Search results for: risk management failure

Authors: Phillip Garrad, Saritha Unnikrishnan

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The recent popularity of connected and autonomous vehicles (CAV) corresponds with an increase in the risk of cyber-attacks. These cyber-attacks have been instigated by both researchers or white-coat hackers and cyber-criminals. As Connected Vehicles move towards full autonomy, the impact of these cyber-attacks also grows. The current research details challenges faced in cybersecurity testing of CAV, including access and cost of the representative test setup. Other challenges faced are lack of experts in the field. Possible solutions to how these challenges can be overcome are reviewed and discussed. From these findings, a software simulated CAV network is established as a cost-effective representative testbed. Penetration tests are then performed on this simulation, demonstrating a cyber-attack in CAV. Studies have shown Artificial Intelligence (AI) to improve runtime, increase efficiency and comprehensively cover all the typical test aspects in penetration testing in other industries. There is an attempt to introduce similar AI models to the software simulation. The expectation from this implementation is to see similar improvements in runtime and efficiency for the CAV model. If proven to be an effective means of penetration test for CAV, this methodology may be used on a full CAV test network.

Keywords: cybersecurity, connected vehicles, software simulation, artificial intelligence, penetration testing

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Authors: Ahmet Yetik, Seyit Ali Kara, Cevat Özarpa

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Load changes occur on natural gas and oil pipelines due to natural disasters. The displacement of the soil around the natural gas and oil pipes due to situations that may cause erosion, such as earthquakes, landslides, and floods, is the source of this load change. The exposure of natural gas and oil pipes to variable loads causes deformation, cracks, and breaks in these pipes. Cracks and breaks on the pipes cause damage to people and the environment due to reasons such as explosions. Especially with the examinations made after natural disasters, it can be easily understood which of the pipes has more damage in the regions followed. It has been determined that the earthquakes in Turkey caused permanent damage to the pipelines. This project was designed and realized because it was determined that there were cracks and gas leaks in the insulation gaskets placed in the pipelines, especially at the junction points. In this study, A new SCADA (Supervisory Control and Data Acquisition) application has been developed to monitor load changes caused by natural disasters. The newly developed SCADA application monitors the changes in the x, y, and z axes of the stresses occurring in the pipes with the help of strain gauge sensors placed on the pipes. For the developed SCADA system, test setups in accordance with the standards were created during the fieldwork. The test setups created were integrated into the SCADA system, and the system was followed up. Thanks to the SCADA system developed with the field application, the load changes that will occur on the natural gas and oil pipes are instantly monitored, and the accumulations that may create a load on the pipes and their surroundings are immediately intervened, and new risks that may arise are prevented. It has contributed to energy supply security, asset management, pipeline holistic management, and sustainability.

Keywords: earthquake, natural gas pipes, oil pipes, strain measurement, stress measurement, landslide

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Authors: Vincenzo Piemonte

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The liver is a complex, large-scale biochemical reactor which plays a unique role in the human physiology. When liver ceases to perform its physiological activity, a functional replacement is required. Actually, liver transplantation is the only clinically effective method of treating severe liver disease. Anyway, the aforementioned therapeutic approach is hampered by the disparity between organ availability and the number of patients on the waiting list. In order to overcome this critical issue, research activities focused on liver support device systems (LSDs) designed to bridging patients to transplantation or to keep them alive until the recovery of native liver function. In recirculating albumin dialysis devices, such as MARS (Molecular Adsorbed Recirculating System), adsorption is one of the fundamental steps in albumin-dialysate regeneration. Among the albumin-bound toxins that must be removed from blood during liver-failure therapy, bilirubin and tryptophan can be considered as representative of two different toxin classes. The first one, not water soluble at physiological blood pH and strongly bounded to albumin, the second one, loosely albumin bound and partially water soluble at pH 7.4. Fixed bed units are normally used for this task, and the design of such units requires information both on toxin adsorption equilibrium and kinetics. The most common adsorptive media used in LSDs are activated carbon, non-ionic polymeric resins and anionic resins. In this paper, bilirubin adsorption isotherms on different adsorptive media, such as polymeric resin, albumin-coated resin, anionic resin, activated carbon and alginate beads with entrapped albumin are presented. By comparing all the results, it can be stated that the adsorption capacity for bilirubin of the five different media increases in the following order: Alginate beads < Polymeric resin < Albumin-coated resin < Activated carbon < Anionic resin. The main focus of this paper is to provide useful guidelines for the optimization of liver support devices which implement adsorption columns to remove albumin-bound toxins from albumin dialysate solutions.

Keywords: adsorptive media, adsorption equilibrium, artificial liver devices, bilirubin, mathematical modelling

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Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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Authors: D. T. Chabalala, J. M. Ndambuki, M. F. Ilunga

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Sedimentation includes the processes of erosion, transportation, deposition, and the compaction of sediment. Sedimentation in reservoir results in a decrease in water storage capacity, downstream problems involving aggregation and degradation, blockage of the intake, and change in water quality. A study was conducted in Caledon River catchment in the upstream of Welbedacht Reservoir located in the South Eastern part of Free State province, South Africa. The aim of this research was to investigate and develop a model for an Integrated Catchment Modelling of Sedimentation processes and management for the Welbedacht reservoir. Revised Universal Soil Loss Equation (RUSLE) was applied to determine sources of sediment at different areas of the catchment. The model has been also used to determine the impact of changes from management practice on erosion generation. The results revealed that the main sources of sediment in the watershed are cultivated land (273 ton per hectare), built up and forest (103.3 ton per hectare), and grassland, degraded land, mining and quarry (3.9, 9.8 and 5.3 ton per hectare) respectively. After application of soil conservation practices to developed Revised Universal Soil Loss Equation model, the results revealed that the total average annual soil loss in the catchment decreased by 76% and sediment yield from cultivated land decreased by 75%, while the built up and forest area decreased by 42% and 99% respectively. Thus, results of this study will be used by government departments in order to develop sustainable policies.

Keywords: Welbedacht reservoir, sedimentation, RUSLE, Caledon River

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Authors: Lamis Naddaf, Yuval Tabach

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We identified missense genetic variants with the potential to enhance resistance against cancer. Such a field has not been widely explored as researchers tend to investigate the mutations that cause diseases, in response to the suffering of patients, rather than those mutations that protect from them. In conjunction with the genomic revolution and the advances in genetic engineering and synthetic biology, identifying the protective variants will increase the power of genotype-phenotype predictions and have significant implications for improved risk estimation, diagnostics, prognosis, and even personalized therapy and drug discovery. To approach our goal, we systematically investigated the sites of the coding genomes and selected the alleles that showed a correlation with the species’ cancer resistance. Interestingly, we found several amino acids that are more generally preferred (like the Proline) or avoided (like the Cysteine) by the resistant species. Furthermore, Cancer resistance in mammals and reptiles is significantly predicted by the number of the predicted protecting variants (PVs) a species has. Moreover, PVs-enriched-genes are enriched in pathways relevant to tumor suppression. For example, they are enriched in the Hedgehog signaling and silencing pathways, which its improper activation is associated with the most common form of cancer malignancy. We also showed that the PVs are mostly more abundant in healthy people compared to cancer patients within different human races.

Keywords: cancer resistance, protecting variant, naked mole rat, comparative genomics

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Authors: K. Berhanu

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Improper land use results in land degradation and decline in agricultural productivity. Hence, in order to get maximum benefits out of land, proper utilization of its resources is inevitable. The present study was aimed at identifying the landcover changes in the study area in the last 25 years and determines the extent and direction of change that has occurred. The study made use of Landsat TM 1986 and 2011 Remote Sensing Satellite Image for analysis to determine the extent and pattern of rangeland change. The results of the landuse/landcover change detection showed that in the last 25 years, 3 major changes were observed, grassland and open shrub-land resource significantly decreased at a rate of 17.1km2/year and 12 km2/year/, respectively. On the other hand in 25 years dense bushland, open bush land, dense shrubland and cultivated land has shown increment in size at a rate of 0.23km2/year,13.5 km2/year, 6.3 km2/year and 0.2 km2/year, respectively within 25 years. The expansion of unpalatable woody species significantly reduced the rangeland size and availability of grasses. The consequence of the decrease in herbaceous biomass production might result in high risk of food insecurity in the area unless proper interventions are made in time.

Keywords: GIS and remote sensing, Dire District, land use/land cover, land sat TM

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Authors: T. Warinpramote, J. Sanguanjeen, P. Pholphakwaen, S. Kittisorayut, J. Kerdtubtim, S. Palachote, M. Taweechotipatr

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Cholesterol is a type of lipid molecule which is the significant risk factor for coronary heart disease. Currently, there are many cholesterol-lowering alternative treatments especially bile salt hydrolase positive lactobacilli. BSH can cleave the peptide linkage of bile salt, which results in removal of the amino acid group from the steroid core and increases production of the new bile acid by using more cholesterol. The purpose of this study was to isolate, and screen probiotic characteristics of lactobacilli from fermented Thai foods and further investigated for their comparative BSH activity. The result showed that 2 of 81 Lactobacillus strains, JPK2-2 and JPK3-2, isolated from Brassica juncea (L.) had significantly exhibited high BSH activity. In addition, these Lactobacillus strains showed their results that the ability to tolerate acid and bile salt. Furthermore, the using of 16S rDNA sequencing for definitive microbial identifications showed that these 2 strains belong to Lactobacillus plantarum. In the future, the L. plantarum with BSH activity strains JPK2-2 and JPK3-2 may be the candidate probiotics for application in functional foods and dairy products to improve in the patient with cardiovascular diseases.

Keywords: Lactobacillus plantarum, probiotics, bile salt hydrolase, cholesterol-lowering, fermented Thai food

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Authors: Anne Camille P. Balabag, Via B. Cabarda, Ruffa Mae Lomboy, Aira Joyce Nesus

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Nowadays, Filipinos seem to dominate the outsourcing industry, one factor that affects quality service is organization mismanagement. Traditionally, Filipino promotions are based on tenure rather than competence. Seniority refers to a superior rank that an employee holds in an industrial setting based on a position withheld in a company. Yet, seniority also holds the paradigm for Filipino family structures. With this, the researchers believe that Filipinos have a deeper take on seniority, which became the motivation for this study. The researchers wanted to contextualize the Filipino concept of seniority, the perception, and reactions of Filipino employees to its existence, and uncover their relevant experiences within the industrial setting. Following a phenomenological research design, data collected from ten (10) participants with various demographic backgrounds, chosen through purposive sampling, and interviewed utilizing a semi-structured interview and analyzed using thematic analysis revealed seven primary themes: (1) Reality of Tenureship and Competence, (2) Disparity in Age Influence, (3) Special Power of Seniority, (4) Seniority is Necessity, (5) The Filipino Organizational Values, (6) Art of Seniority in Human Resource, and (7) Confessions of the Inner Child. The findings suggest that seniority exists based on a ranking system created through human resource management and mirrored from traditional Filipino values. Also, the researchers identified three Filipino industrial values: respect, pakikipagkapwa-tao (treating others as a fellow human being), and utang na loob (debt of gratitude). Lastly, birth order was found to have direct and indirect effects on their conduct in an industrial context.

Keywords: organizational psychology, human resource management, filipino psychology, industrial values

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Authors: Narendra Kumar

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In developing countries, the majority of people with diabetes are in the age range of 45-64 years and more women than men. As in many areas of the India, non-insulin dependent diabetes mellitus has become major problems. Now it is spreading among the middle class and poor at an alarming stage in India and Kerala is turning to be the world capital of diabetes. This study uses two round NSS data from the ‘National Sample Survey Organization, India’ to investigate the predictors of diabetes in Kerala. The overall estimates for diabetes prevalence among elderly show that higher in men than women, but there are more women with diabetes than men. Education of respondent has been found a significant characteristics, further respondent working status, caste/tribe have substantial impact on diabetes in Kerala. The disease is more common for people who are mostly physically inactive. This whole picture is very much prominent in the urban areas compared with the rural ones. Not working elderly have significantly higher with diabetes than for those working in elderly. Socioeconomic status was inversely associated with diabetes prevalence. For men and women, the prevalence of diabetes and hypertension were significantly higher in the urban population while smoking, smokeless tobacco consumption was more prevalent in the rural population. High alcohol intake increases diabetes risk among elderly. Finally these findings specified that an increase improve health care services and changing life style of elderly which should in turn raise diabetes patient survival and should decrease comorbidities due to diabetes in Kerala.

Keywords: elderly, diabetes, prevalence, Kerala

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Authors: Li-Ching Chen

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The case-control design has been widely applied in clinical and epidemiological studies to investigate the association between risk factors and a given disease. The retrospective design can be easily implemented and is more economical over prospective studies. To adjust effects for confounding factors, methods such as stratification at the design stage and may be adopted. When some major confounding factors are difficult to be quantified, a matching design provides an opportunity for researchers to control the confounding effects. The matching effects can be parameterized by the intercepts of logistic models and the conditional logistic regression analysis is then adopted. This study demonstrates an information-matrix-based goodness-of-fit statistic to test the validity of the logistic regression model for matched case-control data. The asymptotic null distribution of this proposed test statistic is inferred. It needs neither to employ a simulation to evaluate its critical values nor to partition covariate space. The asymptotic power of this test statistic is also derived. The performance of the proposed method is assessed through simulation studies. An example of the real data set is applied to illustrate the implementation of the proposed method as well.

Keywords: conditional logistic model, goodness-of-fit, information matrix, matched case-control studies

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Authors: Okhee Woo

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Purpose: The aim of this study is to evaluate 2-year cumulative effective radiation dose and cumulative organ dose on regular follow-up computed tomography (CT) scans in patients with breast cancer and to establish personalized low-dose CT protocol. Methods and Materials: A retrospective study was performed on the patients with breast cancer who were diagnosed and managed consistently on the basis of routine breast cancer follow-up protocol between 2012-01 and 2016-06. Based on ICRP (International Commission on Radiological Protection) 103, the cumulative effective radiation doses of each patient for 2-year follow-up were analyzed using the commercial radiation management software (Radimetrics, Bayer healthcare). The personalized effective doses on each organ were analyzed in detail by the software-providing Monte Carlo simulation. Results: A total of 3822 CT scans on 490 patients was evaluated (age: 52.32±10.69). The mean scan number for each patient was 7.8±4.54. Each patient was exposed 95.54±63.24 mSv of radiation for 2 years. The cumulative CT radiation dose was significantly higher in patients with lymph node metastasis (p = 0.00). The HER-2 positive patients were more exposed to radiation compared to estrogen or progesterone receptor positive patient (p = 0.00). There was no difference in the cumulative effective radiation dose with different age groups. Conclusion: To acknowledge how much radiation exposed to a patient is a starting point of management of radiation exposure for patients with long-term CT follow-up. The precise and personalized protocol, as well as iterative reconstruction, may reduce hazard from unnecessary radiation exposure.

Keywords: computed tomography, breast cancer, effective radiation dose, cumulative organ dose

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Authors: T. M. Tawfik, M. A. Badr, E. Y. El-Kady, O. E. Abdellatif

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Electric power shortage is a serious problem in remote rural communities in Egypt. Over the past few years, electrification of remote communities including efficient on-site energy resources utilization has achieved high progress. Remote communities usually fed from diesel generator (DG) networks because they need reliable energy and cheap fresh water. The main objective of this paper is to design an optimal economic power supply from hybrid standalone energy system (HSES) as alternative energy source. It covers energy requirements for reverse osmosis desalination unit (DU) located in National Research Centre farm in Noubarya, Egypt. The proposed system consists of PV panels, Wind Turbines (WT), Batteries, and DG as a backup for supplying DU load of 105.6 KWh/day rated power with 6.6 kW peak load operating 16 hours a day. Optimization of HSES objective is selecting the suitable size of each of the system components and control strategy that provide reliable, efficient, and cost-effective system using net present cost (NPC) as a criterion. The harmonization of different energy sources, energy storage, and load requirements are a difficult and challenging task. Thus, the performance of various available configurations is investigated economically and technically using iHOGA software that is based on genetic algorithm (GA). The achieved optimum configuration is further modified through optimizing the energy extracted from renewable sources. Effective minimization of energy charging the battery ensures that most of the generated energy directly supplies the demand, increasing the utilization of the generated energy.

Keywords: energy management, hybrid system, renewable energy, remote area, optimization

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Authors: Nazir Amir

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Teaching approaches to present science and mathematics content amongst academically-low-achieving students may need to be different than approaches that are adopted for the more academically-inclined students, primarily due to the different learning needs and learning styles of these students. In crafting out lessons to motivate and engage these students, teachers need to consider the backgrounds of these students and have a good understanding of their interests so that lessons can be presented in ways that appeal to them, and made relevant not just to the world around them, but also to their personal experiences. This presentation highlights how the author worked with a Professional Learning Community (PLC) of teachers in crafting out fun and feasible classroom teaching approaches to present science and mathematics content in ways that are made Relevant, Appealing, and Personal (RAP) to groups of academically-low-achieving students in Singapore. Feedback from the students and observations from their work suggest that they were engaged through the RAP-modes of instruction, and were able to appreciate the role of science and mathematics through a variety of low-cost design-based STEM (Science, Technology, Engineering, and Mathematics) activities. Such results imply that teachers teaching academically-low-achieving students, and those in under-resourced communities, could consider infusing RAP-infused instructions into their lessons in getting students develop positive attitudes towards STEM subjects.

Keywords: STEM Education, STEAM Education, Curriculum Instruction, Academically At-Risk Students, Singapore

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Authors: Muhammad Xaaceph Khan, Abida Butt, Farah Kausar

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Due to geogenic and anthropogenic factors, heavy metals concentrations increased throughout the world and deposit into soil. Thus available to different plants and travel in different food chains. The present study was designed to achieve bioaccumulation of Cd and Zn in the wheat-aphid-beetle food chain. For this purpose, wheat plants were grown in three different treatments: Cd, Zn, Cd+Zn. Data showed that Cd content in soil and wheat plant increases with increase in Cd concentration while plant weighs, panicle weight, seed number per panicle and seed weight per panicle decreases with increase in Cd content in the soil. Zn content in soil and wheat plant increases with increase in Cd concentration while plant weighs, panicle weight, seed number per panicle, and seed weight per panicle increase with an increase in Zn content in the soil. With the addition of Zn in Cd-treated soil, the uptake of Cd decreases in all parts of wheat plants. Bioaccumulation from wheat plant to aphids and then its predators were also studied. Cd concentration increases from low to high concentration in all arthropods. Same was observed in Zn concentrations, while in Cd+Zn, Cd accumulation decreases but Zn accumulates increases. Health risk index (HRI) also showed that in the presence of Zn, the HRI improves and can help to reduce health risks associated with Cd.

Keywords: aphid, beetle, bioaccumulation, cadmium, wheat, zinc

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Authors: Edward Ridyard, Vinary Varadarajan

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Background and Aims: The first year as a doctor in any country represents a major career transition in any physician's life. During this period, many physicians concentrate on obtaining clinical skills but may not obtain the important skills necessary to cope with stress. In this study we elucidate stress levels amongst FY1 doctors regarding the transitioning into specialty career choices, working in the NHS and anxiety about future career success. Methods: A prospective single blinded analysis of Foundation Year one (FY1) trainees using a non-mandatory online questionnaire was distributed. No exclusion criteria were applied. The only inclusion criteria was the doctor was in a full-time FY1 post and this was their first job in the UK. A total of n= 22 doctors were included in the study. After data collection, statistical analysis using chi-squared testing was applied. Results: The large majority of FY1 doctors (72.7%) already knew what specialty they wished to pursue (p=0.0001). With regards to their future careers 45.5% of FY1 doctors stated "above average" stress levels. The majority of FY1 doctors (64.3%) stated their stress levels working in the NHS were either "above average" or "high". Finally, 81.8% of respondents know colleagues who have been put off from pursuing specialties due to the stress of competition. Conclusions: A large majority of FY1 doctors already know at this early stage what area they would like to specialise in. With this in mind, a large proportion have above "average" levels of stress with regards to securing this future career path. The most worrying finding is that 64.3% of FY1s stated they had "above average" or "high" stress levels working in the NHS. We therefore recommend formal stress management education to be incorporated into the foundation programme curriculum.

Keywords: stress, anxiety, junior doctor, education

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Authors: Saqib Ali

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Sources are classified into two depending upon the factor of reviving. These sources, which cannot be revived into their original shape once they are consumed, are considered as nonrenewable energy resources, i.e., (coal, fuel) Moreover, those energy resources which are revivable to the original condition even after being consumed are known as renewable energy resources, i.e., (wind, solar, hydel) Renewable energy is a cost-effective way to generate clean and green electrical energy Now a day’s majority of the countries are paying heed to energy generation from RES Pakistan is mostly relying on conventional energy resources which are mostly nonrenewable in nature coal, fuel is one of the major resources, and with the advent of time their prices are increasing on the other hand RES have great potential in the country with the deployment of RES greater reliability and an effective power system can be obtained In this thesis, a similar concept is being used and a hybrid power system is proposed which is composed of intermixing of renewable and nonrenewable sources The Source side is composed of solar, wind, fuel cells which will be used in an optimal manner to serve load The goal is to provide an economical, reliable, uninterruptable power supply. This is achieved by optimal controller (PI, PD, PID, FOPID) Optimization techniques are applied to the controllers to achieve the desired results. Advanced algorithms (Particle swarm optimization, Flower Pollination Algorithm) will be used to extract the desired output from the controller Detailed comparison in the form of tables and results will be provided, which will highlight the efficiency of the proposed system.

Keywords: distributed generation, demand-side management, hybrid power system, micro grid, renewable energy resources, supply-side management

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Shirin Sarejloo

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Background: Electrophysiological-related manifestation of COVID-19 is a matter of debate in the literature nowadays. A wide spectrum of arrhythmias was observed among patients who have been infected with COVID-19. Objectives: This study discussed the prevalence of arrhythmias and conduction system disease in patients with COVID-19. Method: In this retrospective study, demographic and electrocardiographic data of 432 expired COVID-19 patients who had been admitted to Faghihi Hospital of Shiraz University of Medical Sciences from August2020 until December 2020 were reviewed. Results: Atrioventricular nodal block (AVB) was found in 40(9.3%) patients. Furthermore, 28(6.5%) of them suffered from the first degree of AVB, and 12(2.8%) suffered from complete heart block (CHB). Among 189 cases (59.0%), ST-T changes agreed with myocardial infarction or localized myocarditis. Findings of myocardial injury, including fragmented QRS and prolonged QTc were observed among 91 (21.1%) and 28 (6.5%), respectively. In victims of COVID-19, conduction disease was not related to any comorbidities. Fragmented QRS, axis deviation, presence of S1Q3T3, and poor R wave progression were significantly related to conduction system abnormalities in victims of COVID-19 (P-value > 0.05). Conclusion: Our findings can serve in future studies that aim to develop a risk stratification method for susceptible COVID-19 patients. The myocardial injury appears to role significantly in COVID-19 morbidity and mortality. Consequently, we recommend health policymakers consider separate catheterization laboratories that provide service only to COVID-19 patients.

Keywords: COVID-19, conduction system, ECG, atrioventricular block

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Authors: Cinzia Cruder, Deborah Falla, Francesca Mangili, Laura Azzimonti, Liliana Araujo, Aaron Williamon, Marco Barbero

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Background and aims: According to the existing literature, musicians are at risk to experience a range of musculoskeletal painful conditions. Recently, digital technology has been developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing analysis. Additionally, the association between pain drawing (PD) variables and clinical features in musicians with pain were explored. Materials and Methods: One hundred fifty-eight musicians (90 women and 68 men; age 22.4±3.6 years) were recruited from Swiss and UK conservatoires. Participants were asked to complete a survey including both background musical information and clinical features, the Quick Dash (QD) questionnaire and the digital PDs. Results: Of the 158 participants, 126 musicians (79.7%) reported having pain, with more prevalence in the areas of the neck and shoulders, the lower back and the right arm. The mean of pain extent was 3.1% ±6.5. The mean of QD was larger for musicians showing the presence of pain than for those without pain. Additionally, the results indicated a positive correlation between QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity. Conclusions: The high prevalence of pain among musicians has been confirmed using a digital PD. In addition, positive correlations between pain extent and upper limb disability has been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.

Keywords: pain location, pain extent, musicians, pain drawings

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Authors: Rizgar Abdullah Sabir Jaf, Bayan Sedeeq Azeez Hussin, Dler Moosa Ahmed Karim

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Presently, economic and technological developments are growing faster in an unparalleled way. The result of that is innovative changing a great deal of a great deal of assumption, concepts, transactions, and high of competition between companies all over the world. The title of the thesis is one of the subjects that get large concerns in the financial and business world in the present time. That is because many competitive firms have appeared in the regional and global markets and the rapid changes that covered all fields of life. The subjects of the dissertation have a special importance in making the firm's businesses succeed in general and the industrial firms especially. Thus, the basic purpose of this study is to determine whether target costing is used in the costing application process in their customer expectation, profit margin, cost and price determination, cost reduction and management operations. In today’s intensely competitive and highly volatile business environment, consistent development of low cost and high quality products meeting the functional requirements is a key to a company's survival. Companies continuously strive to reduce the costs while still producing quality products to stay ahead in the competition. Many companies have turned to target costing to achieve this objective. The results indicate that there is a significant positive relationship (at the significance level less than 0.05) between the factors competitive advantage and management accounting techniques in the firm's sample study.

Keywords: strategic information, target cost, competitive advantage, Iraqi soft drink firms

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Saurav Kumar

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Rural-urban migration is the most commonly adopted strategy in rural areas to overcome the risk associated with the subsistence economy and diversify income. The Garhwal Himalaya has the highest rate of rural-urban migration in India, which has serious repercussions. Despite this, there is a dearth of literature on the implications of rural-urban migration in the Garhwal Himalaya. This paper attempts to fill this void. The objectives of the paper are to look into various types, patterns, determinants, and implications of rural-urban migration in the Garhwal Himalaya. In order to meet the objectives, 15 villages were selected from five districts of the Garhwal Himalaya. In every district, three villages were chosen from different altitudes, including five from river valleys, five from mid-altitudes, and five from highlands. The villages range in altitude from 550m to 2660m. A total of 658 households were surveyed from the villages, covering 100% samples from each village. Using a structured questionnaire, the author asked the heads of each household about the types of rural-urban migration they practiced, the year of first migration, destinations of migration, and reasons for migration. Further, migrants’ age, sex, caste, marital status, educational background, income, occupation, and remittances sent by migrants were also inquired about. The study reveals that rural-urban migration is a serious problem in Garhwal Himalayas, posing various socio-economic issues. Without immediate action, it will have serious consequences. Finally, this study suggests some policy measures to minimize the current rate of rural-urban migration in the Garhwal Himalaya.

Keywords: rural-urban migration, Garhwal Himalaya, patterns, determinants, implications

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Authors: Anusha Vaddiraj Pallapu

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Across the globe, there is a steady increase in people residing in urban areas. Due to this increase in urban population, urban health is affecting. The major issues identified like overcrowding, air pollution, unhealthy diet, inadequate infrastructure, poor solid waste management systems and insufficient access to health facilities, these issues are gradually clearly observed in health statistics of diseases and deaths rapidly increase in urban areas. Therefore, the present study aims to assess the health statistics and infrastructure services at urban areas to know the cause and effect between Infrastructure, its management and diseases (water borne). Most of the Indian cities have the municipal boundaries, which authorized by their respective municipal corporations and development authorities. Generally, cities have various zones under which municipal wards exist. The paper focuses on the city Ahmedabad, at Gujarat state. Ahmedabad Municipal Corporation (AMC) is divided into six zones namely Central zone, West zone, New-West zone, East zone, North zone, and South zone. Each zone includes various wards within it. Incidence of diseases in Ahmadabad which are linked to infrastructure was identified such as water-borne diseases. Later on, the occurrence of water-borne diseases at urban area was examined at each zone level. The study methodology follows four steps i.e. 1) Pre-Field literature study: Study on Sewerage system in urban areas and its best practices and public health status globally and Indian scenario; 2) Field study: Data collection and interviews of stakeholders regarding heal status and issues at each zone and ward level; 3) Post field: Data analysis with qualitative description of each ward of zones, followed by correlation coefficient analysis between sewerage coverage, diseases and density of each ward using geographic information system mapping (GIS); 4) Identification of reasons: Affected health on each of zone and wards followed by correlation analysis on each reason. The results reveal that the health conditions in Ahmedabad municipal zones or boundaries are effected due to the slums created by the migrated people from various rural and urban areas. It is also observed that due to increase in population water supply and sewerage management is affecting. The overall effect on infrastructure is creating the health diseases which detailed in the paper using geographical information system in Indian city.

Keywords: infrastructure, municipal wards, GIS, water supply, sewerage, medical facilities, water borne diseases

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Authors: Sheila R. Pai, N. K. Subbalakshmi, C. Vidya

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Background: Accumulating evidence from prospective studies suggests an increased risk of type 2 diabetes associated with sleep deprivation and sleep disorders. Shift work by disrupting the circadian rhythm, could possibly cause metabolic disturbances. Objective: To investigate the influence of shift work on fasting blood glucose in hospital workers population. Materials and Methods: This was a cross-sectional study including 90 night shift workers (study group) and 90 day workers (controls) drawn from paramedical personnel. Night shift work was on a forward rotation basis, with an average of one night shift every 4 weeks. Each night shift rotation was for a period of 7 days, with a total of 8 hours of shift work per night. In the entire subjects body mass index (BMI) and fasting blood sugar (FBS) was measured. Statistical analysis included unpaired t test, Mann-Whitney ‘U’ test and Chi-square test. P value less than 0.05 was considered significant. Result: The study and control groups were comparable with regard to age, sex distribution and duration of employment. FBS was higher in study group compared to controls (p < 0.0001). There was no significant difference in BMI between control and study group. Conclusion: Shift work may adversely influence glucose metabolism.

Keywords: shift work, fasting blood sugar, sleep disturbances, diabetes

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Authors: Chenyu Huang, Minrong Cui, Hua Fang, Luqing Zhang, Yunlong Yu

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The emergence and spread of antibiotic resistance genes (ARGs) have become a pressing issue in global agricultural production. However, understanding how these ARGs spread across different spatial scales, especially when exposed to both pesticides and antibiotics, has remained a challenge. Here, metagenomic assembly and binning methodologies were used to determine the mechanism of ARG propagation within soil-lettuce systems exposed to both fungicides and antibiotics. The results of our study showed that the presence of fungicide and antibiotic stresses had a significant impact on certain bacterial communities. Notably, we observed that ARGs were primarily transferred from the soil to the plant through plasmids. The selective pressure exerted by fungicides and antibiotics contributed to an increase in unique ARGs present on lettuce leaves. Moreover, ARGs located on chromosomes and plasmids followed different transmission patterns. The presence of diverse selective pressures, a result of compound treatments involving antibiotics and fungicides, amplifies this phenomenon. Consequently, there is a higher probability of bacteria developing multi-antibiotic resistance under the combined pressure of fungicides and antibiotics. In summary, our findings highlight that combined fungicide and antibiotic treatments are more likely to drive the acquisition of ARGs within the soil-plant system and may increase the risk of human ingestion.

Keywords: soil-lettuce system, fungicide, antibiotic, ARG, transmission

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Authors: Piyaphan Changwatchai

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Global value chain is important for current world economy through foreign direct investment. Multinational enterprises' efficient location seeking for each stage of production lead to global production network and more global value chain participation of several countries. Global value chain participation has several effects on participating countries in several aspects including the environment. The effect of global value chain participation on the environment is ambiguous. As a result, this research aims to study the effect of global value chain participation on countries' CO₂ emission and methane emission by using quantitative analysis with secondary panel data of sixty countries. The analysis is divided into two types of global value chain participation, which are forward global value chain participation and backward global value chain participation. The results show that, for forward global value chain participation, GDP per capita affects two types of pollutants in downward bell curve shape. Forward global value chain participation negatively affects CO₂ emission and methane emission. As for backward global value chain participation, GDP per capita affects two types of pollutants in downward bell curve shape. Backward global value chain participation negatively affects methane emission only. However, when considering Asian countries, forward global value chain participation positively affects CO₂ emission. The recommendations of this research are that countries participating in global value chain should promote production with effective environmental management in each stage of value chain. The examples of policies are providing incentives to private sectors, including domestic producers and MNEs, for green production technology and efficient environment management and engaging in international agreements in terms of green production. Furthermore, government should regulate each stage of production in value chain toward green production, especially for Asia countries.

Keywords: CO₂ emission, environment, global value chain participation, methane emission

Procedia PDF Downloads 176

Authors: Maria Angelica Trak-Fellermeier, Alison K. Macchi, Rodolfo Galvan, Yolangel Hernandez, Thresia Gambon, Rebeca Martinez, Cristina Palacios

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Poor lifestyle habits, vitamin D deficiency, and inadequate calcium intake, particularly during the COVID-19 pandemic, may contribute to severe osteopenia in childhood, increasing future fractures and osteoporosis risk. We here present a case of osteopenia in a 13-year-old white, Hispanic, premenarchal girl who completed the baseline visit of the MetA-Bone Trial during the COVID-19 pandemic. The premenarchal girl has a family history of osteoporosis (maternal grandfather) but no previous fractures; moderate outdoor activity was <1 hour/day 3 times/week with 8 hours/day of sleep. Consumption of dairy products and vegetables was <1 serving/day. Lab blood tests confirmed vitamin D deficiency (serum 25(OH)D: 9 ng/L) and hyperphosphatemia (5.2 mg/dL); other tests were normal. DXA scan Z‐score was ‐2.2 SD (indicative of osteopenia by age and sex). The premenarchal girl was referred to a pediatrician, who confirmed the results, and prescribed a daily supplement with 2000 IU of vitamin D and 1000 mg of calcium. Seclusion during the COVID-19 pandemic may have contributed to the severity of the findings. Therefore, we recommend screening children undergoing growth spurts for vitamin D, calcium, and poor lifestyle habits during and after the pandemic.

Keywords: bone mass, vitamin D, puberty, Hispanic

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Authors: Alaa Koaik, Bruno Jurkiewiez, Sylvain Bel

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Recently, the use of GFRP pultruded profiles increased in the domain of civil engineering especially in the construction of sandwiched slabs and footbridges. However, under heavy loads, the risk of using these profiles increases due to their high deformability and instability as a result of their weak stiffness and orthotropic nature. A practical solution proposes the assembly of these profiles with concrete slabs to create a stiffer hybrid element to support higher loads. The connection of these two elements is established either by traditional means of steel studs (bolting in our case) or bonding technique. These two techniques have their advantages and disadvantages regarding the mechanical behavior and in-situ implementation. This paper presents experimental results of interface characterization and bending behavior of two hybrid beams, PB7 and PB8, designed and constructed using both connection techniques. The results obtained are exploited to design and build a hybrid footbridge BPBP1 which is tested within service limits (elastic domain). Analytical methods are also developed to analyze the behavior of these structures in the elastic range and the ultimate phase. Comparisons show acceptable differences mainly due to the sensitivity of the GFRP moduli as well as the non-linearity of concrete elements.

Keywords: analytical model, concrete, flexural behavior, GFRP pultruded profile, hybrid structure, interconnection slip, push-out

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Authors: Petri Kouvo, Aino Kainulainen, Kimmo Koivunen

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Separate collection system for recyclable wastes in the Helsinki region was ranked second best of European capitals. The collection system includes paper, cardboard, glass, metals and biowaste. Residual waste is collected and used in energy production. The collection system excluding paper is managed by the Helsinki Region Environmental Services HSY, a public organization owned by four municipalities (Helsinki, Espoo, Kauniainen and Vantaa). Paper collection is handled by the producer responsibility scheme. The efficiency of the collection system in the Helsinki region relies on a good coverage of door-to-door-collection. All properties with 10 or more dwelling units are required to source separate biowaste and cardboard. This covers about 75% of the population of the area. The obligation is extended to glass and metal in properties with 20 or more dwelling units. Other success factors include public awareness campaigns and a fee system that encourages recycling. As a result of waste management regulations for source separation of recyclables and biowaste, nearly 50 percent of recycling rate of household waste has been reached. For households and small and medium size enterprises, there is a sorting station fleet of five stations available. More than 50 percent of wastes received at sorting stations is utilized as material. The separate collection of plastic packaging in Finland will begin in 2016 within the producer responsibility scheme. HSY started supplementing the national bring point system with door-to-door-collection and pilot operations will begin in spring 2016. The result of plastic packages pilot project has been encouraging. Until the end of 2016, over 3500 apartment buildings have been joined the piloting, and more than 1800 tons of plastic packages have been collected separately. In the summer 2015 a novel partial flow digestion process combining digestion and tunnel composting was adopted for source separated household and commercial biowaste management. The product gas form digestion process is converted in to heat and electricity in piston engine and organic Rankine cycle process with very high overall efficiency. This paper describes the efficient collection system and discusses key success factors as well as main obstacles and lessons learned as well as the partial flow process for biowaste management.

Keywords: biowaste, HSY, MSW, plastic packages, recycling, separate collection

Procedia PDF Downloads 203