Search results for: healthcare supply chain

Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

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Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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Authors: Omer Al-Kaabi, Ahmed Nasr, Abdullah Al-Ghafri, Mohammed Abdelfattah

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The Falaj system, derived from natural water sources, is a man-made canal system designed to supply communities of farmers with water for domestic and agricultural purposes. For thousands of years, Falaj has served communities by harnessing the force of gravity; it persists as a vital water management system in numerous regions across the Sultanate of Oman. Remarkably, predates the establishment of many fundamental hydraulic principles used today. Al-Khatmain Falaj, with its accessibility and historical significance spanning over 2000 years, was chosen as the focal point of this study. The research aimed to investigate the efficiency of Al-Khatmain Falaj in meeting specific water demands. The HEC-RAS model was utilized to visualize water flow dynamics within the Falaj channels, accompanied by graphical representations of pertinent variables. The application of HEC-RAS helped to measure different water flow scenarios within the channel, enabling a clear comparison with the demand area catchment. The cultivated land of Al-Khatmain is 723,124 m² and consists of 16,873 palm trees representing 91% of the total area and the remaining 9% is mixed types of trees counted 3,920 trees. The study revealed a total demand of 8,244 m³ is required to irrigate the cultivated land. Through rigorous analysis, the study has proven that the Falaj system in Al-Khatmain operates with high efficiency, as the average annual water supply is 9676.8 m3/day. Additionally, the channel designed at 0.6m width x 0.3m height efficiently holds the optimal water supply, with an average flow depth of 0.21m. Also, the system includes an overflow drainage channel to mitigate floods and prevent crop damage based on seasonal requirements. This research holds promise for examining diverse hydrological conditions and devising effective strategies to manage scenarios of both high and low flow rates.

Keywords: Al-Khatmain, sustainability, Falaj, HEC-RAS, water management system

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Authors: Albert W. K. Tan

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This research consolidates a comprehensive array of publications from peer-reviewed journals, case studies, and seminar reports focused on reverse logistics and network design. By synthesizing this secondary knowledge, our objective is to identify and articulate key decision factors crucial to reverse logistics network design for e-commerce. Through this exploration, we aim to present a refined mathematical model that offers valuable insights for companies seeking to optimize their reverse logistics operations. The primary goal of this research endeavor is to develop a comprehensive framework tailored to advising organizations and companies on crafting effective networks for their reverse logistics operations, thereby facilitating the achievement of their organizational goals. This involves a thorough examination of various network configurations, weighing their advantages and disadvantages to ensure alignment with specific business objectives. The key objectives of this research include: (i) Identifying pivotal factors pertinent to network design decisions within the realm of reverse logistics across diverse supply chains. (ii) Formulating a structured framework designed to offer informed recommendations for sound network design decisions applicable to relevant industries and scenarios. (iii) Propose a mathematical model to optimize its reverse logistics network. A conceptual framework for designing a reverse logistics network has been developed through a combination of insights from the literature review and information gathered from company websites. This framework encompasses four key stages in the selection of reverse logistics operations modes: (1) Collection, (2) Sorting and testing, (3) Processing, and (4) Storage. Key factors to consider in reverse logistics network design: I) Centralized vs. decentralized processing: Centralized processing, a long-standing practice in reverse logistics, has recently gained greater attention from manufacturing companies. In this system, all products within the reverse logistics pipeline are brought to a central facility for sorting, processing, and subsequent shipment to their next destinations. Centralization offers the advantage of efficiently managing the reverse logistics flow, potentially leading to increased revenues from returned items. Moreover, it aids in determining the most appropriate reverse channel for handling returns. On the contrary, a decentralized system is more suitable when products are returned directly from consumers to retailers. In this scenario, individual sales outlets serve as gatekeepers for processing returns. Considerations encompass the product lifecycle, product value and cost, return volume, and the geographic distribution of returns. II) In-house vs. third-party logistics providers: The decision between insourcing and outsourcing in reverse logistics network design is pivotal. In insourcing, a company handles the entire reverse logistics process, including material reuse. In contrast, outsourcing involves third-party providers taking on various aspects of reverse logistics. Companies may choose outsourcing due to resource constraints or lack of expertise, with the extent of outsourcing varying based on factors such as personnel skills and cost considerations. Based on the conceptual framework, the authors have constructed a mathematical model that optimizes reverse logistics network design decisions. The model will consider key factors identified in the framework, such as transportation costs, facility capacities, and lead times. The authors have employed mixed LP to find the optimal solutions that minimize costs while meeting organizational objectives.

Keywords: reverse logistics, supply chain management, optimization, e-commerce

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Authors: Mohammed Aladalah

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The emergence of digital citizens is no longer mere speculation; therefore, governments’ use of Web 2.0 tools (hereafter Gov 2.0) should be a part of all current and future e-government plans. The potential of Gov 2.0 to facilitate greater communication, participation, and collaboration with citizens has been highlighted and discussed extensively in recent literature. However, the current levels of citizens’ participation in Gov 2.0 have not lived up to the hype. Therefore, governments need to rethink the way in which they implement Gov 2.0, and take advantage of the digitally-engaged population. We propose a two-dimensional framework to tackle this issue: first, on the supply side, governments tend to use Gov 2.0 mainly for the dissemination of information and for self-promotion without the desire to encourage any interaction with citizens; this is due to many reasons, including the lack of time and the possibility of loss of control. The second dimension of the framework is the demand side; citizens are unwilling to participate in Gov 2.0 activities because they do not perceive its value or trust the government. We attempt to consider the elements of both supply and demand in order to provide a comprehensive solution whereby the potential of Gov 2.0 can be fully utilized. Our framework is based on the theoretical foundation of service science and value co-creation theory. This paper makes two significant contributions: (a) it provides an initial framework intended to increase citizens’ participation in Gov 2.0; and (b) it enhances the understanding of the government’s Gov 2.0 applications, particularly in terms of factors that ensure their attractiveness for citizens. This work is the first step in a comprehensive research undertaking, the purpose of which is to study public’s engagement with the Gov 2.0 concept. It contributes to providing a better understanding of e-government and its future.

Keywords: e-government, Gov 2.0, citizens participation, digital citizen

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Authors: Vijaya Subramaniam, Loh Soh Kheang, Astimar Abdul Aziz

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Water footprint (WFP) has gained importance due to the increase in water scarcity in the world. This study analyses the WFP for an agriculture sector, i.e., the oil palm supply chain, which produces oil palm fresh fruit bunch (FFB), crude palm oil, palm kernel, and crude palm kernel oil. The water accounting and vulnerability evaluation (WAVE) method was used. This method analyses the water depletion index (WDI) based on the local blue water scarcity. The main contribution towards the WFP at the plantation was the production of FFB from the crop itself at 0.23m³/tonne FFB. At the mill, the burden shifts to the water added during the process, which consists of the boiler and process water, which accounted for 6.91m³/tonne crude palm oil. There was a 33% reduction in the WFP when there was no dilution or water addition after the screw press at the mill. When allocation was performed, the WFP reduced by 42% as the burden was shared with the palm kernel and palm kernel shell. At the kernel crushing plant (KCP), the main contributor towards the WFP 4.96 m³/tonne crude palm kernel oil which came from the palm kernel which carried the burden from upstream followed by electricity, 0.33 m³/tonne crude palm kernel oil used for the process and 0.08 m³/tonne crude palm kernel oil for transportation of the palm kernel. A comparison was carried out for mills with biogas capture versus no biogas capture, and the WFP had no difference for both scenarios. The comparison when the KCPs operate in the proximity of mills as compared to those operating in the proximity of ports only gave a reduction of 6% for the WFP. Both these scenarios showed no difference and insignificant difference, which differed from previous life cycle assessment studies on the carbon footprint, which showed significant differences. This shows that findings change when only certain impact categories are focused on. It can be concluded that the impact from the water used by the oil palm tree is low due to the practice of no irrigation at the plantations and the high availability of water from rainfall in Malaysia. This reiterates the importance of planting oil palm trees in regions with high rainfall all year long, like the tropics. The milling stage had the most significant impact on the WFP. Mills should avoid dilution to reduce this impact.

Keywords: life cycle assessment, water footprint, crude palm oil, crude palm kernel oil, WAVE method

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Authors: Lubica Muckova, Petr Jost, Jaroslav Pejchal, Daniel Jun

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The development of acetylcholinesterase reactivators, i.e. antidotes against organophosphorus poisoning, is an important goal of defence research. The aim of this study was to compare cytotoxicity and chemical structure of 5 currently available (pralidoxime, trimedoxime, obidoxime, methoxime, and asoxime) and 4 newly developed compounds (K027, K074, K075, and K203). In oximes, there could be at least four important structural factors affecting their toxicity, including the number of oxime groups in the molecule, the position of oxime group(s) on pyridinium ring, the length of carbon linker, and the substitution by oxygen or insertion of the double bond into the connection chain. The cytotoxicity of tested substances was measured using colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay (MTT assay) in SH-SY5Y cell line. Toxicity was expressed as toxicological index IC₅₀. The tested compounds showed different cytotoxicity ranging from 1.5 to 27 mM. K027 was the least, and methoxime was the most toxic reactivator. The lowest toxicity was found in a monopyridinium reactivator and bispyridinium reactivators with simple 3C carbon linker. Shortening of connection chain length to 1C, incorporation of oxygen moiety into 3C compounds, elongation of carbon linker to 4C and insertion of a double bond into 4C substances increase AChE reactivators' cytotoxicity. Acknowledgements: This work was supported by a long-term organization development plan Medical Aspects of Weapons of Mass Destruction of the Faculty of Military Health Sciences, University of Defence.

Keywords: acetylcholinesterase, cytotoxicity, organophosphorus poisoning, reactivators of acetylcholinesterase

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Authors: Ömer Faruk Ada, Türker Baş, M. Yaman Öztek

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In this study, we aim to investigate the skills to be owned by procurement professionals in order to fulfill their developing and changing role completely. Market conditions, competitive pressure, and high financial costs make it more important than ever for organizations to be able to use resources more efficiently. Research shows that procurement expenses consist more than 50 % of the operating expenses. With increasing profit impact of procurement, reviewing the position of the procurement function within the organization has become inevitable. This study is significant as it indicates the necessary skills that procurement professionals must have to keep in step with the transformation of procurement units from transaction oriented to value chain oriented. In this study, the transformation of procurement is investigated from the perspective of procurement professionals and we aim to answer following research questions: • How do procurement professionals perceive their role within the organization? • How has their role changed and what challenges have they had to face? • What portfolio of skills do they believe will enable them to fulfill their role effectively? Literature review consists of the first part of the study by investigating the changing role of procurement from different perspectives. In the second part, we present the results of the in-depth interviews with 15 procurement professionals and we used descriptive analysis as a methodology. In the light of these results, we classified procurement skills under operational, tactical and strategic levels and Procurement Skills Framework has been developed. This study shows the differences in the perception of purchasing by professionals and the organizations. The differences in the perception are considered as an important barrier beyond the procurement transformation. Although having the necessary skills has a significant effect for procurement professionals to fulfill their role completely and keep in step with the transformation of the procurement function, It is not the only factor and the degree of high-level management and organizational support has also a direct impact during this transformation.

Keywords: procuement skills, procurement transformation, strategic procurement, value chain

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Authors: V. Viswanathan, Md. Irshad Ahmad, Prashant K. Singh, Nayeem Ahmad, Pradeep Sharma, Sujata Sharma, Tej P Singh

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Lactoperoxidase (LPO) is a heme containing mammalian enzyme which uses hydrogen peroxide (H2O2) to catalyze the conversion of substrates into oxidized products. LPO is found in body fluids and tissues such as milk, saliva, tears, mucosa and other body secretions. The previous structural studies have shown that LPO converts substrates, thiocyanate (SCN‾) and iodide (I‾) ions into oxidized products, hypothiocyanite (OSCN‾) and hypoiodite (IO‾) ions, respectively. We report here a new structure of the complex of LPO with an oxidized product, nitrite (NO2‾). This product was generated from NO using the two step reaction of LPO by adding hydrogen peroxide (H2O2) in the solution of LPO in 0.1M phosphate buffer at pH 6.8 as the first step. In the second step, NO gas was added to the above mixture. This was crystallized using 20% (w/v) PEG-3350 and 0.2M ammonium iodide at pH 6.8. The structure determination showed the presence of NO2‾ ion in the distal heme cavity of the substrate binding site of LPO. The structure also showed that the propionate group, which is linked to pyrrole ring D of the heme moiety, was disordered. Similarly, the side chain of Asp108, which is covalently linked to heme moiety, was also split into two components. As a result of these changes, the conformation of the side chain of Arg255 was altered, allowing it to form new interactions with the disordered carboxylic group of propionate moiety. These structural changes are indicative of an intermediate state in the catalytic reaction pathway of LPO.

Keywords: lactoperoxidase, structure, nitric oxide, nitrite ion, intermediate, complex

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Authors: Jacintha Menezes, Ramalingam Dharmalingam, Palaiahnakote Shivakumara

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In the recent years, Omani acid lime cultivation and production has been affected by Citrus greening or Huanglongbing (HLB) disease. HLB disease is one of the most destructive diseases for citrus, with no remedies or countermeasures to stop the disease. Currently used Polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) HLB detection tests require lengthy and labor-intensive laboratory procedures. Furthermore, the equipment and staff needed to carry out the laboratory procedures are frequently specialized hence making them a less optimal solution for the detection of the disease. The current research uses hyperspectral imaging technology for automatic detection of citrus trees with HLB disease. Omani citrus tree leaf images were captured through portable Specim IQ hyperspectral camera. The research considered healthy, nutrition deficient, and HLB infected leaf samples based on the Polymerase chain reaction (PCR) test. The highresolution image samples were sliced to into sub cubes. The sub cubes were further processed to obtain RGB images with spatial features. Similarly, RGB spectral slices were obtained through a moving window on the wavelength. The resized spectral-Spatial RGB images were given to Convolution Neural Networks for deep features extraction. The current research was able to classify a given sample to the appropriate class with 92.86% accuracy indicating the effectiveness of the proposed techniques. The significant bands with a difference in three types of leaves are found to be 560nm, 678nm, 726 nm and 750nm.

Keywords: huanglongbing (HLB), hyperspectral imaging (HSI), · omani citrus, CNN

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Authors: Lukasz Baka

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Objective. The study aimed to investigate the direct and indirect - mediated through insomnia - effect of coronavirus anxiety on exhaustion from the perspective of Hobfol Conservation of Resources (COR) theory. According to COR theory, critical events (e.g. the coronavirus epidemic) make people fearful of losing their valuable resources. A prolonged state of anxiety may lead to sleep troubles, which over time, results in an increase in exhaustion. Materials and Methods: Data were collected among 440 Polish healthcare providers, including nurses and midwives, doctors, paramedics, medical assistance, and wardens. Three measurements were used: Coronavirus Anxiety Scale (CAS), Copenhagen Psychosocial Questionnaire (COPSOQ, sleep trouble subscale) and Oldenburg Burnout Inventory (OLBI, exhaustion subscale). Hypotheses were tested by the use of Structural Equation Modelling (SEM). Results: The obtained results fully support the hypotheses. Both the direct and indirect relationships between coronavirus anxiety and exhaustion were observed. Specifically, high coronavirus anxiety increased insomnia, which in turn contributed to the development of exhaustion. Conclusion: The results are consistent with the COR theory. Prolonged coronavirus anxiety and sleep problems depleted healthcare providers’ resources and made them feel exhausted. Exhaustion among these workers can have serious consequences not only for themselves but also for the health of their patients, therefore researches into effective ways to deal with coronavirus anxiety are needed.

Keywords: coronavirus anxiety, front-line healt-care workers, insomnia, job burnout

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Authors: P. Chambe, B. Canova, A. Balabanian, M. Pele, N. Coeur

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To avoid battery assisted tags with limited lifetime batteries, it is proposed here to replace them by energy harvesting systems, able to feed from local environment. This would allow total independence to RFID systems, very interesting for applications where tag removal from its location is not possible. Example is here described for luggage safety in airports, and is easily extendable to similar situation in terms of operation constraints. The idea is to fix RFID tag with energy harvesting system not only to identify luggage but also to supply an embedded microcontroller with a sensor delivering luggage weight making it impossible to add or to remove anything from the luggage during transit phases. The aim is to optimize the harvested energy for such RFID applications, and to study in which limits these applications are theoretically possible. Proposed energy harvester is based on two energy sources: piezoelectricity and electromagnetic waves, so that when the luggage is moving on ground transportation to airline counters, the piezo module supplies the tag and its microcontroller, while the RF module operates during luggage transit thanks to readers located along the way. Tag location on the luggage is analyzed to get best vibrations, as well as harvester better choice for optimizing the energy supply depending on applications and the amount of energy harvested during a period of time. Effects of system parameters (RFID UHF frequencies, limit distance between the tag and the antenna necessary to harvest energy, produced voltage and voltage threshold) are discussed and working conditions for such system are delimited.

Keywords: RFID tag, energy harvesting, piezoelectric, EM waves

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Authors: Mohammad Abdulaziz Algrnas, Emma Mulliner

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Housing projects have been established in Saudi Arabia, by both government and private construction companies, to meet the increasing demand from Saudi inhabitants across the country. However, the real estate market supply does not meet consumer preference requirements. Preferences normally differ depending on the consumer’s situation, such as the household’s sociological characteristics (age, household size and composition), resources (income, wealth, information and experience), tastes and priorities. Collecting information about consumer attitudes, preferences and perceptions is important for the real estate market in order to better understand housing demand and to ensure that this is met by appropriate supply. The aim of this paper is to identify consumer preferences for housing in Saudi Arabia. A quantitative closed-ended questionnaire was conducted with housing consumers in Saudi Arabia in order to gain insight into consumer needs, current household situation, preferences for a number of investigated housing attributes and consumers’ perceptions around the current housing problem. 752 survey responses were obtained and analysed in order to describe preferences for housing attributes and make comparisons between groups. Factor analysis was also conducted to identify and reduce the attributes. The results indicate a difference in preference according to the gender of the respondents and depending on their region of residence.

Keywords: housing attributes, Saudi Arabia, consumer preferences, housing preferences

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Authors: María Araya Léon, Ainoa Abella, Aura Murillo, Ricardo Guasch, Laura Clèries

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Objectives: This article aims to examine scientific theory framed within the term hospitals of the future from a multidisciplinary and cross-sectional perspective. To understand the connection that the various cross-sectional areas we studied have with architectural spaces and to determine the future outlook of the works examined and how they can be classified into the categories of need/solution, evolution/revolution, collective/individual, and preventive/corrective. Background: The changes currently taking place within the context of healthcare demonstrate how important these projects are and the need for companies to face future changes. Method: A systematic review has been carried out focused on what will the hospitals of the future be like in relation to the elements that form part of their use, design, and architectural space experience, using the WOS database from 2016 to 2019. Results: The large number of works about sensoring & big data and the scarce amount related to the area of materials is worth highlighting. Furthermore, no growth concerning future issues is envisaged over time. Regarding classifications, the articles we reviewed address evolutionary and collective solutions more, and in terms of preventive and corrective solutions, they were found at a similar level. Conclusions: Although our research focused on the future of hospitals, there is little evidence representing this approach. We also detected that, given the relevance of the research on how the built environment influences human health and well-being, these studies should be promoted within the context of healthcare.

Keywords: hospitals, future, architectural space, disruptive approach

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Authors: David Muyise

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Mixed Integer Programming (MIP) is an approach that involves the optimization of a range of decision variables in order to minimize or maximize a particular objective function. The main objective of this study was to apply the MIP approach to optimize the deployment of waste plastic to fuel oil processing plants in Uganda. The processing plants are meant to reduce plastic pollution by pyrolyzing the waste plastic into a cleaner fuel that can be used to power diesel/paraffin engines, so as (1) to reduce the negative environmental impacts associated with plastic pollution and also (2) to curb down the energy gap by utilizing the fuel oil. A programming model was established and tested in two case study applications that are, small-scale applications in rural towns and large-scale deployment across major cities in the country. In order to design the supply chain, optimal decisions on the types of waste plastic to be processed, size, location and number of plants, and downstream fuel applications were concurrently made based on the payback period, investor requirements for capital cost and production cost of fuel and electricity. The model comprises qualitative data gathered from waste plastic pickers at landfills and potential investors, and quantitative data obtained from primary research. It was found out from the study that a distributed system is suitable for small rural towns, whereas a decentralized system is only suitable for big cities. Small towns of Kalagi, Mukono, Ishaka, and Jinja were found to be the ideal locations for the deployment of distributed processing systems, whereas Kampala, Mbarara, and Gulu cities were found to be the ideal locations initially utilize the decentralized pyrolysis technology system. We conclude that the model findings will be most important to investors, engineers, plant developers, and municipalities interested in waste plastic to fuel processing in Uganda and elsewhere in developing economy.

Keywords: mixed integer programming, fuel oil plants, optimisation of waste plastics, plastic pollution, pyrolyzing

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Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur

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Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.

Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi

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Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

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Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

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Authors: Merieleen Engtipi

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India's total share of global population is nearly 18%; however, its per capita energy consumption is only one-third of global average. The demand and supply of electricity are uneven in the country; around 240 million of the population have no access to electricity. However, with India's trajectory for modernisation and economic growth, the demand for energy is only expected to increase. India is at a crossroad, on the one hand facing the increasing demand for energy and on the other hand meeting the Paris climate policy commitments, and further the struggle to provide efficient energy. This paper analyses the policies to meet India’s need for energy, as the per capita energy consumption is likely to be double in 6-7 years period. Simultaneously, India's Paris commitment requires curbing of carbon emission from fossil fuels. There is an increasing need for renewables to be cheaply and efficiently available in the market and for clean technology to extract fossil fuels to meet climate policy goals. Fossil fuels are the most significant generator of energy in India; with the Paris agreement, the demand for clean energy technology is increasing. Finally, the U.S. decided to withdraw from the Paris Agreement; however, the two countries plan to continue engaging bilaterally on energy issues. The U.S. energy cooperation under Trump administration is significantly vital for greater energy security, transfer of technology and efficiency in energy supply and demand.

Keywords: energy demand, energy cooperation, fossil fuels, technology transfer

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Authors: David Oluwole Moses, Odeyemi Adebowale Toba, Olawale Adetunji Kola

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Candida auris, an emerging fungus, has been reported in more than 30 countries around the world since its first detection in 2009. Due to its several virulence factors, resistance to antifungals, and persistence in hospital settings, Candida auris has been reported to cause treatment-failure infections. This study was therefore carried out to determine the incidence of Candida auris in a tertiary hospital in Ekiti State, Nigeria. In this study, a total of 115 samples were screened for Candida species using cultural and molecular methods. The carriage of virulence factors and antifungal resistance among C. auris was detected using standard microbiological methods. Candida species isolated from the samples were 15 (30.0%) in clinical samples and 22 (33.85%) in hospital equipment screened. Non-albicans Candida accounted for 3 (20%) and 8 (36.36%) among the isolates from the clinical samples and equipment, respectively. Only five of the non-albicans Candida isolates were C. auris. All the isolates produced biofilm, gelatinase, and hemolysin, while none produced germ tubes. Two of the isolates were resistant to all the antifungals tested. Also, all the isolates were resistant to fluconazole and itraconazole. Nystatin appeared to be the most effective among the tested antifungals. The isolation of Candida auris is being reported for the second time in Nigeria, further confirming that the fungus has spread beyond Lagos and Ibadan, where it was first reported. The extent of the spread of the nosocomial fungus needed to be further investigated and curtailed in Nigeria before its outbreak in healthcare facilities.

Keywords: candida auris, virulence factors, antifungals, pathogen, hospital, infection

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Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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Authors: Marriette Sakah, Christoph Kuhn, Samuel Gyamfi

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Global electricity demand of households in 2005 is estimated to double by 2025 and nearly double again in 2030. The residential sector promises considerable demand growth through infrastructural and equipment investments, the majority of which is projected to occur in developing countries. This lays bare the urgency for enhanced efficiency in all energy systems combined with exploitation of local potential for renewable energy systems. This study explores options for reducing energy consumption, particularly in residential buildings and providing robust, decentralized and renewable energy supply for African cities. The potential of energy efficiency measures and the potential of harnessing local resources for renewable energy supply are quantitatively assessed. The scale of research specifically addresses the city level, which is regulated by local authorities. Local authorities can actively promote the transition to a renewable-based energy supply system by promoting energy efficiency and the use of alternative renewable fuels in existing buildings, and particularly in planning and development of new settlement areas through the use of incentives, regulations, and demonstration projects. They can also support a more sustainable development by shaping local land use and development patterns in such ways that reduce per capita energy consumption and are benign to the environment. The subject of the current case study, Tema, is Ghana´s main industrial hub, a port city and home to 77,000 families. Residential buildings in Tema consumed 112 GWh of electricity in 2013 or 1.45 MWh per household. If average household electricity demand were to decline at an annual rate of just 2 %, by 2035 Tema would consume only 134 GWh of electricity despite an expected increase in the number of households by 84 %. The work is based on a ground survey of the city’s residential sector. The results show that efficient technologies and decentralized renewable energy systems have great potential for meeting the rapidly growing energy demand of cities in developing countries.

Keywords: energy efficiency, energy saving potential, renewable energy integration, residential buildings, urban Africa

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Authors: Rita Ghosh, Joykrishna Dey

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PEG-based amphiphiles are of tremendous importance for its widespread applications in pharmaceutics, household purposes, and drug delivery. Previously, a number of single PEG-tailed amphiphiles having significant applications have been reported from our group. Therefore, it was of immense interest to explore the properties and application potential of PEG-based double tailed amphiphiles. Herein, for the first time, two novel double PEG-tailed amphiphiles having different PEG chain lengths have been developed. The self-assembly behavior of the newly developed amphiphiles in aqueous buffer (pH 7.0) was thoroughly investigated at 25 oC by a number of techniques including, 1H-NMR, and steady-state and time-dependent fluorescence spectroscopy, dynamic light scattering, transmission electron microscopy, atomic force microscopy, and isothermal titration calorimetry. Despite having two polar PEG chains both molecules were found to have strong tendency to self-assemble in aqueous buffered solution above a very low concentration. Surprisingly, the amphiphiles were shown to form stable vesicles spontaneously at room temperature without any external stimuli. The results of calorimetric measurements showed that the vesicle formation is driven by the hydrophobic effect (positive entropy change) of the system, which is associated with the helix-to-random coil transition of the PEG chain. The spectroscopic data confirmed that the bilayer membrane of the vesicles is constituted by the PEG chains of the amphiphilic molecule. Interestingly, the vesicles were also found to exhibit structural transitions upon addition of salts in solution. These properties of the vesicles enable them as potential candidate for drug delivery.

Keywords: double-tailed amphiphiles, fluorescence, microscopy, PEG, vesicles

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Authors: Tej Varma Y, Debi D. Pant

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Photophysics and rotational dynamics of the fluorescent probe, 6-methoxyquinoline (6MQ) with cationic surfactant, alkyltrimethylammonium bromide (nTAB) micelle solutions have been investigated (n = 12, 14 and 16). Absorption and emission peaks of the dye have been observed to shift at concentrations around critical micellar concentration (cmc) of nTAB compared to that of bulk solutions suggesting probe is in a lower polar environment. The probe senses changes in polarity (ET (30)) brought about by variation of surfactant chain length concentration and is invariably solubilized in the aqueous interface or palisade layer. The order of change in polarity observed was DTAB > CTAB > TTAB. The binding constant study shows that the probe binds strongest with TTAB (is of the order TTAB > CTAB > DTAB) due to deeper penetration into the micelle. The anisotropy decay for the probe in all the nTAB micelles studied have been rationalized based on a two-step model consisting of fast-restricted rotation of the probe and slow lateral diffusion of the probe in the micelle that is coupled to the overall rotation of the micelle. Fluorescence lifetime measurements of probe in the cationic micelles demonstrate the close proximity of the 6MQ to the Br - counterions. The fluorescence lifetimes of TTAB and DTAB are much shorter than in CTAB. These results indicate that 6MQ resides to a substantial degree in the head group region of the micelles. All the changes observed in the steady state fluorescence, microenvironment, fluorescence lifetimes, fluorescence anisotropy, and other calculations are in agreement with each other suggesting binding of the cationic surfactant with the neutral dye molecule.

Keywords: photophysics, chain length, ntaB, micelles

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Authors: Jason M. Hegenauer, Nicholas Fucci

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In the late 1990s, a major deinstitutionalization movement of elderly patients took place, since which, the design of long-term care facilities has not been adequately analyzed in the United States. Over the course of the last 25 years, major innovations in construction methods, technology, and medicine have been developed, drastically changing the landscape of healthcare architecture. In light of recent events, and the expected increase in elderly populations with the aging of the baby-boomer generation, it is evident that reconsideration of these facilities is essential for the proper care of aging populations. The global response has been effective in stifling this pandemic; however, widespread disease still poses an imminent threat to the human race. Having witnessed the devastation Covid-19 has reaped throughout nursing homes and long-term care facilities, it is evident that the current strategies for protecting our most vulnerable populations are not enough. Light renovation of existing facilities and previously overlooked considerations for new construction projects can drastically lower the risk at nursing homes and long-term care facilities. A reconfigured entry sequence supplements several of the features which have been long-standing essentials of the design of these facilities. This research focuses on several aspects identified as needing improvement, including indoor environment quality, security measures incorporated into healthcare architecture and design, and architectural mitigation strategies for sick building syndrome. The results of this study have been compiled as 'best practices' for the design of future healthcare construction projects focused on the health, safety, and quality of life of the residents of these facilities. These design strategies, which can easily be implemented through renovation of existing facilities and new construction projects, minimize risk of infection and spread of disease while allowing routine functions to continue with minimal impact, should the need for future lockdowns arise. Through the current lockdown procedures, which were implemented during the Covid-19 pandemic, isolation of residents has caused great unrest and worry for family members and friends as they are cut off from their loved ones. At this time, data is still being reported, leaving infection and death rates inconclusive; however, recent projections in some states list long-term care facility deaths as high as 60% of all deaths in the state. The population of these facilities consists of residents who are elderly, immunocompromised, and have underlying chronic medical conditions. According to the Centers for Disease Control, these populations are particularly susceptible to infection and serious illness. The obligation to protect our most vulnerable population cannot be overlooked, and the harsh measures recently taken as a response to the Covid-19 pandemic prove that the design strategies currently utilized for doing so are inadequate.

Keywords: building security, healthcare architecture and design, indoor environment quality, new construction, sick building syndrome, renovation

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Authors: Wan You Ning

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Addressing the rising prevalence of mental health issues among youths, the Multi-dimensional Approach to Resilience and Support in Advanced School-based Mental Health Service Delivery (MARS-ASMHSD) framework proposes the implementation of advanced mental health services in low-resource areas to further instil mental health resilience among students in a school-based setting. Recognizing the unsustainability of direct service delivery due to rapidly growing demands and costs, the MARS-ASMHSD framework endorses the deinstitutionalization of mental healthcare and explores a tiered, multi-dimensional approach in mental healthcare provision, establishing advanced school-based mental health service delivery. The framework is developed based on sustainable and credible evidence-based practices and modifications of existing mental health service deliveries in Asia, including Singapore, Thailand, Malaysia, Japan, and Taiwan. Dissemination of the framework model for implementation will enable a more progressive and advanced school-based mental health service delivery in low-resource areas. Through the evaluation of the mental health landscape and the role of stakeholders in the respective countries, the paper concludes with a multi-dimensional framework model for implementation in low-resource areas. A mixed-method independent research study is conducted to facilitate the framework's development.

Keywords: mental health, youths, school-based services, framework development

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Authors: Merav Ben Natan, Heba Igbarin, Arwa Watted

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Introduction: The rising prevalence of autism spectrum disorders (ASD) has heightened the need to understand the challenges faced by children with ASD and their families in emergency departments (EDs). Children with ASD often experience additional health issues and heightened anxiety in the chaotic ED environment, which can impact their care and parental satisfaction. Purpose: This study aimed to examine factors identified by mothers as affecting their satisfaction with the care provided to their children in the ED, among mothers of children with ASD in comparison to mothers of children without ASD. Design and methods: In this correlational quantitative study, 128 Israeli mothers – 59 (46%) mothers of children with ASD and 69 (54%) of children without ASD - completed an online survey based on a Ministry of Health national survey of patient experience. Results: Mothers of children with ASD expressed lower satisfaction with the care provided. The difference was particularly evident concerning waiting times for examination of the child by nurses and physicians in the ED, whether the nurses were attentive and responsive to the mother's questions and concerns, whether the ED staff demonstrated coordination and cooperation with regard to medical care of the child, and whether work in the ED was conducted in an orderly and organized manner. The presence of communication difficulties in children predicted mothers' satisfaction with care. Conclusions: These findings suggest that certain needs of mothers and/or their children with ASD do not receive an appropriate response in the ED. Practice implications: It is important to raise the awareness of healthcare providers in EDs regarding the needs of children with ASD and their parents, especially children with communication difficulties. Strategies should be implemented to improve the experience of children with ASD and their parents in the ED.

Keywords: autism spectrum disorder, emergency department, parental satisfaction, healthcare challenges

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Authors: Abhimanyu Behera

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Over the past few years, energy security and sustainable development have moved rapidly into the global agenda. There are two main reasons: first, the impact of high and often volatile energy prices; second, concerns over environmental sustainability particularly about the global climate. Both issues are critically important in which impressive economic growth has boosted the demand for energy and put corresponding strains on the environment. Energy security is a broad concept that focuses on energy availability and pricing. Specifically, it refers to the ability of the energy supply system i.e. suppliers, transporters, distributors and regulatory, financial and R&D institutions to deliver the amount of competitively priced energy that customers demand, within accepted standards of reliability, timeliness, quality, safety. Traditionally, energy security has been defined in the context of the geopolitical risks to external oil supplies but today it is encompassing all energy forms, all the external and internal links bringing the energy to the final consumer, and all the many ways energy supplies can be disrupted including equipment malfunctions, system design flaws, operator errors, malicious computer activities, deficient market and regulatory frameworks, corporate financial problems, labour actions, severe weather and natural events, aggressive acts (e.g. war, terrorism and sabotage), and geopolitical disruptions. In practice, the most challenging disruptions are those linked to: 1) extreme weather events; 2) mismatched electricity supply and demand; 3) regulatory failures; and 4) concentration of oil and gas resources in certain regions of the world. However, insecure energy supplies inhibit development by raising energy costs and imposing expensive cuts in services when disruptions actually occur. The energy supply sector can best advance sustainable development by producing and delivering secure and environmentally-friendly sources of energy and by increasing the efficiency of energy use. With this objective, this paper seeks to highlight the significance of energy security and sustainable development in today’s world. Moreover, it critically overhauls the major challenges towards sustainability of energy security and what are the major policies are taken to overcome these challenges by Government is lucidly explicated in this paper.

Keywords: energy, policies, security, sustainability

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Authors: Vandana Maurya

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Positive psychological capital is the key contributor to the competitive advantage of the organizations. Moreover, work engagement and sense of humor are also positive notions and are able to facilitate positive workplace behaviour but the mechanism behind these relationships are not well understood. The purpose of this study was to examine the relationships among work engagement, sense of humor and outcome variables (organizational citizenship behaviour and ethical performance) as well as investigating how psychological capital (PsyCap) mediates the relationships between work engagement, sense of humor and the outcome variables among healthcare professionals. A cross-sectional survey was conducted on healthcare professionals (n= 240). Data were collected using questionnaires which includes Utrecht Work Engagement Scale (UWES), Multi-dimensional Sense of Humor Scale (MSHS), Psychological Capital Questionnaire (PCQ), Organizational Citizenship Behavior Questionnaire, and Ethical Performance Scale (EPS). The results of the regression analyses showed that work engagement and sense of humor both positively predicted the outcome variables. Mediation analysis reveals that psychological capital mediates the relationship between predictor and outcome variables. The study recommends that the framework presented in this study can be an important tool for managers to enhance their employees’ psychological capital by increasing their levels of work engagement and sense of humor. In turn, psychological capital could be a positive resource for employees to dealing more ethically and enhancing more positive workplace behaviour.

Keywords: ethical performance, humor, organizational citizenship behavior, PsyCap, work engagement

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Authors: Arūnas Gudinavičius, Andrius Šuminas

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The analysis of scholarly journals formats is fragmented and needs to be studied from a point of view of scientific communication. While PDF is to the author’s best knowledge probably the most popular digital format of XXI century, but there are more formats available: HTML, EPUB, etc. Our aim is to analyze how these formats important to the readers and what is their contribution to scientific communication. We want to investigate how printed journals are still popular between scholars and does different formats are preferred between fields of science . In most cases, publishing of scientific journals are examined from a narrow perspective of a particular university science affair administrators or research funding institution. We believe that more data o n formats used in scholarly periodicals currently published in Lithuania as well as in Eastern Europe are needed. Science communication is often analyzed as a directed chain of information in the author-publisher-reader cycle. The paper is focusing on the publishing part of this chain. A distinction is made between formal and informal forms of scientific communication, which is relevant in today's context, when both forms of communication intertwine and complement each other. In our research, we will analyze formal documentary (formats of publication of scientific articles) communication - scientific information recorded in a certain medium and formatted in certain format (printed, PDF, HTML, EPUB, etc.). In our research, we will analyze the stage of publication of research results in scientific journals and their dissemination through specific publication formats. The paper is to systematize and analyze the various types of formats of scientific journal published in XXI century in Lithuania (small publishing market). The research analyses the case of small European country and presents publishing formats characteristics of the publication of scientific periodicals.

Keywords: scientific communication, scientific journals, publishing formats, reading

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Authors: Szu-Hua Wang, Yi-Wen Chen

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Urban ecosystems are complex coupled human-environment systems. They contain abundant natural resources for producing natural assets and attract urban assets to consume natural resources for urban development. Urban ecosystems provide several ecosystem services, including provisioning services, regulating services, cultural services, and supporting services. Rapid global climate change makes urban ecosystems and their ecosystem services encountering various natural disasters. Lots of natural disasters have occurred around the world under the constant changes in the frequency and intensity of extreme weather events in the past two decades. In Taiwan, hydrological disasters have been paid more attention due to the potential high sensitivity of Taiwan’s cities to climate change, and it impacts. However, climate change not only causes extreme weather events directly but also affects the interactions among human, ecosystem services and their dynamic feedback processes indirectly. Therefore, this study adopts a systematic method, solar energy synthesis, based on the concept of the eco-energy analysis. The Taipei area, the most densely populated area in Taiwan, is selected as the study area. The changes of ecosystem services between 2015 and Typhoon Soudelor have been compared in order to investigate the impacts of extreme precipitation events on ecosystem services. The results show that the forest areas are the largest contributions of energy to ecosystem services in the Taipei area generally. Different soil textures of different subsystem have various upper limits of water contents or substances. The major contribution of ecosystem services of the study area is natural hazard regulation provided by the surface water resources areas. During the period of Typhoon Soudelor, the freshwater supply in the forest areas had become the main contribution. Erosion control services were the main ecosystem service affected by Typhoon Soudelor. The second and third main ecosystem services were hydrologic regulation and food supply. Due to the interactions among ecosystem services, fresh water supply, water purification, and waste treatment had been affected severely.

Keywords: ecosystem, extreme precipitation events, ecosystem services, solar energy synthesis

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Authors: Abdelkader T. Ahmed

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Greywater is any wastewater draining from a household including kitchen sinks and bathroom tubs, except toilet wastes. Although this used water may contain grease, food particles, hair, and any number of other impurities, it may still be suitable for reuse after treatment. Greywater reusing serves two purposes including reduction the amount of freshwater needed to supply a household, and reduction the amount of wastewater entering sewer systems. This study aims to investigate and design a simple and cheap unit to treat the greywater in household via using ceramic membranes and reuse it in supplying water for toilet flushing. The study include an experimental program for manufacturing several tablet ceramic membranes from clay and sawdust with three different mixtures. The productivity and efficiency of these ceramic membranes were investigated by chemical and physical tests for greywater before and after filtration through these membranes. Then a treatment unit from this ceramic membrane was designed based on the experimental results of lab tests. Results showed that increase sawdust percent with the mixture increase the flow rate and productivity of treated water but decrease in the same time the water quality. The efficiency of the new ceramic membrane reached 95%. The treatment unit save 0.3 m3/day water for toilet flushing without need to consume them from the fresh water supply network.

Keywords: ceramic membranes, filtration, greywater, wastewater treatment

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