Search results for: oral public health

Authors: Stephen Rulisa, Aimee Nyiramahirwe

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Background: Strategies to increase the uptake of contraception services have been adopted in Rwanda, but the unmet need for family planning remains high. Women in the postpartum period are at higher risk for unintended pregnancy due to the silent conversion from lactational amenorrhea to reactivation of ovulatory cycles. The purpose of this study was to explore the role of male partners in the uptake of postpartum contraception. Methods: A prospective cross-sectional study was conducted among women who delivered at the University Teaching Hospital of Kigali for a period of 3 months with random sampling. A questionnaire was used to collect socio-demographic and antenatal data, information on male companionship, and intent to use postpartum contraception at admission. Participants were contacted six weeks later to collect data on contraceptive use. The outcome variables were uptake of postpartum contraception and types of contraceptives taken (long-acting vs. short-acting), controlling for male companionship during the antenatal period. A Chi-square test was used and a p-value ≤0.05 was considered significant. Results: A total of 209 women were recruited with a mean age of 30.8±5.2 years. The majority (60.9%) were multigravida, and 66.5% were multiparous. More than half (55%) had male partner companionship, 18.3% had companionship for four antenatal visits, and 28.2% had education on contraception with their male partner. Factors significantly associated with uptake of postpartum contraception were: age above 30 years, owning or heading a business, multigravidity, multiparity, antenatal care at a health center or district hospital, cesarean delivery, and previous utilization of contraception. Male companionship significantly increased the intent to use contraception, uptake of modern contraception in general, and uptake of long active contraceptives but did not predict the uptake of short-acting contraceptives. Conclusions: Our study demonstrates a positive association between male companionship during antenatal care, labor and delivery with the uptake of postpartum family planning. Our study suggests more sensitization to involve the male partners, improving the education on contraception during antenatal care and further research to assess the sustained uptake of contraception beyond the postpartum period.

Keywords: postpartum, family planning, contraception, male partner, uptake

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Authors: Navven Desai, Veena Soraganvi

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Heavy metals such as lead, cadmium and mercury do not have biological significance hence they are known to be extremely toxic heavy metals. Water contains various heavy metals like Cadmium (Cd), Chromium (Cr), Copper (Cu), Nickel (Ni), Arsenic (As), Lead (Pb), and Zinc (Zn) etc., when it gets polluted with industrial waste water. These heavy metals cause various health effects even at low concentration when consumed by humans. Most of the heavy metals are poisonous to living organisms. Heavy metals are non-degradable and are preserved in the environment through bioaccumulation. Therefore removal of heavy metals from water is necessary. In recent years, a great deal of attentions has been focused on to the application of nanosized metal oxides to treat heavy metals, especially titanium oxides, ferric oxides, manganese oxides, aluminium oxides and magnesium oxides as adsorbent and photocatalyst. TiO2 based photocatalysts have attracted continuously increasing attention because of the excellent properties such as high light -conversion efficiency, chemical stability, nontoxic nature, low cost. The catalyst displays high photocatalytic activity because of its large surface area. In this study, the photocatalytic degradation of Lead (Pb) from aqueous solution was investigated in natural sunlight by using TiO2 as Nanomaterial. This study was performed at laboratory scale. All the experiments were carried out in the batch process. The concentration of lead was constant (25mg/lit) in the experiment and effect of titanium dioxide dose and pH were varied to study the removal efficiency of the lead by adsorption. Further study was performed on the dependence of photocatalytic reaction on the reaction temperature. The aqueous solution was prepared by Lead metal powder. TiO2 photo catalyst nanopowder used was Sisco-74629 grade. The heavy metal is analyzed with VARIAN AA 240 atomic adsorption spectrophotometer. The study shows, with increasing TiO2 dose and pH the lead removal increases. According to study, it can be concluded that the utilization of titanium dioxide accounted for higher efficiency in the removal of lead from aqueous solution.

Keywords: adsorption, heavy metals, nanomaterial, photocatalysis

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Authors: T. Iakovleva

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Present paper suggests a theoretical model that describes the process of the development of responsible innovations on the firm level in health and welfare sectors. There is a need to develop new firm strategies in these sectors. This paper suggests to look on the concept of responsible innovation that was originally developed on the social level and to apply this new concept to the new area of firm strategy. The rapid global diffusion of information and communication technologies has greatly improved access to knowledge. At the same time, communication is cheap, information is a commodity, and global trade increases technological diffusion. As a result, firms and users, including those outside of industrialized nations, get early exposure to the latest technologies and information. General-purpose technologies such as mobile phones and 3D printers enable individuals to solve local needs and customize products. The combined effect of these changes is having a profound impact on the innovation landscape. Meanwhile, the healthcare sector is facing unprecedented challenges, which are magnified by budgetary constraints, an aging population and the desire to provide care for all. On the other hand, patients themselves are changing. They are savvier about their diseases, they expect their relation with the healthcare professionals to be open and interactive, but above all they want to be part of the decision process. All of this is a reflection of what is already happening in other industries where customers have access to large amount of information and became educated buyers. This article addresses the question of how ICT research and innovation may contribute to developing solutions to grand societal challenges in a responsible way. A broad definition of the concept of responsibility in the context of innovation is adopted in this paper. Responsibility is thus seen as a collective, uncertain and future-oriented activity. This opens the questions of how responsibilities are perceived and distributed and how innovation and science can be governed and stewarded towards socially desirable and acceptable ends. This article addresses a central question confronting politicians, business leaders, and regional planners.

Keywords: responsible innovation, ICT, healthcare, welfare sector

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Authors: S. Reshma Reghu, Shiburaj Sugathan, T. G. Nandu, K. B. Ramesh Kumar, Mathew Dan

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Bacterial diseases are considered to be one of the most prevalent health hazards in the developing world and many bacteria are becoming resistant to existing antibiotics making the treatment ineffective. Thus, it is necessary to find novel targets and develop new antibacterial drugs with a novel mechanism of action. The process of bacterial cell division is a novel and attractive target for new antibacterial drug discovery. FtsZ, a homolog of eukaryotic tubulin, is the major protein of the bacterial cell division machinery and is considered as an important antibacterial drug target. Zingiberaceae, the Ginger family consists of aromatic herbs with creeping rhizomes. Many of these plants have antimicrobial properties.This study aimed to determine the anti-bacterial activity of selected Zingiberaceous plants by targeting bacterial cell division protein, FtsZ. Essential oils and methanol extracts of Amomum ghaticum, Alpinia galanga, Kaempferia galanga, K. rotunda, and Zingiber officinale were tested to find its antibacterial efficiency using disc diffusion method against authentic bacterial strains obtained from MTCC (India). Essential oil isolated from A.galanga and Z.officinale were further assayed for FtsZ inhibition assay following non-radioactive malachite green-phosphomolybdate assay using E. coli FtsZ protein obtained from Cytoskelton Inc., USA. Z.officinale essential oil possess FtsZ inhibitory property. A molecular docking study was conducted with the known bioactive compounds of Z. officinale as ligands with the E. coli FtsZ protein homology model. Some of the major constituents of this plant like catechin, epicatechin, and gingerol possess agreeable docking scores. The results of this study revealed that several chemical constituents in Ginger plants can be utilised as potential source of antibacterial activity and it can warrant further investigation through drug discovery studies.

Keywords: antibacterial, FtsZ, zingiberaceae, docking

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Authors: A. Aulinger, A. M. Backes, J. Bieser, V. Matthias, M. Quante

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High concentrations of particles pose a threat to human health. Thus, legal maximum concentrations of PM10 and PM2.5 in ambient air have been steadily decreased over the years. In central Europe, the inorganic species ammonium sulphate and ammonium nitrate make up a large fraction of fine particles. Many studies investigate the influence of emission reductions of sulfur- and nitrogen oxides on aerosol concentration. Here, we focus on the influence of ammonia (NH3) emissions. While emissions of sulphate and nitrogen oxides are quite well known, ammonia emissions are subject to high uncertainty. This is due to the uncertainty of location, amount, time of fertilizer application in agriculture, and the storage and treatment of manure from animal husbandry. For this study, we implemented a crop growth model into the SMOKE emission model. Depending on temperature, local legislation, and crop type individual temporal profiles for fertilizer and manure application are calculated for each model grid cell. Additionally, the diffusion from soils and plants and the direct release from open and closed barns are determined. The emission data was used as input for the Community Multiscale Air Quality (CMAQ) model. Comparisons to observations from the EMEP measurement network indicate that the new ammonia emission module leads to a better agreement of model and observation (for both ammonia and ammonium). Finally, the ammonia emission model was used to create emission scenarios. This includes emissions based on future European legislation, as well as a dynamic evaluation of the influence of different agricultural sectors on particle formation. It was found that a reduction of ammonia emissions by 50% lead to a 24% reduction of total PM2.5 concentrations during winter time in the model domain. The observed reduction was mainly driven by reduced formation of ammonium nitrate. Moreover, emission reductions during winter had a larger impact than during the rest of the year.

Keywords: ammonia, ammonia abatement strategies, ctm, seasonal impact, secondary aerosol formation

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Authors: Anna Lierova, Jitka Kasparova, Marcela Jelicova, Lucie Korecka, Zuzana Bilkova, Zuzana Sinkorova

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Hyaluronic acid (HA) is a simple linear, unbranched polysaccharide with a lot of exceptional physiological and chemical properties such as high biocompatibility and biodegradability, strong hydration and viscoelasticity that depend on the size of the molecule. It plays the important role in a variety of molecular events as tissue hydration, mechanical protection of tissues and as well as during inflammation, leukocyte migration, and extracellular matrix remodeling. Also, HA-based biomaterials, including HA scaffolds, hydrogels, thin membranes, matrix grafts or nanoparticles are widely use in various biomedical applications. Our goal is to determine the radioprotective effect of hyaluronic acid nanoparticles (HA NPs). We are investigating effect of ionizing radiation on stability of HA NPs, in vitro relative toxicity of nanoscale as well as effect on cell lines and specific surface receptors and their response to ionizing radiation. An exposure to ionizing radiation (IR) can irreversibly damage various cell types and may thus have implications for the level of the whole tissue. Characteristic manifestations are formation of over-granulated tissue, remodeling of extracellular matrix (ECM) and abortive wound healing. Damages are caused by either direct interaction with DNA and IR proteins or indirectly by radicals formed during radiolysis of water Accumulation and turnover of ECM are a hallmark of radiation induces lung injury, characterized by inflammation, repair or remodeling health pulmonary tissue. HA is a major component of ECM in lung and plays an important role in regulating tissue injury, accelerating tissue repair, and controlling disease outcomes. Due to that, HA NPs were applied to in vivo model (C57Bl/6J mice) before total body or partial thorax irradiation. This part of our research is targeting on effect of exogenous HA on the development and/or mitigating acute radiation syndrome and radiation induced lung injuries.

Keywords: hyaluronic acid, ionizing radiation, nanoparticles, radiation induces lung damages

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Authors: Maciej Jedrzejczyk, Karolina Marzantowicz

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Traditional utility value chain is being transformed during last few years into unbundled markets. Increased distributed generation of energy is one of considerable challenges faced by Smart Grid networks. New sources of energy introduce volatile demand response which has a considerable impact on traditional middlemen in E&U market. The purpose of this research is to search for ways to allow near-real-time electricity markets to transact with surplus energy based on accurate time synchronous measurements. A proposed framework evaluates the use of secure peer-2-peer (P2P) communication and distributed transaction ledgers to provide flat hierarchy, and allow real-time insights into present and forecasted grid operations, as well as state and health of the network. An objective is to achieve dynamic grid operations with more efficient resource usage, higher security of supply and longer grid infrastructure life cycle. Methods used for this study are based on comparative analysis of different distributed ledger technologies in terms of scalability, transaction performance, pluggability with external data sources, data transparency, privacy, end-to-end security and adaptability to various market topologies. An intended output of this research is a design of a framework for safer, more efficient and scalable Smart Grid network which is bridging a gap between traditional components of the energy network and individual energy producers. Results of this study are ready for detailed measurement testing, a likely follow-up in separate studies. New platforms for Smart Grid achieving measurable efficiencies will allow for development of new types of Grid KPI, multi-smart grid branches, markets, and businesses.

Keywords: autonomous agents, Distributed computing, distributed ledger technologies, large scale systems, micro grids, peer-to-peer networks, Self-organization, self-stabilization, smart grids

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Authors: Norbert W. Paul

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Since a number of years, scientific interest in human resilience is rapidly increasing especially in psychology and more recently and highly visible in neurobiological research. Concepts of resilience are regularly discussed in the light of liminal experiences and existential challenges in human life. Resilience research is providing both, explanatory models and strategies to promote or foster human resilience. Surprisingly, these approaches attracted little attention so far in philosophy in general and in ethics in particular. This is even more astonishing given the fact that the neurosciences as such have been and still are of major interest to philosophy and ethics and even brought about the specialized field of neuroethics, which, however, is not concerned with concepts of resilience, so far. As a result of the little attention given to the topic of resilience, the whole concept has to date been a philosophically under-theorized. This abstinence of ethics and philosophy in resilience research is lamentable because resilience as a concept as well as resilience interventions based on neurobiological findings do undoubtedly pose philosophical, social and ethical questions. In this paper, we will argue that particular notions of resilience are crossing the sometimes fine line between maintaining a person’s mental health despite the impact of severe psychological or physical adverse events and ethically more debatable discourses of enhancement. While we neither argue for or against enhancement nor re-interpret resilience research and interventions by subsuming them strategies of psychological and/or neuro-enhancement, we encourage those who see social or ethical problems with enhancement technologies should also take a closer look on resilience and the related neurobiological concepts. We will proceed in three steps. In our first step, we will describe the concept of resilience in general and its neurobiological study in particular. Here, we will point out some important differences in the way ‘resilience’ is conceptualized and how neurobiological research understands resilience. In what follows we will try to show that a one-sided concept of resilience – as it is often presented in neurobiological research on resilience – does pose social and ethical problems. Secondly, we will identify and explore the social and ethical challenges of (neurobiological) enhancement. In the last and final step of this paper, we will argue that a one-sided reading of resilience can be understood as latent form of enhancement in transition and poses ethical questions similar to those discussed in relation to other approaches to the biomedical enhancement of humans.

Keywords: resilience, neurosciences, epistemology, bioethics

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Authors: Hafiza Javaria Ashraf, Asim Abbasi, Muhammad Hussnain Babar, Muhammad Sufyan

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Brevicoryne brassicae (Aphid) is not only the major biotic constraint of rapeseed crop but also transmits 20 different viral pathogens that cause diseases in crucifers. Aphids cause major losses to rapeseed by stunting growth and yield, with real damage being contamination of harvested heads. The misuse of pesticides has led to tremendous economic losses and hazards to human health and environmental pollution. Thus, newer approaches for pest control are continuously being sought. The naturally occurring, biologically active plant-based products seem to have a prominent role in the development of future commercial pesticides not only for increased productivity but their eco-friendly nature. The present experiment was carried out in Research Area of Ayub Agriculture Research Institute, Faisalabad to check the efficacy of different botanicals against rapeseed aphid. The tested botanicals were, neem seed extract, neem leaf extract, dathora seed extract, kaner leaf extract and aak leaf extract. Insecticide, advantage 20 EC served as the positive control in the experiment. Data was recorded before and after 1, 3 and 7 days of treatment application. The results of the experiment revealed that neem seed extract exhibited maximum mortality (48.42%) followed by dathora (45.54%) and kaner leaf extract (40.29%) after 7 days of treatment application. However minimum mortality i.e. 26.64% was observed in case of aak leaf extract. Advantage encountered maximum mortality i.e. 86.14%. All treatments caused maximum mortality after 7 days of treatment application. In case of pollinators maximum population reduction was observed in case of insecticide (74.29%) while minimum reduction was observed in neem leaf extract (11.57%). Hence it was concluded that unlike insecticides, plant based products can be a better option for regulating pests and conserving beneficial insect fauna.

Keywords: Aphid, mortality, plant based, pollinators

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Authors: Axel Mancebo, Ana M. Bada, Angel Casacó, Bárbara González, Avelina León, María E. Arteaga, Consuelo González, Belinda Sánchez, Adriana Carr, Nuris Ledón, Arianna Iglesias

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Despite the many preventive and therapeutic modalities aimed at curing cancer, it remains as a serious world health problem. Promising recent developments suggest that cancer immunotherapy may be the next great hope for cancer treatment. EGFRs are receptor tyrosine kinases and it is considered an important therapeutic target related with tumor progression, and several types of molecular therapies, including monoclonal antibodies, small molecules, and vaccines, have been developed to target the HER family of receptors. On the other hand, gangliosides are membrane glycosphingolipids that contain two variants of sialic acid, the N-acetylated (NeuAc) and the N-glycolylated (NeuGc) variant. The high expression of this antigen-specific molecule has been associated with malignant tumor progression and immunosuppressive mechanisms, so ganglioside could be considered as the target for cancer immunotherapy. We have been working for several years in the safety evaluation of cancer vaccines targeting these two systems, the EGF receptor and ganglioside. We presented in this work results of repeated dose toxicity studies performed in Sprague Dawley rats and Cynomolgus monkeys, including clinical observations, body weight and rectal temperature measuring, clinical pathology analysis, gross necropsy and histological examination in rodent studies, and immunological evaluation. Immunizations were capable of inducing mainly inflammatory effects at the injection site, with findings largely attributable to the adjuvants used and probably enhanced by the immunological properties of the antigens. In general, these vaccines were shown to be well tolerated, and these studies in relevant species allow treating cancer patients with tumors during long periods with relative weight safety margin.

Keywords: cancer vaccines, safety, toxicology, rats, non human primates

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Authors: Lauren C. Porter, Andrew Curtis, Eric Jefferis, Susanne Mitchell

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A wealth of research has been generated examining the variation in crime across neighborhoods. However, there is also a striking degree of crime concentration within neighborhoods. A number of studies show that a small percentage of street segments, intersections, or addresses account for a large portion of crime. Not surprisingly, a focus on these crime hot spots can be an effective strategy for reducing community level crime and related ills, such as health problems. However, research is also limited in an important respect. Studies tend to use official data to identify hot spots, such as 911 calls or calls for service. While the use of call data may be more representative of the actual level and distribution of crime than some other official measures (e.g. arrest data), call data still suffer from the 'dark figure of crime.' That is, there is most certainly a degree of error between crimes that occur versus crimes that are reported to the police. In this study, we present an alternative method of identifying crime hot spots, that does not rely on official data. In doing so, we highlight the potential utility of neighborhood-insiders to identify and understand crime dynamics within geographic spaces. Specifically, we use spatial video and geo-narratives to record the crime insights of 36 police, ex-offenders, and residents of a high crime neighborhood in northeast Ohio. Spatial mentions of crime are mapped to identify participant-identified hot spots, and these are juxtaposed with calls for service (CFS) data. While there are bound to be differences between these two sources of data, we find that one location, in particular, a corner store, emerges as a hot spot for all three groups of participants. Yet it does not emerge when we examine CFS data. A closer examination of the space around this corner store and a qualitative analysis of narrative data reveal important clues as to why this store may indeed be a hot spot, but not generate disproportionate calls to the police. In short, our results suggest that researchers who rely solely on official data to study crime hot spots may risk missing some of the most dangerous places.

Keywords: crime, narrative, video, neighborhood

Procedia PDF Downloads 218

Authors: Jiajia Peng, Yijun Dong, Jianjun Ren, Yu Zhao

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Objectives: Understanding the association between sleep traits and tinnitus could help prevent and provide appropriate interventions against tinnitus. Therefore, this study aimed to assess the relationship between different sleep patterns and tinnitus. Design: A cross-sectional analysis using baseline data (2006–2010, n=168,064) by logistic regressions was conducted to evaluate the association between sleep traits (including the overall health sleep score and five sleep behaviors), and the occurrence (yes/no), frequency (constant/transient), and severity (upsetting/not upsetting) of tinnitus. Further, a prospective analysis of participants without tinnitus at baseline (n=9,581) was performed, who had been followed up for seven years (2012–2019) to assess the association between new-onset tinnitus and sleep characteristics. Moreover, a subgroup analysis was also carried out to estimate the differences in sex by dividing the participants into male and female groups. A sensitivity analysis was also conducted by excluding ear-related diseases to avoid their confounding effects on tinnitus (n=102,159). Results: In the cross-sectional analysis, participants with “current tinnitus” (OR: 1.13, 95% CI: 1.04–1.22, p=0.004) had a higher risk of having a poor overall healthy sleep score and unhealthy sleep behaviors such as short sleep durations (OR: 1.09, 95% CI: 1.04–1.14, p<0.001), late chronotypes (OR: 1.09, 95% CI: 1.05–1.13, p<0.001), and sleeplessness (OR: 1.16, 95% CI: 1.11–1.22, p<0.001) than those participants who “did not have current tinnitus.” However, this trend was not obvious between “constant tinnitus” and “transient tinnitus.” When considering the severity of tinnitus, the risk of “upsetting tinnitus” was obviously higher if participants had lower overall healthy sleep scores (OR: 1.31, 95% CI: 1.13–1.53, p<0.001). Additionally, short sleep duration (OR: 1.22, 95% CI: 1.12–1.33, p<0.001), late chronotypes (OR: 1.13, 95% CI: 1.04–1.22, p=0.003), and sleeplessness (OR: 1.43, 95% CI: 1.29–1.59, p<0.001) showed positive correlations with “upsetting tinnitus.” In the prospective analysis, sleeplessness presented a consistently significant association with “upsetting tinnitus” (RR: 2.28, P=0.001). Consistent results were observed in the sex subgroup analysis, where a much more pronounced trend was identified in females compared with males. The results of the sensitivity analysis were consistent with those of the cross-sectional and prospective analyses. Conclusions: Different types of sleep disturbance may be associated with the occurrence and severity of tinnitus; therefore, precise interventions for different types of sleep disturbance, particularly sleeplessness, may help in the prevention and treatment of tinnitus.

Keywords: tinnitus, sleep, sleep behaviors, sleep disturbance

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Authors: Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail, Brian Davies

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Aim: This study aims to identify the barriers and challenges hindering the implementation of effective controls and the adoption of safe work practices to protect workers from respirable crystalline silica (RCS) exposure. Problem or Situation: Tunnelling is one of many occupations that expose workers to the harmful effects of respirable crystalline silica. Despite various control measures, such as engineering controls and personal protective equipment, exposures remain inadequately controlled, leading to incurable silicosis and other severe illnesses, such as lung cancer. Methods: The research involved surveying tunnel construction workers, conducting interviews, and facilitating focus group discussions. Additionally, site observations and content analysis of work procedures and instructions were performed. Results: Preliminary data analysis reveals notable findings. While there is a commendable level of knowledge and commitment among management and workers concerning RCS exposure in tunnelling, there is a striking lack of prioritization regarding dust control. Moreover, the risks associated with dust exposure are not sufficiently acknowledged. Additionally, the data suggests that engineers and supervisors responsible for implementing dust controls often possess limited knowledge regarding the factors influencing the effectiveness of these measures. These findings emphasise the need for a paradigm shift, including higher prioritisation of dust control, adoption of holistic dust reduction strategies, and enhanced knowledge about effective control measures. Conclusion: This research shed light on tunnel construction workers' barriers and challenges in protecting themselves from RCS exposure. This knowledge will be essential in developing interventions and strategies to enhance dust exposure and prevent the adverse health effects of respirable crystalline silica exposure in tunnelling and similar industries.

Keywords: respirable crystalline silica, dust control, worker practices, exposure prevention, silicosis

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Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku

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Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.

Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk

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Authors: Eleni Stefanidou, Nikolaos Katsenios, Ioanna Karamichali, Aspasia Efthimiadou, Panagiotis Madesis

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The excessive use of pesticides and fertilizers has significant environmental and human health-related negative effects. In the frame of the development of sustainable agriculture practices, especially in the context of extreme environmental changes (climate change), it is important to develop alternative practices to increase productivity and biotic and abiotic stress tolerance. Beneficial bacteria, such as symbiotic bacteria in legumes (rhizobia) and symbiotic or free-living Plant Growth Promoting Rhizobacteria (PGPR), which could act as "plant probiotics", can promote plant growth and significantly increase the resistance of crops under adverse environmental conditions. In this study, we explored the symbiotic relationships between Faba bean (Vicia faba L.) cultivars with different PGPR bacteria, aiming to identify the possible influence on yield and biotic-abiotic phytoprotection benefits. Transcriptomic analysis of root and whole plant samples was executed for two Vicia faba L. cultivars (Polikarpi and Solon) treated with selected PGPR bacteria (6 treatments: B. subtilis + Rhizobium-mixture, A. chroococcum + Rhizobium-mixture, B. subtilis, A. chroococcum and Rhizobium-mixture). Preliminary results indicate a significant yield (Seed weight and Total number of pods) increase in both varieties, ranging around 25%, in comparison to the control, especially for the Solon cultivar. The increase was observed for all treatments, with the B. subtilis + Rhizobium-mixture treatment being the highest performing. The correlation of the physiological and morphological data with the transcriptome analysis revealed molecular mechanisms and molecular targets underlying the observed yield increase, opening perspectives for the use of nitrogen-fixing bacteria as a natural, more ecological enhancer of legume crop productivity.

Keywords: plant probiotics, PGPR, legumes, sustainable agriculture

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Authors: Ruchi Garg

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Background: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, named after the first President of India, was established on the 10th of March, 1967 as a National Center for ophthalmic science to provide state-of-the-art patient care, expand human resources for medical education and undertake research to find solutions to eye health problems of national importance. The average number of cataract surgeries performed per month is 700 to 1000. Methods: Anticipating implementation in 50% cases hundred cases of cataract surgery were observed to study the existing system of surgical safety followed at Dr. R.P. Center and gap analysis done against the WHO surgical safety checklist for cataract surgery. A modified WHO surgical safety checklist for cataract surgery was developed and implemented in the center. Barriers in the implementation of the surgical safety checklist were also identified, and remedial measures were suggested. Results: Significant improvement was noticed in all the parameters after the introduction of the modified checklist. The additional points which were added in the modified surgical safety checklist were implemented in almost all the cases by the nursing staff. The overall mean compliance percentage before the implementation of the modified surgical safety checklist at Dr. R.P.C was 37%±10.1 (P=0.001). While after the introduction of the modified surgical safety checklist, the mean compliance has improved to 62.7%±10.3; the Wilcoxon rank sum test/Independent test is applied for each domain. Conclusions: The cataract procedure is the most common surgical procedure performed in the population in India. High volume and high turnover increase the potential for errors. Compliance with the surgical safety checklist before intervention was 32%. After intervention in the form of a focus group discussion and introduction of a modified surgical safety checklist has resulted in an increase in the compliance rate to 67%, this study revealed that changes or additional work are not happily accepted by the staff. After six months of intervention with the modified surgical safety checklist compliance rate was still high, this suggests that constant supervision and monitoring by senior staff can sustain the compliance rate.

Keywords: patient safety, hospital safety, quality, WHO surgical safety checklist

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Authors: Sheng Yu Chen, Shi-Heng Wang

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Aim: Based on human, animal experiments, and genetic studies, cysteinyl leukotrienes, LTC4, LTD4, and LTE4, are inflammatory substances that are metabolized by 5-lipooxygenase from arachidonic acid, and these substances trigger asthma. In addition, the synthetic pathway of cysteinyl leukotriene is relevant to the increase in cardiovascular diseases such as myocardial ischemia and stroke. Given the situation, we aim to investigate whether cysteinyl leukotrienes receptor antagonist (LTRA), montelukast which cures those who have asthma has potential protective effects on cardiovascular diseases. Method: We conducted a cohort study, and enrolled participants which are newly diagnosed with asthma (ICD-9 CM code 493. X) between 2002 to 2011. The data source is from Taiwan National Health Insurance Research Database Patients with a previous history of myocardial infarction or ischemic stroke were excluded. Among the remaining participants, every montelukast user was matched with two randomly non-users by sex, and age. The incident cardiovascular diseases, including myocardial infarction and ischemic stroke, were regarded as outcomes. We followed the participants until outcomes come first or the end of the following period. To explore the protective effect of montelukast on the risk of cardiovascular disease, we use multivariable Cox regression to estimate the hazard ratio with adjustment for potential confounding factors. Result: There are 55876 newly diagnosed asthma patients who had at least one claim of inpatient admission or at least three claims of outpatient records. We enrolled 5350 montelukast users and 10700 non-users in this cohort study. The following mean (±SD) time of the Montelukast group is 5 (±2.19 )years, and the non-users group is 6.2 5.47 (± 2.641) years. By using multivariable Cox regression, our analysis indicated that the risk of incident cardiovascular diseases between montelukast users (n=43, 0.8%) and non-users (n=111, 1.04%) is approximately equal. [adjusted hazard ratio 0.992; P-value:0.9643] Conclusion: In this population-based study, we found that the use of montelukast is not associated with a decrease in incident MI or IS.

Keywords: asthma, inflammation, montelukast, insurance research database, cardiovascular diseases

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Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

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Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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Authors: Xiaowei Zhang, Min Xu, Saeid Habibi, Fengjun Yan, Ryan Ahmed

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Recently, Electric Vehicles (EVs) have received extensive consideration since they offer a more sustainable and greener transportation alternative compared to fossil-fuel propelled vehicles. Lithium-Ion (Li-ion) batteries are increasingly being deployed in EVs because of their high energy density, high cell-level voltage, and low rate of self-discharge. Since Li-ion batteries represent the most expensive component in the EV powertrain, accurate monitoring and control strategies must be executed to ensure their prolonged lifespan. The Battery Management System (BMS) has to accurately estimate parameters such as the battery State-of-Charge (SOC), State-of-Health (SOH), and Remaining Useful Life (RUL). In order for the BMS to estimate these parameters, an accurate and control-oriented battery model has to work collaboratively with a robust state and parameter estimation strategy. Since battery physical parameters, such as the internal resistance and diffusion coefficient change depending on the battery state-of-life (SOL), the BMS has to be adaptive to accommodate for this change. In this paper, an extensive battery aging study has been conducted over 12-months period on 5.4 Ah, 3.7 V Lithium polymer cells. Instead of using fixed charging/discharging aging cycles at fixed C-rate, a set of real-world driving scenarios have been used to age the cells. The test has been interrupted every 5% capacity degradation by a set of reference performance tests to assess the battery degradation and track model parameters. As battery ages, the combined model parameters are optimized and tracked in an offline mode over the entire batteries lifespan. Based on the optimized model, a state and parameter estimation strategy based on the Extended Kalman Filter (EKF) and the relatively new Smooth Variable Structure Filter (SVSF) have been applied to estimate the SOC at various states of life.

Keywords: lithium-ion batteries, genetic algorithm optimization, battery aging test, parameter identification

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Authors: Nicholas Pearce, Eun-jin Kim

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Pathologies of the cardiovascular (CV) system remain a serious and deadly health problem for human society. Computational modelling provides a relatively accessible tool for diagnosis, treatment, and research into CV disorders. However, numerical models of the CV system have largely focused on the function of the ventricles, frequently overlooking the behaviour of the atria. Furthermore, in the study of the pressure-volume relationship of the heart, which is a key diagnosis of cardiac vascular pathologies, previous works often evoke popular yet questionable time-varying elastance (TVE) method that imposes the pressure-volume relationship instead of calculating it consistently. Despite the convenience of the TVE method, there have been various indications of its limitations and the need for checking its validity in different scenarios. A model of the combined left ventricle (LV) and left atrium (LA) is presented, which consistently considers various feedback mechanisms in the heart without having to use the TVE method. Specifically, a synergistic model of the left ventricle is extended and modified to include the function of the LA. The synergy of the original model is preserved by modelling the electro-mechanical and chemical functions of the micro-scale myofiber for the LA and integrating it with the microscale and macro-organ-scale heart dynamics of the left ventricle and CV circulation. The atrioventricular node function is included and forms the conduction pathway for electrical signals between the atria and ventricle. The model reproduces the essential features of LA behaviour, such as the two-phase pressure-volume relationship and the classic figure of eight pressure-volume loops. Using this model, disorders in the internal cardiac electrical signalling are investigated by recreating the mechano-electric feedback (MEF), which is impossible where the time-varying elastance method is used. The effects of AV node block and slow conduction are then investigated in the presence of an atrial arrhythmia. It is found that electrical disorders and arrhythmia in the LA degrade the CV system by reducing the cardiac output, power, and heart rate.

Keywords: cardiovascular system, left atrium, numerical model, MEF

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Authors: O. Elkana, O Heyman, S. Hamdan, M. Franko, J. Vatine

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Objective: To investigate whether a direct link exists between perceived pain (PP) and executive functions (EF), above and beyond the influence of depression symptoms, in the context of medical rehabilitation. Design: Cross-sectional study. Setting: Rehabilitation Hospital. Participants: 125 medical records of hospitalized patients were screened for matching to our inclusion criteria. Only 60 patients were found fit and were asked to participate. 19 decline to participate on personal basis. The 41 neurologically intact patients (mean age 46, SD 14.96) that participated in this study were in their sub-acute stage of recovery, with fluent Hebrew, with intact upper limb (to neutralize influence on psychomotor performances) and without an organic brain damage. Main Outcome Measures: EF were assessed using the Wisconsin Card Sorting Test (WCST) and the Stop-Signal Test (SST). PP was measured using 3 well-known pain questionnaires: Pain Disability Index (PDI), The Short-Form McGill Questionnaire (SF-MPQ) and the Pain Catastrophizing Scale (PCS). Perceived pain index (PPI) was calculated by the mean score composite from the 3 pain questionnaires. Depression symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Results: The results indicate that irrespective of the presence of depression symptoms, PP is directly correlated with response inhibition (SST partial correlation: r=0.5; p=0.001) and mental flexibility (WSCT partial correlation: r=-0.37; p=0.021), suggesting decreased performance in EF as PP severity increases. High correlations were found between the 3 pain measurements: SF-MPQ with PDI (r=0.62, p<0.001), SF-MPQ with PCS (r=0.58, p<0.001) and PDI with PCS (r=0.38, p=0.016) and each questionnaire alone was also significantly associated with EF; thus, no specific questionnaires ‘pulled’ the results obtained by the general index (PPI). Conclusion: Examining the direct association between PP and EF, beyond the contribution of depression symptoms, provides further clinical evidence suggesting that EF and PP share underlying mediating neuronal mechanisms. Clinically, the importance of assessing patients' EF abilities as well as PP severity during rehabilitation is underscored.

Keywords: depression, executive functions, mental-flexibility, neuropsychology, pain perception, perceived pain, response inhibition

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Authors: Marah Joy A. Nanglegan

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A survey was conducted to describe knowledge, attitude, practices, information needs, and information seeking behavior of small-scale farmers on Organic Agriculture Production (OAP) in a rural community in Ifugao, Philippines. Respondents’ age ranged from 23-67 years old. Most of them are male, married, and have reached high school level. The major source of income is farming with an average monthly income of less than Php 5,000 for a household size of seven. More than fifty percent of the respondents are members of a farmer’s organization. Farm size is less than one hectare. Majority of them own their farms and have been farming for more than twenty years. Very few attended training on Organic Agriculture Production (OAP). Most of them are not aware of any OAP program in their community. Hence, their farming practices are mostly conventional. The overall level of knowledge on OAP among all respondents was below the average. On attitude, most of the respondents agreed that organic farming would decrease production costs by reducing input purchases. They believe it benefits both the consumer and the producer. In fact, they are aware of the many benefits of organic farming, especially on health. Likewise, many of them agreed on the benefits of organic farming to soil fertility, to the environment, and to increase the income of farmers. Many of them, however, see organic farming as troublesome and difficult in terms of time and effort, obtaining organic inputs, limited production, and marketing aspects. They also have heavy reliance on pesticides and herbicides to control pests and diseases. On practices, majority of the respondents stated that they practiced crop rotation, manual weeding, and the use of animal manure. Most of them desired to do organic farming but needed information such as production techniques, costs, and marketing opportunities. Their most preferred communication channel is through extension agents and contact farmers. Their most preferred communication method is through trainings and seminars as well as through farm demonstrations. Results of this study will serve as a basis for developing appropriate communication strategies to improve knowledge, attitude, and practices of respondents on organic agriculture as well as enhance the promotion of organic agriculture production in the community.

Keywords: Ifugao, knowledge attitude practices, organic agriculture, Philippines

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Authors: Selamat Muliadi

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This study aimed to explain conceptual the role of Zakat on sustainable economic development by Rumah Zakat. Rumah Zakat is a philanthropic institution that manages zakat and other social funds through community empowerment programs. In running the program, including economic empowerment and socio health services are designed for these recipients. Rumah Zakat's connection with the establisment of Sustainable Development Goals (SDGs) which is to help impoverished recipients economically and socially. It’s an important agenda that the government input into national development, even the region. The primary goal of Zakat on sustainable economic development, not only limited to economic variables but based on Islamic principles, has comprehensive characteristics. The characteristics include moral, material, spiritual, and social aspects. In other words, sustainable economic development is closely related to improving people’s living standard (Mustahiq). The findings provide empiricial evidence regarding the positive contribution and effectiveness of zakat targeting in reducing poverty and improve the welfare of people related with the management of zakat. The purpose of this study was to identify the role of Zakat on sustainable economic development, which was applied by Rumah Zakat. This study used descriptive method and qualitative analysis. The data source was secondary data collected from documents and texts related to the research topic, be it books, articles, newspapers, journals, or others. The results showed that the role of zakat on sustainable economic development by Rumah Zakat has been quite good and in accordance with the principle of Islamic economics. Rumah Zakat programs are adapted to support intended development. The contribution of the productive program implementation has been aligned with four goals in the Sustainable Development Goals, i.e., Senyum Juara (Quality Education), Senyum Lestari (Clean Water and Sanitation), Senyum Mandiri (Entrepreneur Program) and Senyum Sehat (Free Maternity Clinic). The performance of zakat in the sustainable economic empowerment community at Rumah Zakat is taking into account dimensions such as input, process, output, and outcome.

Keywords: Zakat, social welfare, sustainable economic development, charity

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Authors: Soledad Carinelli, Iñigo Fernández, José Luis González-Mora, Pedro A. Salazar-Carballo

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Mastitis is the most relevant inflammatory disease in cattle, affecting the animal health and causing important economic losses on dairy farms. This disease takes place in the mammary gland or udder when some opportunistic microorganisms, such as Staphylococcus aureus, Streptococcus agalactiae, Corynebacterium bovis, etc., invade the teat canal. According to the severity of the inflammation, mastitis can be classified as sub-clinical, clinical and chronic. Standard methods for mastitis detection include counts of somatic cells, cell culture, electrical conductivity of the milk, and California test (evaluation of “gel-like” matrix consistency after cell lysed with detergents). However, these assays present some limitations for accurate detection of subclinical mastitis. Currently, haptoglobin, an acute phase protein, has been proposed as novel and effective biomarker for mastitis detection. In this work, an electrochemical biosensor based on polydopamine-modified magnetic nanoparticles (MNPs@pDA) for haptoglobin detection is reported. Thus, MNPs@pDA has been synthesized by our group and functionalized with hemoglobin due to its high affinity to haptoglobin protein. The protein was labeled with specific antibodies modified with alkaline phosphatase enzyme for its electrochemical detection using an electroactive substrate (1-naphthyl phosphate) by differential pulse voltammetry. After the optimization of assay parameters, the haptoglobin determination was evaluated in milk. The strategy presented in this work shows a wide range of detection, achieving a limit of detection of 43 ng/mL. The accuracy of the strategy was determined by recovery assays, being of 84 and 94.5% for two Hp levels around the cut off value. Milk real samples were tested and the prediction capacity of the electrochemical biosensor was compared with a Haptoglobin commercial ELISA kit. The performance of the assay has demonstrated this strategy is an excellent and real alternative as screen method for sub-clinical bovine mastitis detection.

Keywords: bovine mastitis, haptoglobin, electrochemistry, magnetic nanoparticles, polydopamine

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Authors: Patsy Tan, Dana Baltutis

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This presentation demonstrates the effectiveness of music therapy in co-treatment with speech pathology and occupational therapy as an innovative way when working with children and adolescents with complex individual differences to facilitate communication, emotional, motor and social skills development. Each child with special needs and their carer has an individual profile which encompasses their visual-spatial, auditory, language, learning, mental health, family dynamic, sensory-motor, motor planning and sequencing profiles. The most common issues among children with special needs, especially those diagnosed with Autism Spectrum Disorder, are in the areas of regulation, communication, and social-emotional development. The ability of children living with challenges to communicate and use language and understand verbal and non-verbal information, as well as move their bodies to explore and interact with their environments in social situations, depends on the children being regulated both internally and externally and trusting their communication partners and understanding what is happening in the moment. For carers, it is about understanding the tempo, rhythm, pacing, and timing of their own individual profile, as well as the profile of the child they are interacting with, and how these can sync together. In this study, music therapy is used in co-treatment sessions with a speech pathologist and/or an occupational therapist using the DIRFloortime approach to facilitate the regulation, attention, engagement, reciprocity and social-emotional capacities of children presenting with complex individual differences. Documented changes in 10 domains of children’s development over a 12-month period using the Individual Music Therapy Assessment Profile (IMTAP) were observed. Children were assessed biannually, and results show significant improvements in the social-emotional, musicality and receptive language domains indicating that co-treatment with a music therapist using the DIRFloortime framework is highly effective. This presentation will highlight strategies that facilitate regulation, social-emotional and communication development for children and adolescents with complex individual profiles.

Keywords: communication, shared attention, regulation, social emotional

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Authors: Jun Hyung Lee, Robin B. Guevarra, Jin Ho Cho, Bo-Ra Kim, Jiwon Shin, Doo Wan Kim, Young Hwa Kim, Minho Song, Hyeun Bum Kim

Abstract:

Colibacillosis is one of the major health problems in young piglets ultimately resulting in their death, and it is common especially in young piglets. For the swine industry, colibacillosis is one of the important economic burdens. Therefore, it is necessary for the swine industries to prevent Colibacillosis in piglets in order to reduce economic losses. Thus, we tested three types of natural plant extracts (PEs) to evaluate antibacterial effects against Shiga toxin-producing Escherichia coli (STEC) isolated from the piglet. Three PEs including turmeric oleoresin (containing curcumin 79 to 85%), capsicum oleoresin (containing capsaicin 40%-40.1%), and garlic essential oil (100% natural garlic) were tested using the direct contact agar diffusion test, minimum inhibitory concentration test, growth curve assay, and heat stability test. The tests were conducted with PEs at each concentration of 2.5%, 5%, and 10%. For the heat stability test, PEs with 10% concentration were incubated at each 4, 20, 40, 60, 80, and 100 °C for 1 hour, then the direct contact agar diffusion test was used. For the positive and negative controls, 0.5N HCl and 1XPBS were used. All the experiments were duplicated. In the direct contact agar diffusion test, garlic essential oil with 2.5%, 5%, and 10% concentration showed inhibit zones of 1.1cm, 3.0cm, and 3.6 cm in diameters compared to that of 3.5cm diameter for 0.5N HCl. The minimum inhibited concentration of garlic essential oil was 2.5%. Growth curve assay showed that the garlic essential oil was able to inhibit STEC growth significantly after 4 hours. The garlic essential oil retained the ability to inhibit STEC growth after heat treatment at each temperature. However, turmeric and capsicum oleoresins were not able to significantly inhibit STEC growth by all the tests. Even though further tests using the piglets will be required to evaluate effects of garlic essential oil for the Colibacillosis prevention for piglets, our results showed that the garlic essential oil could be used as a potential natural agent to prevent Colibacillosis in swine.

Keywords: garlic essential oil, pig, Colibacillosis, Escherichia coli

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Authors: Shikhar Shrivastava, Varun Khare

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Background: We are confronted by a society that is becoming more complex, more mobile, and more dysfunctional. Teen pregnancy, suicide, elopement, and the perusal of dangerous drugs have become commonplace. In addition, children do not settle their disputes as they once did. Guns and knives are quotidian. Therefore, it has been an exigent to have a "Juvenile Code" that would provide specific substantive and procedural rules for juveniles in the justice system. However, until the twentieth century, there was little difference between how the justice system treated adults and children. Age was considered only in terms of appropriate punishment and juveniles were eligible for the same punishment as adults. Findings: The increased prevalence and legislative support for specialized courts, Juvenile Justice Boards, including juvenile drug, mental health and truancy court programs, as well as diversion programs and evidence-based approaches into the fabric of juvenile justice are just a few examples of recent advances. In India, various measures were taken to prosecute young offenders who committed violent crimes as adults. But it was argued that equating juveniles with adult criminals was neither scientifically correct nor normatively defensible. It would defeat the very purpose of the justice system. Methodology and Conclusion: This paper attempts to bring forth the results of analytical and descriptive research that examined changing trends in juvenile justice legislation. It covers the investigative and inspective practices of police, the various administrative agencies who have roles in implementing the legislation, the courts, and the detention centers. In this paper we shall discuss about how the juvenile justice system is the dumping ground for many of a youths’ problem. The changing notions of justice, from retributive to restorative and rehabilitative shall be discussed. A comparative study of the Juvenile act in India and that of the U.S has been discussed. Specific social institutions and forces that explain juvenile delinquency are identified. In addition, various influences on juvenile delinquency are noted, such as families, schools, peer groups and communities. The text concludes by addressing socialization, deterrence, imprisonments, alternatives, restitution and preventions.

Keywords: juvenile, justice system, retributive, rehabilitative, delinquency

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: Jessica Achebe, Susan Tighe

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The recent Canadian infrastructure report card reveals the unhealthy state of municipal infrastructure intensified challenged faced by municipalities to maintain adequate infrastructure performance thresholds and meet user’s required service levels. For a road agency, huge funding gap issue is inflated by growing concerns of the environmental repercussion of road construction, operation and maintenance activities. As the reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to optimal allocation of resources and reduced road user cost. Incorporating environmental sustainability measure into pavement management is solution widely cited and studied. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this study reviewed previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for sustainable network-level pavement management.

Keywords: pavement management, sustainability, network-level evaluation, environment measures

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Authors: Max Plotnikov, Arkadius Schier

Abstract:

To counteract climate change, the European Commission adopted the European Green Deal (EDG) in 2019. Some of the main objectives of the EDG are climate neutrality by 2050, decarbonization, sustainable mobility, and the shift from a linear economy to a circular economy in the European Union. The mobility turnaround envisages, among other things, the switch from classic internal combustion vehicles to electromobility. The aforementioned goals are therefore accompanied by increased demand for lithium-ion batteries (LIBs) and the associated logistics. However, this inevitably gives rise to challenges that need to be addressed. Depending on whether the LIB is transported by road, rail, air, or sea, there are different regulatory frameworks in the European Union that relevant players in the value chain must adhere to. LIBs are classified as Dangerous Goods Class 9, and against this backdrop, there are various restrictions that need to be adhered to when transporting them for various actors. Currently, the exchange of information in the value chain between the various actors is almost entirely paper-based. Especially in the transport of dangerous goods, this often leads to a delay in the transport or to incorrect data. The exchange of information with the authorities is particularly essential in this context. A solution for the digital exchange of information is currently being developed. Electronic freight transport information (eFTI) enables fast and secure exchange of information between the players in the freight transport process. This concept is to be used within the supply chain from 2025. Another initiative that is expected to improve the monitoring of LIB in this context, among other things, is the battery pass. In July 2023, the latest battery regulation was adopted in the Official Journal of the European Union. This battery pass gives different actors static as well as dynamic information about the batteries depending on their access rights. This includes master data such as battery weight or battery category or information on the state of health or the number of negative events that the battery has experienced. The integration of the battery pass with the eFTI platform will be investigated for synergy effects in favor of the actors for battery transport.

Keywords: battery logistics, battery passport, data sharing, eFTI, sustainability

Procedia PDF Downloads 59