Search results for: assessment of risk and need
Commenced in January 2007
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Paper Count: 10427

Search results for: assessment of risk and need

1937 Effect of Blood Sugar Levels on Short Term and Working Memory Status in Type 2 Diabetics

Authors: Mythri G., Manjunath ML, Girish Babu M., Shireen Swaliha Quadri

Abstract:

Background: The increase in diabetes among the elderly is of concern because in addition to the wide range of traditional diabetes complications, evidence has been growing that diabetes is associated with increased risk of cognitive decline. Aims and Objectives: To find out if there is any association between blood sugar levels and short-term and working memory status in patients of type 2 diabetes. Materials and Methods: The study was carried out in 200 individuals aged between 40-65 years consisting of 100 diagnosed cases of Type 2 Diabetes Mellitus and 100 non-diabetics from OPD of Mc Gann Hospital, Shivamogga. Rye’s Auditory Verbal Learning Test, Verbal Fluency Test and Visual Reproduction Test, Working Digit Span Test and Validation Span Test were used to assess short-term and working memory. Fasting and Post Prandial blood sugar levels were estimated. Statistical analysis was done using SPSS 21. Results: Memory test scores of type 2 diabetics were significantly reduced (p < 0.001) when compared to the memory scores of age and gender matched non-diabetics. Fasting blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.837), VFT (r=-0.888), VRT(r=-0.787), WDST (r=-0.795) and VST (r=-0.943). Post- Prandial blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.922), VFT (r=-0.848), VRT(r=-0.707),WDST (r=-0.729) and VST (r=-0.880) Memory scores in all 5 tests were found to be negatively correlated with the FBS and PPBS levels in diabetic patients (p < 0.001). Conclusion: The decreased memory status in diabetic patients may be due to many factors like hyperglycemia, vascular disease, insulin resistance, amyloid deposition and also some of the factor combine to produce additive effects like, type of diabetes, co-morbidities, age of onset, duration of the disease and type of therapy. These observed effects of blood sugar levels of diabetics on memory status are of potential clinical importance because even mild cognitive impairment could interfere with todays’ activities.

Keywords: diabetes, cognition, diabetes, HRV, respiratory medicine

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1936 Effective, Affordable, and Accessible Treatment for Pregnancy’s Commonest Complication: Online Synchronous Interpersonal Psychotherapy for Mothers with Postpartum Depression

Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

Abstract:

Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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1935 Human Activities Damaging the Ecosystem of Isheri Ogun River, South West Nigeria

Authors: N. B. Ikenweiwe, A. A. Alimi, N. A. Bamidele, O. A. Ewumi, K. Fasina, S. O. Otubusin

Abstract:

A study on the physical, chemical and biological parameters of the lower course of Ogun River, Isheri-Olofin was carried out between January and December 2014 in order to determine the effects of the anthropogenic activities of the Kara abattoir and domestic waste depositions on the quality of the water. Water samples were taken twice each month at three selected stations A, B and C (based on characteristic features or activity levels) along the water course. Samples were analysed using standard methods for chemical and biological parameters the same day in the laboratory while physical parameters were determined in-situ with water parameters kit. Generally, results of Transparency, Dissolved Oxygen, Nitrates, TDS and Alkalinity fall below the permissible limits of WHO and FEPA standards for drinking and fish production. Results of phosphates, lead and cadmium were also low but still within the permissible limit. Only Temperature and pH were within limit. Low plankton community, (phytoplankton, zooplankton), which ranges from 3, 5 to 40, 23 were as a result of low levels of DO, transparency and phosphate. The presence of coliform bacteria of public health importance like Escherichia coli, Proteus vulgaris, Aeromonas sp., Shigella sp, Enterobacter aerogenes as well as gram negative bacteria Proteus morganii are mainly indicators of faecal pollution. Fish and other resources obtained from this water stand the risk of being contaminated with these organisms and man is at the receiving end. The results of the physical, chemical and some biological parameters of Isheri, Ogun River, according to this study showed that the live forms of aquatic and fisheries resources there are dwelling under stress as a result of deposition of bones, horns, faecal components, slurry of suspended solids, fat and blood into the water. Government should therefore establish good monitoring system against illegal waste depositions and create education programmes that will enlighten the community on the social, ecological and economic values of the river.

Keywords: damage, ecosystem, human activities, Isheri ogun river

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1934 Renewable Energy and Environment: Design of a Decision Aided Tool for Sustainable Development

Authors: Mustapha Ouardouz, Mina Amharref, Abdessamed Bernoussi

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The future energy, for limited energy resources countries, goes through renewable energies (solar, wind etc.). The renewable energies constitute a major component of the energy strategy to cover a substantial part of the growing needs and contribute to environmental protection by replacing fossil fuels. Indeed, sustainable development involves the promotion of renewable energy and the preservation of the environment by the use of clean energy technologies to limit emissions of greenhouse gases and reducing the pressure exerted on the forest cover. So the impact studies, of the energy use on the environment and farm-related risks are necessary. For that, a global approach integrating all the various sectors involved in such project seems to be the best approach. In this paper we present an approach based on the multi criteria analysis and the realization of one pilot to achieve the development of an innovative geo-intelligent environmental platform. An implementation of this platform will collect, process, analyze and manage environmental data in connection with the nature of used energy in the studied region. As an application we consider a region in the north of Morocco characterized by intense agricultural and industrials activities and using diverse renewable energy. The strategic goals of this platform are; the decision support for better governance, improving the responsiveness of public and private companies connected by providing them in real time with reliable data, modeling and simulation possibilities of energy scenarios, the identification of socio-technical solutions to introduce renewable energies and estimate technical and implantable potential by socio-economic analyzes and the assessment of infrastructure for the region and the communities, the preservation and enhancement of natural resources for better citizenship governance through democratization of access to environmental information, the tool will also perform simulations integrating environmental impacts of natural disasters, particularly those linked to climate change. Indeed extreme cases such as floods, droughts and storms will be no longer rare and therefore should be integrated into such projects.

Keywords: renewable energies, decision aided tool, environment, simulation

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1933 Site Specific Nutrient Management Need in India Now

Authors: A. H. Nanher, N. P. Singh, Shashidhar Yadav, Sachin Tyagi

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Agricultural production system is an outcome of a complex interaction of seed, soil, water and agro-chemicals (including fertilizers). Therefore, judicious management of all the inputs is essential for the sustainability of such a complex system. Precision agriculture gives farmers the ability to use crop inputs more effectively including fertilizers, pesticides, tillage and irrigation water. More effective use of inputs means greater crop yield and/or quality, without polluting the environment the focus on enhancing the productivity during the Green Revolution coupled with total disregard of proper management of inputs and without considering the ecological impacts, has resulted into environmental degradation. To evaluate a new approach for site-specific nutrient management (SSNM). Large variation in initial soil fertility characteristics and indigenous supply of N, P, and K was observed among Field- and season-specific NPK applications were calculated by accounting for the indigenous nutrient supply, yield targets, and nutrient demand as a function of the interactions between N, P, and K. Nitrogen applications were fine-tuned based on season-specific rules and field-specific monitoring of crop N status. The performance of SSNM did not differ significantly between high-yielding and low-yielding climatic seasons, but improved over time with larger benefits observed in the second year Future, strategies for nutrient management in intensive rice systems must become more site-specific and dynamic to manage spatially and temporally variable resources based on a quantitative understanding of the congruence between nutrient supply and crop demand. The SSNM concept has demonstrated promising agronomic and economic potential. It can be used for managing plant nutrients at any scale, i.e., ranging from a general recommendation for homogenous management of a larger domain to true management of between-field variability. Assessment of pest profiles in FFP and SSNM plots suggests that SSNM may also reduce pest incidence, particularly diseases that are often associated with excessive N use or unbalanced plant nutrition.

Keywords: nutrient, pesticide, crop, yield

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1932 Effect of Antioxidant-Rich Nutraceutical on Serum Glucose, Lipid Profile and Oxidative Stress Markers of Salt-Induced Metabolic Syndrome in Rats

Authors: Nura Lawal, Lawal Suleiman Bilbis, Rabiu Aliyu Umar, Anas A. Sabir

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Metabolic syndrome (MS) a high-risk condition involving obesity, dyslipidemia, hypertension, and diabetes mellitus is prevalent in Nigeria. The study aims to formulate an antioxidant-rich nutraceutical from locally available foodstuff (onion, garlic, ginger, tomato, lemon, palm oil, watermelon seeds) and investigate their effects on blood pressure, body weight, serum glucose, lipid profile, insulin and oxidative stress markers in salt-induced rats. The rats were placed on 8% salt diet for 6 weeks and then supplementation and treatment with nutraceutical and nifedipine in the presence of salt diet for additional 4 weeks. Feeding rats with salt diet for 6 weeks increased blood pressure and body weight of the salt-loaded rats relative to control. Significant (P < 0.001) increase in serum blood glucose and lipid profile, and the decrease in high-density lipoprotein-cholesterol (HDL-C) was observed in salt-loaded rats as compared with control. Both supplementation and treatment (nifedipine) lowered the blood pressure but the only supplementation lowered the body weight. Supplementation with nutraceutical resulted in significant (P < 0.001) decrease in the serum blood glucose, lipid profile, malonyldialdehyde (MDA), insulin levels, insulin resistance, and increased HDL-C and antioxidant indices. The percentage protection against atherogenesis was 76.5±2.13%. There is strong positive correlation between blood pressure, body weight and serum blood glucose, lipid profile, markers of oxidative stress and strong negative correlation with HDL-C and antioxidant status. The results suggest that the nutraceuticals are useful in reversing most of the component of metabolic syndrome and might be beneficial in the treatment of patients with metabolic syndrome.

Keywords: metabolic syndrome, hypertension, diabetes mallitus, obesity

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1931 Epidemiology of Toxoplasma gondii Infection in Animals of the Arabian Peninsula: A Systematic Review and Meta-Analysis

Authors: Ebtisam A. Al-Mslemani, Khalid A. Enan, Asmaa Abdelgadier, Nada Assaad, Zaynab Elhussein, Khalid Eltom

Abstract:

Background: Toxoplasma gondii (T. gondii) is a zoonotic parasite that can be transmitted from animals to humans, with felids acting as its definitive host. Thus, understanding the epidemiology of this parasite in animal populations is vital to controlling its transmission to humans as well as to other animal groups. Objectives: This systematic review and meta-analysis aim to summarise and analyse reports of T. gondii infection in animal species residing in the Arabian Peninsula. Methods: It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with relevant studies being retrieved from MEDLINE/PubMed, Scopus, Cochrane Library, Google Scholar and ScienceDirect. All articles published in Arabic or English languages between January 2000 and December 2020 were screened for eligibility. The random effects model was used to calculate the pooled prevalence of T. gondii infection in different animal populations which were found to harbour this infection. The critical appraisal tool for prevalence studies designed by the Joanna Briggs Institute (JBI) was used to assess the risk of bias in all included studies. Results: A total of 15 studies were retrieved, reporting prevalence estimates from 4 countries in this region and in 13 animal species. A quantitative meta-analysis estimated a pooled prevalence of 43% in felids [95% confidence interval (CI) = 23-64%, I2 index = 100%], 48% in sheep (95% CI = 27-70%, I2 = 99%) and 21% in camels (95% CI = 7-35%, I2 = 99%). Evidence of possible publication bias was found in both felids and sheep. Conclusions: This meta-analysis estimates a high prevalence of T. gondii infection in animal species that are of high economic and cultural importance to countries of this region. Hence, these findings provide valuable insight to public health authorities as well as economic and animal resources advisors in countries of the Arabian Peninsula.

Keywords: Arabian Peninsula, toxoplasma gondii, animals; meta-analysis, toxoplasmosis

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1930 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty: A Retrospective Study at a Tertiary Orthopaedic Centre

Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

Abstract:

Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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1929 Media Framing and Democratization Under Multi-Party System: A Case Study of the 2023 Malaysian Six-State Elections

Authors: Chew Zhao Hong

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Since the transition of power in 2018, the Malaysian political landscape has experienced substantial shifts and complexities. The decline of the longstanding ruling party, United Malays National Organization (UMNO), following the party rotation, has given rise to splinter parties such as the Indigenous Unity Party (Bersatu), along with the enduring presence of the Pan-Malaysian Islamic Party (PAS) in the northern region of the Malay Peninsula. However, the "Sheraton Move" in 2020 led to the fall of the Pakatan Harapan government and the emergence of Perikatan Nasional, signifying the ascent of a third political force. The 2022 general elections marked Malaysia's entry into a hung parliament, culminating in an intricate negotiation that resulted in a coalition government formed by Pakatan Harapan, Barisan Nasional, and the Sarawak parties alliance (GPS), collectively governing the Malaysian federal administration. During the 2023 state elections, Pakatan Harapan and Barisan Nasional formed an unprecedented alliance, yet the media framing benefited Perikatan Nasional, even securing substantial support from UMNO's traditional constituencies. In the era of converging new media, Malaysia’s democratization faces new challenges: first, political leaders leveraging media to cultivate unfiltered personas risk inducing populism; second, under the influence of agenda-setting and two-step flow theories, media contributes to polarization; lastly, Malaysia's multi-party system is no longer effectively moderate extreme ideologies into the political center. This study examines the role of media framing and its impact on the democratization process within Malaysia's consociational democracy under a multi-party system and analyzes media discourse before and after the 2023 Malaysian state elections to explore how different parties shape public opinion and political discourse, and how political messages may be amplified or distorted in the process.

Keywords: multi-party system, democratization, elections, political polarization, Malaysia, media framing

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1928 Linguistic Competencies of Students with Hearing Impairment

Authors: Khalil Ullah Khan

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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in the recent era vow to have addressed the situation and claim significant contributions in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess the linguistic competencies of students with hearing impairment in the English language. The goals were further broken down to identify the level of reading abilities in the subject population. The population involved students with HI studying at a higher secondary level in Lahore. A simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with the accelerated learning program by the Punjab Government to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach the findings. Spearman’s correlation was used to find out the relationship between the degree of hearing loss, grade level, gender and type of amplification device. An Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify for an independent level of reading according to their grades, as the majority fall at the frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence, as it is shown in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade. Wise. However, scores could only correspond to frustration level, and independent levels were never achieved. Reported achievements at the instructional level of the subject population may further to linguistic skills if practiced purposively.

Keywords: linguistic competence, hearing impairment, reading levels, educationist

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1927 Conceptualizing Psycho-Social Intervention with Juvenile Offenders as Attachment Therapy: A Practical Approach

Authors: Genziana Lay

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A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.

Keywords: attachment, child, adolescent, crime, juvenile, psychosocial

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1926 Assessment of Acute Oral Toxicity Studies and Anti Diabetic Activity of Herbal Mediated Nanomedicine

Authors: Shanker Kalakotla, Krishna Mohan Gottumukkala

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Diabetes is a metabolic disorder characterized by hyperglycemia, carbohydrates, altered lipids and proteins metabolism. In recent research nanotechnology is a blazing field for the researchers; latterly there has been prodigious excitement in the nanomedicine and nano pharmacological area for the study of silver nanoparticles synthesis using natural products. Biological methods have been used to synthesize silver nanoparticles in presence of medicinally active antidiabetic plants, and this intention made us assess the biologically synthesized silver nanoparticles from the seed extract of Psoralea corylfolia using 1 mM silver nitrate solution. The synthesized herbal mediated silver nanoparticles (HMSNP’s) then subjected to various characterization techniques such as XRD, SEM, EDX, TEM, DLS, UV and FT-IR respectively. In current study, the silver nanoparticles tested for in-vitro anti-diabetic activity and possible toxic effects in healthy female albino mice by following OECD guidelines-425. Herbal mediated silver nanoparticles were successfully obtained from bioreduction of silver nitrate using Psoralea corylifolia plant extract. Silver nanoparticles have been appropriately characterized and confirmed using different types of equipment viz., UV-vis spectroscopy, XRD, FTIR, DLS, SEM and EDX analysis. From the behavioral observations of the study, the female albino mice did not show sedation, respiratory arrest, and convulsions. Test compounds did not cause any mortality at the dose level tested (i.e., 2000 mg/kg body weight) doses till the end of 14 days of observation and were considered safe. It may be concluded that LD50 of the HMSNPs was 2000mg/kg body weight. Since LD50 of the HMSNPs was 2000mg/kg body weight, so the preferred dose range for HMSNPs falls between the levels of 200 and 400 mg/kg. Further In-vivo pharmacological models and biochemical investigations will clearly elucidate the mechanism of action and will be helpful in projecting the currently synthesized silver nanoparticles as a therapeutic target in treating chronic ailments.

Keywords: herbal mediated silver nanoparticles, HMSNPs, toxicity of silver nanoparticles, PTP1B in-vitro anti-diabetic assay female albino mice, 425 OECD guidelines

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1925 Intermittent Effect of Coupled Thermal and Acoustic Sources on Combustion: A Spatial Perspective

Authors: Pallavi Gajjar, Vinayak Malhotra

Abstract:

Rockets have been known to have played a predominant role in spacecraft propulsion. The quintessential aspect of combustion-related requirements of a rocket engine is the minimization of the surrounding risks/hazards. Over time, it has become imperative to understand the combustion rate variation in presence of external energy source(s). Rocket propulsion represents a special domain of chemical propulsion assisted by high speed flows in presence of acoustics and thermal source(s). Jet noise leads to a significant loss of resources and every year a huge amount of financial aid is spent to prevent it. External heat source(s) induce high possibility of fire risk/hazards which can sufficiently endanger the operation of a space vehicle. Appreciable work had been done with justifiable simplification and emphasis on the linear variation of external energy source(s), which yields good physical insight but does not cater to accurate predictions. Present work experimentally attempts to understand the correlation between inter-energy conversions with the non-linear placement of external energy source(s). The work is motivated by the need to have better fire safety and enhanced combustion. The specific objectives of the work are a) To interpret the related energy transfer for combustion in presence of alternate external energy source(s) viz., thermal and acoustic, b) To fundamentally understand the role of key controlling parameters viz., separation distance, the number of the source(s), selected configurations and their non-linear variation to resemble real-life cases. An experimental setup was prepared using incense sticks as potential fuel and paraffin wax candles as the external energy source(s). The acoustics was generated using frequency generator, and source(s) were placed at selected locations. Non-equidistant parametric experimentation was carried out, and the effects were noted on regression rate changes. The results are expected to be very helpful in offering a new perspective into futuristic rocket designs and safety.

Keywords: combustion, acoustic energy, external energy sources, regression rate

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1924 Uncertainty Quantification of Corrosion Anomaly Length of Oil and Gas Steel Pipelines Based on Inline Inspection and Field Data

Authors: Tammeen Siraj, Wenxing Zhou, Terry Huang, Mohammad Al-Amin

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The high resolution inline inspection (ILI) tool is used extensively in the pipeline industry to identify, locate, and measure metal-loss corrosion anomalies on buried oil and gas steel pipelines. Corrosion anomalies may occur singly (i.e. individual anomalies) or as clusters (i.e. a colony of corrosion anomalies). Although the ILI technology has advanced immensely, there are measurement errors associated with the sizes of corrosion anomalies reported by ILI tools due limitations of the tools and associated sizing algorithms, and detection threshold of the tools (i.e. the minimum detectable feature dimension). Quantifying the measurement error in the ILI data is crucial for corrosion management and developing maintenance strategies that satisfy the safety and economic constraints. Studies on the measurement error associated with the length of the corrosion anomalies (in the longitudinal direction of the pipeline) has been scarcely reported in the literature and will be investigated in the present study. Limitations in the ILI tool and clustering process can sometimes cause clustering error, which is defined as the error introduced during the clustering process by including or excluding a single or group of anomalies in or from a cluster. Clustering error has been found to be one of the biggest contributory factors for relatively high uncertainties associated with ILI reported anomaly length. As such, this study focuses on developing a consistent and comprehensive framework to quantify the measurement errors in the ILI-reported anomaly length by comparing the ILI data and corresponding field measurements for individual and clustered corrosion anomalies. The analysis carried out in this study is based on the ILI and field measurement data for a set of anomalies collected from two segments of a buried natural gas pipeline currently in service in Alberta, Canada. Data analyses showed that the measurement error associated with the ILI-reported length of the anomalies without clustering error, denoted as Type I anomalies is markedly less than that for anomalies with clustering error, denoted as Type II anomalies. A methodology employing data mining techniques is further proposed to classify the Type I and Type II anomalies based on the ILI-reported corrosion anomaly information.

Keywords: clustered corrosion anomaly, corrosion anomaly assessment, corrosion anomaly length, individual corrosion anomaly, metal-loss corrosion, oil and gas steel pipeline

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1923 Effects of Rising Cost of Building Materials in Nigeria: A Case Study of Adamawa State

Authors: Ibrahim Yerima Gwalem, Jamila Ahmed Buhari

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In recent years, there has been an alarming rate of increase in the costs of building materials in Nigeria, and this ugly phenomenon threatens the contributions of the construction industry in national development. The purpose of this study was to assess the effects of the rising cost of building materials in Adamawa State Nigeria. Four research questions in line with the purpose of the study were raised to guide the study. Two null hypotheses were formulated and tested at 0.05 level of significance. The study adopted a survey research design. The population of the study comprises registered contractors, registered builders, selected merchants, and consultants in Adamawa state. Data were collected using researcher designed instrument tagged effects of the rising cost of building materials questionnaire (ERCBMQ). The instrument was subjected to face and content validation by two experts, one from Modibbo Adama University of Technology Yola and the other from Federal Polytechnic Mubi. The reliability of the instrument was determined by the Cronbach Alpha method and yielded a reliability index of 0.85 high enough to ascertain the reliability. Data collected from a field survey of 2019 was analyzed using mean and percentage. The means of the prices were used in the calculations of price indices and rates of inflation on building materials. Findings revealed that factors responsible for the rising cost of building materials are the exchange rate of the Nigeria Naira with a mean rating (MR) = 4.4; cost of fuel and power supply, MR = 4.3; and changes in government policies and legislation, MR = 4.2, while fluctuations in the construction cost with MR = 2.8; reduced volume of construction output, MR = 2.52; and risk of project abandonment, MRA = 2.51, were the three effects. The study concluded that adverse effects could result in a downward effect on the contributions of the construction industries on the gross domestic product (GDP) in the nation’s economy. Among the recommendations proffered include that the government should formulate a policy that will play down the agitations on the use of imported building materials by encouraging research in the production of local building materials.

Keywords: effects, rising, cost, building, materials

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1922 The Investigate Relationship between Moral Hazard and Corporate Governance with Earning Forecast Quality in the Tehran Stock Exchange

Authors: Fatemeh Rouhi, Hadi Nassiri

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Earning forecast is a key element in economic decisions but there are some situations, such as conflicts of interest in financial reporting, complexity and lack of direct access to information has led to the phenomenon of information asymmetry among individuals within the organization and external investors and creditors that appear. The adverse selection and moral hazard in the investor's decision and allows direct assessment of the difficulties associated with data by users makes. In this regard, the role of trustees in corporate governance disclosure is crystallized that includes controls and procedures to ensure the lack of movement in the interests of the company's management and move in the direction of maximizing shareholder and company value. Therefore, the earning forecast of companies in the capital market and the need to identify factors influencing this study was an attempt to make relationship between moral hazard and corporate governance with earning forecast quality companies operating in the capital market and its impact on Earnings Forecasts quality by the company to be established. Getting inspiring from the theoretical basis of research, two main hypotheses and sub-hypotheses are presented in this study, which have been examined on the basis of available models, and with the use of Panel-Data method, and at the end, the conclusion has been made at the assurance level of 95% according to the meaningfulness of the model and each independent variable. In examining the models, firstly, Chow Test was used to specify either Panel Data method should be used or Pooled method. Following that Housman Test was applied to make use of Random Effects or Fixed Effects. Findings of the study show because most of the variables are positively associated with moral hazard with earnings forecasts quality, with increasing moral hazard, earning forecast quality companies listed on the Tehran Stock Exchange is increasing. Among the variables related to corporate governance, board independence variables have a significant relationship with earnings forecast accuracy and earnings forecast bias but the relationship between board size and earnings forecast quality is not statistically significant.

Keywords: corporate governance, earning forecast quality, moral hazard, financial sciences

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1921 A Realist Review of Interventions Targeting Maternal Health in Low- and Middle-income Countries

Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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1920 Initial Palaeotsunami and Historical Tsunami in the Makran Subduction Zone of the Northwest Indian Ocean

Authors: Mohammad Mokhtari, Mehdi Masoodi, Parvaneh Faridi

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history of tsunami generating earthquakes along the Makran Subduction Zone provides evidence of the potential tsunami hazard for the whole coastal area. In comparison with other subduction zone in the world, the Makran region of southern Pakistan and southeastern Iran remains low seismicity. Also, it is one of the least studied area in the northwest of the Indian Ocean regarding tsunami studies. We present a review of studies dealing with the historical /and ongoing palaeotsunamis supported by IGCP of UNESCO in the Makran Subduction Zone. The historical tsunami presented here includes about nine tsunamis in the Makran Subduction Zone, of which over 7 tsunamis occur in the eastern Makran. Tsunami is not as common in the western Makran as in the eastern Makran, where a database of historical events exists. The historically well-documented event is related to the 1945 earthquake with a magnitude of 8.1moment magnitude and tsunami in the western and eastern Makran. There are no details as to whether a tsunami was generated by a seismic event before 1945 off western Makran. But several potentially large tsunamigenic events in the MSZ before 1945 occurred in 325 B.C., 1008, 1483, 1524, 1765, 1851, 1864, and 1897. Here we will present new findings from a historical point of view, immediately, we would like to emphasize that the area needs to be considered with higher research investigation. As mentioned above, a palaeotsunami (geological evidence) is now being planned, and here we will present the first phase result. From a risk point of view, the study shows as preliminary achievement within 20 minutes the wave reaches to Iranian as well Pakistan and Oman coastal zone with very much destructive tsunami waves capable of inundating destructive effect. It is important to note that all the coastal areas of all states surrounding the MSZ are being developed very rapidly, so any event would have a devastating effect on this region. Although several papers published about modelling, seismology, tsunami deposits in the last decades; as Makran is a forgotten subduction zone, more data such as the main crustal structure, fault location, and its related parameter are required.

Keywords: historical tsunami, Indian ocean, makran subduction zone, palaeotsunami

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1919 Physical Fitness Normative Reference Values among Lithuanian Primary School Students: Population-Based Cross-Sectional Study

Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.

Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves

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1918 Compositional Assessment of Fermented Rice Bran and Rice Bran Oil and Their Effect on High Fat Diet Induced Animal Model

Authors: Muhammad Ali Siddiquee, Md. Alauddin, Md. Omar Faruque, Zakir Hossain Howlader, Mohammad Asaduzzaman

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Rice bran (RB) and rice bran oil (RBO) are explored as prominent food components worldwide. In this study, fermented rice bran (FRB) was produced by employing edible gram-positive bacteria (Lactobacillus acidophilus, Lactobacillus bulgaricus, and Bifidobacterium bifidum) at 125 x 10⁵ spore g⁻¹ of rice bran, and investigated to evaluate nutritional quality. The crude rice bran oil (CRBO) was extracted from RB, and its quality was also investigated compared to market-available rice bran oil (MRBO) in Bangladesh. We found that fermentation of rice bran with lactic acid bacteria increased total proteins (29.52%), fat (5.38%), ash (48.47%), crude fiber (38.96%), and moisture (61.04%) and reduced the carbohydrate content (36.61%). We also found that essential amino acids (methionine, tryptophan, threonine, valine, leucine, lysine, histidine, and phenylalanine) and non-essential amino acids (alanine, aspartate, glycine, glutamine, proline, serine, and tyrosine) were increased in FRB except methionine and proline. Moreover, total phenolic content, tannin content, flavonoid content, and antioxidant activity were increased in FRB. The RBO analysis showed that γ-oryzanol content (10.00mg/g) was found in CRBO compared to MRBO (ranging from 7.40 to 12.70 mg/g) and Vitamin-E content 0.20% was found higher in CRBO compared to MRBO (ranging 0.097 to 0.12%). The total saturated (25.16%) and total unsaturated fatty acids (74.44%) were found in CRBO, whereas MRBO contained total saturated (22.08 to 24.13%) and total unsaturated fatty acids (71.91 to 83.29%), respectively. The physiochemical parameters were found satisfactory in all samples except acid value and peroxide value higher in CRBO. Finally, animal experiments showed that FRB and CRBO reduce the body weight, glucose, and lipid profile in high-fat diet-induced animal models. Thus, FRB and RBO could be value-added food supplements for human health.

Keywords: fermented rice bran, crude rice bran oil, amino acids, proximate composition, gamma-oryzanol, fatty acids, heavy metals, physiochemical parameters

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1917 The Reality of Teaching Arabic for Specific Purposes in Educational Institutions

Authors: Mohammad Anwarul Kabir, Fayezul Islam

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Language invariably is learned / taught to be used primarily as means of communications. Teaching a language for its native audience differs from teaching it to non-native audience. Moreover, teaching a language for communication only is different from teaching it for specific purposes. Arabic language is primarily regarded as the language of the Quran and the Sunnah (Prophetic tradition). Arabic is, therefore, learnt and spread all over the globe. However, Arabic is also a cultural heritage shared by all Islamic nations which has used Arabic for a long period to record the contributions of Muslim thinkers made in the field of wide spectrum of knowledge and scholarship. That is why the phenomenon of teaching Arabic by different educational institutes became quite rife, and the idea of teaching Arabic for specific purposes is heavily discussed in the academic sphere. Although the number of learners of Arabic is increasing consistently, yet their purposes vary. These include religious purpose, international trade, diplomatic purpose, better livelihood in the Arab world extra. By virtue of this high demand for learning Arabic, numerous institutes have been established all over the world including Bangladesh. This paper aims at focusing on the current status of the language institutes which has been established for learning Arabic for specific purposes in Bangladesh including teaching methodology, curriculum, and teachers’ quality. Such curricula and using its materials resulted in a lot of problems. The least, it confused teachers and students as well. Islamic educationalists have been working hard to professionally meet the need. They are following a systematic approach of stating clear and achievable goals, building suitable content, and applying new technology to present these learning experiences and evaluate them. It also suggests a model for designing instructional systems that responds to the need of non-Arabic speaking Islamic communities and provide the knowledge needed in both linguistic and cultural aspects. It also puts forward a number of suggestions for the improvement of the teaching / learning Arabic for specific purposes in Bangladesh after a detailed investigation in the following areas: curriculum, teachers’ skills, method of teaching and assessment policy.

Keywords: communication, Quran, sunnah, educational institutes, specific purposes, curriculum, method of teaching

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1916 Assessment of Groundwater Aquifer Impact from Artificial Lagoons and the Reuse of Wastewater in Qatar

Authors: H. Aljabiry, L. Bailey, S. Young

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Qatar is a desert with an average temperature 37⁰C, reaching over 40⁰C during summer. Precipitation is uncommon and mostly in winter. Qatar depends on desalination for drinking water and on groundwater and recycled water for irrigation. Water consumption and network leakage per capita in Qatar are amongst the highest in the world; re-use of treated wastewater is extremely limited with only 14% of treated wastewater being used for irrigation. This has led to the country disposing of unwanted water from various sources in lagoons situated around the country, causing concern over the possibility of environmental pollution. Accordingly, our hypothesis underpinning this research is that the quality and quantity of water in lagoons is having an impact on the groundwater reservoirs in Qatar. Lagoons (n = 14) and wells (n = 55) were sampled for both summer and winter in 2018 (summer and winter). Water, adjoining soil and plant samples were analysed for multiple elements by Inductively Coupled Plasma Mass Spectrometry. Organic and inorganic carbon were measured (CN analyser) and the major anions were determined by ion chromatography. Salinization in both the lagoon and the wells was seen with good correlations between Cl⁻, Na⁺, Li, SO₄, S, Sr, Ca, Ti (p-value < 0.05). Association of heavy metals was observed of Ni, Cu, Ag, and V, Cr, Mo, Cd which is due to contamination from anthropological activities such as wastewater disposal or spread of contaminated dust. However, looking at each elements none of them exceeds the Qatari regulation. Moreover, gypsum saturation in the system was observed in both the lagoon and wells water samples. Lagoons and the water of the well are found to be of a saline type as well as Ca²⁺, Cl⁻, SO₄²⁻ type evidencing both gypsum dissolution and salinization in the system. Moreover, Maps produced by Inverse distance weighting showed an increasing level of Nitrate in the groundwater in winter, and decrease chloride and sulphate level, indicating recharge effect after winter rain events. While E. coli and faecal bacteria were found in most of the lagoons, biological analysis for wells needs to be conducted to understand the biological contamination from lagoon water infiltration. As a conclusion, while both the lagoon and the well showed the same results, more sampling is needed to understand the impact of the lagoons on the groundwater.

Keywords: groundwater quality, lagoon, treated wastewater, water management, wastewater treatment, wetlands

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1915 Sustainable Ecological Agricultural Systems in Bangladesh: Environmental, Economic and Social Perspective of Compost

Authors: Protima Chakraborty

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The sustainability of conventional agriculture in Bangladesh is under threat from the continuous degradation of land and water resources, and from declining yields due to indiscriminate use of agrochemicals. NASL (Northern Agro Services Limited) is pursuing efforts to promote ecological agriculture with emphasis on better use of organic fertilizer resources and the reduction of external inputs. This paper examines the sustainability of two production systems in terms of their environmental soundness, economic viability and social acceptability based on empirical data collected through making demonstration land cultivation, a household survey, soil sample analysis, observations and discussions with key informants. Twelve indicators were selected to evaluate sustainability. Significant differences were found between the two systems in crop diversification, soil fertility management, pests and diseases management, and use of agrochemicals & Organic Compost. However, significant variations were found in other indicators such as land-use pattern, crop yield and stability, risk and uncertainties, and food security. Although crop yield and financial return were found to be slightly higher in the ecological system, the economic return and value addition per unit of land show the positive difference of using compost rather than chemical fertilizer. The findings suggest that ecological agriculture has a tendency towards becoming ecologically, economically and socially more sound than conventional agriculture, as it requires considerably fewer agro-chemicals, adds more organic matter to the soil, provides balanced food, and requires higher local inputs without markedly compromising output and financial benefits. Broad-policy measures, including the creation of mass awareness of adverse health effects of agrochemical-based products, are outlined for the promotion of ecological agriculture.

Keywords: Bangladesh, compost, conventional agriculture, organic fertilizer, environmental sustainability, economic viability, social acceptability

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1914 The Impact of Total Parenteral Nutrition on Pediatric Stem Cell Transplantation and Its Complications

Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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1913 A Furniture Industry Concept for a Sustainable Generative Design Platform Employing Robot Based Additive Manufacturing

Authors: Andrew Fox, Tao Zhang, Yuanhong Zhao, Qingping Yang

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The furniture manufacturing industry has been slow in general to adopt the latest manufacturing technologies, historically relying heavily upon specialised conventional machinery. This approach not only requires high levels of specialist process knowledge, training, and capital investment but also suffers from significant subtractive manufacturing waste and high logistics costs due to the requirement for centralised manufacturing, with high levels of furniture product not re-cycled or re-used. This paper aims to address the problems by introducing suitable digital manufacturing technologies to create step changes in furniture manufacturing design, as the traditional design practices have been reported as building in 80% of environmental impact. In this paper, a 3D printing robot for furniture manufacturing is reported. The 3D printing robot mainly comprises a KUKA industrial robot, an Arduino microprocessor, and a self-assembled screw fed extruder. Compared to traditional 3D printer, the 3D printing robot has larger motion range and can be easily upgraded to enlarge the maximum size of the printed object. Generative design is also investigated in this paper, aiming to establish a combined design methodology that allows assessment of goals, constraints, materials, and manufacturing processes simultaneously. ‘Matrixing’ for part amalgamation and product performance optimisation is enabled. The generative design goals of integrated waste reduction increased manufacturing efficiency, optimised product performance, and reduced environmental impact institute a truly lean and innovative future design methodology. In addition, there is massive future potential to leverage Single Minute Exchange of Die (SMED) theory through generative design post-processing of geometry for robot manufacture, resulting in ‘mass customised’ furniture with virtually no setup requirements. These generatively designed products can be manufactured using the robot based additive manufacturing. Essentially, the 3D printing robot is already functional; some initial goals have been achieved and are also presented in this paper.

Keywords: additive manufacturing, generative design, robot, sustainability

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1912 Satellite Photogrammetry for DEM Generation Using Stereo Pair and Automatic Extraction of Terrain Parameters

Authors: Tridipa Biswas, Kamal Pandey

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A Digital Elevation Model (DEM) is a simple representation of a surface in 3 dimensional space with elevation as the third dimension along with X (horizontal coordinates) and Y (vertical coordinates) in rectangular coordinates. DEM has wide applications in various fields like disaster management, hydrology and watershed management, geomorphology, urban development, map creation and resource management etc. Cartosat-1 or IRS P5 (Indian Remote Sensing Satellite) is a state-of-the-art remote sensing satellite built by ISRO (May 5, 2005) which is mainly intended for cartographic applications.Cartosat-1 is equipped with two panchromatic cameras capable of simultaneous acquiring images of 2.5 meters spatial resolution. One camera is looking at +26 degrees forward while another looks at –5 degrees backward to acquire stereoscopic imagery with base to height ratio of 0.62. The time difference between acquiring of the stereopair images is approximately 52 seconds. The high resolution stereo data have great potential to produce high-quality DEM. The high-resolution Cartosat-1 stereo image data is expected to have significant impact in topographic mapping and watershed applications. The objective of the present study is to generate high-resolution DEM, quality evaluation in different elevation strata, generation of ortho-rectified image and associated accuracy assessment from CARTOSAT-1 data based Ground Control Points (GCPs) for Aglar watershed (Tehri-Garhwal and Dehradun district, Uttarakhand, India). The present study reveals that generated DEMs (10m and 30m) derived from the CARTOSAT-1 stereo pair is much better and accurate when compared with existing DEMs (ASTER and CARTO DEM) also for different terrain parameters like slope, aspect, drainage, watershed boundaries etc., which are derived from the generated DEMs, have better accuracy and results when compared with the other two (ASTER and CARTO) DEMs derived terrain parameters.

Keywords: ASTER-DEM, CARTO-DEM, CARTOSAT-1, digital elevation model (DEM), ortho-rectified image, photogrammetry, RPC, stereo pair, terrain parameters

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1911 Evaluation of a Staffing to Workload Tool in a Multispecialty Clinic Setting

Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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1910 Impact of Climate Change on Forest Ecosystem Services: In situ Biodiversity Conservation and Sustainable Management of Forest Resources in Tropical Forests

Authors: Rajendra Kumar Pandey

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Forest genetic resources not only represent regional biodiversity but also have immense value as the wealth for securing livelihood of poor people. These are vulnerable to ecological due to depletion/deforestation and /or impact of climate change. These resources of various plant categories are vulnerable on the floor of natural tropical forests, and leading to the threat on the growth and development of future forests. More than 170 species, including NTFPs, are in critical condition for their survival in natural tropical forests of Central India. Forest degradation, commensurate with biodiversity loss, is now pervasive, disproportionately affecting the rural poor who directly depend on forests for their subsistence. Looking ahead the interaction between forest and water, soil, precipitation, climate change, etc. and its impact on biodiversity of tropical forests, it is inevitable to develop co-operation policies and programmes to address new emerging realities. Forests ecosystem also known as the 'wealth of poor' providing goods and ecosystem services on a sustainable basis, are now recognized as a stepping stone to move poor people beyond subsistence. Poverty alleviation is the prime objective of the Millennium Development Goals (MDGs). However, environmental sustainability including other MDGs, is essential to ensure successful elimination of poverty and well being of human society. Loss and degradation of ecosystem are the most serious threats to achieving development goals worldwide. Millennium Ecosystem Assessment (MEA, 2005) was an attempt to identify provisioning and regulating cultural and supporting ecosystem services to provide livelihood security of human beings. Climate change may have a substantial impact on ecological structure and function of forests, provisioning, regulations and management of resources which can affect sustainable flow of ecosystem services. To overcome these limitations, policy guidelines with respect to planning and consistent research strategy need to be framed for conservation and sustainable development of forest genetic resources.

Keywords: climate change, forest ecosystem services, sustainable forest management, biodiversity conservation

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1909 Importance of CT and Timed Barium Esophagogram in the Contemporary Treatment of Patients with Achalasia

Authors: Sanja Jovanovic, Aleksandar Simic, Ognjan Skrobic, Dragan Masulovic, Aleksandra Djuric-Stefanovic

Abstract:

Introduction: Achalasia is an idiopathic primary esophageal motility disorder characterized by esophageal peristalsis and impaired swallow-induced relaxation of the lower esophageal sphincter (LES). It is a rare disease that affects both genders with an incidence of 1/100.000 and a prevalence rate of 10/100,000 per year. Objective: Laparoscopic Heller myotomy (LHM) represents a therapy of choice for patients with achalasia, providing excellent outcomes. The aim of this study was to evaluate the significance of computed tomography (CT) in analyzing achalasia subtypes and timed barium esophagogram (TBE) in evaluation of LHM success, as a part of standardized diagnostic protocol. Method: Fifty-one patients with achalasia, confirmed by manometric studies, in addition to standardized diagnostic methods, underwent CT and TBE. CT was done with multiplanar reconstruction, measuring the wall thickness above the esophago-gastric junction in the axial plane. TBE was performed preoperatively and two days postoperatively swallowing low-density barium sulfate, and plane upright frontal films were performed 1, 2 and 5 minutes after the ingestion. In all patients, LHM was done, and pre and postoperative height and weight of the barium column were compared. Results: According to CT findings we divided patients into 3 subtypes of achalasia according to wall thickness: < 4mm as subtype one, between 4 - 9mm as II, and > 10 mm as subtype 3. Correlation of manometric results, as a reference values, and CT findings indicated CT sensitivity of 90% and specificity of 70 % in establishing subtypes of achalasia. The preoperative values of TBE at 1, 2 and 5 minutes were: median barium column height 17.4 ± 7.4, 15.9 ± 6.2 and 13.9 ± 6.2 cm; median column width 5 ± 1.5, 4.7 ± 1.6 and 4.5 ± 1.8 cm respectively. LHM significantly reduced these values (height 7 ± 4.6, 5.8 ± 4.2, 3.7 ± 3.4 cm; width 2.9 ± 1.3, 2.6 ± 1.3 and 2.4 ± 1.4 cm), indicating the quantitative estimates of emptying as excellent (p value < 0.01). Conclusion: CT has high sensitivity and specificity in evaluation of achalasia subtypes, and can be introduced as an additional method for standardized evaluation of these patients. The quantitative assessment of TBE based on measurements of the barium column is an accurate and beneficial method, which adequately estimates esophageal emptying success of LHM.

Keywords: achalasia, computed tomography, esophagography, myotomy

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1908 Computational System for the Monitoring Ecosystem of the Endangered White Fish (Chirostoma estor estor) in the Patzcuaro Lake, Mexico

Authors: Cesar Augusto Hoil Rosas, José Luis Vázquez Burgos, José Juan Carbajal Hernandez

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White fish (Chirostoma estor estor) is an endemic species that habits in the Patzcuaro Lake, located in Michoacan, Mexico; being an important source of gastronomic and cultural wealth of the area. Actually, it have undergone an immense depopulation of individuals, due to the high fishing, contamination and eutrophication of the lake water, resulting in the possible extinction of this important species. This work proposes a new computational model for monitoring and assessment of critical environmental parameters of the white fish ecosystem. According to an Analytical Hierarchy Process, a mathematical model is built assigning weights to each environmental parameter depending on their water quality importance on the ecosystem. Then, a development of an advanced system for the monitoring, analysis and control of water quality is built using the virtual environment of LabVIEW. As results, we have obtained a global score that indicates the condition level of the water quality in the Chirostoma estor ecosystem (excellent, good, regular and poor), allowing to provide an effective decision making about the environmental parameters that affect the proper culture of the white fish such as temperature, pH and dissolved oxygen. In situ evaluations show regular conditions for a success reproduction and growth rates of this species where the water quality tends to have regular levels. This system emerges as a suitable tool for the water management, where future laws for white fish fishery regulations will result in the reduction of the mortality rate in the early stages of development of the species, which represent the most critical phase. This can guarantees better population sizes than those currently obtained in the aquiculture crop. The main benefit will be seen as a contribution to maintain the cultural and gastronomic wealth of the area and for its inhabitants, since white fish is an important food and economical income of the region, but the species is endangered.

Keywords: Chirostoma estor estor, computational system, lab view, white fish

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