, the peripheral areas around the national parks and wildlife reserves, are available for the purpose of benefitting the local inhabitants by providing forest products for subsistence needs of basic forest products outside the protected areas. The forest area within the buffer zone has been managed as a buffer zone community forest (BZCF) for the last 25 years after the approval of the buffer zone management regulation 1996. With a case study of select BZCF in Bardia National Park, this study aims to analyze whether the benefit provided by BZCF is equally available to poor users among other socioeconomic classes of the users. The findings are based on the analysis of cross-sectional data involving household surveys (n=305) and key informants’ interviews (n=10) as well as office records available at different 5 buffer zone community forest user groups offices. Results indicate that despite the provisions of subsidized rates for poor; poor households were more deprived due to higher forest products price particularly, the timber price in buffer zone. Evidence also indicate that due to the increased forest coverage, the incidence of wildlife damage has also increased and impacted the poor more due to lack of land ownership as well as limited alternatives. Clear community forest management guidelines with equitable benefit sharing and compensatory mechanisms to the users of poor socioeconomic class have been identified as a solution to increase the benefit to poor users in BZCFUGs.

Keywords: crop depredation, forest products, users, wellbeing ranking

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Authors: Tingting Liu, Yufeng Wu, Xi Tian, Yu Gong, Tieyong Zuo

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The household solid waste generated by household in Beijing is increasing quickly due to rapid population growth and lifestyle changes. However, there are no rigorous data on the generation and collection of the recyclable household solid wastes. The Beijing city government needs this information to make appropriate policies and plans for waste management. To address this information need, we undertook the first comprehensive study of recyclable household solid waste for Beijing. We carried out a survey of 500 families across sixteen districts in Beijing. We also analyzed the quantities, spatial distribution and categories of collected waste handled by curbside recyclers and permanent recycling centers for 340 of the 9797 city-defined residential areas of Beijing. From our results, we estimate that the total quantity of recyclable household solid waste was 1.8 million tonnes generated by Beijing household in 2013 and 71.6% of that was collected. The main generation categories were waste paper (24.4%), waste glass bottle (23.7%) and waste furniture (14.3%). The recycling rate was varied among different kinds of municipal solid waste. Also based on our study, we estimate there were 22.8 thousand curbside recyclers and 5.7 thousand permanent recycling centers in Beijing. The problems of household solid waste collecting system were inadequacies of authorized collection centers, skewed ratios of curbside recyclers and authorized permanent recycling centers, weak recycling awareness of residents and lack of recycling resources statistics and appraisal system. According to the existing problems, we put forward the suggestions to improve household solid waste management.

Keywords: Municipal waste; Recyclable waste; Waste categories; Waste collection

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Authors: Kgomotso Matobole, Pascal Mwenge, Tumisang Seodigeng

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The global urbanisation and worldwide economic growth have caused a high rate of food waste generation, resulting in environmental pollution. Food waste disposed on landfills decomposes to produce methane (CH₄), a greenhouse gas. Inadequate waste management practices contribute to food waste polluting the environment. Thus effective organic fraction of municipal solid waste (OFMSW) management and treatment are attracting widespread attention in many countries. This problem can be minimised by the employment of anaerobic digestion process, since food waste is rich in organic matter and highly biodegradable, resulting in energy generation and waste volume reduction. The current study investigated the Biomethane Potential (BMP) of the Vaal University of Technology canteen food waste using anaerobic digestion. Tests were performed on canteen food waste, as a substrate, with total solids (TS) of 22%, volatile solids (VS) of 21% and moisture content of 78%. The tests were performed in batch reactors, at a mesophilic temperature of 37 °C, with two different types of inoculum, primary and digested sludge. The resulting CH₄ yields for both food waste with digested sludge and primary sludge were equal, being 357 Nml/g VS. This indicated that food waste form this canteen is rich in organic and highly biodegradable. Hence it can be used as a substrate for the anaerobic digestion process. The food waste with digested sludge and primary sludge both fitted the first order kinetic model with k for primary sludge inoculated food waste being 0.278 day^-1 with R² of 0.98, whereas k for digested sludge inoculated food waste being 0.034 day^-1, with R² of 0.847.

Keywords: anaerobic digestion, biogas, bio-methane potential, food waste

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Authors: Teresa Wills, Geraldine Mccarthy, Nicola Cornally

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Background: Obesity is an emerging healthcare epidemic affecting virtually all age and socio-economic groups and is one of the most serious and prevalent diseases of the 21st century. It is a public health challenge because of its prevalence, associated costs and health effects. The increasing prevalence of obesity has created a social perception that overweight body sizes are healthy and normal. This normalization of obesity within our society and the acceptance of higher body weights have led to individuals being unaware of the reality of their weight status and gravity of this situation thus impeding recognition of obesity. Given the escalating global health problem of obesity and its co-morbidities, the need to re-appraise its management is more compelling than ever. It is widely accepted that the causes of obesity are complex and multi-factorial. Engagement of individuals in weight management programmes is difficult if they do not perceive they have a problem with their weight. Recognition of the problem is a key component of obesity management and identifying the main predictors of behaviour is key to designing health behaviour interventions. Aim: The aim of the research was to determine factors relating to motivation to change behaviours in individuals who perceive themselves to be overweight. Method: The research design was quantitative, correlational and cross-sectional. The design was guided by the Health Belief Model. Data were collected online using a multi-section and multi-item questionnaire, developed from a review of the theoretical and empirical research. A sample of 202 men and women who perceived themselves to be overweight participated in the research. Descriptive and inferential statistical analyses were employed to describe relationships between variables. Findings: Following multivariate regression analysis, perceived barriers to weight loss and perceived benefits of weight loss were significant predictors of motivation to change behaviour. The perceived barriers to weight loss which were significant were psychological barriers to weight loss (p = < 0.019) and environmental barriers to physical activity (p= < 0.032).The greatest predictor of motivation to change behaviour was the perceived benefits of weight loss (p < 0.001). Perceived susceptibility to obesity and perceived severity of obesity did not emerge as significant predictors in this model. Total variance explained by the model was 33.5%. Conclusion: Perceived barriers to weight loss and perceived benefits of weight loss are important determinants of motivation to change behaviour. These findings have important implications for health professionals to help inform their practice and for the development of intervention programmes to prevent and control obesity.

Keywords: motivation to change behaviours, obesity, predictors of behavior, interventions, overweight

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Authors: Sayan Munshi, Subrajit Banerjee, Indrani Chakraborty

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Tourism is a prime sector in the economic development of many countries in particular the Indian sub-continent. Tourism is considered an integral pillar in the Make in India Program under the Government of India. The statistics of tourism in India had evolved from a past with the formation of History. The sector had shown dynamic changes in the statistics since 1980. With the evolving tourism along with destinations, this sector has been converted into the prime industry, as it not only impacts the destination but on the other hand supports the periphery of the destination. Tourism boost revenue and creates varied economic possibilities for the residents. Due to the influx of tourism in the cities, a load on the infrastructure and services can be observed, specifically in the Physical Infrastructure sectors. Due to the floating population in the designated tourism core of the Urban / Peri-Urban area, issues pertaining to Solid waste management and Transportation are highly observed. Thus, a need for capacity building arises for the infrastructure impacted by tourism, which may result in the upgradation of the lifestyle of the city and its permanent users. As tourism of a region has a dependency on the infrastructure, the paper here focuses on the relationship between tourism potential of a region and the infrastructural determinants of the city or region and hence to derive a structural equation supporting the relationship, further determine a coefficient and suggest the domain of in need of upgradation or retrofitting possibilities. The outcome of the paper is to suggest possible recommendations towards the formation of policies on an urban level to support the tourism potential of the region.

Keywords: urban planning, tourism planning, infrastructure, transportation, solid waste management

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Authors: Roya Biabani, Mentore Vaccari, Piero Ferrari

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Accumulated microplastic (MPLs) in soil pose the risk of adsorbing and transporting polychlorinated biphenyls (PCBs) into the food chain or bodies. PCBs belong to a class of man-made hydrophobic organic chemicals (HOCs) that are classified as probable human carcinogens and a hazard to biota. Therefore, to take effective action and not aggravate the already recognized problems, the knowledge of PCB remediation in the presence of MPLs needs to be complete. Due to the high efficiency and little secondary pollution production, thermal desorption (TD) has been widely used for processing a variety of pollutants, especially for removing volatile and semi-volatile organic matter from contaminated solids and sediment. This study investigates the fate of PCB compounds during the thermal remediation method. For this, the PCB-contaminated soil was collected from the earth-canal downstream Caffaro S.p.A. chemical factory, which produced PCBs and PCB mixtures between 1930 and 1984. For MPL analysis, MPLs were separated by density separation and oxidation of organic matter. An operational range for the key parameters of thermal desorption processes was experimentally evaluated. Moreover, the temperature treatment characteristics of the PCBs-contaminated soil under anaerobic and aerobic conditions were studied using the Thermogravimetric Analysis (TGA).

Keywords: contaminated soils, microplastics, polychlorinated biphenyls, thermal desorption

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Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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Over the past decade, the non-elective admissions in the UK have increased significantly. Taking into account limited resources (i.e. beds), the related service managers are obliged to manage their resources effectively due to the non-elective admissions which are mostly admitted to inpatient specialities via A&E departments. Geriatric medicine is one of specialities that have long length of stay for the non-elective admissions. This study aims to develop a discrete event simulation model to understand how possible increases on non-elective demand over the next 12 months affect the bed occupancy rate and to determine required number of beds in a geriatric medicine speciality in a UK hospital. In our validated simulation model, we take into account observed frequency distributions which are derived from a big data covering the period April, 2009 to January, 2013, for the non-elective admission and the length of stay. An experimental analysis, which consists of 16 experiments, is carried out to better understand possible effects of case studies and scenarios related to increase on demand and number of bed. As a result, the speciality does not achieve the target level in the base model although the bed occupancy rate decreases from 125.94% to 96.41% by increasing the number of beds by 30%. In addition, the number of required beds is more than the number of beds considered in the scenario analysis in order to meet the bed requirement. This paper sheds light on bed management for service managers in geriatric medicine specialities.

Keywords: bed management, bed occupancy rate, discrete event simulation, geriatric medicine, non-elective admission

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Authors: Karl Peltzer, Supa Pengpid

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Introduction: The aim of this study was to assess suicidal ideation and associated factors in school-going adolescents in the Association of Southeast Asian Nations (ASEAN) Member States. Methods: The analysis included 30284 school children aged 13-15 years from seven ASEAN that participated in the cross-sectional Global School-based Student Health Survey (GSHS) between 2007 and 2013. Results: The overall prevalence of suicidal ideation across seven ASEAN countries (excluding Brunei) was 12.3%, significantly higher in girls (15.1%) than boys (9.3%). Among eight ASEAN countries with the highest prevalence of suicidal ideation was in the Philippines (17.0%) and Vietnam (16.9%) and the lowest in Myanmar (1.1%) and Indonesia (4.2%). In multivariate logistic regression analysis, female gender, older age (14 or 15 years), living in a low income or lower middle income country, having no friends, loneliness, bullying victimization, having been in a physical fight in the past 12 months, lack of parental or guardian support, tobacco use and having a history of ever got drunk were associated with suicidal ideatiion. Conclusion: Different rates of suicidal ideation were observed in ASEAN member states. Several risk factors for suicidal ideation were identified which can help guide preventive efforts.

Keywords: adolesents, ASEAN, correlates, suicidal behaviour

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Authors: Xuelin Zhang, Shouxiang Lu, Changhai Li

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The commercial retardant flame polycarbonate samples as the main high speed train interior carriage material with different thicknesses were investigated in Fire Propagation Apparatus with different external heat fluxes under different oxygen concentration from 12% to 40% to study the fire characteristics and quantitatively analyze the ignition time, mass loss rate and heat blockage. The additives of commercial retardant flame polycarbonate were intumescent and maintained a steady height before ignition when heated. The results showed the transformed ignition time (1/t_ig)ⁿ increased linearly with external flux under different oxygen concentration after deducting the heat blockage due to pyrolysis products, the mass loss rate was taken on linearly with external heat fluxes and the slop of the fitting line for mass loss rate and external heat fluxes decreased with the enhanced oxygen concentration and the heat blockage independent on external heat fluxes rose with oxygen concentration increasing. The inquired data as the input of the fire simulation model was the most important to be used to evaluate the fire risk of commercial retardant flame polycarbonate.

Keywords: ignition time, mass loss rate, heat blockage, fire characteristic

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Authors: Alaa Morsy, Youssef Ibrahim

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Earthquake is one of the most catastrophic events, which makes enormous harm to properties and human lives. As a piece of a safe building configuration, reinforced concrete walls are given in structures to decrease horizontal displacements under seismic load. Shear walls are additionally used to oppose the horizontal loads that might be incited by the impact of wind. Reinforced concrete walls in residential buildings might have openings that are required for windows in outside walls or for doors in inside walls or different states of openings due to architectural purposes. The size, position, and area of openings may fluctuate from an engineering perspective. Shear walls can encounter harm around corners of entryways and windows because of advancement of stress concentration under the impact of vertical or horizontal loads. The openings cause a diminishing in shear wall capacity. It might have an unfavorable impact on the stiffness of reinforced concrete wall and on the seismic reaction of structures. Finite Element Method using software package ‘ANSYS ver. 12’ becomes an essential approach in analyzing civil engineering problems numerically. Now we can make various models with different parameters in short time by using ANSYS instead of doing it experimentally, which consumes a lot of time and money. Finite element modeling approach has been conducted to study the effect of opening shape, size and position in RC wall with different thicknesses under axial and lateral static loads. The proposed finite element approach has been verified with experimental programme conducted by the researchers and validated by their variables. A very good correlation has been observed between the model and experimental results including load capacity, failure mode, and lateral displacement. A parametric study is applied to investigate the effect of opening size, shape, position on different reinforced concrete wall thicknesses. The results may be useful for improving existing design models and to be applied in practice, as it satisfies both the architectural and the structural requirements.

Keywords: Ansys, concrete walls, openings, out of plane behavior, seismic, shear wall

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Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

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Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

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Authors: Alireza Saidi

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Aside from injuries due to direct contact with hot or cold substances or objects, exposure to extreme temperatures in the workplace involves physical hazards to workers. On the other hand, a poorly acclimatized worker may have reduced performance and alertness and may, therefore, be more vulnerable to the risk of accidents and injuries. Due to the incompatibility of the standards put in place with certain workplaces and the lack of thermoregulation in many protective equipments, thermal strains remain among the physical risks most present in many work sectors. However, many of these problems can be overcome thanks to the potential of intelligent textile technologies allowing intelligent thermoregulation in protective equipment. Nowadays, technologies such as heating elements, cooling elements are applied in products intended for sport and leisure, and research work has been carried out in the integration of temperature sensors and thermal stress detectors in personal protective equipment. However, the usage of all of these technologies in personal protective equipment remains very marginal. This article presents a portrait of the current state of intelligent thermoregulation systems by carrying out a synthesis of technical developments, which is accompanied by a gap analysis of current developments. Thus, the research work necessary for the adaptation and integration of intelligent thermoregulation systems with personal protective equipment is discussed in order to offer a perspective of future developments.

Keywords: personal protective equipment, smart textiles, thermoregulation, thermal strain

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