Search results for: continuous improvement

Authors: Ibrahim Turfanda, Soniya Rai, Karan Vadher

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Objectives— The study aims to compare real-world adherence to and persistence with dulaglutide and liraglutide in patients with type 2 diabetes (T2D) initiating treatment in UAE. Methods— This was a retrospective, non-interventional study (observation period: 01 March 2017–31 August 2019) using the UAE Dubai e-Claims database. Included: adult patients initiating dulaglutide/liraglutide 01 September 2017–31 August 2018 (index period) with: ≥1 claim for T2D in the 6 months before index date (ID); ≥1 claim for dulaglutide/liraglutide during index period; and continuous medical enrolment for ≥6 months before and ≥12 months after ID. Key endpoints, assessed 3/6/12 months after ID: adherence to treatment (proportion of days covered [PDC; PDC ≥80% considered ‘adherent’], per-group mean±standard deviation [SD] PDC); and persistence (number of continuous therapy days from ID until discontinuation [i.e., >45 days gap] or end of observation period). Patients initiating dulaglutide/liraglutide were propensity score matched (1:1) based on baseline characteristics. Between-group comparison of adherence was analysed using the McNemar test (α=0.025). Persistence was analysed using Kaplan–Meier estimates with log-rank tests (α=0.025) for between-group comparisons. This study presents 12-month outcomes. Results— Following propensity score matching, 263 patients were included in each group. Mean±SD PDC for all patients at 12 months was significantly higher in the dulaglutide versus the liraglutide group (dulaglutide=0.48±0.30, liraglutide=0.39±0.28, p=0.0002). The proportion of adherent patients favored dulaglutide (dulaglutide=20.2%, liraglutide=12.9%, p=0.0302), as did the probability of being adherent to treatment (odds ratio [97.5% CI]: 1.70 [0.99, 2.91]; p=0.03). Proportion of persistent patients also favoured dulaglutide (dulaglutide=15.2%, liraglutide=9.1%, p=0.0528), as did the probability of discontinuing treatment 12 months after ID (p=0.027). Conclusions— Based on the UAE Dubai e-Claims database data, dulaglutide initiators exhibited significantly greater adherence in terms of mean PDC versus liraglutide initiators. The proportion of adherent patients and the probability of being adherent favored the dulaglutide group, as did treatment persistence.

Keywords: adherence, dulaglutide, effectiveness, liraglutide, persistence

Procedia PDF Downloads 108

Authors: Morgan Cheng, Wilson Ho, Max Yiu, Dragon Tsui, Wylog Wong, Richard Kwan, K. C. Lam, Hannah Lo, C. L. Wong

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Hong Kong has been known worldwide for its ability to thrive under trying circumstances. The 7.5 million residents of this mature and busy metropolis are living in a primarily high-rise city whereby development and renewal of the cityscape are taking place unceasingly. Hong Kong residents are therefore affected by the virtually continuous and numerous construction activities. In 2020, the Hong Kong environmental protection department (EPD) completed a feasibility study on managing construction noise, including those associated with the renovation of domestic premises. Part of the study was the review of management and control of construction noise in other metropolitan cities globally. As far as the authors are aware of, such worldwide and extensive review of best practices on construction noise control has not been conducted for over 20 years. In order to benefit from international best practices, the extensive review is to identify possible areas for improvement in Hong Kong. The consultant of the study first referred to the United Nations Report ‘The World’s Cities in 2016’ and examined the top 100 cities therein. The 20 most suitable cities were then chosen for further review. Upon screening of each of these 20 cities, 12 cities with the more relevant management practices were selected for further scrutiny. These 12 cities were: Asia – Tokyo, Seoul, Taipei, Guangzhou, Singapore; Europe – City of Westminster (London), Berlin; North America – Toronto, New York City, San Francisco; Oceania – Sydney, Melbourne. Afterwards, three cities, namely Sydney, City of Westminster, and New York City, were selected for in-depth review. These cities were chosen primarily because of the maturity, success, and effectiveness of their construction noise management and control measures, as well as their similarity to Hong Kong in key and selected aspects. One of the more important findings of the review is the usefulness of early focus, with the aim of designing the noise issues away wherever practicable. The consultant examined the similar yet different construction noise early focus mechanisms of the three cities. This paper describes this landmark worldwide and extensive review of international best practices on construction noise management and control. The methodology, approach, and key findings are presented to give readers a succinct yet comprehensive view. The authors shared the findings with the acoustics professionals worldwide with the hope of global advancement of more mature construction noise management while welcoming sustainable development and construction.

Keywords: construction noise, international best practices, noise control, noise management

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Authors: Asmamaw Yehun, Tsegaye Gogie, Martin Vermeer, Addisu Hunegnaw

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The Global Positioning System (GPS) is a space-based radio positioning system, which is capable of providing continuous position, velocity, and time information to users anywhere on or near the surface of the Earth. The main objective of this work was to estimate the integrated precipitable water vapour (IPWV) using ground GPS and Low Earth Orbit (LEO) Radio Occultation (RO) to study spatial-temporal variability. For LEO-GPS RO, we used Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) datasets. We estimated the daily and monthly mean of IPWV using six selected ground-based GPS stations over a period of range from 2012 to 2016 (i.e. five-years period). The main perspective for selecting the range period from 2012 to 2016 is that, continuous data were available during these periods at all Ethiopian GPS stations. We studied temporal, seasonal, diurnal, and vertical variations of precipitable water vapour using GPS observables extracted from the precise geodetic GAMIT-GLOBK software package. Finally, we determined the cross-correlation of our GPS-derived IPWV values with those of the European Centre for Medium-Range Weather Forecasts (ECMWF) ERA-40 Interim reanalysis and of the second generation National Oceanic and Atmospheric Administration (NOAA) model ensemble Forecast System Reforecast (GEFS/R) for validation and static comparison. There are higher values of the IPWV range from 30 to 37.5 millimetres (mm) in Gambela and Southern Regions of Ethiopia. Some parts of Tigray, Amhara, and Oromia regions had low IPWV ranges from 8.62 to 15.27 mm. The correlation coefficient between GPS-derived IPWV with ECMWF and GEFS/R exceeds 90%. We conclude that there are highly temporal, seasonal, diurnal, and vertical variations of precipitable water vapour in the study area.

Keywords: GNSS, radio occultation, atmosphere, precipitable water vapour

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Authors: Emel Sonmezer, Hayri Baran Yosmaoglu

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The negative impact of chronic pain syndromes on sexual function has been reported in several studies; however, the influences of treatment strategies on sexual dysfunction have not been evaluated widely. The aim of this study was to determine the effects of pelvic floor exercise on sexual dysfunction in female patients with chronic low back pain. Forty-two patient with chronic low back pain were enrolled this study. Subjects were divided into two groups. Group 1 received conventional physiotherapy consist of heat therapy, ergonomic education, William flexion exercise during 6 weeks. Group 2 received pelvic floor exercises in addition to conventional physiotherapy. Female Sexual Function Index (FSFI) was used for the assessment of sexual function. Pain intensity was assessed with Visual Analogue Scale. Quality of life was assessed with World Health Organization Quality of Life Scale. All measurements were taken before and after treatment. In conventional physiotherapy group; there were significant improvement in pain intensity (p= 0,003), physical health (p=0,011), psychological health (p=0,042) subscales of quality of life scale, arousal (p=0,042), lubrication (p=0,028) and pain (p= 0,034) subscales of FSFI. In additional pelvic floor exercise group; there were significant improvement in pain intensity (p= 0,005), physical health (p=0,012) psychological health (p=0,039) subscales of quality of life scale, arousal (p=0,024), lubrication (p=0,011), orgasm (p=0,035) and pain (p= 0,015) subscales and total score (p=0,016) of FSFI. Total FSFI score (p=0,025) and orgasm (p=0,017) subscale of FSFI were significantly higher for the additional pelvic floor exercise group than the conventional physiotherapy group.The outcome of this study suggested that conventional physiotherapy may contribute to improve pain, quality of life and some parameters of the sexual function in patients with low back pain. Although additional pelvic floor exercise did not reveal more treatment effect in terms of quality of life and pain intensity, it caused significant improvement in sexual function. It is recommended that pelvic floor exercise should be added to treatment programs in order to manage sexual dysfunction more effectively in patients with chronic low back pain.

Keywords: physiotherapy, chronic pain, sexual dysfunction, pelvic floor

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Authors: M. Shivakumar, S. R. Somashekhar, C. V. Raju

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Secondary salinization of agricultural lands in any command areas of the world is the major issue in the recent past. Currently, it is estimated that the 954 mh of saline and alkaline soil is present in the world. Thousands of hectares of land, getting added every year. Argentina, Bangladesh and Australia are most affected countries. In India, out of 142.80 million hectare (mh) cropped area, 56 mh is irrigated area. Of which, more than 9 mh (about 16.%) of land is found to be alkaline/saline. Due to continuous utilization of same land for same agricultural activities, excessive usage of fertilizers and water, most of the soils have become alkaline, saline or water logged. These lands are low productive and at times totally unfit for agricultural activities. These soils may or may not posses good physical condition, but plants may suffer from its inability to absorb water from salty solution. Plants suffer from dehydration and loose water to the soil, shrink, resulting death of plant. This process is called plasmolysis. It is the fact that soil is an independent, organic body of nature that acquires properties in accordance with forces which act upon it. Aquaculture is one of the solutions to utilize such problematic soils for food production. When the impoundments are constructed in an area 10-15% of the affected areas, the excess water along with the salts gets into impoundments and management of salt is easier in water than in the soil. Due to high organic input in aquaculture such as feed, manure and continuous deposition of fecal matter, pH of the soil gets reduced and over the period of time such soils can be put back into the original activity. Under National Agricultural Development Program (NADP), the project was implemented in 258 villages of Mandya District, Karnataka State, India and found that these lands can be effectively utilized for fish culture and increase the proteinacious food production by many folds while conserving the soils. The findings of the research can be adopted and up scaled in any country.

Keywords: saline and alkaline soils, Aquaculture, Problematic soils, Reclamation

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Authors: Raj Chavan

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Currently, there are over 14,500 Water Resource Recovery Facilities (WRRFs) in the United States, with ~35% of them having some type of nutrient limits in place. These WRRFs account for about 1% of overall power demand and 2% of total greenhouse gas emissions (GHG) in the United States and contribute for 10 to 15% of the overall nutrient load to surface rivers in the United States. The evolution of densification technologies toward more compact and energy-efficient nutrient removal processes has been impacted by a number of factors. Existing facilities that require capacity expansion or biomass densification for higher treatability within the same footprint are being subjected to more stringent requirements relating to nutrient removal prior to surface water discharge. Densification of activated sludge has received recent widespread interest as a means for achieving process intensification and nutrient removal at WRRFs. At the core of the technology are the aerobic sludge granules where the biological processes occur. There is considerable interest in the prospect of producing granular sludge in continuous (or traditional) activated sludge processes (CAS) or densification of biomass by moving activated sludge flocs to a denser aggregate of biomass as a highly effective technique of intensification. This presentation will provide a fundamental understanding of densification by presenting insights and practical issues. The topics that will be discussed include methods used to generate and retain densified granules; the mechanisms that allow biological flocs to densify; the role that physical selectors play in the densification of biological flocs; some viable ways for managing biological flocs that have become densified; effects of physical selection design parameters on the retention of densified biological flocs and finally some operational solutions for customizing the flocs and granules required to meet performance and capacity targets. In addition, it will present some case studies where biological and physical parameters were used to generate aerobic granular sludge in the continuous flow system.

Keywords: densification, aerobic granular sludge, nutrient removal, intensification

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Authors: Yusuf Ersoy Yildirim, Ismail Tas, Ceren Gorgusen, Tugba Yeter, Aysegul Boyacioglu, K. Mehmet Tugrul, Murat Tugrul, Ayten Namli, H. Sabri Ozturk, M. Onur Akca

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In recent years, a lot of research has been done for the sustainable use of scarce resources in the world. Especially, effective and sustainable use of water resources has been researched for many years. Sub-surface drip irrigation (SDI) is one of the most effective irrigation methods in which efficient and sustainable use of irrigation water can be achieved. When the literature is taken into consideration, it is often emphasized that, besides its numerous advantages, it also allows the application of irrigation water to the plant root zone along with air. It is stated in different studies that the air applied to the plant root zone with irrigation water has a positive effect on the root zone. Plants need sufficient oxygen for root respiration as well as for the metabolic functions of the roots. Decreased root respiration due to low oxygen content reduces transpiration, disrupts the flow of ions, and increases the ingress of salt reaching toxic levels, seriously affecting plant growth. Lack of oxygen (Hypoxia) can affect the survival of plants. The lack of oxygen in the soil is related to the exchange of gases in the soil with the gases in the atmosphere. Soil aeration is an important physical parameter of a soil. It is highly dynamic and is closely related to the amount of water in the soil and its bulk weight. Subsurface drip irrigation; It has higher water use efficiency compared to irrigation methods such as furrow irrigation and sprinkler irrigation. However, in heavy clay soils, subsurface drip irrigation creates continuous wetting fronts that predispose the rhizosphere region to hypoxia or anoxia. With subsurface drip irrigation, the oxygen is limited for root microbial respiration and root development, with the continuous spreading of water to a certain region of the root zone. In this study, the change in sugar beet yield caused by air application in the SDI system will be explained.

Keywords: sugar beet, subsurface drip irrigation, air application, irrigation efficiency

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Suhaib Salahuddin Alzubair Suliman

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This paper examines the mechanical strength of different binders including pure ordinary Portland cement (OPC) and others having OPC supplemented by two maximum sizes of waste glass powder (GP) of 75-μm and 150μm. Chemical analysis of the GPs using PCEDX test analysis has revealed it silica (SiO2 ) content % is 86.883 and Calcium oxide (CaO) is 12.203%while there are traces of other impurities . Furthermore, the specific gravity of GP was measured. The experiments have been conducted on 63 specimens mortar made with standard sand with 20%,25%, and 30% of GP levels of substituting OPC. The specimens are tested at 3, 7 and 28 days for compressive strength and flexural strength. The specimens made with maximum GP size of 75-μm have outperformed the control OPC mortar at 28 days test age than size 150-μm at various replacement levels. In addition to that, the mechanical strengths were evaluated compressive strength and flexural strength tests were conducted for GPs. The findings from this study indicated that the mortars modified with GP 75μm and replacement ratio of 20% showed an improvement in compressive strength and flexural strength compared to the control mortar at the 28 days of curing with significant development between 7 and 28 days. Mortar with GP size 75-μm containing 30% & 20% replacement of cement have exhibited the highest flexural strength among all mortar mixtures. The improvement in the mechanical strength of the mortars modified with GP can be attributed to the pozzolanic property of GPs, which leads to a more densified microstructure and improved interfacial bonding between sand and cement paste matrix in mortars.

Keywords: glass powder, pozzolana, compressive strength, flexural strength, mortar

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Authors: Tshilidzi C. Manyanya, Nthaduleni S. Nethengwe, Edmore Kori

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The UNFCCC, FAO, GCF, IPCC and other global structures advocate for agro-ecology do address food security and sovereignty. However, most of the expected outcomes concerning agro-ecological were not empirically tested for universal application. Agro-ecology is theorised to increase crop health over ago-ecological farms and decrease over conventional farms. Increased crop health means increased carbon sequestration and thus less CO2 in the atmosphere. This is in line with the view that global warming is anthropogenically enhanced through GHG emissions. Agro-ecology mainly affects crop health, soil carbon content and yield on the cultivated land. Economic sustainability is directly related to yield capacity, which is theorized to increase by 3-10% in a space of 3 - 10 years as a result of agro-ecological implementation. This study aimed to empirically assess the practicality and validity of these assumptions. The study utilized mainly GIS and RS techniques to assess the effectiveness of agro-ecology in crop health improvement from satellite images. The assessment involved a longitudinal study (2013 – 2015) assessing the changes that occur after a farm retrofits from conventional agriculture to agro-ecology. The assumptions guided the objectives of the study. For each objective, an agro-ecological farm was compared with a conventional farm in the same climatic conditional occupying the same general location. Crop health was assessed using satellite images analysed through ArcGIS and Erdas. This entailed the production of NDVI and Re-classified outputs of the farm area. The NDVI ranges of the entire period of study were thus compared in a stacked histogram for each farm to assess for trends. Yield capacity was calculated based on the production records acquired from the farmers and plotted in a stacked bar graph as percentages of a total for each farm. The results of the study showed decreasing crop health trends over 80% of the conventional farms and an increase over 80% of the organic farms. Yield capacity showed similar patterns to those of crop health. The study thus showed that agro-ecology is an effective strategy for crop-health improvement and yield increase.

Keywords: agro-ecosystem, conventional farm, dialectical, sustainability

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Authors: Irfan Ahmed Rind

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Science education has recently become the top priority of government of Pakistan. Number of schemes has been initiated for the improvement of science teaching and learning at primary and secondary levels of education, most importantly training in-service science teachers on inquiry based teaching and learning to empower students and encourage creativity, critical thinking, and innovation among them. Therefore, this approach has been promoted in the recent continuous professional development trainings for the in-service teachers. However, the follow ups on trained science teachers and educators suggest that these teachers fail to implement the inquiry based teaching and learning in their classes. In addition, these trainings also fail to bring any significant change in students’ science content knowledge and understanding as per the annual national level surveys conducted by government and independent agencies. Research suggests that science has been taught using scientific positivism, which supports objectivity based on experiments and mathematics. In contrary, the inquiry based teaching and learning are based on constructivism, which conflicts with the positivist epistemology of science teachers. It was, therefore, assumed that science teachers struggle to implement the inquiry based teaching approach as it conflicts with their basic epistemological beliefs. With this assumption, this research aimed to (i) understand how science teachers conceptualize the nature of science, and how this influence their understanding of learning, learners, their own roles as teachers and their teaching strategies, (ii) identify the conflict of science teachers’ epistemological beliefs with the inquiry based teaching approach, and (iii) find the ways in which science teachers epistemological beliefs may be developed from positivism to constructivism, so that they may effectively use the inquiry based teaching approach in teaching science. Using qualitative case study approach, thirty six secondary and higher secondary science teachers (21 male and 15 female) were selected. Data was collected using interviewed, participatory observations (sixty lessons were observed), and twenty interviews from students for verifications of teachers’ responses. The findings suggest that most of the science teacher were positivist in defining the nature of science. Most of them limit themselves to one fix answer that is provided in the books and that there is only one 'right' way to teach science. There is no room for students’ or teachers’ own opinion or bias when it comes to scientific concepts. Inquiry based teaching seems 'no right' to them. They find it difficult to allow students to think out of the box. However, some interesting exercises were found to be very effective in bringing the change in teachers’ epistemological beliefs. These will be discussed in detail in the paper. The findings have major implications for the teachers, educators, and policymakers.

Keywords: science teachers, epistemology, metacognition, inquiry based teaching

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Authors: Shoumodip Roy, Ankit Singhania, M. K. G. Choudhury, Santanu Mallick, M. K. Agarwal, R. V. Ramna, Uttam Singh

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One of the key corporate goals of Tata Steel company is to demonstrate Environment Leadership. Decreasing specific CO₂ emission is one of the key steps to achieve the stated corporate goal. At any Blast Furnace, specific CO₂ emission is directly proportional to fuel intake. To reduce the fuel intake at G Blast Furnace, an initial benchmarking exercise was carried out with international and domestic Blast Furnaces to determine the potential for improvement. The gap identified during the exercise revealed that the benchmark Blast Furnaces operated with superior raw material quality than that in G Blast Furnace. However, since the raw materials to G Blast Furnace are sourced from the captive mines, improvement in the raw material quality was out of scope. Therefore, trials were taken with different operating regimes, to identify the key process parameters, which on optimization could significantly reduce the fuel intake in G Blast Furnace. The key process parameters identified from the trial were the Stoichiometric Oxygen Ratio, Melting Capacity ratio and the burden distribution inside the furnace. These identified process parameters were optimized to bridge the gap in fuel intake at G Blast Furnace, thereby reducing specific CO₂ emission to benchmark levels. This paradigm shift enabled to lower the fuel intake by 70kg per ton of liquid iron produced, thereby reducing the specific CO₂ emission by 15 percent.

Keywords: benchmark, blast furnace, CO₂ emission, fuel rate

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Authors: Özlem Öksüzer

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In this paper, we introduce variation detracting property of Kantorovich-Stancu type operators in the space of functions of bounded variation. These problems are studied with respect to the variation seminorm.

Keywords: Kantorovich-Stancu type operators, variation seminorm, variation detracting property, absolutely continuous function

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Authors: Kaoutar Lamrini Uahabi, Mohamed Atounti

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In the present work, we consider one category of curves denoted by L(p, k, r, n). These curves are continuous arcs which are trajectories of roots of the trinomial equation zn = αzk + (1 − α), where z is a complex number, n and k are two integers such that 1 ≤ k ≤ n − 1 and α is a real parameter greater than 1. Denoting by L the union of all trinomial curves L(p, k, r, n) and using the box counting dimension as fractal dimension, we will prove that the dimension of L is equal to 3/2.

Keywords: feasible angles, fractal dimension, Minkowski sausage, trinomial curves, trinomial equation

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Authors: Preethi Sudarshanie Dassanayake, R. A. Sudath Weerasiri

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Objective: The objective of this study were to find out highest expectation and perception,highest gap between perception and expectation of service quality, and to find out such gaps between perception and expectation with regard to service quality dimensions were whether statistically significant. Methodology: This study carried out at the Out Patient Department (OPD) of the Veterinary Teaching Hospital (VTH), University of Peradeniya. Modified version of SERVQUAL with 22-pairs of items regarding expectation and perception of service quality in dimensions of tangible, reliability, responsiveness, assurance and empathy were included in Part 1 and the Part 2 of the questionnaire consisted of questions regarding socio-demographic factors. Sample size was 200 and sampling procedure was Systematic Random Sampling. Customers above 18 years of age, able to read, write and understand Sinhala or English language, visits more than twice in last six months and who willing to respond were selected. Findings: The analysis revealed customers expectations of service higher than the perceived for all 22- items of the SERVQUAL. This high expectation suggests that there is sufficient room for further improvement of service quality in all five dimensions. Originality/Value of the Paper: This study gave a new insight for poorly researched area of veterinary health service quality in Sri Lankan context. It provides hospital administrators and policy makers to develop strategies for further improvement of service quality according to customers' view.

Keywords: expectation, perception, service quality, SERVQUAL, veterinary health care

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Authors: Ons Triki, Fathi Abid

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Along with the increase in the use of leasing contracts in corporate finance, multiple studies aim to model the credit risk of the lease in order to cover the losses of the lessor of the asset if the lessee goes bankrupt. In the current research paper, a convertible lease contract is elaborated in a continuous time stochastic universe aiming to ensure the financial stability of the firm and quickly recover the losses of the counterparties to the lease in case of default. This work examines the term structure of the lease rates taking into account the credit default risk and the capital structure of the firm. The interaction between the lessee's capital structure and the equilibrium lease rate has been assessed by applying the competitive lease market argument developed by Grenadier (1996) and the endogenous structural default model set forward by Leland and Toft (1996). The cumulative probability of default was calculated by referring to Leland and Toft (1996) and Yildirim and Huan (2006). Additionally, the link between lessee credit risk and lease rate was addressed so as to explore the impact of convertible lease financing on the term structure of the lease rate, the optimal leverage ratio, the cumulative default probability, and the optimal firm value by applying an endogenous conversion threshold. The numerical analysis is suggestive that the duration structure of lease rates increases with the increase in the degree of the market price of risk. The maximal value of the firm decreases with the effect of the optimal leverage ratio. The results are indicative that the cumulative probability of default increases with the maturity of the lease contract if the volatility of the asset service flows is significant. Introducing the convertible lease contract will increase the optimal value of the firm as a function of asset volatility for a high initial service flow level and a conversion ratio close to 1.

Keywords: convertible lease contract, lease rate, credit-risk, capital structure, default probability

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Authors: Hisham A. Hashem, Sameh Galal, Bassem M. Moeshed

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A 36 years old male patient presented to our unit with a history of motor-car accident from 7 months complaining of disfigurement and double vision. On examination and investigations, there was an orbital floor fracture in the left eye with inferior rectus muscle entrapment causing diplopia, dystopia and enophthalmos. Under general anesthesia, a sub-ciliary incision was performed, and the orbital floor fracture was repaired with a double layer Medpor sheet (30x50x15) with removing and freeing fibrosis that was present and freeing of the inferior rectus muscle. Remarkable improvement of the dystopia was noticed, however, there was a residual diplopia in upgaze and enophthalmos. He was then referred to a strabismologist, which upon examination found left hypotropia of 8 ΔD corrected by 8 ΔD base up prism and positive forced duction test on elevation and pseudoptosis. Under local anesthesia, a limbal incision approach with hangback 4mm recession of inferior rectus muscle was performed after identifying an inferior rectus muscle structure. Improvement was noted shortly postoperative with correction of both diplopia and pseudoptosis. Follow up after 1, 4 and 8 months was done showing a stable condition. Delayed surgery in cases of orbital floor fracture may still hold good results provided proper assessment of the case with management of each sign separately.

Keywords: diplopia, dystopia, late surgery, orbital floor fracture

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Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper

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Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.

Keywords: patient safety, quality improvement, serious incidents, falls, clinical care

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Authors: Vitalijus Leibenka

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After 2014 the world of Russia’s actions in annexing Crimea has seen a hybrid war that has helped Russia achieve its goals. The world and NATO nations have pointed out that hybrid action can help achieve not only military but also economic and political goals. One of the weapons of action in hybrid warfare is information warfare tools, the use of which helps to carry out actions in the context of hybrid warfare as a whole. In addition, information war tools can be used alone, over time and for long-term purposes. Although forms of information war, such as propaganda and disinformation, have been used in the past, in old conflicts and wars, new forms of information war have emerged as a result of technological development, making the dissemination of information faster and more efficient. The world understands that information is becoming a weapon, but not everyone understands that both information war and information warfare differ in their essence and full content. In addition, the damage and impact of the use of information war, which may have worse consequences than a brief military conflict, is underestimated. Lithuania is also facing various interpretations of the information war. Some believe that the information attack is an information war and the understanding of the information war is limited to a false message in the press. Others, however, deepen and explain the essence of the information war. Society has formed in such a way that not all people are able to assess the threats of information war, to separate information war from information attack. Recently, the Lithuanian government has been taking measures in the context of the information war, making decisions that allow the development of the activities of the state and state institutions in order to create defense mechanisms in the information war. However, this is happening rather slowly and incompletely. Every military conflict, related to Lithuania in one way or another, forces Lithuanian politicians to take up the theme of information warfare again. As a result, a national cyber security center is being set up, and Russian channels spreading lies are banned. However, there is no consistent development and continuous improvement of action against information threats. Although a sufficiently influential part of society (not a political part) helps to stop the spread of obscure information by creating social projects such as “Demaskuok” and “Laikykis ten su Andriumi tapinu”, it goes without saying that it will not become a key tool in the fight against information threats. Therefore, in order to achieve clean dissemination of information in Lithuania, full-fledged and substantial political decisions are necessary, the adoption of which would change the public perception of the information war, its damage, impact and actions that would allow to combat the spread. Political decisions should cover the educational, military, economic and political areas, which are one of the main and most important in the state, which would allow to fundamentally change the situation against the background of information war.

Keywords: information war, information warfare, hybrid war, hybrid warfare, NATO, Lithuania, Russia

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Authors: Kuhorfah Emmanuel Mawuli

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Generally, for firms to enhance their operational efficiency of logistics, it is imperative to assess the logistics function. The cost of logistics conventionally represents a key consideration in the pricing decisions of firms, which suggests that cost efficiency in logistics can go a long way to improve margins. Warehousing, which is a key part of logistics operations, has the prospect of influencing operational efficiency in logistics management as well as customer value, but this potential has often not been recognized. It has been found that there is a paucity of research that evaluates the efficiency of warehouses. Indeed, limited research has been conducted to examine potential barriers to effective warehousing management. Due to this paucity of research, there is limited knowledge on how to address the obstacles associated with warehousing management. In order for warehousing management to become profitable, there is the need to integrate, balance, and manage the economic inputs and outputs of the entire warehouse operations, something that many firms tend to ignore. Management of warehousing is not solely related to storage functions. Instead, effective warehousing management requires such practices as maximum possible mechanization and automation of operations, optimal use of space and capacity of storage facilities, organization through "continuous flow" of goods, a planned system of storage operations, and safety of goods. For example, there is an important need for space utilization of the warehouse surface as it is a good way to evaluate the storing operation and pick items per hour. In the setting of Mantrac Ghana, not much knowledge regarding the management of the warehouses exists. The researcher has personally observed many gaps in the management of the warehouse facilities in the case organization Mantrac Ghana. It is important, therefore, to assess the warehouse facility management of the case company with the objective of identifying weaknesses for improvement. The study employs an in-depth qualitative research approach using interviews as a mode of data collection. Respondents in the study mainly comprised warehouse facility managers in the studied company. A total of 10 participants were selected for the study using a purposive sampling strategy. Results emanating from the study demonstrate limited warehousing effectiveness in the case company. Findings further reveal that the major barriers to effective warehousing facility management comprise poor layout, poor picking optimization, labour costs, and inaccurate orders; policy implications of the study findings are finally outlined.

Keywords: assessing, warehousing, facility, management

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Authors: Beatriz Martinez-Pastor, Maria Nogal, Alan O'Connor

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During the last years, the number of extreme weather events has increased. A variety of extreme weather events, including river floods, rain-induced landslides, droughts, winter storms, wildfire, and hurricanes, have threatened and damaged many different regions worldwide. These events have a devastating impact on critical infrastructure systems resulting in high social, economical and environmental costs. These events have a huge impact in transport systems. Since, transport networks are completely exposed to every kind of climatological perturbations, and its performance is closely related with these events. When a traffic network is affected by a climatological hazard, the quality of its service is threatened, and the level of the traffic conditions usually decreases. With the aim of understanding this process, the concept of resilience has become most popular in the area of transport. Transport resilience analyses the behavior of a traffic network when a perturbation takes place. This holistic concept studies the complete process, from the beginning of the perturbation until the total recovery of the system, when the perturbation has finished. Many concepts are included in the definition of resilience, such as vulnerability, redundancy, adaptability, and safety. Once the resilience of a transport network can be evaluated, in this case, the methodology used is a dynamic equilibrium-restricted assignment model that allows the quantification of the concept, the next step is its improvement. Through the improvement of this concept, it will be possible to create transport networks that are able to withstand and have a better performance under the presence of climatological hazards. Analyzing the impact of a perturbation in a traffic network, it is observed that the response of the different links, which are part of the network, can be completely different from one to another. Consequently and due to this effect, many questions arise, as what makes a link more critical before an extreme weather event? or how is it possible to identify these critical links? With this aim, and knowing that most of the times the owners or managers of the transport systems have limited resources, the identification of the critical links of a transport network before extreme weather events, becomes a crucial objective. For that reason, using the available resources in the areas that will generate a higher improvement of the resilience, will contribute to the global development of the network. Therefore, this paper wants to analyze what kind of characteristic makes a link a critical one when an extreme weather event damages a transport network and finally identify them.

Keywords: critical links, extreme weather events, hazard, resilience, transport network

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Authors: Tsepiso Mofolo, Luna Bergh

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The Lesotho construction industry fails to embrace environmental practices, which has then lead to excessive consumption of resources, land degradation, air and water pollution, loss of habitats, and high energy usage. The industry is highly inefficient, and this undermines its capability to yield the optimum contribution to social, economic and environmental developments. Sustainable construction is, therefore, imperative to ensure the cultivation of benefits from all these intrinsic themes of sustainable development. The development of a sustainable construction industry requires a holistic approach that takes into consideration the interaction between Lean Construction principles, socio-economic and environmental policies, technological advancement and the principles of construction or project management. Sustainable construction is a cutting-edge phenomenon, forming a component of a subjectively defined concept called sustainable development. Sustainable development can be defined in terms of attitudes and judgments to assist in ensuring long-term environmental, social and economic growth in society. The key concept of sustainable construction is Lean Construction. Lean Construction emanates from the principles of the Toyota Production System (TPS), namely the application and adaptation of the fundamental concepts and principles that focus on waste reduction, the increase in value to the customer, and continuous improvement. The focus is on the reduction of socio-economic waste, and protestation of environmental degradation by reducing carbon dioxide emission footprint. Lean principles require a fundamental change in the behaviour and attitudes of the parties involved in order to overcome barriers to cooperation. Prevalent barriers to adoption of Lean Construction in Lesotho are mainly structural - such as unavailability of financing, corruption, operational inefficiency or wastage, lack of skills and training and inefficient construction legislation and political interferences. The consequential effects of these problems trigger down to quality, cost and time of the project - which then result in an escalation of operational costs due to the cost of rework or material wastage. Factor and correlation analysis of these barriers indicate that they are highly correlated, which then poses a detrimental potential to the country’s welfare, environment and construction safety. It is, therefore, critical for Lesotho’s construction industry to develop a robust governance through bureaucracy reforms and stringent law enforcement.

Keywords: construction industry, sustainable development, sustainable construction industry, lean construction, barriers to sustainable construction

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Authors: Laxuman Thakuri

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Despite the large number of in-depth case studies focused on policy analysis, institutional arrangement, and collective action of common property resource management; how the local institutions take the pricing decision of forest products in community forest management and what kinds of effects produce it, the answers of these questions are largely silent among the policy-makers and researchers alike. The study examined how the local institutions take the pricing decision of forest products in the lowland community forestry of Nepal and how the decisions affect to equitable distribution of benefits and livelihood improvement which are also objectives of Nepalese community forestry. The study assumes that forest products pricing decisions have multiple effects on equitable distribution and livelihood improvement in the areas having heterogeneous socio-economic conditions. The dissertation was carried out at four community forests of lowland, Nepal that has characteristics of high value species, matured-experience of community forest management and better record-keeping system of forest products production, pricing and distribution. The questionnaire survey, individual to group discussions and direct field observation were applied for data collection from the field, and Lorenz curve, gini-coefficient, χ²-text, and SWOT (Strong, Weak, Opportunity, and Threat) analysis were performed for data analysis and results interpretation. The dissertation demonstrates that the low pricing strategy of high-value forest products was supposed crucial to increase the access of socio-economically weak households, and to and control over the important forest products such as timber, but found counter productive as the strategy increased the access of socio-economically better-off households at higher rate. In addition, the strategy contradicts to collect a large-scale community fund and carry out livelihood improvement activities as per the community forestry objectives. The crucial part of the study is despite the fact of low pricing strategy; the timber alone contributed large part of community fund collection. The results revealed close relation between pricing decisions and livelihood objectives. The action research result shows that positive price discrimination can slightly reduce the prevailing inequality and increase the fund. However, it lacks to harness the full price of forest products and collects a large-scale community fund. For broader outcomes of common property resource management in terms of resource sustainability, equity, and livelihood opportunity, the study suggests local institutions to harness the full price of resource products with respect to the local market.

Keywords: community, equitable, forest, livelihood, socioeconomic, Nepal

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Authors: Jubaida Gulshan Ara, Zebun Nasreen Ahmed

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Urban flood and drought has been a major problem of Dhaka city, particularly in recent years. Continuous increase of the city built up area, and limiting rainwater infiltration zone, are thought to be the main causes of the problem. Proper rainwater management, even at the individual plot level, might bring significant improvement in this regard. As residential use pattern occupies a significant portion of the city surface, the scope of rainwater harvesting (RWH) in residential buildings can be investigated. This paper reports on a research which explored the scope of rainwater harvesting in residential plots, with multifamily apartment buildings, in Dhaka city. The research investigated the basics of RWH, contextual information, i.e., hydro-geological, meteorological data of Dhaka city and the rules and legislations for residential building construction. The study also explored contemporary rainwater harvesting practices in the local and international contexts. On the basis of theoretical understanding, 21 sample case-studies, in different phases of construction, were selected from seven different categories of plot sizes, in different residential areas of Dhaka city. Primary data from the 21 case-study buildings were collected from a physical survey, from design drawings, accompanied by a questionnaire survey. All necessary secondary data were gathered from published and other relevant sources. Collected primary and secondary data were used to calculate and analyze the RWH needs for each case study, based on the theoretical understanding. The main findings have been compiled and compared, to observe residential development trends with regards to building rainwater harvesting system. The study has found that, in ‘Multifamily Apartment Building’ of Dhaka city, storage, and recharge structure size for rainwater harvesting, increases along with occupants’ number, and with the increasing size of the plot. Hence, demand vs. supply ratio remains almost the same for different sizes of plots, and consequently, the size of the storage structure increases significantly, in large-scale plots. It has been found that rainwater can meet only 12%-30% of the total restricted water demand of these residential buildings of Dhaka city. Therefore, artificial groundwater recharge might be the more suitable option for RWH, than storage. The study came up with this conclusion that, in multifamily residential apartments of Dhaka city, artificial groundwater recharge might be the more suitable option for RWH, than storing the rainwater on site.

Keywords: Dhaka city, rainwater harvesting, residential plots, urban flood

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Authors: Sridhar S, Govinda Raj Mandela, Aruna Mangalpady

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In the present day scenario, Indian underground mines are moving towards full scale mechanisation for improvement of production and productivity levels. These mines are employing a wide variety of earth moving machines for the transportation of ore and overburden (waste). Low Profile Dump Trucks (LPDTs) have proven more advantageous towards improvement of production levels in underground mines through quick transportation. During the operation of LPDT, different kinds of vibrations are generated which can affect the health condition of the operator. Keeping this in view, the present research work focuses on measurement and evaluation of Hand Arm Vibrations (HAVs) from the steering system of LPDTs. The study also aims to evaluate the HAVs of different job components of a work cycle in operating LPDTs. The HAVs were measured and evaluated according to ISO 5349-2: 2001 standards, and the daily vibration exposures A(8) were calculated. The evaluated A(8) results show that LPDTs of 60 and 50 tons capacity have vibration levels more than that of the Exposure Action Value (EAV) of 2.5 m/s2 in every job component of the work cycle. Further, the results show that the vibration levels were more during empty haulage especially during descending journey when compared to other job components in all LPDTs considered for the study.

Keywords: low profile dump trucks, hand arm vibrations, exposure action value, underground mines

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Authors: Onabajo Paul

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The testing and assessment of physical fitness of school-aged adolescents in Nigeria has been going on for several decades. Originally, these tests strictly focused on identifying health and physical fitness status and comparing the results of adolescents with others. There is a considerable interest in health and performance fitness of adolescents in which results attained are compared with criteria representing positive health rather than simply on score comparisons with others. Despite the fact that physical education program is being studied in secondary schools and physical activities are encouraged, it is observed that regular assessment of students’ fitness level and health status seems to be scarce or not being done in these schools. The purpose of the study was to assess the heath and performance fitness of adolescents in middle-income schools in Lagos State. A total number of 150 students were selected using the simple random sampling technique. Participants were measured on hand grip strength, sit-up, pacer 20 meter shuttle run, standing long jump, weight and height. The data collected were analyzed with descriptive statistics of means, standard deviations, and range and compared with fitness norms. It was concluded that majority 111(74.0%) of the adolescents achieved the healthy fitness zone, 33(22.0%) were very lean, and 6(4.0%) needed improvement according to the normative standard of Body Mass Index test. For muscular strength, majority 78(52.0%) were weak, 66(44.0%) were normal, and 6(4.0%) were strong according to the normative standard of hand-grip strength test. For aerobic capacity fitness, majority 93(62.0%) needed improvement and were at health risk, 36(24.0%) achieved healthy fitness zone, and 21(14.0%) needed improvement according to the normative standard of PACER test. Majority 48(32.0%) of the participants had good hip flexibility, 38(25.3%) had fair status, 27(18.0%) needed improvement, 24(16.0%) had very good hip flexibility status, and 13(8.7%) of the participants had excellent status. Majority 61(40.7%) had average muscular endurance status, 30(20.0%) had poor status, 29(18.3%) had good status, 28(18.7%) had fair muscular endurance status, and 2(1.3%) of the participants had excellent status according to the normative standard of sit-up test. Majority 52(34.7%) had low jump ability fitness, 47(31.3%) had marginal fitness, 31(20.7%) had good fitness, and 20(13.3%) had high performance fitness according to the normative standard of standing long jump test. Based on the findings, it was concluded that majority of the adolescents had better Body Mass Index status, and performed well in both hip flexibility and muscular endurance tests. Whereas majority of the adolescents performed poorly in aerobic capacity test, muscular strength and jump ability test. It was recommended that to enhance wellness, adolescents should be involved in physical activities and recreation lasting 30 minutes three times a week. Schools should engage in fitness program for students on regular basis at both senior and junior classes so as to develop good cardio-respiratory, muscular fitness and improve overall health of the students.

Keywords: adolescents, health-related fitness, performance-related fitness, physical fitness

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Authors: Subodh Kumar, Sanjeev Kumar Sharma, Gaurav Kaushik, Pramod Avti, Phulen Sarma, Bikash Medhi, Krishan Lal Khanduja

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Background: It is well known that cigarette smoke is one of the causative factors in various lung diseases especially cancer. Carcinogens and oxidant molecules present in cigarette smoke not only damage the cellular constituents (lipids, proteins, DNA) but may also regulate the molecular pathways involved in inflammation and cancer. Continuous oxidative stress caused by the constituents of cigarette smoke leads to higher PhospholipaseA₂ (PLA₂) activity, resulting in elevated levels of secondary metabolites whose role is well defined in cancer. To reduce the burden of chronic inflammation as well as oxidative stress, and higher levels of secondary metabolites, we checked the curative potential of PLA₂ inhibitor Bromoenol Lactone (BEL) during continuous exposure of cigarette smoke condensate (CSC). Aim: To check the therapeutic potential of Bromoenol Lactone (BEL), an inhibitor of PhospholipaseA₂s, in pathways of CSC-induced changes in type I and type II alveolar epithelial cells. Methods: Effect of BEL on CSC-induced PLA2 activity were checked using colorimetric assay, cellular toxicity using cell viability assay, membrane integrity using fluorescein di-acetate (FDA) uptake assay, reactive oxygen species (ROS) levels and apoptosis markers through flow cytometry, and cellular regulation using MAPKinases levels, in lung epithelium. Results: BEL significantly mimicked CSC-induced PLA₂ activity, ROS levels, apoptosis, and kinases level whereas improved cellular viability and membrane integrity. Conclusions: Current observations revealed that BEL may be a potential therapeutic agent during Cigarette smoke-induced anomalies in lung epithelium.

Keywords: cigarette smoke condensate, phospholipase A₂, oxidative stress, alveolar epithelium, bromoenol lactone

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Authors: Darren A. Whitaker, Dan Palmer, Jens Wesholowski, James Flaherty, John Mack, Ahmad B. Albadarin, Gavin Walker

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Traditional mechanosynthesis has been performed by either ball milling or manual grinding. However, neither of these techniques allow the easy application of process control. The temperature may change unpredictably due to friction in the process. Hence the amount of energy transferred to the reactants is intrinsically non-uniform. Recently, it has been shown that the use of Twin-Screw extrusion (TSE) can overcome these limitations. Additionally, TSE enables a platform for continuous synthesis or manufacturing as it is an open-ended process, with feedstocks at one end and product at the other. Several materials including metal-organic frameworks (MOFs), co-crystals and small organic molecules have been produced mechanochemically using TSE. The described advantages of TSE are offset by drawbacks such as increased process complexity (a large number of process parameters) and variation in feedstock flow impacting on product quality. To handle the above-mentioned drawbacks, this study utilizes UV-Vis spectrophotometry (InSpectroX, ColVisTec) as an online tool to gain real-time information about the quality of the product. Additionally, this is combined with real-time process information in an Advanced Process Control system (PharmaMV, Perceptive Engineering) allowing full supervision and control of the TSE process. Further, by characterizing the dynamic behavior of the TSE, a model predictive controller (MPC) can be employed to ensure the process remains under control when perturbed by external disturbances. Two reactions were studied; a Knoevenagel condensation reaction of barbituric acid and vanillin and, the direct amidation of hydroquinone by ammonium acetate to form N-Acetyl-para-aminophenol (APAP) commonly known as paracetamol. Both reactions could be carried out continuously using TSE, nuclear magnetic resonance (NMR) spectroscopy was used to confirm the percentage conversion of starting materials to product. This information was used to construct partial least squares (PLS) calibration models within the PharmaMV development system, which relates the percent conversion to product to the acquired UV-Vis spectrum. Once this was complete, the model was deployed within the PharmaMV Real-Time System to carry out automated optimization experiments to maximize the percentage conversion based on a set of process parameters in a design of experiments (DoE) style methodology. With the optimum set of process parameters established, a series of PRBS process response tests (i.e. Pseudo-Random Binary Sequences) around the optimum were conducted. The resultant dataset was used to build a statistical model and associated MPC. The controller maximizes product quality whilst ensuring the process remains at the optimum even as disturbances such as raw material variability are introduced into the system. To summarize, a combination of online spectral monitoring and advanced process control was used to develop a robust system for optimization and control of two TSE based mechanosynthetic processes.

Keywords: continuous synthesis, pharmaceutical, spectroscopy, advanced process control

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Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

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Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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Authors: Anubha Kaushik, Raman Preet

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Distillery wastewater in the form of spent wash is a complex and strong industrial effluent, with high load of organic pollutants that may deplete dissolved oxygen on being discharged into aquatic systems and contaminate groundwater by leaching of pollutants, while untreated spent wash disposed on land acidifies the soil. Stringent legislative measures have therefore been framed in different countries for discharge standards of distillery effluent. Utilising the organic pollutants present in various types of wastes as food by mixed microbial populations is emerging as an eco-friendly approach in the recent years, in which complex organic matter is converted into simpler forms, and simultaneously useful gases are produced as renewable and clean energy sources. In the present study, wastewater from a rice bran based distillery has been used as the substrate in a dark fermenter, and native microbial consortium from the digester sludge has been used as the inoculum to treat the wastewater and produce hydrogen. After optimising the operational conditions in batch reactors, sequential batch mode and continuous flow stirred tank reactors were used to study the best operational conditions for enhanced and sustained hydrogen production and removal of pollutants. Since the rate of hydrogen production by the microbial consortium during dark fermentation is influenced by concentration of organic matter, pH and temperature, these operational conditions were optimised in batch mode studies. Maximum hydrogen production rate (347.87ml/L/d) was attained in 32h dark fermentation while a good proportion of COD also got removed from the wastewater. Slightly acidic initial pH seemed to favor biohydrogen production. In continuous stirred tank reactor, high H₂ production from distillery wastewater was obtained from a relatively shorter substrate retention time (SRT) of 48h and a moderate organic loading rate (OLR) of 172 g/l/d COD.

Keywords: distillery wastewater, hydrogen, microbial consortium, organic pollution, sludge

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