Search results for: medical resource cost

Authors: Kurniawan Agung Pambudi, Alfian Deo Pradipta

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Yogyakarta is the famous tourism city in Indonesia. The Tugu Jogja is a tourism center located in Jetis. To support the tourism activities required facilities such as tourist hotel and guest house. The existence of tourism also has an impact on the environment. The surface of the land is covered by cement and a local company dealing in ceramics, then an infiltration process is not running. The existence of the building in layers resulting in the amount of water resource in Jetis decreases. The purpose of this research is to know the impact of the construction of the building in layers in Jetis. To obtain the data done by observation, measurements and taking the land profile, along with the interview to people in Jetis. The results of the study showed that the number of water sources in Jetis, Yogyakarta start decreases as a result of the construction of the building on stilts as a result, the height of the surface of the groundwater decreases and digging a pit must be in to get the source of the waters. Based on the results of research it can be concluded that the height of the surface of the groundwater decreases. To resolve the issue required a method to rainwater can seep into the ground for maximum. The rain that fell upon the precarious houses or other buildings is channeled toward the ground through the tubes with the depth of 1-2 meters. Rainwater will be absorbed into the land and increase the amount of ground water.

Keywords: rain water, tube, water resource, groundwater

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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: S. Avdasheva, D. Tsytsulina

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In many regulated industries over the world price cap as a method of price regulation replaces cost-plus pricing. It is a kind of incentive regulation introduced in order to enhance productive efficiency by strengthening sellers’ incentives for cost reduction as well as incentives for more efficient pricing. However pricing under cap is not neutral for competition in the market. We consider influence on competition on the markets where benchmark for cap is chosen from when sellers are multi-market. We argue that the impact of price cap regulation on market competition depends on the design of cap. More specifically if cap for one (regulated) market depends on the price of the supplier in other (non-regulated) market, there is sub-type of price cap regulation (known in Russian tariff regulation as ‘netback minus’) that enhance incentives to collude in non-regulated market.

Keywords: price regulation, competition, collusion

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Authors: Valentina Alessandra Carvalho do Vale, Elmo Thiago Lins Cöuras Ford, Rudson de Sousa Lima

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Around the planet Earth, access to clean water is a problem whose importance has increased due to population growth and its misuse. Thus, projects that seek to transform water sources improper (salty and brackish) in drinking water sources are current issues. However, this transformation generally requires a high cost of implementation, operation and maintenance. In this context, the aim of this work is the development of a passive solar distiller for brackish water, made from recycled and durable materials such as aluminum, cement, glass and PVC basins. The results reveal factors that influence the performance and viability of the expansion project.

Keywords: solar distiller, passive distiller, distiller with pyramidal roof, ecologically correct

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Authors: Lebogang L. R. Mphahlele, Bruce B. Sithole

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Chicken meat is the highest consumed meat in south Africa, with a per capita consumption of >33 kg yearly. Hence, South Africa produces over 250 million kg of waste chicken feathers each year, the majority of which is landfilled or incinerated. The discarded feathers have caused environmental pollution and natural protein resource waste. Therefore, the valorisation of waste chicken feathers is measured as a more environmentally friendly and cost-effective treatment. Feather contains 91% protein, the main component being beta-keratin, a fibrous and insoluble structural protein extensively cross linked by disulfide bonds. Keratin is usually converted it into nanofibers via electrospinning for a variety of applications. keratin nanofiber composites have many potential biomedical applications for their attractive features, such as high surface-to-volume ratio and very high porosity. The application of nanofibers in the biomedical wound dressing requires antimicrobial properties for materials. One approach is incorporating inorganic nanoparticles, among which silver nanoparticles played an important alternative antibacterial agent and have been studied against many types of microbes. The objective of this study is to combine synthetic polymer, chicken feather keratin, and antibacterial nanoparticles to develop novel electrospun antibacterial nanofibrous composites for possible wound dressing application. Furthermore, this study will converting a two-dimensional electrospun nanofiber membrane to three-dimensional fiber networks that resemble the structure of the extracellular matrix (ECM)

Keywords: chicken feather keratin, nanofibers, nanoparticles, nanocomposites, wound dressing

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Authors: Getenet Shumet Birhan, Biruk Lelisa Eticha, Gizachew Tilahun Belete, Fisseha Admassu Ayele

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Context: Glaucoma is a significant public health concern globally, being the second leading cause of blindness. This study focuses on adult glaucoma patients in Ethiopia, specifically at the University of Gondar. Research Aim: The main objective is to assess the prevalence of visual impairment and identify associated factors among adult glaucoma patients at the University of Gondar. Methodology: The study used an institution-based cross-sectional design, collecting data from 423 glaucoma patients through interviews and medical chart reviews. Descriptive statistics and logistic regression were employed for analysis. Findings: The study found a high prevalence of visual impairment (77.6%) among adult glaucoma patients, with factors such as female sex, rural residence, glaucoma type, disease stage, and duration of diagnosis significantly associated with visual impairment. Theoretical Importance: This research adds valuable insights into the prevalence and determinants of visual impairment among glaucoma patients in Ethiopia, contributing to the existing literature on eye health in low-resource settings. Data Collection: Data were collected through face-to-face interviews and medical chart reviews at the University of Gondar, utilizing a structured questionnaire. Analysis Procedures: Descriptive statistics, frequency analysis, and binary logistic regression were employed to analyze the data and identify factors associated with visual impairment in adult glaucoma patients. Question Addressed: The study sought to answer the question of the prevalence of visual impairment and its associated factors among adult glaucoma patients at the University of Gondar in Northwest Ethiopia. Conclusion: The research concludes that visual impairment is significantly high among adult glaucoma patients in this setting, with several factors playing a role in its occurrence.

Keywords: visual impairment, glaucoma, Ethiopia, Gondar

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Authors: Angela Meyer

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The operation and maintenance cost for wind parks make up a major fraction of the park’s overall lifetime cost. To minimize the cost and risk involved, an optimal operation and maintenance strategy requires continuous monitoring and analysis. In order to facilitate this, we present a decision support system that automatically scans the stream of telemetry sensor data generated from the turbines. By learning decision boundaries and normal reference operating states using machine learning algorithms, the decision support system can detect anomalous operating behavior in individual wind turbines and diagnose the involved turbine sub-systems. Operating personal can be alerted if a normal operating state boundary is exceeded. The presented decision support system and method are applicable for any turbine type and manufacturer providing telemetry data of the turbine operating state. We demonstrate the successful detection and diagnosis of anomalous operating states in a case study at a German onshore wind park comprised of Vestas V112 turbines.

Keywords: anomaly detection, decision support, machine learning, monitoring, performance optimization, wind turbines

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Authors: Mehmet Nefes, Selman Demirel, Hasan H. Ertok, Cenk Sen

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A typical reliability engineering problem regarding communication satellites has been considered to determine redundancy allocation scheme of power amplifiers within payload transponder module, whose dominant function is to amplify power levels of the received signals from the Earth, through maximizing reliability against mass, power, and other technical limitations. Adding each redundant power amplifier component increases not only reliability but also hardware, testing, and launch cost of a satellite. This study investigates a multi-objective approach used in order to solve Redundancy Allocation Problem (RAP) for a communication satellite payload transponder, focusing on design cost due to redundancy and reliability factors. The main purpose is to find the optimum power amplifier redundancy configuration satisfying reliability and capacity thresholds simultaneously instead of analyzing respectively or independently. A mathematical model and calculation approach are instituted including objective function definitions, and then, the problem is solved analytically with different input parameters in MATLAB environment. Example results showed that payload capacity and failure rate of power amplifiers have remarkable effects on the solution and also processing time.

Keywords: communication satellite payload, multi-objective optimization, redundancy allocation problem, reliability, transponder

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Authors: Doaa M. Atia, Faten H. Fahmy, Ninet M. A. El-Rahman, Hassan T. Dorra

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In this paper, the optimum design for renewable energy system powered an aquaculture pond was determined. Hybrid Optimization Model for Electric Renewable (HOMER) software program, which is developed by U.S National Renewable Energy Laboratory (NREL), is used for analyzing the feasibility of the stand-alone and hybrid system in this study. HOMER program determines whether renewable energy resources satisfy hourly electric demand or not. The program calculates energy balance for every 8760 hours in a year to simulate operation of the system. This optimization compares the demand for the electrical energy for each hour of the year with the energy supplied by the system for that hour and calculates the relevant energy flow for each component in the model. The essential principle is to minimize the total system cost while HOMER ensures control of the system. Moreover the feasibility analysis of the energy system is also studied. Wind speed, solar irradiance, interest rate and capacity shortage are the parameters which are taken into consideration. The simulation results indicate that the hybrid system is the best choice in this study, yielding lower net present cost. Thus, it provides higher system performance than PV or wind stand-alone systems.

Keywords: wind stand-alone system, photovoltaic stand-alone system, hybrid system, optimum system sizing, feasibility, cost analysis

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Authors: Narupon Kunbootsri, P. Sirasaporn

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Frozen shoulder is a common problem present by pain and limit range of motion. The prevalence of frozen shoulder showed 18-31% of population. The effect of frozen shoulder lead to limit activities daily living life, high medical care cost and so on. Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom relate to physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder relate to onset of symptom, range of motion and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, range of motion and obtaining physical modalities were recorded. There was a statistically significant increase in shoulder flexion [mean difference 38.88 with 95%CI were [16.00-61.77], shoulder abduction [mean difference 48.47 with 95%CI were 16.07-90.59], shoulder internal rotation [mean difference 22.36 with 95%CI were 2.81-37.18] and shoulder external rotation [mean difference 32.12 with 95%CI were [(-2.47)-(46.91)]. In addition, the onset of symptom was 76.42±46.90 days. And the physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, range of motions, onset of symptom, physiotherapy, physical modality

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Authors: Suleh Yusufu Godi, Ado Makama Adamu

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Marketing involves all the legal, physical, and economic services which are necessary in moving products from producer to consumers. The more efficient the marketing functions are performed the better the marketing system for the farmers, marketing agents, and the society at large. Rice marketing ensures the flow of product from producers to consumers in the form, time and place of need. Therefore, this study examined profitability of milled rice marketing in Gombe metropolis, Gombe State. Data were collected using structured questionnaires from ninety randomly selected rice marketers in Gombe metropolis. The data were analyzed using descriptive statistics, farm budget technique and regression analysis. The study revealed the total rice marketing cost incurred by rice marketers to be N6, 610,214.70. This gave an average of N73, 446.83 per marketer and N37.30 per Kilogram of rice. The Gross Income for rice marketers in Gombe metropolis was N15, 064,600.00. This value gave an average of N167, 384.44 per rice marketer or N85.00 per kilogram of rice. The study also revealed net income for all rice marketers to be N8, 454,385.30. This gave an average of N93, 937.61 per rice marketer or N47.70 per Kilogram of rice. The study further revealed a marketing margin, marketing efficiency and return per naira invested on rice marketing to be 39.30%, 150.16% and N0.56, respectively. The result of regression analysis shows that age, sex and cost of transportation are positive and significantly affect marketing margin of rice marketers in Gombe Metropolis. However, the main constraints to rice marketing in Gombe metropolis include inadequate electricity, capital, high transportation cost, instability of prices and low patronage among others. The study recommends provision of adequate electrical power supply in the State especially the State capital and also encouraging rice marketers in Gombe metropolis to form cooperative societies so as to have easy access to credit facilities especially from the formal sources.

Keywords: rice marketers, milled rice, cost and return, marketing margin, efficiency, profitability

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Authors: Neha Budhwani

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Polycyclic aromatic hydrocarbons (PAHs) are formed during the pyrolysis of scrap tyres to produce tyre pyrolytic oil (TPO). Due to carcinogenic, mutagenic, and toxic properties PAHs are priority pollutants. Hence it is essential to remove PAHs from TPO before utilising TPO as a petroleum fuel alternative (to run the engine). Agricultural wastes have promising future to be utilized as biosorbent due to their cost effectiveness, abundant availability, high biosorption capacity and renewability. Various low cost adsorbents were prepared from natural sources. Uptake of PAHs present in tyre pyrolytic oil was investigated using various low-cost adsor¬bents of natural origin including sawdust (shiham), coconut fiber, neem bark, chitin, activated charcol. Adsorption experiments of different PAHs viz. naphthalene, acenaphthalene, biphenyl and anthracene have been carried out at ambient temperature (25°C) and at pH 7. It was observed that for any given PAH, the adsorption capacity increases with the lignin content. Freundlich constant kf and 1/n have been evaluated and it was found that the adsorption isotherms of PAHs were in agreement with a Freundlich model, while the uptake capacity of PAHs followed the order: activated charcoal> saw dust (shisham) > coconut fiber > chitin. The partition coefficients in acetone-water, and the adsorption constants at equilibrium, could be linearly correlated with octanol–water partition coefficients. It is observed that natural adsorbents are good alternative for PAHs removal. Sawdust of Dalbergia sissoo, a by-product of sawmills was found to be a promising adsorbent for the removal of PAHs present in TPO. It is observed that adsorbents studied were comparable to those of some conventional adsorbents.

Keywords: natural adsorbent, PAHs, TPO, coconut fiber, wood powder (shisham), naphthalene, acenaphthene, biphenyl and anthracene

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Authors: Ananta R. Adhikari

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In today's era, polymer composite utilization has witnessed a significant increase across various fronts of material science advancement. Despite the development of many highly sophisticated technologies aimed at modifying polymer composites, there persists a quest for a technology that is straightforward, energy-efficient, easily controllable, cost-effective, time-saving, and environmentally friendly. Microwave technology has emerged as a major technique in material synthesis and modification due to its unique characteristics such as rapid, selective, uniform heating, and, particularly, direct heating based on molecular interaction. This study will be about the utilization of microwave energy as an alternative technique for material processing. Specifically, we will explore ongoing research conducted in our laboratory, focusing on its applications in the medical field.

Keywords: polymer composites, material processing, microstructure, microwave radiation

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Authors: Lubna Eljabu, Mohammad Etemad, Stan Matwin

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Port authorities have many challenges in congested ports to allocate their resources to provide a safe and secure loading/ unloading procedure for cargo vessels. Selecting a destination port is the decision of a vessel master based on many factors such as weather, wavelength and changes of priorities. Having access to a tool which leverages AIS messages to monitor vessel’s movements and accurately predict their next destination port promotes an effective resource allocation process for port authorities. In this research, we propose a method, namely, Reference Route of Trajectory (RRoT) to assist port authorities in predicting inflow and outflow traffic in their local environment by monitoring Automatic Identification System (AIS) messages. Our RRoT method creates a reference route based on historical AIS messages. It utilizes some of the best trajectory similarity measure to identify the destination of a vessel using their recent movement. We evaluated five different similarity measures such as Discrete Fr´echet Distance (DFD), Dynamic Time Warping (DTW), Partial Curve Mapping (PCM), Area between two curves (Area) and Curve length (CL). Our experiments show that our method identifies the destination port with an accuracy of 98.97% and an fmeasure of 99.08% using Dynamic Time Warping (DTW) similarity measure.

Keywords: spatial temporal data mining, trajectory mining, trajectory similarity, resource optimization

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Authors: Abhimanyu Pati, Krishna Kumar Veluri

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The paper intends to bring out a real life experience encountered during actual implementation of a large scale Tier-1 Enterprise Resource Planning (ERP) system in a multi-location, discrete manufacturing organization in India, involved in manufacturing of auto components and aggregates. The business complexities, prior to the implementation of ERP, include multi-product with hierarchical product structures, geographically distributed multiple plant locations with disparate business practices, lack of inter-plant broadband connectivity, existence of disparate legacy applications for different business functions, and non-standardized codifications of products, machines, employees, and accounts apart from others. On the other hand, the manufacturing environment consisted of processes like Assemble-to-Order (ATO), Make-to-Stock (MTS), and Engineer-to-Order (ETO) with a mix of discrete and process operations. The paper has highlighted various business plan areas and concerns, prior to the implementation, with specific focus on strategic issues and objectives. Subsequently, it has dealt with the complete process of ERP implementation, starting from strategic planning, project planning, resource mobilization, and finally, the program execution. The step-by-step process provides a very good learning opportunity about the implementation methodology. At the end, various organizational challenges and lessons emerged, which will act as guidelines and checklist for organizations to successfully align and implement ERP and achieve their business objectives.

Keywords: ERP, ATO, MTS, ETO, discrete manufacturing, strategic planning

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Authors: Nnadi Ezekiel Ejiofor

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In Enugu, Nigeria, this study investigates the connection between strategic leadership and project management sustainability, with an emphasis on building projects in the State. The study set out to accomplish two specific goals: first, it sought to establish a link between creative project management and resource efficiency in construction projects in Enugu State, Nigeria; and second, it sought to establish a link between innovative thinking and waste minimization in those same projects. A structured questionnaire was used to collect primary data from 45 registered construction enterprises in the study area as part of the study's descriptive research approach. Due to the nonparametric nature of the data, Spearman Rank Order Correlation was used to evaluate the acquired data. The findings demonstrate that creative project management had a significant positive impact on resource efficiency in construction projects carried out by architecture firms in Enugu State, Nigeria (r =.849; p.001), and that innovative thinking had a significant impact on waste reduction in those same projects (r =.849; p.001). It was determined that strategic leadership had a significant impact on the sustainability of project management, and it was thus advised that project managers should foresee, prepare for, and effectively communicate present and future developments to project staff in order to ensure that the objective of sustainable initiatives, such as recycling and reuse, is implemented in construction projects.

Keywords: construction, project management, strategic leadership, sustainability, waste reduction

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Authors: Hung-Chi Chang

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For an extended EPQ model with random yield, the existent study revealed that both the disaggregating and consolidating shipment policies for the imperfect quality items are independent of holding cost, and recommended a model with economic benefit by comparing the least total cost for each of the three models investigated. To better capture the real situation, we generalize the existent study to include different holding costs for perfect and imperfect quality items. Through analysis, we show that the above shipment policies are dependent on holding costs. Furthermore, we derive a simple decision rule solely based on the thresholds of problem parameters to select a superior model. The results are illustrated analytically and numerically.

Keywords: consolidating shipments, disaggregating shipments, EPQ, imperfect quality, inventory

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Authors: E. Vazquez-Santacruz, M. Gamboa-Zuniga

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In this paper, we show a methodology for bodies classification in lying state using HOG descriptors and pressures sensors positioned in a matrix form (14 x 32 sensors) on the surface where bodies lie down. it will be done in real time. Our system is embedded in a care robot that can assist the elderly patient and medical staff around to get a better quality of life in and out of hospitals. Due to current technology a limited number of sensors is used, wich results in low-resolution data array, that will be used as image of 14 x 32 pixels. Our work considers the problem of human posture classification with few information (sensors), applying digital process to expand the original data of the sensors and so get more significant data for the classification, however, this is done with low-cost algorithms to ensure the real-time execution.

Keywords: real-time classification, sensors, robots, health care, elderly patients, artificial intelligence

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Authors: Tamar Trop

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Bike sharing systems can be important elements of smart cities as they have the potential for impact on multiple levels. These systems can add a significant alternative to other modes of mass transit in cities that are continuously looking for measures to become more livable and maintain their attractiveness for citizens, businesses and tourism. Bike-sharing began in Europe in 1965, and a viable format emerged in the mid-2000s thanks to the introduction of information technology. The rate of growth in bike-sharing schemes and fleets has been very rapid since 2008 and has probably outstripped growth in every other form of urban transport. Today, public bike-sharing systems are available on five continents, including over 700 cities, operating more than 800,000 bicycles at approximately 40,000 docking stations. Since modern bike sharing systems have become prevalent only in the last decade, the existing literature analyzing these systems and their sustainability is relatively new. The purpose of the presented study is to assess the sustainability of these newly emerging transportation systems, by using the Envision™ rating system as a methodological framework and the Israeli 'Tel -O-Fun' – bike sharing project as a case study. The assessment was conducted by project team members. Envision™ is a new guidance and rating system used to assess and improve the sustainability of all types and sizes of infrastructure projects. This tool provides a holistic framework for evaluating and rating the community, environmental, and economic benefits of infrastructure projects over the course of their life cycle. This evaluation method has 60 sustainability criteria divided into five categories: Quality of life, leadership, resource allocation, natural world, and climate and risk. 'Tel -O-Fun' project was launched in Tel Aviv-Yafo on 2011 and today provides about 1,800 bikes for rent, at 180 rental stations across the city. The system is based on a complex computer terminal that is located in the docking stations. The highest-rated sustainable features that the project scored include: (a) Improving quality of life by: offering a low cost and efficient form of public transit, improving community mobility and access, enabling the flexibility of travel within a multimodal transportation system, saving commuters time and money, enhancing public health and reducing air and noise pollution; (b) improving resource allocation by: offering inexpensive and flexible last-mile connectivity, reducing space, materials and energy consumption, reducing wear and tear on public roads, and maximizing the utility of existing infrastructure, and (c) reducing of greenhouse gas emissions from transportation. Overall, 'Tel -O-Fun' project was highly scored as an environmentally sustainable and socially equitable infrastructure. The use of this practical framework for evaluation also yielded various interesting insights on the shortcoming of the system and the characteristics of good solutions. This can contribute to the improvement of the project and may assist planners and operators of bike sharing systems to develop a sustainable, efficient and reliable transportation infrastructure within smart cities.

Keywords: bike sharing, Envision™, sustainability rating system, sustainable infrastructure

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Authors: Nathaniel Deboever, Malcolm Breeze, Adrian Sheen

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Basic surgical and suturing techniques are a fundamental requirement for all doctors. In order to gain confidence and competence, doctors in training need to obtain sufficient teaching and just as importantly: practice. Young doctors with an apt level of expertise on these simple surgical skills, which are often used in the Emergency Department, can help alleviate some pressure during a busy evening. Unfortunately, learning these skills can be quite difficult during medical school or even during junior doctor years. The aim of this project was to adequately train medical students attending University of Sydney’s Nepean Clinical School through a series of workshops highlighting practical skills, with hopes to further extend this program to junior doctors in the hospital. The sessions instructed basic skills via tutorials, demonstrations, and lastly, the sessions cemented these proficiencies with practical sessions. During such an endeavor, it is fundamental to employ models that appropriately resemble what students will encounter in the clinical setting. The sustainability of workshops is similarly important to the continuity of such a program. To address both these challenges, the authors have developed models including suturing platforms, knot tying, and vessel ligation stations, as well as a shave and punch biopsy models and ophthalmologic foreign body device. The unique aspect of this work is that we utilized hands-on teaching sessions, to address a gap in doctors-in-training and junior doctor curriculum. Presented to you through this poster are our approaches to creating models that do not employ animal products and therefore do not necessitate particular facilities or discarding requirements. Covering numerous skills that would be beneficial to all young doctors, these models are easily replicable and affordable. This exciting work allows for countless sessions at low cost, providing enough practice for students to perform these skills confidently as it has been shown through attendee questionnaires.

Keywords: medical education, surgical models, surgical simulation, surgical skills education

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Authors: S. Periyadharshini, K. Ramkumar, S. Jayalalitha, M. GuruPrasath, R. Manikandan

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This paper presents a formulation and solution for industrial load management and product grade problem. The formulation is created using linear programming technique thereby optimizing the electricity cost by scheduling the loads satisfying the process, storage, time zone and production constraints which will create an impact of reducing maximum demand and thereby reducing the electricity cost. Product grade problem is formulated using integer linear programming technique of optimization using lingo software and the results show that overall increase in profit margin. In this paper, time of use tariff is utilized and this technique will provide significant reductions in peak electricity consumption.

Keywords: cement industries, integer programming, optimal formulation, objective function, constraints

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Authors: Hung Hing Chan, Tai-Shan Hu

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Kaohsiung has been an industrial city of Taiwan for over a hundred year. Consequently, there are several abandoned industrial lands left when the process of deindustrialization has started, resulting in the decay of the adjacent urban communities. These industrial lands, which are brownfields that are potentially or already contaminated by hazardous substances, have created social injustice to the surrounding communities. The redevelopments of industrial lands bring a sustainable development to the communities, while the redevelopments can be in different forms, depending on the natural conditions. This research studies the possible approaches to facilitate social sustainability of urban regeneration resulted from the industrial land redevelopment projects, which has always been ignored. The aim of the research is to find out the best western practices of brownfield redevelopment to facilitate social aspect of sustainable urban regeneration and make a contribution to the industrial land redevelopment of Taiwan. The research is conducted via literature review and case study. Industrial land redevelopment has been a social focus in the blighted communities to promote urban regeneration after the post-industrial age. The tendency of this kind of redevelopment is towards constructing the built environment, as a result the environmental and economic aspect of sustainability of the redeveloped industrial land will be boosted, while the social aspect will not be necessarily better since the local communities affected are rarely engaged in the decision-making process and inadequate resource allocation to the projects is not guaranteed. To ensure the improvement of social sustainability is reached, the recommendations of this research, such as civic engagement, a formation of dedicated brownfield regeneration agency and resource allocation to employ brownfield process manager and to strategic communication, should be incorporated into the real practices of industrial land-led urban regeneration. Besides, the case study also shows that the social sustainability of industrial land-led urban regeneration can be promoted by (1) upholding the local feature and public participation in the regeneration process, (2) allocating resources and enforcing responsibility system, and (3) assuring financial resource for the urban regeneration projects and residents. Subsequent research will involve in-depth interviews with the chiefs of the village of related communities in Kaohsiung and questionnaire with the community members to comprehend their opinions regarding social sustainability, aiming at evaluating the social sustainability and finding out which kind of redevelopment project tends to support the social dimension of sustainable development more.

Keywords: brownfield, industrial land, redevelopment, social sustainability, urban regeneration

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Authors: Iman Shabanzadeh

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Earthquake is known as one of the most frequent natural hazards in Iran. Therefore, policy making to improve the strengthening of structures is one of the requirements of the approach to prevent and reduce the risk of the destructive effects of earthquakes. In order to choose the optimal policy in the face of earthquakes, this article tries to examine the cost of financial damages caused by earthquakes in the building sector and compare it with the costs of retrofitting. In this study, the results of adopting the scenario of "action after the earthquake" and the policy scenario of "strengthening structures before the earthquake" have been collected, calculated and finally analyzed by putting them together. Methodologically, data received from governorates and building retrofitting engineering companies have been used. The scope of the study is earthquakes occurred in the geographical area of Iran, and among them, eight earthquakes have been specifically studied: Miane, Ahar and Haris, Qator, Momor, Khorasan, Damghan and Shahroud, Gohran, Hormozgan and Ezgole. The main basis of the calculations is the data obtained from retrofitting companies regarding the cost per square meter of building retrofitting and the data of the governorate regarding the power of earthquake destruction, the realized costs for the reconstruction and construction of residential units. The estimated costs have been converted to the value of 2021 using the time value of money method to enable comparison and aggregation. The cost-benefit comparison of the two policies of action after the earthquake and retrofitting before the earthquake in the eight earthquakes investigated shows that the country has suffered five thousand billion Tomans of losses due to the lack of retrofitting of buildings against earthquakes. Based on the data of the Budget Law's of Iran, this figure was approximately twice the budget of the Ministry of Roads and Urban Development and five times the budget of the Islamic Revolution Housing Foundation in 2021. The results show that the policy of retrofitting structures before an earthquake is significantly more optimal than the competing scenario. The comparison of the two policy scenarios examined in this study shows that the policy of retrofitting buildings before an earthquake, on the one hand, prevents huge losses, and on the other hand, by increasing the number of earthquake-resistant houses, it reduces the amount of earthquake destruction. In addition to other positive effects of retrofitting, such as the reduction of mortality due to earthquake resistance of buildings and the reduction of other economic and social effects caused by earthquakes. These are things that can prove the cost-effectiveness of the policy scenario of "strengthening structures before earthquakes" in Iran.

Keywords: disaster economy, earthquake economy, cost-benefit analysis, resilience

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Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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Authors: Ngabirano Levis

Abstract:

One of Africa’s major environmental challenges remains air pollution. In 2017, UNICEF estimated over 400,000 children in Africa died as a result of indoor pollution, while 350 million children remain exposed to the risks of indoor pollution due to the use of biomass and burning of wood for cooking. Over time, indeed, the major causes of mortality across Africa are shifting from the unsafe water, poor sanitation, and malnutrition to the ambient and household indoor pollution, and greenhouse gas (GHG) emissions remain a key factor in this. In addition, studies by the OECD estimated that the economic cost of premature deaths due to Ambient Particulate Matter Pollution (APMP) and Household Air Pollution across Africa in 2013 was about 215 Billion US Dollars and US 232 Billion US Dollars, respectively. This is not only a huge cost for a continent where over 41% of the Sub-Saharan population lives on less than 1.9 US Dollars a day but also makes the people extremely vulnerable to the negative climate change and environmental degradation effects. Such impacts have led to extended droughts, flooding, health complications, and reduced crop yields hence food insecurity. Climate change, therefore, poses a threat to global targets like poverty reduction, health, and famine. Despite efforts towards mitigation, air contributors like carbon dioxide emissions are on a generally upward trajectory across Africa. In Egypt, for instance, emission levels had increased by over 141% in 2010 from the 1990 baseline. Efforts like the climate change adaptation and mitigation financing have also hit obstacles on the continent. The International Community and developed nations stress that Africa still faces challenges of limited human, institutional and financial systems capable of attracting climate funding from these developed economies. By using the qualitative multi-case study method supplemented by interviews of key actors and comprehensive textual analysis of relevant literature, this paper dissects the key emissions and air pollutant sources, their impact on the well-being of the African people, and puts forward suggestions as well as a remedial mechanism to these challenges. The findings reveal that whereas climate change mitigation plans appear comprehensive and good on paper for many African countries like Uganda; the lingering political interference, limited research guided planning, lack of population engagement, irrational resource allocation, and limited system and personnel capacity has largely impeded the realization of the set targets. Recommendations have been put forward to address the above climate change impacts that threaten the food security, health, and livelihoods of the people on the continent.

Keywords: Africa, air pollution, climate change, mitigation, emissions, effective planning, institutional strengthening

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Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

Abstract:

Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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Authors: Jongwan Eun, Sam Helwany, Lakshyana K. C.

Abstract:

The United Arab Emirates (UAE) is significantly dependent on desalinated water and groundwater resource, which is expensive and highly energy intensive. Despite the scarce water resource, stagnates only 54% of the recycled water was reused in 2012, and due to the lack of infrastructure to reuse the recycled water, the portion is expected to decrease with growing water usage. In this study, an “Oasis” complex comprised of Sustainable Farming Compartments (SFC) was proposed for reusing treated wastewater. The wastewater is used to decrease the ambient temperature of the SFC via an evaporative cooler. The SFC prototype was designed, built, and tested in an environmentally controlled laboratory and field site to evaluate the feasibility and effectiveness of the SFC subjected to various climatic conditions in Abu Dhabi. Based on the experimental results, the temperature drop achieved in the SFC in the laboratory and field site were5 ̊C from 22 ̊C and 7- 15 ̊C (from 33-45 ̊C to average 28 ̊C at relative humidity < 50%), respectively. An energy simulation using TRNSYS was performed to extend and validate the results obtained from the experiment. The results from the energy simulation and experiments show statistically close agreement. The total power consumption of the SFC system was approximately three and a half times lower than that of an electrical air conditioner. Therefore, by using treated wastewater, the SFC has a promising prospect to solve Abu Dhabi’s ecological concern related to desertification and wind erosion.

Keywords: ecological farming system, energy simulation, evaporative cooling system, temperature, treated waste water, temperature

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Authors: Nawaf A. Alqahtani, Ali M. Alqahtani, Khalid A. Alqahtani, Huda S. Abdullfattah, Ebtehal A. Alessa, Khalid S. Al Gelban, Ossama A. Mostafa

Abstract:

Background: The internet is an exciting medium that is becoming an essential part of everyday life. Although the internet is fully observed in Saudi Arabia, young people may be vulnerable to problematic internet use, possibly leading to addiction. Aim of study: To explore the magnitude of internet addiction (IA) among medical students associated risk factors and its impact on students' academic achievement. Subjects and Methods: A cross sectional study was conducted in 2014 on 571 medical students (293 males and 278 females) at the College of Medicine, King Khalid University, Abha, Saudi Arabia. Data Collection was done through using the Arabic version of the Compulsive Internet Use Scale and a checklist of demographic characteristics. Results: Age of participants ranged from 19 to 26 years (Mean+SD: 21.9+1.5 years). Internet access was available to 97.4% of students at home and to 80.2% of students at their mobile phones. The most frequently accessed websites by medical students were the social media (90.7%), scientific website (50.4%) and the news websites (31.3%). IA was mild in 47.8% of medical students while 5.8% had moderate IA. None of the students had severe IA. Prevalence of IA was significantly higher among female medical students (p=0.002), availability of internet at home (p=0.022), and availability of internet at the students' mobile phone (p=0.041). The mean General Point Average (GPA) was highest among students with mild IA (4.0+0.6), compared with 3.6+0.6 among those with moderate addiction, and 3.9+0.6 among those who did not show IA. Differences in mean GPA according to grade of IA were statistically significant ((P=0.001). Conclusions: Prevalence of IA is high among medical students in Saudi Arabia. Risk factors for IA include female gender, availability of internet at home or at the mobile phone. IA has a significant impact on students' GPA. Periodic screening of medical students for IA and raising their awareness toward the possible risk of IA are recommended.

Keywords: internet addiction, medical students, risk factors, Saudi Arabia

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Authors: Po-Jung Huang, Chi-Ching Lee, Bertrand Chin-Ming Tan, Yuan-Ming Yeh, Julie Lichieh Chu, Tin-Wen Chen, Cheng-Yang Lee, Ruei-Chi Gan, Hsuan Liu, Petrus Tang

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Whole-exome sequencing focuses on the protein coding regions of disease/cancer associated genes based on a priori knowledge is the most cost-effective method to study the association between genetic alterations and disease. Recent advances in high throughput sequencing technologies and proteomic techniques has provided an opportunity to integrate genomics and proteomics, allowing readily detectable mutated peptides corresponding to mutated genes. Since sequence database search is the most widely used method for protein identification using Mass spectrometry (MS)-based proteomics technology, a mutant proteome database is required to better approximate the real protein pool to improve disease-associated mutated protein identification. Large-scale whole exome/genome sequencing studies were launched by National Cancer Institute (NCI), Broad Institute, and The Cancer Genome Atlas (TCGA), which provide not only a comprehensive report on the analysis of coding variants in diverse samples cell lines but a invaluable resource for extensive research community. No existing database is available for the collection of mutant protein sequences related to the identified variants in these studies. CMPD is designed to address this issue, serving as a bridge between genomic data and proteomic studies and focusing on protein sequence-altering variations originated from both germline and cancer-associated somatic variations.

Keywords: TCGA, cancer, mutant, proteome

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Authors: Ahmad Latif Virk, Naeem Ahmad, Muhammad Ishaq Asif Rehmani

Abstract:

Amid the present environmental crises, developing environment-resilient and cost-effective conservation agriculture strategies to feed the world's ever-growing population is pertinent. Therefore, a field study was conducted to test the hypothesis that residue retention under no-till (NTR) would enhance energy productivity (EP) and energy use efficiency (EUE) while offsetting the carbon footprints (CF), water footprints (WF) and greenhouse gases emissions (GHGs) in rice (Oryza sativa L.)-wheat (Triticum aestivum L.) double cropping system. Two tillage systems viz., conventional tillage (CT) and conservation tillage (no-till; NT), with or without residue retention, were combined into four treatments as CT0 (puddled rice, conventional wheat - residue); CTR (puddled rice, conventional wheat + residue); NT0 (direct rice seeding, zero-tilled wheat - residue); NTR (direct rice seeding, zero-tilled wheat + residue) were evaluated. Overall, results showed that the NT system had 34.2% lower energy consumption, 1.2 times more EP than CT system. Moreover, NTR had 19.8% higher EUE than CT0. The overall system grain yield ranged from 7.8 to 9.3 Mg ha−1 under NT0 and CTR, respectively. The NTR had 56.6% and 17.9% lesser CF and WF, respectively, than CT0. The net GHGs emissions (CO2-eq kg ha−1) under CT0 were the highest, while NTR had the lowest emissions. The NTR enhanced carbon sequestration in soil that can offset half of the system's CO2 emissions. The findings of this study might help develop a suitable strategy for resource/energy conservation and higher productivity while offsetting GHGs emissions in the Indo-Gangetic Plains.

Keywords: residue, yield, indirect emissions, energy use efficiency, carbon sequestration

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